ANCC PMHNP Certification Exam Review: Questions and Answers, Exams of Nursing

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ANCC PMHNP Cert Exam Review Questions & Answers.

How do you assess cranial nerve V trigeminal? - Correct Answer Tell patient to close eyes, take piece of cotton or other soft item and lightly touch either one of both sides of each of the three divisions of the trigeminal. How do you assess for cranial nerve VII facial? - Correct Answer Observe the patient for nystagmus or twitching of the eye. This nerve controls facial movements and expression, check for symmetry. Have the patient wrinkle forehead, close eyes, smile, pucker lips, show teeth, and puff out cheeks. primitive reflexes - Correct Answer reflexes, controlled by "primitive" parts of the brain, that disappear during the first year of life Mororeflex - Correct Answer Extending of limbs when they hear a loud noise (defend themselves) rooting reflex - Correct Answer a baby's tendency, when touched on the cheek, to turn toward the touch, open the mouth, and search for the nipple palmer grasp - Correct Answer grasping with the whole hand scope of practice - Correct Answer The range of clinical procedures and activities that are allowed by law for a profession Quality Improvement (QI) - Correct Answer an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others and inform health care policy PDSA model - Correct Answer Plan-Do-Study-Act Model from the Institute for Healthcare Improvement (IHI) Trendelenburg sign - Correct Answer Occurs with severe subluxation of one hip When the child stands on the good leg, the pelvis looks level. When the child stands on the affected leg the pelvis drops toward the good side CYP450 inhibitors - Correct Answer Fluvoxamine

Fluoxetine Paroxetine Duloxetine Sertraline CYP450 inducers - Correct Answer Carbamazepine Phenobarbital Phenytoin Rifampin Griseofulvin St John's Wort What is the adverse effect of Depakote on the liver? - Correct Answer can cause liver damage, and the risk is more likely to occur during the first 6 months of taking the medication. Signs might include nausea or vomiting, loss of appetite, abdominal pain, dark-colored urine, facial swelling, and yellowing of the skin or white of eyes What would you do for a patient on Depakote with +4 protein in the urine? - Correct Answer Rule out UTI, no adjustment for medication is needed What happens when you take carbamazepine (tegertal) and erythromycin together? - Correct Answer It will decrease the effect of the antibiotic by inhibition What happens when you take zyprexa and smoke? - Correct Answer nicotine will increase the excretion of the drug thereby inhibiting it's effect ICP in Infants S/S - Correct Answer Bulging fontanels, high-pitch cry, irritability, restlessness ICP CHILDREN signs and symptoms - Correct Answer • Headache

• Vomiting (usually projectile)
• Seizures
• Diplopia (Dbl vision), blurred vision Neuro cry - Correct Answer high-pitched and very grating on the ears due to their neurological sxs being overwhelmed

mesocortical pathway - Correct Answer a path through which dopaminergic projections travel to reach the neocortex mescolimbic pathway - Correct Answer The mesolimbic pathway, sometimes referred to as the reward pathway, is a dopaminergic pathway in the brain. The pathway connects the ventral tegmental area in the midbrain, to the ventral striatum of the basal ganglia in the forebrain. The ventral striatum includes the nucleus accumbens and the olfactory tubercle. Nigrostriatal pathway - Correct Answer the dopaminergic tract from the substantia nigra to the striatum Tuberoinfundibular pathway - Correct Answer from hypothalamus to anterior pituitary - > DA released from these neurons inhibit prolactin secretion - > when DA receptors here are blocked prolactin levels rise cause galactorrhea) primary prevention - Correct Answer Efforts to prevent an injury or illness from ever occurring. secondary prevention - Correct Answer Efforts to limit the effects of an injury or illness that you cannot completely prevent, screening exams. tertiary prevention - Correct Answer actions taken to contain damage once a disease or disability has progressed beyond its early stages menopause hormone therapy - Correct Answer most effective therapy for moderate - severe vasomotor symptoms - use quality of life scales to identify degree of vasomotor symptom severity *should not be used for protection against CVD or dementia congestive heart failure and depression - Correct Answer MDD is highly prevalent in these patients Thyroid levels while on lithium - Correct Answer Because of the high incidence of thyroid dysfunction that occurs during lithium treatment, patients should have a careful thyroid physical examination and determination of serum thyroid-stimulating hormone (TSH) and antithyroid peroxidase antibody titers before lithium treatment is begun. Patients with

normal thyroid function initially should be reevaluated every 6 to 12 months for several years, and thyroid dysfunction should be treated if diagnosed. The development of thyroid dysfunction does not typically require discontinuation of lithium. If thyroid function is abnormal at the initial evaluation, lithium can still be given if necessary, but the thyroid dysfunction should be treated. SSRIs MOA - Correct Answer block reuptake of serotonin by inhibiting the presynaptic reuptake SNRIs mechanism - Correct Answer Inhibit 5 - HT and norepinephrine reuptake. Lithium mechanism of action - Correct Answer Not established, possibly related to inhibition of phosphoinosital cascade It inhibits excitatory neurotransmitters such as dopamine and glutamate, and promotes GABA-mediated neurotransmission. Carbamazepine mechanism - Correct Answer Block voltage-dependent sodium channels Structural Therapy - Correct Answer A therapeutic approach directed at changing or realigning the organization of a family to modify dysfunctional patterns and clarify boundaries. Developed by Salvador Minuchin. crisis intervention - Correct Answer five-step problem-solving technique to promote adaptation and improve future coping Irvin Yalom - Correct Answer A leading figure in contemporary group therapy, especially the interpersonal approach group therapy - Correct Answer therapy conducted with groups rather than individuals, permitting therapeutic benefits from group interaction boderline personality disorder - Correct Answer impulsive actions, often with the potential for self-harm as well as mood instability and chaotic relationships DBT (dialectical behavior therapy) - Correct Answer a form of therapy used to treat borderline personality disorder that combines elements of the behavioral and cognitive treatments with a mindfulness approach based on Eastern meditative practices eating disorder treatment - Correct Answer - correct dangerous eating patterns

18 - 24 mild to moderate anxiety GAD- 7 - Correct Answer 1 - 4 minimal anxiety 5 - 9 Mild anxiety 10 - 14 Moderate anxiety 15 - 21 Severe anxiety Zung Self-Rating Depression Scale - Correct Answer 50 - 69 indicates depression 70 (+) severe depression MoCA - Correct Answer 26 - 30 normal 22.1 mild impairment 16.2 Alzheimer's Disease MMSE - Correct Answer 24 - 30 normal 23 - 20 mild 19 - 10 middle-moderate Alzheimer's 9 - 0 Late stage-severe Alzheimer's Dementia - Correct Answer a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes delirium - Correct Answer an acutely disturbed state of mind that occurs in fever, intoxication, and other disorders and is characterized by restlessness, illusions, and incoherence of thought and speech. Pediatric SSRIs - Correct Answer fluoxetine (ages 8 and up) escitalopram (ages 12 and up) Pediatric OCD FDA medications - Correct Answer clomipramine (anafranil) 10 years and up fluoxetine (prozac) 8 years and up fluvoxamine (luvox) 8 years and up

sertraline (zoloft) 6 years and up galactorrhea - Correct Answer abnormal flow of milk from the breasts Dopamine - Correct Answer a neurotransmitter that regulates motor behavior, motivation, pleasure, and emotional arousal Serotonin - Correct Answer A neurotransmitter that affects hunger,sleep, arousal, and mood. GABA - Correct Answer An inhibitory neurotransmitter in the brain. Glutamate - Correct Answer A major excitatory neurotransmitter; involved in memory Acetylcholine - Correct Answer A neurotransmitter that enables learning and memory and also triggers muscle contraction Crisis training is proven to be effective in helping to deescalate situations to prevent the officer from using what? - Correct Answer Lethal force Signs of child abuse - Correct Answer Head injuries;bruises and welts in the shapes of objects;Burns;human bites;rope burn;fractures in different stages of healing AIDS dementia complex (ADC) - Correct Answer Encephalitis, behavioral changes, decline in cognitive function Progressive slowing of motor functions Apoptosis - Correct Answer process of programmed cell death Recovery (training principle) - Correct Answer Holistic, person-centered approach to mental health care. Two premises: 1) It is possible to recover from a mental health condition; 2) The most effective recovery is patient-directed neuron death - Correct Answer the stage of early nervous system development during which large numbers of neurons die, typically those that have not established effective synaptic contacts

• Cognitive Therapy
• Exposure Therapy Zyprexa (olanzapine) - Correct Answer monitor for metabolic syndrome Risperidone (Risperdal) - Correct Answer monitor for prolactin level increases gastric emptying drugs - Correct Answer Metoclopramide, Erythromycin, Domperidone, Cisapride oversupply linked to schizophrenia. undersupply linked to tremors and decreased mobility in Parkinson's disease - Correct Answer Dopamine With Alzheimer's disease, ACh-producing neurons deteriorate. - Correct Answer Acetylcholine undersupply of serotonin - Correct Answer linked to depression Undersupply of norepinephrine. - Correct Answer can depress mood undersupply of GABA - Correct Answer linked to seizures, tremors, and insomnia