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Test Bank for PMHNP Boards Questions and Answers / A+
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What is true of interprofessionality? Correct ans - All health professionals have individual professional competencies What is the significance of an experimental p-value of 0.05 Correct ans - There is a 5% chance of a similar result occurring by chance alone What percentage of children with oppositional defiance disorder will develop conduct disorder? Correct ans - 30% In the DSM-5, selective mutism is now considered what type of disorder? Correct ans - anxiety disorder Symptoms of selective mutism must persist for at least Correct ans - 1 month Common competencies Correct ans - overlap more than one health care professional, although not necessarily all health care professionals, and are competencies expected of all health care professionals Complementary competencies Correct ans - enhance the qualities of other professions in provision of care Collaborative competencies Correct ans - those that each individual profession must possess to work with others, including those who practice within different specialties within a profession. Interpersonal collaboration is _______ centered Correct ans - patient Cognitive therapy is recommended for patients that have Correct ans - negative cognitive distortions irrational beliefs faulty conceptions Humanistic Therapy focuses on assisting patients with Correct ans - self- actualization and self-directed growth Behavioral Therapy focuses on Correct ans - changing maladaptive behaviors through the use of behavioral modification techniques Existential therapy is for Correct ans - reflection on life confronting self
120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing diarrhea? Correct ans - 6 ((120X160)/(80x40)) The New Freedom Commission on Mental Health (NFCMH) released a report that suggested Correct ans - implementation a national campaign to reduce the stigma of seeking care Focusing on promoting recovery and building resilience The efficacy of mental health treatments was found to be well documented in Correct ans - influential report issued by US Surgeon General in 1999 State of high negative emotion and pessimism Correct ans - neuroticism Commonly known as an optimistic outlook on life They are are outgoing, like social interaction, respond to external rewards, have more active dopamine networks, and are responsive to positive reinforcement. Correct ans - Extraversion (high levels protect from psychiatric illness) Introverts are more likely to be _______ motivated and more likely to respond to _______ reinforcement Correct ans - internally negative (more likely to interact with internal motivation/self-image) Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at the expense of self-assertion Correct ans - Agreeableness Associated with self-control and a focused, organized approach to life. Are achievement-oriented goal setters who can delay immediate gratification to obtain their long term desired outcome. They are considered responsible, reliable, and dependable. Correct ans - conscientiousness In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior (FAB). What is true about FAB? Correct ans - FAB is concerned only with observable stimuli connected to operant behavior FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and consequent stimuli) The goal of FAB is modifying willful operant behavior Gestalt theory deals with _____, not _____ Correct ans - perceptual psychology behavior Medication that can delay ejaculation in patients with premature ejaculation Correct ans - Paroxetine (and other SSRIs) (others include:
The drugs that are FDA approved for GAD Correct ans - Paroxetine Citalopram Escitalopram Venlafaxine Duloxetine Buspar A surrogate has the right to terminate pregnancy if Correct ans - the pregnancy threatens her health or life or she is a genetic parent If the surrogate receives both ovum and sperm from couple, she loses the right to Correct ans - determine whether or not child will be aborted (this is up to the couple) Which medication is most effective for treating social phobia/social anxiety disorder, especially when refractory? Correct ans - Phenelzine A 55-year-old female patient has Stg II HTN. On exam, she has trace pedal edema bilaterally, but her lungs are clear. Her ECG reveals 2nd degree heart block. Which of the following BP medications should be avoided? Correct ans - Calcium Channel Blockers 3 Contraindications to use a calcium channel blocker Correct ans - 1st or second degree heart block Bradycardia CHF 4 Side effects of calcium channel blockers Correct ans - Headache Lower extremity edema Bradycardia Heart Block An NP is evaluating a 78 year old female with depression. She suspects the patient may have Parkinson's disease. Which of the following is consistent with that diagnosis? Correct ans - Postural instability Pill-rolling tremor Shuffling Gait Difficulty initiating movement Mask-like facies (difficulty initiating movement) Writhing movements occur with Correct ans - Huntington's chorea
10 Non-motor manifestations of Parkinsons Correct ans - Autonomic dysfunction Gastrointestical dysfunction Rhinorrhea Sleep disturbance Fatigue Mood disorder Cognitive dysfunction Dementia Psychosis Hallucinations What type of therapy is most useful in depressed HIV positive outpatients? Correct ans - Interpersonal psychotherapy What type of therapy is most useful in patients with borderline personality disorder? Correct ans - Dialectical behavioral therapy The NP is caring for a patient dying of lymphoma. The pt's wife states that the pt has been mismanaged and that another practitioner must be assigned to the patient for him to improve. This NP suspects that this individual is in which stage of grief according to Elizabeth Kugler-Ross? Correct ans - Bargaining Involves resisting or refusing to remember information that has been supplied Correct ans - Denial Pica and spoon shaped nails are associated with Correct ans - Iron-deficiency anemia (microcytic) 2 common causes of microcytic anemia Correct ans - iron deficiency anemia of inflammation/chronic disease (TB, HIV, endocarditis, RA, Chrohn's DM, kidney disease, CA) (Other causes: lead toxicity, alcohol/drug use, zinc excess (copper deficiency)) Initial symptoms of B12 deficiency Correct ans - Generalized weakness Paresthesias Possible ataxia Late symptoms of B12 deficiency Correct ans - Memory impairment Depressed mood 5 P's of Vitamin B12 deficiency Correct ans - Pancytopenia
1mg Xanax = ____ mg of Clonazepam (Klonopin) Correct ans - 1 1mg Xanax = ____ mg of chlordiazepoxide (Librium) Correct ans - 25 1mg of Xanax = ____ mg of diazepam (Valium) Correct ans - 10 Pt wanting something immediate and non-addictive for breakthrough anxiety Correct ans - Hydroxyzine How long do GAD symptoms need to occur to make the diagnosis? Correct ans - 6 months First lab test to check for Sjogren's Correct ans - Anti-nuclear antibody tests To diagnose Cyclothymic disorder, it must be present for _______ in adults Correct ans - 2 years To diagnose Cyclothymic disorder, it must be present for _______ in pediatrics Correct ans - 1 year 4 physiological disturbances that may explain some of the symptoms of panic Correct ans - impaired lactate metabolism abnormality of locus coeruleus (Ser, NE, GABA, Dop, cholecystokinin) carbon dioxide hypersensitivity (hyperventilation) A 45-year-old man presents to the ER for "panic attack". He appears agitated, confused, and dizzy. He became more agitated and combative with staff upon further questioning. He states he was prescribed Xanax 0.5mg 3x daily by outpatient psychiatrist. His vitals are WNL. What is most likely his dx Correct ans - Benzodiazepine intoxication Anxiety, tremors, nightmares, insomnia, anorexia, nausea, vomiting, hypotension, seizures, delirium and hyperprexia are sx of. ______ which can result in _______ Correct ans - Benzodiazepine withdrawal (serious medical complications including death) Confusion, AH, VH following a period of insomnia can be a sx of Correct ans - withdrawal delirium Female patients with PTSD commonly have this comorbid diagnoses Correct ans
- Major depressive disorder (50%) Percentage of people with PTSD who have alcohol use disorder Correct ans - male 50%
female 27% Percentage of people with PTSD who have simple or social phobias Correct ans - 30% both male and female Percentage of people with PTSD who have persistent depressive disorder ( previously dysthymia) Correct ans - 20% for both male and female Treatment plan for OCD Correct ans - SSRI or Clomipramine Psychotherapy Normal Rinne test is for this nerve Correct ans - CN VIII What ethnic groups are at higher risk for social phobia Correct ans - Native American What ethnic groups are at lower risk for social phobia Correct ans - Asian Black Latino Onset of social phobia is Correct ans - Usually begins in late adolescence or early adulthood (13-20 years) 3 CBT techniques for social phobias Correct ans - exposure cognitive restructuring social skills training Medication used to help with social phobia for public speaking Correct ans - propranolol FDA approved SSRI for social phobia Correct ans - paroxetine What type of fracture is a red flag for child abuse? Correct ans - Spiral of long bone (caused by twisting of extremity) Bruises on the torso in different stages of healing often indicate Correct ans - abuse Tanner Stage: Breast buds undeveloped with papilla elevation only. Villus hair only Correct ans - I Tanner Stage: Breast buds palpable, straight pubic hair mostly on labia Correct ans - II
an over-the-counter nonnarcotic drug found in cough preparations which inhibits serotonin reuptake and could cause serotonin syndrome in patients on SSRI's Correct ans - Dextromethorphan (Delsym) Pre-cursor for Serotonin production Correct ans - L-tryptophan In panic disorder, 1 of the attacks is followed by at least ______ of persistent worry about having additional attacks, worry about implications of attacks or its consequences, or significant change in behavior related to attacks. Correct ans - 1 month The origins of panic disorder include Correct ans - childhood trauma With delayed onset of PTSD, how much time must have past from trauma to onset of symptoms Correct ans - 6 months First line medication for polymyalgia rheumatica Correct ans - oral prednisone Acute stress disorder is diagnosed if the characteristic symptoms present within what period of time after experiencing the traumatic event? Correct ans - 1 month In what Tanner's stage will a male's penis grow more in length than width Correct ans - III In what Tanner's stage will a male's scrotum begins to grow and redden. Where pubic hair will be straight, fine and sparse Correct ans - II In what Tanner's stage will a male's pubic hair look more like an adult, but will not cover as much area. Where penis will thicken, testes and scrotum continue to grow. Correct ans - IV Brain structure R/T development of GAD Correct ans - Amygdala What circumstance(s) are often correlated to the onset of panic disorder Correct ans - separation from family serious illness of friend/family accident major relationship loss/change abusing substances postpartum Lifetime prevalence of anxiety disorders in the US Correct ans - 25 - 35% (18% prevalence)
Buspar needs ______ to have similar efficacy to benzodiazepines Correct ans - 4 weeks How many panic symptoms must be present for diagnoses. Correct ans - 4 Part of Brain responsible for smell Correct ans - Limbic Part of brain (lobe) responsible for visual functions Correct ans - Occipital Part of brain (lobe) responsible for sensory integration and somatosensory function Correct ans - Parietal Part of brain (lobe) responsible for executive function, social conduct, judgement, and some motor function Correct ans - Frontal Occasional crossing of eyes is not normal after the infant is older than ___________ Correct ans - 2 months If strabismus is left untreated, what may result? Correct ans - ambylopia (affected eye decrease in vision) What would be the normal testosterone level of a Tanner V male Correct ans - 265 - 800 ng/dl Bactrim is contraindicated in Correct ans - Glucose- 6 - phosphatase deficiency Folate deficiency anemia patients with significant hepatic impairment pregnant patiens Pt has severe headache behind right eye with eye pain and tearing, sees halos around light fixtures. C/o N/V. R pupil fixed more oval than round, mid-dilated and cloudy. What might be happening Correct ans - Acute angle closure glaucoma (Emergency) What STD is not reportable in all 50 states Correct ans - HPV Romberg test is a test of Correct ans - balance A child will recognize faces and smile appropriately at familiar faces by age ____ Correct ans - 3 A typical _____ can count up to 20 with minimal assistance of an older child or parent Correct ans - 4 year old
Pharmacological treatment of alcohol use disorder Correct ans - Start Naltrexone at 25mg PO daily (1-hour observation for rxn). Naltrexone maintenance dose is usually 50mg PO q day or 380mg IM q 4 weeks Naltrexone side effects Correct ans - Elevated LFTs Mild dysthymia GI upset Resembles GABA and is possibly an NMDA antagonist Correct ans - Acamprosate Aldehyde dehydrogenase inhibitor Correct ans - Disulfiram (Antabuse) Modest efficacy, may work better in combination with Naltrexone for alcohol use disorder Correct ans - Acamprosate No convincing efficacy found for use of this Alcohol Use Disorder pharmacological treatment Correct ans - Disulfiram (Antabuse) Most commonly reported side effect of ECT Correct ans - Retrograde amnesia Neurodevelopmental disorder of biological origin that manifests in learning difficulties and problems in acquiring academic skills markedly below age level and manifested in the early years for at least 6 months that is not attributed to intellectual disabilities, development disorders or neurological or motor disorders Correct ans - Specific Learning Disorder Specific Learning Disorders can be specified as impairment in Correct ans - Reading Written Expression Mathematics The MOST important component when developing evidence based guidelines Correct ans - An evidence review How does botox improve depression? Correct ans - Reducing frown lines when injected into glabellar region According to a study in the 1990s mothers of anorexic pts have an increased prevalence of this disorder Correct ans - Obsessive-compulsive disorder The AST:ALT ratio in patients with Alcoholic liver disease Correct ans - <0.
Liver biopsy reveals fibrosis, necrosis of liver cells, and nodule formation Correct ans - Liver cirrhosis Acute condition with nystagmus, ataxia, confusion, and opthalmoplegia Correct ans - Wernicke-Korsacoff syndrome Elevated bilirubin level is often found in Correct ans - Alcoholic hepatitis Which drug's mechanism of action includes blockage of the voltage dependent sodium channel blockers, augmentation of gamma amino butyrate activity of GABA-A receptors, antagonism of AMPA/kainate subtype of glutamate receptor, and inhibition of carbonic anydrase enzyme? Correct ans - Topiramate Ex of drugs that are partial agonists at postsynaptic serotonin receptors Correct ans - Hallucinogens like LSD and MDMA Drug associated with inhibition of catecholamine reuptake in neurons and blockage of NMDA glutamate receptors Correct ans - PCP Individuals with panic disorder are most commonly affected by which other psychiatric disorder Correct ans - Agoraphobia When is the use of transdermal selegiline not beneficial? Correct ans - For patients with pheochromocytoma (excess NE can cause HTN crisis) and with planned surgery (need to dc patch for 10 days prior to elective surgery) Responsible for the catabolism of serotonin, norepinephrine and dopamine Correct ans - Monoamine oxidase (MAO) Medication that is an irreversible MAO inhibitor that works by selectively inhibiting both MAO-A and MAO-B in the CNS with preservation of MAO-A in the gut. Unless high dosed, little need to follow tyramine restricted diet. Correct ans - Selegiline Adverse effect of carbamazepine that can be an emergency Correct ans - hyponatremia toxic epidermal necrolysis Erythema multiform Steven's Johnson Thrombocytopenia Aplastic Anemia Agranulocytosis SLE arrhythmias Hepatitis
What is a precursor for antisocial personality disorder Correct ans - conduct disorder List of Cluster B personality disorders Correct ans - antisocial borderline histrionic narcissistic List the cluster A personality disorders Correct ans - paranoid schizoid schizotypal List of Cluster C personality disorders Correct ans - avoidant dependent obsessive-compulsive pervasive pattern of excessive emotionality and attention seeking beginning in early adulthood and present in a variety of contexts Correct ans - Histrionic Personality Disorder A pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness must last at least _______ for Oppositional Defiant Disorder diagnosis Correct ans
- 6 months Oppositional defiant disorder does not include: Correct ans - aggression toward people or animals destruction of property pattern of theft or deceit Recurrent behavioral outburst representing a failure to control aggressive impulses. Correct ans - Intermittent Explosive Disorder In Intermittent Explosive disorder, physical aggression does not result in Correct ans - damage or destruction to property physical injury to animals or other individuals Kubler-Ross's stages of grief Correct ans - denial anger bargaining depression/sadness acceptance Symptoms can be associated with another medical condition Correct ans - Somatic symptom disorder
Somatic symptom disorder symptoms persist for Correct ans - >6 months Despite frequent doctors visits and tests, this pt is rarely reassured and can feel that his/her medical care is insufficient Correct ans - Somatic symptom disorder In order to meet DSM V criteria for somatic symptom disorder, in addition to somatic symptoms, pts must have Correct ans - maladaptive thoughts, feelings, and behaviors that define the disorder, in addition to their somatic symptoms. The Mental Health Party Act (1996) provides Correct ans - equal lifetime and annual limits for mental health care as compared to physical health care. The zoster vaccination is recommended for _____ Correct ans - adults over the age of 60 The pneumococcal vaccination is recommended for _______ Correct ans - adults over the age of 65 The Tdap vaccination is recommended _________ Correct ans - every 10 years Understanding the objective reality of a situation coupled with the motivation and emotional impetus to master the situation or change behavior is: Correct ans - true insight Form of thinking that is logical, organized, reality oriented, and influenced by the demands of the environment Correct ans - second process thinking What percentage of the population meets the criteria for 1 or more personality disorders? Correct ans - 15% Study on daily exercise improving sleep quality in seniors. What is the dependent variable Correct ans - Sleep quality The federal law that allows parents to provide insurance coverage for their children up to age 26 is Correct ans - Affordable Care Act (ACA) Pedophiles attracted to female victims usually prefer females of what age? Correct ans - 8 - 10 years old What is true of appropriation bills? Correct ans - They provide for spending authority for a single fiscal year
Disturbance of the rapprochement subphrase is associated with Correct ans - persistent longing for and dread of fusion with object that is thought to be secondary to aggression or withdrawal in the mother. Thought to contribute to the development of borderline personality disorder. Phase in which infant shows increased interest in outside world Correct ans - Hatching Stage where infant recognizes his or her mother but lacks a sense of individuality Correct ans - symbiotic Narcissistic personality disorders are likely due to Correct ans - inadequate soothing during the symbiotic phase and inadequate refueling during the separation- individuation Describes the child's understanding that his or her mother is a separate individual and he or she is also separate Correct ans - Object constancy Object constancy leads to the formation of Correct ans - internalization, which will allow the child to have an internal representation of mother in turn allowing healthy separation, exploration, and development of self-esteem The three most common causes of secondary obesity Correct ans - Cushing's syndrome Hypothyroidism Genetic conditions Compassion, a desire to do good Correct ans - beneficence Avoidance of harm Correct ans - Nonmaleficence the equal and fair distribution of resources, regardless of other factors Correct ans
- Justice Dedication, fairness, honesty, advocacy and commitment to patients. It involves an agreement to keep promises and commitments based on the virtue of caring. Correct ans - Fidelity Most widely used tool for assessing the healthcare safety culture within an organization Correct ans - Culture of Patient Safety Assessment developed by AHRQ
The Iowa Model of EBP (evidence-based practice) is characterized by which statement? Correct ans - It is important to determine if an identified issue is a priority of the organization The trigger for change can be Correct ans - Knowledge focused or Problem focused Identification of a problem and determination of its priority Correct ans - first step in Iowa Model Review and critique of available literature Correct ans - Second step in Iowa Model Identification of research evidence to support a change in clinical practice Correct ans - 3rd stage of Iowa Model Implementation of change Correct ans - 4th step of Iowa Model Monitoring of Outcomes Correct ans - 5th and final step of Iowa Model Knowledge-focused triggers include Correct ans - new research practice guidelines Problem-Focused Triggers include Correct ans - Clinical problems Issues in risk management The first step in getting a bill to the floor is? Correct ans - Drafting a bill Probability results of study are due to chance Correct ans - P value Medicare part A coverage includes Correct ans - 1. hospital care and medicines received in hospital
- SNF
- nursing home care
- hospice
- home health services Sampling used when the proportion of the study population belonging to each group of interest in known, to obtain an adequate study sample from a small group in the study population. Correct ans - Stratified sampling Selection of groups under study is random Correct ans - Cluster sampling
