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PMHNP Exam Reported Questions images Test Questions
And Answers A+ Rated
DBT (dialectical behavior therapy) Correct ans - relaxation muscle prior to DBT Greatest patient at risk for Violence Correct ans - Substance abuse EMDR (eye movement desensitization and reprocessing) Correct ans - eye movement desensitization and reprocessing What is dissemination? Correct ans - 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 ans - Moderate cognitive impairment What is Tegretol in the CYP450 system? Correct ans - Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? Correct ans - Inducer - will lower dose of Lamictal What is a Type I research error? Correct ans - There IS a difference but you say there isn't a difference. What is a Type II research error? Correct ans - There is NO difference but you say there is a difference. What is pseudo-dementia? Correct ans - 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 ans - Yes. What is a drug 1/2 life? Correct ans - The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? Correct ans - Zyprexa, Abilify, Seroquel - low doses
What is a risk of using Tramadol? Correct ans - Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? Correct ans - HLAB- When might you see toxic epidermal necrolysis? Correct ans - With worsening of SJS How many generations do you include for a genogram? Correct ans - 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? Correct ans - Amino Acids What is epigenetics? Correct ans - Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? Correct ans - Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? Correct ans - Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? Correct ans - 10- 25 yo When do females typically present with schizophrenia? Correct ans - 25-35 yo What does Erythromycin to trileptal? Correct ans - 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 ans - Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct ans - Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor
0-29 females What is a retic count? Correct ans - 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 ans - Anemia - acute or chronic bleeding What does an increased retic count indicate? Correct ans - Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? Correct ans - Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? Correct ans - Increase tegretol levels. What happens if a pregnant women takes Accutane? Correct ans - Birth defects. What labs do you get with RA? Correct ans - 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 ans - ANA When do you assume informed consent? Correct ans - Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? Correct ans - Same as with informed consent Who can declare a patient incompetent and appoint a guardian? Correct ans - Only a court Does impaired judgment mean one is incompetent? Correct ans - No. Can an advanced directive ever be revoked? Correct ans - Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? Correct ans - Nothing. They are all the same.
Does the de facto rule of proxy apply in same sex marriages? Correct ans - No. How do Asians see HC providers? Correct ans - As in a position of authority. Expect to give instructions and help make decisions What does it mean when an Asian patient does not make eye contact with the NP? Correct ans - SIgn of respect What is the evil eye? Correct ans - When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness. How do you protect from the evil eye? Correct ans - Red ribbon on an infant Amulet for adults How do you treat for evil eye? Correct ans - Access traditional healer
- traditional care. For there to be a duty to a patient, what must exist? Correct ans - Relationship What is a proximate cause? Correct ans - Connection between A + B. For there to be damages, what must exist first? Correct ans - Negligence What is an occurrence basis liability insurance? Correct ans - "occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? Correct ans - 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 ans - Board of Nursing State What are the various controlled substance classes? Correct ans - Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes.
What happens if a patient refuses to sign an ROI? Correct ans - Can decline to treat Health plan may condition enrollment on provision of consent When is HIPAA not required? Correct ans - 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 ans - Yes, no other way to give care. Is it ok to leave a message on a patient's vm? Correct ans - Yes, but should be limited. What is the impact of steroid inhalers on children? Correct ans - Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? Correct ans - Cataracts, glaucoma, thinning of bones and skin What is included in the treatment of fibromyalgia? Correct ans - Sleeping meds Antidepressants Pain meds What psychoactives are first line treatment for fibro? Correct ans - Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's What is the purpose of telepsychiatry? Correct ans - Increase the ability to reach rural and underserved areas. What is the purpose of Motivational Interviewing? Correct ans - Explore ambiguity Maintain passive position What is required for Medicare submission? Correct ans - ICD 10 and narrative or CPT What is the neurotransmitter problem in Schizophrenia? Correct ans - Excess dopamine in mesolimbic pathway. What is the neurotransmitter problem in ADHD? Correct ans - Dopamine, norepinephrine and serotonergic dysfunction
What is the benefit of play therapy? Correct ans - Don't have to confront emotions head on. What neurotransmitters are involved in the bioamine hypothesis of depression? Correct ans - Noradrenaline Serotonin Dopamine MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse. How do you test CN XII? Correct ans - Stick out your tongue. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? Correct ans - CN V - Trigeminal What are two important things to measure when using Zyprexa? Correct ans - Lipid level and abdominal circumference What is included in the mini-cognitive exam? Correct ans - Clock, memory questions from MSE. What is HIV related dementia often mistaken for, especially at the beginning? Correct ans - Depression What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000? Correct ans - Stop and repeat lab. Normal is 1500-8000 mm Can you take Buspar during pregnancy? Correct ans - Category B - ok if really needed. Can you take Klonopin during pregnancy? Correct ans - 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 ans - Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? Correct ans - Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? Correct ans - Microalbumin?
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 ans - 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 ans - 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 ans - Provide brief supportive therapy Latida and Geodon Correct ans - Take with food Moro reflex absent Correct ans - Do xray Health Care Policy Model Correct ans - Access, Cost, Quality Pt wants to stop medications Correct ans - explore reason for stopping Its their right 16 year old falls with the wrong crowd Correct ans - Conduct disorder change agent Correct ans - the person formally in charge of guiding a change effort Administrator 14 year old girl clenching her teeth Correct ans - Cranial Nerve V- Trigeminal nerve Infant dying Correct ans - Give child to parents and comfort parents borderline personality disorder Treatment Correct ans - dialectical behavior therapy Aggressive patient give Correct ans - IM geodon SIGECAPS of Depression Correct ans - Sleep Interest Guilt
Energy Concentration Appetite psychomotor retardation Suicide DIGFAST for mania Correct ans - Distractibility Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talking increase 5 year old tells u his brother sodomized him Correct ans - Tell mom don't leave him alone with patient and call CPS implement crisis Just culture Correct ans - "Just culture" model: proposed to reconcile the twin needs for no-blame and appropriate accountability The focus is on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors while maintaining individual accountability by establishing zero tolerance for reckless behavior. Distinguishes between Human error (e.g. slips), At-risk behavior (e.g. taking shortcuts), Reckless behavior (e.g. ignoring required safety steps). In a just culture, the response to an error or near-miss is predicated on the type of behavior associated with the error, not the severity of the event. Child reports Sexual Abuse Correct ans - Interview the young child and infants child with parent First sign of temprofrontal Dementia Correct ans - Behavior and personalty changes Tow amines related to depression Correct ans - Serotonin and norepinephrine Want to start an consulting firm what tool would be needed to show economic viability Correct ans - Revenue and expenses Patient stopped smoking (Cessation) Correct ans - Decreased Zyprexia Promote resilience in schizophrenia for a patient that lives alone and doing well Correct ans - Refer to peer support
Native American wants his healer present Correct ans - Involve mother of the patient and healer, mom was cleared for you to involve her 16 year old shows up with mother for first therapy is Correct ans - confidential mom sits in lobby Patient acts out due to missing session what do you do Correct ans - You relate to childhood abandonment and talk about it with the patient How do you assess the competency of a medical procedure Correct ans
- Identify a pen and recall 3 words Patient thinks someone has infiltrated the church because he watched it on TV 2 years ago, what diagnosis Correct ans - Delusional disorder Increase ICP (signs and symptoms) Correct ans - Baby Neuro cry Menopausal woman Correct ans - Hormone therapy and replacement Patient on antidepressants for 3 weeks and attempted Suicide Correct ans - Stop medication immediately You want to decrease seclusion on your unit who considered the primary change agent Correct ans - Unit staff You are a lead NP over other NPs in a rural setting how would you go about the change Correct ans - Make online form and have them vote on it 16 year old refuse treatment Correct ans - Send to psych specialist for acting out kids Positive Trendelenburg Sign Correct ans - Refer to Ortho/specialist Pelvis drops to when patient raises one foot off the floor. Drug affects Flonase Correct ans - Zantac (Histamine 2 Blocker) Antagonist Little boy wet his sheets, What kind of therapy would you suggest Correct ans - Behavior therapy DDVAP acts in much the same manner as antidiuretic hormone. Correct ans - Makes less urine Lithium level 1.2u what are you concerned with Correct ans - 4+ Ketones
What does depakote do to Lamictal Correct ans - Increase laminate 200% Inducers of Cytochrome P450 (CYP450) Correct ans - Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort A substance that speeds up a chemical reaction Inhibitor Correct ans - A substance that slows down or stops a chemical reaction cytochrome p450 inhibitors Correct ans - CRACK AMIGOS Cimetidine Ritonavir Acute Alcohol Ciprofloxacin Ketoconazole Amiodarone Macrolides Isoniazid Grapefruit juice Omeprazol Sulfonamides Carb and Barb Correct ans - decrease INR Deapkote and Disulfruram Correct ans - Increase INR GAL-Renall metabolized Correct ans - Gabapentin Acamprostate Lithium Grapefruit juice Correct ans - One glass can reduce absorption by 47% Blood levels will be Increased Trazodone (Desyrel) Correct ans - Get EKG. Trazodone (Desyrel) Correct ans - Get an eye exam can cause Glaucoma Grapefruit juice or grapefruit Correct ans - Increase trazodone PICOT Correct ans - Patient population of interest Intervention of interest Comparison of interest Outcome Time
negative symptoms of schizophrenia Correct ans - the absence of appropriate behaviors (expressionless faces, rigid bodies) negative symptoms of schizophrenia Correct ans - Decreased dopamine -mesocorticol pathway mesocortical pathway Correct ans - VTA to prefrontal cortex negative symptoms Nigrostriatal pathway Correct ans - EPS DUE TO LOW DOPAMINE IN THIS AREA Communication from SnPC of the basal ganglia to the striatum (caudate + putamen) of the BG via DA; used to initiate movement PDSA model Correct ans - PLAN- Do-carry out Study -examine results Act-decide what action Tanner's stages Correct ans - Tanner stages Correct ans - MMSE (Mini Mental State Examination)- Correct ans - Stage May be Normal 25- Mild/Early 21- Moderate 10- Severe 0- A pt states that she has been raped. What do you do Correct ans - ensure safety Hamilton D score of 28 Correct ans - Assess for Suicide Hamilton Depression Rating Scale Correct ans - 17-21 questions 0-7 Normal 14-18 Moderate
20 Severe Depression Beck Depression Inventory (BDI) Correct ans - 0-13 Minimal depression 14-19 Mild Depression 20-28 Moderate Depression 29-63 Severe Depression
Patient Health Questionnaire (PHQ-9) Correct ans - 1-4 minimal 5-9 Mild depression 10-14 Moderate Depression 15-19 Moderate Severe Depression 20-27 Severe Depression A brief 9-item self-report questionnaire used as a screening tool to assess severity of depression; widely used by health care providers, in validity is well established, particularly for identifying severe depression. Hamilton Anxiety Rating Scale (HAM-A) Correct ans - 14-17 Mild Anxiety 18-24 Moderate Anxiety 25-30 Severe Anxiety Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Correct ans - OCD 0-7 subclinical 8-15 Mild 16-23 Moderate 24-31 Severe 32-40 Extreme PTSD (Post Traumatic Stress Disorder) Correct ans - EMDR Dilated pupils Correct ans - Stimulant intoxication constricted (pinpoint) pupils Correct ans - Opiods nystagmus Correct ans - Phencyclidine conjuctival injection, muchies (super hungry), psychomotor slowness? Correct ans - Marijuana Marijuana Correct ans - a drug, often smoked, whose effects include euphoria, impairment of judgment and concentration and occasionally hallucinations; rarely reported as addictive Boy states that he wishes to be a girl and tells you not to tell his parent s Correct ans - Don't tell ODD what will you do to prevent it from becoming Conduct disorder Correct ans - Therapy to target mood and aggression Herpes rooster 3 weeks later sleep difficulties and sad mood Correct ans
Latino women wanting prenatal class Correct ans - Consult with cultural group in community Anorexia Correct ans - Set up family therapy quasi-experimental design Correct ans - Research method similar to an experimental design except that it makes use of naturally occurring groups rather than randomly assigning subjects to groups. The ventricle enlargement observed in clients with Correct ans - schizophrenia is most often accompanied by Encopresis Treatment Correct ans - Behavior management: toilet refusal behavior, scheduled toileting time, incentives. Prevention of constipation Counseling Medication that contradicts albuterol Correct ans - Adderall (amphetamine / dextroamphetamine) Advair Diskus (fluticasone / salmeterol) amoxicillin (Amoxil, Trimox, Apo-Amoxi, Moxatag, Amoxicot, DisperMox, Biomox, Moxilin, Wymox) Ativan (lorazepam) Atrovent (ipratropium) azithromycin (Zithromax, Azithromycin Dose Pack, Z-Pak, Zmax) Benadryl (diphenhydramine) caffeine Flonase (fluticasone nasal) ibuprofen ipratropium (Atrovent, Ipratropium Inhalation Solution, Atrovent HFA, Ipratropium Inhalation Aerosol) Lasix (furosemide) metoprolol (Metoprolol Succinate ER, Metoprolol Tartrate, Lopressor, Toprol- XL, Kapspargo Sprinkle) Mucinex (guaifenesin) oxycodone (OxyContin, Roxicodone, Xtampza ER, OxyIR, Oxaydo, Dazidox, Oxyfast, Oxecta, RoxyBond, Oxydose, Percolone, M-Oxy, ETH-Oxydose, Endocodone, Roxicodone Intensol) prednisone (Deltasone, Rayos, Sterapred, Prednicot, Sterapred DS, Liquid Pred, Meticorten, Orasone, Prednicen-M) Singulair (montelukast) Spiriva (tiotropium) Symbicort (budesonide / formoterol) Tylenol (acetaminophen) Vitamin B12 (cyanocobalamin) Vitamin D3 (cholecalciferol)
Zyrtec (cetirizine) t-tests Correct ans - statistical measure: test means of 2 independent samples, significantly different? ANOVA (analysis of variance) Correct ans - 3 OR MORE an inferential statistical test for comparing the means of three or more groups Pearson's r Correct ans - a statistic that measures the direction and strength of the linear relation between two variables that have been measured on an interval or ratio scale p-value Correct ans - The probability of results of the experiment being attributed to chance. LEVEL OF SIGNGNIFICANCE Early onset of HIV dementia Correct ans - Apathy Lack of Interest Abnormal of MRI-SLow But cognitive," functions such as memory, reasoning, judgment, concentration, and problem solving. Other common symptoms are changes in personality and behavior, speech problems, and motor (movement) problems such as clumsiness and poor balance. show brain atrophy (shrinkage) Yalom Correct ans - Universality: Members recognize that other members share similar feelings, thoughts and problems Altruism: Members gain a boost to self concept through extending help to other group members Instillation of hope: Member recognizes that other members' success can be helpful and they develop optimism for their own improvement Imparting information: Education or advice provided by the therapist or group members Corrective:Opportunity to reenact critical family dynamics with group members in a corrective manner Development of socializing techniques: The group provides members with an environment that fosters adaptive and effective communication
