Georgette Review PMHNP Test with correct answers, Exams of Nursing

Download Georgette Review PMHNP Test with correct answers and more Exams Nursing in PDF only on Docsity! Georgette Review PMHNP Test with correct answers When many answers are remarkably similar, they are usually _____________ - Correct Answer wrong Interprofessional collaboration is encouraged. - Correct Answer Collaborate is usually right. Delegate is usually wrong. ADPIER - Correct Answer Assessment, diagnosis, Plan, intervention, evaluate, and refer out last. Lithium - Correct Answer Normal 0.6-1.2 Lithium toxicity occurs at levels - Correct Answer > 1.5 Signs of Lithium toxicity - Correct Answer severe nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait Lithium is gold standard for - Correct Answer MANIA Lithium has evidence shown to - Correct Answer reduce suicidal ideation What does lithium cause in neonate, especially 1st trimester - Correct Answer Epstein anomaly (congenital heart defect?) Dehydration and hyponatremia cause lithium levels to - Correct Answer rise Baseline labs before initiation of lithium - Correct Answer TSH Creatinine (0.6-1.2) BUN (10-20) HCG (all psychotropic females 12-51) EKG 50+ Urinalysis (check for proteins, 4+ may indicate kidney disease) Side Effects of Lithium - Correct Answer hypothyroidism Cease hand tremors with toxicity Maculopapular rash Diarrhea, vomiting, cramps--signs of toxicity. Monitor closely. Anorexia T wave inversions Leukocytosis Pt education for lithium - Correct Answer staying hydrated Avoiding NSAIDS Compliance Depakote normal level - Correct Answer 50-125 Depakote toxicity level - Correct Answer greater than 150 Teratogenic effects of Depakote - Correct Answer sina bifida Adverse effects of Depakote - Correct Answer alopecia Hepatotoxicity (RUQ pain or brown/red urine--order LFTs) AST 5-40, ALT 5-35, yellowing of skin or eyes, fatigue Signs of Depakote toxicity - Correct Answer disorientation, lethargy, respiratory depression, nausea/vomiting Intervention for Depakote toxicity - Correct Answer DC med Check level LFT Ammonia MAOI + tyramine causes - Correct Answer hypertensive crisis Symptoms of hypertensive crisis - Correct Answer elevated BP Sudden explosive like headache Facial flushing Palpitations Pupillary dilation Diaphoresis Fever Hypertensive crisis occurs with MAOI + - Correct Answer MEPERIDINE STIMULANTS Decongestants TCAs Atypical St. John's wart L-tryptophan Asthma meds Bulimia, weight is ___________ - Correct Answer within the normal range. Pharm treatment for bulimia - Correct Answer Fluoxetine SSRIs and TCAs effective in reducing binging and purging Signs of anorexia nervosa - Correct Answer low BMI Amennorrhea Emaciation Bradycardua Hypotension Pharm treatment for anorexia - Correct Answer there is none therapy Which of the following physical exam findings would help the PMHNP differentiate anorexia nervosa from bulimia nervosa? A. Russell sign B. Low BMI C. Erosion of dental enamel D. Hypertrophy of salivary glands - Correct Answer Low BMI If a patient is depression, low energy, fatigued, you would prescribe - Correct Answer Wellbutrin Wellbutrin is contraindicated in patients with - Correct Answer seizure disorder or conditions that increase risk of seizures such as eating disorder. Which of the following medications has a unique mechanism that is both a norepinephrine and dopamine reuptake inhibitor? A. Bupropion (Wellbutrin) B. Sertraline (Zoloft) C. Clomipramine (Anafranil) D. Duloxetine (Cymbalta) - Correct Answer bupropion Clairol is metabolized by - Correct Answer cytochrome P450 enzyme CYP1A2 Inducer’s - Correct Answer induce metabolism and therefore decrease serum levels of other drugs that are substrates Smoking will do what to drug levels - Correct Answer decrease therapeutic levels of the drug Bull Shit CRAP GPS Induces my rage - Correct Answer Barbiturates St. Johns Wart Carbamazepine Rifampicin Alcohol Phenytoin Griseofulvin Phenobarbital Sulphonylureas If your patient is a smoker, you will need ___________doses of their medication. - Correct Answer higher Inhibitors - Correct Answer inhibit metabolism and therefore increase levels of the drug. SICKFACES.com for Inhibitors - Correct Answer Sodium valproate Isoniazid Cimetidine Ketoconazole Alcohol Chloramphenicol Erythromycin Sulfonamide Cipro Omeprazole Metronidazole Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with clozapine? a. 2D6 b. 1A2 c. 2C19 d. 2C9 - Correct Answer 1A2 (Want a 2-cigarette break) When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? A. Decreased body fat B. Increased liver capacity C. Decreased protein binding D. Increased muscle concentration - Correct Answer Decreased protein binding For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium and the thiazide diuretic has induced: A. hypokalemia B. hyponatremia C. Increased renal clearance of lithium D. Decreased renal clearance of lithium - Correct Answer A. decreased renal clearance of lithium Where is norepinephrine produced - Correct Answer locus coeruleus and medullary reticular formation Norepinephrine is associated with - Correct Answer mood disorders Serotonin is made where in the brain - Correct Answer raphe nuclei of the brainsteam Serotonin is associated with - Correct Answer sleep and mood disorder Dopamine is made in - Correct Answer substantia nigra, central tegmental area, ventral tegmental area, Dopamine is associated with - Correct Answer addiction and psychosis Acetylcholine is made - Correct Answer basal nucleus of Meynert Most abundant inhibitory neurotransmitter in the brain - Correct Answer GABA I don't have enough GABA, my anxiety is high Med used to increase GABA - Correct Answer benzos Fred flinstone needs a Zanny, Gabba dabba do. Most excitatory neutransmitter - Correct Answer glutamate Increased level of corticotropin releasing hormone in the amygdala, hippocampus and locus coeruleus - Correct Answer increases symptoms of anxiety. Autism - Correct Answer deficits in social communication and social interaction across multiple settings Parents of kids with autism may report - Correct Answer No response when called by name Little or no eye contact Children with autism often like to line up, stack, or organize objects and toys. Screenings for autism - Correct Answer ADOS M-CHAT ASQ Pharm management for autism - Correct Answer antipsychotics are effective for symptoms such as tantrums, aggressive behaviors, self-injurious behaviors Which serotonin receptor antagonism makes an antipsychotic "atypical" - Correct Answer 5HT2A? Excess dopamine in this area causes positive schizophrenic symptoms - Correct Answer mesolimbic pathway Decreased dopamine leads to negative symptoms of schizophrenia - Correct Answer neocortical pathway Increased blockade of dopamine here leads to EPS - Correct Answer nigrostriatal pathway Blockade of dopamine in this pathway can lead to increased prolactin levels - Correct Answer tuber infundibular pathway Muscle spasms ninth face, neck, tongue, back/neck muscles - Correct Answer acute dystonia Oculogyric crisis, which can lead to permanent injury. Patients have prolonged involuntary upwards deviation of the eyes bilaterally. - Correct Answer Rare presentation of acute dystonia. Pharm treatment for dystonia - Correct Answer Cogentin (IM first then oral) Restlessness, inability to sit still. Pacing. Mistaken for anxiety. - Correct Answer Akathisia Commonly used rating scale for akathisia is - Correct Answer Barnes Akathisia rating scale and extrapyramidal symptom rating scale. Treatment for akathisias First line Second line Third line - Correct Answer 1st: beta-blocker Second: Cogentin Third: benzodiazepine Absence of movement or difficulty initiating movement - Correct Answer akinesia Treatment: Cogentin Presence of symptoms of Parkinson's produced by D2 blockade in the nigrostriatal pathway - Correct Answer Pseudo-Parkinsonism Signs of Parkinsons - Correct Answer muscle rigidity shuffling gait mask like facial expression pill rolling tremors cogwheel rigidity Treatment for pseudo Parkinsonism - Correct Answer cogentin Involuntary abnormal muscle movement of the mouth tongue face and jaw that may progress to limbs. Can take 1-2 years to occur. - Correct Answer Tardive dyskinesia Signs of tar dive dyskinesia - Correct Answer lip smacking Protrusion of the tongue Chewing motion Facial dyskinesia Involuntary movement. Treatment for TD - Correct Answer Stop offending antipsychotic, reduce the dose, or switch to clozapine. COGENTIN WORSENS IT Ingress or Ousted approved Non-psych med that can cause TD - Correct Answer Reglan A patient has been treated for the past several years with fluphenazine (Prolixin). You tonic that he is drooling and has a slight pill rolling movement of the fingers. These are EPS symptoms known as A. pseudo Parkinsonism B. anticholinergic effects C. Tardive dyskinesia D. Acute dystonia - Correct Answer A. Pseudo Parkinsonism A patient is diagnosed with schizophrenia. Which of the following would be the appropriate question for the PMHNP to ask when assessing side effects produced by dopamine antagonism in the nigrostriatal pathway? A. Are you experiencing constipation? B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression? C. Are you experiencing increased thirst? D. Are you experiencing breast discharge? - Correct Answer Are you experiencing pill rolling tremors, shuffling gait, and mask like facial expression Fetal alcohol syndrome - Correct Answer Everything is low low weight, small features of the face. Which if the following antidepressants is associated with the most cardiovascular side effects? - Correct Answer Citalopram--causes QT prolongation What the body does to drugs? - Correct Answer Pharmacokinetics What the drug does to the body - Correct Answer pharmacodynamics The drug binds to the receptors and activates a biological response (opens the ion channel) - Correct Answer agonist effect drug causes the opposite effect of the agonist. Binds to the same receptor but closes the channel - Correct Answer inverse agonist drug does not fully activate the receptor - Correct Answer partial agonist drug binds to the receptor but foes not activate a biological response - Correct Answer antagonist The study of what the drug does to the body. - Correct Answer Pharmacodynamics When studying pharmacodynamics involving receptor, you know that an agonist produces the following effect? A. Does not fully activate the receptor B. Blocks the agonist from opening the channel C. Causes the opposite effect D. Activates a biological response and opens the ion channel. - Correct Answer Activates a biological response and opens the channel. Medications that can cause mania (very high yield) - Correct Answer Steroids Antabuse Isoniazid Antidepressants in persons with bipolar Flonase Medications causing depression - Correct Answer steroids beta blockers interferon Accurate Some retroviral drugs Antineoplastic drugs Benzos Progesterone Fragile X syndrome - Correct Answer all their facial structures are larger. Severe adverse effect caused by antipsychotics - Correct Answer neuroleptic malignant syndrome C. Levothyroxine D. Clarithromycin - Correct Answer Propranolol A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of manic symptoms and insomnia. Your patient has been stable on lithium for the past six months To determine if a medication change or increase is warranted, it is important to gather more information. You suspect a possible medication-induced manic episode when the patient endorses what? A. She was recently placed on a beta blocker for anxiety. B. She was recently prescribed a benzo C. She recently had a flare up of her rheumatoid arthritis and received treatment for one week (aka a steroid) D. She recently began a new retroviral agent for hepatitis - Correct Answer recently treated for RA Scale to test for alcohol withdrawal - Correct Answer CIWA Score on CIWA that warrants PRN - Correct Answer greater than 8 Medication that will make patient physically ill if combined with alcohol - Correct Answer disulfiram (Antabuse) Antabuse should not be taken for at leas ________________ after drinking - Correct Answer 12 hours. Signs and symptoms of alcohol withdrawal - Correct Answer N/V/D Tremors Sweats Anxiety Agitation Tactile disturbances Auditory disturbances Visual disturbances Headache Altered sensorium Agitation Rating scale of opiate withdrawal - Correct Answer COWS Signs and symptoms of opioid withdrawal - Correct Answer yawning, irritability, pupillary dilation Piloerection Muscle aches Lacrimation Rhinorrhea Treat COWS when score is greater than - Correct Answer 7 Moderate withdrawal on COWS - Correct Answer 13-24 Moderate withdrawal on CIWA - Correct Answer scoring 15 Treatment for COWS - Correct Answer Buprenorphine (Sub Oxone) Treatment for CIWA - Correct Answer scheduled meds plus diazepam SBIRT stands for - Correct Answer Screening, Brief Intervention, and Referral to Treatment SBIRT FRAMES - Correct Answer Feedback--tell them about their risk of their current alcohol use Responsibility--reinforce their responsibility for change Advice--based on facts about their drinking, offer simple and direct advice Menu--provide a menu of options for behavior change Empathetic interviewing--consider their perspective. Be non-judgmental Self-efficacy--encourage person to believe they can change. CAGE screening tool - Correct Answer cut down, annoyed, guilty, revelation Acute onset Altered level of consciousness Inattention Poor prognosis--1-year mortality rate of is up to 40% - Correct Answer delirium Treatment of choice for delirium - Correct Answer haloperidol Avoid which class in delirium as it tends to prolong it - Correct Answer benzos Impaired executive functioning, impaired problem solving, and impaired organizational skills, altered memory. Slow onset - Correct Answer dementia John is a 58-year-old male patient with Bipolar 1 disorder and has been stable for 5 years on valproate and Seroquel. He was recently started on Flonase by his primary care. As the PMHNP, you are concerned that the addition of the Flonase may cause A. A hypertensive crisis B. SJS C. NMS D. a manic episode - Correct Answer a manic episode A 16-year off boy presents with a long head, large ears, and hyper extensible joints, is very shy, and starts rocking and flapping his hands when he is upset. Which of the following is your most likely diagnosis? A. Tourette disorder B. Autism C. Fragile X D. Rett disorder - Correct Answer Fragile X What muscle relaxant is recommended to be used in treatment of NMS? A. Bromocriptine B. Trihexyphenidyl C. Dantrolene D. Benztropine - Correct Answer Dantrolene A week after raising the dose of clomipramine, a patient treated for depression presents to the clinic with reports of change in mental status, fever, and hyperreflexxia. As the treating PMHNP, you know these symptoms are consistent with which of the following? A. NMS B. EPS C. Hypertensive crisis D. Serotonin syndrome - Correct Answer serotonin syndrome A 24 year olf female attempts suicide by overdose on an MAOI phenelzine. She is stabilized in the hospital. Ten days later she is started on venlafaxine and becomes tachycardia and diaphoretic, and develops myoclonic jerks. What condition is this? A. NMS B. Opisthotonos C. Akathisia D. Serotonin syndrome - Correct Answer serotonin syndrome a 17 year old arrives at the emergency department with nonspecific complaints The patient's temperature is 100.8, pulse rate and blood pressure are elevated, and pupils are dilated with decreased reaction to light. Two days ago, the patient began taking sertraline for the treatment of depression. The patient has a history of substance use and smoked marijuana one week ago. The diagnosis is - Correct Answer serotonin syndrome Patient being treated for psychosis for 2 weeks develops symptoms of NMS. The following factors help the phn to differentiate NMS from serotonin syndrome. A. autonomic instability, diaphoresis, tremors B. Hyperthermia, leukopenia, tachycardia C. Rigidity, hyperreflexia, orthostatic hypotension D. Mutism, leukocytosis, myoglobinuria - Correct Answer mutism, leukocytosis, myoglobinuria Parkinson features Adversely reacts to antipsychotics - Correct Answer Lewy body dementia---recurrent visual hallucinations. caused by cardiovascular disease. Common in hypertension and CVD - Correct Answer vascular dementia Hallmark signs of vascular dementia - Correct Answer carotid bruits, fundoscopic abnormalities, and enlarged cardiac chambers Personality, language (slurred) and behavioral changes - Correct Answer Picks disease --frontal lobe changes Huntington's disease - Correct Answer subcortical, think motor symptoms High incidence of depression nd psychosis First line agent for psychotic symptoms of dementia - Correct Answer antipsychotics avoid benzos A 69 year old man with diagnosis of delirium has symptoms of psychosis which include frightening auditory and visual hallucinations and paranoid delusions. Which of the following medications should be chosen first for this man's symptoms? A. Haloperidol B. Quetiapine C. Valium D. Olanzapine - Correct Answer haloperidol. An 81 year old female with a history of vascular dementia is brought to the hospital for increased agitation and UTI. Which of the following features most distinguishes the effects of delirium from dementia? A. Altered level of consciousness B. Behavioral disturbances C. Cognitive deficits D. Language difficulties - Correct Answer altered level of consciousness What is the best treatment for AIDS dementia complex A. Acetylcholinesterase inhibitors B. Symptom targeted pharmacologic treatments C. Nonpharmacologic supportive care D. Antiretroviral therapy - Correct Answer Antiretroviral therapy. Aimed at decreasing the number of new cases - Correct Answer primary prevention Any form of screening is what Level of prevention - Correct Answer secondary Aimed at decaying disability and severity - Correct Answer tertiary Decreased effects of the same dose over time - Correct Answer tolerance Tendency of some regions of the brine to react to repeated low-level bioelectrical stimulation, by progressively boosting synaptic discharges, thereby lowering seizure threshold (alcohol and benzos) - Correct Answer kindling Where in the brain are abnormalities found causing ADHD - Correct Answer frontal cortex --high yield Basal ganglia Abnormalities in the reticular activating system Neurotransmitters involved in ADHD - Correct Answer DNS Dopamine Norepinephrine Serotonin ADHD causes DNS - Correct Answer dopamine Nereid Serotonin Hallmarks of ADHD - Correct Answer persistent pattern of inattention or hyperactivity, impulsivity, or both. What to check prior to prescribing a stimulant? - Correct Answer cardiac history, family history of CVD and get an EKG prior to starting Amphetamines are approved in children as young as - Correct Answer 3 Signs of stimulant abuse - Correct Answer insomnia tremors heart palpiations increased BP and HR Rating scale for ADHD - Correct Answer Connors and Vanderbilt Must monitor in two settings Hallmarks of borderline personality disorder - Correct Answer impulsivity with self- damaging behavior Recurrent suicidal behavior Treatment for Borderline - Correct Answer DBT Hallmarks of antisocial personality - Correct Answer reckless disregard for welfare of others lack of remorse indifference to the feelings of others INCREASED HOMICIDAL IDEATION --HIGH YIELD Primarily in girls normal development then decline loss of purposeful hand movements stereotypic hand movements --flapping of hands deceleration of head growth - Correct Answer Rett syndrome Chronically moody, sad irritable for no reason - Correct Answer Disruptive mood dysregulation disorder patient reacts grossly out of proportion to situation sudden rage/anger outbursts - Correct Answer Intermittent explosive disorder Mnemonic for depression SIGECAPS - Correct Answer Sleep disturbance interest reduced guilt and self-blame energy loss and fatigue concentration problems appetite changes psychomotor changes suicidial thoughts Neurotransmitters involved in depression - Correct Answer DNS dopamine, norepinephrine, serotonin cognition and memory symptoms of MDD in older adults is often confused with dementia related symptoms and is called - Correct Answer pseudo dementia = depression Clients with pseudodementia/depression, have a __________________ of symptoms. - Correct Answer acute onset. Dementia patients will have Pseudodementia/depression will have - Correct Answer dementia: lack of answers or confabulate answers pseudodementia: general responses "I Don't know" First line pharm treatment for depression due to safety - Correct Answer SSRIs/SNRIs Second line for depression - Correct Answer TCAs Reason TCAa are second line - Correct Answer Can cause EKG changes A. ADHD B. Bipolar disorder C. Panic disorder D. Primary insomnia - Correct Answer bipolar disorder The neuroprotective treatment of choice for bipolar disorder is - Correct Answer lithium According to the current clinical guidelines for treating a patient with bipolar I disorder mania with psychotic features, an adult psychiatric and mental health nurse practitioner prescribes: A.) Lithium B. Citalopram C. Lamotrigine D. Quetiapine - Correct Answer quetiapine intrusive reexperiencing of a traumatic event - Correct Answer PTSD symptoms of PTSD - Correct Answer hyperarousal, avoidance of stimuli associated with trauma, intrusive symptoms Pharm treatment for pTSD - Correct Answer SSRI (Zoloft) TCA Prazosin AVOID BENZOS Risk factors for OCD - Correct Answer first degree relative and PANDAS--associated with strep infection, Tourette's - Correct Answer At least 2 motor tics and at least one vocal tic have been present. Cause of tourettes - Correct Answer dopamine --hyperactivity of the dopamine system. use of external agents that mimic disease (patient ingests foreign body) - Correct Answer factitious disease excessive worry more than 6 months - Correct Answer GAD Age of onset of schizophrenia in males - Correct Answer 18-25 Age of onset of schizophrenia in females - Correct Answer 25-35 Cause of schizophrenia - Correct Answer intrauterine insults prenatal exposure to toxins, including viral agents Problem in the brain in schizophrenia - Correct Answer enlarged ventricles, everything else decreases Things to monitor and labs while on antispychotic - Correct Answer serum glucose, serum lipid panel, weight, BMI, waist to hip ratio. liver and kidney function CBC non-harm treatment for schizophrenia - Correct Answer ACT (assertive community treatment) Person has psychotic symptoms similar to schizophrenia as well as mood symptoms seen in depression and bipolar - Correct Answer schizoaffective trust vs mistrust - Correct Answer birth to one year virtue in trust vs mistrust - Correct Answer hope autonomy vs shame and doubt - Correct Answer early childhood 1-3 years virtue for autonomy vs shame and doubt - Correct Answer will (they seek will power, independence) Inititiative vs. guilt - Correct Answer late childhood 3-6 years virtue of initiative vs guilt - Correct Answer purpose Ability to be a self-starter, to initiate one's own activities. Industry vs inferiority (VERY HIGH YIELD) - Correct Answer school age 6-12 years Industry vs inferiority virtue - Correct Answer competence Identity vs role confusion - Correct Answer Adolescence 12-20 identity vs role confusion virtue - Correct Answer fidelity personal identity unfavorable: they're confused over who they are. Initimacy vs isolation - Correct Answer Early adulthood 20-35 Intimacy vs isolation virtue - Correct Answer love Generativity vs stagnation - Correct Answer middle adultgood 35-65 years generatively vs stagnation virtue - Correct Answer care key event: parenting integrity vs despair (VERY HIGH YIELD) - Correct Answer late adulthood greater than 65 years integrity vs despair virtue - Correct Answer wisdom fulfillment and comfort with life willing to face death, sense of integrity Piaget focuses on - Correct Answer behavior Piaget Sensorimotor 0-2 - Correct Answer object permanence and object constancy Piaget Preoperational (VERY HIGH YIELD) 2-7 years - Correct Answer magical thinking egocentric Pretend play Piaget Concrete operational 7-11 years - Correct Answer Thinks logically about concrete objects Understands conservation and reversibility Piaget Formal Operational (VERY HIGH YIELD) 12+ years - Correct Answer Reason abstractly Freud Oral Stage - Correct Answer 0-1 Erogenous zone: mough Freud Anal Stage - Correct Answer 1-3 years Erogenous zone: anus Freud Phallic Stage - Correct Answer 3-6 years Erogenous zone is genitals Freud latent stage - Correct Answer 6 to puberty Representation of sexual feelings Freud Genital stage - Correct Answer •puberty-adulthood •sexual urges reawaken & are directed to an individual outside the family circle •unresolved conflicts from previous stages arise •if conflict is resolved, capable of having a mature adult sexual relationship Structural family therapy - Correct Answer boundaries, hierarchies Strategic therapy - Correct Answer paradoxical intervention--tell the family member that they can worry for one hour of the day. Solution focused therapy - Correct Answer miracle question Patient attributes their own unacceptable thoughts feelings, and motives onto another person - Correct Answer projection Redirection of an impulse (usually aggression) onto a powerless substitute target - Correct Answer displacement Displace our unacceptable emotions onto behaviors, which are constructive and socially acceptable, rather than destructive Healthy defense mechanism - Correct Answer sublimation Concentrating on intellectual aspects to avoid emotional aspects of a difficult situation. Ex, cancer patient reading up on their disease - Correct Answer Intellectualization Justification for an unacceptable behavior - Correct Answer rationalization Yalow’s Curative Factors - Correct Answer - Altruism: giving of oneself to help others - Catharsis: relieving of emotions by expressing one's feelings - Universality: recognizing shared feelings and that one's problems are not unique - Existential factors: address accepting the fact that response. For change comes from w/in oneself - Self-understanding: discovering and accepting unknown parts of oneself - Family reenactment: understanding what is was like growing up in one's family through group exp. - Guidance: accepting advice from other members - Identification: benefiting from imitation of the positive behaviors of other group members - Instillation of hope: experiencing optimism through observing improvement of other members - Interpersonal learning: occurs when receiving feedback from grp members re: one's box (input), learning successful ways of relating to group members (output) Study of long-term sequel of adverse childhood events found - Correct Answer positive relationship between heart disease, obesity, DM, unintended pregnancy, depression, anxiety, cancer, COPD, sleep disorders, dissociative disorders, and substance use disorder. Dialectical behavioral therapy (DBT) draws on cognitive theory and behavioral theory, along with other theories. Elements of behavioral therapy in DBT include which of the following? A. Skills training and exposure B. Examination of feelings and relating feelings to visceral sensations C. Working through the transference with the therapist D. Cognitive interpretation of past traumatic events. - Correct Answer A skills training and exposure treatment approach that does not focus on full symptom resolution but emphasizes resilience and control over problems and life. Recovery isn't about getting rid of the problem, but recognizing and fostering their abilities, interests, and dreams. - Correct Answer Recovery Model Goals of Assertive COMMUNITY Treatment - Correct Answer help people become more independent and integrate into the community Reduce reliance on hospitals providing around the clock care. NP Core Competencies - Correct Answer Scientific Foundations Leadership Quality Practice Inquiry Technology and Information Literacy Policy Health Delivery System Ethics Independent Practice Who identifies our scope of practice - Correct Answer state board of nursing? If board of nursing is an answer, to verify information.......... - Correct Answer it is usually the correct answer. Reporting your coworker to the board of nursing... - Correct Answer is usually the incorrect answer. Standard or quality of practice is determined by - Correct Answer American Nurses Association How many releases of information are required to release information on patients chemical and psychiatric care to a third party - Correct Answer 2 Exceptions to confidentiality - Correct Answer patient revels an intent to harm self or others. Answering court orders, subpoenas, or summonses Tara off principal - Correct Answer duty to warn Competency - Correct Answer legal term, we cannot determine competency. We can determine their capacity Care is provided on a fair and equal basis - Correct Answer justice Do no harm Imminent danger - Correct Answer nonmaleficience Promoting wellbeing and doing good - Correct Answer beneficence Promise keeping, integrity, honesty Being respectful, competent and professional - Correct Answer fidelity Telling the truth - Correct Answer veracity Doing for self - Correct Answer autonomy Rennie v Klein Court Case - Correct Answer involuntary patient not found incompetent, has a right to refuse psychotropic medications, Goal of case management - Correct Answer promote quality and cost-effective outcomes. Stark Law - Correct Answer you cannot refer to family members for treatment of your patients. PICOT - Correct Answer Patient or problem Intervention Comparison Outcome Time Evidence from systematic review or meta-analysis of many RCTs - Correct Answer level 1 evidence Evidence from at least one RCT - Correct Answer level 2 evidence Before implementing/creating change of policy - Correct Answer assess/address/identify potential organizational barriers and facilitators Meet with stakeholders Patient advocacy - Correct Answer reduce stigma of mental illness through education Help patients receive available services