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ANCC REVIEW QUESTIONS (PMHNP IQ) BANK ANSWEREDALL

CORRECTLY ANSWERED; LATEST UPDATED 2023/2024.

The Centers for Medicare and Medicaid Services (CMS) administer what twomajor public insurance programs? Correct Answer: Medicaid and Medicare

How is Medicaid funded? Correct Answer: by both federal and state tax dollarsWho is eligible

for Medicaid? Correct Answer: Low-income children Low-income pregnant women

Elderly and disabled individuals who qualify for the Supplemental SecurityIncome Program

How is Medicare funded? Correct Answer: by federal tax dollars

Who is eligible for Medicare? Correct Answer: The elderly age 65 and olderhaving worked 40 quarters and paid Medicare taxes

Certain younger individuals with disabilities Individuals with end-stage renal disease Individuals in need of a kidney transplant

Individuals receiving Social Security Disability and who have amyotrophic lateralsclerosis

What is covered under Medicare Part A? Correct Answer: hospitalization (up to 90days), skilled nursing facility (up to 100 days), hospice (up to 6 months for terminally ill), and some home health care

What is covered under Medicare Part B? Correct Answer: ambulatory practitioner service; physical, occupational, and speech therapy; medical equipment; diagnostic tests; and some preventative care

What is Medicare Part C? Correct Answer: Medicare Advantage; optional coverage for beneficiaries who can choose to receive all of their health care services through one of the provider organizations covered under the MedicareAdvantage Plan

What is Medicare Part D? Correct Answer: optional coverage for outpatient pharmaceuticals; prescription drug coverage program available to all Medicarebeneficiaries. Private companies approved by Medicare provide the coverage.

What service is guaranteed to be covered by Medicaid? Correct Answer: familyplanning services

Other services covered under Medicaid include: inpatient medical hospitalizations

outpatient services home health services home health aides

skilled nursing facilities services for those age 21 and olderservices rendered by NPs and nurse midwives

medical supplies for use in-home

pregnancy-related services up to 60 days postpartum

What services may not be covered under Medicaid? Correct Answer: vision careeyeglasses dental care

dentures hearing examshearing aides

routine physical exams

inpatient psychiatric hospitalizations

health alliance Correct Answer: public agency that uses its bargaining power to negotiate competitive prices for health insurance from the private insurance market

special interest agency Correct Answer: group of people seeking or receivingspecial advantages through political lobbying

public interest groups Correct Answer: promote issues of general public concern

political action committee Correct Answer: an organization that raises moneyprivately to influence elections or legislation, especially at the federal level

preventative factors Correct Answer: factors that prevent or protect the personfrom developing a psychiatric condition or disorder

What are the 3 categories of preventative factors? Correct Answer: biological,psychological, social

Biological preventative factors Correct Answer: Without a history of mentalillness in the family Healthy nutritional status

Good general health

Psychological preventative factors Correct Answer: Good self-esteemGood self- concept

Internal locus of control Healthy ego defenses

Social preventative factors Correct Answer: Low-stress occupationHigher socioeconomic status

Higher level of education

What is a risk closely associated with lamotrigine? Correct Answer: Stevens-Johnson syndrome

• a serious, life-threatening side effect in which a painful burning rash appears

Treatment: discontinue medication immediately; patient should report to ER forstabilization

According to Erik Erikson, failure to resolve which psychosocial stage is associated with later development of conversion disorder? Correct Answer:Initiative vs. Guilt

Failure to successfully resolve the psychosocial stage Initiative vs Guilt isassociated with later development of this psychopathology

According to Erik Erikson, failure to resolve the Trust vs Mistrust psychosocial stage is associated with later development of what? Correct Answer: psychosis, addictions, depression

According to Erik Erikson, failure to resolve the Autonomy vs Shame and Doubt psychosocial stage is associated with later development of what? Correct Answer:paranoia, obsession, compulsions, and impulsivity

According to Erik Erikson, failure to resolve the Industry vs Inferiority psychosocial stage is associated with later development of what? Correct Answer:creative inhibition

What are Erik Erikson's stages of psychosocial development? Correct Answer:Trust vs Mistrust: birth to 12-18 months

Autonomy vs Shame and Doubt: 12 - 18 months to 3 yearsInitiative vs Guilt: 3 to 5-6 years

Industry vs Inferiority: 5 - 6 years to adolescence Identity vs Role Confusion: adolescence to adulthoodIntimacy vs Isolation: adulthood

Generativity vs Stagnation: middle adulthoodEgo Integrity vs Despair: late adulthood

Trust vs Mistrust Correct Answer: Erikson's first stage during the first year of life,infants learn to trust when they are cared for in a consistent warm manner

birth to 12 - 18 months

Autonomy vs Shame and Doubt Correct Answer: 12 - 18 months to 3 yearsErikson's stage in which a toddler learns to exercise will and to do things independently; failure to do so causes shame and doubt

Failure to resolve the Autonomy vs. Shame and Doubt phase can lead to what?Correct Answer: the development of paranoia, obsessions, compulsions

Initiative vs Guilt Correct Answer: 3 to 5 - 6 years

Erikson's third stage in which the child finds independence in planning, playingand other activities

Failure to resolve the Initiative vs. Guilt stage can lead to the development of what? Correct Answer: conversion disorder, phobias, and psychosomatic disorders

Industry vs Inferiority Correct Answer: 5 - 6 years to adolescence

Erikson's fourth stage of identity typically occurs between the ages of 7 - 13; when achild successfully navigates this stage, they develop competency and learn to be productive

Failure to resolve the Industry vs. Inferiority stage can contribute to what? CorrectAnswer: creative inhibition

Identity vs Role Confusion Correct Answer: Erikson's stage during which teenagers and young adults (adolescence to adulthood) search for and become theirtrue selves

Failure to successfully resolve the psychosocial stage Identity vs. Role Confusionis linked to what? Correct Answer: delinquent behavior, borderline psychotic episodes, and gender-related identity disorders

Intimacy vs Isolation Correct Answer: adulthood

Erikson's stage in which individuals form deeply personal relationships, marry,begin families

Generativity vs Stagnation Correct Answer: Erikson's stage of social development in which middle-aged (middle adulthood) people begin to devote themselves more to fulfilling one's potential and doing public service

Ego Integrity vs Despair Correct Answer: people in late adulthood either achieve asense of integrity of the self by accepting the lives they have lived or yield to despair that their lives cannot be relived

Ego Integrity vs Despair is the final stage of psychosocial development. Successful resolution of this stage is characterized by a sense of what? Correct Answer: unityin life's accomplishments

Failure to resolve ego integrity vs despair leads to what? Correct Answer: regretover lost opportunities of life

What psychoactive substance is most widely used in the US? Correct Answer:cannabinoids Cannabinoids, particularly cannabis, are the most widely used psychoactive substances in the United States. The 12 - month prevalence of cannabis use disorderis 3.4%. The rates of cannabis use disorder are highest among adult and adolescentmales.

True or False? The risk of depression is equal between males and females in earlychildhood. Correct Answer: True

To diagnose depression, symptoms must be present for how long? Correct Answer: at least 2 weeks

In the majority of cases, depression during childhood remits when? CorrectAnswer: during the first year after diagnosis

In the majority of cases, childhood depression recurrence occurs when? CorrectAnswer: recurrence is high during the first 5 years

What are the hyperactive and impulsive traits of ADHD? Correct Answer:Fidgeting Leaving seat/can't sit still

Running/climbing

Unable to engage in quiet activities Always on the go

Excessive talking Blurting out information

Difficulty waiting their turn Interrupts others

What are the inattentive traits of ADHD? Correct Answer: Poor attention to detailsDifficulty sustaining attention

Does not listen when spoken toDoes not follow instructions Disorganized

Avoids or dislikes takes that require sustained mental effortBad handwriting

Loses things Distracted Forgetful

What is the most effective treatment for ADHD? Correct Answer: Psychosocialinterventions (CBT directed on the patient's behavior) and methylphenidate (pharmacotherapy).

Pharmacotherapy itself can work, but the results are better with the help ofpsychosocial interventions.

Autism Spectrum Disorder (ASD) Correct Answer: a psychiatric disorder thatforms in early childhood and is marked by significant deficiencies in communication and social interaction, and by rigidly fixated interests and repetitive/stereotyped behaviors

Unspecified intellectual disability Correct Answer: term used when a child is fiveyears old or older and cannot be reliably assessed due to a physical or mental impairment

Borderline intellectual functioning Correct Answer: describes a person with a nominal IQ ranking of 71 to 84 who does not have the coping problems associatedwith an intellectual disability

Patients who fear situations or places where they might have trouble obtaining helpif they become scared Correct Answer: Agoraphobia

Patients who fear embarrassment when they speak, write , or eat in public CorrectAnswer: Social anxiety disorder

Patients who feel tense or anxious a majority of the time and worry about manydifferent issues Correct Answer: Generalized anxiety disorder

Physical signs of generalized anxiety disorder include what? Correct Answer: muscle tension, generalized muscle aches and soreness, tremors, twitching, subjective complaints of shakiness, shortness of breath, autonomic hyperarousalsigns, tachycardia, increased respiratory rates, dizziness and numbness, fatigue, muscle tension, and insomnia.

Patients who experience brief episodes of intense dread accompanied by physicalsymptoms like chest pain, chills, shortness of breath, and irregular heartbeat Correct Answer: Panic disorder

Panic attacks trigger what response? Correct Answer: fight-or-flight responses

True or False? The complex central nervous system can trigger physical symptomsof panic in the client even when there is no actual danger. Correct Answer: True

Panic disorder is significantly comorbid with many general medical conditions,including what? Correct Answer: Irritable bowel syndrome

Dizziness

Cardiac arrhythmias Hyperthyroidism Asthma

COPD

What are the five categories of phobias? Correct Answer: Animal (spiders, insects,dogs, etc.) Natural environment (heights, storms, water, etc.)

Blood-injection-injury (needles, invasive medical procedures, blood transfusions,etc.) Situational (elevator, airplane, enclosed places, etc.)

Other (situations that may lead to vomiting, loud sounds, costumed characters, etc.)

What phobia do men and women experience at equal rates? Correct Answer:blood- injection-injury phobias

What phobia(s) are women more likely than men to experience? Correct Answer:animal, natural environment, and situational phobias

What is the primary purpose of the corpus callosum? Correct Answer: This is alarge bundle of white matter that connects the right and left hemispheres and facilitate sensorimotor information exchange.

What is HIPPA? Correct Answer: Health Insurance Portability and AccountabilityAct The first national comprehensive privacy protection act

Guarantees patients 4 fundamental rights:

1. to be educated about HIPPA privacy protection2. to have access to their own medical records
2. to request an amendment of their health information to which they object4. to require permission for disclosure of their personal information

Under what circumstances can patient confidentiality be broken? Correct Answer:1. patient demonstrates increased potential for self-harm or harm to others

2. there is suspected abuse of children, older adults, or people with disabilities3. NP determines patient needs to be hospitalized
3. patient requests their information be shared with a 3rd party

What is the Tarasoff principle? Correct Answer: Duty to warn potential victims ofimminent danger of homicidal patients

What is the TIGER initiative? Correct Answer: Technology Informatics GuidingEducation Reform; formed to develop a shared vision, strategies, and specific actions for improving nursing practice, education, and the delivery of patient carethrough the use of health information technology

developed 10 - year plan for nursing's path toward computer and informationliteracy

What did the TIGER initiative successfully define? Correct Answer: the basic technology competencies and required curriculum for nurse practitioner education

What did the TIGER initiative declare? Correct Answer: that it is a nurse practitioner's responsibility to understand and shape the landscape of health caretechnology in order to improve access, quality, and the patient experience

What is ARRA? Correct Answer: American Recovery and Reinvestment Act of

includes the Health Information Technology and Clinical Health (HITECH) Act,which attempts to update the American infrastructure, including the use of electronic health records and meaningful use

The strategic plan of the Office of the National Coordinator for Health InformationTechnology (ONC) includes what five goals? Correct Answer: Achieve adoption and information exchange through the meaningful use of health information technology (HIT)

Improve care, improve population health, and reduce health care costs through theuse of HIT Inspire confidence and trust in HIT

Empower individuals with HIT to improve their health and the health care systemAchieve rapid learning and technological advancement

Which federal entity is responsible for accomplishing the goals of the Health Information Technology for Economic and Clinical Health (HITECH) Act? CorrectAnswer: Office of the National Coordinator for Health Information Technology (ONC)

Which inferential statistic tests the relationship between two variables? CorrectAnswer: Pearson's r correlation

What are inferential statistics? Correct Answer: numerical data or values thatenable one to generalize, infer, or reach conclusions that extend beyond the immediate data alone Examples: t-test, Analysis of Variance (ANOVA), Pearson's r correlation,probability,

p-value

Which inferential statistic assesses whether the means of 2 groups are statisticallydifferent from each other? Correct Answer: t-test

Which inferential statistic tests the difference among 3 or more groups? CorrectAnswer: Analysis of Variance (ANOVA)

Which inferential statistic tests the likelihood of an event occurring? CorrectAnswer: probability

Which inferential statistic describes the probability of a particular result occurringby chance alone? Correct Answer: p-value (level of significance)

example: If p=0.01, there is a 1% probability of obtaining the result by chancealone

3 phases of therapeutic relationship between a nurse practitioner and his or herpatient Correct Answer: 1. Introduction/Orientation

2. Working

3. Termination

What actions take place during the introduction phase of the therapeutic relationship between a nurse practitioner and his or her patient? Correct Answer:1. Create a trusting environment (begin to learn to trust and know each other as partners in the relationship

Trust, respect, honesty and effective communication are key principles inestablishing a relationship)

2. Establish professional boundaries

3. Establish parameters of the relationship (e.g., place of meeting, length,

frequency, role or service offered, confidentiality, duration of relationship)

What actions take place during the working phase of the therapeutic relationship between a nurse practitioner and his or her patient? Correct Answer: 1. Clarifyingpatient expectations and mutually identifying goals

2. Implementing the treatment plan3. Monitoring the patient's health
3. Undertaking preventative health care5. Measuring outcomes of care

6. Evaluating outcomes of care

7. Reprioritizing plan and objectives indicated

What actions take place during the termination phase of the therapeutic relationship between a nurse practitioner and his or her patient? Correct Answer:1. Mutual understanding and a celebration of goals that have been met

2. Share feelings related to the ending of the therapeutic relationship

3. Validating plans for the future; develop long-term plan of care4.

Increased autonomy of both the client and the nurse

The four major dimensions of recovery include what? Correct Answer: health,home, purpose, and community

What is the initial management of severe respiratory depression in a patient withphenobarbital overdose? Correct Answer: artificial ventilation

What is the antidote for barbiturate overdose? Correct Answer: there is no antidote

What is the treatment for barbiturate overdose? Correct Answer: Supportivetherapy with hydration is the best method of treating barbiturate overdose.

Continuous monitoring of the client's airway is essential. The body may need to bewarmed. Aggressive IV hydration is required to counter low blood pressure.

If respiratory depression occurs, endotracheal intubation and mechanicalventilatory support are appropriate.

What possible psychiatric emergency would you suspect if a patient presents withpsychosis, dry mouth, hyperpyrexia, mydriasis, restlessness, and tachycardia?

Correct Answer: anticholinergic intoxication

How should you treat a patient presenting with anticholinergic intoxication? Correct Answer: discontinue the offending medication or substance and considerIV physostigmine and benzodiazepines

remember, antipsychotics are contraindicated in this situation!

How would a patient with alcohol withdraw present? Correct Answer: irritability,nausea, vomiting, insomnia, malaise, autonomic hyperactivity, and shakiness

How would a patient with benzodiazepine intoxication present? Correct Answer:sedation, somnolence, ataxia

What is the antidote for benzodiazepine overdose? Correct Answer: flumazenil

How would a patient with catatonic schizophrenia present? Correct Answer: marked psychomotor disturbance (either excitement or stupor) and exhaustion

What are some common non-psychoactive dietary supplements with physiological(not

psychological) effects used to cure illnesses and maintain health? fatty acids (heart disease)

Correct Answer: Omega- 3

Tryptophan (nitrogen balance in adults and growth in infants; also aids in creationof niacin - essential in creating neurotransmitter serotonin)

Vitamin E (prevent coronary heart disease, support immune function, preventinflammation, promote eye health, and lower the risk of cancer)

Melatonin (sleep)

Fish oil (reduce inflammation, lower cholesterol)

Changes in calcium levels can cause what conditions? Correct Answer: Decreasedlevels can cause acute renal failure.

Increased levels can cause acidosis, Addison's disease, and hyperthyroidism.

Fish oil is known to interact with what medication(s)? Correct Answer: Warfarin,aspirin, NSAIDs, garlic, ginko

Melatonin is known to interact with what medication(s)? Correct Answer: aspirin,NSAIDs, beta blockers, corticosteroids, valerian, kava kava, and alcohol

Vitamin E is known to interact with what medication(s)? Correct Answer: antiplatelet drugs (warfarin), statins - increases anticoagulant effects & increasesadditive effects and risk of rhabdomyolysis (muscle wasting)

What is belladonna? Correct Answer: A perennial plant/psychoactive herbal supplement also known as "deadly nightshade" due to the toxic effects of its foliage and berries from which atropine is derived; produces psychological effectsbelieved to aid in relieving psychiatric symptoms

What is a common non-psychoactive supplement used to help cure symptoms ofillnesses such as depression, osteoarthritis, and liver disease? Correct Answer: SAM-e

This is a dietary supplement used to treat the symptoms discussed.

What is risk management? Correct Answer: activities or systems designed to recognize and intervene to reduce the risk of injury to patients OR the process ofrecognizing and intervening in order to reduce subsequent claims against healthcare providers

implemented to reduce non-healthy behaviors in patients and high-risk situations

What is risk assessment?

continuous monitoring for high-risk situations and assessing persons for non-healthy behaviors

What is forensic risk assessment? Correct Answer: intended to protect the public from persons with known mental disorders having dangerous, violent, and criminalhistories

What is risk mitigation? Correct Answer: process of minimizing the impact ofidentified risks; act of process change in order to mitigate the risk finding

What is risk intervention? Correct Answer: task performed in real time in order toprevent an immediate risk

delirium Correct Answer: mental disorder marked by confusion and uncontrolledexcitement able to return to baseline with appropriate diagnosis and treatment

What are some findings of delirium? Correct Answer: acute onset of confusionpicking and random actions that are purposeless

acute reversal of sleep-wake cycle

disturbance that fluctuates, usually during the day impaired recent and intermediate memory psychomotor agitation

course of illness may resolve within hours to days

dementia Correct Answer: group of disorders characterized by the gradual development of multiple cognitive deficits or a slowly progressive decline inmental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes

Patients with dementia present with what findings? Correct Answer: impairedexecutive functioning

impaired global intellect with preservation of level of consciousnessimpaired problem-solving

impaired organizational skills altered memory

What type of dementia is associated with deficits in language, motor function, andrecognition? Correct Answer: Alzheimer's disease

Correct Answer: evaluation of threats to determinevulnerabilities;

What are the earliest symptoms of Alzheimer's disease? Correct Answer: mood changes - usually manifested as apathy rather than depression and are resistant toantidepressant medications but responsive to cholinesterase inhibitors

The onset of symptoms in Alzheimer's disease follows what progression? CorrectAnswer: 1. mood changes

2. cognitive impairment

3. decline in functional independence4.

behavioral and motor symptoms

Which type of dementia is usually accompanied by extrapyramidal symptoms?Correct Answer: Lewy body dementia

Which type of dementia is accompanied by spasmodic movement and incoordination? Correct Answer: Huntington's disease

Which type of dementia usually presents as extremely talkative and disinhibited?Correct Answer: frontotemporal dementia

The precise mechanism of action of selective serotonin reuptake inhibitors (SSRIs)remains unknown. Considering the delayed therapeutic response, one theory involves what? Correct Answer: The down-regulation of postsynaptic 5-HT2 receptor sites

What is acute mechanism of action of SSRIs? Correct Answer: inhibit serotonin reuptake pumps, thus increasing the amount of available serotonin in the synapse however, do not experience relief for several weeks

also inhibit the dopamine system, but this is most likely unrelated to their antidepressant effect

Which type of psychoactive drug elevates serotonin and norepinephrine levels byinhibiting their presynaptic reuptake? Correct Answer: selective serotonin reuptake inhibitors (SSRIs)

Which SSRI is FDA-approved for the treatment of adolescents? Correct Answer: fluoxetine (Prozac)

Vilazodone (Viibryd) Correct Answer: SPARI - serotonin partial agonist reuptakeinhibitor

and serotonin multimodal (S-MM) antidepressantnot FDA-approved for adolescents

Vortioxetine (Trintellix) Correct Answer: serotonin multimodal (S-MM)antidepressant not FDA-approved for adolescents

Bupropion (Wellbutrin) Correct Answer: NDRI (norepinephrine dopaminereuptake inhibitor) Antidepressant; Smoking Cessation Aid;

not FDA-approved for adolescents

What are target symptoms of antidepressant treatment? Correct Answer: depressedmood sleep/rest disturbance

anxiety irritability

impaired concentration impaired memory appetite disturbance agitation anhedonia

impaired energy and motivation

What hormonal changes are present with depression? Correct Answer: elevatedcortisol level decreased catecholamine and testosterone

What are the common core symptoms of major depressive disorders in children?Correct Answer: irritability, somatic complaints, and social withdrawal

What are the less common symptoms of major depressive disorders in children?Correct Answer: psychosis, motor retardation, hypersomnia, and increased appetite

specifiers Correct Answer: special descriptions added to a patient's diagnosis to provide more information; help characterize the condition and describe its overallcourse

What specifiers are used to describe mood disorders? Correct Answer: withatypical features

with melancholic featureswith anxious distress with catatonic features with mixed features

with peripartum onset with psychotic featureswith rapid cycling with seasonal pattern

With atypical features specifier Correct Answer: eat a lot and gain weight, sleepexcessively, and have a feeling of being sluggish or paralyzed; also sensitive to rejection.

With melancholic features specifier Correct Answer: feel worse in the morningthan in the afternoon, and they experience decreased appetite, weight loss, and agitation

also tend to feel excessively guilty and have trouble making decisions

With anxious distress specifier Correct Answer: have high levels of tension,restlessness, worry, and fear

With catatonic features specifiers Correct Answer: exhibit either motorhyperactivity or inactivity

With mixed features specifier Correct Answer: experience a mixture of both manicand depressive symptoms

With peripartum onset specifier Correct Answer: develop a mood episode duringpregnancy or within a month of having the baby

With psychotic features specifier Correct Answer: develop delusions orhallucinations along with their mood symptoms

With rapid cycling specifier Correct Answer: have experienced at least four moodepisodes in the past year

With seasonal pattern specifier Correct Answer: regularly become ill at a certaintime of the year

amygdala Correct Answer: A limbic system structure involved in memory andemotion, particularly fear and aggression.

responsible for connecting sensory smell information with emotions

basal ganglia Correct Answer: structures in the forebrain that help to controlmovement stabilizes somatic motor activity

initiates complex motor function

maintains muscle tone, posture, and common reflexes

Synapse Correct Answer: connection between neurons

converts action potential in the presynaptic neuron into a chemical signal that isthen transferred to the postsynaptic neuron

Neurotransmitters Correct Answer: chemicals synthesized from dietary substratesthat communicate information from one cell to another

What are the 4 categories of neurotransmitters? Correct Answer: MonoaminesAmino acids Cholinergics

Neuropeptides (divided into nonopioid type and opioid type)

What are some examples of monoamine neurotransmitters (also called biogenicamines)?

Correct Answer: dopamine norepinephrine

serotonin

What is the general function of dopamine? Correct Answer: involves normal functioning of thinking, decision-making, reward-seeking behavior, fine muscleaction, and integrated cognition

Dopamine irregularities are closely linked to what? Correct Answer: diseaseprocesses such as schizophrenia

What is the general function of norepinephrine? Correct Answer: involves alertness, focused attention, orientation, fight-or-flight, learning, memory, andfocus and attention

Norepinephrine irregularities are closely linked to what? Correct Answer: diseaseprocesses such as panic disorders and anxiety

What is the general function of serotonin? Correct Answer: regulation of sleep,pain perception, mood states, temperature, aggression, and libido

Serotonin irregularities are closely linked to what? Correct Answer: depressivedisorders

What are some examples of amino acids? Correct Answer: glutamateGABA aspartate

acetylcholine

glutamate Correct Answer: A major excitatory amino acid neurotransmitter;involved in memory

What is the general function of glutamate? Correct Answer: involves memory andsustained autonomic functions

Glutamate irregularities are closely linked to what? Correct Answer: bipolar typedisorders seizure disorders

schizophrenia

What is the general function of GABA? Correct Answer: reduces arousal,aggression, and anxiety

What are some examples of opioid-type neuropeptides? Correct Answer:endorphins enkephalins

dynorphins

In common psychiatric disorders, which neurotransmitter is implicated in the complex pathophysiology of certain disease processes involving normal functionssuch as decision- making and integrate cognition? Correct Answer: Dopamine

Genes direct the production of what? Correct Answer: proteins(NOT amino acids)

What is a serious long-term consequence of high-dose thioridazine? CorrectAnswer: retinal pigmentation

It can occur in patients prescribed >1,000 mg

Even when the medication is stopped, this side effect may persist and lead toblindness

What are some potential major side effects of antipsychotic medications? CorrectAnswer: hyperprolactinemia, priapism, and tardive dyskinesia

galactorrhea Correct Answer: milky nipple discharge unrelated to the normal milkproduction of breastfeeding

Quetiapine (Seroquel) Correct Answer: atypical antipsychotic medication

hyperprolactinemia Correct Answer: an indication of elevated prolactin levels which can cause galactorrhea and is a risk factor for those taking antipsychotics,especially second-generation antipsychotics such as Invega or Risperdal

Trazodone (Desyrel) Correct Answer: atypical antidepressantinhibits serotonin reuptake

not a first-line treatment of depression

may worsen hypersomnia (often used for sleep)

Alprzolam (Xanax) Correct Answer: benzodiazepineused in the short-term treatment of severe anxiety

Tiagabine (Gabitril) Correct Answer: non-benzodiazepine anxiolytic used fortreating anxiety in adults

Levomilnacipran (Fetzima) Correct Answer: Serotonin-Norepinephrine ReuptakeInhibitors (SNRI) antidepressant

Brexpiprazole (Rexulti) Correct Answer: atypical antipsychotic

A 33-year-old female is diagnosed with panic disorder and started on clonazepam. What is the recommended dose? Correct Answer: 0.25 mg/day and titrating up to1mg/day after 3 days.

The correct way to prescribe clonazepam for panic disorder is to start with 0.25mg/day and titrate up to 1 mg/day after three days.

What medication for Alzheimer's disease is contraindicated due to heavy smoking?Correct Answer: There are no contraindications due to smoking for these medications. You can prescribe any cholinesterase inhibitor (rivastigmine, donepezil, galantamine), but galantamine might be the best choice because of its dual actions of inhibiting acetylcholinesterase and positive allosteric modulation ofnicotinic cholinergic receptors.

Which national nursing association certifies psychiatric-mental health nurse practitioners? Correct Answer: American Nurses Credentialing Center (ANCC),which is a subsidiary of the American Nurses Association (ANA)

certification Correct Answer: a process by which a professional organization grants recognition to an individual who, upon completion of a competency-basedcurriculum, can demonstrate a predetermined standard of specialty practice

awarded by a professional organization

verifies mastery of a particular medical specialty determines scope of practice

NOT established by the government

NP certification determines what? Correct Answer: scope of practice

NP certification assures the public of what? Correct Answer: that the NP hasmastered a body of knowledge in a particular medical specialty

credentialing Correct Answer: Process used to protect the public by ensuring aminimum level of professional competence

licensure Correct Answer: The process whereby a competent authority, usually thestate, allows people to perform a regulated act or engage in the practice of that profession

prohibits all unlicensed persons from engaging in legally protected practice

In PTSD, is the proximal relationship between the person's physical self and thetraumatic event distant or close in nature? Correct Answer: close

Pretraumatic risk factors for PTSD Correct Answer: female genderemotional disturbances prior to age 6

childhood mental illness externalizing behaviors

lower socioeconomic statuslow education

childhood adversity

fatalistic or self-blaming coping mechanisms minority social/ethnic status

low intelligence poor social support

family history of psychiatric disorders

Peritraumatic risk factors for PTSD Correct Answer: severity of traumaduration of trauma

perceived life threat personal injury

trauma perpetrated by a loved one or caregiver

witnessing a threat directed toward a loved one or caregiver dissociation during trauma

for military personnel, witnessing atrocities or killing the enemy

Posttraumatic risk factors for PTSD Correct Answer: negative appraisalsinappropriate coping strategies

development of an acute stress reaction subsequent exposures to reminders

subsequent adverse life events and financial losseslack of social support

2010 IOM report "The Future of Nursing: Leading Change, Advancing Health" Correct Answer: considered obstacles that all nurses encounter as they provide quality health care in the United States

4 key messages:

1. nurses should practice to the full extent of their education

2. nurses should seek higher levels of education through seamless academicprogression

3. nurses should be full and equal partners with physicians

4. to improve the quality of health care, nurses need an improved

information infrastructure

6 goals for quality improvement in health care identified by the 2001 IOM "Crossing the Quality Chasm: A New Health System for the 21st Century" CorrectAnswer: 1. safe