Test Content Outline Effective Date: August 6, Psychiatric-Mental Health Nurse Practitioner Board Certification Examination

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1 Test Content Outline

Effective Date: August 6, 2013

Psychiatric-Mental Health Nurse Practitioner

Board Certification Examination

There are 200 questions on this examination. Of these, 175 are scored questions and 25 are pretest questions that are not scored. Pretest questions are used to determine how well these questions will perform before they are used on the scored portion of the examination. The pretest questions cannot be distinguished from those that will be scored, so it is important for a candidate to answer all questions. A candidate's score, however, is based solely on the 175 scored questions. Performance on pretest questions does not affect a candidate's score.

This Test Content Outline identifies the areas that are included on the examination. The percentage and number of questions in each of the major categories of the scored portion of the examination are also shown.

Category Domains of Practice No. of Questions Percent

I Foundations for Advanced Practice Nursing

51 29%

II Professional Role and Policy 46 26%

III Independent Practice Competencies 78 45%

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Test Content Outline American Nurses Credentialing Center Effective Date: August 6, 2013 Psychiatric-Mental Health Nurse Practitioner

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Note: Each item written within the test content outline classifications IA1 – IA10 addresses at least one of the age groups noted below

1. Infant: birth - 1 year (23 months) (L1) 2. Preschool: 2 - 4 years (L2)

3. School Age: 5 - 12 years (L3) 4. Adolescent: 13 - 17 years (L4)

5. Adult: 18 - 64 years (L5) 6. Young-Old: 65 - 74 years (L6) 7. Middle-Old: 75 - 84 years (L7) 8. Oldest-Old: 85 years and Older (L8)

I. Foundations for Advanced Practice Nursing (29%) A. Advanced Pathophysiology, Neurobiology, and Neuroanatomy

Knowledge of:

1. Developmental physiology and normal etiology across the life span

2. Pathogenesis and clinical manifestation of commonly found/seen altered health states 3. Advanced anatomy and physiology of the neurological system

4. Symptoms and related circuitry of normal and abnormal neurobiology Skills in:

5. Analyzing the relationship between normal physiology and pathological phenomena produced by altered states across the life span

6. Analyzing physiologic responses to illness and treatment modalities 7. Assessing normal and abnormal neurological function

8. Assessing brain function based on patient symptoms

9. Interpreting implications of abnormal findings from diagnostic testing 10. Identifying needs of individuals with neural system dysfunction

Note: Each item written within the test content outline classifications IB1 – IB6 addresses at least one of the drug agents noted below

1. Antiinfective (D1) 2. Antineoplastic (D2) 3. Cardiovascular (D3) 4. Endocrine (D4)

5. Eye, ear, and skin (D5) 6. Gastrointestinal (D6) 7. Genitourologic (D7) 8. Immunologic (D8) 9. Musculoskeletal/analgesic (D9) 10. Neurologic (D10) 11. Psychiatric (D11) 12. Respiratory (D12)

B. Advanced Pharmacology and Psychopharmacology Knowledge of:

1. Pharmacotherapeutics of broad categories of medications

2. Pharmacokinetics and pharmacodynamics of broad categories of medications 3. Pharmacokinetics and pharmacodynamics of psychotropic medications Skills in:

4. Analyzing the relationship between pharmacologic agents and physiologic/pathologic responses

5. Selecting general pharmacologic agents for the management of general health problems in patients with psychiatric symptoms

6. Selecting psychopharmacologic agents for the management of symptoms and neural system dysfunction (i.e., categories of drugs relative to specific disorders)

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Note: Each item written within the test content outline classifications IC1 – IC7 addresses at least one of the body systems noted below

1. Head, eyes, ears, nose, and throat (B1) 2. Respiratory (B2)

3. Cardiovascular (B3) 4. Gastrointestinal (B4)

5. Genitourinary/Reproductive (B5) 6. Musculoskeletal (B6)

7. Neurological (including psychiatric) (B7) 8. Endocrine (B8) 9. Hematopoietic (B9) 10. Immune (B10) 11. Integumentary (B11) C. Advanced Health/Physical Assessment

Knowledge of:

1. Mental health disorders due to general medical conditions

2. General physical conditions associated with mental health disorders Skills in:

3. Developing a comprehensive health assessment, including complete developmental/functional assessment, health history, family/genetic history, physical examination, and appropriate diagnostic testing

4. Performing a physical examination

5. Relating assessment findings to underlying pathology, psychopathology, and/or physiologic changes

6. Selecting general laboratory tests

7. Interpreting relevant laboratory and diagnostic data D. Epidemiology

Knowledge of:

1. Broad ecological, global, and social determinants of health Skills in:

2. Synthesizing epidemiological data to design and deliver evidence-based practice E. Patient-Centered Care

Knowledge of:

1. Trauma informed care (i.e., awareness of potential traumatization via interventions) 2. Cultural competencies and spirituality

3. Recovery model of care (e.g., resilience, empowerment, autonomy) Skills in:

4. Establishing and maintaining a therapeutic alliance 5. Assessing health literacy of a patient

6. Incorporating patient preferences, lifestyle, values, goals, rights, and responsibilities into care II. Professional Role and Policy (26%)

A. Leadership Knowledge of:

1. Leadership principles and concepts 2. Political activism

3. Reflective thinking principles, concepts, and practices 4. Conflict resolution, negotiation, mediation, workplace civility

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Skills in:

5. Advocating for the value and role of the nurse practitioner

6. Fostering collaboration with multiple stakeholders to improve health care 7. Building and leading collaborative interprofessional care teams

8. Communicating within or across organizations B. Quality Improvement and Safety

Knowledge of:

1. Quality improvement methods and measures (e.g., trend analysis, data collection, analysis of errors)

2. Anticipatory planning Skills in:

3. Directing quality improvement methods to provide safe, timely, effective, equitable care 4. Conducting peer review to promote a just culture of safety

C. Practice Inquiry Knowledge of:

1. Evidence-based practice (e.g., levels of evidence, appraisal of evidence)

Skills in:

2. Translating research into practice 3. Managing practice change

4. Applying clinical investigative skills to improve health outcomes

5. Disseminating evidence from inquiry to diverse audiences using multiple modalities D. Health Policy and Advocacy

Knowledge of:

1. Interdependence of policy and practice 2. Health policy development

Skills in:

3. Advocating for social justice, improved access, quality, and cost-effective care 4. Analyzing ethical, legal, and social factors influencing policy development

5. Advocating for health policies to ameliorate the impact of stigma on services for prevention and treatment of mental health problems, substance use, and psychiatric disorders E. Technology and Information Literacy

Knowledge of:

1. Ethical and legal issues related to the use of information technology, including copyright, privacy, and confidentiality (e.g., Health Insurance Portability and Protection Act)

2. Electronic health records, including policies related to implementation and use that impact care outcomes

Skills in:

3. Using information and communication technologies, resources, and principles of learning to teach and/or treat

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F. Health Delivery System

Knowledge of:

1. Organizational science (e.g., structure, systems, complexity science)

2. Health care economics (e.g., budgeting, finance, resource stewardship [human, financial, and materials], cost-benefit analysis, marketing)

Skills in:

3. Designing and implementing innovative models of care delivery and coordination

III. Independent Practice Competencies (45%) A. Ethical, Legal, and Scope and Standards

Knowledge of:

1. Scopes and standards of practice

2. Regulations and guidelines related to the psychiatric and mental health nurse practitioner’s practice

Skills in:

3. Integrating ethical principles in decision-making 4. Evaluating the ethical consequences of decisions

5. Applying ethically sound solutions to complex issues related to individuals, populations, and systems of care

6. Providing and obtaining informed consent B. Health Promotion and Disease Prevention

Knowledge of:

1. Growth, development, and life stages across the life span (e.g., theories, concepts, and variances)

2. Neuroprotective strategies (e.g., sources including environmental, psychotherapeutic approaches, and medications)

Skills in:

3. Performing a risk assessment of the patient, including the assessment of lifestyle and other risk factors (suicide, homicide, violence)

4. Assessing for barriers and facilitators to care

5. Selecting appropriate health promotion and disease prevention guidelines based on individual patient variances

6. Implementing primary, secondary, and tertiary prevention activities, including early intervention 7. Designing community-centered and culturally responsive strategies for health promotion and

disease prevention

8. Providing patient-centered anticipatory guidance and counseling across the life span (e.g., prenatal, end-of-life care)

C. Disorder and Symptom Management Knowledge of:

1. Theories of treatment modalities

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Note: Each item written within the test content outline classification IIIC8 addresses at least one of the drug agents noted below

1. Antiinfective (D1) 2. Antineoplastic (D2) 3. Cardiovascular (D3) 4. Endocrine (D4)

5. Eye, ear, and skin (D5) 6. Gastrointestinal (D6) 7. Genitourologic (D7) 8. Immunologic (D8) 9. Musculoskeletal/analgesic (D9) 10. Neurologic (D10) 11. Psychiatric (D11) 12. Respiratory (D12) Skills in:

3. Applying evidence-based therapeutic communication strategies in providing treatment 4. Managing psychiatric emergencies

5. Managing patients in crises

6. Selecting and Implementing evidence-based psychotherapies (including individual, groups, and families)

7. Conducting psychoeducation 8. Managing pharmacotherapeutics

9. Recommending non-pharmacotherapeutics, including complementary and alternative treatments

10. Evaluating patient responses and modifying the treatment plan as necessary D. Advanced Psychiatric and Mental Health Assessment

Knowledge of:

1. Diagnostic criteria (e.g., Diagnostic and Statistical Manual of Mental Disorders, current International Classification of Disease)

2. Psychopathology Skills in:

3. Conducting a clinical interview

4. Performing an initial age and developmentally appropriate comprehensive psychiatric evaluation

5. Performing a problem-focused psychiatric evaluation

6. Analyzing the relationship between normal and specific system alterations associated with mental health problems, psychiatric disorders, and treatment

7. Selecting and interpreting diagnostic and screening tools 8. Developing and prioritizing a differential diagnoses list 9. Formulating multiaxial diagnoses

Last Updated 5/4/2012

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