Download PMHNP Review - georgette's Exam 2025 Questions with Correct Answers | 100% pass Reflexes e and more Exams Nursing in PDF only on Docsity!
PMHNP Review - georgette's Exam 2025
Questions with Correct Answers | 100% pass
Reflexes expected at 1 month - Answer Moro until 4 months, Palmer until 4 months, Plantar util 8 months, Babinski (2 years is disease) Signs of fetal alcohol syndrome - Answer small head, shoey palpebral fissure, inner epicanthal folds. Do IEP and early intervention specialist Rhett Syndrome - Answer a rare disorder found virtually exclusively in girls, is a neurodevelopmental disorder in which the child usually develops normally unitl about 6 to 18 months of age at which characteristics of the syndrome emerge; characteristics include: hypotonia (loss of muscle tone), reduced eye contact, decelerated head growth,and disinterest in play activities EPS types - Answer Tardive dyskinesia happen after years (eps is a precursor). Acutedystonia (hours), Parkinsons (weeks), Akathisia (days) Where do EPS originate - Answer nigrostiatal tract. How does Tegretol interact with cipro - Answer cipro and erythromycin are
inhibitors.Cause increased level of Tegretol. Black box warning Tegretol side effects - Answer Aplastic anemia, agranulocytosis, steven johnsons, hyponatremia. Watch with cipro and erythro nuchal rigidity - Answer stiffness in cervical neck area, meningitis ACE inhibitors - Answer - pril, CHF signs of serotonin syndrome - Answer - shivering
- anxiety
- diaphoresis
- hyperthermia Shits and Shivers diarrhea, shivering, hyperreflexia/myoclonis, increased temperature, vital sign instability,encephalopathy, restlessness, sweating Serotonin Discontinuation Syndrome - Answer syndrome caused by abrupt withdrawal of an antidepressant drug, resulting in sensory disturbances, sleeping disturbances,
Grade 2/5 hoarse systolic heart murmur - Answer aortic stenosis Woman with GAD advise on medication - Answer stop benzos because can cause floppy baby syndrome and cleft palate, cotinue buspar What to give to agitated pt in seclusion - Answer IM Geodon Labs for macrocytic anemia - Answer Folic acid, vitamin B12, ESR/CRP, HGB, MCV(liver) When to assess a patient in restraints for face/face - Answer 1 hour then 8 hours therapeutic communication - Answer open ended, 'tell me' Reluctant/silent patient - Answer open ended questions Patients husband shows up but not the patient - Answer both people need to be present, reschedule Abnormal Trendelenburg Test - Answer Hip disease, refer child out, assessed during head to toe Hamilton Depression Scale - Answer i. Severe 19 - 23 (monitor for SI) ii. Moderate 14 - 18
iii. Mild 8 - 130 - 7 normal GAD- 7 scale - Answer More than 15 severe HAM-A - Answer Hamilton Anxiety Scale, most commonly used 14 domains, 14=mild, 18 - 24= moderate, 25 - 30=severe Anxiety 25/15 severe Scope of practice - Answer comes from the state, board of nursing/american nurse association Elderly patient with dementia how do you know id can give consent - Answer Able torepeat back risks and benefits elements= nature/pupose of tx, risks/benefits of tx, risks/benefits not doing tx, alternatives, diagnosis/prognosis Patient moving states, what do you do with medication? - Answer send enough medication is standard of practice just culture - Answer refers to an organization's commitment to accountability and a focus supporting universal safety in health care. Find out the error ad where went
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wg, increase lipids/glucose REMS pharmacy need clozaril registry to dispense to start: WBC must be >_ and ANC >_ WBC + ANC weekly q6months, then every 2w q6months, then monthly Labs for rheumatoid arthritis - Answer. ESR erythrocyte sedimentation rate elevation.Synovial fluid analysis. X ray of joints. Rheumatoid factor titer, CRP, Hgb PTSD nightmares - Answer prazosin adjustment disorder - Answer reaction to a specific life event (identified stressor), symtoms within 3 monhts but no more than 6 months. Think about a patient move Norepinephrine (NE) - Answer Synthesized in locus coeruleus arousal and other functions like mood, hunger, and sleep locus coeruleus - Answer a small nucleus in the reticular formation that is involved in directing attention 5HT - Answer raphe nucleus raphe nuclei - Answer a string of nuclei in the midline of the midbrain and brainstem
PANDAS - Answer Pediatric Autoimmune Neuropsychiatric Disorders Associated withStreptococcal infections. OCD- recent strep throat PTSD - Answer Acute stress disorder- less than 1 monthPTSD- after 1 month Medicine that can cause mania - Answer steroids/prenisolone, antabuse, isoniazid, patient wakes up screaming at night - Answer ask family if anyone else has sleep problems pulling hair out - Answer OCD/trichotillomania how do you get paid for medicare - Answer CPT current procedural code patient in hospital with no family and failing cognitive test - Answer perform an MRI, labsto rule out substances Patient cold what labs to get? - Answer Check TSH. What medication to give for serotonin syndrome - Answer Cyproheptadine Medication for NMS? - Answer Dantrolene and bromocriptine Zung scale - Answer from 25 - 100, 25 - 49 is normal, 70+ is severe
Beck Scales - Answer Eight, separate, self-report inventories designed to assess different areas. Scores from 0 - 63over 30 is severe PHQ9 - Answer score 1 - 27, over 20 is severe zung, beck, PHQ9, HAM - Answer 70, 30, 20, 25 DEA regulation monitoring - Answer State and Federal, PMP Aggression in brain - Answer Stimulation of the amygdala results in augmented aggressive behavior hypothalamus, is believed to serve a regulatory role in aggression nurse attacked 3 weeks ago and now scared to go to work - Answer Acute Stress Disorder, as it happened less than 1 month ago masturbating 3 year old - Answer Phallic stage is normal 3 - 6 years old
Lab values concerning for patients on lithium - Answer 4+ protein in urine, Leukocytosis,creatinine, BUN, Na, Erythromycin and Tegretol - Answer Erythromycin is an inhibitor (H=high level). If onTegretol and Erythromycin together would want to reduce the dose of Tegretol 14 year old with no axillary hair, has not gotten her period yet - Answer Normal tannerstage, start by 16 On Interferon and Lexapro - Answer Interferon can cause depression, increase LexaproAccutane - Answer can cause depression and birth defects Patient on risperdal and elevated prolactin - Answer stop or decrease the medication, tubin tract Neurotransmitters involved in alcoholism - Answer dopamine and gaba Patient abusing stimulants, what does NP assess for - Answer Insomnia and tremor, irritability, weight loss, nervous, hypertension, tachycardia
Anorexic teenager with pain when eating - Answer refeeding syndrome causes delayedgastric emptying Beck inventory score of 10? - Answer 0 - 63, over 30 severe, dont start medication juststart therapy Treatment for ADHD - Answer stimulant and therapy together 65 year old started on a SSRI - Answer may experience an increase in anxiety in elderly, expect increased side effects, do an EKG What medication can alter absorption of antipsychotics? - Answer Antacids, can decrease antispsychotic effects Dark brown urine - Answer check LFT, Person with EPS will most likely experience what - Answer Tardive dyskinesia Apoptosis? - Answer neuron loss because of suffocation, enzyme breakdown Patient lost a friend now experiences paralysis - Answer conversion syndrome, repression of unconscious intrapsychic conflicts patient continues to say "I dont know" - Answer depression, not dementia MMSE scores - Answer 24-30 no cognitive impairment
Clenched teeth? - Answer CN 5 Trigeminal (masseter or masticatory muscle). Puff cheeks - Answer CN 7 facial (sensory and motor) Started on a medication then comes back in 2 weeks? - Answer Increase the dose after1-2 weeks, therapeutic effects 4-6 weeks Zantac is for what? - Answer H2 inhibitor Best therapy for negative thinking - Answer CBT, all or nothing thinking catastrophicthinking Humanistic therapy-self Existential- reflection/self control/personal responsibility Patient is borderline and suicidal what therapy? - Answer DBT, goal to decrease emotional reactivity/crisis bxs and self validation. Tics what advise? - Answer fairly common in children and will often remit on its own,ADHD concomittant ODD child - Answer help the parents with positive reinforcement and parenting skills, limit setting, logical consequences, consistency, power stuggle/control issues problematic, parenting/family dysfunction exacerbates
Fungus on toenial - Answer scrape toenail and sent for testing Age for schizophrenia female - Answer 25- 35 bipolar not taking medication - Answer "tell me how the medication works in your body" patient has neuropathic pain, what medication will help? gabapentin not helping - Answer Alpha 2 delta, pregabalin- lyrica When opening independent practice - Answer consider cost and revenue, must calculate the time spent with patient vs time spent on risk called indirect vs direct processing Can disclose info to medicare /CMS without consent - Answer First line neuro- protective for bipolar - Answer lithium What to check in terms of depakote in young girl - Answer check HCG, blackbox for pregnancy, can cause spinal bifida-tetrogenic, also check LFTs, CBC assertive inquiry - Answer
Adolescent with substance abuse and working out has muscle aches - Answer urine isred colored- hematuria, concerned for rhabdomyolysis (muscle breakdown), What are you looking at when you are assessing the function of an elderly individual
- Answer ability to manage a checkbook, instrumental ADLs go first (meds, phone, drive, house week, balancing check book), then ADLs eating/dressing, Exec functions=judgement, planning, taxes First symptom of metabolic syndrome? - Answer large waist circumference Autistic child not responding to your verbal commands - Answer this is normal, repetitive patterns of bx, impaired social interactions, verbal/nonverbal communication common Women is anxious about administering medication to a child - Answer stop and addressher anxiety Why would you be concerned about immature retuculocytes? - Answer tests looking at reticulocytes hep evaluate conditions affecting RBCs such as anemia, low reticulocytes may be seen with iron deficiency anemia, pernicious anemia, folic acid deficiency, aplastic anemia
First line neuro-protective for bipolar - Answer lithium What medication can alter absorption of antipsychotics? - Answer
