PMHNP Actual Exam Solved 100

PMHNP Actual Exam / Solved 100% Autosomal Dominant - ANSWER Genetic inheritance, is more rare (i.e. Huntington's disease), is present in more than one generation.Autosomal Recessive - ANSWER Expressed in one generation, inherited from unaffected parent, is more common.CAGE Questionnaire - ANSWER For substance abuse, Cut, Annoyed, Guilty, Eye opener Suicidal Risk Assessment - ANSWER SLAP: Social support, Lethality, Access to means, Plan and previous attempts, & family history Suicidal Risk Assessment #2

ISPATHWARM - ANSWER ISPATHWARM: Ideation, Substance abuse, Purpose for

living, Anxiety/agitation, Trapped feeling, Hopelessness, Withdrawing from friends, Anger with rage, Reckless in behaviors, Mood changes Depression Assessment

SIGECAPS - ANSWER SIGECAPS: Sleep, Interest, Guilt, Energy, Concentration,

Appetite, Psychomotor retardation, Suicidality Mania Assessment DIGFAST - ANSWER DIGFAST: Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity increase, Sleep deficit, Talkativeness Mental Status Exam Components (All Borderline Subjects Are Tough Troubled Characters) - ANSWER Appearance, Behavior, Speech, Affect, Thought Process, Thought Content, Cognitive Examination Hamilton Depression Rating (HDRS) for very severe depression - ANSWER more than 23 Hamilton Depression Rating (HDRS) for severe depression - ANSWER 19-23 Hamilton Depression Rating (HDRS) for moderate depression - ANSWER 14-18 Hamilton Depression Rating (HDRS) for mild depression - ANSWER 8-13 Hamilton Depression Rating (HDRS) for no depression - ANSWER 0-7 Hamilton Anxiety Rating for moderate to severe anxiety - ANSWER 25-30 Hamilton Anxiety Rating for mild to moderate anxiety - ANSWER 18-24 A+

Hamilton Anxiety Rating mild anxiety - ANSWER <17 General screening labs - ANSWER CBC, Chem, Thyroid, Hepatic, b12, folate, drug levels Lithium labs - ANSWER evaluate thyroid function, check creatinine clearance regularly Depakote labs - ANSWER check hepatic function Olfactory Nerve (On) - ANSWER CN I: Sensory: (test by smell- coffee, tea, non astringent smells) Optic Nerve (Old) - ANSWER CN II: Sensory- visual acuity test (confrontation method to assess visual fields) Oculomotor (Olympus) - ANSWER CN III: Motor- eye movement (follow penlight through six fields of gaze, test OD, OS individually) Trochlear Nerve

(Towering) - ANSWER CN IV: Motor- eye movement (superior oblique-same test as

oculomotor) Trigeminal Nerve

(Tops) - ANSWER CN V: Both- superficial and deep structures of head and face,

mastification/corneal reflex (test by show teeth) Abducens Nerve

(A) - ANSWER CN VI: Motor- specific eye movements (test same as oculomotor)

Facial Nerve (Fin) - ANSWER CN VII: Both- taste of anterior 2/3 of tongue, sensation in ear canal, facial movement (use salt/sugar for taste, evaluate corneal reflex, raise eyebrows, keep eyes closed, and resist attempt to open, puff cheeks) Acoustic Nerve (And) - ANSWER CN VIII: Sensory- Hearing/tickling watch and whisper (tuning fork with Rinne- positive as normal, when air conduction persists twice as long as bone conduction) Glossopharyngeal Nerve

(German) - ANSWER CN IX: Both- Swallow, taste of posterior 1/3 of tongue, pain,

touch, and temp of mucosa and pharynx (check for deviation of uvula to unaffected side) A+

Vagus Nerve

(Viewed) - ANSWER CN X: Both- Elevation of the uvula (swallow, have patient say

aaah and check uvula elevation, gag reflex, and ability to swallow water) Accessory Nerve

(A) - ANSWER CN XI: Motor- Innervates trapezius and sternocleidomastoid (shrug

shoulders against resistance, turn head against hand on cheek) Hypoglossal (Hop) - ANSWER CN XII: Motor- motor of the tongue (push tongue against the inside of cheek, stick out tongue and check for fasciculation) Lithium therapeutic levels (acute mania) - ANSWER 0.6-1.2 mEq/L Lithium therapeutic levels (maintenance) - ANSWER 0.8-1.0 mEq/L Lithium adverse effect level - ANSWER > 2 mEq/L >2.5 mEq/L = seizure, death Valproic acid therapeutic levels - ANSWER 50-120 ug/ml Sensitivity - ANSWER true positives (the degree to which those who have a disease screen positive) Specificity - ANSWER true negatives (the degree to which those who not have a disease test negative) Incidence - ANSWER frequency with which a disease appears in a population given the rate in which new cases occur during a specific time period Prevalence - ANSWER proportion of a population that is affected by a disease at a particular time Major cause of death for adolescents - ANSWER motor vehicle accident, suicide, accidents, homicide, malignancy, cv or congenital disease Major cause of death for young adults - ANSWER Motor vehicle accidents, homicide, suicide, injuries, heart disease, AIDS Major cause of death for middle age adult - ANSWER Heart disease, accidents, lung cancer, CVA, breast and colorectal cancer, COPD Major cause of death for elderly adults - ANSWER Heart disease, CVA, COPD, pneumonia and influenza Primary prevention - ANSWER measures to promote health prior to onset of problems (teaching) A+

Secondary prevention - ANSWER focuses on early identification and treatment of existing problems (screening) Tertiary prevention - ANSWER rehabilitation and restoration of health Diagnosis of diabetes - ANSWER fasting BG > 126 on 2 separate occasions random BG of >200 with s/s of diabetes oral glucose tolerance test >200 Total cholesterol recommendations - ANSWER <200 LDL recommendation - ANSWER <100, <70 goal HDL recommendation - ANSWER >40 men >50 women Triglycerides recommendation - ANSWER <150 Mitral stenosis - ANSWER loud first heart sound (s1) murmur, low pitched, mid diastolic, apical crescendo rumble Mitral regurgitation - ANSWER third heart sound (S3) with systolic murmur at 5th intercostal space midclavicular line (apex), may radiate to base or left axilla, musical, blowing, or high pitched Aortic stenosis - ANSWER systolic, "blowing", rough harsh murmur at second right ICS usually radiating to the neck Aortic regurgitation - ANSWER diastolic, "blowing" murmur at second left ICS S1 - ANSWER mitral/tricuspid (AV) valves closure S2 - ANSWER aortic/pulmonic (semilunar) valves closure systole - ANSWER period between S1 and S2 diastole - ANSWER period between S2 and S1 S3 - ANSWER "Kentucky", increased fluid states (CHF, pregnancy) S4 - ANSWER "Tennesse", stiff ventricular wall (MI, left ventricular hypertrophy, chronic hypertension) HIV window period - ANSWER immune system responding to viral presence in serum but virus hidden in lymphatic system A+