GEORGETTE'S LMR PMHNP Certification Exam Review 2023-2025: Questions and Answers, Exams of Nursing

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GEORGETTE'S LMR PMHNP CERTIFICATION EXAM

REVIEW 2023 UPDATED AND REVISED 2024 - 2025

What drugs should be avoided with Kava Kava? - Alprazolam, CNS depressants (e.g., phenobarbital, zolpidem) - ANSWER -

Kava Kava Cultural Formulation Interview perform what 3 functions? - Clarify meaning of illness, Empower the patient, Validate symptoms within cultural context - ANSWER - >Cultural Formulation Interview What is the normal range for TSH? - 0.5 - 5.0 mu/L - ANSWER - TSH Normal Range What are lab values in Hyperthyroidism - Decreased TSH, Increased T4 and T3 - ANSWER - >Hyperthyroidism Lab Values What are labs in Hypothyroidism? - Increased TSH, Decreased T4 and T3 - ANSWER - >Hypothyroidism Lab Values What are 5 primary symptoms of Hyperthyroidism? - Heat intolerance, Agitation, Anxiety, Irritability, Tachycardia, Mood swings, Weight loss - ANSWER - >Hyperthyroidism Symptoms What are 4 primary symptoms of Hypothyroidism? - Cold intolerance, Lethargy, Weight gain, Decreased libido - ANSWER

• Hypothyroidism Symptoms

Hypothyroidism mimics symptoms of what psychiatric disorder? - Depression - ANSWER - >Hypothyroidism and Depression Hyperthyroidism mimics symptoms of what psychiatric disorder? - Mania - ANSWER - >Hyperthyroidism and Mania Valproic acid produces what teratogenic effect? - Spina bifida (neural tube defect) - ANSWER - >Valproic Acid Teratogenic Effect What is the primary organ where valproic acid is toxic? - Liver (hepatoxicity) - ANSWER - >Valproic Acid Toxicity What are 4 signs of hepatoxicity? - Abdominal pain in the URQ, Reddish-brown urine, Yellowing of the skin and sclera, Fatigue - ANSWER - >Signs of Hepatotoxicity What is the therapeutic range for valproic acid? - 50 - 125 mcg/ml - ANSWER - >Valproic Acid Therapeutic Range What is a toxic level of valproic acid? - >150 mcg/ml - ANSWER -

Valproic Acid Toxic Level What are 4 signs of valproic acid toxicity? - Disorientation, Lethargy, Respiratory depression, Nausea/vomiting - ANSWER - Valproic Acid Toxicity Signs

With suspected toxicity with valproic acid, what labs should be drawn? - DC drug, Check drug level, Obtain LFTs, Obtain ammonia level - ANSWER - >Valproic Acid Toxicity Labs What is the major side effect with Kava Kava? - Liver damage - ANSWER - >Kava Kava Side Effect What herbal supplement is used for anxiety, stress, and insomnia? - Kava Kava - ANSWER - >Kava Kava Uses What are 5 symptoms of Stephen's Johnson Syndrome? - Fever, Body aches, Severe red rash, Peeling skin, Facial and tongue swelling - ANSWER - >Stephen's Johnson Syndrome Symptoms Which mood stabilizer causes the least weight gain? - Lamotrigine (Lamictal) - ANSWER - >Mood Stabilizer Weight Gain Which 3 SGAs cause the least weight gain? - Lurasidone (Latuda), Aripiprazole (Abilify), Ziprasidone (Geodon) - ANSWER

• SGAs Weight Gain Which SGA is the least sedating? - Aripiprazole (Abilify) - ANSWER - >Least Sedating SGA What are 3 hallmark symptoms of delirium? - Acute disturbance of LOC, impaired cognition, inattention - ANSWER - Delirium Hallmark Symptoms

How are agitation and psychotic symptoms treated in delirium?

• Low dose Haldol - ANSWER - >Delirium Treatment What 4 drugs can cause mania? - Steroids, Disulfiram (Antabuse), Isoniazid (INH), Antidepressants (in BPD) - ANSWER

• Drugs Inducing Mania What 6 drugs can induce depression? - Steroids, Beta blockers, Interferon, Isotretinoin (Accutane), Retroviral drugs, Antineoplastic drugs, Benzodiazepines, Progesterone - ANSWER

• Drugs Inducing Depression Steroids can induce what 3 psychiatric states? - Mania, Depression, Psychosis - ANSWER - >Steroids and Psychiatric States What medication to treat acne cause cause birth defects? - Isotretinoin (Accutane) - ANSWER - >Isotretinoin Birth Defects What is the therapeutic range for lithium? - 0.6-1.2 mEq/L - ANSWER - >Lithium Therapeutic Range What medication has a neuroprotective effect for bipolar disorder? - Lithium - ANSWER - >Lithium Neuroprotective Effect What is the gold standard for treating manic episodes - Lithium

• ANSWER - >Gold Standard for Manic Episodes

What mood stabilizer has anti-suicidal effects? - Lithium - ANSWER - >Lithium Anti-Suicidal Effects What are 5 labs should be drawn with lithium? - Thyroid panel (TSH), Serum creatinine, BUN, Urinalysis, HCG - ANSWER -

Lithium Labs What is a normal SCr range? - 0.6-1.2 mg/dL - ANSWER - Normal SCr Range What is the normal range for BUN? - 10 - 20 mg/dL - ANSWER - Normal BUN Range

When should you suspect kidney disease with a urinalysis? - 4+ protein - ANSWER - >Kidney Disease Urinalysis 4+ protein in the kidney suggests - Kidney disease - ANSWER -

4+ Protein and Kidney Disease What are 7 side effects of lithium? - Hypothyroidism, Fine hand tremors, Maculopapular rash, GI upset (N/V/D, cramps, anorexia), Polyuria, polydipsia, diabetes insipidus, T-wave inversions, Leucocytosis - ANSWER - >Lithium Side Effects What are 7 signs of lithium toxicity? - Severe nausea, vomiting, diarrhea, Confusion, Drowsiness, Muscle weakness, Heart palpitations, Coarse hand tremor, Unsteadiness while standing or walking - ANSWER - >Lithium Toxicity Signs

Which 3 drugs can increase lithium levels by decreasing renal clearance? - NSAIDs (ibuprofen, indomethacin), Thiazides, ACEI

• ANSWER - >Drugs Increasing Lithium Levels What is a toxic level of lithium? - 1.5 mEq/L or higher - ANSWER

• Lithium Toxic Level At what level do you monitor lithium closely (but not discontinue)? - 1.3 mEq/L or higher - ANSWER - >Lithium Monitoring Level With suspected lithium toxicity, what do you do first? - Lithium level (not VS) - ANSWER - >Lithium Toxicity First Action What is the appropriate action if lithium level is 1.5 mEq/L? - DC lithium, Check lithium level - ANSWER - >Lithium Level Action What 2 conditions can increase lithium levels? - Dehydration, Hyponatremia - ANSWER - >Conditions Increasing Lithium Levels What birth defect can lithium cause? - Ebstein anomaly (congenital heart defect) - ANSWER - >Lithium Birth Defect What 3 neurotransmitters are associated with ADHD? - DNS - ANSWER - >ADHD Neurotransmitters What 3 parts of the brain are affected with ADHD? - Frontal cortex, Basal ganglia, Reticular Activating System - ANSWER - ADHD Affected Brain Parts

The Frontal cortex, Basal ganglia, Reticular Activating System are associated with which psychiatric disorder? - ADHD - ANSWER - >ADHD Associated Brain Parts Inattentive Type ADHD demonstrates abnormalities in which part of the brain? - Prefrontal cortex - ANSWER - >Inattentive Type ADHD Brain Abnormality What should be done before placing a patient on stimulants for ADHD (priority)? - Cardiac history - ANSWER - >Stimulants for ADHD Priority Excessive worry, apprehension, or anxiety about events or activities that occurs more days than not for a period of at least 6 months is - GAD - ANSWER - >Generalized Anxiety Disorder If a patient is receiving Haldol 5 mg PO bid, how much Haldol Decanoate should they receive? - 20 x 10 mg = 200 mg (q month) - ANSWER - >Haldol Conversion to Depot Form What is the formula for converting oral Haldol to depot form? - 20 x daily dose - ANSWER - >Haldol Conversion Formula What does thought process assess? - thoughts and ideas - ANSWER - >Thought Process Assessment The way a patient organizes his thoughts and ideas is called - Thought process - ANSWER - >Thought Organization

A normal thought process is described as - Logical, Linear, Coherent, Goal-oriented - ANSWER - >Normal Thought Process Moving from thought to thought and never getting to the point is called - Tangentiality ('goes on tangent') - ANSWER -

Tangentiality Providing unnecessary detail but eventually getting to the point is called - Circumstantiality ('goes in circles') - ANSWER - Circumstantiality Themes that occupy a patient's thoughts and perceptual disturbances is called - Thought content - ANSWER - >Thought Content Thought content includes 3 items - Suicidal ideation, Homicidal ideation, Hallucinations/Delusions - ANSWER - >Thought Content Items Asking a patient to count backward from 100 by seven (serial 7s) measures 3 processes - Concentration, Attention, Calculation - ANSWER - >Serial 7s Assessment Asking the year, season, date, month, and location measures - Orientation - ANSWER - >Orientation Assessment

Asking a patient to repeat 'bed, bad, ball' measures - Registration (ability to learn new material) - ANSWER -

Registration Assessment Asking a patient to repeat objects 5 minutes later measures - Recall (memory) - ANSWER - >Recall Assessment Asking the patient who is the president of the US or governor of state is measuring - Fund of Knowledge - ANSWER - >Fund of Knowledge Assessment What is a simple test that can be administered in a minute or two to measure possible dementia? - Clock Drawing Test - ANSWER - >Clock Drawing Test Impairments in the clock drawing test (CDT) can be associated with damage to - Right parietal lobe (right hemisphere) - ANSWER - >Clock Drawing Test Impairments Hyperactivity of dopamine in the mesolimbic pathway modulates - positive psychotic symptoms - ANSWER - Dopamine and Positive Symptoms Decreased dopamine in the mesocortical pathway (dorsolateral prefrontal cortex) leads to what 2 symptoms? - Negative symptoms, Depressive symptoms - ANSWER - >Dopamine and Negative Symptoms

The nigrostriatal pathway modulates - motor movements - ANSWER - >Nigrostriatal Pathway Function Dopamine has what type of relationship with acetylcholine - Inverse - ANSWER - >Dopamine and Acetylcholine Relationship Dopamine blockage in the nigrostriatal pathway leads to what 4 side effects? - Acute dystonia, Parkinsonism syndromes, Akathisia, Tardive dyskinesia - ANSWER - >Dopamine Blockage Side Effects Blocking the tuberoinfundibular pathway leads to - Increased prolactin - ANSWER - >Tuberoinfundibular Pathway Effect What are 5 symptoms of hyperprolactinemia? - Amenorrhea, Galactorrhea, Sexual dysfunction, Gynecomastia, Osteoporosis (Long-term) - ANSWER - >Hyperprolactinemia Symptoms What antipsychotic has the greatest effect on prolactin? - Risperidone - ANSWER - >Prolactin Effect Antipsychotic What is the black box warning for carbamazepine? - Agranulocytosis - ANSWER - >Carbamazepine Black Box Warning What are 8 symptoms of aplastic anemia? - Pallor, Fatigue, Headache, Fever, Nosebleeds, Bleeding gums, Skin rash, SOB - ANSWER - >Aplastic Anemia Symptoms

What ethnic group is most susceptible to SJS with carbamazepine? - Asians - ANSWER - >SJS Susceptible Ethnic Group Having the HLA-B1502 allele increases the risk for - SJS - ANSWER - >HLA-B1502 Allele Risk Which ethnic group is most likely to have the HLA-B* allele? - Asians - ANSWER - >HLA-B1502 Allele Ethnic Group Asians are most likely to have what allele? - ANSWER - >Asians and HLA-B Asians are most likely to have what allele? - HLA-B1502 - ANSWER - >Asians In which ethnic group must you screen for the HLA-B allele before initiating therapy? - Asian - ANSWER - >HLA- B* A sudden fever, chills, a sore throat, and weakness are symptoms of - Agranulocytosis - ANSWER - >Agranulocytosis What are 4 symptoms of agranulocytosis - A sudden fever, Chills, Sore throat, Weakness - ANSWER - >Symptoms of agranulocytosis At what ANC should clozapine be stopped (even if asymptomatic)? - <1000 - ANSWER - >Clozapine

What is neutropenia? - <2000 PMNs - ANSWER - >Neutropenia What does DIGFAST stand for? - Distractibility, Indiscretion, Grandiosity, FOI, Activity increased, Sleep decreased, Talkativeness - ANSWER - >DIGFAST What are 5 neurological symptoms in Conversion Disorder? - Blindness, Mutism, Paralysis, Paresthesia (glove stocking syndrome), Seizures - ANSWER - >Conversion Disorder When do symptoms typically begin with Conversion Disorder? - After a stressful experience (suddenly) - ANSWER - >Symptoms onset in Conversion Disorder What are 5 stressful events in a child's life that can cause adjustment disorder? - Family move, Parent divorce/separation, Loss of pet, Birth of sibling, Sudden or chronic illness - ANSWER - >Adjustment Disorder A child with an Adjustment Disorder with disturbances of conduct may have what symptoms? - Not going to school, destroying property, driving recklessly, or fighting - ANSWER -

Adjustment Disorder with disturbances of conduct What is the required duration of behavior for a DSM- 5 diagnosis of Oppositional Defiant Disorder (ODD)? - 6 months - ANSWER - >Oppositional Defiant Disorder (ODD)

How many symptoms must a child with Oppositional Defiant Disorder (ODD) display to meet DSM-5 criteria? - 4 - ANSWER -

Symptoms for ODD What is the mainstay treatment of Oppositional Defiant Disorder (ODD)? - Therapy - ANSWER - >Mainstay treatment for ODD What is the primary therapy used to treat Oppositional Defiant Disorder (ODD)? - Child and parent problem-solving skills training - ANSWER - >Primary therapy for ODD A repetitive and persistent pattern of behavior in which the rights of others or societal norms or rules are violated is what disorder? - Conduct Disorder - ANSWER - >Conduct Disorder What are 3 characteristics of Conduct Disorder? - Destruction of property, Deceit or theft, Lack of remorse - ANSWER - Characteristics of Conduct Disorder What 2 factors differentiate Conduct Disorder from ODD? - Severity, Aggression - ANSWER - >Differentiating factors for Conduct Disorder and ODD What are 4 pharmacologic treatments for Conduct Disorder? - Antipsychotics, Mood stabilizers, SSRIs, Alpha agonists - ANSWER - >Pharmacologic treatments for Conduct Disorder

What is the mainstay treatment for Conduct Disorder? - Therapy - ANSWER - >Mainstay treatment for Conduct Disorder What type of therapy is used in the treatment of Conduct Disorder? - Behavioral therapy - ANSWER - >Type of therapy for Conduct Disorder What is Multisystemic family therapy? - Home-based model for youth with serious antisocial and criminal offenses by empowering parents with resources and skills and reducing barriers to resources needed for effective management of youth - ANSWER - >Multisystemic family therapy What is the goal of multisystemic family therapy (MFT)? - Reduce barriers to resources for youth with problematic behavior - ANSWER - >Goal of multisystemic family therapy (MFT) What is the moderate range for MMSE - 10 - 20 - ANSWER -

Moderate range for MMSE What is the moderate range for SLUM? - 10 - 20 - ANSWER - Moderate range for SLUM What is the moderate range for HAM-D? - 14 - 18 - ANSWER - Moderate range for HAM-D What is the moderate range for PHQ- 9 - 10 - 14 - ANSWER - Moderate range for PHQ- 9

What is the moderate range for BDI? - 19 - 29 - ANSWER -

Moderate range for BDI What is the moderate range for HAM-A? - 18 - 24 - ANSWER - Moderate range for HAM-A What is the moderate range for GAD- 7 - 10 - 14 - ANSWER - Moderate range for GAD- 7 What is the moderate range for COWS? - 13 - 24 - ANSWER - Moderate range for COWS If a patient's COWS score is between 5 - 12, what do you do? - Administer clonidine - ANSWER - >COWS score 5 - 12 If a patient's COWS score is between 13 - 24, what do you do? - Administer buprenorphine (Suboxone) - ANSWER - >COWS score 13 - 24

When do you administer clonidine on the COWS? - mild symptoms (>7) - ANSWER - >Clonidine administration on COWS When do you administer buprenorphine (Suboxone) on the COWS? - moderate symptoms (13-24) - ANSWER -

Buprenorphine administration on COWS What is a moderate range on the CIWA? - 16 - 20 - ANSWER - Moderate range on CIWA

When do you administer prn benzodiazepine on the CIWA? - Mild symptoms (8 or greater) - ANSWER - >PRN benzodiazepine on CIWA When do you administer scheduled benzodiazepine on the CIWA? - moderate symptoms (15 or higher) - ANSWER -

Scheduled benzodiazepine on CIWA If a patient has severe depression (over 18 on HAM-D) (over 14 on PHQ-9) (over 29 on BDI), how do you treat it? - Medication

and/or therapy, Assess for suicidal ideation - ANSWER - >Severe depression treatment If a patient has moderate depression (14 - 18 on HAM-D) (10 - 14 on PHQ-9) (19 - 29 on BDI), how do you treat it? - Medication and/or therapy - ANSWER - >Moderate depression treatment If a patient has mild depression (<14 on HAM-D) (<10 on PHQ-

9. (<19 on BDI), how do you treat it? - Therapy or nothing - ANSWER - >Mild depression treatment If a patient has mild anxiety (<18 on HAM-A) (<10 on GAD-7), how do you treat? - Therapy or nothing - ANSWER - >Mild anxiety treatment

If a patient has severe anxiety (>24 on HAM-A) (>14 on GAD-7) how do you treat? - Medication and/or therapy - ANSWER -

Severe anxiety treatment If a patient has moderate anxiety (18-24 on HAM-A) (10 - 14 on GAD-7) how do you treat it? - Medication and/or therapy - ANSWER - >Moderate anxiety treatment What are 4 areas in the brain that can cause aggression, impulsivity, and difficulty with abstract thinking? - Prefrontal cortex, Amygdala, Basal ganglia, Hippocampus - ANSWER - Brain areas causing aggression Abnormalities in the Prefrontal cortex, Amygdala, Basal ganglia, and Hippocampus can cause what 3 symptoms? - Aggression, Impulsivity, Difficulty with abstract thinking - ANSWER - Symptoms from brain abnormalities What are 6 symptoms of NMS? - Extreme muscular rigidity, Mutism, Elevated CPK (creatine phosphokinase), Myoglobinuria, Leukocytosis, Elevated LFTs - ANSWER - Symptoms of NMS How do you treat NMS? - DC antipsychotic, Bromocriptine or Dantrolene - ANSWER - >Treatment for NMS What does Dantrolene treat in NMS? - Muscle rigidity - ANSWER - >Dantrolene in NMS

How do you treat Serotonin Syndrome? - DC Antidepressant, Cyproheptadine - ANSWER - >Treatment for Serotonin Syndrome What combination medications increases the risk of Serotonin Syndrome - multiple antidepressants (SSRI/SNRI/TCA/MOAI) - ANSWER - >Risk factors for Serotonin Syndrome When switching from an MAOI to SSRI/SNRI, how long should you wait? - 2 weeks - ANSWER - >Waiting period from MAOI to SSRI/SNRI When switching from Prozac to an MAOI, how long should you wait? - 5 - 6 weeks - ANSWER - >Waiting period from Prozac to MAOI When switching from Prozac to any antidepressant (TCA, SNRA, or MAOI), how long should you wait? - 5 - 6 weeks - ANSWER -

Waiting period from Prozac to any antidepressant When switching from an SSRI/SNRI to a MAOI, how long should you wait? - 2 weeks - ANSWER - >Waiting period from SSRI/SNRI to MAOI What is the function of compulsions in OCD? - Reduce subjective anxiety level - ANSWER - >Function of compulsions in OCD

What is PANDAS? - Pediatric Autoimmune Neuropsychiatric Disorder associated with streptococcal infections in children - ANSWER - >PANDAS If a child has both intrusive thoughts and tics, his most likely diagnosis is - OCD - ANSWER - >Diagnosis with intrusive thoughts and tics If a child has multiple tics both no ruminating thoughts, his diagnosis is most likely - Tourette's - ANSWER - >Diagnosis with multiple tics What 2 neurotransmitters are associated with OCD? - Serotonin, Norepinephrine - ANSWER - >Neurotransmitters associated with OCD A childhood depressive disorder that is diagnosed in children older than 6 but younger than 18 is most likely - DMDD - ANSWER - >Childhood depressive disorder A child with chronic dysregulated mood ('mood'), frequent intense temper outbursts, severe irritability, and anger is most likely to have what diagnosis? - DMDD - ANSWER - >Chronic dysregulated mood in children The age criteria for a DSM-5 diagnosis of Disruptive Mood Dysregulation Disorder (DMDD) is - >6 and <18 (7-17 yrs.) - ANSWER - >Age criteria for DMDD

A child who is chronically 'moody' is most likely to have what diagnosis? - DMDD - ANSWER - >Chronically moody child diagnosis What are 2 symptoms associated with lead poisoning? - Developmental delay (learning difficulties), Pica (paint chips) - ANSWER - >Symptoms of lead poisoning Which 2 demographic characteristics are associated with lead poisoning? - rural areas, 1970's - ANSWER - >Demographic characteristics of lead poisoning A child with developmental delay who eats things (such as paint chips) may have - Lead poisoning - ANSWER - >Lead poisoning diagnosis What 4 assessments should be done in a patient receiving an antipsychotic that causes weight gain? - BMI, Hip-to-waist ratio, Glucose, Lipid panel - ANSWER - >Assessments for antipsychotic weight gain Where is norepinephrine produced? - Locus coeruleus, Medullary reticular formation - ANSWER - >Norepinephrine production The neurotransmitter produced in the locus coeruleus and medullary reticular formation is - Norepinephrine - ANSWER -

Norepinephrine neurotransmitter

What neurotransmitter is produced in the raphe nuclei in the brainstem? - Serotonin - ANSWER - >Serotonin production Serotonin is produced in - raphe nuclei in the brainstem - ANSWER - >Serotonin production location What neurotransmitter is produced in the substantia nigra, the ventral tegmental area (VTA), and the nucleus accumbens? - Dopamine - ANSWER - >Dopamine production What 3 areas of the brain is dopamine produced? - Substantia nigra, Ventral tegmental area (VTA), Nucleus Accumbens - ANSWER - >Dopamine production areas Where is acetylcholine synthesized? - Basal nucleus of Meynert

• ANSWER - >Acetylcholine synthesis The Basal nucleus of Meynert is the area where what neurotransmitter is produced? - Acetycholine - ANSWER -

Acetylcholine production area What is the function of the amygdala? - ANSWER - >Function of the amygdala A neurotransmitter involved in many functions including muscle activation. - ANSWER - >Acetylcholine Emotions (aggression, fear, anxiety) - ANSWER - >Amygdala

Emotions, stress, learning, and memory - ANSWER -

Hippocampus A disorder associated with persistent deficits in social communication and social interactions across multiple settings.

• ANSWER - >Autism Spectrum Disorder Glutamate, GABA, Serotonin - ANSWER - >Neurotransmitters associated with Autism Spectrum Disorder A theory claiming that dysfunction of a particular neuron system may be a cause of poor social interaction and cognition in autism. - ANSWER - >Broken Mirror Theory Motor: 2 or more and Vocal: 1 or more (not necessarily at same time) - ANSWER - >Tourette's Disorder criteria for tics

1 year - ANSWER - >Tourette's Disorder duration criteria <18 yrs - ANSWER - >Tourette's Disorder age criteria Antipsychotic (haloperidol, pimozide, aripiprazole*) - ANSWER - Pharmacological treatment of Tourette's Disorder Previous suicide attempt, 45 and older (55 for women), Divorced, single, or separated, White (Caucasian), Living alone, Psychiatric disorder, Physical illness, Substance abuse, Family history of suicide, Recent loss, Male gender - ANSWER - >Risk factors for suicide

Low BMI, Amenorrhea, Emaciation (abnormally thin), Bradycardia, Hypotension - ANSWER - >Physical characteristics of Anorexia Nervosa Normal range - ANSWER - >BMI in Bulimia Nervosa Within 4 weeks of traumatic event - ANSWER - >Acute Stress Disorder onset of symptoms Intrusive re-experiencing, Increased arousal (hyperarousal), Avoidance of stimuli associated with trauma - ANSWER -

Hallmark symptoms of PTSD SSRIs, TCAs, Prazosin for nightmares - ANSWER - Pharmacological treatments for PTSD EMDR, CBT - ANSWER - >Nonpharmacologic treatments for PTSD Pulse, Sweating, Restlessness, Pupil size, Bone aches, Running nose or tearing, GI upset, Yawning, Tremors, Anxiety/irritability, Gooseflesh skin, Dilated pupils - ANSWER - >Components of the COWS Nausea/vomiting, Tremor, Sweats, Anxiety, Agitation, Tactile disturbances, Auditory disturbances, Headaches, Orientation - ANSWER - >Components of the CIWA Scale

Acamprosate (Campral), Disulfiram (Antabuse), Naltrexone (Vivitrol, ReVia) - ANSWER - >Treatments for Alcohol Use Disorder Acamprosate (Campral) - ANSWER - >Agent for Alcohol Use Disorder not metabolized by the liver Instillation of hope, Universality, Group cohesiveness, Altruism - ANSWER - >Therapeutic factors of Yalom's Group Therapy An approach to organizational change which focuses on strengths rather than weaknesses. - ANSWER - >Appreciative Inquiry Projects designed to improve systems, decrease cost, and improve productivity - ANSWER - >Goals of Quality Improvement The process/strategy of Quality Improvement: Plan, Do, Study, Act - ANSWER - >PDSA Cycle Process, Policy reform, Policy environment, Policy makers - ANSWER - >Components of Health Policy Formulation, Implementation, and Evaluation (FIE) - ANSWER -

3 - part process component of Health Policy Changes in programs and practices in Health Policy. - ANSWER - Policy Reform

The arena the process takes place in (government, media, public). - ANSWER - >Policy environment Key players and stakeholders. - ANSWER - >Policy Makers Assess/address organizational barriers and facilitators. - ANSWER - >First action when developing Health Policy A treatment approach that does not focus on full symptom resolution but emphasizes resilience and control over problems and life. - ANSWER - >Recovery Model Not a step-by-step process, but one based on continual growth and occasional setbacks. - ANSWER - >Nonlinear treatment approach Learning from experience (e.g. relapse), Nonlinear, Self- directed, Individualized and Person-Centered. - ANSWER -

Characteristics of the Recovery Model Screens for Substance Use Disorders: Screening, Brief, Intervention, Referral, Treatment. - ANSWER - >SBIRT Duty to warn victim of imminent danger of homicidal patients. - ANSWER - >Tarasoff Principle Patients have the right to refuse treatment and use an appeal process. - ANSWER - >Rennie vs. Klein Court Case