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ANCC PMHNP EXAM-WITH 100%
VERIFIED SOLUTIONS- 202 4/
What is dissemination? Correct Answer: Getting the research information out to those who need to know it! Publication - highest level Presenting at National Conference Presenting at Local Conference Journal Club where one person reviews an article What does a 17 on MMSE mean? Correct Answer: Moderate cognitive impairment What is Tegretol in the CYP450 system? Correct Answer: Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? Correct Answer: Inducer - will lower dose of Lamictal What is a Type I research error? Correct Answer: There IS a difference but you say there isn't a difference. What is a Type II research error? Correct Answer: There is NO difference but you say there is a difference.
What is pseudo-dementia? Correct Answer: Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve. Is it normal for a 1 month old to have a palmar grasp? Correct Answer: Yes. What is a drug 1/2 life? Correct Answer: The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? Correct Answer: Zyprexa, Abilify, Seroquel - low doses
By adulthood, PFC involved as well When do males typically present with schizophrenia? Correct Answer: 10-25 yo When do females typically present with schizophrenia? Correct Answer: 25 - 35 yo What does Erythromycin to trileptal? Correct Answer: You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? Correct Answer: Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct Answer: Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor
What should you watch for with Tegretol? Correct Answer: Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? Correct Answer: CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? Correct Answer: CKMB What is the risk of a seriously elevated CKMB? Correct Answer: Polymyositis Rhabdo What is a normal CKMB? Correct Answer: 0.3 mcg/L What psychoactives does Detrol interact with? Correct Answer: Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? Correct Answer: CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? Correct Answer: CD4 < Viral Load is high <20% get it with antiretroviral treatment
What is a normal sed rate or ESR? Correct Answer: 0 - 22 males 0-29 females What is a retic count? Correct Answer: Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow. What does a decreased retic count indicate? Correct Answer: Anemia - acute or chronic bleeding What does an increased retic count indicate? Correct Answer: Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? Correct Answer: Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? Correct Answer: Increase tegretol levels. What happens if a pregnant women takes Accutane? Correct Answer: Birth defects. What labs do you get with RA? Correct Answer: Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis.
CRP and ESR are both increased in RA but NOT in osteoarthritis. Where does the NP Code of Ethics come from? Correct Answer: ANA When do you assume informed consent? Correct Answer: Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? Correct Answer: Same as with informed consent Who can declare a patient incompetent and appoint a guardian? Correct Answer: Only a court Does impaired judgment mean one is incompetent? Correct Answer: No.
What is an occurrence basis liability insurance? Correct Answer: "occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? Correct Answer: provides coverage for a claim that is brought within the policy period, no matter when the loss occurred. Who sets the minimum requirements for NP's? Correct Answer: Board of Nursing State
What are the various controlled substance classes? Correct Answer: Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes. Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate Schedule III - Moderate Abuse Potential - hydrocodone, codeine Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine Schedule V - Very low abuse potential - anti-tussives, lomotil What classes of CS's is the NP approved to prescribe? Correct Answer: Schedules III-V ONLY. Where does 50% of healthcare funds come from? Correct Answer: The government Who is eligible for Medicare? Correct Answer: >65 or under 65 with diability, ANY age with renal disease. What is incident to billing? Correct Answer: Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD. Allows NP to get reimbursed at 100% rather than 85%. How are Medicaid benefits determined? Correct Answer: State determines qualification - Partnership between State and Fed Govt.
National ID for providers, health plans and employers. Not SIMPLY Confidentiality. What must be signed prior to any healthcare in the state Correct Answer: Notice of Privacy Practices Statement What happens if a patient refuses to sign an ROI? Correct Answer: Can decline to treat Health plan may condition enrollment on provision of consent When is HIPAA not required? Correct Answer: Emergency treatment Substantial communication barriers and consent is inferred Involuntary committment Is it ok to announce a patient's name in a waiting room? Correct Answer: Yes, no other way to give care. Is it ok to leave a message on a patient's vm? Correct Answer: Yes, but should be limited. What is the impact of steroid inhalers on children? Correct Answer: Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? Correct Answer: Cataracts, glaucoma, thinning of bones and skin
What is included in the treatment of fibromyalgia? Correct Answer: Sleeping meds Antidepressants Pain meds What psychoactives are first line treatment for fibro? Correct Answer: Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's What is the purpose of telepsychiatry? Correct Answer: Increase the ability to reach rural and underserved areas.
How do you test CN XII? Correct Answer: Stick out your tongue. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? Correct Answer: CN V - Trigeminal What are two important things to measure when using Zyprexa? Correct Answer: Lipid level and abdominal circumference What is included in the mini-cognitive exam? Correct Answer: Clock, memory questions from MSE. What is HIV related dementia often mistaken for, especially at the beginning? Correct Answer: Depression What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000? Correct Answer: Stop and repeat lab.
Normal is 1500 - 8000 mm Can you take Buspar during pregnancy? Correct Answer: Category B - ok if really needed. Can you take Klonopin during pregnancy? Correct Answer: Category C - avoid if possible; does excrete into breast-milk and infant could get withdrawal symptoms. What is the concern when prescribing Lamictal with Depakote? Correct Answer: Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? Correct Answer: Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? Correct Answer: Microalbumin? What is often common to patients with fibro? Correct Answer: Sexual abuse How is telepsychiatry evaluated? Correct Answer: Outcome based - measure at intervals. What happens with a patient taking Lithium and who gets dehydrated? Correct Answer: Levels increase
Amgdyla Correct Answer: Fear, Anxiety, and Aggression Neurotransmitter for Addiction Correct Answer: Dopamine and GABA Neurotransmitter for Mood Disorder Correct Answer: Serotonin and norepinephrine Which drug affects Carbamazepine/tegretol Correct Answer: Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol Signs and Symptoms of stimulant abuse Correct Answer: insomnia and tremor Depakote check Correct Answer: HCG levels Depakote causes Correct Answer: Spinal bifida Grasp reflex. Correct Answer: an infantile reflex in which an infant closes her hand into a fist when her palm is touched Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age. Moro reflex. Correct Answer: The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms
and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months. pincer grasp Correct Answer: 9 months Uses thumb and index finger (pincer grasp) to pick up small objects like Cheerios. Pt has MI looses his job stable on psych medications Correct Answer: Provide brief supportive therapy Latida and Geodon Correct Answer: Take with food Moro reflex absent Correct Answer: Do xray Health Care Policy Model Correct Answer: Access, Cost, Quality
