{"id":117057,"date":"2023-08-27T17:06:02","date_gmt":"2023-08-27T17:06:02","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=117057"},"modified":"2023-08-27T17:06:06","modified_gmt":"2023-08-27T17:06:06","slug":"pmhnp-bundled-exams-with-verified-solutions-all-graded-a","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2023\/08\/27\/pmhnp-bundled-exams-with-verified-solutions-all-graded-a\/","title":{"rendered":"PMHNP Bundled Exams with Verified Solutions (All Graded A+)"},"content":{"rendered":"\n<p>PMHNP Certification Exam Questions<br>and Answers Already Passed<br>Tarasoff Principle \u2714\u27141976 &#8211; duty to warn victims of potential harm from client<br>Deontological Theory \u2714\u2714Ethical theory that states an action is judged as good or bad based on<br>the act itself regardless of the consequences<br>Teleological Theory \u2714\u2714Ethical theory that states an action is judged as good or bad based on the<br>consequence or outcome<br>Virtue ethics \u2714\u2714ethical theory that states actions are chosen based on the moral virtues (eg.<br>honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person<br>making the decision<br>Erikson&#8217;s developmental stage infancy age range \u2714\u2714birth-1 year<br>Erikson&#8217;s developmental stage infancy developmental tasks \u2714\u2714trust vs. mistrust<br>Erikson&#8217;s developmental stage infancy indications of developmental mastery \u2714\u2714Ability to form<br>meaningful relationships, hope about the future trust in others<br>Erikson&#8217;s developmental stage infancy indication of developmental failure \u2714\u2714poor relationships,<br>lack of future hope, suspicious of others<br>Erikson&#8217;s developmental stage early childhood age \u2714\u27141-3 yo<br>Erikson&#8217;s developmental stage early childhood developmental task \u2714\u2714autonomy vs. shame and<br>doubt<\/p>\n\n\n\n<p>Erikson&#8217;s developmental stage early childhood indications of developmental mastery \u2714\u2714selfcontrol, self-esteem, willpower<br>Erikson&#8217;s developmental stage early childhood indications of developmental failure \u2714\u2714poor selfcontrol, low self esteem, self-doubt, lack of independence<br>Erikson&#8217;s developmental stage late childhood age \u2714\u27143-6yo<br>Erikson&#8217;s developmental stage late childhood developmental task \u2714\u2714initiative vs guilt<br>Erikson&#8217;s developmental stage late childhood indications of developmental mastery \u2714\u2714selfdirected behavior, goal formation, sense of purpose<br>Erikson&#8217;s developmental stage late childhood indications of developmental failure \u2714\u2714lack of selfinitiated behavior, lack of goal orientation<br>Erikson&#8217;s developmental stage school-age ages \u2714\u27146-12yo<br>Erikson&#8217;s developmental stage school-age developmental task \u2714\u2714industry vs. inferiority<br>Erikson&#8217;s developmental stage school-age indications of developmental mastery \u2714\u2714ability to<br>work; sense of competency and achievement<br>Erikson&#8217;s developmental stage school-age indications of developmental failure \u2714\u2714sense of<br>inferiority, difficulty with working, learning<br>Erikson&#8217;s developmental stage adolescence ages \u2714\u271412-20yo<\/p>\n\n\n\n<p>Erikson&#8217;s developmental stage adolescence developmental task \u2714\u2714identity vs role confusion<br>Erikson&#8217;s developmental stage adolescence indications of developmental mastery \u2714\u2714personal<br>sense of identity<br>Erikson&#8217;s developmental stage adolescence indications of developmental failure \u2714\u2714identity<br>confusion, poor self-identification in group settings<br>Erikson&#8217;s developmental stage early adulthood ages \u2714\u271420-35 years<br>Erikson&#8217;s developmental stage early adulthood developmental task \u2714\u2714intimacy vs isolation<br>Erikson&#8217;s developmental stage early adulthood indications of developmental mastery<br>\u2714\u2714committed relationships, capacity to love<br>Erikson&#8217;s developmental stage early adulthood indications of developmental failure \u2714\u2714emotional<br>isolation, egocentrism<br>Erikson&#8217;s developmental stage middle adulthood ages \u2714\u271435-65 yo<br>Erikson&#8217;s developmental stage middle adulthood developmental task \u2714\u2714generativity vs. selfabsorption or stagnation<br>Erikson&#8217;s developmental stage middle adulthood indications of developmental mastery \u2714\u2714ability<br>to give time and talents to others, ability to care for others<br>Erikson&#8217;s developmental stage middle adulthood indications of developmental failure \u2714\u2714selfabsorption, inability to row and change as a person, inability to care for others<\/p>\n\n\n\n<p>Erikson&#8217;s developmental stage late adulthood age \u2714\u2714>65yo<br>Erikson&#8217;s developmental stage late adulthood developmental task \u2714\u2714integrity vs despair<br>Erikson&#8217;s developmental stage late adulthood indications of developmental mastery \u2714\u2714fulfilment<br>and comfort with life, willingness to face death, insight and balanced perspective on life&#8217;s events<br>Erikson&#8217;s developmental stage late adulthood indications of developmental failure \u2714\u2714bitterness,<br>sense of dissatisfaction with life, despair over impending death<br>Psychodynamic (Psychoanalytic) Theory \u2714\u2714-Sigmund Freud<br>-all bx is purposeful and meaningful<br>-principle of psychic determinism<br>-most mental activity is unconscious<br>-conscious behaviors and choices are affected by unconscious mental content<br>-childhood experiences shape adult personality<br>-instincts, urges, or fantasies function as drives that motivate thoughts, feelings, and bx<br>-Id, Ego, Superego<br>-conflict is experienced consciously as anxiety<br>Principle of psychic determinism \u2714\u2714Even apparently meaningless, random, or accidental<br>behavior is actually motivated by underlying unconscious mental content<br>Intellectual disability typical age onset \u2714\u2714infancy- usually evident at birth<br>ADHD typical age onset \u2714\u2714early childhood (per DSM by age 12)<br>Schizophrenia typical age onset \u2714\u271418-25 for men<br>25-35 for women<\/p>\n\n\n\n<p>PMHNP certification Exam Questions<br>and Answers with Verified Solutions<br>Which patient is at highest risk for SI<br>A. 30y\/o married AA female with previous SI attempt *1 risk factor<br>B. 35 y\/o single Asian male with previous SI attempt *3 risk factors<br>C. 38 y\/o single AA male who is a manager of a bank *2 risk factors<br>D. 68 y\/o single white male with depression *5 risk factors (age, male, white, depression) \u2714\u2714D.<br>68 y\/o single white male with depression *5 risk factors (age, male, white, depression)<br>Count the risk factors<br>When interview teenagers (16 y\/o) that arrive with their parents what should you do? \u2714\u2714interview<br>them separately from parents.<br>-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents<br>may be upset but remember you are advocating for the child.<br>Which Ethnic group has the highest rate of suicide? \u2714\u2714Native Americans<br>Example A patient is being treated for schizophrenia with olanzapine. Which of the following is<br>the most common side effect of olanzapine?<br>A. Increased waist circumference<br>B. EPS (not as common in atypical antipsychotics d\/t 5HT2A)-receptor antagonism<br>C. Increased Lipids<br>D. Metabolic Syndrome \u2714\u2714D. Metabolic Syndrome (UMBRELLA ANSWER)<br>Which antipsychotics have the least weight gain? \u2714\u2714Latuda, Abilify, (also least sedating),<br>Geodon-if patient has metabolic syndrome consider switching to one of the medications above. Or<br>if the patient is overly sedated try switching to ABILIFY<\/p>\n\n\n\n<p>Which mood stabilizer have the least weight gain? \u2714\u2714Lamictal<br>-But remember all mood stabilizers cause some weight gain<br>When presented with a question about typical vs atypical antipsychotic the answer is usually to<br>start of a \u2714\u2714atypical<br>A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest<br>cycle, and changes in libido. What is the neuroanatomical area of the brain that is responsible for<br>the normal regulation of these functions?<br>A. Thalamus<br>B. Hypothalamus<br>C. Limbic System<br>D. Hippocampus \u2714\u2714Hypothalamus<br>A, B, &amp; D are all part of the limbic system so you can rule that out<br>When a patient is hesitant to participate in treatment you should encourage? \u2714\u2714Bring a support<br>person like a husband<br>Thyroid-Stimulating hormone normal level \u2714\u27140.5-5.0 Mu\/L<br>When T4 and T3 are high and TSH is low what is the diagnosis \u2714\u2714HYPERTHYROIDISM, TSH<br>secretion decreases: TSH LOW \u00e0 key symptoms HEAT INTOLERANCE<br>Key symptoms of Heat Intolerance \u2714\u2714Hyperthyroidism<br>When T4 and T3 are Low and TSH is high what is the diagnosis \u2714\u2714(HYPOTHYROIDISM) TSH<br>secretion increased: TSH HIGH \u00e0 COLD INTERANCE<br>Key symptoms of Cold Intolerance \u2714\u2714Hypothyroidism<\/p>\n\n\n\n<p>Hyperthyroid can mimic \u2714\u2714Mania<br>Hypothyroid can mimic \u2714\u2714Depression<br>A patient on depakote complains of RUQ pain and has reddish\/brown urine \u2714\u2714Hepatoxicity<br>-Check LFTs<br>Signs of Depakote toxicity \u2714\u2714Disorientation, confusion, lethargy<br>You suspect depakote toxicity what do you do? \u2714\u2714Check<br>-LFT<br>-Ammonia<br>-Depakote Level<br>What herbal supplement can cause hepatoxicity? \u2714\u2714Kava Kava<br>When taking Kava Kava in combinations with other medications you should caution about<br>\u2714\u2714Risk of Hepatoxicity and Sedation<br>TCAs carry a risk of \u2714\u2714Hepatotoxicity<br>Signs of Stevens-Johnson Syndrome \u2714\u2714-fever, mouth pain, swelling, burning eyes, blisters, skin<br>pain<br>two psychotropics known to cause steven johnson syndrome \u2714\u2714lamictal and tegretol<br>What nationality is most suseptible of getting steven johnson? \u2714\u2714Asians<\/p>\n\n\n\n<p>When treating asians with tegretal screen for? \u2714\u2714HLAB-1502 Allele<br>What two medications cause agranulocytosis? \u2714\u2714Clozaril &amp; Tegretal<br>Agranulocytosis when to discontinue medication \u2714\u2714Less than 1000<br>When monitoring for agranulocytosis in patients look for s\/s of what? \u2714\u2714Infection<br>-Fever, sore throat, fatigue, chills<br>Before starting any mood stabilizer in a female of childbearing age be sure to check? \u2714\u2714HCG<br>Which two medications may decrease the risk of suicide? \u2714\u2714clozaril and lithium<br>Medications that increase lithium level \u2714\u2714NSAID-ibuprofen, INDOCIN<br>THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril<br>Ace inhibitors are treatment of choice for? \u2714\u2714Heart Failure<br>Certain medications are known to increase lithium level, but HOW? \u2714\u2714by reducing renal<br>clearance<br>When educating a patient about lithium teach them about \u2714\u2714Hyponatremia<br>Dehydration-hot days, exercise<br>Normal Lithium Level \u2714\u27140.6-1.2<br>Lithium Toxicity \u2714\u27141.5 or above<br>Discontinue and re-order lithium level<\/p>\n\n\n\n<p>PMHNP Exam Reported Questions<br>Latest Update with Complete Solutions<br>What is dissemination? \u2714\u2714Getting the research information out to those who need to know it!<br>Publication &#8211; highest level<br>Presenting at National Conference<br>Presenting at Local Conference<br>Journal Club where one person reviews an article<br>What does a 17 on MMSE mean? \u2714\u2714Moderate cognitive impairment<br>What is Tegretol in the CYP450 system? \u2714\u2714Inducer &#8211;&gt;will lower dose of Lamictal and BCP&#8217;s<br>What do BCP&#8217;s do to Lamictal? \u2714\u2714Inducer &#8211; will lower dose of Lamictal<br>What is a Type I research error? \u2714\u2714There IS a difference but you say there isn&#8217;t a difference.<br>What is a Type II research error? \u2714\u2714There is NO difference but you say there is a difference.<br>What is pseudo-dementia? \u2714\u2714Cognitive impairment secondary to depression that clears when<br>treated in the elderly. Dementia won&#8217;t improve.<br>Is it normal for a 1 month old to have a palmar grasp? \u2714\u2714Yes.<br>What is a drug 1\/2 life? \u2714\u2714The time it takes for 50% of a drug to be eliminated from the body.<br>What 3 atypicals can be used with teens? \u2714\u2714Zyprexa, Abilify, Seroquel &#8211; low doses<\/p>\n\n\n\n<p>What is a risk of using Tramadol? \u2714\u2714Serotonin Syndrome as it is very serotonergic.<br>What is the allele seen in Asians that increase the risk of SJS? \u2714\u2714HLAB-1502<br>When might you see toxic epidermal necrolysis? \u2714\u2714With worsening of SJS<br>How many generations do you include for a genogram? \u2714\u27141st degree &#8211; mother, father, siblings<br>2nd degree &#8211; grandparents &amp; cousins<br>3rd degree &#8211;<br>What does messenger RNA code for? \u2714\u2714Amino Acids<br>What is epigenetics? \u2714\u2714Factors that affect genes &#8211; environmental, smoking, stress, etc\u2026<br>What part of the brain is involved with OCD? \u2714\u2714Basal Ganglia<br>Occipito-Frontal<br>What happens to the brain during adolescence? \u2714\u2714Dendritic pruning<br>Emotions are controlled by amygdala<br>By adulthood, PFC involved as well<br>When do males typically present with schizophrenia? \u2714\u271410-25 yo<br>When do females typically present with schizophrenia? \u2714\u271425-35 yo<br>What does Erythromycin to trileptal? \u2714\u2714You will need to decreases the level because<br>Trileptal(inducer) and erythromycin is a inhibitor<br>ACE Inhibitors are the drug of choice for what? \u2714\u2714Heart Failure<\/p>\n\n\n\n<p>HTN<br>What are some psychiatric side effects seen with some asthma drugs \u2714\u2714Leukotriene receptor<br>agonists &#8211; singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression,<br>insomnia, SI, tremor<br>What should you watch for with Tegretol? \u2714\u2714Agranulocytosis and Hyponatremia<br>What are the 3 CK muscle enzyme tests? \u2714\u2714CKBB, CKMM, CKMB<br>Which one of the 3 muscle enzymes are related to cardiac muscle damage? \u2714\u2714CKMB<br>What is the risk of a seriously elevated CKMB? \u2714\u2714Polymyositis<br>Rhabdo<br>What is a normal CKMB? \u2714\u27140.3 mcg\/L<br>What psychoactives does Detrol interact with? \u2714\u2714Topamax<br>KCL<br>Zonegran<br>What CN are you assessing when you have the patient shrug their shoulders? \u2714\u2714CN XI &#8211; Spinal<br>Accessory<br>What do you see in labs with HIV &amp; Dementia? \u2714\u2714CD4 &lt;200<br>Viral Load is high<br>&lt;20% get it with antiretroviral treatment<br>What is the scoring with the Beck Depression Inventory? \u2714\u2714Self-Report &#8211; 0-63<br>0-13 &#8211; minimal<\/p>\n\n\n\n<p>14-19 &#8211; mild<br>20-28 &#8211; moderate<br>29-63 &#8211; severe<br>What is sensitivity? \u2714\u2714Helps rule-out disease = True Positive = Snout<br>What is specificity? \u2714\u2714Helps rule-in disease = True Negative = Spin<br>What does a sed rate measure? \u2714\u2714Inflammation (ESR &#8211; Erythrocyte Sedimentation Rate) =<br>distance in mm RBC&#8217;s have descended in 1 hour.<br>What is a normal sed rate or ESR? \u2714\u27140-22 males<br>0-29 females<br>What is a retic count? \u2714\u2714Measures % of reticulocytes in blood (immature RBC&#8217;s) Indicates<br>whether enough RBC&#8217;s are being produced by bone marrow.<br>What does a decreased retic count indicate? \u2714\u2714Anemia &#8211; acute or chronic bleeding<br>What does an increased retic count indicate? \u2714\u2714Bone marrow disorder or Vitamin Deficiency<br>What does an abnormal retic ount indicate in general? \u2714\u2714Doesn&#8217;t diagnose anything. First step is<br>ID source of the issue.<br>What happens when you mix tegretol and macrolides? \u2714\u2714Increase tegretol levels.<br>What happens if a pregnant women takes Accutane? \u2714\u2714Birth defects.<\/p>\n\n\n\n<p>ANCC PMHNP QUESTIONS AND<br>ANSWERS WITH COMPLETE<br>SOLUTIONS<br>Purpose of Dopamine \u2714\u2714Inhibition of prolactin production<br>Sleep<br>Learning<br>Attention<br>Pleasure and reward<br>Movement<br>Memory<br>Mood<br>What term best describes the reelationship between an individual&#8217;s health and a number of other<br>variables, including the amoutn of healthcare consumed? \u2714\u2714Health production function- math<br>expression that shows the relationship between an individual&#8217;s health and a number of other<br>variables.<br>How much time should you allow for Celexa to provide its initial therapeutic effect and the patient<br>to see an improvement in symptoms? \u2714\u27144-6 weeks<br>Clients have what rights? \u2714\u2714Right to privacy and confidentiality<br>Right to least restrictive treatment measures<br>Right to consent and withdraw consent at any given time<br>Which inferential statistic determines whether the means of 2 groups are statistically different from<br>each other? \u2714\u2714t-test<br>enables one to reach conclusions that extend beyond the immediate data alone<\/p>\n\n\n\n<p>(ANOVA tests the difference among 3 or more groups, Pearson&#8217;s r correlation- tests the<br>relationship between 2 variables, probability-likelihood, p value- probability of a particular result<br>occurring by chance)<br>What symptoms would a patient exhibit if they were experiencing an excess serotonin?<br>\u2714\u2714Restlessness, agitation, myoclonus, vital sign abnormalilties<br>What term descries a colletion of individuals who coordinate lobbying efforts around a common<br>interest and seek to influence policymakers? \u2714\u2714Special interest group.<br>What are 3 phases of a therapeutic relationship between NP and pt? \u2714\u27141. Intro<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>Working3. Termination<br>The following describes what stage of a therapeutic relationship? Clarifying patient expectations,<br>ID goals, treatment plan, preventative healthcare, measuring outcomes of care, reprioritizing plan<br>\u2714\u2714Working phase<br>Which type of family therapy uses genograms, structural mapping, emphasizes understanding to<br>produce change in the family structure. \u2714\u2714Structural family therapy<br>Symptoms of exess GABA \u2714\u2714excess sleepiness, increased blood pressure, shallow breathing<br>Symptoms of insufficient GABA \u2714\u2714Sz, trouble concentrating, insomnia, depression, anxiety<br>A Hamilton Anxiety score of 14-17 indicates what? \u2714\u2714Mild Anxiety<br>A Hamilton Anxiety score of 18-24 indicates what? \u2714\u2714Moderate Anxiety<br>A Hamilton Anxiety score of 25-30 indicates what? \u2714\u2714Severe Anxiety<\/li>\n<\/ol>\n\n\n\n<p>When would you not use seclusion and restraint? \u2714\u2714Extremely unstable medical or psychiatric<br>conditions<br>Delirious or demented patients unable to tolerate decreased stimulation<br>Overtly suicidal patients<br>When should you use seclusions and restraint? \u2714\u2714Prevent significant disruption to treatment<br>program or physical surroundings<br>Decrease sensory overstimulation<br>What is the difference between pharmacokinetics, and pharmaodynamics? \u2714\u2714pharmacokinetics<br>is whatthe body does to drugs, pharmacodynamics is what the drug does to the body<br>Problems with the frontal lobe could lead to what \u2714\u2714personality changes<br>problems with the temporal lobe can lead to \u2714\u2714aphasia and amnesia<br>problems with the occipital lobe can lead to \u2714\u2714visual field defects<br>problems with the parietal lobe can lead to \u2714\u2714densory perceptual disturbances and agnosia<br>This type of advanced nurse evaluates, diagnoses, and treats a wide range of medical conditions<br>\u2714\u2714nurse practitioner<br>This type of advanced practice nurse consults researches educates and coordinates care<br>\u2714\u2714Clinical nurse specialist<br>This type of advnaced practice nurse provides well-woman gyno care, management pregnancy,<br>child birth, antipartum post partum. \u2714\u2714Nurse midwife<\/p>\n\n\n\n<p>Sample Test Questions ANCC \u2013 PMHNP<br>Latest Update Already Passed<br>A patient with borderline personality disorder experiences intense anxiety when an adult<br>psychiatric and mental health nurse practitioner goes on vacation. The best explanation for this<br>reaction is that the patient:<br>A. has failed to develop clear ego boundaries.<br>B. has failed to master object constancy.<br>C. is employing primitive idealization.<br>D. is employing projective identification. \u2714\u2714B. has failed to master object constancy<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>A patient has been taking escitalopram (Lexapro) 10 mg daily for four weeks. Initially, the<br>patient reported depression and suicidal thoughts. The patient&#8217;s sleep, appetite, energy, and<br>appearance have now begun to improve. Which statement applies to this patient?<br>A. The medication should be discontinued.<br>B. The medication should be increased.<br>C. The patient&#8217;s risk for suicide is not a concern.<br>D. The patient&#8217;s suicide potential is increased. \u2714\u2714D. The patient&#8217;s suicide potential is increased.<\/li>\n\n\n\n<li>Which behavior reflects existentially oriented therapy?<br>A. Attempting to understand a patient&#8217;s subjective world<br>B. Challenging a patient&#8217;s irrational beliefs<br>C. Developing specific plans for change<br>D. Establishing general group goals \u2714\u2714A. Attempting to understand a patient&#8217;s subjective world<\/li>\n\n\n\n<li>Serving as a member on a crisis team, an adult psychiatric and mental health nurse practitioner<br>provides crisis intervention to the survivors of a plane crash. Forty-eight hours after the accident,<br>the survivors describe vivid flashbacks, startle reactions, and disrupted sleep patterns. The nurse<br>practitioner responds by:<br>A. advising the survivors to consider using a hypnotic medication for a brief period.<\/li>\n<\/ol>\n\n\n\n<p>B. educating the survivors about prodromal symptoms of posttraumatic stress disorder.<br>C. encouraging the survivors to rest during the day.<br>D. suggesting that the survivors join a posttrauma support group. \u2714\u2714B. educating the survivors<br>about prodromal symptoms of posttraumatic stress disorder.<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"5\">\n<li>An adult psychiatric and mental health nurse practitioner uses the interpersonal therapy model<br>with a patient to establish a therapeutic alliance based upon empathy and trust. The nurse<br>practitioner recognizes the patient&#8217;s readiness to terminate therapy when the patient demonstrates:<br>A. an understanding that leaving a significant other may be painful, but also presents an<br>opportunity for growth.<br>B. breathing and muscle relaxation exercises that decrease muscle tension and anxiety.<br>C. free association, and considers the nurse practitioner&#8217;s interpretation of the patient&#8217;s dreams.<br>D. new adaptive skills and responses after completing &#8220;homework assignments.&#8221; \u2714\u2714A. an<br>understanding that leaving a significant other may be painful, but also presents an opportunity for<br>growth.<\/li>\n\n\n\n<li>An Hispanic patient informs an adult psychiatric and mental health nurse practitioner during a<br>wellness visit that he or she occasionally uses hot chili juice to relieve a &#8220;nervous condition.&#8221; The<br>patient denies any complaints related to this practice. The nurse practitioner&#8217;s response is to:<br>A. actively discourage the patient from continuing this treatment.<br>B. offer a medication to treat the nervous condition.<br>C. suggest an alternative food to relieve the nervous condition.<br>D. view this as a self-care ritual that needs to be preserved. \u2714\u2714D. view this as a self-care ritual<br>that needs to be preserved.<\/li>\n\n\n\n<li>Before an older adult patient initiates pharmacotherapy with a medication that is cleared by the<br>kidneys, an adult psychiatric and mental health nurse practitioner assesses the patient&#8217;s:<br>A. blood urea nitrogen level.<br>B. creatinine clearance.<br>C. specific gravity.<br>D. urinary sediment. \u2714\u2714B. creatinine clearance.<\/li>\n\n\n\n<li><\/li>\n<\/ol>\n\n\n\n<p>ANCC PMHNP Exam Prep Questions and<br>Answers Already Passed<br>mesocortical pathway \u2714\u2714executive function: attention, focus, depression<br>nigrostriatal pathway \u2714\u2714from substantia nigra (brainstem) to striatum (muscles): Parkinson&#8217;s<br>mesolimbic pathway \u2714\u2714projects to nucleus accumbens (part of limbic system). Pleasure, reward,<br>positive symptoms of schizophrenia: Addiction, gambling<br>Tuberoinfundibular pathway \u2714\u2714regulation of prolactin (acts on pituitary). Hypersexuality in<br>mania<br>Dopamine \u2714\u2714produced in substania nigra and VTA. D2 &amp; D4 receptors most important. Elevated<br>in the mesolimbic pathway associated with pleasure and psychosis. Antispychotics block<br>dopamine. travels through mesocoritcal, mesolimbic, nigrostriatal, and tuberinfundibular<br>pathways<br>Serotonin \u2714\u27145-HT. produced in raphe nucleus. emotion, impulses, dreams. 5HT2A receptors =<br>atypical antipsychotics.<br>Norepinephrine \u2714\u2714produced in locus coeruleus. arousal and vigilance<br>GABA \u2714\u2714inhibitory. produces calm in conjunction with benzodiazepines.<br>ACTH \u2714\u2714motor control, learning, memory, sleep, and dreams. Helps with balance. Decrease in<br>Alzheimer&#8217;s disease<\/p>\n\n\n\n<p>hypothalamus-pituitary-adrenal axis (HPA) \u2714\u2714CRH, ACTH, then cortisol. Worsens with stress<br>and depression<br>hypothalamus-pituitary-thyroid (HPT) \u2714\u2714TRH, TSH, T4. Hypothyroid causes depression, weight<br>gain, slow metabolism. Hyperthyroid is opposite.<br>hypothalamus-pituitary-gonadal (HPG) \u2714\u2714GnRH, FSH, LH. Malfunctions cause infertility<br>problems.<br>gray matter \u2714\u2714neurons are found<br>frontal lobe \u2714\u2714executive function, voluntary movement, speech (Broca&#8217;s area)<br>Temporal lobe \u2714\u2714memory, cognition, speech, emotions (aka limbic area)<br>parietal lobe \u2714\u2714receive and process sensory input<br>Wernicke&#8217;s area \u2714\u2714temporal and parietal lobes; speech<br>amygdala \u2714\u2714fear response.<br>hippocampus \u2714\u2714memory. Make up limbic system with amydgala<br>HIPAA \u2714\u27141. education about privacy protection, 2. access to own medical records, 3. request<br>amendment to health information to which they object, 4. require permission for disclosure of<br>medical issues<br>forensic nursing \u2714\u2714based on crime committed and investigational aspects<\/p>\n\n\n\n<p>Test Bank for PMHNP Boards 2022 Questions and<br>Answers Already Passed<br>What is true of interprofessionality? \u2714\u2714All health professionals have individual professional<br>competencies<br>What is the significance of an experimental p-value of 0.05 \u2714\u2714There is a 5% chance of a similar<br>result occurring by chance alone<br>What percentage of children with oppositional defiance disorder will develop conduct disorder?<br>\u2714\u271430%<br>In the DSM-5, selective mutism is now considered what type of disorder? \u2714\u2714anxiety disorder<br>Symptoms of selective mutism must persist for at least \u2714\u27141 month<br>Common competencies \u2714\u2714overlap more than one health care professional, although not<br>necessarily all health care professionals, and are competencies expected of all health care<br>professionals<br>Complementary competencies \u2714\u2714enhance the qualities of other professions in provision of care<br>Collaborative competencies \u2714\u2714those that each individual profession must possess to work with<br>others, including those who practice within different specialties within a profession.<br>Interpersonal collaboration is <strong><em>_<\/em><\/strong> centered \u2714\u2714patient<br>Cognitive therapy is recommended for patients that have \u2714\u2714negative cognitive distortions<br>irrational beliefs<\/p>\n\n\n\n<p>faulty conceptions<br>Humanistic Therapy focuses on assisting patients with \u2714\u2714self-actualization and self-directed<br>growth<br>Behavioral Therapy focuses on \u2714\u2714changing maladaptive behaviors through the use of behavioral<br>modification techniques<br>Existential therapy is for \u2714\u2714reflection on life<br>confronting self<br>120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate<br>lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing<br>diarrhea? \u2714\u27146 ((120X160)\/(80&#215;40))<br>The New Freedom Commission on Mental Health (NFCMH) released a report that suggested<br>\u2714\u2714implementation a national campaign to reduce the stigma of seeking care<br>Focusing on promoting recovery and building resilience<br>The efficacy of mental health treatments was found to be well documented in \u2714\u2714influential report<br>issued by US Surgeon General in 1999<br>State of high negative emotion and pessimism \u2714\u2714neuroticism<br>Commonly known as an optimistic outlook on life They are are outgoing, like social interaction,<br>respond to external rewards, have more active dopamine networks, and are responsive to positive<br>reinforcement. \u2714\u2714Extraversion (high levels protect from psychiatric illness)<br>Introverts are more likely to be <em>motivated and more likely to respond to<\/em><br>reinforcement \u2714\u2714internally<\/p>\n\n\n\n<p>negative (more likely to interact with internal motivation\/self-image)<br>Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at<br>the expense of self-assertion \u2714\u2714Agreeableness<br>Associated with self-control and a focused, organized approach to life. Are achievement-oriented<br>goal setters who can delay immediate gratification to obtain their long term desired outcome. They<br>are considered responsible, reliable, and dependable. \u2714\u2714conscientiousness<br>In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior<br>(FAB). What is true about FAB? \u2714\u2714FAB is concerned only with observable stimuli connected<br>to operant behavior<br>FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and<br>consequent stimuli)<br>The goal of FAB is modifying willful operant behavior<br>Gestalt theory deals with <strong><em><strong>, not<\/strong><\/em><\/strong> \u2714\u2714perceptual psychology<br>behavior<br>Medication that can delay ejaculation in patients with premature ejaculation \u2714\u2714Paroxetine (and<br>other SSRIs)<br>(others include:<br>Topical anesthetic<br>Tramadol<br>Phosphodiesterase-5 inhibitors)<br>First line treatment for lithium induced diabetes insipidus \u2714\u2714Amiloride (K potassium diuretic)<br>in addition to dc lithium when possible.<\/p>\n\n\n\n<p>Ways to reduce polyuria associated with lithium toxicity \u2714\u2714reduce lithium dose to minimum<br>effective dose<br>take once daily at night (may be 5-30% lower than when given in divided doses over the day)<br>Encourage adequate fluid intake<br>What is true about ECT in Parkinson&#8217;s disease \u2714\u2714it&#8217;s more likely to cause transient delirium<br>(worsened dyskinesias induced by l-dopa)<br>Lithium effects with Parkison&#8217;s disease \u2714\u2714may worsen tremor<br>nonselective MAOIs decrease the efficacy of <strong><em><strong>_ and increase the risk of a <em>___<\/em><\/strong><\/em><\/strong> \u2714\u2714ldopa products<br>hypertensive crisis<br>Selegiline is selective for \u2714\u2714MAO-B<br>(after 10mg there is an increase in risk of serotonin syndrome if given with other meds that increase<br>serotonin)<br>SSRI&#8217;s can <strong><em>_<\/em><\/strong> Parkinsonism tremor \u2714\u2714worsen (and decrease &#8216;off time&#8217;)<br>Process describes the mechanism by which the hippocampus stores memories \u2714\u2714long-term<br>potentiation<br>loss of memory relating to a particular category of information (inability to recall important<br>autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with<br>ordinary forgetting) \u2714\u2714systematized amnesia<br>Lack of memories from a circumscribed period of time, usually immediately following a traumatic<br>event \u2714\u2714localized amnesia<\/p>\n\n\n\n<p>PMHNP Boards Questions and Answers<br>with Complete Solutions<br>A 14-year-old patient has nonspecific complaints about pain in his or her legs. The physical<br>examination is unremarkable. Laboratory results are within normal limits except for a markedly<br>elevated alkaline phosphatase level. The psychiatric-mental health nurse practitioner \u2714\u2714interprets<br>the findings as normally occurring during a rapid adolescent growth spurt<br>Laboratory findings for a patient with an alcohol use disorder indicate increased liver function<br>values and: \u2714\u2714increased MCV and elevated triglyceride levels.<br>A new patient arrives at the office for treatment for depression. The patient reports taking<br>simvastatin (Zocor) and lisinopril (Zestril). When selecting an antidepressant, the psychiatricmental health nurse practitioner eliminates fluoxetine (Prozac), based on the knowledge that the<br>combination can lead to increased plasma levels of the statin, resulting in an increased risk of<br>muscle damage and rhabdomyolysis. The nurse practitioner&#8217;s reason is that: \u2714\u2714one medication is<br>a CYP450 3A4 substrate and one is a CYP450 3A4 inhibitor.<br>A 28-year-old patient who is psychotic arrives at the clinic with family members but refuses to<br>meet if the family members are present. The psychiatric-mental health nurse practitioner \u2714\u2714asks<br>the family members to leave for the appointment.<br>The psychiatric-mental health nurse practitioner is responsible for initiating quality improvement<br>at a community mental health clinic. The effective strategy for evaluating the clinic&#8217;s services is<br>to: \u2714\u2714use a survey to elicit patient satisfaction responses.<br>The psychiatric-mental health nurse practitioner evaluates a new adult patient via telemedicine.<br>The patient has questions about a new medication that he or she recently started. The nurse<br>practitioner decides to provide psychoeducation and to: \u2714\u2714e-mail drug information and resources<\/p>\n\n\n\n<p>Any court of law that evaluates the standards of care provided by a psychiatric-mental health nurse<br>practitioner \u2714\u2714considers what a reasonably prudent health care provider would do.<br>The psychiatric-mental health nurse practitioner and a team of local mental health professionals<br>are asked to provide crisis counseling service, after a gunman recently took a class hostage at a<br>local elementary school, wounded several students, and then shot himself. In preparing for this<br>assignment, the nurse practitioner recognizes that: \u2714\u2714a child&#8217;s developmental stage will influence<br>his or her response to catastrophic stress<br>Which community-based program is a tertiary level intervention? \u2714\u2714Partial hospitalization<br>program that provides intensive group therapy for rehabilitation.<br>A 32-year-old female patient informs the psychiatric-mental health nurse practitioner that she is<br>three months pregnant. She has been stable on fluoxetine (Prozac) for the last two years. The<br>patient asks whether she may safely continue this medication during her pregnancy. The nurse<br>practitioner responds: \u2714\u2714&#8221;Let&#8217;s review the risks and benefits of continuing or discontinuing<br>Prozac for you and your baby.&#8221;<br>Established clinical guidelines suggest that suicidality is decreased by treating patients who have<br>borderline personality disorder with: \u2714\u2714dialectical behavioral therapy.<br>A six-year-old patient with autistic spectrum disorder has not responded to six months of<br>psychosocial interventions and continues to demonstrate aggressive tendencies toward a younger<br>sibling. The psychiatric-mental health nurse practitioner prescribes: \u2714\u2714risperidone (Risperdal)<br>0.25 mg once a day.<br>The psychiatric-mental health nurse practitioner working in a crisis stabilization unit evaluates a<br>patient verbalizing suicidal thoughts after being sexually assaulted. Before processing through the<br>traumatic event, the nurse practitioner first attempts to \u2714\u2714provide an environment of safety.<\/p>\n\n\n\n<p>ANCC Review Questions (PMHNP IQ)<br>Already Passed<br>What direct-acting dopamine receptor agonist is recommended to be used in the treatments of<br>neuroleptic malignant syndrome (NMS) fo help lower the dopamine blockade? \u2714\u2714Bromocriptine<br>(Parlodel) is the recommended direct acting dopamine receptor agonist to help decrease the<br>dopamine blockade. Danrolene (Dantrium) is a muscle relaxant. Benzotropine (Cogentin) and<br>Trihexyphenidyl (Artane) are anticholinergic medications used for extrapyramidal side effects<br>(EPS).<br>Mr. Smith is a 56 year old white male who has been successfully treated on Selegiline for over 4<br>years. Mr. Smith is going in for elective surgical procedure. Which medication is strictly<br>contraindicated with Selegiline? \u2714\u2714Meperidine is strictly prohibited when a patient is treated on<br>a monoamine oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.<br>A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which of the<br>following actions? \u2714\u2714Institute twice-weekly complete blood count with differentials and monitor<br>closely.<br>The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or<br>granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised immune system. At<br>a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week<br>while patient may continue clozapine in the absence of any other signs or symptoms.<br>A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts.<br>The PMHNP should consider which antipsychotic medication that is the only antipsychotic to<br>reduce the risk of suicide in schizophrenia? \u2714\u2714Clozaril (clozapine) is the only known<br>antipsychotic medication that had been shown to reduce the risk of suicide in patients diagnosed<br>with schizophrenia.<\/p>\n\n\n\n<p>A patient being treated for major depressive disorder and on sertraline (Zoloft), 150 mg po daily<br>for the past 16 years, presents to the psychiatric mental health practitioner for an outpatient followup visit. During the visit she states that she has not been feeling well, reporting the flu. She also<br>states she has not taken her medication in the last five days. Which of the following symptoms<br>would she be describing if you suspect selective serotonin reputable inhibitors (SSRIs)<br>discontinuation syndrome? \u2714\u2714A) Agitation; nausea, dysphoria, and disequilibrium<br>The patient has SSRI discontinuation syndrome and would be presenting with flu-like symptoms.<br>If the patient had serotonin syndrome, she would present with symptoms of autonomic instability.<br>Which of the following statements reflect the current understanding of dopamine (DA) pathways<br>and clinical symptoms in schizophrenia? \u2714\u2714A) Negative symptoms are related to DA deficit in<br>the cerebral cortex; positive symptoms are related to DA excess in the nucleus accumbens and<br>mesolimbic system.<br>Negative symptoms &amp; cognitive impairment are thought to be related to hypoactivity of the<br>mesocortical dopiminergic tract, which by its association with the prefrontal cortex and neocortex<br>contributes to motivation, planning, sequencing of behaviors in time, attention, and social<br>behavior. Positive symptoms (hallucination and delusions) are thought to be caused by dopamine<br>hyperactivity in the mesolimbic tract, which regulates emotion. This hyperactivity could result in<br>overactive modulation of nueurotransmission from the nucleus accumbens.<br>Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety. What area of the<br>brain has a large majority of norepinephrine neurons? \u2714\u2714Locus coeruleus<br>There are two areas in the brain that produce norepinephrine neurons, one is the locus coeruleus<br>and the other is the medullary reticular formation.<br>Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an individual is treated<br>on clozapine? \u2714\u2714A) 1A2<\/p>\n\n\n\n<p>Practice Questions and Answers PMHNP<br>Latest Updated 2022<br>what term describes a scientific study that gathers multiple studies and analyzes them to draw a<br>larger conclusion? \u2714\u2714systematic review<br>borderline personality disorder falls under which cluster of personality disorder traits? \u2714\u2714B<br>a 36 year old caucasian male arrives for his usual monthly medication appointment. diagnosed<br>with schizophrenia &amp; has been stabilized on haldol for 9 years. today he states he has an inner<br>feeling of restlessness &amp; inability to remain still. what type of E.P.S is suspected? \u2714\u2714akathisia<br>which part of medicare provides optional coverage for beneficiaries? \u2714\u2714part c<br>the cerebrum contains all of the following areas of the brain except one. cerebral cortex, brainstem,<br>limbic system, or hypothalamus \u2714\u2714brainstem<br>in a family systems context, what is the definition of morphogenesis? \u2714\u2714a family&#8217;s tendency to<br>adapt to change when changes are necessary.<br>how does the body remove both serotonin and norepinephrine from the synaptic cleft? \u2714\u2714an<br>active re-uptake process<br>a 53 year old menopausal woman presents with complaints of anhedonia, depressed mood, &amp;<br>vasomotor symptoms. what medication effectively treats both vasomotor symptoms and<br>depression? \u2714\u2714desvenlafaxine\/pristiq<br>it is an S.N.R.I.<br>which personality disorder is most likely to have fantasies of success? \u2714\u2714narcissistic<\/p>\n\n\n\n<p>who should receive a shingles vaccine? \u2714\u2714anyone over the age of 60 who has had chickenpox<br>some states use the umbrella term advanced practice nurse to refer to all of the following except<br>which one? nurse anesthetists, certified nurse midwife, mid-level providers, or nurse practitioners<br>\u2714\u2714mid-level providers<br>eating disorders are characterized by what? \u2714\u2714disordered patterns of eating, accompanied by<br>distress, disparagement, preoccupation, &amp; a distorted perception of one&#8217;s body shape<br>the federal government offered financial awards to encourage hospitals to implement meaningful<br>use. the financial awards are tied to specific objectives related to the effective use of electronic<br>health records. give 3 examples of this. \u2714\u27141. electronic prescribing<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>electronic medication interaction checks<\/li>\n\n\n\n<li>computerized provider order entry<br>for an act to be considered criminal, it must have 2 components: actus reus &amp; mens rea. what is<br>actus reus? \u2714\u2714voluntary conduct<br>which complementary &amp; alternative medicine technique is based on manipulating the flow of<br>energy throughout the body? \u2714\u2714acupuncture<br>who authored the report crossing the quality chasm, which emphasized the need for inter<br>professional collaboration in order to improve the quality of health care? \u2714\u2714institute of medicine<br>is a durable power of attorney limited to terminal illness only? \u2714\u2714no<br>what term describes a system where the insurer is not only the payer but also the provider of care?<br>\u2714\u2714managed care<\/li>\n<\/ol>\n\n\n\n<p>what term best describes a public agency that uses its bargaining power to negotiate competitive<br>prices for health insurance from the private insurance market? \u2714\u2714health alliance<br>freud would argue that adults who use &#8216;biting&#8217; sarcasm as a defense mechanism are fixated in which<br>psychosexual stage of development? \u2714\u2714oral<br>what term is used to describe patients who injure themselves by self-mutilation but who do not<br>wish to die? \u2714\u2714parasuicide<br>what most accurately describes an individual with avoidant personality disorder? \u2714\u2714these patients<br>are timid and easily wounded by criticism from others<br>what are 3 reasons for homelessness? \u2714\u2714mental illness, poverty, &amp; inadequate public assistance<br>what is the primary goal of the AMA&#8217;s scope of practice partnership initiative? \u2714\u2714to limit patients&#8217;<br>choice of which health care provider they can see for treatment<br>as a nurse practitioner you are expected to be competent in what areas? \u2714\u2714policy, practice inquiry,<br>and technology and information literacy<br>what term describes a digital version of a patient&#8217;s medical file? \u2714\u2714electronic health record<br>what term describes the death rate for a given population? \u2714\u2714mortality rate<br>what action takes place during the working phase of a therapeutic relationship? \u2714\u2714clarifying<br>patient expectations and mutually identifying goals<\/p>\n\n\n\n<p>PMHNP ANCC Exam Questions and<br>Answers Already Graded A+<br>Descriptive Vividness \u2714\u2714The researcher describes the data gathering process in sufficient detail<br>that the reader can personally experience it. The data collected, often in the form of personal<br>statements, should be quoted directly and extensively, because this is the raw data from the study.<br>Methodological Congruence \u2714\u2714The researcher presents the philosophical and methodological<br>approach used and cites references to support their approach. The subjects, sampling method, datagathering and data-analysis strategies, and processes for informed consent are clearly and<br>concisely described.<br>Theoretical Conectedness \u2714\u2714Any theory developed from the study is clearly stated, logically<br>consistent, reflective of the data, and in accord with other available knowledge.<br>Analytical Precision \u2714\u2714Is not concerned with statistics and instruments. If refers to the decisionmaking process by which the researchers synthesize concrete data (words of the subjects) into an<br>abstract that clarifies the meaning and the importance of the study. The last of the 5 criteria is<br>Heuristic Relevance &#8211; The researcher clarifies the significance of the study, its applicability to<br>public health or community nursing, and its likely influence o the future research.<br>Phenelzine \u2714\u2714An MAOI that patients with atypical depression respond particularly well to.<br>Atomoxetine \u2714\u2714A norepinephrine reuptake inhibitor approved for the treatment of ADHD.<br>Loxapine \u2714\u2714A typical, tetracyclic antipsychotic with antidepressant properties. Its active<br>metabolite is amoxapine, which is a secondary amine tricyclic antidepressant.<\/p>\n\n\n\n<p>HITECH \u2714\u2714Implementation of EHR for information exchanges and improving population health.<br>This was done by Obama and the ARRA.<br>Suppression \u2714\u2714The intentional or conscious exclusion of painful or disturbing thoughts or<br>emotions from awareness.<br>A healthy defense mechanism because the client channels conflicting energies into growthpromoting activities.<br>Medications that can induce depression \u2714\u2714beta blockers, steroids, interferon, Accutane,<br>benzodiazepines, progesterone, some antivirals, and antineoplasmics.<br>Medications that can induce mania \u2714\u2714Steroids, Isoniazid, antidepressants (in people who already<br>have bipolar disorder), and Antabuse.<br>Medigap Insurance Policies \u2714\u2714Private insurance policies purchased by elderly individuals to<br>cover some or all of their medical expenses not paid for by Medicare.<br>Medicare Advantage Plan \u2714\u2714Formerly Medicare + Choice, this created regional Preferred<br>Provider Organizations (PPOs) and gave Medicare enrollees the option of enrolling in private<br>insurance plans.<br>Medicare + Choice \u2714\u2714Was a part of the Balanced Budget Act of 1997 that significantly increase<br>the number of managed care insurance plans available to recipients. This was replaced with the<br>Medicare Advantage Plan in 200.<br>List of the Second Generation (atypical) Antipsychotics (9) \u2714\u2714Clozaril (clozapine), Zyprexa<br>(olanzapine), Latuda (lurasidone), ziprasidone, Risperdal (risperidone), Invega Sustenna<br>(palperidone), Fanapt (iloperidone), Seroquel (quetiapine), Saphris (asenapine),<\/p>\n\n\n\n<p>List of First Generation (typical) Antipsychotics (10) \u2714\u2714Haldol (haloperidol), Prolixin<br>(fluphenazine), Navane (thiothixene), Thorazine (chlorpromazine), Loxitane (loxapine), Mellaril<br>(thioridazine), Trilafon (perphenazine), Orap (pimozide), Solian amisulpride), Stellazine<br>(trifluoperazine)<br>List the 6 common benzodiazepines in order from shortest to longest half-life \u2714\u2714Xanax<br>(alprazolam): 6-10 hrs<br>Serax (oxazepam): 8 hrs<br>Ativan (lorazepam): 12-18 hrs<br>Klonopin (clonazepam): 30-40 hrs<br>Valium (diazepam): 100 hrs<br>Librium (chlordiazepoxide): 36-200 hrs<br>List of SNRIs (6) \u2714\u2714Cymbalta (duloxetine), Pristiq (desvenlafaxine), Effexor (venlafaxine),<br>Fetzima (levomilnacipran), Savella (milnacipran), Strattera (atomoxetine)<br>Action of Tricyclic Antidepressants (TCAs) \u2714\u2714They target serotonin, norepinephrine, and<br>histamine-1 receptors<br>List the Tricyclic Antidepressants (9) \u2714\u2714Pamelor (nortriptyline), Elavil (amitriptyline),<br>amoxapine (no branded), Anafranil (clomipramine), Norpramin (desipramine), Tofranil<br>(imipramine), Vivactil (protriptyline), Sinequan\/Silenor (doxepin), Surmontil (trimipramine)<br>FINISH acronym for SSRI withdrawal \u2714\u2714Flu-like symptoms<br>Irritability<br>Nausea<br>Imbalance\/instability\/incoordination\/dizzy (motor)<br>Sensory disturbances<br>Headache, hyperarousal (anxiety\/agitation)<\/p>\n\n\n\n<p>ANCC Certification PMHNP Chapter 7<br>Questions and Answers Rated A+<br>Mood Disorders \u2714\u2714Most common psych illnesses<br>Primary characteristic is persistent disturbance in mood \u2714\u2714Major Depressive Disorder<br>Often occurs without precipitating event \u2714\u2714MDD<br>Object loss theory \u2714\u2714Fairbairn, Winnicott &amp; guntrip<br>Aggression turned inward theory of MDD \u2714\u2714Freud<br>Cognitive Theory \u2714\u2714Beck<br>Learned Helplessness-Hopelessness Theory \u2714\u2714Seligman<br>Genetic predisposition \u2714\u2714Strong genetic load for depression for child of depressed parent -having<br>3 fold increase in lifetime risk of MDD &amp; 40% chance of depressive episode before age 18.<br>Endocrine dysfunction Theory \u2714\u2714Probably related to etiology of MDD<br>Sleep disturbances, appetite disturbances, libido disturbances, lethargy, anhedonia are<br>neurovegitative symptoms that are related to functions of the \u2714\u2714Hypothalamus and pituitary<br>gland secretions<br>Endocrine dysfunction and pregnancy \u2714\u2714A high incidence of postpartum mood disturbances is<br>suggested with this<\/p>\n\n\n\n<p>Hypothalamic-pituitary-adrenal axis (HPA) \u2714\u2714A theory of MDD, may be a result of an abnormal<br>stress response related to dysregulation of this system<br>HPA axis \u2714\u2714Controls the physiological response to stress and is composed of interconnective<br>feedback pathways between the hypothalamus, pituitary gland, and adrenal gland.<br>Hypothalamus releases \u2714\u2714corticotropin-releasing hormone (CRH)<br>Adrenocorticotropin hormone (ACTH) \u2714\u2714Released by pituitary in response to CRH by<br>hypothalamus<br>Cortisol \u2714\u2714Released by adrenal glands in response to ACTH by pituitary gland<br>Hyperactivity of the HPA axis \u2714\u2714Demonstrated to be present in individuals with MDD. May also<br>have elevated cortisol levels<br>Elevated cortisol levels \u2714\u2714Over time damages the CNS by altering neurotransmission and<br>electrical signal conduction. Cortisol over time can cause changes in size and function of brain<br>tissue<br>Dexamethasone suppression test (DST) \u2714\u2714Not commonly used in clinical practice for screening<br>of depression as it is too non specific.<br>Hypovolemic hippocampus and hypovolemic prefrontal cortex-limbic striatal regions<br>\u2714\u2714Abnormalities demonstrated by neuroimaging in individuals with chronic and severe<br>depression<br>Brain damage, including that from stroke and trauma \u2714\u2714Depression is a acommon comorbidity<br>in individuals who have experienced these events<\/p>\n\n\n\n<p>PMHNP Exam Reported Questions<br>images, PMHNP 2022\/2023 Graded A+<br>DBT (dialectical behavior therapy) \u2714\u2714relaxation muscle prior to DBT<br>Greatest patient at risk for Violence \u2714\u2714Substance abuse<br>EMDR (eye movement desensitization and reprocessing) \u2714\u2714eye movement desensitization and<br>reprocessing<br>What is dissemination? \u2714\u2714Getting the research information out to those who need to know it!<br>Publication &#8211; highest level<br>Presenting at National Conference<br>Presenting at Local Conference<br>Journal Club where one person reviews an article<br>What does a 17 on MMSE mean? \u2714\u2714Moderate cognitive impairment<br>What is Tegretol in the CYP450 system? \u2714\u2714Inducer &#8211;&gt;will lower dose of Lamictal and BCP&#8217;s<br>What do BCP&#8217;s do to Lamictal? \u2714\u2714Inducer &#8211; will lower dose of Lamictal<br>What is a Type I research error? \u2714\u2714There IS a difference but you say there isn&#8217;t a difference.<br>What is a Type II research error? \u2714\u2714There is NO difference but you say there is a difference.<br>What is pseudo-dementia? \u2714\u2714Cognitive impairment secondary to depression that clears when<br>treated in the elderly. Dementia won&#8217;t improve.<\/p>\n\n\n\n<p>Is it normal for a 1 month old to have a palmar grasp? \u2714\u2714Yes.<br>What is a drug 1\/2 life? \u2714\u2714The time it takes for 50% of a drug to be eliminated from the body.<br>What 3 atypicals can be used with teens? \u2714\u2714Zyprexa, Abilify, Seroquel &#8211; low doses<br>What is a risk of using Tramadol? \u2714\u2714Serotonin Syndrome as it is very serotonergic.<br>What is the allele seen in Asians that increase the risk of SJS? \u2714\u2714HLAB-1502<br>When might you see toxic epidermal necrolysis? \u2714\u2714With worsening of SJS<br>How many generations do you include for a genogram? \u2714\u27141st degree &#8211; mother, father, siblings<br>2nd degree &#8211; grandparents &amp; cousins<br>3rd degree &#8211;<br>What does messenger RNA code for? \u2714\u2714Amino Acids<br>What is epigenetics? \u2714\u2714Factors that affect genes &#8211; environmental, smoking, stress, etc\u2026<br>What part of the brain is involved with OCD? \u2714\u2714Basal Ganglia<br>Occipito-Frontal<br>What happens to the brain during adolescence? \u2714\u2714Dendritic pruning<br>Emotions are controlled by amygdala<br>By adulthood, PFC involved as well<br>When do males typically present with schizophrenia? \u2714\u271410-25 yo<\/p>\n\n\n\n<p>When do females typically present with schizophrenia? \u2714\u271425-35 yo<br>What does Erythromycin to trileptal? \u2714\u2714You will need to decreases the level because<br>Trileptal(inducer) and erythromycin is a inhibitor<br>ACE Inhibitors are the drug of choice for what? \u2714\u2714Heart Failure<br>HTN<br>What are some psychiatric side effects seen with some asthma drugs \u2714\u2714Leukotriene receptor<br>agonists &#8211; singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression,<br>insomnia, SI, tremor<br>What should you watch for with Tegretol? \u2714\u2714Agranulocytosis and Hyponatremia<br>What are the 3 CK muscle enzyme tests? \u2714\u2714CKBB, CKMM, CKMB<br>Which one of the 3 muscle enzymes are related to cardiac muscle damage? \u2714\u2714CKMB<br>What is the risk of a seriously elevated CKMB? \u2714\u2714Polymyositis<br>Rhabdo<br>What is a normal CKMB? \u2714\u27140.3 mcg\/L<br>What psychoactives does Detrol interact with? \u2714\u2714Topamax<br>KCL<br>Zonegran<\/p>\n\n\n\n<p>What CN are you assessing when you have the patient shrug their shoulders? \u2714\u2714CN XI &#8211; Spinal<br>Accessory<br>What do you see in labs with HIV &amp; Dementia? \u2714\u2714CD4 &lt;200<br>Viral Load is high<br>&lt;20% get it with antiretroviral treatment<br>What is the scoring with the Beck Depression Inventory? \u2714\u2714Self-Report &#8211; 0-63<br>0-13 &#8211; minimal<br>14-19 &#8211; mild<br>20-28 &#8211; moderate<br>29-63 &#8211; severe<br>What is sensitivity? \u2714\u2714Helps rule-out disease = True Positive = Snout<br>What is specificity? \u2714\u2714Helps rule-in disease = True Negative = Spin<br>What does a sed rate measure? \u2714\u2714Inflammation (ESR &#8211; Erythrocyte Sedimentation Rate) =<br>distance in mm RBC&#8217;s have descended in 1 hour.<br>What is a normal sed rate or ESR? \u2714\u27140-22 males<br>0-29 females<br>What is a retic count? \u2714\u2714Measures % of reticulocytes in blood (immature RBC&#8217;s) Indicates<br>whether enough RBC&#8217;s are being produced by bone marrow.<br>What does a decreased retic count indicate? \u2714\u2714Anemia &#8211; acute or chronic bleeding<br>What does an increased retic count indicate? \u2714\u2714Bone marrow disorder or Vitamin Deficiency<\/p>\n\n\n\n<p>ANCC Review Questions (PMHNP IQ)<br>Latest 2022\/2023 Already Graded A<br>What direct-acting dopamine receptor agonist is recommended to be used in the treatments of<br>neuroleptic malignant syndrome (NMS) fo help lower the dopamine blockade?<br>A) benzotropine (Cogentin)<br>B) bromocriptine (Parlodel)<br>C) dantrolene (Dantrium)<br>D) trihexyphenidyl (Artane) \u2714\u2714A) Bromocriptine (Parlodel) is the recommended direct acting<br>dopamine receptor agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a<br>muscle relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are anticholinergic<br>medications used for extrapyramidal side effects (EPS).<br>Mr. Smith is a 56 year old white male who has been successfully treated on Selegiline for over 4<br>years. Mr. Smith is going in for elective surgical procedure. Which medication is strictly<br>contraindicated with Selegiline?<br>A) Non-steroidal anti-inflammatory drugs (NSAIDS)<br>B) Codeine<br>C) Morphine<br>D) Meperidine \u2714\u2714D) Meperidine is strictly prohibited when a patient is treated on a monoamine<br>oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.<br>A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which of the<br>following actions?<br>A) Consult with hematologist to determine appropriate antibiotic regimen and monitor closely.<br>B) Institute twice-weekly complete blood count with differentials and monitor closely.<br>C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor closely.<\/p>\n\n\n\n<p>D) Institute daily complete blood count with differentials and monitor closely. \u2714\u2714B) Institute<br>twice-weekly complete blood count with differentials and monitor closely.<br>The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or<br>granulocytes of 1,000 to 1,500 for agranulocytosis and severely compromised immune system. At<br>a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week<br>while patient may continue clozapine in the absence of any other signs or symptoms.<br>A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts.<br>The PMHNP should consider which antipsychotic medication that is the only antipsychotic to<br>reduce the risk of suicide in schizophrenia?<br>A) Abilify (aripriprazole)<br>B) Latuda (lurasidone)<br>C) Invega (iloperidone)<br>D) Clozaril (clozapine) \u2714\u2714D) Clozaril (clozapine) is the only known antipsychotic medication<br>that had been shown to reduce the risk of suicide in patients diagnosed with schizophrenia.<br>A patient being treated for major depressive disorder and on sertraline (Zoloft), 150 mg po daily<br>for the past 16 years, presents to the psychiatric mental health practitioner for an outpatient followup visit. During the visit she states that she has not been feeling well, reporting the flu. She also<br>states she has not taken her medication in the last five days. Which of the following symptoms<br>would she be describing if you suspect selective serotonin reputable inhibitors (SSRIs)<br>discontinuation syndrome?<br>A) Agitation, nausea, dysphoria, and diequilibrium<br>B) Agitation, nausea, tremor, and ataxia.<br>C) Restlessness, tremor, fever, and shivering.<br>D) Restlessness, headache, increased heart rate, and diarrhea. \u2714\u2714A) Agitation; nausea, dysphoria,<br>and disequilibrium<\/p>\n\n\n\n<p>PMHNP Study\/practice questions and<br>answers 100% pass<br>Which of the following statements does not reflect current understanding of neurotransmitter<br>pathways implicated in anxiery disorders?<br>A. Increase levels of CRF in amygdala, hippocampus and LC increase symptoms of anxiety.<br>B. Decreaseing GABA in the Mesolimbic cortex diminishes symptoms of anxiery.<br>C. Increasing serotoneric activity in the amygdala diminishes symptoms of anxiety.<br>D. Decreasing NE in the LC diminishes symptoms of anxiety. \u2714\u2714A, C &amp; D are all correct so the<br>answer is B<br>As a PMHNP, you know anti-psychotic meds have side effects. Which side effects of antipsychotic<br>meds has an insidious delayed-onself of 1-2 after starting the medication? \u2714\u2714A. Dry Mouth<br>B. Tardive Dyskinesia<br>C. Wt gain<br>D. Sedation<br>We know that Dry mouth, drowsiness, dizziness, restlessness, wt gain, constipation &amp; N\/V are all<br>SE but, Tardive Dyskinesia does not start for 1-2 years.<br>My answer &#8211; B. <em>Tardive Dyskinesia (TD<\/em>)<br>** long standing blockage of DA2 in nigrostriatal pathway leads to TD<br>Which Serotonin receptor antagonism makes an antipsychotic &#8220;atypical&#8221;?<br>A. 5HT1A<br>B. 5HT3A<br>C. 5HT4A<br>D. 5HT2A \u2714\u2714Atypical antipsychotic drugs such as clozapine, olanzapine, quetiapine, risperidone,<br>sertindole, and ziprasidone are potent 5-HT2a receptor antagonists and relatively weaker dopamine<br>D2 antagonists.<br>Commonly Prescribed Typical and Atypical Antipsychotic Medications<br>Typical antipsychotics include:<\/p>\n\n\n\n<p>Haldol (haloperidol); Loxitane (loxapine);<br>Mellaril (thioridazine); Geodon (ziprasidone)<br>Moban (molindone); Seroquel (quetiapine)<br>Navane (thiothixene); Zyprexa (olanzapine)<br>Prolixin (fluphenazine); Serentil (mesoridazine)<br>Stelazine (trifluoperazine); Trilafon (perphenazine)<br>Thorazine (chlorpromazine)<br>Atypical antipsychotics include:<br>Abilify (aripiprazole); Clozaril (clozapine)<br>Geodon (ziprasidone); Seroquel (quetiapine)<br>Zyprexa (olanzapine)<br>Which medication inhibits both dopamine and norepinephrine?<br>A. Venlafaxine (effexor)<br>B. Duloxetine (Cymbalta)<br>C. Buproprion (Wellbutrin)<br>D. Imipramine (Tofranil) \u2714\u2714C. Buproprion (Wellbutrin)<br>Bupropion inhibits the presynaptic reuptake of both dopamine (DA) and noradrenaline (NA),<br>leading to increased levels of both of these neurotransmitters in the synaptic cleft<br>Current understanding of Dopamine (DA) pathways &amp; clinical symptoms in schizophrenia is<br>reflected in which statement?<br>A. Neg symptoms are related to DA deficit in meslimbic system and pos (+) symptoms are related<br>to DA excess in the (SN) substanita nigra &amp; (VTA) ventral tegmental area.<br>B. (-) symptoms are related to DA excess in the CC cerebral cortex; + symptoms are related to DA<br>in the (NA) nucleus accumbens and mesolimbic system<br>C. (-) related to DA in (MS) mesolimbic system; + are related to DA deficit in the SN and VTA<br>D. (-) related to DA deficit in the CC; (+) related to DA excess in the NA &amp; MS \u2714\u2714ANS. D?<\/p>\n\n\n\n<p>PMHNP Comprehensive Questions and<br>Answers Latest Update Already Passed<br>AIMS \u2714\u2714Abnormal Involuntary Movement Scale for 8 and older<br>12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics<br>Rating 0-4, &gt;2 to diagnose TD and reduce dose<br>BARS \u2714\u2714Barnes Akathisia Rating Scale for 8 and older<br>4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and\/or<br>SSRIs<br>CRS-R \u2714\u2714Connors Rating Scales &#8211; Revised for 3-17<br>ADHD Parent (80 items) and Teacher Scales (59 items)<br>Low T-score of 61= mildly atypical; &gt;70 = markedly atypical<br>Subscales for Oppositional Behaviors, Cognitive Problems, Hyperactivity, ADHD Index,<br>Anxious-Shy, Perfectionism, Social Problems, DSM-IV Subscales and Connors&#8217; Global Index<br>Vanderbilt ADHD Parent and Teacher \u2714\u271455 parent, 43 teacher items for 6-12<br>Initial assessment rates symptoms and impairment in academic and behavioral performance<br>ASRS-1 \u2714\u2714Adult ADHD Self-Report Scale, 16 and older<br>Two-part Screening<br>Part A: 6 questions, 4 symptoms suggest ADHD<br>Part B: 12 questions to clarify and quantify<br>AUDIT-C \u2714\u2714Alcohol Use Disorders Identification Test &#8211; Consumption, &gt; 13<br>Documents use and frequency in prior year<br>0-4, F &gt;3 = positive, M &gt;4 = positive, &gt;8 = hazardous drinking<\/p>\n\n\n\n<p>CAGE-AID \u2714\u2714IDs problem drinking or druging, 13 and older<br>(C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs<br>CRAFFT \u2714\u27146-item screen for alcohol or drugs in adolescents, 14-18<br>(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)<br>BAI \u2714\u2714Beck Anxiety Inventory, 17 and older<br>Assesses 21 symptoms of anxiety, 0-36 scores<br>HAM-A \u2714\u2714Hamilton Anxiety Scale, most commonly used<br>14 domains, 14=mild, 18-24= moderate, 25-30=severe<br>LSAS-CA \u2714\u2714Liebowitz Social Anxiety Scale-Child\/Adolescent Version, 7 and older<br>24 items, social and performance<br>55-65=moderate social phobia, 65-80=marked, 80-95=severe, &gt;95=very severe<br>MMSE \u2714\u2714Mini Mental Status Exam<br>30 items, 24-30= no cognitive impairment; 18-23=mild cognitive impairment; 0-17= severe<br>cognitive impairment<br>MOCA \u2714\u2714Montreal Cognitive Assessment<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>26=normal, add point for &lt;12th grade education<br>SPMSQ \u2714\u2714Short Portable Mental Status Questionnaire<br>10 items, more than 3 incorrect indicates dementia<br>BDI-2 \u2714\u2714Beck Depression inventory, 13 and older<br>presence and impact of depressive symptoms<br>21 items, &lt;10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe<\/p>\n<\/blockquote>\n\n\n\n<p>CCSD \u2714\u2714Cornell Scale for Depression in Dementia<br>19 items, &lt;6=no significant depression; 8-17=probable major depression; &gt;18=definite depression<br>MDQ \u2714\u2714Mood Disorder Questionnaire<br>Screen for mania or hypomania<br>positive if 7 or more of 13 items in question #1 present and #2 is yes and #3 gets moderate or<br>serious problem response<br>YMRS \u2714\u2714Young Mania Rating Scale, 11 items (adult)<br>Range 0-60; adults with 12 or more=mania<br>CY-BOCS \u2714\u2714\u2026<br>YBOCS \u2714\u2714Yale-Brown Obsessive Compulsive Scale<br>10 items; age 14 and older<br>gold standard for OC symptoms<br>score indicates level of severity<br>BPRS \u2714\u2714Brief Psychiatric Rating Scale, 18 and older<br>Assesses psychopathology (+, &#8211; and affective) with schizophrenia, not for screening or DX<br>PANSS \u2714\u2714Positive and Negative Syndrome Scale, 18 and older<br>measures changes in symptom intensity in psychosis and schizophrenia<br>Gold standard in studies of treatment efficacy<br>SPS \u2714\u2714Suicide Probability Scale, 13 and older<br>Rapid measure of suicide risk<br>higher score indicates greater risk<br>CIWA-Ar \u2714\u2714Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised<\/p>\n\n\n\n<p>9 item symptom rating scale, max score 67; &lt;10 does not warrant intervention COWS \u2714\u2714Clinical Opiate Withdrawal Scale Quantifies severity of withdrawal syndrome, guides dosing, monitors over time Used for induction of Suboxone 5-12=mild; 13-24= moderate; 25-36=mod to severe; &gt;36=severe<br>T4, FREE THYROXINE \u2714\u27140.8-2.8<br>Increased In Graves<br>Decreased In Hypothyroidism<br>TSH \u2714\u27142- 10 mu\/l<br>Normal values can range from 0.4 &#8211; 4.0 mIU\/L (milli-international units per liter),<br>Calcium, Ca++ \u2714\u27148.8-10.5<br>&lt;7.0, tetany<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p>11.0, hyperparathyroidism<br>13.5, hypercalcemic coma, metastatic cancer<br>Sodium, Na+ \u2714\u2714135-148 mEq\/L<br>hypernatremia \u2714\u2714dehydration<br>hypovolemia<br>diabetes insipidus<br>eating too much salt<br>gastroenteritis<br>drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds<br>hyponatremia \u2714\u2714drugs such as lithium, vasopressin, diuretics<br>addisons<\/p>\n\n\n\n<p>PMHNP Exam Prep Questions and<br>Answers Rated A+<br>Conrad, a 26-year-old male, is being treated for cuts after being arrested for breaking the<br>windows in the home of his girlfriend, who has just told him that they are through. He has a<br>history of having been physically abused by his father, setting fires as a child, treatment for<br>substance abuse, and arrest for stealing a car. Which of the following personality disorders<br>might the clinician consider?<br>Question 1 options:a)<br>Narcissistic<br>b)<br>Paranoid<br>c)<br>Antisocial<br>d)<br>Histrionic \u2714\u2714Antisocial<br>In a biopsychosocial case formulation, social contributions would be considered to be:<br>a)<br>Genetic influences and adverse circumstances of birth<br>b)<\/p>\n\n\n\n<p>Substance use and medical disorders<br>c)<br>Cognitive deficits and dysregulation of emotions<br>d)<br>Religious\/cultural factors and living situations \u2714\u2714Religious\/cultural factors and living situations<br>Which of the following criteria would preclude the use of brief dynamic therapy?<br>a)<br>Adequate ego strengths<br>b)<br>Psychological problems in multiple domains<br>c)<br>Use of mature defense mechanisms<br>d)<br>Adequate ability to process information \u2714\u2714Use of mature defense mechanisms<br>In treatment of the acute phase of mania, the focus is on:a)<br>Protecting the patient&#8217;s biopsychosocial safety<\/p>\n\n\n\n<p>b)<br>Educating the patient about social rhythms theory<br>c)<br>Interventions that address impairment of vocational functioning<br>d)<br>Interventions for self-management of finance \u2714\u2714Protecting the patient&#8217;s biopsychosocial safety<br>During an initial assessment, the relevant features of communication are its ability to:<br>a)<br>Promote a therapeutic alliance and increase understanding.<br>b)<br>Prompt a disclosure of past successes and failures.<br>c)<br>Bring about changes in behavior.<br>d)<br>Educate the patient about what is important to disclose. \u2714\u2714<br>Symptoms of anxiety and panic are associated with a low level of which neurotransmitter?<\/p>\n\n\n\n<p>a)<br>Cortisol<br>b)<br>Dopamine<br>c)<br>Gamma-aminobutyric acid<br>d)<br>Glutamate \u2714\u2714Gamma-aminobutyric acid<br>Which class of antidepressants has the most anticholinergic side effects?<br>a)<br>Monoamine oxidase inhibitors (MAOIs)<br>b)<br>Selective serotonin reuptake inhibitors (SSRIs)<br>c)<br>Tricyclic antidepressants (TCAs)<br>d)<br>Serotonin norepinephrine reuptake inhibitors (SNRIs) \u2714\u2714Tricyclic antidepressants (TCAs)<\/p>\n\n\n\n<p>ANCC PMHNP Psych-Mental Health<br>NP_Test 1 Questions and Answers Rated<br>A+<br>Your patient, whose wife died a few months ago, appears to be very unkempt and apathetic.<br>Although several months have passed since his wife&#8217;s death he has not progressed at all through<br>his grieving. You assess this condition as which of the following?<br>disenfranchised grief<br>panic disorder<br>complicated grief<br>physiologic grief \u2714\u2714Correct Answer:<br>complicated grief<br>A person has uncomplicated grief when he or she has normal physical, psychological, cognitive<br>and spiritual responses to the death of a significant other. But when the person shows persistent<br>maladaptive behaviors such as not taking care of personal hygiene and\/or appearance and does not<br>progress through the mourning process, this is complicated grief.<br>If a patient has had a myocardial infarction, which of the following atypical antidepressants should<br>not be prescribed within the recovery phase?<br>Trazodone<br>Duloxetine<br>Bupropion<br>Desvenlafaxine \u2714\u2714Correct Answer:<br>Trazodone<br>If a patient has had a myocardial infarction, during the recovery phase, the patient should not be<br>prescribed this medication. Trazodone (Desyrel) can cause the patient to develop orthostatic<br>hypotension and priapism.<\/p>\n\n\n\n<p>To get your teaching ideas and concepts across to a poor reader which of the following would be<br>most appropriate?<br>Use longer sentences.<br>Use abstract concepts.<br>Discourage questioning.<br>Use examples and review. \u2714\u2714Correct Answer:<br>Use examples and review.<br>To get the idea across to a poor reader use examples and review. The other choices are not helpful.<br>You should use short sentences and easy to read layouts; be concrete rather than abstract; and teach<br>them how to ask questions about their health. Also, tell context first and use visual, use common<br>words and examples, and explain meaning.<br>A 21-year old woman presents with complaints of milky discharge from her breasts. She doesn&#8217;t<br>have any other symptoms and is not pregnant, nor has been before. She tells the nurse about each<br>medication that she takes. Which of these drugs may be implicated as the cause of the symptom?<br>aspirin<br>Lamotrigine<br>Risperidone<br>sertraline \u2714\u2714Correct Answer:<br>Risperidone<br>Risperidone can cause the greatest prolactin elevation among atypical psychotics. A milky white<br>discharge known as galactorrhea could be a sign of an underlying condition. The fact that the<br>woman takes Risperidone, an atypical antipsychotic, would likely point to the cause and should be<br>switched with one less likely to have that same side effect.<br>Which of the following would be considered one of the main things that is responsible for about<br>2\/3 of psychiatric hospital readmissions?<br>Not sufficient care.<\/p>\n\n\n\n<p>Medication noncompliance<br>Biophysical assessments<br>None of the above \u2714\u2714Correct Answer:<br>Medication noncompliance<br>Medication noncompliance is a major problem with the psychiatric mental health patients. The<br>home health nurses assists by helping the patients<br>to see the relationship between their compliance with their medication regimen and control of their<br>symptoms.<br>Which of the following would be considered an important form of communication that can help to<br>promote consistency in the care of the patient at the<br>same time that it justifies their stay in the hospital?<br>Review of care.<br>Documentation<br>Verbal reporting<br>None of the above \u2714\u2714Correct Answer:<br>Documentation<br>The other 3 options above are incorrect.<br>One of the most important aspects of nursing is documentation. Documentation can promote<br>consistency in the care of the patient and is also used to help justify the patient remaining in the<br>hospital.<br>Effects of an overdose of LSD (Lysergic acid diethylamide) can include all of the following<br>except?<br>Vomiting<br>Respiratory failure<br>Hypertensive crisis<br>Seizures \u2714\u2714Correct Answer:<br>Hypertensive crisis<\/p>\n\n\n\n<p>Hypertensive crisis would be considered a symptom of PCP overdose. Vomiting, respiratory<br>failure and seizures would be considered an effect<br>of LSD overdose.<br>Symptoms of serotonin syndrome include all of the following EXCEPT:<br>insomnia<br>nausea<br>loss of coordination<br>sweating or shivering with goose bumps \u2714\u2714Correct Answer:<br>nausea<br>Symptoms of serotonin syndrome can present in patients that have drug combinations that are<br>contraindicated. They can vary from restlessness and agitation to tremors, chills, headaches, and<br>insomnia as well as loss of coordination. Nausea has not been implicated in serotonin syndrome.<br>What is the rate of suicide attempts for patients having dissociative identity disorder?<br>30%<br>45%<br>70%<br>60% \u2714\u2714Correct Answer:<br>70%<br>People with dissociative identity disorder have one of the highest risks for suicide. According to<br>the Diagnostic and Statistical Manual of Mental Disorders (DSM-5),more than 70% of outpatients<br>with DID have attempted suicide, and multiple suicide attempts are common.<br>Of the following, which would not be considered a phase of schizophrenia treatment?<br>Maintenance<br>Acute<br>Cognitive<\/p>\n<\/blockquote>\n\n\n\n<p>Clinical PMHNP Exam 1 study questions<br>with complete solutions<br>Which theory of depression was developed based on observing that patients who were being<br>treated for Hep C developed depressive symptoms?<br>A. The monoamine theory<br>B. The inflammation theory<br>C. The HPA axis theory<br>D. The stress-diathesis theory \u2714\u2714b. The inflammation theory<br>Which of the following health conditions have a high co-morbidity with depression?<br>A. Hypertension<br>B. Asthma<br>C. Diabetes mellitus<br>D. Cardiovascular disease<br>E. Celiac disease<br>F. Cognitive impairment<br>G. Obesity<br>H. Cancer \u2714\u2714A. Hypertension<br>C. Diabetes Mellitus<br>D. Cardiovascular disease<br>F. Cognitive impairment<br>G. Obesity<br>H. Cancer<br>In the Cutler video on depression, he highlights that there are 200 different ways to meet the<br>diagnostic criteria for depression.<br>A. True<br>B. False \u2714\u2714A. True<\/p>\n\n\n\n<p>You have diagnosed a 53-year-old male with moderate MDD and he has declined psychotherapy<br>but has agreed to pharmacotherapy. He has diagnoses of Type 2 D.M. with a BMI of 32.1. Which<br>of the following antidepressants would provide a dual benefit for this patient?<br>A. Sertraline<br>B. Fluoxetine<br>C. Duloxetine<br>D. Mirtazapine \u2714\u2714C. Duloxetine<br>Your patient was started on fluoxetine and after ten weeks of treatment his PhQ 9 score is 9. What<br>is your assessment of the efficacy of treatment based on this score?<br>A. The patient is in remission<br>B. The response is adequate but not in remission<br>C. The response is possibly inadequate<br>D. The response is inadequate \u2714\u2714B. The response is adequate but not in remission<br>In the Star*D trial what percentage of patients treated for depression failed to respond to initial<br>pharmacotherapy?<br>A. 20%<br>B. 30%<br>C. 40%<br>D. 50% \u2714\u2714D. 50%<br>In the Star D trial for patients that achieved remission what percentage relapsed after 4.4 months?<br>A. 25%<br>B. 33%<br>C. 42%<br>D. 53% \u2714\u2714B. 33%<br>When should adjunctive therapy be considered in treating MDD? (select all that apply)<br>A. Already tried 3 or &gt; antidepressants<\/p>\n\n\n\n<p>B. Initial antidepressant well tolerated<br>C. Partial response (>50% improvement)<br>D. Specific residual symptoms or side effects that can be targeted<br>E. Severity of depression, more functional impairment<br>F. Patient preference \u2714\u2714B. Initial antidepressant well tolerated<br>D. Specific residual symptoms or side effects that can be targeted<br>E. Severity of depression, more functional impairment<br>F. Patient preference<br>Rates of remission increased with each additional change in therapy, especially when switching.<br>A. True<br>B. False \u2714\u2714B. False<br>You have diagnosed your patient with Major Depressive Disorder and after six weeks of being<br>treated with fluoxetine 20 mg there is no treatment response. According to the VA\/DoD Guidelines<br>for treatment of MDD what is the next step?<br>A. Switch to another monotherapy either an antidepressant or psychotherapy.<br>B. Switch to a different antidepressant<br>C. Augment with a second antidepressant<br>D. Augment with a second medication or psychotherapy<br>A. A, C<br>B. B<br>C. C<br>D. A, D \u2714\u2714D. A,D<br>Your patient has experienced her first episode of MDD and is in remission. How long should the<br>antidepressant be continued after remission has been achieved to reduce the risk of relapse?<br>A. 2 months<br>B. 4 months<br>C. 6 months<br>D. One year \u2714\u2714C. 6 months<\/p>\n\n\n\n<p>PMHNP I &#8211; Exam 1 &#8211; Review Book<br>Questions and Answers with Verified<br>Solutions<br>The purpose of the ANA&#8217;s PMH Nsg: Scope and Standards of Practice is to:<br>a. Define the role and actions for the NP<br>b. Establish the legal authority for the prescription of psychotropic medications<br>c. Define the legal statutes of the role of the PMHNP<br>d. Define the differences between the physician role and the NP role \u2714\u2714a. Define the role and<br>actions for the NP<br>The trend in legal rulings on cases involving mental illness over the past 25 years has been to:<br>A &#8211; Encourage juries to find defendants not guilty by reason of insanity<br>B &#8211; Protect the individual&#8217;s freedoms or rights when he or she is committed to a mental hospital<br>C &#8211; Place increasing trust in mental health professionals to make good and ethical decisions<br>D &#8211; Decrease the &#8220;red tape&#8221; associated with commitments so that commitments are faster and easier<br>\u2714\u2714B. Identifies the trend of ensuring the protection of individual civil liberties for psychiatric<br>clients.<br>Mr Smithers, an involuntarily hospitalized patient experiencing psychotic symptoms, refuses to<br>take any of his ordered medication because he believes &#8220;Jesus Christ told me I am the prophet and<br>must fast for a year.&#8221; Your actions should be based on your knowledge that:<br>A &#8211; Psych clients cannot refuse treatment<br>B &#8211; Psych clients don&#8217;t always know what&#8217;s good for them<br>C &#8211; Psych clients can refuse treatment<br>D &#8211; Psych clients cannot be trusted to make good healthcare decisions and, therefore, the nurse&#8217;s<br>best clinical judgment should guide actions \u2714\u2714C. As with any client, psych clients can refuse<br>treatment unless a legal process resulting in a mandatory court order for treatment has been<br>obtained.<\/p>\n\n\n\n<p>Which of the following statements best reflects the difference between the nurse-client (N-C)<br>relationship and a social relationship? In the N-C relationship\u2026<br>A &#8211; the primary focus is on the client and his needs.<br>B &#8211; goals are deliberately left vague and unspoken so that the client can work on any issue.<br>C &#8211; the nurse is solely responsible for making the relationship work.<br>D &#8211; there is no place for social interaction. \u2714\u2714A &#8211; the primary focus is on the client and his needs.<br>Social relationships are mutual interpersonal relationships in which the needs of both parties are<br>addressed. The N-C relationship is most concerned with meeting the needs of the client.<br>In forming a therapeutic relationship with clients, the PMHNP must consider developing many<br>characteristics that are known to be helpful in relationship-building. These characteristics include<br>all of the following EXCEPT:<br>A &#8211; genuineness<br>B &#8211; acceptance<br>C &#8211; authenticity<br>D &#8211; accuracy in assessment \u2714\u2714D &#8211; accuracy in assessment<br>Although an important aspect of the PMHNP role, accuracy in assessment does not in and of itself<br>facilitate relationship building<br>In forming a therapeutic relationship with clients, the PMHNP must consider developing many<br>characteristics that are known to be helpful in relationship building. Which of the following is an<br>essential part of building a therapeutic relationship?<br>A. Collecting a family history<br>B. Like-mindedness<br>C. Authenticity<\/p>\n\n\n\n<p>ANCC Exam Prep \u2013 PMHNP Latest 2022<br>FH, family tree, pedigree, genogram \u2714\u2714Tools used in determining likelihood of genetic disorder<br>in family, inheritance patterns, and risk of recurrence in family members<br>U.S. Surgeon General&#8217;s Family History Initiative \u2714\u2714Recommended that families know their<br>family history<br>Autosomal dominant conditions may be present in more than one generation and \u2714\u2714In up to 50%<br>of offspring when one parent is affected (such as Marfan syndrome)<br>Recessive conditions \u2714\u2714Appear only in one generation<br>Affects individuals who have two copies of a faulty gene, one from each (unaffected) parent<br>\u2714\u2714Recessive conditions (ex: CF, hemochromatosis)<br>X-linked disorders are caused by faulty genes on an \u2714\u2714X chromosome (fragile X syndrome, color<br>blindness)<br>Communication process used whenever there is a genetic risk and often involves offering a test<br>that could provide info about the genetic status of the person\/implications for the family<br>\u2714\u2714Genetic counseling<br>Primary role is to offer info and support to persons concerned a out an illness that may have a<br>genetic basis \u2714\u2714Genetic Counselor<br>There are a total of \u2714\u271446 chromosomes, in 23 pairs<br>Chromosomes \u2714\u2714Structures of DNA<\/p>\n\n\n\n<p>PMHNP BOARDS QUESTIONS AND<br>ANSWERS RATED A<br>State legislative statues do what two things \u2714\u27141. grant legal authority for NP practice<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>Provides nurse practice act specific to state<br>What does the Nurse Practice Act do \u2714\u27141. provides title protection<\/li>\n\n\n\n<li>defines advanced practice<\/li>\n\n\n\n<li>prevailing state laws that define scope of practice<\/li>\n\n\n\n<li>places restriction on practice<\/li>\n\n\n\n<li>disciplinary action<\/li>\n\n\n\n<li>regulate NP development of collaborative agreement with MD<\/li>\n\n\n\n<li>guides statutory law<\/li>\n\n\n\n<li>oversees license<\/li>\n\n\n\n<li>credentialing<\/li>\n\n\n\n<li>certification<br>11 defines scope of practice<\/li>\n\n\n\n<li>defines standards of practice<br>what are state grounds for disciplinary action \u2714\u2714- practicing with out licesne<\/li>\n<\/ol>\n\n\n\n<ul class=\"wp-block-list\">\n<li>falsification of records<\/li>\n\n\n\n<li>medicare fraud<\/li>\n\n\n\n<li>failure to use appropriate nursing judgement<br>-failure to follow accepted nursing standards<\/li>\n\n\n\n<li>failure to complete accurate nursing documentation<br>what is a collaborative aggrement \u2714\u2714also known as a protocol that describes whaty types of durgs<br>might be prescribed and difines some form of oversight for NP practice<\/li>\n<\/ul>\n\n\n\n<p>what is statutory law \u2714\u2714-rules and regulations difer for each state<br>-may further define scope of practice and practice requirements<br>-may provide restrictions in practice unique to specific state<br>what is licensure \u2714\u2714- a process by which an agency of state gov. grants permission to persons to<br>engate in the practice of that profession<br>-also progibits all others from legally doing protectedpractice<br>what is credentialing \u2714\u2714process used to protect the public y ensureing a minimum level of<br>professional competence<br>What is certification? \u2714\u2714-a credential that provides title protection<br>-determines scope of practice<br>-the process by which a professional organization or association certifies that a person licensed to<br>practic as a professional has met certain predetermed standsrds specified by that profession for<br>specialty practice<br>-assuuers the public that a person has mastery of specified body of knowledge<br>-assures that the person has acquired the skils necessary to function in a particular specialty<br>define scope of practice \u2714\u2714-defines the NP roles and actions<br>-identifies the competencies assumed to be held by all nps who function in a particluar role<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">-varies broadly from state to state<\/h2>\n\n\n\n<p>what are standards of practice. \u2714\u2714authoritative statements regarding the quality and type of<br>practice that should be provided<br>-provide a way to judge the nature of care provided<br>-reflect professional agreement focused on the minimum levels of acceptable performance<br>-reflect the expectation for the care that should be provided to clients with vaious illnesses<br>-can be used to legally describe the standard of care that must be met by a provider<\/p>\n\n\n\n<p>-may be precise protocols thta must be followed o more general guidelines that recommend<br>actions.<br>what is confidentiality \u2714\u2714-the clients right to assume that information given to the healthcare<br>provider will not be discoled<br>-protected under federal statute through the medical record confidentiality act of 1995<br>-pretains to verbal and written client information<br>-requires that the provider discuss confidentiality issues with clients establish consent and clarify<br>andy questions about disclosure of information<br>-requires that provider obtain a signed medical authorization and consent form to reease medical<br>records and information when requested by the client o another healthcare provider<br>What is HIPPA \u2714\u2714-the first nathional comprehensive rivacy protection act<br>-guarantees clients four fundamental rights to:<br>-to be educated about HIPAA privacy protection<br>-to have access to their own medi al records,<br>-to request amendment of their health inforamtion to which they object<br>-to require their permission for disclosure of their prsonal information<br>What is the HITECH Act? \u2714\u2714incentive payments for sharing specific electronic health record<br>data<br>meaningful use incentives<br>electronic heal reconds can improve both individual and population based health outcomes<br>electronic health records can improve quality safety efficiency effectiveness and outcome<br>what does HITECH include \u2714\u2714e-prescribing<br>computerized physican order set<br>tracking care and avoiding uplication of services<\/p>\n\n\n\n<p>PMHNP board exam nonpharmacological treatment questions<br>and answers graded A<br>Most common issues for individual therapy \u2714\u27141. losses<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"2\">\n<li>interpersonal conflicts<\/li>\n\n\n\n<li>symptomatic presentations such as panic<br>phobias, and negativity<\/li>\n\n\n\n<li>Unfulfilled expectations at life transitions<\/li>\n\n\n\n<li>Characterological issues such as narcissim<br>or aggressiveness<br>Psychoanalytic therapy \u2714\u27141. Originated by Freud<\/li>\n\n\n\n<li>believed that behavior is determined by<br>unconsious motivations and instincual drives .<\/li>\n\n\n\n<li>promotes change by the development of<br>greater insight and awareness of maladaptive<br>defenses<\/li>\n\n\n\n<li>attends to past developmental and<br>psychodynamic factors which shape present<br>behaviors.<br>Cognitive Therapy \u2714\u27141. Originated by Beck<\/li>\n\n\n\n<li>Purports that external events do not cause<br>anxiety or maladaptive responses<\/li>\n\n\n\n<li>States that a persons expectations, perceptions,<br>and interpretations of events cause anxiety<\/li>\n\n\n\n<li>allows clients to view relaity more clearly<br>through an examination of their central distorted<\/li>\n<\/ol>\n\n\n\n<p>cognitions<\/p>\n\n\n\n<ol class=\"wp-block-list\" start=\"5\">\n<li>Goal is to change clients irrational beliefs, faulty<br>conceptions and negative cognitive disortions<br>Behavioral Therapy \u2714\u2714Originated by Lazarus<br>Focuses on changing maladaptive behaviors by participating in active behavioral techniques such<br>as exposure, relaxation, problem-solving, and role playing<br>Dialectical behavioral therapy \u2714\u2714Originated by linehan<br>commonly used with people with borderline personality disorder<br>focuses on emotional regulation, tolerance for distress, self-management skills, interpersonal<br>effectiveness, and mindfulness, with an emphasis on treating therapy-interfering bheaviours<br>Goals of dialectical behavioral therapy \u2714\u2714Decrease suicidal behaviors<br>decrease therapy interfering behaviors<br>decrease emotional reactivity<br>decrease sel-invalidation<br>decrease crisis-generalting behaviors<br>decrease passivity<br>increase realistic decision making<br>increase accurate communication of emotions and competencies<\/li>\n\n\n\n<li><\/li>\n<\/ol>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>PMHNP Certification Exam Questionsand Answers Already PassedTarasoff Principle \u2714\u27141976 &#8211; duty to warn victims of potential harm from clientDeontological Theory \u2714\u2714Ethical theory that states an action is judged as good or bad based onthe act itself regardless of the consequencesTeleological Theory \u2714\u2714Ethical theory that states an action is judged as good or bad based on [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-117057","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117057","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=117057"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/117057\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=117057"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=117057"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=117057"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}