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PMHNP ANCC Exam Questions And Answers/100% Correct.2023 Updates Best Exam Solutions graded A+
Typology: Exams
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Descriptive Vividness Correct ans - The researcher describes the data gathering process in sufficient detail that the reader can personally experience it. The data collected, often in the form of personal statements, should be quoted directly and extensively, because this is the raw data from the study. Methodological Congruence Correct ans - The researcher presents the philosophical and methodological approach used and cites references to support their approach. The subjects, sampling method, data-gathering and data-analysis strategies, and processes for informed consent are clearly and concisely described. Theoretical Conectedness Correct ans - Any theory developed from the study is clearly stated, logically consistent, reflective of the data, and in accord with other available knowledge. Analytical Precision Correct ans - Is not concerned with statistics and instruments. If refers to the decision-making process by which the researchers synthesize concrete data (words of the subjects) into an abstract that clarifies the meaning and the importance of the study. The last of the 5 criteria is Heuristic Relevance - The researcher clarifies the significance of the study, its applicability to public health or community nursing, and its likely influence o the future research. Phenelzine Correct ans - An MAOI that patients with atypical depression respond particularly well to. Atomoxetine Correct ans - A norepinephrine reuptake inhibitor approved for the treatment of ADHD. Loxapine Correct ans - A typical, tetracyclic antipsychotic with antidepressant properties. Its active metabolite is amoxapine, which is a secondary amine tricyclic antidepressant. HITECH Correct ans - Implementation of EHR for information exchanges and improving population health. This was done by Obama and the ARRA. Suppression Correct ans- The intentional or conscious exclusion of painful or disturbing thoughts or emotions from awareness. A healthy defense mechanism because the client channels conflicting energies into growth-promoting activities.
Medications that can induce depression Correct ans - beta blockers, steroids, interferon, Accutane, benzodiazepines, progesterone, some antivirals, and antineoplasmics. Medications that can induce mania Correct ans- Steroids, Isoniazid, antidepressants (in people who already have bipolar disorder), and Antabuse. Medigap Insurance Policies Correct ans - Private insurance policies purchased by elderly individuals to cover some or all of their medical expenses not paid for by Medicare. Medicare Advantage Plan Correct ans- Formerly Medicare + Choice, this created regional Preferred Provider Organizations (PPOs) and gave Medicare enrollees the option of enrolling in private insurance plans. Medicare + Choice Correct ans - Was a part of the Balanced Budget Act of 1997 that significantly increase the number of managed care insurance plans available to recipients. This was replaced with the Medicare Advantage Plan in 200. List of the Second Generation (atypical) Antipsychotics (9) Correct ans
List the Tricyclic Antidepressants (9) Correct ans - Pamelor (nortriptyline), Elavil (amitriptyline), amoxapine (no branded), Anafranil (clomipramine), Norpramin (desipramine), Tofranil (imipramine), Vivactil (protriptyline), Sinequan/Silenor (doxepin), Surmontil (trimipramine) FINISH acronym for SSRI withdrawal Correct ans - Flu-like symptoms Irritability Nausea Imbalance/instability/incoordination/dizzy (motor) Sensory disturbances Headache, hyperarousal (anxiety/agitation) Signs of NMS (Neuroleptic Malignant Syndrome) Correct ans - Initial Symptoms: altered sensorium, hyperreflexia, fever Then signs of autonomic instability: extreme muscle rigidity, hypotension, tachycardia, diaphoresis, tachypnea, hyperthermia, coma, death. Check for increased WBCs (leukocytosis)/LFTs/CPK Signs of Lithium toxicity Correct ans - Confusion, diplopia, nausea/diarrhea, ataxia, lethargy, fatigue, clumsiness, weakness, muscle cramping, severe tremor, blurred vision, nystagmus, increased DTRs, altered mental status, cardiac dysrhythmias Signs of Serotonin Snydrome Correct ans- agitation, restlessness, rapid heart rate, blood pressure elevation, headache, sweating, shivering, goose bumps, myoclonic jerking and loss of coordination, confusion, fevers, unconsciousness, seizures Medications that can increase lithium level Correct ans - NSAIDs, ACE Inhibitors (-prils), ARBs (-sartans), tetracyclines, metronidazole Medications that can decrease lithium level Correct ans - potassium- sparing diuretics, thiazide diuretics, theophylline Clozaril - monitoring considerations Correct ans - Monitor ANC (absolute neutrophil count); pt needs an ANC of at least 1500 to start clozaril therapy; watch for Benign Ethnic Neutropenia (BED); Monitor ANC weekly x6 months, every 2 weeks x6 months, then monthly if ANC is at least 1500. Substances that can cause a false + drug test for PCP & methadone Correct ans - Niquil, OTC cough meds Substances that can cause a false + drug test for heroin & morphine Correct ans - rifampin, fluoroquniolones
Substances that can cause a false + drug test for cocaine Correct ans
Creatinine Correct ans - 0.4-0.8 or less than
Normal GFR Correct ans - >90 mL/min. If a patient is on psychotropics, as long as their GRF is >60, no dose adjustments need to be made. What is the best measure of kidney function? Correct ans - GFR (glomerular filtration rate) Normal Plate Count Correct ans- 140,000-340, Normal hemoglobin value for males and femalesCorrect ans - Males: 13.5- Females: 12.5- Normal MCV (mean corpuscular volume) value Correct ans - 78-100 Normal TSH Range Correct ans - 0.4- Normal Free T4 range Correct ans - 10- Substances that can cause a false + drug test for codeine Correct ans
risk
paroxetine, valproate, carbamazepine, lithium alprazolam, chlordiazepoxide, clonazepam, diazepam, lorazepam, oxazepam ACE Inhibitors (-prils), ARBs (-sartans), ibuprofen (3rd trimester), tetracyclines Drug Category X and examples Correct ans- Absolutely Contraindicated in pregnancy Accutane, misoprostol, thalidomide, flurazepam, temazepam, triazolam Types of inferential statistics Correct ans - p-value, Pearson's r correlation, t-test,ANOVA T-test Correct ans - Compares whether the means of two groups are statistically different ANOVA Correct ans - tests the differences of 3 or more groups Pearson's r correlation Correct ans - tests the relationship between 2 variables HLB-B*1502 Correct ans - Allele that some asian's have which makes them unable to metabolize carbamazepine, increasing their risk for Steven's- Johnson syndrome which can lead to toxic epithelial necrolysis. Asians must be tests for this gene prior to beginning therapy. TIGER Correct ans - technology competencies for NPs to improve access to quality & patient experience Who is covered by Medicare? Correct ans- Adults >65 who have worked at least 4 quarters and paid Medicare taxes End stage renal disease those who need a kidney transplant those with ALS Some younger people with disabilities Those receiving SSDI Who is covered by Medicaid? Correct ans - Low-income children Low-income pregnant women Elderly & disable individuals who qualify for the supplemental security income program HAM-D (Hamilton Depression Scale) Correct ans - 17- questions. Each question with 3-5 possible responses that increase in severity. 0-7 normal
or = 20 moderately severe depression
BDI (Beck Depression Inventory) Correct ans- 21 questions, scores range 0-63. 0-13: minimal depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression Edinburgh Postnatal Depression Scale (EPDS) Correct ans- 10 questions. > or = possible depression SLUMS (St. Louis University Mental Status Exam) Correct ans - HS Education: Normal: 27- MCI: 20- Dementia: 1- Less than HS education: Normal: 20- MCI: 14- Dementia: 1- CIWA Correct ans - Very mild: 0-9 Mild: 10- Moderate: 16- Severe: 21- PHQ-9 (Patient Health Questionnaire 9) Correct ans - 9 questions 1-4 minimal depression 5-9 mild depression 10-14 moderate depression 15-19 moderately severe depression 20-27 severe depression MADRS (Montgomery Asberg Depression Rating Scale) Correct ans
impairment 1-2 word recall and normal CDT= no cognitive impairment
3/3 word recall= negative screen for dementia MMSE (Mini mental status exam) Correct ans - Screens for cognitive impairment and used to follow cognitive function over time. High education may score falsely high. 30-point questionnaire: Intact 25- Mild 21- Moderate 10- 20 Severe < or = MoCA (Montreal Cognitive Assessment) Correct ans
(Phenergan) with codeine, diphenoxylate/atropine (Lomotil)
Role of hypothalamus Correct ans - homeostasis; basic needs (eating drinking, temperature regulation, sleep-wake cycle). Braine stem reponsibility and parts Correct ans - Pons, Midbrain, medulla oblongata Regulates BP, respirations, level of arousal, and digestions. Relays information to the cerebellum Thalamus Correct ans - transmits sensory information to the cerebrum. influences affect, mood, and body movements associated with strong emotions. Kohlberg Correct ans - Stages of Moral Development 6 Domains in Diagnosing Neurocognitive Disorders Correct ans -
4 focuses of IPT (interpersonal therapy) Correct ans - 1. Complicated bereavement
Failure: Emotional isolation, and egocentrism Generativity vs Stagnation Correct ans- Age: 35- Mastery: ability to give time and talents to others and ability to care for others Failure: self-absorption, inability to grow-change as a person, inability to care for others Integrity vs Despair Correct ans- age 65+ Mastery: fulfillment and comfort with life, willingness to face heath, insight and balanced perspective on life's events Failure: biternes, sense of dissatisfaction with life, despair over impending death. Piaget Stages Correct ans- 1. Sensorimotor
Activities: fixated on toilet training and sphincter control, activities of expulsion and retention Failure: depressive disorders Phallic Stage Correct ans - Age: 3-6 years Activities: Exhibitionism, masturbation with focus on Oedipal Conflict, sexual fantasies about opposite sex parent, castration anxiety (males), hear of loss of maternal love (females) Failure: Sexual identity disorders Latency Stage Correct ans- Age: 7-11 years Activities: peer relationships, learning, motor skills development, socialization Failure: inability to form social relationships Genital Stage Correct ans- Age: 12+ years Activities: integration and synthesis of behaviors from early stages, primary genital-based sexuality Failure: Sexual perversion disorders Durham vs the United States (1954) Correct ans - Origin of the insanity defense. Determined than an individual is not criminally responsible if the unlawful act was the product of mental illness. O'connor vs Donaldson (1976) Correct ans - Ruled that harmless mentally ill patients cannot be conned against their will. Determined that the presence of a mental illness alone cannot justify involuntary hospitalization. Rennie vs Klein (1979) Correct ans- Determined that patients may have the right to refuse any treatment and use an appeal process. Roger vs Oken (1981) Correct ans - Patient has a right to refuse treatment but a guardian can consent to treatment for them Ford vs Wainwright (1986) Correct ans - Established a person's competence to be executed. :
Optic Sensory
Sight; tested using Snellen chart. Also, examiner views optic disc with ophthalmoscope, peripheral vision with confrontation test Cranial Nerve III Correct ans - Oculomotor Motor Extraocular movements, tested with CNs IV and VII. Pupils and corneal light reflex. Check for PERRLA Cranial Nerve IV Correct ans - Trochlear Motor Extraocular movements, tested with CNs III and VII. Innervates superior oblique muscle, turns eyes down and laterally (out) Cranial Nerve V Correct ans - Trigeminal Both Sensation of touch and pain on the face. Movement of facial muscles (chewing). Specifically, have patient clench down and palpate the master muscle for tone. Cotton wisp test, and poke with pins with eyes closed on face. Cranial Nerve VI Correct ans- Abducens Motor Extraocular movements, tested with CNs III and IV. Turns eyes laterally (outwards) Cranial Nerve VII Correct ans - Facial Both Facial expressions. Sensation on face. Saliva and tears secretion. Taste (identify sugar, vinegar, and salt with eyes closed). Movement of facial muscles: frown, smile, raise eyebrows, puff out cheeks Cranial Nerve VIII Correct ans - Acoustic (vestibulocochlear) Sensory Hearing: Weber and Rinne test, Whisper Test. Audiometer. Equilibrium, sensation. Cranial Nerve IX Correct ans- Glossopharyngeal Both Taste on anterior 2/3 tongue. Tongue movement. Test with vagus nerve. Cranial Nerve X Correct ans- Vagus Both Carotid blood pressure regulation, lower HR, gag reflex (put tongue depressor on back of tongue), taste, stimulated digestive organs. Test with glossopharyngeal nerve). Check for elevation of uvula by having pt open mouth, say "ahh".
Cranial Nerve XI Correct ans - Spinal Accessory Motor Move face against examiners hand (test SCM), and shrug shoulders against examiner (trapezius muscle). Also controls swallowing. Have them sip water. Cranial Nerve XII Correct ans- Hypoglossal Motor (tongue movement) Stick out tongue and wiggle side to side; protrude tongue and check for involuntary movements. Patient's Access to Responsible Care Alliance Correct ans - A coalition of organizations that represent the interests of millions of patients & non- phyisican healthcare providers. Pharmacodynamics Correct ans- What the drug does to the body (target sites for drug actions). Examples: receptors, ion channels, enzymes, carrier proteins. Transtheoretical Model Stages of Changes Correct ans - Precontemplati on contemplation preparation action maintenance termination Excitatory Response Correct ans - Depolarization. Involves opening of sodium & calcium channels so these ion channels can enter the cell. Inhibitory Response Correct ans - Repolarization. Involved the opening of chloride channels so chloride can enter the cell & potassium can leave the cell. Schedule I Drugs Correct ans - Heroin, Marijuana Who developed motivational interview (MI)? Correct ans - William Miller and Stephen Rollnick Minuchen Correct ans - Developed Structural Family Therapy.vFamily is an organization/structure; learn each member's likes and goals to change the family structure. Bowen Correct ans- Develeped family systems therapy. Individuals problem behavior may serve a purpose as having a unique role in their family unit. The goal of this therapy is
homeostasis.
Gonzalez-Jaimes and Turnbull Plaza developed what? Correct ans - "mirror psychotherapy" for patients with adjustment disorder and depressed moof secondary have having a myocardial infarction. Nightingale's view of the nurse's role Correct ans - The nurse is the provider of fresh-air, light, cleanliness, warmth, quiet, and nutrition. Who was interpersonal therapy (ITP) developed by? Correct ans
What does medicare part D cover? Correct ans - Optional coverage for outpatient pharmaceuticals (think D for DRUG).
Medical savings account Correct ans - a healthcare reform plan that allows individuals to establish tax-free savings funds to finance their medical care Pharmacokinetics Correct ans - What the body does to the drug. Types include: absorption, distribution, metabolism, excretion. Cerebellum Correct ans - coordinates balance, posture, movement, memory, impulse control, cognition, language Hippocampus Correct ans- involved in memory and converting short- term memory into long term memory; learning Amygdala Correct ans - regulates basic powerful emotions: fear, rage, sexual desire Bowlby Correct ans - attachment theory: kids who come from parents with highly expressed emotions and unresolved losses tend to develop disorganized attachment characterized by not feeling safe with their caregivers & an inability to feel soothing comfort antagonistic effect Correct ans - drug binds to receptors and activates a biological response inverse agonist Correct ans - drug causes the opposite effect of an agonist partial agonistic effect Correct ans - drug does not fully activate the receptors antagonistic effect Correct ans - drug binds to the receptor but does not activate a biological response. carbamazepine and lamotrigine drug-drug interaction Correct ans - when taken together, carbamazepine will cause an increase in lamotrigine levels in the blood(up to 200% increase) First generation antipsychotics mechanism of action Correct ans