Download ANCC PMHNP Test Bank 200+ Questions With Verified Answers and more Exams Nursing in PDF only on Docsity!
ANCC PMHNP Test Bank 200+ Questions With
Verified Answers
Behavioral management starts....? - correct answer>>Immediately upon admission If a child reports abuse.....? - correct answer>>Interview the child separately from parents Report to CPS Child shows to appointment w/o parents, plays with a toy in a sexual way, or if you suspect child abuse - correct answer>>Report to CPS, even on suspicion alone Where to interview a patient? - correct answer>>Private office with the door open Test taking strategies - correct answer>>Narrow it down to 2 possible choices When 2 choices are opposite, one is usually the answer When answer options are very similar to each other, they are usually not correct Absolutes are usually incorrect Test taking strategies 2 - correct answer>>Assessment before intervention Safety even before assessment Choose the most comprehensive option Safety plan is correct, NOT no harm contract
Tics are....? - correct answer>>Contraindication of a stimulant Before discharge....? - correct answer>>Can a patient stay safe and cope effectively Its important to build rapport with adolescents by.... - correct answer>>Ensuring confidentiality What you can keep confidential for an adolescent patient: - correct answer>>If the patient is attracted to the same gender If the patient is in a relationship with someone of the same age What can cause ethical dilemma with parent and child? - correct answer>>Separating child from parent for interview, but remember that the child is your primary patient and your patient has a right to confidentiality What to do for a patient with bipolar disorder who is not taking medications because they are forgetting? - correct answer>>Behavioral therapy Women may be at risk of suicide when....? - correct answer>>They are discharged home without an OB/GYN completing a risk assessment on them interprofessional collaboration - correct answer>>is encouraged. Delegation: - correct answer>>Try not to delegate
Native Americans: - correct answer>>Believe that mental illness and substance use disorders are caused by an imbalance with the world. Native Americans 2: - correct answer>>Have the highest rate of suicide and suicide attempts Confrontational answers are.... - correct answer>>Usually incorrect When providing psychoeducation to a patient of a specific culture: - correct answer>>The information should be based on cultural context Native Americans 3: - correct answer>>Use a healing stick; do not take the stick away. Make accommodations for patients. When serving a multicultural population: - correct answer>>Provide multicultural teaching; Use ethnospecific assessment parameters Patients want to use a traditional/spiritual healer - correct answer>>Obtain clearance for informed consent first but allow this. MAKE CULTURAL ACCOMMODATIONS! If a patient can't speak English... - correct answer>>Provide an interpreter for culturally sensitive care Susto - correct answer>>Latino Folk illness- a shocking, unpleasant or frightening experience that is believed to cause the soul to leave the body
Apoptosis - correct answer>>Cell death Thyroid problems can cause mood abnormalities - correct answer>>Depressed? Check thyroid. Manic? Check thyroid. Check TSH first and then T3 and T4. Values are: - correct answer>>0.5-5. Hyperthyroidism is a lower score Hypothyroidism is a higher score Hyperthyroidism symptoms - correct answer>>Heat intolerance, agitation, anxiety, irritability, tachycardia, mood swings, weight loss Hypothyroidism symptoms - correct answer>>Cold intolerance, lethargy, weight gain, decreased libido Depakote can cause: - correct answer>>spina bifida hepatoxicity elevated ammonia levels pancreatitis (abdominal pain that radiates to back) Symptoms of liver toxicity related to depakote - correct answer>>Upper right quadrant abdominal pain Reddish brown urine Yellowing of skin and whites of eyes D/C and order LFT
lamotrigine - correct answer>>can cause stevens johnson syndrome (severe rash) mood stabilizer that causes the least weight gain Antipsychotics that cause the least weight gain - correct answer>>ZAL (ziprasidone, aripirazole, lurasidone) Antipsychotics and weight gain - correct answer>>Check BMI, hip-to-waist ratio, glucose, and lipid panel Nonpharmacologic management- exercise and diet pharmacologic- switch to antipsychotic that causes less weight gain. ZAL New patient labs - correct answer>>CMP, lipid panel, A1C Carbamazepine (tegretol) facts - correct answer>>Black box warning for agranulocytosis (decreased WBCs) and aplastic anemia. Can cause stevens johnson syndrome. Screening for asian patients on carbamazepine? - correct answer>>HLA B 1502, increases risk of stevens johnson syndrome in asian patients antiepileptics carbamazepine, topiramate, and phenytoin (dilantin) can make.. - correct answer>>oral birth control less effective carbamazepine and closaril can cause agranulocytosis so you should... - correct answer>>monitor for signs of infection: fever, chills, sore throat, weakness
DC carbamazepine/clozaril at ANC of - correct answer>>ANC less than 1, DC carbamazepine/clozaril at WBC of - correct answer>>2,000-3,000 whether patient shows signs of infection or not closapine/clozaril can cause ---------- and it is the only antipsychotic that can...? - correct answer>>myocarditis and cardiomyopathy It is the only antipsychotic that can reduce risk of suicide in patients with schizophrenia Lithium facts - correct answer>>0.6-1.2 therapeutic range. Over 1.5 can cause toxicity. Gold standard in treating manic episodes. Evidence of anti-suicidal effects. Patient has a family history of Hashimoto Thyroiditis but is stable on lithium...? - correct answer>>Don't change lithium dose, refer patient to endocrinologist Lithium labs - correct answer>>Thyroid panel (TSH) Serum creatinine 0.6-1. BUN 10- 20 Proteinuria 4+ may indicate kidney disease Pregnancy test (HCG) for women of childbearing age 12- 51
Elevated CPK (creatine phosphokinase) from muscle destruction Myogoblinuria (breakdown of muscle, rhabdomyolysis) Elevated WBC and Elevated LFT Fever NMS treatment - correct answer>>Bromocriptine (parlodel) D2 agonist Dantrolene (dantrium) muscle relaxant DC the offending agent Serotonin Syndrome - correct answer>>Caused by antidepressants Hyperreflexia Myoclonic jerks Fever Tachycardia Agitation Confusion/disorientation GI upset When switching from MAOI to fluoxetine....? - correct answer>>Wait 2 weeks St. John's Wort: - correct answer>>Increases serotonin Can impair glucose tolerance/ reduce insulin response
How long to wait after stopping old drug before starting a new drug? - correct answer>>A wash out period of 5 half lives Homicidal ideation is associated with - correct answer>>Antisocial personality disorder SSRI needs time to degenerate; when switching from fluoxetine to MAOI - correct answer>>Wait 5 weeks Children have a reduced placebo rate in studies for efficacy of SSRI: - correct answer>>Black box warning on antidepressants for children, adolescents, young adults. Always assess for SI Depression neurotransmitters - correct answer>>serotonin, norepinephrine, dopamine Brain structures associated with depression - correct answer>>Amygdala is enlarged Hippocampus and thalamus are reduced SSRIs are first line treatment for depression because....: - correct answer>>They are safer in case of an overdose Antidepressants and other drugs that can help with chronic neuropathic pain - correct answer>>SNRI (duloxetine), TCA (amitriptyline, doxepin, imipramine) Alpha 2 delta ligands gabapentin and pregabalin
Schizophrenia neurobiological defects: - correct answer>>Enlarged venetricles Atrophy of cerebral cortex. Smaller frontal and temporal lobes Reduced symmetry in temporal, frontal, occipital lobes Decreased cerebral blood flow. Hippocampal and amygdala reduction Due to abnormalities in various brain structures, schizophrenic patients can display: - correct answer>>Aggression, impulsivity, abstract thinking problems Patients with schizophrenia need __________ training? - correct answer>>Social skills training. This is a tertiary prevention strategy. Also they made need referral to an exercise program to improve quality of life. Calculating Haldol IM dose - correct answer>>Start with 20x oral dose for first month. Do not exceed 100mg IM dose at one time. Break up shots for later in the month if needed. Nonpharmacologic treatment for schizophrenia - correct answer>>Group Therapy Assertive Community Treatment (ACT) - correct answer>>Mental health services are provided in a community health setting, rather than a more restrictive residential or hospital setting for those experiencing severe mental illness.
Schizophreniform - correct answer>>Symptoms last for at least 1 month but less than 6 months. After 6 months the diagnosis can be changed to schizophrenia. Mental status exam components - correct answer>>Thought process: Organized thoughts and ideas Thought content: No SI, HI, A/V hallucinations Clock drawing test (CDT) - correct answer>>Used to screen for neurological problems and dementia. Impairments on the CDT can be associated with damage to the right parietal lobe. Mini- mental status exam (MMSE) - correct answer>>Measures cognitive impairment. Can be used to screen for dementia. Tests: concentration (counting backward by 7), ability to learn new material (name 3 unrelated objects, ask patient to repeat them), recall (3 objects names 5 minutes later), and fund of knowledge (who is president?) MMSE scoring - correct answer>> 25 - 30 Normal 21 - 24 Mild impairment/ possible early stage Alzheimer's 10 - 20 Moderate Alzheimer's 0 - 9 Late stage/ severe Alzheimer's Stereognostic testing - correct answer>>Tests patient's ability to recognize objects by touch alone. Useful for detecting impairment in the parietal lobe. MTHFR gene mutation - correct answer>>Can cause low homocysteine, b (folate) and b
Treatment for EPS - correct answer>>Cogentin (benztropine) Metoclopramide (reglan) can cause - correct answer>>EPS like symptoms Tardive dyskinesia treatment - correct answer>>Lower the dose of antipsychotic or change the drug Ingrezza (valbenazine) or Austedo (deuterbenzene) Steroids can cause - correct answer>>Mania, Depression, Psychosis Bipolar disorder facts: - correct answer>>High degree of heritability There is no single bipolar gene If developing over the age of 45, it is most likely due to a medical condition. Anorexia symptoms - correct answer>>pain after eating/ fullness delayed gastric emptying, can be cause by famotidine or omeprazole Bipolar 1 VS Bipolar 2 - correct answer>> 1 - extreme changes in mood or energy last for one week 2 - symptoms are less intense, lasts for 4 days Lithium can ________ nerve cells from damange in bipolar disorder - correct answer>>protect
Nonpharmacologic treatment for Bipolar disorder - correct answer>>Supportive groups Rapid cycling is______ - correct answer>>4 or more manic or depressive episodes in one year. Bipolar episodes can be triggered by ______ - correct answer>>Family hx of rapid cycling, stressful life events, trauma, drug use, certain medications (antidepressants, steroids, stimulants) Borderline personality disorder hallmarks - correct answer>>Impulsivity, often with self-harming behavior Pattern of intense, unstable relationships Recurrent suicidal behavior Frantic efforts to avoid real or imagined abandonment Nonpharmacological treatment for Borderline Personality Disorder - correct answer>>Dialectical Behavioral Therapy (DBT) A patient with borderline personality disorder presents with anger, irritability, and self-harming behavior. Treat with : - correct answer>>Lithium A patient with borderline personality disorder presents with a depressed mood, emotional lability, and interpersonal problems, rejection sensitivity, aggression, hostility. Treat with : - correct answer>>Depakote Schizoid personality disorder - correct answer>>Appears cold and detached
Journaling - correct answer>>is a CBT tool that helps individuals understand and manage their thoughts. Interpersonal Therapy - correct answer>>The goal is to identify and modify interpersonal problems, to understand and manage relationship problems. (marital conflict) Psychodynamic therapy - correct answer>>Focuses on unconscious processes and how they might influence past and present behavior. Humanistic therapy - correct answer>>Focuses on self directed growth and self actualization. Each person has the potential to find meaning. Originated by Carl Rogers. Existential therapy - correct answer>>Well suited for those facing issues of existence. Try to understand the patient's subjective experience. Goals are to live authentically and to focus on the present and personal responsibility. Logotherapy - correct answer>>A type of existential therapy which aims to alleviate psychological distress by empowering individuals to discover their unique life purpose and values. Victor Frankl. Trauma-focused cognitive behavioral therapy - correct answer>>CBT for youth with PTSD and mood disorders resulting from sexual abuse, physical abuse, violence, or grief
Multisystemic family therapy (MST) - correct answer>>Targets youths 12-17 with serious criminal offenses and antisocial behavior. Empower parents with resources and skills to better manage their youth. Strategic therapy - correct answer>>Paradoxical directive/intervention-- use with caution solution-focused therapy - correct answer>>Miracle question: What would life be like without the problem Family systems therapy - correct answer>>Goal is to increase family's awareness of each member's function and to promote self-differentiation. Triangles, and triangulation are key terms. Structural family therapy - correct answer>>There are clearly defined boundaries and hierarchies; Enactment allows therapist to map, track, and modify the family structure. Aspects of mindfulness - correct answer>>Breath awareness, awareness of body sensations, thoughts, or sounds. Rooting reflex - correct answer>>A baby will turn his head and open his mouth when stroked on the side of the face. It disappears by 4-6 months. Landau reflex - correct answer>>Baby will extend legs and head when laid prone. Disappears by 12-24 months.
