PMHNP Exam Reported Questions and Answers Latest 2022 Test with complete solutions

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PMHNP Exam Reported Questions and Answers Latest 2022 Test with complete solutions What is dissemination? Correct Answer- Getting the research information out to those who need to know it! Publica... tion - 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? Correct Answer- 25-35 yoWhat does Erythromycin to trileptal? Correct Answer- 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 Answer- Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct Answer- Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? Correct Answer- Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? Correct Answer- CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? Correct Answer- CKMB What is the risk of a seriously elevated CKMB? Correct Answer- Polymyositis Rhabdo What is a normal CKMB? Correct Answer- 0.3 mcg/L What psychoactives does Detrol interact with? Correct Answer- Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? Correct Answer- CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? Correct Answer- CD4 <200 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 Answer- Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? Correct Answer- Nothing. They are all the same. Does the de facto rule of proxy apply in same sex marriages? Correct Answer- No. How do Asians see HC providers? Correct Answer- As in a position of authority. Expect to give instructions and help make decisionsWhat does it mean when an Asian patient does not make eye contact with the NP? Correct Answer- SIgn of respect What is the evil eye? Correct Answer- 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 Answer- Red ribbon on an infant Amulet for adults How do you treat for evil eye? Correct Answer- Access traditional healer + traditional care. For there to be a duty to a patient, what must exist? Correct Answer- Relationship What is a proximate cause? Correct Answer- Connection between A + B. For there to be damages, what must exist first? Correct Answer- Negligence 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, methyphenidateSchedule 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, <21 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? Correct Answer- Yes, no other way to give care. Is it ok to leave a message on a patient's vm? Correct Answer- Yes, but should be limited. What is the impact of steroid inhalers on children? Correct Answer- Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? Correct Answer- Cataracts, glaucoma, thinning of bones and skin What is included in the treatment of fibromyalgia? Correct Answer- Sleeping meds Antidepressants Pain medsWhat psychoactives are first line treatment for fibro? Correct Answer- Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's What is the purpose of telepsychiatry? Correct Answer- Increase the ability to reach rural and underserved areas. What is the purpose of Motivational Interviewing? Correct Answer- Explore ambiguity Maintain passive position What is required for Medicare submission? Correct Answer- ICD 10 and narrative or CPT 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 AnswerNoradrenaline 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 AnswerDepression 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 mm3 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 If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? Correct Answer- Zyprexa What happens when taking Lithium and NSAIDS? Correct Answer- NSAIDS can cause Lithium levels to increase and for the patient to become toxic! What medications are at risk to cause SJS in the Asian population? Correct Answer- HLAB-1502 Allele increase risks of SJS. Trileptal, Tegretol and other AED's. Amgdyla Correct Answer- Fear, Anxiety, and Aggression Neurotransmitter for Addiction Correct Answer- Dopamine and GABA Neurotransmitter for Mood Disorder Correct Answer- Serotonin and norepinephrine Which drug affects Carbamazepine/tegretol Correct Answer- Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol Signs and Symptoms of stimulant abuse Correct Answer- insomnia and tremor Depakote check Correct Answer- HCG levelsDepakote causes Correct Answer- Spinal bifida Grasp reflex. Correct Answer- an infantile reflex in which an infant closes her hand into a fist when her palm is touched 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 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 disorderchange 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 increase5 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 cultu [Show More]

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