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ANCC PMHNP Cert Exam Review Questions And
Answers A+ Verified
1. How do you assess cranial nerve V trigeminal?
ANS Tell patient to close eyes, take piece of cotton or other soft item and lightly touch either one of both sides of each of the three divisions of the trigeminal.
2. How do you assess for cranial nerve VII facial?
ANS Observe the patient for nystag- mus or twitching of the eye. This nerve controls facial movements and expression, check for symmetry. Have the patient wrinkle forehead, close eyes, smile, pucker lips, show teeth, and puff out cheeks.
3. primitive reflexes
ANS reflexes, controlled by "primitive" parts of the brain, that disappear during the first year of life
4. Mororeflex
ANS Extending of limbs when they hear a loud noise (defend themselves)
5. rooting reflex
2 / ANS a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple
6. palmer grasp
ANS grasping with the whole hand
7. scope of practice
ANS The range of clinical procedures and activities that are allowed by law for a profession
8. Quality Improvement (QI)
ANS an approach to the continuous study and improve- ment of the processes of providing health care services to meet the needs of patients and others and inform health care policy
9. PDSA model
ANS Plan-Do-Study-Act Model from the Institute for Healthcare Im- provement (IHI)
10. Trendelenburg sign
ANS Occurs with severe subluxation of one hip When the child stands on the good leg, the pelvis looks level. When the child stands on the affected leg the pelvis drops toward the good side
11. CYP450 inhibitors
ANS Fluvoxamine Fluoxetine Paroxetine Duloxetine
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14. What would you do for a patient on Depakote with +4 protein in the
urine? ANS Rule out UTI, no adjustment for medication is needed
15. What happens when you take carbamazepine (tegertal) and erythromycin
together? ANS It will decrease the effect of the antibiotic by inhibition
16. What happens when you take zyprexa and smoke?
ANS nicotine will increase the excretion of the drug thereby inhibiting it's effect
17. ICP in Infants S/S
ANS Bulging fontanels, high-pitch cry, irritability, restlessness
18. ICP
CHILDREN signs and symptoms ANS • Headache
- Vomiting (usually projectile)
- Seizures
- Diplopia (Dbl vision), blurred vision
19. Neuro cry
ANS high-pitched and very grating on the ears due to their neurological sxs being overwhelmed
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20. Neuroleptic Malignant Syndrome
ANS Adverse reaction to antipsychotics with severe "lead pipe" rigidty, FEVER, and mental status changes. FEVER ANS Fever Encephalopathy Vitals unstable Elevated enzymes Rigidity of muscles
21. NMS treatment
ANS Dantrolene D2 agonists (e.g., bromocriptine).
22. lead poisoning
ANS A medical condition caused by toxic levels of the metal lead in the blood
23. Lead poisoning treatment
ANS chelation therapy
24. Amygdala's role in emotion
ANS - Aggression center
- Role in storing implicit emotional memories
- Stimulation (+) anger/violence or fear/anxiety
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27. Four dopaminergic pathways
ANS mesocortical mesolimbic nigrostriatal tuberoinfundibular
28. mesocortical pathway
ANS a path through which dopaminergic projections travel to reach the neocortex
29. mescolimbic pathway
ANS The mesolimbic pathway, sometimes referred to as the reward pathway, is a dopaminergic pathway in the brain. The pathway connects the ventral tegmental area in the midbrain, to the ventral striatum of the basal ganglia in the forebrain. The ventral striatum includes the nucleus accumbens and the olfactory tubercle.
30. Nigrostriatal pathway
ANS the dopaminergic tract from the substantia nigra to the striatum
31. Tuberoinfundibular pathway
ANS from hypothalamus to anterior pituitary -> DA released from these neurons inhibit prolactin secretion -> when DA receptors here are blocked prolactin levels rise cause galactorrhea)
32. primary prevention
ANS Efforts to prevent an injury or illness from ever occurring.
33. secondary prevention
8 / ANS Efforts to limit the effects of an injury or illness that you cannot completely prevent, screening exams.
34. tertiary prevention
ANS actions taken to contain damage once a disease or disabil- ity has progressed beyond its early stages
35. menopause hormone therapy
ANS most effective therapy for moderate -severe vasomotor symptoms - use quality of life scales to identify degree of vasomotor symptom severity *should not be used for protection against CVD or dementia
36. congestive heart failure and depression
ANS MDD is highly prevalent in these patients
37. Thyroid levels while on lithium
ANS Because of the high incidence of thyroid dysfunction that occurs during lithium treatment, patients should have a careful thy- roid physical examination and determination of serum thyroid-stimulating hormone (TSH) and antithyroid peroxidase antibody titers before lithium treatment is begun. Patients with normal thyroid function initially should be reevaluated every 6 to 12 months for several years, and thyroid dysfunction should be treated if diagnosed. The development of thyroid dysfunction does not typically require discontinuation of lithium. If thyroid function is abnormal at the initial evaluation, lithium can still be given if necessary, but the thyroid dysfunction
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40. Lithium mechanism of action
ANS Not established, possibly related to inhibition of phosphoinosital cascade It inhibits excitatory neurotransmitters such as dopamine and glutamate, and promotes GABA-mediated neurotransmission.
41. Carbamazepine mechanism
ANS Block voltage-dependent sodium channels
42. Structural Therapy
ANS A therapeutic approach directed at changing or realigning the organization of a family to modify dysfunctional patterns and clarify boundaries. Developed by Salvador Minuchin.
43. crisis intervention
ANS five-step problem-solving technique to promote adaptation and improve future coping
44. Irvin Yalom
ANS A leading figure in contemporary group therapy, especially the interpersonal approach
45. group therapy
ANS therapy conducted with groups rather than individuals, permit- ting therapeutic benefits from group interaction
46. boderline personality disorder
ANS impulsive actions, often with the potential for self-harm as well as mood instability
11 / and chaotic relationships
47. DBT (dialectical behavior therapy)
ANS a form of therapy used to treat borderline personality disorder that combines elements of the behavioral and cognitive treat- ments with a mindfulness approach based on Eastern meditative practices
48. eating disorder treatment
ANS -correct dangerous eating patterns -address psychological and situational factors that have led to / are maintaining the disorder -often requires family and friend participation
49. When to admit for eating disorder?
ANS 75% below ideal body weight and/or electrolyte imbalances
50. just culture
ANS culture where staff are willing to come forward with information about errors so everyone can learn from mistakes; the culture recognizes the need for accountability & at times disciplinary action
51. GERIATRIC ANEMIA
ANS lower than normal RBC that is common in seniors
52. PHQ-9 scores
ANS 1-4 min depression 5-9 Mild depression
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54. HAM-D
ANS 0-7 normal 8-16 Mild 17-23 Moderate 24 (+) Severe
55. HAM-A
ANS 17 or less indicates mild anxiety 18- mild to moderate anxiety
56. GAD-
ANS 1-4 minimal anxiety 5- Mild anxiety 10-14 Moderate anxiety 15-21 Severe anxiety
57. Zung Self-Rating Depression Scale
ANS 50-69 indicates depression 70 (+) severe depression
58. MoCA
ANS 26-30 normal 22.1 mild impairment 16.2 Alzheimer's Disease
59. MMSE
ANS 24-30 normal 23-
14 / mild 19-10 middle-moderate Alzheimer's 9- 0 Late stage-severe Alzheimer's
60. Dementia
ANS a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes
61. delirium
ANS an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech.
62. Pediatric SSRIs
ANS fluoxetine (ages 8 and up) escitalopram (ages 12 and up)
63. Pediatric OCD FDA medications
ANS clomipramine (anafranil) 10 years and up fluoxetine (prozac) 8 years and up fluvoxamine (luvox) 8 years and up sertraline (zoloft) 6 years and up
64. galactorrhea
ANS abnormal flow of milk from the breasts
65. Dopamine
ANS a neurotransmitter that regulates motor behavior, motivation, plea- sure, and
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70. Crisis training is proven to be effective in helping to deescalate situations
to prevent the officer from using what? ANS Lethal force
71. Signs of child abuse
ANS Head injuries;bruises and welts in the shapes of ob- jects;Burns;human bites;rope burn;fractures in different stages of healing
72. AIDS dementia complex (ADC)
ANS Encephalitis, behavioral changes, decline in cognitive function Progressive slowing of motor functions
73. Apoptosis
ANS process of programmed cell death
74. Recovery (training principle)
ANS Holistic, person-centered approach to mental health care. Two premises ANS 1) It is possible to recover from a mental health condition;
- The most effective recovery is patient-directed
75. neuron death
ANS the stage of early nervous system development during which large numbers of neurons die, typically those that have not established effective synaptic contacts
76. Mini-Cog Test
ANS Quick method for assessing dementia. If abnormal, screen
17 / further with MMSE. Use these two methods ANS the clock drawing test with word recall test (three unrelated words). Instruct patient to draw a clock and mark it with the hands showing a certain time. Example ANS Instruct patient to "Draw a clock that shows 20 minutes past 4."
- Scoring clock test ANS Hands point to the correct time and numbers on clock are in correct sequence.
77. meta-analysis
ANS a statistical technique that averages the results of two or more studies to see if the effect of an independent variable is reliable
78. PTSD diagnostic criteria
ANS Three or more of the following should be present for more than 1 month ANS
1. Inability to recall an important aspect of the event
2. avoidance of activities, people, places that remind the patient of the event
3. attempts to avoid thinking or talking about the event
4. Feelings of detachment or estrangement from others
5. markedly decreased interest or anhedonia (inability to experience pleasure)
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- If manifestations include nightmares or insomnia, Minipress has been prescribed. (Normally used to treat HTN, Minipress blocks the brain's response to NE and has been effective in suppressing nightmares.) THERAPY ANS
- Cognitive Therapy
- Exposure Therapy
80. Zyprexa (olanzapine)
ANS monitor for metabolic syndrome
81. Risperidone (Risperdal)
ANS monitor for prolactin level increases
82. gastric emptying drugs
ANS Metoclopramide, Erythromycin, Domperidone, Cis- apride
83. oversupply linked to schizophrenia. undersupply linked to tremors and
decreased mobility in Parkinson's disease ANS Dopamine
84. With Alzheimer's disease, ACh-producing neurons deteriorate.
ANS Acetyl- choline
85. undersupply of serotonin
20 / ANS linked to depression
86. Undersupply of norepinephrine.
ANS can depress mood
87. undersupply of GABA
ANS linked to seizures, tremors, and insomnia
