Ancc-pmhnp-exam-reported-questions-qbank-answered-all-correctly-answered.pdf, Exams of English Language

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PMHNP Exam Reported Questions

What is dissemination? -

Getting the research information out to those who need to know it!

Publication - highest level

Presenting at National Conference

Presenting at Local Conference

Journal Club where one person reviews an article

What does a 17 on MMSE mean? -

Moderate cognitive impairment

What is Tegretol in the CYP450 system? -

Inducer -->will lower dose of Lamictal and BCP's

What do BCP's do to Lamictal? -

Inducer - will lower dose of Lamictal

What is a Type I research error? -

There IS a difference but you say there isn't a difference.

What is a Type II research error? -

There is NO difference but you say there is a difference.

What is pseudo-dementia? -

Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve.

Is it normal for a 1 month old to have a palmar grasp? -

Yes.

What is a drug 1/2 life? -

The time it takes for 50% of a drug to be eliminated from the body.

What 3 atypicals can be used with teens? -

Zyprexa, Abilify, Seroquel - low doses

What is a risk of using Tramadol? -

Serotonin Syndrome as it is very serotonergic.

What is the allele seen in Asians that increase the risk of SJS? -

HLAB-

When might you see toxic epidermal necrolysis? -

With worsening of SJS

How many generations do you include for a genogram? -

1st degree - mother, father, siblings

2nd degree - grandparents & cousins

3rd degree -

What does messenger RNA code for? -

Amino Acids

What is epigenetics? -

Factors that affect genes - environmental, smoking, stress, etc...

What part of the brain is involved with OCD? -

Basal Ganglia

Occipito-Frontal

What is the risk of a seriously elevated CKMB? -

Polymyositis

Rhabdo

What is a normal CKMB? -

0.3 mcg/L

What psychoactives does Detrol interact with? -

Topamax

KCL

Zonegran

What CN are you assessing when you have the patient shrug their shoulders? -

CN XI - Spinal Accessory

What do you see in labs with HIV & Dementia? -

CD4 <

Viral Load is high

<20% get it with antiretroviral treatment

What is the scoring with the Beck Depression Inventory? -

Self-Report - 0-

0-13 - minimal

14-19 - mild

20-28 - moderate

29-63 - severe

What is sensitivity? -

Helps rule-out disease = True Positive = Snout

What is specificity? -

Helps rule-in disease = True Negative = Spin

What does a sed rate measure? -

Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour.

What is a normal sed rate or ESR? -

0-22 males

0-29 females

What is a retic count? -

Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow.

What does a decreased retic count indicate? -

Anemia - acute or chronic bleeding

What does an increased retic count indicate? -

Bone marrow disorder or Vitamin Deficiency

What does an abnormal retic ount indicate in general? -

Doesn't diagnose anything. First step is ID source of the issue.

What happens when you mix tegretol and macrolides? -

Increase tegretol levels.

What happens if a pregnant women takes Accutane? -

Birth defects.

What labs do you get with RA? -

Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis.

What does it mean when an Asian patient does not make eye contact with the NP? -

SIgn of respect

What is the evil eye? -

When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness.

How do you protect from the evil eye? -

Red ribbon on an infant

Amulet for adults

How do you treat for evil eye? -

Access traditional healer + traditional care.

For there to be a duty to a patient, what must exist? -

Relationship

What is a proximate cause? -

Connection between A + B.

For there to be damages, what must exist first? -

Negligence

What is an occurrence basis liability insurance? -

"occurred" during the policy period, no matter when the claim is brought against the insured

What is a claims made/based liability insurance? -

provides coverage for a claim that is brought within the policy period, no matter when the loss occurred.

Who sets the minimum requirements for NP's? -

Board of Nursing

State

What are the various controlled substance classes? -

Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes.

Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate

Schedule III - Moderate Abuse Potential - hydrocodone, codeine

Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine

Schedule V - Very low abuse potential - anti-tussives, lomotil

What classes of CS's is the NP approved to prescribe? -

Schedules III-V ONLY.

Where does 50% of healthcare funds come from? -

The government

Who is eligible for Medicare? -

65 or under 65 with diability, ANY age with renal disease.

What is incident to billing? -

Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD.

Allows NP to get reimbursed at 100% rather than 85%.

How are Medicaid benefits determined? -

Is it ok to leave a message on a patient's vm? -

Yes, but should be limited.

What is the impact of steroid inhalers on children? -

Slows bone growth and may decrease ultimate height.

What is the long-term impact of using steroid inhalers? -

Cataracts, glaucoma, thinning of bones and skin

What is included in the treatment of fibromyalgia? -

Sleeping meds

Antidepressants

Pain meds

What psychoactives are first line treatment for fibro? -

Cymbalta, Effexor

Elavil, Pamelor

Lyrica, Gabapentin

Ultram, Benzo's

What is the purpose of telepsychiatry? -

Increase the ability to reach rural and underserved areas.

What is the purpose of Motivational Interviewing? -

Explore ambiguity

Maintain passive position

What is required for Medicare submission? -

ICD 10 and narrative or CPT

What is the neurotransmitter problem in Schizophrenia? -

Excess dopamine in mesolimbic pathway.

What is the neurotransmitter problem in ADHD? -

Dopamine, norepinephrine and serotonergic dysfunction

What is the benefit of play therapy? -

Don't have to confront emotions head on.

What neurotransmitters are involved in the bioamine hypothesis of depression? -

Noradrenaline

Serotonin

Dopamine

MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse.

How do you test CN XII? -

Stick out your tongue.

What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? -

CN V - Trigeminal

What are two important things to measure when using Zyprexa? -

Lipid level and abdominal circumference

What is included in the mini-cognitive exam? -

Clock, memory questions from MSE.

What is HIV related dementia often mistaken for, especially at the beginning? -

Depression

Levels increase

What happens with a patient taking Lithium and drinks a lot of water? -

Levels decrease

If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? -

Zyprexa

What happens when taking Lithium and NSAIDS? -

NSAIDS can cause Lithium levels to increase and for the patient to become toxic!

What medications are at risk to cause SJS in the Asian population? -

HLAB-1502 Allele increase risks of SJS.

Trileptal, Tegretol and other AED's.

Amgdyla -

Fear, Anxiety, and Aggression

Neurotransmitter for Addiction -

Dopamine and GABA

Neurotransmitter for Mood Disorder -

Serotonin and norepinephrine

Which drug affects Carbamazepine/tegretol -

Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol

Signs and Symptoms of stimulant abuse -

insomnia and tremor

Depakote check -

HCG levels

Depakote causes -

Spinal bifida

Grasp reflex. -

an infantile reflex in which an infant closes her hand into a fist when her palm is touched

Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age.

Moro reflex. -

The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months.

pincer grasp -

9 months

Uses thumb and index finger (pincer grasp) to pick up small objects like Cheerios.

Pt has MI looses his job stable on psych medications -

Provide brief supportive therapy

Latida and Geodon -

Take with food

Moro reflex absent -

Do xray

Health Care Policy Model -

Access, Cost, Quality

Appetite

psychomotor retardation

Suicide

DIGFAST for mania -

Distractibility

Indiscretion

Grandiosity

Flight of ideas

Activity increase

Sleep deficit

Talking increase

5 year old tells u his brother sodomized him -

Tell mom don't leave him alone with patient and call CPS implement crisis

Just culture -

"Just culture" model: proposed to reconcile the twin needs for no-blame and appropriate accountability

The focus is on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors while maintaining individual accountability by establishing zero tolerance for reckless behavior.

Distinguishes between

Human error (e.g. slips),

At-risk behavior (e.g. taking shortcuts),

Reckless behavior (e.g. ignoring required safety steps).

In a just culture, the response to an error or near-miss is predicated on the type of behavior associated with the error, not the severity of the event.

Child reports Sexual Abuse -

Interview the young child and infants child with parent

First sign of temprofrontal Dementia -

Behavior and personalty changes

Tow amines related to depression -

Serotonin and norepinephrine

Want to start an consulting firm what tool would be needed to show economic viability -

Revenue and expenses

Patient stopped smoking (Cessation) -

Decreased Zyprexia

Promote resilience in schizophrenia for a patient that lives alone and doing well -

Refer to peer support

Spirit stick -

Teach staff about culture competence

Problems in the parietal lobe can lead -

Sensory-perceptual disturbances and agnosia(inability to perceive objects)

R-L confusion

Difficulty writing (agraphia)

Aphasia(difficulty of language)

PDSA cycle -

For Plan-Do-Study-Act.

Describes how to test a change: by trying it, observing the consequences, and then learning from those consequences.

Appreciative Inquiry -

Involve mother of the patient and healer, mom was cleared for you to involve her

16 year old shows up with mother for first therapy is -

confidential mom sits in lobby

Patient acts out due to missing session what do you do -

You relate to childhood abandonment and talk about it with the patient

How do you assess the competency of a medical procedure -

Identify a pen and recall 3 words

Patient thinks someone has infiltrated the church because he watched it on TV 2 years ago, what diagnosis -

Delusional disorder

Increase ICP (signs and symptoms) -

Baby Neuro cry

Menopausal woman -

Hormone therapy and replacement

Patient on antidepressants for 3 weeks and attempted Suicide -

Stop medication immediately

You want to decrease seclusion on your unit who considered the primary change agent -

Unit staff

You are a lead NP over other NPs in a rural setting how would you go about the change -

Make online form and have them vote on it

16 year old refuse treatment -

Send to psych specialist for acting out kids

Positive Trendelenburg Sign -

Refer to Ortho/specialist

Pelvis drops to when patient raises one foot off the floor.

Drug affects Flonase -

Zantac (Histamine 2 Blocker) Antagonist

Little boy wet his sheets, What kind of therapy would you suggest -

Behavior therapy

DDVAP acts in much the same manner as antidiuretic hormone. -

Makes less urine

Lithium level 1.2u what are you concerned with -

4+ Ketones

What does depakote do to Lamictal -

Increase laminate 200%

Inducers of Cytochrome P450 (CYP450) -

Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort

A substance that speeds up a chemical reaction

Inhibitor -

A substance that slows down or stops a chemical reaction

cytochrome p450 inhibitors -

CRACK AMIGOS

Cimetidine