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PMHNP EXAM REPORTED (TEST BANK) 250+ VERIFIED
QUESTIONS AND CORRECT ANSWERS
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 What is a risk of using Tramadol? - Correct Answer>>Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? - Correct Answer>>HLAB- 1502 When might you see toxic epidermal necrolysis? - Correct Answer>>With worsening of SJS How many generations do you include for a genogram? - Correct Answer>>1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? - Correct Answer>>Amino Acids What is epigenetics? - Correct Answer>>Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? - Correct Answer>>Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? - Correct Answer>>Dendritic pruning Emotions are controlled by amygdala 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? -
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 the scoring with the Beck Depression Inventory? - Correct Answer>>Self-Report - 0 - 63 0 - 13 - minimal 14 - 19 - mild 20 - 28 - moderate 29 - 63 - severe What is sensitivity? - Correct Answer>>Helps rule-out disease = True Positive = Snout What is specificity? - Correct Answer>>Helps rule-in disease = True Negative = Spin What does a sed rate measure? - Correct Answer>>Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. 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. Can an advanced directive ever be revoked? - Correct
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. Must be impoverished Must be US resident and low or very low income. Can you have Medicare and Medicaid? - Correct Answer>>Yes, impoverished elderly but Medicaid is always payor of last resort. Is dental care included in Medicaid? - Correct Answer>>Yes, < gets basic dental as part of the Medicaid plan. What is the purpose of HIPAA? - Correct Answer>>National standards for electronic HC transactions 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? -
What is the neurotransmitter problem in Schizophrenia? - Correct Answer>>Excess dopamine in mesolimbic pathway. What is the neurotransmitter problem in ADHD? - Correct Answer>>Dopamine, norepinephrine and serotonergic dysfunction What is the benefit of play therapy? - Correct Answer>>Don't have to confront emotions head on. What neurotransmitters are involved in the bioamine hypothesis of depression? - Correct Answer>>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 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 What happens with a patient taking Lithium who decreases sodium intake? - Correct Answer>>Levels increase What happens with a patient taking Lithium and drinks a lot of water? - Correct Answer>>Levels decrease
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 Pt wants to stop medications - Correct Answer>>explore reason for stopping Its their right 16 year old falls with the wrong crowd - Correct Answer>>Conduct disorder change agent - Correct Answer>>the person formally in charge of guiding a change effort Administrator 14 year old girl clenching her teeth - Correct Answer>>Cranial
Nerve V-Trigeminal nerve Infant dying - Correct Answer>>Give child to parents and comfort parents borderline personality disorder Treatment - Correct Answer>>dialectical behavior therapy Aggressive patient give - Correct Answer>>IM geodon SIGECAPS of Depression - Correct Answer>>Sleep Interest Guilt Energy Concentration Appetite psychomotor retardation Suicide DIGFAST for mania - Correct Answer>>Distractibility Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talking increase 5 year old tells u his brother sodomized him - Correct Answer>>Tell mom don't leave him alone with patient and call CPS implement crisis Just culture - Correct Answer>>"Just culture" model: proposed to reconcile the twin needs for no-blame and appropriate
competence Problems in the parietal lobe can lead - Correct Answer>>Sensory-perceptual disturbances and agnosia(inability to perceive objects) R-L confusion Difficulty writing (agraphia) Aphasia(difficulty of language) PDSA cycle - Correct Answer>>For Plan-Do-Study-Act. Describes how to test a change: by trying it, observing the consequences, and then learning from those consequences. Appreciative Inquiry - Correct Answer>>an organizational change strategy that directs the group's attention away from its own problems and focuses participants on the group's potential and positive elements Appreciative Inquiry - Correct Answer>>an organizational change philosophy and process building organizations around what works, rather than focusing on and trying to fix what doesn't work Appreciative Inquiry (AI) - Correct Answer>>Identify the problem Analyze the problem Generate Solutions Implement Best Solutions Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change)
Destiny (Make it happen, Implenting Change) Appreciative Inquiry - Correct Answer>>Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change) Destiny (Make it happen, Implenting Change) CIWA-Ar - Correct Answer>>Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised 9 item symptom rating scale, max score 67; <10 does not warrant intervention Hispanic patient lost his parent complain stomach ache his pop couldn't fix what do you do - Correct Answer>>Validate his experience and provide care in a culturally specific way to that patient Native American wants his healer present - Correct Answer>>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 Answer>>confidential mom sits in lobby Patient acts out due to missing session what do you do - Correct Answer>>You relate to childhood abandonment and talk about it with the patient How do you assess the competency of a medical procedure - Correct Answer>>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
laminate 200% Inducers of Cytochrome P450 (CYP450) - Correct Answer>>Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort A substance that speeds up a chemical reaction Inhibitor - Correct Answer>>A substance that slows down or stops a chemical reaction cytochrome p450 inhibitors - Correct Answer>>CRACK AMIGOS Cimetidine Ritonavir Acute Alcohol Ciprofloxacin Ketoconazole Amiodarone Macrolides Isoniazid Grapefruit juice Omeprazol Sulfonamides Carb and Barb - Correct Answer>>decrease INR Deapkote and Disulfruram - Correct Answer>>Increase INR GAL-Renall metabolized - Correct Answer>>Gabapentin Acamprostate Lithium Grapefruit juice - Correct Answer>>One glass can reduce absorption by 47% Blood levels will be Increased
Trazodone (Desyrel) - Correct Answer>>Get EKG. Trazodone (Desyrel) - Correct Answer>>Get an eye exam can cause Glaucoma Grapefruit juice or grapefruit - Correct Answer>>Increase trazodone PICOT - Correct Answer>>Patient population of interest Intervention of interest Comparison of interest Outcome Time limbic system - Correct Answer>>A doughnut-shaped system of neural structures at the border of the brainstem and cerebral hemispheres; associated with emotions such as fear and aggression and drives such as those for food and sex. Includes the hippocampus, amygdala, and hypothalamus. Amygdala - Correct Answer>>A limbic system structure involved in memory and emotion, anxiety, particularly fear and aggression. PANDAS - Correct Answer>>Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections OCD Mental Health Parity Act 1996 - Correct Answer>>ensure equal coverage for mental and physical illness equal life time and annual limits charge of DEA - Correct Answer>>state and federal
