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PMHNP Psychopharm Exam 11 2024
The goal of primary prevention is the ___ of disease and examples of primary prevention include: (x2) - Prevention of Disease Immunization Counseling about Safety The goal of secondary prevention is ___ of disease and examples of secondary prevention include: (x2) - Early Detection of Disease Blood Pressure Colonoscopy The goal of tertiary prevention is ___ of disease and examples of tertiary prevention include: (x1) - Minimizing Negative Outcomes from Disease Adjust therapy to avoid end organ damage Screen men for colorectal CA at ___ y/o age and women for Cervical/Breast CA at ___ y/o - 50 y/o 21 y/o Up to 44% of patients taking Valproate (Depakote) will have elevated ___ - ALT/AST The GGT ranges from ___ u/L and can be elevated due to ___ - 0 - 45 u/L ETOH abuse The best measurement of kidney function is GFR and GFR is normal at ___ mL/min - > mL/min If a patients Na levels are low (<35), they will ___ lithium which can result in the medical emergency of ___ and signs of this medical emergency include (x3) Lithium can cause (x2) making it hard to moniter NA levels and there is an increased risk of gouter and ___ for Pts on Lithium The medical emergency ___ is Tx with ___ (which should considered at levels >2.5 mEq/L absolutely be done if lithium levels reach ___ mEq/L) - Reabsorb lithium Lithium Toxicity Hyperreflexia Arrhythmias
Lithium Toxicity 4.0 mEq/L Nystagmus Polydipsia / Polyuria Peripheral Edema To initiate a Pt on the 3rd line antipsychotic ___ the ANC needs to be over ___ and stop treatment if ANC is ___ - Clozapine (Clozaril) ANC >1, ANC<1, Normal TSH levels - 0.4-4. High TSH (0.4-4.0 mlU/ mL normal) and Low T4 (10-27 pmol/L normal) - Hypothyroidism Low TSH (0.4-4.0 mlU/ mL normal) and High T4 (10-27 pmol/L normal) - Hyperthyroidism Defense mechanisms are derived out of Freud's ___ Models (Id, Ego, SuperEgo) - Psychoanalytic Birth order was stressed by ___ who recognized ___ as a driving force and created ___ theory
- Adler Inferiority (think Inferiority Complex) Personality Theory Attachment Theory was developed by ___ and the purpose of attachment is to ensure closeness and stability through a ___ in development Healthy attachment is ___ attachment in both children and adults - Bowlby Secure Base (Sense of Security for child) Secure Attachment unconditional positive regard was created by ___ who believed that Pts would develop ___ & self-acceptance - Carl Rogers
The action of any antipsychotic is to block the ___ receptor and the ___ receptor inhibits the formation of cAMP by inhibition of the enzyme ___ - D adenylate cyclase Concomitant use of triptans and SSRI or SNRI antidepressants has led to an FDA warning for ___ (but the risk is low according to JAMA study) Tx for ___ is Cyproheptadine (Periactin), fluids and ___ to decrease seizure-like movement/muscle stiffness - Serotonin Syndrome Benzos The ability of a Pt who had a stroke to regain the ability to speak by recruiting other areas of the brain to compensate for damaged regions is ___ - Neural Plasticity African Americans patients are more likely to be ___ and over-diagnosed with (x2) - Involuntarily Hospitalized Substance Abuse / Schizophrenia Sickness, unhappiness and role functioning from ___ leaving body in Latino culture is ___ - Soul Susto The H.S.S.A. Mature Defense Mechanism - Humor Suppression Sublimation Altruism Effective therapeutic technique in ___ Psychotherapy (IPT) is ___ - Interpersonal Psychotherapy Role Playing Dantrium (Dantrolene) or Parlodel (Bromocriptine) are both used in the Tx of ___ - NMS Lead Pipe Rigidity Tremors Dyskinesia Patient with bipolar most likely to be misdiagnosed with unipolar depression is ___ - Bipolar II Mood disorder (i.e. Bipolar, MDD, SAD...) with typically an early age of onset - Dysthymia
(x3) Cat B psychiatric medications - Busparone (Buspar) Clozapine (Closaril) Lurasidone (Latuda) Due to QT prolongation, max dose of Citalopram (Celexa) is ___ in adults over ___. - 20 mg
60 y/o SSRI withdrawal syndrome is ___ but not ___ - Bothersome Deadly John Bowlby developed ___ with the idea that the caregiver provides (x2) creating a stable base for the child - Attachment Theory Safety/Security A credential is used to provide ___ to the public by ensuring a minimum level of competence and title protect of psychiatric nurse practitioners for certification is provided by the ___ Scope of practice for any NP is determined by ___ - Protect American Nurses Association (ANA) State Law To be deemed incompetent requires a ___ A durable power of attorney for health care designates in writing an agent to act on behalf of an individual medically and should be considered for patients with chronic ___ - Court Ruling Psychiatric Disorders When considering probability is lies between ___ (something not possible) and ___ (something that will occur on every instance) and in order for the p value to have SIGNIFICANCE it must by ___ - 0 1 <. The ___ Report ensures that all investigators or participants in research must pass a test on protection of human subjects - Belmont Report Treatment of choice for trichomonas vaginalis is the oral antibiotic ___ - Metronidazole (Flagyl) If insomnia is presenting in later years, this may be due to ___ rhythms, but is common in Pts with ___ - Chronobiological Rhythms
Bandura's Social Cognitive Theory postulate that behavior is the result of ___ factors, ___ factors, and ___ which is the perception one has of their ability to ___ to a certain level - Cognitive / Environmental Self-Efficacy Preform a Task x3 Phases of the therapeutic Nurse-Client Relationship (Peplau) ___ Introduction & creating Tx goals ___ Implementing Tx plan ___ Focus on self management {(x2) by client is expected} - Orientation Working Termination (Regression/Resistance) Harry Stack Sullivan's ___Theory hypothesized that there are two drives for all behavior: ___ drive (i.e. sleep, hunger, sex) ___ drive (i.e. conforming to social norms) These desires form the hierarchy of needs (survival to____) - Interpersonal Theory Satisfaction Drive Security Drive Self-Actualization Leininger's theory of ___ care is premised on regardless of the ___, the essence of nursing is the ___ - Theory of Cultural Care Culture Care In Caring Theory, ___ proposed that the aspects of care that potentiate therapeutic healing and relationships are ___ - Watson Curative Factors P I C O T - Population Intervention
Comparison Outcome Time Process of Quality Improvement P D S A - Plan - Plan the Change Do - Carry out the Plan Study - Examine results Act - Improve the process (based on decision influenced by outcome) The bundle of ___ matter (called ) that connects the left and right hemispheres of the brain allowing for decussation of sensorimotor exchange - White Matter Corpus Callosum Issues with hearing of memory are associated with the ___ region of the brain - Temporal Another name for the striatum is the ___ and issues with the ___ can lead to bradykinesis, hyperkinesia, dystonia () - Basal Ganglia EPS While the precursor for neurotransmitters NE / DA is ___ the precursor for the indole 5HT is ___ - Tyrosine Tryptophan Substance P, Endorphins and Enkephalins are all classified as ___ - Neuropeptides overweight BMI obese BMI - 26 - 29. 30 - 35 Aspect of Gestalt Therapy - Taking action towards self that we wish someone else would do for us - Retroflection Aspect of Gestalt Therapy - Organism and Environment have poor differentiation (dysfunctional closeness) - Confluence Aspect of Gestalt Therapy - Assigning aspect of self to others in an effort to dismiss their feelings (i.e. ___ guilt because you feel guilty) - Projection (projecting guilt because you feel guilty)
