Download PMHNP Certification Exam Testbank: Key Concepts and Theories - Prof. PURDUL and more Exams Nursing in PDF only on Docsity!
PMHNP CERTIFICATION EXAM TESTBANK
2024/25 UPDATE
Tarasoff Principle - ✔ 1976 - duty to warn victims of potential harm from client Deontological Theory - ✔Ethical theory that states an action is judged as good or bad based on the act itself regardless of the consequences Teleological Theory - ✔Ethical theory that states an action is judged as good or bad based on the consequence or outcome Virtue ethics - ✔ethical theory that states actions are chosen based on the moral virtues (eg. honesty, courage, compassion, wisdom, gratitude, self- respect) or the character of the person making the decision Erikson's developmental stage infancy age range - ✔birth-1 year Erikson's developmental stage infancy developmental tasks - ✔trust vs. mistrust Erikson's developmental stage infancy indications of developmental mastery
- ✔Ability to form meaningful relationships, hope about the future trust in others Erikson's developmental stage infancy indication of developmental failure - ✔poor relationships, lack of future hope, suspicious of others Erikson's developmental stage early childhood age - ✔1-3 yo Erikson's developmental stage early childhood developmental task - ✔autonomy vs. shame and doubt Erikson's developmental stage early childhood indications of developmental mastery - ✔self-control, self-esteem, willpower Erikson's developmental stage early childhood indications of developmental failure - ✔ poor self-control, low self esteem, self-doubt, lack of independence Erikson's developmental stage late childhood age - ✔3-6yo Erikson's developmental stage late childhood developmental task - ✔initiative vs guilt Erikson's developmental stage late childhood indications of developmental mastery - ✔ self-directed behavior, goal formation, sense of purpose
Erikson's developmental stage late childhood indications of developmental failure - ✔ lack of self-initiated behavior, lack of goal orientation Erikson's developmental stage school-age ages - ✔6-12yo
Erikson's developmental stage late adulthood developmental task - ✔integrity vs despair Erikson's developmental stage late adulthood indications of developmental mastery - ✔ fulfilment and comfort with life, willingness to face death, insight and balanced perspective on life's events Erikson's developmental stage late adulthood indications of developmental failure - ✔ bitterness, sense of dissatisfaction with life, despair over impending death Psychodynamic (Psychoanalytic) Theory - ✔-Sigmund Freud -all bx is purposeful and meaningful -principle of psychic determinism -most mental activity is unconscious -conscious behaviors and choices are affected by unconscious mental content -childhood experiences shape adult personality -instincts, urges, or fantasies function as drives that motivate thoughts, feelings, and bx -Id, Ego, Superego -conflict is experienced consciously as anxiety Principle of psychic determinism - ✔Even apparently meaningless, random, or accidental behavior is actually motivated by underlying unconscious mental content Intellectual disability typical age onset - ✔infancy- usually evident at birth ADHD typical age onset - ✔early childhood (per DSM by age 12) Schizophrenia typical age onset - ✔18- for men 25-35 for women Major Depression typical age onset - ✔late adolescence to young adulthood dementia typical age onset - ✔most common after age 85 Freud's Id - ✔-contains primary drives or instincts -drives are largely unconscious -operates on the pleasure principle -"I want" pleasure principle - ✔the id seeks immediate satisfaction freud's ego - ✔-rational mind, logical and abstract thinking -"I think, I evaluate" Freud's superego - ✔-sense of conscience or right vs wrong
-develops around age 6 -"I should or ought" Freud's psychosexual stage of development oral stage age - ✔0-18 months Freud's psychosexual stage of development oral stage primary means of discharging drives and achieving gratification - ✔sucking, chewing, feeding, crying Freud's psychosexual stage of development oral stage psych disorder linked to failure of stage - ✔schizophrenia, substance abuse, paranoia Freud's psychosexual stage of development anal stage age - ✔ 18 months- years Freud's psychosexual stage of development anal stage primary means of discharging drives and achieving gratification - ✔sphincter control, activities of expulsion and retention Freud's psychosexual stage of development anal stage psych disorder linked to failure of stage - ✔depressive disorder Freud's psychosexual stage of development phallic stage age - ✔3-6 years Freud's psychosexual stage of development phallic stage primary means of discharging drives and achieving gratification - ✔exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and female fear of lost maternal love Freud's psychosexual stage of development phallic stage psychiatric disorder linked to failure of stage - ✔sexual identity disorders Freud's psychosexual stage of development latency stage age - ✔6years- puberty Freud's psychosexual stage of development latency stage primary means of discharging drives and achieving gratification - ✔peer relationships, learning, motor- skills development, socialization Freud's psychosexual stage of development latency stage psych disorder linked to failure of stage - ✔inability to form social relationships Freud's psychosexual stage of development genital stage age - ✔puberty forward Freud's psychosexual stage of development genital stage primary means of discharging drives and achieving gratification - ✔integration and synthesis of behaviors from early stages, primary genital-based sexuality
-rationalization -undoing -intellectualization -suppression -sublimation -altruism Hierarchy of needs - ✔-Maslow -survival -safety and security needs -love and belonging -self-esteem -self-actualizaiton Sullivan's stage of interpersonal development infancy age - ✔birth-18 months Sullivan's stage of interpersonal development infancy developmental task - ✔oral gratification, anxiety occurs for the first time Sullivan's stage of interpersonal development childhood age - ✔ 18 months- 6 years Sullivan's stage of interpersonal development childhood developmental task - ✔delayed gratification Sullivan's stage of interpersonal development juvenile age - ✔6-9 years Sullivan's stage of interpersonal development juvenile developmental task - ✔forming peer relationships Sullivan's stage of interpersonal development preadolescence age - ✔9- years Sullivan's stage of interpersonal development preadolescence developmental task - ✔ same-sex relationships Sullivan's stage of interpersonal development early adolescence age - ✔12- years Sullivan's stage of interpersonal development early adolescence developmental task - ✔opposite- sex relationships Sullivan's stage of interpersonal development late adolescence age - ✔14- years Sullivan's stage of interpersonal development late adolescence developmental taks - ✔ self-identity developed Health Belief Model - ✔Marshall Becker
explains that healthy people do not always take advantage of screening or preventative programs because of certain variables: -perception of susceptibility -seriousness of illness -perceived benefits of tx -perceived barriers to change -expectations of efficacy transtheoretical model of change - ✔states that change such as in health bx occurs in 6 predictable stages -precontemplation -contemplation -preparation -action -maintenance motivational interviewing - ✔miller and rollnick -focused, goal-directive therapy -motivation is elicited from the client -nonconfrontational, nonadversarial self-efficacy and social learning theory - ✔-albert bandura -behavior is the result of cognitive and environmental factors theory of cultural care - ✔-madeline Leininger -regardless of the culture, care is the unifying focus and the essence of nursing theory of self-care - ✔Dorothy orem -self care therapeutic nurse-client relationship theory or interpersonal theory - ✔Hildegard Peplau -first significant psych nursing theory -sees nursing as an interpersonal process in which all interventions occur within the context of the nurse-client relationship phases of the nurse-client relationship - ✔-orientation -working phase (identification, exploration) -termination phase (resolution) caring theory - ✔jean Watson caring is an essential component of nursing t test - ✔assesses whether the means of two groups are statistically different from each other
-referred to as the adrenergic system serotonin - ✔-known as an indole -produced in the raphe nuclei of the brainstem -precursor is tryptophan -major neurotransmitter implicated in mood and anxiety disorders -5HT1a, 5HT1d, 5HT2, 5HT2a, 5HT3, 5HT4 receptors amino acids - ✔glutamate, aspartate, gamma-aminobutyric acid (GABA), glycine glutamate - ✔-universal excitatory neurotransmitter -major neurotransmitter involved in process of kindling (implicated in sz dx and bipolar dx) -imbalance implicated in mood dx and schizophrenia -AMPA and MNDA receptors aspartate - ✔another excitatory neurotransmitter -works with glutamate GABA - ✔universal inhibitory neurotransmitter -site of action of benzos, alcohol, barbiturates, and other CNS depressants -GABAa and GABAb receptors glycine - ✔-another inhibitory neurotransmitter -works with GABA cholinergics - ✔acetylcholine acetylcholine - ✔synthesized by the basal nucleus of Meynert -precursors are acetylcoenzyme A and choline -nicotinic and muscarinic receptors neuropeptides - ✔-nonopioid type (substance P, somatostatin) -opioid type (endorphins, enkephalines, dynorphins) -modulate pain -Decreased amount of neuropeptides is thought to cause substance abuse
- opioid type receptors: mu, kappa, epsilon, delta, sigma dopamine general function - ✔thinking decision making reward-seeking behavior fine muscle action integrated cognition
dopamine symptoms of deficit - ✔mild: pour impulse control, poor spatiality, lack of abstractive thought -severe: Parkinson's disease, endocrine alterations, movement disorders -substance abuse, anhedonia Dopamine symptoms of excess - ✔-mild: improved creativity, improved ability for abstract thinking, improved executive functioning, improved spatiality -severe: disorganized thinking, loose association, tics, stereotypic bx -schizophrenia, psychosis norepinephrine general function - ✔alertness focused attention orientation primes fight or flight learning memory norepinephrine symptoms of deficit - ✔-dullness, low energy, depressive affect -depression norepinephrine symptoms of excess - ✔-anxiety, hyper alertness, increase startle, paranoia, decreased appetite -anxiety serotonin general function - ✔regulation of sleep pain perception mood states temperature regulation of aggression libido precursor for melatonin serotonin symptoms of deficit - ✔irritability, hostility, depression, sleep dysregulation, loss of appetite, loss of libido OCD, anxiety disorders, schizophrenia serotonin symptoms of excess - ✔sedation, increased aggression, hallucinations (rare) acetylcholine general function - ✔attention, memory, thirst, mood regulation, REM sleep, sexual behavior, muscle tone acetylcholine symptoms of deficit - ✔lack of inhibition, decreased memory, euphoria, antisocial action, speech decrease, dry mouth, blurred vision, constipation alzheimers dx
-advantage: widely available, relatively inexpensive
-disadvantage: lack of sensitivity, cannot differentiate white matter from gray mater; cannot view structures close to the bone tissue; underestimation of brain atrophy, inability to image sagittal and coronal views magnetic resonance imaging (MRI) - ✔provides a series of 2D images that represent the brain -advantages: can view brain structures close to the skull and can separate white matter from gray matter; readily available; resolution of brain tissue superior to CT scanning -disadvantages: expensive, many contras to use, claustrophobia Functional imaging - ✔measures function of areas of the brain and bases the resulting assessment on blood flow -may use radioactive pharmaceuticals to cross blood-brain barrier -mainly used for research -EEG and evoked potentials testing -magnetoencephalography MEG -single photon emission computed tomography SPECT -positron emission tomography PET EEG and evoked potentials testing - ✔least expensive test convey info on electrical functioning of CNS Magnetoencephalography MEG - ✔similar to EEG detects different electrical activities used in complementary fashion with EEG testing single photon emission computed tomography (SPECT) - ✔information of cerebral blood flow limited available expensive positron emission tomography PET - ✔images of brain when positron- emitting radionuclei interact with an electron expensive combined structural and functional testing - ✔examine structure in conjunction with function mainly for research functional MRI fMRI 3D, event realted functional MRI 3fEMRI Fluorine magnetic spectroscopy Dopamine D2 receptor binding genetic testing FDA required in people of Asian descent - ✔presence of HLA- B*1502 allel
interfering factors of ALT levels - ✔values can be increased with Tylenol, allopurinol, aspirin, ampicillin, carbamazepine, cephalosporins, codeine, digitalis, indomethacin, heparin, isoniazid, methotrexate, methyldopa, oral contraceptives, phenothiazines, propranolol, tetracycline, and verapamil GGT is used to evaluate and monitor clients with what - ✔known or suspected alcohol abuse levels rise even after ingestion of small amounts of alcohol primary preventions - ✔aimed at decreasing the incidence (number of new cases) of mental disorders helping people avoid stressors or cope with them more adaptively secondary prevention - ✔aimed at decreasing the prevalence (number of existing cases) of mental disorders early case finding screening prompt and effective tx tertiary prevention - ✔aimed at decreasing the disability and severity of mental disorder rehabilitative services avoidance or postponement of complications drug steady state - ✔drugs usually are administered once every half-life to achieve this it takes approx. 5 half lives to achieve a steady state and 5 half lives to completely eliminate a drug enzyme inducers can - ✔decrease the serum level of other drugs that are substrates of that enzyme possibly causing subtherapeutic drug levels CP450 inhibitors - ✔bupropion clomipramine cimetidine clarithromycin fluoroquinolon es grapefruit ketoconazole nefazodone SSRIs CP450 inducers - ✔carbamazepine hypericum/ st johns wort phenytoin
phenobarbital tobacco enzyme inhibitors can - ✔increase the serum level of other drugs that are substrates of that enzyme possibly causing toxic levels agonist effect - ✔Drug binds to receptors and activates a biological response inverse agonist effect - ✔Drug causes the opposite effect of agonist; binds to same receptor partial agonist effect - ✔drug does not fully activate the receptors antagonist effect - ✔Drug binds to the receptor but does not activate a biological response schedule 1 drugs - ✔nonmedicinal substances high abuse potential used for research only not available by prescription heroin and marijuana typical antipsychotics - ✔haloperidol (Haldol), haloperidol deconate (Haldol deconate) loxapine (loxitane) thioridazine (mallaril) thiothixene (navane) fluphenazine (prolixin), fluphenazine deconate (prolixin doconate) mesoridazine (serentil) trifluoperazine (stelazine) chlorpromazine (thorazine) perphenazine (trilafon) second generation antipsychotics - ✔clozapine (Clozaril) ziprasidone (Geodon) risperidone (Risperdal) quetiapine (Seroquel) olanzapine (Zyprexa) aripiprazole (abilify) paliperidone (Invega) iloperidone (fanapt) asenapine (saphris) lurasidone (luatuda)
divalproex sodium (Depakote) lithium carbonate (eskalith, lithobid, lithonate, lithotabs) lamotrigine (lamictal) carbamazepine (tegretol) carbamazepine ER (equetro) oxcarbazepine (Trileptal; off label) Tricyclics - ✔clomipramine (anafranil) amoxapine (asendin) amitriptyline (Elavil) desipramine (norpramin) nortripyline (pamelor) doxepin (sinequan) trimipramine (surmontil) imipramine e(tofranil) protriptyline (vivactil) Serotonin selective reuptake inhibitors SSRIs - ✔citalopram (celexa) fluvoxamine (Luvox) paroxetine (paxil) paroxetine mesylate (pexeva) fluoxetine Prozac) sertraline (Zoloft) escitalopram (Lexapro) Monoamine oxidase inhibitors MAOIs - ✔phenelzine (nardil) tranylcyprmie sulfate (parnate) selegiline transdermal (EMSAM) SNRIs and other agents - ✔trazodone (Desyrel) venlafaxine (Effexor) desvenlafaxine (Pristiq) mirtazapine (Remeron) nefazodone (serzone) bupropion (Wellbutrin, Forfivo, Aplenzin) duloxetine (Cymbalta) vilazodone (viibryd) vortioxetine (brintellix) levomilnacipran (Fetzima) Benzodiazepines BNZs - ✔lorazepam (Ativan) clonazepam (klonopin)
chlordiazepoxide (Librium) oxazepam (serax) clorazepate (tranxene) alprazolam (xanex)
