Medical Terminology and Concepts, Exams of Nursing

Download Medical Terminology and Concepts and more Exams Nursing in PDF only on Docsity! PMHNP EXAM REPORTED QUESTIONS NEWEST ACTUAL EXAM 2025 QUESTION AND DETAILED CORRECT ANSWERS (VERIFIED ANSWERS) | A+ STUDYGUIDE What do you see in labs with HIV & Dementia? Correct Answer CD4 <200 Viral Load is high <20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? Correct Answer Self-Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? Correct Answer Helps rule-out disease = True Positive = Snout What is specificity? Correct Answer Helps rule-in disease = True Negative = Spin What does a sed rate measure? Correct Answer Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? Correct Answer 0-22 males 0-29 females What is a retic count? Correct Answer Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow. What does a decreased retic count indicate? Correct Answer Anemia - acute or chronic bleeding What does an increased retic count indicate? Correct Answer Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? Correct Answer Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? Correct Answer Increase tegretol levels. What happens if a pregnant women takes Accutane? Correct Answer Birth defects. What labs do you get with RA? Correct Answer Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis. CRP and ESR are both increased in RA but NOT in osteoarthritis. What is a claims made/based liability insurance? Correct Answer provides coverage for a claim that is brought within the policy period, no matter when the loss occurred. Who sets the minimum requirements for NP's? Correct Answer Board of Nursing State What are the various controlled substance classes? Correct Answer Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes. Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate Schedule III - Moderate Abuse Potential - hydrocodone, codeine Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine Schedule V - Very low abuse potential - anti-tussives, lomotil What classes of CS's is the NP approved to prescribe? Correct Answer Schedules III-V ONLY. Where does 50% of healthcare funds come from? Correct Answer The government Who is eligible for Medicare? Correct Answer >65 or under 65 with diability, ANY age with renal disease. What is incident to billing? Correct Answer Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD. Allows NP to get reimbursed at 100% rather than 85%. How are Medicaid benefits determined? Correct Answer State determines qualification - Partnership between State and Fed Govt. Must be impoverished Must be US resident and low or very low income. Can you have Medicare and Medicaid? Correct Answer Yes, impoverished elderly but Medicaid is always payor of last resort. Is dental care included in Medicaid? Correct Answer Yes, <21 gets basic dental as part of the Medicaid plan. What is the purpose of HIPAA? Correct Answer National standards for electronic HC transactions National ID for providers, health plans and employers. Not SIMPLY Confidentiality. What must be signed prior to any healthcare in the state Correct Answer Notice of Privacy Practices Statement What happens if a patient refuses to sign an ROI? Correct Answer Can decline to treat Health plan may condition enrollment on provision of consent When is HIPAA not required? Correct Answer Emergency treatment Substantial communication barriers and consent is inferred Involuntary committment Is it ok to announce a patient's name in a waiting room? Correct Answer Yes, no other way to give care. Is it ok to leave a message on a patient's vm? Correct Answer Yes, but should be limited. What is the impact of steroid inhalers on children? Correct Answer Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? Correct Answer Cataracts, glaucoma, thinning of bones and skin What is included in the treatment of fibromyalgia? Correct Answer Sleeping meds Antidepressants Pain meds What is the concern when prescribing Lamictal with Depakote? Correct Answer Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? Correct Answer Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? Correct Answer Microalbumin? What is often common to patients with fibro? Correct Answer Sexual abuse How is telepsychiatry evaluated? Correct Answer Outcome based - measure at intervals. What happens with a patient taking Lithium and who gets dehydrated? Correct Answer Levels increase What happens with a patient taking Lithium who decreases sodium intake? Correct Answer Levels increase What happens with a patient taking Lithium and drinks a lot of water? Correct Answer Levels decrease If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? Correct Answer Zyprexa What happens when taking Lithium and NSAIDS? Correct Answer NSAIDS can cause Lithium levels to increase and for the patient to become toxic! What medications are at risk to cause SJS in the Asian population? Correct Answer HLAB-1502 Allele increase risks of SJS. Trileptal, Tegretol and other AED's. Amgdyla Correct Answer Fear, Anxiety, and Aggression Neurotransmitter for Addiction Correct Answer Dopamine and GABA Neurotransmitter for Mood Disorder Correct Answer Serotonin and norepinephrine Which drug affects Carbamazepine/tegretol Correct Answer Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol Signs and Symptoms of stimulant abuse Correct Answer insomnia and tremor Depakote check Correct Answer HCG levels Depakote causes Correct Answer Spinal bifida Grasp reflex. Correct Answer an infantile reflex in which an infant closes her hand into a fist when her palm is touched Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age. Moro reflex. Correct Answer The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months. pincer grasp Correct Answer 9 months Uses thumb and index finger (pincer grasp) to pick up small objects like Cheerios. Pt has MI looses his job stable on psych medications Correct Answer Provide brief supportive therapy Latida and Geodon Correct Answer Take with food Moro reflex absent Correct Answer Do xray Health Care Policy Model Correct Answer Access, Cost, Quality Child reports Sexual Abuse Correct Answer Interview the young child and infants child with parent What is dissemination? Correct Answer Getting the research information out to those who need to know it! Publication - highest level Presenting at National Conference Presenting at Local Conference Journal Club where one person reviews an article What does a 17 on MMSE mean? Correct Answer Moderate cognitive impairment What is Tegretol in the CYP450 system? Correct Answer Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? Correct Answer Inducer - will lower dose of Lamictal What is a Type I research error? Correct Answer There IS a difference but you say there isn't a difference. What is a Type II research error? Correct Answer There is NO difference but you say there is a difference. What is pseudo-dementia? Correct Answer Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve. Is it normal for a 1 month old to have a palmar grasp? Correct Answer Yes. What is a drug 1/2 life? Correct Answer The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? Correct Answer Zyprexa, Abilify, Seroquel - low doses What is a risk of using Tramadol? Correct Answer Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? Correct Answer HLAB-1502 When might you see toxic epidermal necrolysis? Correct Answer With worsening of SJS How many generations do you include for a genogram? Correct Answer 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? Correct Answer Amino Acids What is epigenetics? Correct Answer Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? Correct Answer Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? Correct Answer Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? Correct Answer 10-25 yo When do females typically present with schizophrenia? Correct Answer 25-35 yo What does Erythromycin to trileptal? Correct Answer You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? Correct Answer Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct Answer Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? Correct Answer Agranulocytosis and Hyponatremia Appreciative Inquiry (AI) Correct Answer Identify the problem Analyze the problem Generate Solutions Implement Best Solutions Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change) Destiny (Make it happen, Implenting Change) Appreciative Inquiry Correct Answer Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change) Destiny (Make it happen, Implenting Change) CIWA-Ar Correct Answer Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised 9 item symptom rating scale, max score 67; <10 does not warrant intervention Hispanic patient lost his parent complain stomach ache his pop couldn't fix what do you do Correct Answer Validate his experience and provide care in a culturally specific way to that patient Native American wants his healer present Correct Answer Involve mother of the patient and healer, mom was cleared for you to involve her 16 year old shows up with mother for first therapy is Correct Answer confidential mom sits in lobby Patient acts out due to missing session what do you do Correct Answer You relate to childhood abandonment and talk about it with the patient How do you assess the competency of a medical procedure Correct Answer Identify a pen and recall 3 words Patient thinks someone has infiltrated the church because he watched it on TV 2 years ago, what diagnosis Correct Answer Delusional disorder Increase ICP (signs and symptoms) Correct Answer Baby Neuro cry Menopausal woman Correct Answer Hormone therapy and replacement Patient on antidepressants for 3 weeks and attempted Suicide Correct Answer Stop medication immediately You want to decrease seclusion on your unit who considered the primary change agent Correct Answer Unit staff You are a lead NP over other NPs in a rural setting how would you go about the change Correct Answer Make online form and have them vote on it 16 year old refuse treatment Correct Answer Send to psych specialist for acting out kids Positive Trendelenburg Sign Correct Answer Refer to Ortho/specialist Pelvis drops to when patient raises one foot off the floor. Drug affects Flonase Correct Answer Zantac (Histamine 2 Blocker) Antagonist Little boy wet his sheets, What kind of therapy would you suggest Correct Answer Behavior therapy DDVAP acts in much the same manner as antidiuretic hormone. Correct Answer Makes less urine Lithium level 1.2u what are you concerned with Correct Answer 4+ Ketones What does depakote do to Lamictal Correct Answer Increase laminate 200% Inducers of Cytochrome P450 (CYP450) Correct Answer Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort A substance that speeds up a chemical reaction charge of DEA Correct Answer state and federal Stereogenesis Correct Answer identify an object without sight a sense that allows a person to recognize the size, shape, and texture of an object Sterogenesis abnormality in Correct Answer parietal lobe Clozaril (Clozapine) Correct Answer WBC-2500 ANC LESS than 1000 (950) dc medication how treat child with depression Correct Answer Zoloft and therapy 3 year old masturbates, plays with self, says naught things Correct Answer normal for Piaget NMS treatment Correct Answer Dantrolene: MUSCLE RELAXTION D2 agonists (e.g., bromocriptine). For NMS, think FEVER: Fever Encephalopathy Vitals unstable Elevated enzymes Rigidity of muscles mesolimbic system Correct Answer POSITIVE symptoms of schizophrenia due to high dopamine negative symptoms of schizophrenia Correct Answer the absence of appropriate behaviors (expressionless faces, rigid bodies) negative symptoms of schizophrenia Correct Answer mesocorticol pathway mesocortical pathway Correct Answer VTA to prefrontal cortex negative symptoms Nigrostriatal pathway Correct Answer EPS DUE TO LOW DOPAMINE IN THIS AREA Communication from SnPC of the basal ganglia to the striatum (caudate + putamen) of the BG via DA; used to initiate movement PDSA model Correct Answer PLAN- Do-carry out Study -examine results Act-decide what action Tanner's stages Correct Answer Tanner stages Correct Answer MMSE (Mini Mental State Examination)- Correct Answer Stage May be Normal 25-30 Mild/Early 21-24 Moderate 10-21 Severe 0-9 A pt states that she has been raped. What do you do Correct Answer ensure safety Hamilton D score of 28 Correct Answer Assess for Suicide Hamilton Depression Rating Scale Correct Answer 17-21 questions 0-7 Normal 14-18 Moderate > 20 Severe Depression Beck Depression Inventory (BDI) Correct Answer 0-13 Minimal depression 14-19 Mild Depression 20-28 Moderate Depression 29-63 Severe Depression Patient Health Questionnaire (PHQ-9) Correct Answer 1-4 minimal 5-9 Mild depression 10-14 Moderate Depression 15-19 Moderate Severe Depression 20-27 Severe Depression Medicare Correct Answer A federal program of health insurance for persons 65 years of age and older Medicare Advantage Correct Answer a program by which eligible Medicare beneficiaries may choose to receive their health care through a qualified managed care plan, which in turn receives capitation payments from Medicare for each enrollee Medicare A, B, C, D Correct Answer A: Inpatient services B: Outpt services C: Private insurance can provide medicare benefits D: Drugs WATCHERS for GAD 3 of these *** for 6 months Correct Answer worry anxiety tension in muscles concentration hyperarousal energy loss, fatigue restlessness sleep trouble Transtheoretical Model of Change Correct Answer 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance Man working at the Gym and his urine is Cherry color Correct Answer order myoglobinuria Latino women wanting prenatal class Correct Answer Consult with cultural group in community Anorexia Correct Answer Set up family therapy quasi-experimental design Correct Answer Research method similar to an experimental design except that it makes use of naturally occurring groups rather than randomly assigning subjects to groups. The ventricle enlargement observed in clients with Correct Answer schizophrenia is most often accompanied by Encopresis Treatment Correct Answer Behavior management: toilet refusal behavior, scheduled toileting time, incentives. Prevention of constipation Counseling Medication that contradicts albuterol Correct Answer Adderall (amphetamine / dextroamphetamine) Advair Diskus (fluticasone / salmeterol) amoxicillin (Amoxil, Trimox, Apo-Amoxi, Moxatag, Amoxicot, DisperMox, Biomox, Moxilin, Wymox) Ativan (lorazepam) Atrovent (ipratropium) azithromycin (Zithromax, Azithromycin Dose Pack, Z-Pak, Zmax) Benadryl (diphenhydramine) caffeine Flonase (fluticasone nasal) ibuprofen ipratropium (Atrovent, Ipratropium Inhalation Solution, Atrovent HFA, Ipratropium Inhalation Aerosol) Lasix (furosemide) metoprolol (Metoprolol Succinate ER, Metoprolol Tartrate, Lopressor, Toprol-XL, Kapspargo Sprinkle) Mucinex (guaifenesin) oxycodone (OxyContin, Roxicodone, Xtampza ER, OxyIR, Oxaydo, Dazidox, Oxyfast, Oxecta, RoxyBond, Oxydose, Percolone, M-Oxy, ETH-Oxydose, Endocodone, Roxicodone Intensol) prednisone (Deltasone, Rayos, Sterapred, Prednicot, Sterapred DS, Liquid Pred, Meticorten, Orasone, Prednicen-M) Singulair (montelukast) Spiriva (tiotropium) Symbicort (budesonide / formoterol) Tylenol (acetaminophen) Vitamin B12 (cyanocobalamin) Vitamin D3 (cholecalciferol) Zyrtec (cetirizine) t-tests Correct Answer statistical measure: test means of 2 independent samples, significantly different? ANOVA (analysis of variance) Correct Answer 3 OR MORE Interpersonal learning- output Members provide an environment that allows members to interact in a more adaptive manner Self-understanding: m embers gain insight into psychological motivation underlying behavior and emotional reactions Metobolic syndrome Correct Answer group of signs and symptoms including insulin resistance, obesity characterized by excessive fat around the waist and abdomen, hypertension, hyperglycemia, elevated triglycerides, and low levels of HDL NAMI Correct Answer national alliance on mental illness help families of mentally ill: education, support groups health literacy Correct Answer a person's capacity to learn about and understand basic health information and services, and to use these resources to promote one's health and wellness health literacy Correct Answer Man taking insulin asking him to read blood glucose level inferential statistics Correct Answer numerical data that allow one to generalize- to infer from sample data the probability of something being true of a population Mood Disorder Questionnaire (MDQ)-SCREENING Correct Answer Mood Disorder Questionnaire Patient Name ______________________________________ Date of Visit ________________ Please answer each question to the best of your ability 1. Has there ever been a period of time when you were not your usual self and... ...you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? ...you were so irritable that you shouted at people or started fights or arguments? ...you felt much more self- confident than usual? ...you got much less sleep than usual and found that you didn't really miss it? ...you were more talkative or spoke much faster than usual? ...thoughts raced through your head or you couldn't slow your mind down? ...you were so easily distracted by things around you that you had trouble concentrating or staying on track? ...you had more energy than usual? ...you were much more active or did many more things than usual? ...you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night? ...you were much more interested in sex than usual? ...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky? ...spending money got you or your family in trouble? 2. If you checked YES to more than one of the above, have several of these ever happened during the same period of time? 3. How much of a problem did any of these cause you - like being unable to work; having family, money or legal troubles; getting into arguments or fights? No problems Minor problem Moderate problem Serious problem This instrument is designed for screening purposes only and not to be used as a diagnostic tool. Permission for use granted by RMA Hirschfeld, MD YES NO Patient comes with vague symptoms depression irritability Correct Answer BECK Depression scale DISSEMINATED ENCEPHALOMYELITIS Correct Answer Assess for asymmetry of extremities Along with this pattern, the patients usually get neurological symptoms which may include: Confusion, drowsiness, and even coma Unsteadiness and falling Visual blurring or double vision (occasionally) Trouble swallowing Weakness of the arms or legs Fever HA - Provide mental health interventions after stressful events. - The public health nurse provides toxin screenings for migrant workers who may be exposed to pesticides. - Implement a family-planning program to prevent unintended pregnancies for young couples who attend the local community health center. - Encourage clients who are pregnant to participate in prenatal care and Special Supplemental Nutrition Program for Women, Infants and Children to increase the number of healthy babies and reduce the costs related to preterm baby care. - Use case finding to identify existing health problems in your caseload and the population served by your agency. Timely, holistic assessments and interventions can slow disease trajectories and promote healing and health. - Assess disaster victims and triage for care. - Investigate an outbreak of flulike illness in a local school. - Provide programs in child development and behavior management for families who have not yet abused their children but whose children are brought to the attention of social authorities for aggressive behavior problems. - Develop a way for homeless individuals to read their TB skin test, if necessary, and to transfer the results back to the fa Collab with OB NP questions Correct Answer wants to establish a relationship so Mental Health can be reached by more people anorexia nervosa Correct Answer BMI less than 18.5 an eating disorder in which an irrational fear of weight gain leads people to starve themselves Anorexia admission Criteria for hospitalization includes: Correct Answer weight loss over 30% over 6 months, severe hypothermia (temperature lower than 36°C or 96.8°F), heart rate less than 40 beats per minute, systolic blood pressure less than 70 mm Hg, and hypokalemia (less than 3 mEq/L). Culture question: A man injects himself Correct Answer "tell me more about the medications" Acute Stress Disorder (ASD) Correct Answer can be 2-4 weeks a disorder resulting from exposure to a major stressor, with symptoms of anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to "relive" the event in dreams and flashbacks for as long as 1 month following the event Scope of Practice in Nursing Correct Answer State Standards of Practice Correct Answer ANA ADPIE - Nursing Process Correct Answer Assessment Diagnosis Planning Implementation Evaluation Adult panic disorder Correct Answer Buspar Kids panic disorder Correct Answer Clonidine Guafacine OCD (Obsessive Compulsive Disorder) Correct Answer TCA Clomipramical Clomipramine (Anafranil) Correct Answer OCD, depression (tricyclic) agoraphobia Correct Answer fear of open spaces Agoraphobia treatment Correct Answer *BZDs* - short term symptom relief *SSRIs* - long-term maintenance fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) *SNRIs* - long-term maintenance venlafaxine (Effexor) *TCAs* - long-term maintenance imipramine social anxiety disorder Correct Answer BetaBlocker Propanolol 1. orientation 2. working 3. termination roles of the nurse - stranger - resource person - teacher - leader - surrogate - conselor Paplau's Interpersonal Theory Correct Answer Process recording Give Ativan Correct Answer For Alcoholic with Liver problems detailed physical exam Correct Answer Pt states that God did this to me Correct Answer Assess spiritual needs Mini-Cog Correct Answer is another screening tool that can be administered in 5 minutes or less and requires minimal training. 3 item recall, clock drawing test (CDT) women in military and she saw her friend die Correct Answer PTSD Man had appt, wife came and he didnt Correct Answer Tell wife to reschedule appt Tagement (Cimetidine) Correct Answer ^ Benzo ^ Coumadin Erythromycin Correct Answer ^ Xanax levels Disulfiram Correct Answer ^ Coumadin Pt with Eating disorder states getting full Correct Answer Bloating delayed Gastric emptying Realiability Correct Answer consistency Biggest Concern with EHR Correct Answer Confidentiality Qualiatative Correct Answer Measures in natural setting i.e ?, observation Quantitative Correct Answer Data that is in numbers internal validity Correct Answer Was research done right? extent to which we can draw cause-and-effect inferences from a study I don't know answers Correct Answer pseudo dementia interferon Correct Answer decrease Wellbutrin ^ prolactin Correct Answer stop prolactin EPS Correct Answer ^ risk for TD Assess when someone ready to quit drinking Correct Answer See what stage they in Ask when ready to start tx To check for Dementia Correct Answer Have the patient tell you risk/benefits test capacity dairy log Correct Answer CBT treating a 6 y/o pt WHO HAS dx with Luekemia 1 month ago. What do you expect Correct Answer He would think he is being punished fro doing something wrong antidepressant takes Correct Answer 5 weeks 13 year old want to smoke Correct Answer ask him of his plan to stop smoking placement of chronically mental ill Correct Answer ACT Assertive Community Treatment Assertive Community Treatment (ACT) Correct Answer community-based programs that provide many of the services that are necessary for successful community living; includes case management, problem-solving, social skills training, support, teaching on a 24/7 basis