PMHNP certification Exam Questions and Answers 2024 Actual test verified by Expert Top Ran, Exams of Nursing

Download PMHNP certification Exam Questions and Answers 2024 Actual test verified by Expert Top Ran and more Exams Nursing in PDF only on Docsity! PMHNP certification Exam Questions and Answers 2024 Actual test verified by Expert Top Ranked Qs & Ans. Guaranteed Success 1. Which patient is at highest risk for SI? A. 30y/o married AA female with previous SI attempt *1 risk factor B. 35 y/o single Asian male with previous SI attempt *3 risk factors C. 38 y/o single AA male who is a manager of a bank *2 risk factors D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression): D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression) Count the risk factors 2. When interview teenagers (16 y/o) that arrive with their parents what should you do? interview them separately from parents. -This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be upset but remember you are advocating for the child. 3. Which Ethnic group has the highest rate of suicide?: Native Americans 4. Example A patient is being treated for schizophrenia with olanzapine. Which of the following is the most common side effect of olanzapine? A. Increased waist circumference B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor an-paganism C. Increased Lipids D. Metabolic Syndrome: D. Metabolic Syndrome (UMBRELLA ANSWER) 5. Which antipsychotics have the least weight gain? Latoya, Ability, (also least sedating), Geodon-if patient has metabolic syndrome consider switching to one of the medications above. Or if the patient is overly sedated try switching to ABILIFY 6. Which mood stabilizer have the least weight gain?: Laical -But remember all mood stabilizers cause some weight gain 7. When presented with a question about typical vs. atypical antipsychotic the answer is usually to start of a: atypical 1 . 8. A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the brain that is responsible for the normal regulation of these functions? A. Thalamus B. Hypothalamus C. Limbic System D. Hippocampus: Hypothalamus A, B, & D are all part of the limbic system so you can rule that out 9. When a patient is hesitant to participate in treatment you should encourage?: Bring a support person like a husband 10. Thyroid-Stimulating hormone normal level: 0.5-5.0 Mu/L 11. When T4 and T3 are high and TSH is low what is the diagnosis: HY- PERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE 12. Key symptoms of Heat Intolerance: Hyperthyroidism 13. When T4 and T3 are Low and TSH is high what is the diagnosis: (HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE 14. Key symptoms of Cold Intolerance: Hypothyroidism 15. Hyperthyroid can mimic: Mania 16. Hypothyroid can mimic: Depression 17. A patient on Depakote complains of RUQ pain and has reddish/brown urine: Hepatoxicity -Check LFTs 18. Signs of Depakote toxicity: Disorientation, confusion, lethargy 19. You suspect Depakote toxicity what do you do?: Check -LFT -Ammonia -Depakote Level 20. What herbal supplement can cause hepatoxicity?: Kava 21. When taking Kava in combinations with other medications you should caution about: Risk of Hepatoxicity and Sedation 22. TCAs carry a risk of: Hepatotoxicity 23. Signs of Stevens-Johnson Syndrome: -fever, mouth pain, swelling, burning eyes, blisters, skin pain 24. two psychotropic known to cause Steven Johnson syndrome: laical and tegretol 2 / 38 . 45 Serotonin Syndrome: With any drug that increases 5-HT (e.g., MAO inhibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus, cardiovascular instability, flushing, diarrhea, seizures. -Treatment: cyproheptadine (5-HT2 receptor antagonist). 46. Treatment for NMS: Stop Offending Medication -Dantrolene (muscle relaxer) -Bromocriptine (Dopamine D2 agonist). *In question focus on what they are asking for....dopamine agonist vs. muscle relaxer 47. Treatment for Serotonin Syndrome: Stop Med (1 or more SSRI, SSNRI, TCA, MOAI) -Cyproheptadine 48. Trip tans: Used for MIGRAINES -These meds increase serotonin example SUMATRIPTAN 49. patient taking Prozac and started on sumatriptan: -call PCP to ask them to switch the migraine med if patient already on SUMATRIPTAN do not start antidepressant without talking to PCP 50. How long do you wait when switching between an SSRI to an MAOI?: 2 weeks 51. How long do you wait when switching between Prozac and MAOI?: 5-6 weeks wash out period 52. What is the first line treatment for depression and why?: SSRI-First line treatment for depression due to less risk of injury from OVERDOSE 53. If a cancer patient has depression what should you consider?: Treating with a medication with minimal drug/drug side effects like Lexapro 54. Patient with depression worries about sexual dysfunction what would be the medication of choice?: Wilburton 55. Primary symptoms of depression include fatigue and low energy what med would you chose?: Wilburton 56. Wilburton is contraindicated in patients with: Seizures and anorexia 57. Which medications are best for neuropathic pain?: SNRI Gabapentin TCA 58 Secondary to the black box warning providers caring for patients on antidepressants should assess for? Sociality, frequency, and severity at EVERY appointment 59. Which meds have the worse serotonin discontinuation syndrome: Those With short half-lives such as Zoloft 60. Symptoms of serotonin withdrawal syndrome: Fever, achiness, soreness, lethargy, fatigue, impaired memory, decreased concentration, GI UPSET 5 / 38 . Shits and Shivers 61. Ages of onset for schizophrenia in males vs. females: -MALES 18-25 years -FEMALE 25-35 years 62. Schizophrenia increases the risk for: SUICIDE *HIGH RISK OF SI in SCHIZOPHRENIA* Just having schizophrenia increases your risk of suicide. MUST ASK ABOUT SI, EVERYTIME (frequency, severity of thoughts) 63. What increases the causes or increases the risk or schizophrenia: excessive pruning of synapses - inadequate synapse formation, -Intrauterine insults such as maternal exposure to toxins, viral agents, maternal substance use, maternal illness, maternal malnutrition, fetal oxygen deprivation, -first order relative (mom/dad) 64. MRI or PET scan what is seen in schizophrenia: EVERYTHING DECREASES EXCEPT VENTRICLES -You will see VENTRICULAR ENLARGEMENT 65. Stimulants can potentiate the release of what neurotransmitter?: Dopamine which can worsen symptoms of schizophrenia 66. Assertive Community Treatment (ACT): a form of rehabilitation post hospitalization, in home treatment 67. What level of prevention is ACT?: Tertiary 68. What adjunctive treatment is important in schizophrenia: -social skills training -Exercise 69 Exercise for mental health patients can promote: Cognition Quality of Life Long-term health 70. ACT is ideal for patients with a history of: Treatment non-compliance -Think about making the treatment convenient for them-->bringing it to their home 71. What diagnosis has the highest risk of Homicidally: Antisocial 72. In the MMSE how do you test for abstraction?: proverb interpretation (everyone that lives in glass houses shouldn't throw stones) Are they able to think abstractly 73. Thought Process-Tangential: means that their response has nothing to do with the question 74. Circumstantial: means that their response goes in circles instead of getting to the point of the question 75. Mental Status-Thought Content includes: SI/HI/AH/VH 76. Another name for MMSE: Holstein Scale 6 / 38 . 77. How to assess concentration on MMSE: Serial 7s or perform an activity backwards i.e. list the days of the week backwards 78. Assess ability to learn new material: repeat 3 words after me 79. Assess ability to recall: repeat 3 words after 5 minutes 80. Assess fund of knowledge: Who is the president 81. What is a quick and easy way to assess for neurological issues: Clock drawing test 82. If patient is unable to draw a clock this indicates: Problem with the right hemisphere, cerebrum, or parietal lobe 83. mesolimbic pathway: Hyperactivity of dopamine in the this pathway mediates positive psychotic symptoms -Antagonism of D2 receptors in this pathway treats positive psychotic symptoms 84. neocortical pathway: -Decreased dopamine in the this projection to the dorsolateral prefrontal cortex is postulated to be responsible for negative and depressive symptoms of schizophrenia 85. Nigrostriatal Pathway: -This pathway mediates motor movements -Dopamine blockade in this pathway can lead to increase acetylcholine levels 7 / 38 106. Patient has been a chronic smoker and has been stable on Zyrexa but tells you that he recently quit smoking cold turkey: as a provider you know that you must now decrease the dose of the antipyshcotic 107. Medications that cause mania: Steroids, Disulfiram (Antabuse), Isoniazid (INH), Antidepressants in persons with bipolar -If a patient must take steroids, the provider should increase the mood stabilizer 108. Medications that cause depression: steroids, beta blockers, interferon, Accutane (isotrentinoin), some retroviral drugs, antineoplastic drugs, benzodiazepines, progesterone -may need to increase antidepressant 109. Accutane (isotretinoin): Can cause depression and birth defects 110. Flonase: As a provider you know that flonase is a STEROID so it may exacerbate mood symptoms Increase mood stabilizer to maintain stability, steroids can also trigger depression 111. Flonase can trigger mood instability but it can also cause an increase in: Psychosis patient is taking flonase while on antipsychotic but you find that the antipsychotic is ineffective it is likely because the flonase is exacerbating psychosis -increase the dose of antipsychotic 112. Neurotransmitters involved in Addiction: Dopamine and GABA 113. Symptoms of Stimulant Abuse: 1. agitation/aggression 2. impaired judgment 3. euphoria 4. elevated BP 5. tachycardia 6. dilated pupils 7. hallucinations 8. TREMORS 9. IMSOMNIA 114. If an anorexic patient complains of pain or bloating after eating this may indicate: delayed gastric emptying 115. Medications that delay gastric emptying: Omeprazole, ranitidine, famotidine 116. Proton Pump Inhibitors (omeprazole & Protonix): Decrease absorption of antipsychotics & SSRI -MUST WAIT TWO HOURS BEFORE TAKING ANTIPSYCHOTIC OR SSRI 10 / 38 117. When initiating an SSRI on an elderly patient you should advise about: increased anxiety 118. Paradoxical effect: when meds cause the opposite effect than expected 119. Apoptosis: programmed cell death/neuronal loss 120. At age 45 and above the patient displays mania for first time what should be ruled out: MEDICAL CONDITION 121. Patient with bipolar disorder presents with depressed mood & emotional lability: Give Depakote 122. Hallmark sx of Borderline Personality: Recurrent self harm 123. Treatment for Borderline Personality: DBT 124. Creator of DBT: Marsha Linehan 125. What activity is helpful in making a diagnosis of borderline personality: Journaling or diary keeping 126. Conversion Disorder: STRESS leads to neurological symptoms such as seizures, paresthesia, blindness, mutism 127. Adjustment Disorder: adjusting to a situation resulting in depression or anxiety or both or mixed disturbance of emotions and conduct (this type is more common in children: insomnia, peer conflict, verbal altercations, truancy, crying) -Symptoms occur within 3 months of the stressor If question states recently moved, recent death....THINK ADJUSTMENT 128. factitious disorder: when patients introduce foreign substances into their body or contaminate their food -Faking illness but NO MOTIVE BEHIND IT 129. Malingering: Faking illness for financial gain 130. Reactive Attachment: common in children in foster care, abuse from parents -Withdrawn and shows no emotion towards caregiver 131. ODD: They deliberately annoy others, no aggression, defiance of authority -Family Therapy is mainstay -Child management /Parent management skills is the focus in therapy -Positive reinforcement -Boundary Setting 132. Conduct Disorder: violence, criminal, fire setting, killing animals, gang activity, +AGGRESSION, NO REMORSE -May need meds and therapy -Goal of therapy is to target MOOD & AGGRESSSION (mood stabilizers, antipsychotics, alpha agonists/alpha 2 adrenergic receptor blockers such as guanfacine and clonidine) -Monitor BP with guanfacine and clonidine 11 / 38 133. Acute Stress Disorder: similar to PTSD but the timeline differs -heightened arousal, nightmares, flashbacks -LESS THAN ONE MONTH 134. PTSD: -OVER ONE MONTH -3 HALLMARK SXS: intrusive re-experiencing of trauma, increased arousal, avoidance -May also have NIGHTMARESà GIVE PRAZOSIN -Non-pharm tx of PTSD- EMDR, CBT 135. Panic attack vs Panic disorder (treatment): Panic attack = BZ Panic disorder = SSRI Panic Attack is ACUTE Panic Disorder is CHRONIC Feels like impending doom 12 / 38 166. Instruments to use to differentiate between dementia and pseudo dementia: -Use instrument to further screen out cognitive issues such as SLUMS, MOCHA, MMSE 167. -Older individuals with depression may present with irritability and agitation If question is asking you to differentiate between depression and dementia look at the amount of time that the symptoms have been present: 168. hallmark of levy body dementia: visual hallucinations 169. Front temporal lobe Dementia: PICKs Disease -Hallmark is personality changes, language difficulties, poor impulse control, and behavioral changes -May see slurred speech or difficulty getting words out 170. What lobe is associated with ability to understand what others are saying (comprehending speech): Temporal Lobe 171. Neurotransmitters involved in Autism: GABA, Glutamate, Serotonin 172. Autism: a disorder that appears in childhood and is marked by deficient communication, social interaction, Poor eye contact, May not respond when you call their name, Stereotypical movement When play they often like to line up their toys, stack them in tidy rows 15 / 38 PMHNP certification Exam KM Study online at https://quizlet.com/_a5334y . 173 Broken Mirror Theory of Autism: Explains that the child's presentation is caused by the mirror neuron i.e. dysfunction in the mirror neuron 174. Risk Factors for Autism: Male gender, genetic loading, intellectual disability, parents ages, preterm 175. Screening tools for Autism: ADOS-G (autism diagnostic observation schedule-genetic) ASQ (ages and stages questionnaire) M-CHAT (modified-checklist for autism-toddler) 176. Where is Norepinephrine produced?: locus cerulean and medullary reticular formation 177. Where is serotonin produced?: raphe nuclei 178. Where is dopamine produced?: substantial Ingra, ventral tegmental area, nucleus acumens 179. Where is acetylcholine synthesized?: Basal nucleus of Meyer 180. Hippocampus: a neural center located in the limbic system; helps process memory and manage stress 181. Limbic System: The limbic system is the part of the brain involved in our behavioral and emotional responses, especially when it comes to behaviors we need for survival: feeding, reproduction and caring for our young, and fight or flight responses. -Hippocampus -Amygdala -Hypothalamus -Thalamus 182. Amygdala function: Responsible for the response and memory of emotions, especially fear 183. Thalamus function: relay station for sensory impulses, pain 184. hypothalamus function: homeostasis, temperature, thirst, appetite, sex drive, sleep cycle, emotions * believed to serve a regulatory role in aggression 185. anterior cingulate cortex: brain region that regulates cognitive function, decision making, empathy, impulse control, and emotions 186. Cerebellum: Balance and coordination 187 signs of lead toxicity: developmental delay, learning diff., irritability, loss of appetite, weight loss, sluggishness, fatigue, abdominal pain, vomiting, constipate- ton, hearing loss, seizures, eating non-food items PICA Hint home built before 1970's TEST FOR LEAD 188. When caring for an infant that is about to die?: GIVE THE BABY TO THE PARENTS and allow them to grieve 189. Risk factors for osteoporosis: Age smoking caffeine lack of exercise diet lacking calcium and vet D 16 / 38 PMHNP certification Exam KM Study online at https://quizlet.com/_a5334y . *Provide Education* 190. If discharging a patient that is not following up with outpatient care, organize ways to help the patient get to the appointment REMEMBER STAY INVOLVED IN THE CARE: 191. Assume you are doing group therapy and there is a patient that is not comfortable sharing but you are trying to promote interpersonal learning. What should you do?: Provide adjunctive individual session that will help facilitate group participation 192. Cognitive Therapy: -Aaron Beck Replacing irrational or distortive thoughts with positive thoughts 193. Behavioral Therapy: -Arnold Lazarus focuses on changing behavior by identifying problem behaviors, replacing them with appropriate behaviors -Exposure -Relaxation -Skills training -Role Playing 194. Humanistic Therapy: -Carl Rogers person-centered therapy -Self-actualization -Self-Directive Growth -Everyone has the potential to actualize and find meaning in life 195 Existential Therapy: Victor Frankly -an insight therapy that focuses on the elemental problems of existence, such as death, meaning, choice, and responsibility, emphasized making courageous life choices. -Emphasizes accepting freedom and making responsible choices -Focus on the present Why am I here, What is my purpose 196. Interpersonal Therapy: Gerald Kieran & Myrna Weismann --Used for people who have trouble interacting with others, relationship distress -Marital Conflict? -12-16 weeks (3-4 months) 197. EMDR Phases: Desensitization Phase: visualize the trauma, verbalize negative thoughts but remain attentive to physical sensations Installation Phase: Installs and increases strength of the positive thoughts that the patient has declared as a replacement Body Scan: Visualize the trauma along with the positive thought and then scan one’s body mentally to identify any tension within 198. Group therapy: Installation of hope: participants develop hope for creating a different life; they gain hope from others 199. Group therapy: Universality: people have similar problems, thoughts, and feelings and they are NOT ALONE 17 / 38 PMHNP certification Exam KM Study online at https://quizlet.com/_a5334y . 227. When OB wants to hire psych providers: they want to increase mental health access to those that need it the most 228 Normalizing grief and loss in children: Don't tell them what to do because grief responses vary -i.e. Don't tell them to stop working that is prescriptive advice -With children the most important thing is to reinforce FAMILY support an supportive therapy such as group therapy so they can learn from other children who have experienced similar events 229. palmar grasp reflex: normal up to 5-6 months If older baby still has this reflex->refer to specialist 230. Moro (startle) reflex: Normal till 5-6 months If present past normal range->refer to specialist If not present within the normal age->X-ray may be a sign of a broken bone, nerve injury, or spinal injury 231. Babinski reflex: Normal up to 2 years If present past normal range->refer to specialist 232. PDE-5 inhibitors: Sildenafil (Viagra) Vardenafil (Levitra) Tadalafil (Cialis) RAPIDLY ABSORBED Used for erectile disfunction 233. Difference between BMI in anorexia vs Bulimia: Anorexia-Low BMI Bulimia-Normal BMI 234. Parent brings in 16-year-old with BMI 12, Pulse LOW, BP LOW and you determine the patient needs to be sent for medical evaluation but the parents refuse: Contact CPS 235. You read an article that says that most children with ADHD abuse substances... -To translate this information into practice what should you do? -Screen ALL children for ADHD for SUBSTANCE USE -OR Screen ALL children with SUBSTANCE USE for ADHD 236. acupuncture: used for pain and depression 237. Habeas Corpus: legal concept that protects patients from unlawful hospitalization -May be a reason to leave AMA 238 Disseminated Encephalomyelitis: inflammation of nervous system -MUST DO NEURO EXAM -EXAM: May present with ASSYMETRICAL BODY MOVEMENTS 239. Assume you are interviewing a patient and you want them to provide information in a specific timeline, but they are unable: TO help ask them specific questions which helps to ANCHOR their memory 240. Before you administer a medication, you must educate them about the medication but first you should assess: BUT FIRST ASSESS WHAT THEY KNOW ALREADY or WHAT THERE BELIEVES ARE ABOUT THE MEDICATION 20 / 38 PMHNP certification Exam KM Study online at https://quizlet.com/_a5334y . 241. Patient presents with iatrogenic effect: assess ALL the medications that the patient is taking -Don't assume that it is from the medication you prescribed 242. When trying to pass a policy and your co-workers are against it what should you do: educate them on how the policy will benefit patient care 243. To promote a policy how do you get the word out there: Think most FEASIBLE option with WIDE net or audience 244. Working in outpatient setting and you want to ensure continuous improvement in quality of care.: -Create an instrument to monitor clinical outcomes (this helps to identify what you are doing right or wrong) 245. Autoimmune disease can lead to increased: Cytokine level 246. If a child is urinating the bed: -Teach parents to use alarm clock to wake up to urinate (NON PHARM FIRST) -If that doesn't work try DESMOSPRESSIN (decreased enuresis) 247. Are you allowed to look up a patient on social media?: No it violates their trust 248. Assume you started a patient on a medication and they go home and find out that there is a black box warning on the medication that you were unaware of. They call with concerns...: - First, go online and do your own research -Research the RISK vs BENEFIT before you tell the patient to stop the medication 249. Risk factors for sleep apnea: excessive weight, obesity, diabetes, smoking 250. Tolerance: you need higher doses of the medication in order for the medication to be effective 251. PHQ-9: > 5 mild depression > 10 moderate > 15 moderately severe 21 / 38 > 20 severe Max score 27 252. HAM-D: >10 Mild >14 Moderate >17 Severe 253. HAM-A: >8 Mild >15 Moderate >24 Severe 254. Beck Depression Inventory (BDI): 0-13 Subclinical >14 Mild >20 Moderate >29 Severe >40 EXTREME Max score 63 255. GAD-7 Scoring: 0-4: Minimal Anxiety >5 Mild Anxiety >10 Moderate Anxiety >15 Severe Anxiety Max score 21 256. COWS: Medicate with PRNS at score of 7 or above Consider Subtext or Suboxone at 13 or above Remember Methadone is the LEAST safe option due to cardiac issues 257. CIWA: Begin PRN medication at 8 or above Scores of 15 or above consider scheduled medications 258. Patient in alcohol withdrawal and you are choosing medication for CIWA, check what?: LFT if liver disease use ATIVAN because of short half-life over VALIUM 259. *REMEMBER DETOX SHOULD NOT OCCUR OUTPATIENT-->residential or inpatient is needed* especially if pregnant. REMEMBER SAFETY FIRST: 260. Idealization: Seeing someone else as perfect, ideal, or more worthy than everyone else This is often seen in grieving before acceptance of the loss 22 / 38 D. Utilize a survey to assess the educational needs of the staff: D. Utilize a survey to assess the educational needs of the staff *3 Interventions vs 1 Assessment* FIRST YOU NEED TO ASSESS FIRST 285. What is the best way to reduce stigma: THROUGH EDUCATION *THINK WIDEST AUDIENCE 286. Just Culture: individuals are continually learning, designing safety systems, and managing behavioral choices 287. The PMHNP is concerned about access-to-care issues in the local community and wants to help develop health care policy to help patients access care more effectively. A. Asking the clinical manager to explore options for access B. Organizing a political protest C. Working with the local chapter of the nurse’s professional association. Writing letters to the editor of the local newspaper: C. Working with the local chapter of the nurses professional association *Remember strength in numbers but STAY INVOLVED i.e. asking the manager just passes off* 288. If a patient from a specific culture is refusing to accept any diagnosis of mental health disorders because of shame what could be done to address this barrier? A. Educate the family B. Political advocacy C. Public Health Concern D. Community education programs: D. Community education programs *Narrow down to education A/D...then think WIDE NET =Community EDUCATION 289. A client with Bipolar I disorder presents to your PMHNP office for a follow-up visit. During the visit the client informs you he no longer wants to be treated with medication. , and he does not have bipolar disorder, that was a misdiagnosis, He further informs you he stopped all his medications 2 months ago and is here to thank you for your care and tell you he no longer needs appointments. Understanding ethical conflict, you use which of the following ethical principles? A. Autonomy B. No maleficence C. Justice D. Beneficence: A. Autonomy *Patients have the right to self-determination* 25 / 38 290. Recovery Model * RELAPSE IS A LEARNING OPPORTUNITY: -Treatment approach that does not focus on full symptom resolution but emphasizes on resilience and control over problems in life -Self-Direction (do not tell them what to do) -Individualized and Person-Centered -Non-Linear, Recovery is not a step-by-step process, but one based on continual growth, occasional setbacks, and learning from experience 291. In counseling a 23 y/o married Hispanic mother who brought her 4 year old son to the clinic for "mal de mojo" with symptoms of fitful sleep, diarrhea, vomiting, and fever the PMHNO; A. Identifies what steps the mother has already tried in caring for the child B. Explain that the symptoms are viral infection C. Educates about importance of fluid electrolyte imbalance D. Respects the mother's understanding of the child's illness: A. Respects the mother's understanding of the child's illness *In cultural questions remember RESPECT FIRST! Even before assessment 292. Quality Improvement: Projects designed to improve systems, decrease cost, and improve productivity 293. What is an example of a quality improvement process?: Plan, Do, Study, Act 294. Retrospective Chart Review is an example of a Quality Improvement Process If they ask HOW the NP would do a quality Improvement Process the answer may be Plan, Do, Study, Act: 295. The NP is responsible for initiating quality improvement at a community clinic. The effective strategy for evaluating the client’s services is to A. Chart review analysis B. A root cause analysis C. Plan DO Study Act D. Failure effect mode analysis: C. Plan Do Study Act 296. SBIRT: Screening, Brief Intervention, and Referral to Treatment * Use to screen substance use disorders 297. Erikson's stages of psychosocial development: 1. trust vs. mistrust 2. autonomy vs. shame and doubt 3. initiative vs. guilt 4. industry vs. inferiority 5. identity vs. role confusion 26 / 38 6. intimacy vs. isolation 7. generativist vs. stagnation 8. integrity vs. despair 298. Piaget's stages of cognitive development: 1. sensorimotor 2. preoperational 3. concrete operational 4. formal operational 299. Preoperational Stage includes: 2-7 you- MAGICAL THINKING IS NORMAL, if they believe that monsters can fly this is NORMAL Egocentric Understand language 300. formal operational stage: 12+ y/o during which people begin to think logically about abstract concepts KEY WORD is LOGIC think like a scientist or do a science project you must be able to use logic ABSTRACT THINKING such as doing algebra 301. sensorimotor stage: in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities Object permanence 302. concrete operational stage: in Piaget's theory, the stage of cognitive development (from about 6 or 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events i.e. finding similarities in objects, grouping things 303. Risk factors for suicide: Sex (Male), Age (Teenager or Elderly), Depression, Previous Attempt, Ethanol or Drug Use, Loss of rational thinking, Sickness (medical illness), 3 or more prescription medications, Organized plan, No spouse (divorced, widowed, or single especially if childless). Social support lacking. WHITE Women try more often. Men succeed more often. 304. A 72 year old female brought in by her husband with increasing forgetfulness, decreased activity, and decreased appetite for 2 months. She has a history of HTN and is being treated with Lisinopril. The exam is normal and the MMSE provides a score of 24 but she declines to answer some questions and needs to be urged to participate in the assessment. What is the likely diagnosis? A. Alzheimer B. Vascular Dementia C. Depression 27 / 38 . -Screening -Prompt and effective treatment Example: Crisis hotline, disaster response 313. Tertiary Prevention: -aims to prevent the long-term consequences of a chronic illness or disability and to support optimal functioning -Rehab Services -Day treatment -Case management -Social Skills training 314. Pharmacokinetics: what the body does to the drug 315. Pharmacodynamics: what the drug does to the body 316. messenger RNA codes for: amino acids 317. Poor relationships, lack of future hope, suspicious of others indicates developmental failure of what stage: infancy, trust vs mistrust 318. Poor self-esteem, low self-control, self-doubt, lack of independence indicates failure of what stage: early childhood 1-3, autonomy vs shame and doubt 319. Lack of self-initiative, lack of goal orientation indicates failure of what stage: Late childhood 3-6 y/o initiative vs guilt 320. sense of inferiority, difficulty with working/learning indicates a failure of what stage: school age 6-12 y/o industry vs inferiority 321. identity confusion, poor self-identification in groups indicates failure of what stage: adolescence 12-20 y/o identity vs inferiority 322. emotional isolation, egocentrism indicates a failure of what stage: early adulthood 20-35 y/o intimacy vs isolation 323. self-absorption, inability to grow and change as a person, inability to care for others indicates a failure at what stage: middle adulthood 35-65 y/o generativist vs stagnation 324. bitterness, sense of dissatisfaction with life, despair over impending death indicates failure of what stage: >65 y/o integrity vs despair 325. agonist effect: Drug binds to receptors and activates a biological response 326. Inverse agonist effect: Drug causes the opposite effect of agonist 327. partial agonist effect: Drug does not fully activate the receptors 328 Antagonist effect: Drug binds to the receptor but does not activate a biological response 329. Herbals that interact with warfarin: Vitamin E Omega-3 30 / 38 . 330. Black Cohosh: herbal used for menopause 331. Belladonna: herbal used for anxiety 332. chamomile: herbal used for sedation and anxiety 333. Gingko: Herbal used to treat memory, dementia, & sexual dysfunction from SSRIs 334. Ginseng: Herbal product used for stress reduction, fatigue, and depression 335. Valerian: herbal used for sedation 336. Hypertensive crisis can occur when MAOI are taken with: Meperidine Decongestants TCAs Atypical Antipsychotics St. Johns wart L-Tryptophan Stimulants Asthma meds 337. Microcytic anemia: iron deficiency 338. macrocytic anemia: due to foliate or vitamin B12 deficiency Labs: Folic Acid, B12, ESR/CRP, HGB, MCV 339. 14 y/o with no axillary hair and no period: Normal tanner stage, start by 16 340. Two classes of cardiac meds that should not be used together: ACES and ARBS (angiotensin receptor blocker) Together can cause renal dysfunction 341. Abnormal Trendelenburg Test: Hip disease, refer child out, assessed during head to toe 342. too little acetylcholine too much acetylcholine: Alzheimer's Parkinson's and EPS 343. 4 D's Discover, Dream, Design, Destiny: Appreciative Inquiry 31 / 38 344 Cranial Nerve V: Trigeminal Clenched Teeth 345. WBC 1500-2000: Biweekly labs Less than 1000 Stop 346. How can you assess cranial nerve XII?: Ask patient to stick out their tongue 347. First sign of metabolic syndrome: large waist circumference 348. Grade 2/5 hoarse systolic heart murmur: aortic stenosis 349. Ibuprofen + lithium: increases the serum level of lithium up to double 350. Kleinfelter's Syndrome: male with more than one X chromosome (XXY) -Decreased sperm, fertility issues 351. Mental Health Parity Act: forbids health plans from placing lifetime or annual limits on mental health coverage that are less generous than those placed on medical or surgical benefits 352. what does nuchal rigidity indicate?: meningitis 353. Patient is on interferon and Lexapro, as a provider you understand that: interferon can increase depression therefore you may have to increase the Lexapro 354. Patient complains of neuropathic pain and Neurontin is not working: Try Lyrical (pregabalin) its absorbed quickly and the maximum rate of absorption is 3x of Neurontin 355. Patient is in hospital with no family and is failing cognitive test what should you do?: MRI Tux Screen 356. Phases of policy making: formulation, implementation, evaluation 357. Rhett Syndrome: a rare disorder found virtually exclusively in girls, is a neurodevelopmental disorder in which the child usually develops normally until about 6 to 18 months of age at which characteristics of the syndrome emerge; characteristics include: hypotonic (loss of muscle tone), reduced eye contact, decelerated head growth, and disinterest in play activities 358. Signs of fetal alcohol syndrome: small head, smooth palpebral fissure, inner epicanthi folds, thin upper lip 359. Tegretol side effects: Aplastic anemia, agranulocytosis, Steven Johnson’s, hypernatremia. Watch with cipro and erytheo 360 Telemedicine legal question? Licensing Jurisdiction for the NP must be considered 361. A person is seen wandering the streets for 2 days: Delirium 362. Medication used for serotonin syndrome: Cyproheptadine 32 / 38 397. Patient taking breathing treatment Albuterol/Proventil: Do not take MAOI or TCA 398. p-value: The probability of results of the experiment being attributed to chance. 399. Reliability: consistency of measurement 400. Stereo genesis: identify an object without sight i.e. dice in hand 401. Tagamet (cimetidine): H2 receptor antagonist (antacid) Increases benzoin Increases Coumadin 402. Trazodone concerns: EKG-QT prolongation Priapism Glaucoma 403. Turner Syndrome: A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted. -Delayed puberty -Amenorrhea 35 / 38 -Web neck, osteoporosis, and lymphedema -poor social skills 404. To start your own firm as an NP and need to examine economic viability: Show Revenue and expenses 405. 3 CK muscle enzyme tests?: CKMM, CKBB, CKMB (normal 0.3 mg/L) 406. What are the legal ramifications of treating someone without informed consent?: The same as they are with informed consent -Respect -Beneficence -Justice 407. Two important things to measure when prescribing Zyprexa: Waist circumference Lipids 408. What schedule of controlled substances are NPs allowed to prescribe?- : II-V 409. What crania nerve is affected when you ask the patient to shrug their shoulders?: XI (11) Spinal Accessory 410. These medications are really metabolized: Gabapentin Cameral Lithium 411. grapefruit juice: inhibitor that can reduce the absorption of the drug by 47% therefore the drug blood levels will be increased -Decrease dose of drug 412. How do Asians see HC providers? As in a position of authority. Expect to give instructions and help make decisions 413. How do you protect from the evil eye?: Red ribbon on an infant Amulet for adults 414. T-test: assesses whether the means of two groups are statistically different from each other 415. Treatment for children with panic disorder: clonidine guanfacine 416. What do BCP's due to Laical?: Inducer - will lower dose of Laical 417 What does an increased relic count indicate: Bone marrow disorder or Vitamin Deficiency? Normal Range 0.5-1.5 418. What do you see in Labs with HIV dementia: CD4 <200 Viral Load is high <20% get it with antiretroviral treatment 419. What is occuring in the adolescent brain?: Dendritic pruning 36 / 38 Emotions are controlled by amygdala Prefrontal Cortex is still not fully developed (may be why young boys are risk takers) 420. Indomethacin is a: NSAID- WATCH WITH LITHIUM 421. Tramadol: Highly serotonergic 422. Dissemination: the act of spreading widely -publication-highest level -Presenting at national conference -Journal club 423. Sensitivity vs. Specificity: sensitivity - how well a test identifies truly ill people (True positive) specificity - how well a test identifies truly well people (True negative) *In medical diagnosis, testing sensitivity is the ability of a test to correctly identify those with the disease (true positive) whereas test specificity is the ability of the test to correctly identify those without the disease (true negative) 424. What is the purpose of HIPAA?: National standards for electronic HC transactions -National ID for providers, health plans and employers. -Not SIMPLY Confidentiality. 425. DETROL interactions: Topamax KCL Zone ran 426. Yale-Brown Obsessive Compulsive Scale (Y-BOCS): OCD 0-7 subclinical 8-15 Mild 16-23 Moderate 24-31 Severe 32-40 Extreme 427. If you want to decrease the use of seclusion who would be considered the primary change agent: Unit staff 428. Ronnie vs Klein: • right to refuse any treatment Until court orders it "due process" 429. Roger vs. Oaken: determined that patients have an absolute right to refuse treatment, but a guardian may authorize their treatment. ROGERS GUARDIAN 430. Donaldson vs O'Connor: Confinement -It is unconstitutional to commit a person involuntarily who is not imminently dangerous to self or others 37 / 38