Psychiatric Disorders and Treatments, Exams of Nursing

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GEORGETTE LMR_PMHNP FINAL EXAM 2024 NEW

VERSION UPDATE 2024-2025 BEST STUDYING

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GEORGETTE LMR_PMHNP FINAL EXAM 2024 | ALL

CURRENT EXAM VERSIONS AND A STUDY GUIDE |

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Management of metabolic syndrome with SGAs? - CORRECT ANSWER 1. Nonpharm = exercise or nutritional counseling

2. Pharm = switch to other SGA with lower chance of metabolic syndrome What should you not do when advocating for a patient? - CORRECT ANSWER Judge or confront What class of medication is contraindicated with tics? - CORRECT ANSWER Stimulants What should you provide for prior to assessing abuse victims? - CORRECT ANSWER A safe environment What are your actions if a child reports abuse? - CORRECT ANSWER First interview separately from parents then report to CPS What should you do if a child plays with toys in a way that you suspect abuse? - CORRECT ANSWER Report to CPS In what setting as an inpatient provider should you interview a patient? - CORRECT ANSWER Use a private room with the door partially open

How should you begin your interview with adolescents? - CORRECT ANSWER By building rapport with them by ensuring confidentiality absent exceptions Should you interview adolescents with or without parents? - CORRECT ANSWER Without What if an adolescent tells you they are homosexual and they don't want their parents to know? - CORRECT ANSWER This is confidential The patient is being discharged and would like their labs faxed to the rehab facility. What is your initial action? - CORRECT ANSWER Get informed consent/ROI What do you do if a medical evaluation is needed? - CORRECT ANSWER Refer out - this is out of scope What do you do if a patient is takes something and is feeling really funny/unwell in your office?

• CORRECT ANSWER Collect UDS and then refer out Is it considered a mental illness if it is an expected response culturally? What do you offer as treatment? - CORRECT ANSWER No; brief supportive therapy - not medication A mother states her child is experiencing a cultural illness. What is your initial action? - CORRECT ANSWER Respect the mother's cultural understanding of illness prior to assessment Native Americans view mental illness and SUDs as? - CORRECT ANSWER An imbalance between the individual and the world What ethnic group has the highest rate of suicidality in the US? - CORRECT ANSWER Native Americans If a patient believes they need a healing stick in their room, but the staff nurses removed it from them
• what should you do? - CORRECT ANSWER Teach cultural sensitivity and make accommodations for patient to have healing stick available such as 1:

Psychoeducation should be based on? - CORRECT ANSWER Cultural context

How do you promote health in a location with multiple ethnicities and education levels? - CORRECT ANSWER Multiple cultural education and ethnospecific assessment parameters What if a patient wants a traditional healer? - CORRECT ANSWER Allow this - remember ROI/informed consent What should you screen for prior to starting Asians on carbamazepine and why? - CORRECT ANSWER HLAB1502 Allele; risk of SJS When should you d/c carbamazepine if agranulocytosis is suspected? - CORRECT ANSWER If ANC is < 1000 with or without s/s of infection Lithium range? - CORRECT ANSWER 0.6 - 1. What to do if lithium is 1.3 or 1.4? - CORRECT ANSWER Monitor What to do if lithium is 1.5+? - CORRECT ANSWER D/C Benefits of lithium? - CORRECT ANSWER Gold standard for mania, neuroprotective, and antisuicidal effects S/S of lithium toxicity? - CORRECT ANSWER Severe N/V, polydipsia, polyuria, leukocytosis, palpitations, coarse tremor What to do if lithium toxicity is suspected? - CORRECT ANSWER D/C and check serum levels prior to checking VS Kidney disease and drugs that reduce renal clearance can raise lithium levels. What are these drugs? - CORRECT ANSWER NSAIDs, ace inhibitors for heart failure (-pril), and thiazides (HCTZ)

What demonstrates understanding of education on lithium? - CORRECT ANSWER Taking extra water with patient when they go hiking NMS s/s? - CORRECT ANSWER Extreme muscle rigidity, mutism, elevated CPK (muscle contraction and destruction), myoglobinuria (breakdown of muscle cells, rhabdomyolysis), increased WBCs, and increased LFTs Treatment of NMS and MOAs? - CORRECT ANSWER D/C med, bromocriptine (D2 agonist), and dantrolene (muscle relaxant) Serotonin syndrome s/s? - CORRECT ANSWER Hyperreflexia and myoclonic jerks Serotonin syndrome causes? - CORRECT ANSWER SSRIs, SNRIs, MAOIs, - triptans (for migraines like sumatriptan/imitrex) Treatment for serotonin syndrome? - CORRECT ANSWER D/C med and administer cyproheptadine Wash out from SSRI to MAOI or vice-versa? - CORRECT ANSWER 14 days Wash out from Prozac to MAOI? - CORRECT ANSWER 5-6 weeks Drug choice for patient that is depressed and also has cancer? - CORRECT ANSWER Celexa or lexapro d/t fewer drug to drug interactions Drug choice for patient with low energy and fatigue with depression? - CORRECT ANSWER Wellbutrin Drug choice for patient with sexual problems d/t medication or depression? - CORRECT ANSWER Wellbutrin C/I for Wellbutrin? - CORRECT ANSWER Seizure disorder or hx or present eating disorder

Drug choices for patient with chronic neuropathic pain and depression? - CORRECT ANSWER

1. SNRI (cymbalta)
2. TCA (amitriptyline)
3. Alpha 2 delta ligand (gabapentin or lyrica) Black box warning for SSRIs in children, adolescents, and young adults? Intervention for this? - CORRECT ANSWER Increased risk of SI; always assess SI, frequency, and severity Alcohol is a form of _______-_________ and a __________ to the treatment of depression. - CORRECT ANSWER self-medication; barrier Prozac can cause? Intervention? - CORRECT ANSWER Insomnia; take in AM Disorder that most greatly increases thoughts of self-harm? - CORRECT ANSWER Depression Disorder that most greatly increases homicidal ideation? - CORRECT ANSWER Antisocial personality Why is there less evidence available supporting the use of antidepressants in children? - CORRECT ANSWER Lower placebo rates Schizophrenia age of onset in men? Women? - CORRECT ANSWER 18-25; 25- 35 Findings on PET scan or MRI in schizophrenia? - CORRECT ANSWER INCREASED ventricle size; DECREASED everything else No stimulants in schizophrenia due to? - CORRECT ANSWER Increased dopamine release Tertiary prevention for schizophrenia? - CORRECT ANSWER Social skills training

Why should you refer a patient with schizophrenia to exercise programs, especially aerobic exercise? - CORRECT ANSWER It improves cognition, quality of life, and long term health Benefits of assertive community treatment (ACT)? - CORRECT ANSWER Rehab posthospitalization, case management approach, and good for long term hx of noncompliance Oral haldol to IM conversion? - CORRECT ANSWER 20x daily dose of oral dose Max IM dose of haldol per visit? How long until next injection? - CORRECT ANSWER 100 mg; 5-7 days 5 mg oral haldol BID =? IM - CORRECT ANSWER 200 mg Firm belief that is maintained despite lack of evidence? - CORRECT ANSWER Delusion Example of a delusion? - CORRECT ANSWER Believing church members or class members are a cult MSE in preschooler (3-5 yo)? - CORRECT ANSWER Listen and observe; dependent on clinical observation Thought process? - CORRECT ANSWER Organization of patients thoughts and ideas Circumstantial speech? - CORRECT ANSWER Go in circles but eventually answers Tangential speech? - CORRECT ANSWER Never gets to answer of question Thought content? - CORRECT ANSWER What themes occupy patient's mind; i.e. SI, HI, and A/VH MMSE also known as? - CORRECT ANSWER Folstein scale

Serial 7s or months backwards assesses patient's? - CORRECT ANSWER Concentration, attention, and calculation Name 3 objects assesses? - CORRECT ANSWER Registration Name 3 objects after 5 minutes assesses? - CORRECT ANSWER Recall/memory Asking patient to name president of governor assesses? - CORRECT ANSWER Fund of knowledge If a clock drawing test is abnormal this indicates? - CORRECT ANSWER Right parietal lobe/hemisphere damage What makes SGAs different from FGAs? - CORRECT ANSWER 5HT2A = less likely to experience EPS SGAs that can be administered IM? - CORRECT ANSWER Invega, geodon, zyprexa, and abilify Mesolimbic DA pathway? - CORRECT ANSWER Increased DA leads to + symptoms Mesocortical DA pathway? - CORRECT ANSWER Decreased dopamine leads to - symptoms Nigrostriatal DA pathway? - CORRECT ANSWER Decreased dopamine and increased acetylcholine lead to EPS (dystonia, akathisia, and TD) Tuberoinfundibular pathway? - CORRECT ANSWER Decreased dopamine and increased prolactin lead to amenorrhea, galactorrhea, sexual dysfunction, and gynecomastia Long term increased prolactin causes? - CORRECT ANSWER Osteoporosis

Normal prolactin levels for men? Women? - CORRECT ANSWER <20; < Which CYP450 enzyme metabolizes clozaril? - CORRECT ANSWER 1A Cigarettes are inducers of what CYP450 enzyme? - CORRECT ANSWER 1A Cigarette smoking in patients taking clozaril requires increased or decreased doses? - CORRECT ANSWER Increased Cigarette cessation in patients taking clozaril requires increased or decreased doses? - CORRECT ANSWER Decreased Most antibiotics are inducers or inhibitors? Intervention with substrate? - CORRECT ANSWER Inhibitors; reduce substrate Medications that cause mania? - CORRECT ANSWER Steroids, antabuse, isoniazid (INH), and antidepressants in patients with bipolar disorder Medications that cause depression? - CORRECT ANSWER Steroids, accutane, interferon, retrovirals, antineoplastics, BZDs, progesterone, and beta blockers Accutane can cause? - CORRECT ANSWER Birth defects Steroids can also cause? - CORRECT ANSWER Psychosis Intervention for patient on flonase or prednisone? - CORRECT ANSWER Increase mood stabilizer, antidepressant, or antipsychotic based on targeted disorder Neurotransmitters indicated in addiction? - CORRECT ANSWER Dopamine and GABA

S/S of stimulant abuse? - CORRECT ANSWER Insomnia, anxiety, irritability, tremors, palpitations, increased HR, and increased BP Patients with anorexia complain of pain, bloating, and fullness with eating due to? - CORRECT ANSWER Delayed gastric emptying Other causes of delayed gastric emptying? - CORRECT ANSWER Ranitidine, famotidine, and omeprazole Education for patient taking both psychotropics and antacids/PPIs? - CORRECT ANSWER Take 2 hours apart What to monitor for in older adults on SSRIs? - CORRECT ANSWER Increased anxiety and hyponatremia Paradoxical effect? Examples? Intervention? - CORRECT ANSWER Opposite reaction from expected; i.e. BZDs - > increased anxiety or trazodone - > insomnia; avoid med in future Apoptosis? - CORRECT ANSWER Neuronal loss or cell death Greatest risk factor for bipolar disorder? - CORRECT ANSWER Family history, it is very inheritable Patient presenting with first manic episode after age 45? - CORRECT ANSWER Look for medical cause Main determinations for BPD? - CORRECT ANSWER Self-harm and recurrent SI Tx for BPD and originator? - CORRECT ANSWER DBT by Marsha Linehan Patient with BPD has depressed mood and emotional lability, what is your treatment? - CORRECT ANSWER Depakote

Conversion disorder presents after? S/S? - CORRECT ANSWER Stressful event like losing sibling; blindness, mutism, paralysis, paresthesia all medically unexplained Adjustment disorder presents after? Timeline? - CORRECT ANSWER Stressful event like loss of pet or parent; within 3 months of event Subtypes of adjustment disorder? Examples? - CORRECT ANSWER With depressed mood, with anxiety, with mixed anxiety and depressed mood, with disturbances of conduct (think change in school), and with mixed disturbances of emotions and conduct (think of divorce leading to truancy, peer conflict, verbal altercations, insomnia, and frequent crying) ODD timeline? - CORRECT ANSWER Lasts 6+ months ODD s/s? - CORRECT ANSWER Deliberately annoys others, is spiteful, and is vindictive; NO AGGRESSION Tx for ODD? - CORRECT ANSWER Family therapy Conduct disorder s/s? - CORRECT ANSWER Think juvenile detention, AGGRESSION, NO REMORSE Tx of conduct disorder? - CORRECT ANSWER Target mood and aggression (antipsychotics, mood stabilizers, SSRIs, and alpha agonists); therapy Dx of Tourette's syndrome? - CORRECT ANSWER 2 motor tics and 1 vocal tic lasting 1 year+ Childrens motor tics are? - CORRECT ANSWER Fairly common and can be temporary Primary neurotransmitters indicated in tics? - CORRECT ANSWER DOPAMINE, NE, and serotonin

Tx of tics? - CORRECT ANSWER Haldol, pimozide, abilify, clonidine, and guanfacine Acute stress disorder timeline? - CORRECT ANSWER 4 weeks or less A patient assaults you at work and you don't want to return to work for 2-3 weeks. This can be an example of? - CORRECT ANSWER Acute stress disorder PTSD timeline? - CORRECT ANSWER Lasts 1 month or more S/S of PTSD? - CORRECT ANSWER Intrusive re-experiencing, increased arousal, and avoidance of stimuli Tx for PTSD? - CORRECT ANSWER SSRI, TCAs, prazosin for nightmares, EMDR, and CBT EMDR stages? - CORRECT ANSWER 1. Desensitization

2. Instillation
3. Body scan ADHD neurotransmitters? - CORRECT ANSWER DA, NE, and serotonin Area of brain indicated in ADHD? Its functions? - CORRECT ANSWER 1. Dorsolateral prefrontal cortex; executive function, cognitive processes, and attention
4. Basal ganglia
5. Abnormalities of reticular activating system
6. Abnormalities of prefrontal cortex = inattentive type When does aftercare plan begin and what does it include? - CORRECT ANSWER On admission; behavioral management, support, and psychoeducation

What to do if parent is uncomfortable with stimulant medication after education? - CORRECT ANSWER Encourage clonidine or guanfacine; 6-17 years old Parent is anxious about starting medication on child - what interventions? - CORRECT ANSWER Address anxiety and offer brief supportive therapy ADHD medication wears off - intervention? - CORRECT ANSWER Multiple dosing or extended release OCD s/s? - CORRECT ANSWER 1. Recurrent and persistent thoughts, impulses, or images 2. Compulsions -- can be a tic PANDAs? - CORRECT ANSWER Can cause OCD in children and occurs after a strep infection Differentiation between OCD with tics as compulsion and Tourette's? - CORRECT ANSWER OCD also has intrusive thoughts Factitious disorder s/s? - CORRECT ANSWER Foreign substances introduced into body with NO SECONDARY GAIN Factitious disorder imposed on another? - CORRECT ANSWER ABUSE - report to CPS Malingering? - CORRECT ANSWER Faking symptoms for SECONDARY GAIN Reactive attachment d/o s/s? - CORRECT ANSWER Fearful, inhibited, withdrawn, apathetic, no emotion toward caregivers, can also be aggressive, disruptive, and disorganized GAD timeline? - CORRECT ANSWER 6+ months Panic attacks symptom and tx? - CORRECT ANSWER Impending doom; beta blockers, SSRIs

C/I to beta blockers? - CORRECT ANSWER Asthma (can cause bronchospasms) DMDD ages & s/s? - CORRECT ANSWER 6-17 yo; chronic dysregulated mood and frequent intense temper outbursts Anorexia s/s? - CORRECT ANSWER Low BMI <18, amenorrhea, emaciation, bradycardia, and hypotension 16 yo comes into office with parents showing s/s of anorexia. What is your tx? - CORRECT ANSWER Refer for medical evaluation What if parents are refusing medical evaluation for child with s/s of anorexia? - CORRECT ANSWER Contact CPS Neurotransmitters indicated in Autism? - CORRECT ANSWER Glutamate, GABA, and serotonin S/S of Autism? - CORRECT ANSWER Decreased social communication and interaction, no response to name, little or no eye contact, and organizing toys Thought to be cause of Autism? - CORRECT ANSWER DYSFUNCTION OF MIRROR NEURON Patient presents with irritability and labile mood. Screener? - CORRECT ANSWER MDQ Nightmares in children can be due to? - CORRECT ANSWER Genetic factors - is there a family pattern of nightmares? Delerium s/s? - CORRECT ANSWER ACUTE ONSET, LOC disturbance, cognition, and inattention Tx of agitation and psychotic symptoms in delirium? - CORRECT ANSWER Low dose haldol

Labs for delirium? - CORRECT ANSWER UA with culture and sensitivity Dementia s/s? - CORRECT ANSWER Slow progression, mental decline, irritability, personality changes Labs for dementia? - CORRECT ANSWER B12 & folic acid levels Tx of agitation and psychotic symptoms with dementia? - CORRECT ANSWER 1. Nonpharm = quiet environment

2. Pharm = atypical antipsychotics Pseudodementia cause? - CORRECT ANSWER MDD leading to memory impairment Screening in pseudodementia? - CORRECT ANSWER MMSE, SLUM, MoCA, and Mini-cog Pseudodementia s/s? - CORRECT ANSWER Acute onset (can be months), irritability, agitation, hallucinations, delusions, IDK ANSWERS Dementia vs pseudodementia? - CORRECT ANSWER Dementia is chronic (years) & they confabulate Pseudodementia is acute (can be months) and the give IDK answers Subcortical dementia? - CORRECT ANSWER Motor symptoms Cortical dementia? - CORRECT ANSWER Language and memory impairments HIV dementia? - CORRECT ANSWER Subcortical dementia = motor abnormalities, behavioral abnormalities, and cognitive decline Lewy body dementia? - CORRECT ANSWER = VISUAL HALLUCINATIONS

Pick's disease or frontal lobe dementia? - CORRECT ANSWER = slurred speech, personality and behavioral changes Huntington's disease? - CORRECT ANSWER = subcortical dementia, motor abnormalities, depression, and psychosis Amygdala =? - CORRECT ANSWER Aggression Hippocampus =? - CORRECT ANSWER Emotions & stress Anterior cingulate =? - CORRECT ANSWER Cognitive functions, decision making, empathy, impulse control, and emotions Cerebellum =? - CORRECT ANSWER Maintenance of balance and posture NE produced in? - CORRECT ANSWER Locus coeruleus and medullary reticular formation Serotonin produced in? - CORRECT ANSWER Raphe nuclei of the brainstem Dopamine produced in? - CORRECT ANSWER Substantia nigra (regulates motor movements), VTA, and nucleus accumbens Acetylcholine produced in? - CORRECT ANSWER Nucleus of Meynert S/S of lead poisoning? - CORRECT ANSWER Developmental delay, learning difficulties, irritability, loss of appetite, weight loss, sluggishness and fatigue, abdominal pain, vomiting, constipation, hearing loss, seizures, and pica What lobe causes social skills to be affected? - CORRECT ANSWER Frontal lobe

What to do if infant is dying? - CORRECT ANSWER Give infant to parents to hold Grief and loss in children? - CORRECT ANSWER Normalize it as responses vary. Provide psychoeducation and group therapy. Child needs INTACT family. Mood neurotransmitters? - CORRECT ANSWER DA, NE, Serotonin, GABA, and glutamate Risks for osteoporosis? - CORRECT ANSWER Smoking, caffeine, decreased weight bearing exercises, decreased calcium, and decreased vitamin D Interpersonal learning? - CORRECT ANSWER Encourage pt to continue group sessions and adjunctive individual therapy Cognitive therapy? - CORRECT ANSWER Replace distorted thoughts with rational ones Behavioral therapy? - CORRECT ANSWER Skills training, problem solving, modeling, exposure, role playing, and relaxation CBT? - CORRECT ANSWER Cognitive restructuring and JOURNALING Humanistic therapy? - CORRECT ANSWER Person-centered, SELF-ACTUALIZATION, & SELF-DIRECTED GROWTH Interpersonal therapy? - CORRECT ANSWER Interpersonal issues & marital conflict; lasts 1216 weeks Multisystemic family therapy? - CORRECT ANSWER ANTISOCIAL Reduces barriers to families

Strategic therapy? - CORRECT ANSWER Problem and symptom focused. PARADOXICAL STRATEGY Reframe belief system Straightforward directive Solution-focused therapy? - CORRECT ANSWER MIRACLE QUESTIONS Exception finding Scaling questions Structural family therapy? - CORRECT ANSWER HIERARCHIES BOUNDARIES Genograms Family system therapy? - CORRECT ANSWER TRIANGLES SELF-DIFFERENTIATION Genograms Meditation =? - CORRECT ANSWER Muscle relaxation Physical activity =? - CORRECT ANSWER Improve body image, RESILIENCE, and improve relationships & social anxiety Ask what kinds of questions? - CORRECT ANSWER Open-ended What kinds of questions if patient can not construct narrative? - CORRECT ANSWER Yes/No What to do if a joint appt is scheduled but only 1 person shows up? - CORRECT ANSWER Reschedule

What to do if parent calls over phone and says 5-year-old was raped by 15-year-old brother? - CORRECT ANSWER 1. Educate to not leave child alone with brother

2. Call CPS
3. Crisis therapy What to check with rheumatoid arthritis? - CORRECT ANSWER ESR PICOT meaning? - CORRECT ANSWER Population Intervention Comparison intervention Outcome Time Hierarchy of evidence? - CORRECT ANSWER I. Systematic review or meta-analysis of all RCTs
4. One or more well-designed RCT How to promote evidence-based research? - CORRECT ANSWER Have access to current journals Infant with shrill cry =? - CORRECT ANSWER Increased intracranial pressure 3 - 6 year old is masturbating? - CORRECT ANSWER Normal. This is the phallic stage 9 - 16 yo boy with tenderness, swelling, and breast enlargement? - CORRECT ANSWER Normal for up to 6 months Reason for decreased sex drive in elderly women? - CORRECT ANSWER Decreased testosterone & decreased blood flow to pelvic region

Alcohol dehydragenase? - CORRECT ANSWER Women have lower quantity compared to men = women are more likely to get drunk = more likely to have liver problems How to increase psychiatric access to those who need it the most? - CORRECT ANSWER Integrated care Palmer reflex normal until? - CORRECT ANSWER 5-6 months Grasps finger in palm Moro reflex normal until? - CORRECT ANSWER 5-6 months Startle reflex Babinski reflex normal until? - CORRECT ANSWER 2 years Fans toes Phosphodiesterase (PDS) medications? - CORRECT ANSWER Viagra Are rapidly absorbed after PO administration Normocytic macrocytic anemia? - CORRECT ANSWER Check folic acid, B12, and iron levels Adolescent with ADHD =? - CORRECT ANSWER Increased risk of SUDs Screen all adolescents for SUDs & vice-versa Acupuncture =? - CORRECT ANSWER Pain and depression Habeas Corpus =? - CORRECT ANSWER Protects against unlawful hospitalization (Can leave AMA) Disseminated encephalomyelitis =? - CORRECT ANSWER Paresthesia, fatigue, and asymmetrical body movements especially of the extremities.

NEED NEURO EXAM

Autoimmune diseases =? - CORRECT ANSWER Increased cytokine levels Pt can't remember time frame? - CORRECT ANSWER Anchor memory/link memory Prior to teaching you should first? - CORRECT ANSWER Assess current knowledge Iatrogenic s/s? - CORRECT ANSWER Caused by medication or surgery Assess medication hx Policy creation? - CORRECT ANSWER Need input from APRNs Create online forum/survey Discuss how it will improve quality Develop instrument to monitor clinical outcomes Desmopressin tx for? - CORRECT ANSWER Enuresis Don't violate patient's trust - CORRECT ANSWER Social media Conflict of interest? - CORRECT ANSWER Policy to address 1st assess industry provided samples and industry sponsored education What to do if patient says FDA released new black box warning? - CORRECT ANSWER Research risk vs. benefit of use prior to D/C'ing med Off-label use? - CORRECT ANSWER Full disclosure Risk & benefit i.e. trazodone for insomnia vs. priapism

Risk factors for sleep apnea? - CORRECT ANSWER Obesity, DM, and smoking Tolerance? - CORRECT ANSWER Diminished effect with continuous use over a period of time Reflective practice? - CORRECT ANSWER Debriefing strategies after event MMSE moderate and severe? - CORRECT ANSWER Moderate 10-20 Severe 0 - 9 SLUM dementia? - CORRECT ANSWER 0- 20 Ham-D moderate? - CORRECT ANSWER 14- 18 PHQ-9 moderate? - CORRECT ANSWER 10- 14 Beck moderate? - CORRECT ANSWER 19- 29 Ham-A moderate? - CORRECT ANSWER 18- 24 GAD-7 moderate? - CORRECT ANSWER 10- 14 COWS mild (clonidine) - CORRECT ANSWER 5- 12 COWS moderate (buprenorphine, suboxone) - CORRECT ANSWER 13- 24 CIWA moderate (scheduled + prns) - CORRECT ANSWER 16- 20 S/S of opiate withdrawal? - CORRECT ANSWER Yawning, irritability/anxiety, pupillary dilation, piloerection, muscle aches, lacrimation, and rhinorrhea

S/S of alcohol withdrawal? - CORRECT ANSWER Tremors, paroxysmal sweats, tactile disturbances, auditory disturbances, visual disturbances, and headaches Treatment for alcohol dependence? - CORRECT ANSWER Acamprosate, disulfiram, and naltrexone Instillation of hope - CORRECT ANSWER Develop hope for creating a different life Universality - CORRECT ANSWER Others have similar problems Group cohesiveness - CORRECT ANSWER Sense of belonging Altruism - CORRECT ANSWER Helping another Appreciative inquiry? - CORRECT ANSWER Approach to organizational change which focuses on strengths rather than weaknesses Catharsis - CORRECT ANSWER Opening express feelings which were previously suppressed Existential factors - CORRECT ANSWER Deal with meaning of their own existence Methadone can cause? - CORRECT ANSWER Cardiac arrhythmias Choice of BZD for liver disease/hepatitis? - CORRECT ANSWER Ativan Anxiety with hx of SUD? - CORRECT ANSWER Start on buspar or hydroxyzine outpt and refer Pregnant pt with SUD? - CORRECT ANSWER Send inpt to residential center (not call CPS)

Recovery model - CORRECT ANSWER Non-linear = learning from experience 4 components of health policy? - CORRECT ANSWER Process, policy reform, policy environment, POLICY MAKERS (assess/address barriers and facilitators [assess baseline knowledge, beliefs, and practices among providers with a survey], brainstorm with stakeholders) SBIRT? - CORRECT ANSWER Screen for SUDs Tarasoff - CORRECT ANSWER Duty to warn, varies by state Rennie vs. Klein - CORRECT ANSWER Right to refuse psychotropic medications Donalson Vs. O'Connor - CORRECT ANSWER Protects against confinement How to assess if dementia pt can make a decision? - CORRECT ANSWER Can they repeat risks and benefits and choose one medication over the other Properational stage - CORRECT ANSWER 2-7 yo MAGICAL THINKING Formal operations - CORRECT ANSWER 12 yo+ ABSTRACT LOGIC - science project/test hypothesis/algebra Industry vs. inferiority - CORRECT ANSWER School age 6 - 12 Ability to work Sense of inferiority Integrity vs. despair - CORRECT ANSWER Late adulthood

65+

Fulfillment with life Bitterness Vascular dementia hallmarks? - CORRECT ANSWER Carotid bruits, fundoscopic abnormalities, and enlarged cardiac chambers Intimacy vs. isolation - CORRECT ANSWER Early adulthood 20 - 35 Committed relationships Emotional isolation What is the normal range for TSH? - CORRECT ANSWER 0.5 - 5.0 mu/L What are lab values in Hyperthyroidism - CORRECT ANSWER Decreased TSH Increased T4 and T3 What are labs in Hypothyroidism? - CORRECT ANSWER Increased TSH Decreased T4 and T3 What are 5 primary symptoms of Hyperthyroidism? - CORRECT ANSWER Heat intolerance Agitation, Anxiety, Irritability Tachycardia Mood swings Weight loss What are 4 primary symptoms of Hypothyroidism? - CORRECT ANSWER Cold intolerance Lethargy Weight gain Decreased libido