PMHNP Practice questions with answers 2023 1, Exams of Nursing

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PMHNP Practice questions with answers 2023 1 what term describes a scientific study that gathers multiple studies and analyzes them to draw a larger conclusion? ✔systematic review borderline personality disorder falls under which cluster of personality disorder traits? ✔B a 36 year old caucasian male arrives for his usual monthly medication appointment. diagnosed with schizophrenia & has been stabilized on haldol for 9 years. today he states he has an inner feeling of restlessness & inability to remain still. what type of E.P.S is suspected? ✔akathisia which part of medicare provides optional coverage for beneficiaries? ✔part c the cerebrum contains all of the following areas of the brain except one. cerebral cortex, brainstem, limbic system, or hypothalamus ✔brainstem in a family systems context, what is the definition of morphogenesis? ✔a family's tendency to adapt to change when changes are necessary. how does the body remove both serotonin and norepinephrine from the synaptic cleft? ✔an active re-uptake process a 53 year old menopausal woman presents with complaints of anhedonia, depressed mood, & vasomotor symptoms. what medication effectively treats both vasomotor symptoms and depression? ✔desvenlafaxine/pristiq it is an S.N.R.I. which personality disorder is most likely to have fantasies of success? ✔narcissistic who should receive a shingles vaccine? ✔anyone over the age of 60 who has had chickenpox some states use the umbrella term advanced practice nurse to refer to all of the following except which one? nurse anesthetists, certified nurse midwife, mid-level providers, or nurse practitioners ✔mid-level providers eating disorders are characterized by what? ✔disordered patterns of eating, accompanied by distress, disparagement, preoccupation, & a distorted perception of one's body shape the federal government offered financial awards to encourage hospitals to implement meaningful use. the financial awards are tied to specific objectives related to the effective use of electronic health records. give 3 examples of this. ✔1. electronic prescribing 2. electronic medication interaction checks 3. computerized provider order entry for an act to be considered criminal, it must have 2 components: actus reus & mens rea. what is actus reus? ✔voluntary conduct which complementary & alternative medicine technique is based on manipulating the flow of energy throughout the body? ✔acupuncture who authored the report crossing the quality chasm, which emphasized the need for inter professional collaboration in order to improve the quality of health care? ✔institute of medicine is a durable power of attorney limited to terminal illness only? ✔no what term describes a system where the insurer is not only the payer but also the provider of care? ✔managed care what term best describes a public agency that uses its bargaining power to negotiate competitive prices for health insurance from the private insurance market? patient switched to halodol last week presents with oriented to self, fever of 105.3, heart rate 126, breath rate 22, extremities are stiff and rigid, WBCs of 14, creatinine of 2.6. what is the most serious complication of her presentation? ✔rhabdomyolsis what is the primary purpose of the corpus callosum? ✔connect right and left hemispheres and facilitate sensorimotor information exchange what medication can produce a false positive for methamphetamines? ✔prozac/fluoxetine what medication can produce a false positive for benzodiazepines? ✔zoloft/sertraline what medication can produce a false positive for cocaine? ✔motrin what food product can produce a false positive for morphine or heroin? ✔poppy seeds how do managed care organizations control health care costs? ✔bargain with medical practices for reduced rates on visits autism spectrum disorder can present with what deficits? ✔lack of social reciprocity, insistence on sameness, & nonverbal communication what are the general functions of norepinephrine? ✔alertness, focused attention, learning, & memory what are the general functions of dopamine? ✔thinking, fine muscle action, & reward-seeking behavior what are the general functions of GABA? ✔reduces arousal, aggression, & anxiety what are the general functions of serotonin? ✔regulates sleep, pain, mood states, & temperature what is an example of a psychological preventative factor that protects someone from developing a psychiatric disorder? ✔healthy ego defenses compared with physicians, nurse practitioners save the consumer & the insurance company what percent of costs? ✔20 percent a person who is proficient in the use of software, hardware selection, & computer maintenance possesses what skill? ✔computer competency what underlying psychiatric disorder is not linked to insomnia? ✔oppositional defiant disorder the institutional review board ensures what? ✔1. risks to participants are minimized 2. participant selection is equitable 3. adverse events are reported 4. risks & benefits are evaluated 5. informed consent is obtained & documented 6. data safety monitoring plans are implemented when indicated what are signs & symptoms of stevens johnsons syndrome? ✔facial swelling, tongue swelling, macules/papules/burning confluent red rash, skin sloughing, pro-dromal headache, malaise, arthralgia, & painful mucous membranes may occur before rash what is stevens johnsons syndrome? ✔immune reaction to a foreign antigen that can occur with exposure to any anticonvulsant drug what is the therapeutic range for lithium? ✔0.6-1.2 If first onset of manic symptoms occurs after age 40, what is likely the cause? ✔another medical condition what are the side effects of lithium toxicity? ✔slurred speech, confusion, coarse hand tremors, severe GI effect what medications when taken with lithium can double the level? ✔NSAIDs and ACE inhibitors which personality disorder is most likely to be excessively scrupulous? ✔obsessive-compulsive what EPS has a mask like appearance and a shuffling gait? ✔pseudo-parkinson's what findings do you expect to support autism spectrum disorder? ✔flat or blunted affect, little or no eye contact, and lack of emotional reciprocity what psychiatric medication is an inducer of the hepatic cytochrome P450 enzyme? ✔carbamazepine intimate partner violence is defined as what? ✔physical, emotional, economic, or sexual pain and injury that is intentionally inflicted by a person's intimate partner what term describes the amount that people spend before their health insurance pays for the cost of health care? ✔deductible what cranial nerve assessment tests for tactile perception of the facial skin? ✔trigeminal which act incentivizes pharmaceutical companies to develop drugs to treat rare disease? ✔orphan drug act true or false: females have an earlier age of onset than males in obsessive- compulsive disorder ✔false in a hospital psychiatric consultation setting, what is one of the most common mental illness diagnoses? ✔adjustment disorder the literature on group outcomes has revealed that negative group outcomes has been associated with what quality in group leaders? ✔being overly confrontational while treating a 12 year old boy for ADHD, the PHMNP observes what physical features that raise concerns for genetic evaluation for fragile X syndrome? ✔long head and ears, short stature, hyperextensible joints what laboratory test should be ordered to rule out a medical cause of dementia symptoms? ✔vitamin b12 what lifestyle factor poses the greatest risk for depression, irritability, liver problems, and hypertension in a college student? ✔anabolic steroid use families seeking equilibrium in the face of change is an example of what concept? ✔homeostasis norepinephrine is a neurotransmitter that is implicated in alertness and anxiety. what area of the brain has a large majority of norepinephrine neurons? ✔locus coeruleus & medullary reticular formation in bipolar 1, men are more prone than women to have what? ✔manic episodes women are more likely to have depressive episodes & rapid cycling what hematologic changes can occur with lithium? ✔leukocytosis the risk of bleeding on SSRIs, NSAIDs, or aspirin is an example of what principle? ✔pharmacodynamics the core values that underlie advanced practice nursing and culturally competent care are: ✔respect, advocacy, partnership which personality disorder is best treated by combining individual and group psychotherapy due to the intense transferences and countertransferences that are likely to develop? ✔borderline personality disorder what is the most accurate description of agoraphobia? ✔they fear situations or places they might have trouble obtaining help if they become scared what finding or trait is not suggestive of someone experiencing abuse? ✔aggression what circadian rhythm sleep-wake disorder sub type is characterized by falling asleep and waking later than desired? ✔delayed sleep phase type to understand how past development impacts a person's behavior is a goal of what kind of therapy? ✔existential what psychiatric condition is characterized by patients who are experiencing symptoms of schizophrenia but have been ill for only 1 to 6 months? ✔schizophreniform disorder competence to be executed was established in what supreme court case? ✔ford versus wainwright which moral duty does a nurse practitioner leader uphold when he or she tells the truth? ✔veracity the technology informatics funding education reform initiative declared that N.P.s have the responsibility to do what? ✔understand and shape the landscape of health care technology what mental status exam findings would be expected in someone experiencing abuse? ✔depressive traits, passive behaviors, & co-dependence what population has the highest rate of antisocial personality disorder? ✔adult men with alcohol use disorder in a forensic setting-particular to forensic setting what circadian rhythm sleep-wake disorder subtype is characterized by falling asleep and waking progressively later than desired? ✔non-24-hour sleep-wake type what is the evidence hierarchy? 7 items ✔-systematic review of R.C.T.s or non R.C.T. -single R.C.T. or non R.C.T. -systematic review of correlational/observational -single correlational/observational -systematic review of qualitative/descriptive -single descriptive/qualitative -opinions of authorities/experts what type of systematic review statistically analyzes a collection of quantitative studies? ✔meta-analysis what is grassroots lobbying? ✔nonpaid individuals contact their legislators to influence policy what is a migrant worker? ✔leaves their permanent residence to take agricultural jobs in different locations Cluster C personality disorder traits ✔Anxious, fearful, avoidant, dependent, obsessive compulsive what are the symptoms of antidepressant discontinuation syndrome? ✔FINISH: flu-like symptoms, insomnia, nausea, imbalance, sensory disturbance, hyperarousal what are the symptoms of neuroleptic malignant syndrome? ✔FEVER: fever, encephalopathy, vitals instability, elevated wbc/cpk, rigidity what are the symptoms of serotonin syndrome? ✔HARMED: Hyperthermia, Autonomic instability, Rigidity, Myoclonus, encephalopathy, Diaphoresis, what symptoms of serotonin syndrome make it different from neuroleptic malignant syndrome? ✔bad SSRI: body weight increase, anxiety, dizziness, serotonin syndrome, stimulated CNS, reproductive/sexual dysfunction, insomnia what are the atypical antipsychotics? ✔done pine my zone: risperidone, ziprasidone, clozapine, olanzapine, quetiapine, aripiparzole What do atypical antipsychotics treat? ✔positive and negative symptoms of schizophrenia and bipolar What are the typical antipsychotics? ✔hal & thio go to PF Changs: haloperidol, thioridazine, perphenazine, fluphenazine, chlorpromazine what are the side effects of the antipsychotics? ✔i SHADE: impotence, sedation, hypotension, akathisia, dermatological SEs, extrapyramidal what are the mood stabilizers? ✔ox & lam are lit for Val because they have no carbs and good times. oxcarbmazapine, lamotrigine, lithium, valproic acid, carbamazepine, gabapentin, topiramate What do typical antipsychotics treat? ✔negative symptoms of schizophrenia what are the SNRIs? ✔feeling depressed & need a shot of norepi? rent a DVD desvenlafaxine, venlafaxine, & duloxetine What do SNRIs treat? ✔depression, panic, OCD what are the antihistamines? ✔hydroxyzine, hydrochloride, diphenhydramine what are the non-benzodiazipine medications for anxiety? ✔buspar, beta blockers, gabapentin, hydroxyzine, guanfacine, clonidine, prazosin What are benzodiazepines? ✔pams, lams, and librium Diazepam, lorazepam, temazepam, midazolam, alprazolam, chlordiazepoxide What do benzodiazepines treat? ✔Anxiety, alcohol withdrawal, Insomnia, Sedation, Seizures What are the atypical antidepressants? ✔Bupropion, Mirtazapine, Trazodone what are the opiate antagonists? ✔Naloxone, naltrexone what medications are used for non-acute alcohol withdrawal? ✔DANT: disulfiram, acamprosate, naltrexone, topiramate what are the anticonvulsants? ✔Valproate Carbamazepine Lamotrigine what is the role of the axon? ✔carries impulse away from cell body what is the cerebral cortex primarily responsible for? ✔receiving incoming sensory information from the thalamus what inferential statistic tests the relationship between 2 variables? ✔pearson's r correlation what part of the brain is composed of the cells that produce neurotransmitters? ✔brainstem what is a social risk factor for developing a psychiatric disorder? ✔poor community integration what type of advanced practice nurse coordinates care and typically serves in consultative, administrative, or education roles? ✔clinical nurse specialist in almost all cultures, what is the most commonly used intoxicating substance? ✔alcohol what is the female to male ratio of anorexia nervosa in clinical populations? ✔10 to 1 a patient presents with high fever, pharyngitis, and oral and perianal ulcerations. what psychiatric emergency would you suspect? ✔clozapine-induced agranulocytosis -particular to the ulcerations what factor can hinder or constrain growth for the nurse practitioner? ✔growing competition in the job market for nurse practitioners you are treating a 22 year old male for his first episode of major depression. after 2 months of starting his medications, he reports feeling back to normal and wants to stop his medications. when can he safely stop his medications? ✔at least 6 months after beginning treatment a 44 year old woman presents to your office with suspected conversion disorder. according to erikson, failure to resolve which psychosocial stage is associated with later development of this psychpathology? ✔initiative versus guilt what 1976 court case determined that the presence of a mental illness alone cannot justify involuntary hospitalization? ✔o'connor versus donaldson what medication is given to treat a patient with obsessive compulsive disorder? ✔fluoxetine/prozac in how many states do nurse practitioners have the legal authority to prescribe controlled substances? ✔48 how does lithium affect an ECG? ✔it can invert the t-waves