Georgette Review PMHNP Exam Questions and Answers 2024/2025, Exams of Nursing

Download Georgette Review PMHNP Exam Questions and Answers 2024/2025 and more Exams Nursing in PDF only on Docsity! P a g e 1 | 51 Georgette Review PMHNP Exam Questions and Answers 100 % Pass Solution. A male patient informs as adult PMHNP that he has not slept in three days, has poor concentration, and denies fatigue. The patient's diagnosis is: A. ADHD B. Bipolar disorder C. Panic disorder D. Primary insomnia - answer>>bipolar disorder The neuroprotective treatment of choice for bipolar disorder is - answer>>lithium According to the current clinical guidelines for treating a patient with bipolar I disorder mania with psychotic features, an adult psychiatric and mental health nurse practitioner prescribes: A.) Lithium B. Citalopram C. Lamotrigine D. Quetiapine - answer>>quetiapine Which characteristic of fluoxetine provides the greatest degree of safety for patients who have severe depression A. Greater efficacy than an TCA B. Less potential drug interaction C. Less potential for injury with intentional overdose. D. Less potential for suicidal thinking. - answer>>less potential for injury with intentional overdose. Do no harm contracts reduce the risk of suicide - answer>>NO A 72 year old is brought in by her husband with increasing forgetfulness, decreased activity, and decreased appetite for 2 months. She has a history of hypertension and is being treated with P a g e 2 | 51 lisinopril. The exam is normal and the mini mental status exam provides a score of 24 but she declines to answer some questions and needs to be urged to participate in the assessment. What is the most likely diagnosis? A. Alzheimers disease B. Vascular dementia C. Depression D. Delirium - answer>>depression During patient education on sertraline, the PMHNP focuses upon the potential side effect of A. agranulocytosis B. hypernatremia C sexual dysfunction D weight loss - answer>>sexual dysfunction A 23 year old woman is Brought in to to the ER after attempting to commit suicide by cutting her wrists. Which action by the PMHNP would be of highest priority initially? A. Assess her coping behaviors B. Assess her current level of suicidality C. Take her vital signs D. Asess her health history - answer>>take her vital signs A 69 year old man with diagnosis of delirium has symptoms of psychosis which include frightening auditory and visual hallucinations and paranoid delusions. Which of the following medications should be chosen first for this man's symptoms? A. Haloperidol B. Quetiapine C. Valium D. Olanzapine - answer>>haloperidol. An 81 year old female with a history of vascular dementia is brought to the hospital for increased agitation and UTI. Which of the following features most distinguishes the effects of delirium from dementia? P a g e 5 | 51 Appraisal of the patient's SI plan, intent and access to implement plan would be documented in which part of standard psychiatric evaluation A Review of symptoms. B. Diagnosis C. Mental status exam D. History of presenting illness - answer>>C mental status exam a 48 year off Caucasian male presents for his therapy appointment. He is sad about losing his wife recently to covid 19. He reports feeling thoughts of hurting himself. He has a past history of overdosing on propranolol several years ago. Which of the following places him at higher risk of suicide? A. Previous attempt B. Age C. Gender D. Marital Status - answer>>A previous attempt Which of the following patients is at higher risk of suicidie? A. 30 year old married African American female with previous attempt B. A 35 year old single Asian male with previous suicide attempt C. A 38 year old single African American male who is manager of a bank D. A 68 year off single Caucasian male with depression - answer>>D. 68 year old single, caucasian male, depression A 64 year old caucasian male referred for treatment of refractory depression by his PCP reports continued lack of purpose, insomnia, decreased energy, reduced interest in pleasurable activities since losing his wife hit by a drunk driver 3 months ago. Which of the following is an assessment priority? A. Prior and current meds, dose, clinical response, side effects. B. Thoughts of self-harm, plan, intent, access C. Extent of alcohol use, and motivation to reduce to safe levels P a g e 6 | 51 D. Sleep patterns and hygiene - answer>>thoughts of self-harm, plan, intent, access A married female patient has been in therapy with an adult psychiatric and mental health nurse practitioner for 3 months. The patient's husband abuses alcohol and refuses treatment. The night before the next scheduled appointment, the patient telephones the clinical nurse specialist stating that her husband is drunk, violent, and threatening to kill her. The PMHNPs priority intervention is A. To arrange for an emergency psychiatric intervention B. Arrange for the woman's safety C. Request a restraining order D. Request to speak to the husband - answer>>Arrange for the woman's safety. A client says to the PMHNP, Some days life is just not worth it. All my wife and I do is fight and scream. Things at home were be calmer and simpler if I just wasn't there anymore." The most therapeutic response is: A. Do you mean yo are thinking about leaving your wife to moving out?" B. Tell me what you mean by "it would be simpler if you weren't there anymore." C. So you are thinking suicide might be an option for you? D. Remain silent. - answer>>B. Tell me what you mean by "it would be simpler if you weren't there anymore" While working with an older male client, the nurse begins to think that the client reminds her of her grandfather and responds as if she is the granddaughter. The nurse is developing which of the following? A. Empathy B. Modeling C. Transference D. Countertransference - answer>>D Countertransferance When many answers are remarkably similar, they are usually - answer>>wrong Person is aggressive, lack of remorse, destruction of property, deceit or theft - answer>>conduct disorder P a g e 7 | 51 treatment for conduct disorder - answer>>target mood and aggression. person has sudden: blindness, mutism, paralysis, paresthesia, neurological symptoms - answer>>conversion disorder emotional or behavioral reaction to a stressful event or change in person's life within 3 months of it happening. - answer>>adjustment disorder Interprofessional collaboration is encouraged. - answer>>Collaborate is usually right. Delegate is usually wrong. ADPIER - answer>>Assessment, diagnosis, Plan, intervention, evaluate, refer out last. Lithium - answer>>Normal 0.6-1.2 Lithium toxicity occurs at levels - answer>>> 1.5 Signs of Lithium toxicity - answer>>severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait Lithium is gold standard for - answer>>MANIA Lithium has evidence shown to - answer>>reduce suicidal ideation What does lithium cause in neonate, especially 1st trimester - answer>>Ebstein anomaly (congenital heart defect) dehydration and hyponatremia cause lithium levels to - answer>>rise P a g e 10 | 51 Treatment for hypertensive crisis - answer>>DC offending agent Administer PHENTOLAMINE Teratogenic effects of benzos - answer>>floppy baby, cleft palate Teratogenic effects of tegratol - answer>>neural tube defect teratogenic effects of lithium - answer>>ebstein anomaly (heart defect) (avoid, especially 1st trimester) teratogenic effects of depakote - answer>>neural tube defects/spina bifida Adverse reaction to Lamictal - answer>>Steven Johnson's Syndrome Signs of SJS - answer>>FEVER --high yield sore throat facial swelling tongue swelling red rash skin sloughing body aches prodromal headache malaise arthralgia painful mucus membranes Lamotrigine is least likely to cause - answer>>sedation or weight gain P a g e 11 | 51 Carbamazepine (tegretol) black box warning - answer>>agranulocytosis (decrease WBCs) aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA) Carbamazepine and asians - answer>>Screen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele. Child-bearing aged women - answer>>check for pregnancy before starting mood stabilizer start on folic acid to support neural tube development during the first month that a woman is pregnant Clozaril/clozapine can cause - answer>>agranulocytosis and neutropenia For monitoring neutropenia in Clozaril, monitor - answer>>ANC DC clozarli if ANC - answer>>less than 1000 DC clozaril if WBC - answer>>2000-3000, risk of agranulocytosis When on clozaril monitor for - answer>>signs and symptoms of infection: sudden fever, chills, sore throat, weakness Clozaril only known antipsychotic to - answer>>decrease risk of suicide in patients with schizophrenia. Your patient with bipolar disorder is admitted to a medical hospital. The internist contacts your office and asks whether the lithium you prescribed him is effecting his ECG. How do you respond? A. Lithium can prolong the QT interval B. Lithium has no effect on his ECG C. Lithium can invert the t waves P a g e 12 | 51 D. Lithium can shorten the PR interval - answer>>Answer: Lithium can invert the t waves. Mary is a 45-year-old African American female who has been treated on Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is strictly contraindicated with Isocarboxazid? A. Morphine B. NSAIDS C. Methylphenidate D. Acetaminophen - answer>>Answer: Methylphenidate You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client needs to discontinue treatment? A. WBC less than 1800 and ANC less than 1200 B. ANC less than 1,000 C. WBC less than 5,000 D. ANC less than 2000 - answer>>Answer: ANC less than 1000 If given during pregnancy, socium valproate can cause which of the following medical problems in the baby? A. SJS B. Ebstein's anomaly C. Spina bifida D. Cleft palate - answer>>A. Spina bifida Which mood stabilizer is associated with potential life-threatening rash in the Asian population? A. Carbamazepine (tegretol) B. Depakote C. Lithium D. Lamictal - answer>>A. Carbamazepine P a g e 15 | 51 A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Clomipramine (Anafranil) D. Duloxetine (Cymbalta) - answer>>bupropion CLozaril is metabolized by - answer>>cytochrome P450 enzyme CYP1A2 INducers - answer>>induce metabolism and therefore decrease serum levels of other drugs that are substrates Smoking will do what to drug levels - answer>>decrease therapeutic levels of the drug Bull Shit CRAP GPS Induces my rage - answer>>Barbituates St. Johns Wart Carbamazepine Rifampicin Alcohol Phenytoin Griseofulvin Phenobarbital Sulphonylureas If your patient is a smoker you will need doses of their medication. - answer>>higher Inhibitors - answer>>inhibit metabolism and therefore increase levels of the drug. SICKFACES.com for Inhibitors - answer>>Sodium valproate P a g e 16 | 51 Isoniazid Cimetidine Ketoconazole Alcohol Chloramphenicol Erythromycin Sulfonamine Cipro Omeprazole Metronidazole Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with clozapine a. 2D6 b. 1A2 c. 2C19 d. 2C9 - answer>>1A2 (want A 2 cigarette break) When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? A. Decreased body fat B. Increased liver capacity C. Decreased protein binding D. Increased muscle concentration - answer>>Decreased protein binding For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The P a g e 17 | 51 interaction of the lithium and the thiazide diuretic has induced: P a g e 20 | 51 Both hemispheres of the brain are connected by the - answer>>corpus callosum Area of sensorimotor information exchange between two hemispheres - answer>>corpus callosum When there is disturbances in clock drawing test, which hemisphere is compromised - answer>>right hemisphere/right parietal lobe Area for expressive speech - answer>>frontal lobe Broca's Area Problems in the frontal lobe can lead to - answer>>personality changes, emotional changes, and intellectual changes, social skills problems, and behavior changes Area for receptive speech and language comprehension - answer>>Temporal lobe Wernicke's area Problems in the temporal lobe can lead to - answer>>auditory hallucinations, aphasia, and amnesia Occipital lobe - answer>>primary visual area problems in the occipital lobe can lead to - answer>>Visual field deficits, blindness and visual hallucinations. primary sensory area of the brain - answer>>parietal lobe problems in the parietal lobe can lead to - answer>>Sensory-perceptual disturbances and agnosia(inability to perceive objects) R-L confusion P a g e 21 | 51 Difficulty writing (agraphia) Aphasia(difficulty of language) Cerebellum is responsible for - answer>>gross motor skills fine motor skills balance A client experiencing difficulties with working memory, planning, and prioritizing, insight into his problems, and impulse control presents for assessment. In planning his care, the PMHNP should apply his knowledge that these symptoms represent problems with the A. frontal lobe B. Temporal lobe C. Parietal lobe D. Occipital lobe - answer>>frontal lobe Impairments in the clock drawing test can be associated with - answer>>damage to the right parietal lobe What part of the brain is responsible for regulating emotions? A. Wernicke's area B. Occipital lobe C. Hippocampus D. Parietal lobe - answer>>Hippocampus Limbic system responsible for - answer>>emotions and memory Hypothalamus - answer>>appetite, hunger, water balance, circadian rhythms, libido, hormonal regulation P a g e 22 | 51 thalamus - answer>>sensory relay for smell emotions, memory, and regulated affective behaviors amygdala - answer>>regulated emotion mediates mood emotional memories/meanings, fear, anxiety, stress emotion, aggression substantia nigra - answer>>motor movements amygdala= - answer>>emotional memory Which of these brain structures puts emotional meaning on a stimulus, forms, emotional memories and is involved with rage and fear - answer>>amygdala A client presents with complaints of changes in appetite, feeling fatigued, problems with sleep- rest cycle, and changes in libido. What is the neuroanatomical areas off the brain that is responsible for the regulation of these functions? - answer>>Hypothalamus Which serotonin receptor antagonism makes an antipsychotic "atypical" - answer>>5HT2A Excess dopamine in this area causes positive schizophrenic symptoms - answer>>meoslimbic pathway decreased dopamine leads to negative symptoms of schizophrenia - answer>>mesocortical pathway Increased blockade of dopamine here leads to EPS - answer>>nigrostriatal pathway Blockade of dopamine in this pathway can lead to increased prolactin levels - answer>>tuberoinfundibular pathway P a g e 25 | 51 C. Tardive dyskinesia D. Acute dystonia - answer>>A. Pseudoparkinsonism A patient is diagnosed with schizophrenia. Which of the following would be the appropriate question for the PMHNP to ask when assessing side effects produced by dopamine antagonism in the nigrostriatal pathway? A. Are you experiencing constipation? B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression? C. Are you experiencing increased thirst? D. Are you experiencing breast discharge? - answer>>Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression Fetal alcohol syndrome - answer>>Everything is low low weight, small features of the face. Which if the following antidepressants is associated with the most cardiovascular side effects? - answer>>Citalopram--causes QT prolongation What the body does to drugs? - answer>>Pharmacokinetics What the drug does to the body - answer>>pharmacodynamics The drug binds to the receptors and activates a biological response (opens the ion channel) - answer>>agonist effect drug causes the opposite effect of the agonist. Binds to the same receptor but closes the channel - answer>>inverse agonist drug does not fully activate the receptor - answer>>partial agonist P a g e 26 | 51 drug binds to the receptor but foes not activate a biological response - answer>>antagonist The study of what the drug does to the body. - answer>>Pharmacodynamics When studying pharmacodynamics involving receptor, you know that an agonist produces the following effect? A. Does not fully activate the receptor B. Blocks the agonist from opening the channel C. Causes the opposite effect D. Activates a biological response and opens the ion channel. - answer>>Activates a biological response and opens the channel. Medications that can cause mania (very high yield) - answer>>Steroids Antabuse Isoniazid Antidepressants in persons with bipolar Flonase Medications causing depression - answer>>steroids beta blockers interferon accutate some retroviral drugs antineoplastic drugs benzos progesterone Fragile X syndrome - answer>>all their facial structures are larger. P a g e 27 | 51 Severe adverse effect caused by antipsychotics - answer>>neuroleptic malignant syndrome Extreme muscle regidity Mutism elevated CPK Myoglobinura (cherry colored urine) Elevated WBCs Elevated LFts - answer>>signs of NMS Treatment for NMS - answer>>DC Offending agent Bromcriptine (parlodel) Dantrolene (muscle relaxant Serious effect of SSRIs - answer>>serotonin syndrome hyperreflexia, myoclonic jerks, sweating - answer>>serotonin syndromeq Treatment for serotonin syndrome - answer>>DC offending agent Cyprophentadine Drugs/classes that can cause serotonin syndrome - answer>>SSRI/TCA/MAOI/SNRI When switching to an SSRI to MAOI, - answer>>wait 14 days When switching from Prozac to MAOI or TCA - answer>>wait 5-6 weeks When switching from MAOI back to prozac - answer>>wait 2 weeks. P a g e 30 | 51 A. Omeprazole B. Propranolol C. Levothyroxine D. Clarithromycin - answer>>Propranolol A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of manic symptoms and insomnia. Your patient has been stable on lithium for the past six months To determine if a medication change or increase is warranted, it is important to gather more information. You suspect a possible medication-induced manic episode when the patient endorses what? A. She was recently placed on a beta blocker for anxiety. B. She was recently prescribed a benzo C. She recently had a flare up of her rheumatoid arthritis and received treatment for one week (aka a steroid) D. She recently began a new retroviral agent for hepatitis - answer>>recently treated for RA Scale to test for alcohol withdrawal - answer>>CIWA Score on CIWA that warrants PRN - answer>>greater than 8 Medication that will make patient physically ill if combined with alcohol - answer>>disulfiram (Antabuse) Antabuse shouldn't be taken for at leas after drinking - answer>>12 hours. Signs and symptoms of alcohol withdrawal - answer>>N/V/D tremors sweats anxiety agitation P a g e 31 | 51 tactile disturbances auditory disturbances visual disturbances headache altered sensorium agitation Rating scale of opiate withdrawal - answer>>COWS Signs and symptoms of opioid withdrawal - answer>>yawning, irritability, pupillary dilation piloerection muscle aches lacrimation rhinorrhea Treat COWS when score is greater than - answer>>7 Moderate withdrawal on COWS - answer>>13-24 Moderate withdrawal on CIWA - answer>>scoring 15 Treatment for COWS - answer>>Buprenorphine (Suboxone) Treatment for CIWA - answer>>scheduled meds plus diazepam SBIRT stands for - answer>>Screening, Brief Intervention, and Referral to Treatment SBIRT FRAMES - answer>>Feedback--tell them about their risk of their current alcohol use P a g e 32 | 51 Responsibility--reinforce their responsibility for change Advice--based on facts about their drinking, offer simple and direct advice Menu--provide a menu of options for behavior change Empathetic interviewing--consider their perspective. Be non- judgemental Self-efficacy--encourage person to believe they can change. CAGE screening tool - answer>>cut down, annoyed, guilty, eye opener Acute onset altered level of consciousness inattenion poor prognosis--1 year mortality rate of is up to 40% - answer>>delirium Treatment of choice for delirium - answer>>haloperidol Avoid which class in delirium as it tends to prolong it - answer>>benzos impaired executive functioning, impaired problem solving, impaired organizational skills, altered memory. slow onset - answer>>dementia Moderate level on the MMSE - answer>>10-20 Moderate level on the HAM-D - answer>>14-18 Moderate level on the PHQ-9 - answer>>10-14 P a g e 35 | 51 basal ganglia abnormalities in the reticular activating system Neurotransmitters involved in ADHD - answer>>DNS dopamine norepineph serotonin ADHD causes DNS - answer>>dopamine noreip serotonin Hallmarks of ADHD - answer>>persistent pattern of inattention or hyperactivity, impulsivity, or both. What to check prior to prescribing a stimulant? - answer>>cardiac history, family history of CVD and get an EKG prior to starting Amphetamines are approved in children as young as - answer>>3 Signs of stimulant abuse - answer>>insomnia tremors heart palpiations increased BP and HR Rating scale for ADHD - answer>>Connors and Vanderbilt Must monitor in two settings P a g e 36 | 51 Hallmarks of borderline personality disorder - answer>>impulsivity with self-damaging behavior Recurrent suicidal behavior Treatment for Borderline - answer>>DBT Hallmarks of antisocial personality - answer>>reckless disregard for welfare of others lack of remorse indifference to the feelings of others INCREASED HOMICIDAL IDEATION --HIGH YIELD Primarily in girls normal development then decline loss of purposeful hand movements stereotypic hand movements --flapping of hands deceleration of head growth - answer>>Rett syndrome Chronically moody, sad irritable for no reason - answer>>Disruptive mood dysregulation disorder patient reacts grossly out of proportion to situation sudden rage/anger outbursts - answer>>Intermittent explosive disorder Mnemonic for depression SIGECAPS - answer>>Sleep disturbance interest reduced guilt and self-blame energy loss and fatigue concentration problems P a g e 37 | 51 appetite changes psychomotor changes suicidial thoughts Neurotransmitters involved in depression - answer>>DNS dopamine, norepinephrine, serotonin cognition and memory symptoms of MDD in older adults is often confused with dementia related symptoms and is called - answer>>pseudo dementia = depression Clients with pseudodementia/depression, have a of symptoms. - answer>>acute onset. Dementia patients will have Pseudodementia/depression will have - answer>>dementia: lack of answers or confabulate answers pseudodementia: general responses "I Don't know" First line pharm treatment for depression due to safety - answer>>SSRIs/SNRIs Second line for depression - answer>>TCAs Reason TCAa are second line - answer>>Can cause EKG changes More lethal if taken in overdose attempt. Reason to use ECT - answer>>depression with psychotic features treatment resistant depression P a g e 40 | 51 Cause of tourettes - answer>>dopamine --hyperactivity of the dopamine system. use of external agents that mimic disease (patient ingests foreign body) - answer>>factitious disease excessive worry more than 6 months - answer>>GAD Age of onset of schizophrenia in males - answer>>18-25 Age of onset of schizophrenia in females - answer>>25-35 Cause of schizophrenia - answer>>intrauterine insults prenatal exposure to toxins, including viral agents Problem in the brain in schizophrenia - answer>>enlarged ventricles, everything else decreases Things to monitor and labs while on antispychotic - answer>>serum glucose, serum lipid panel, weight, BMI, waist to hip ratio. liver and kidney function CBC non-harm treatment for schizophrenia - answer>>ACT (assertive community treatment) Person has psychotic symptoms similar to schizophrenia as well as mood symptoms seen in depression and bipolar - answer>>schizoaffective trust vs mistrust - answer>>birth to one year P a g e 41 | 51 virtue in trust vs mistrust - answer>>hope autonomy vs shame and doubt - answer>>early childhood 1-3 years virtue for autonomy vs shame and doubt - answer>>will (they seek will power, independence) Inititiative vs. guilt - answer>>late childhood 3-6 years virtue of initiative vs guilt - answer>>purpose Ability to be a self-starter, to initiate one's own activities. Industry vs inferiority (VERY HIGH YIELD) - answer>>school age 6-12 years Industry vs inferiority virtue - answer>>competence Identity vs role confusion - answer>>Adolescence 12-20 identity vs role confusion virtue - answer>>fidelity personal identity unfavorable: they're confused over who they are. Initimacy vs isolation - answer>>Early adulthood 20-35 Intimacy vs isolation virtue - answer>>love P a g e 42 | 51 Generativity vs stagnation - answer>>middle adultgood 35-65 years generatively vs stagnation virtue - answer>>care key event: parenting integrity vs despair (VERY HIGH YIELD) - answer>>late adulthood greater than 65 years integrity vs despair virtue - answer>>wisdom fulfillment and comfort with life willing to face death, sense of integrity Piaget focuses on - answer>>behavior Piaget Sensorimotor 0-2 - answer>>object permanence and object constancy Piaget Preoperational (VERY HIGH YIELD) 2-7 years - answer>>magical thinking egocentric pretend play Piaget Concrete operational 7-11 years - answer>>Thinks logically about concrete objects Understands conservation and reversibility P a g e 45 | 51 action step in preparation - answer>>help the person find the change strategy that is realistic, acceptable, appropriate, and effective. person is engaging in specific, overt actions to change - answer>>action action step in action - answer>>support and advocate help accomplish steps for change. person is engaging in behaviors to prevent relapse - answer>>maintenance action step in maintenance - answer>>help the person identify the possibility of a relapse identify strategies to prevent relapse. therapy that changes the clients irrational beliefs and negative cognitive disortions - answer>>cognitive therapy. method that uses journaling, cognitive restructuring - answer>>cognitive therapy. Who invented DBT - answer>>Marsha Linehan used for borderline personality disorder Goal of DBT - answer>>reduce suicidal behaviors Emphasizes accepting freedom and making responsible choices - answer>>existential therapy well suited to those facing issues of existence, for example those with terminal illness, those contemplating suicide, or going through transition in life Goal: focus on present and personal responsibility focus on a. patient's subjective world - answer>>Existential therapy P a g e 46 | 51 therapy that is person centered self-directed growth self-actualization - answer>>Humanistic therapy therapy that focuses on interpersonal issues causing distress to understand manage relationship problems - answer>>interpersonal therapy therapy used for PTSD Goal: achieve adaptive resolution relate trauma from a negative thought to a positive thought - answer>>EMDR process providing a personal with visual or auditory information about the autonomic physiologic functions of his or her body. - answer>>biofeedback Family systems therapy (VERY HIGH YIELD) - answer>>triangles, triangulation, self- differentiation triangles are not good for the family Structural family therapy - answer>>boundaries, hierarchies Strategic therapy - answer>>paradoxical intervention--tell the family member that they can worry for one hour of the day. Solution focused therapy - answer>>miracle question patient attributes their own unacceptable thoughts feelings, and motives onto another person - answer>>projection P a g e 47 | 51 redirection of an impulse (usually aggression) onto a powerless substitute target - answer>>displacement displace our unacceptable emotions onto behaviors which are constructive and socially acceptable, rather than destructive healthy defense mechanism - answer>>sublimation concentrating on intellectual aspects to avoid emotional aspects of a difficult situation. Ex, cancer patient reading up on their disease - answer>>Intellectualization Justification for an uncceptable behavior - answer>>rationalization Yalom's Curative Factors - answer>>- Altruism: giving of oneself to help others - Catharsis: relieving of emotions by expressing one's feelings - Universality: recognizing shared feelings and that one's problems are not unique - Existential factors: address accepting the fact that respons. for change comes from w/in oneself - Self-understanding: discovering and accepting unknown parts of oneself - Family reenactment: understanding what is was like growing up in one's family through group exp. - Guidance: accepting advice from other members - Identification: benefiting from imitation of the positive behaviors of other group members - Instillation of hope: experiencing optimism through observing improvement of other members - Interpersonal learning: occurs when receiving feedback from grp members re: one's bx (input), learning successful ways of relating to group members (output) study of long term sequel of adverse childhood events found - answer>>positive relationship between heart disease, obesity, DM, unintended pregnancy, depression, anxiety, cancer, COPD, sleep disorders, dissociative disorders, and substance use disorder. P a g e 50 | 51 telling the truth - answer>>veracity doing for self - answer>>autonomy Rennie v Klein Court Case - answer>>involuntary patient not found incompetent, has a right to refuse psychotropic medications, goal of case management - answer>>promote quality and cost-effective outcomes. Stark Law - answer>>you can't refer to family members for treatment of your patients. PICOT - answer>>Patient or problem intervention comparison outcome time evidence from systematic review or meta analysis of many RCTs - answer>>level 1 evidence evidence from at least one RCT - answer>>level 2 evidence Before implementing/creating change of policy - answer>>assess/address/identify potential organizational barriers and facilitators meet with stakeholders patient advocacy - answer>>reduce stigma of mental illness through education P a g e 51 | 51 help patients receive available services Seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix system issues - answer>>just culture of safety Process for quality improvement - answer>>plan, do, study, act reflective practice - answer>>debriefing strategies goal: to improve practice Highest rate of suicide in US - answer>>native Americans True or false A culturally expected response to a stressor does not always mean a mental illness - answer>>true grasp palmar reflex disappear by - answer>>5-6 months moro startle reflex disappear by - answer>>5-6 months babinski reflex normal until - answer>>age 2 shrill cry in baby - answer>>intracranial pressure playing with genitals normal in ages 3-6 - answer>>true treatment for cultural syndrome - answer>>brief supportive therapy