Medical Terminology and Nursing Concepts, Exams of Nursing

Download Medical Terminology and Nursing Concepts and more Exams Nursing in PDF only on Docsity! 1 ANCC PMHNP Exam Latest Question Bank Answered All Correctly Answered Rated A+ ANCC PMHNP EXAM What is dissemination? Correct Answer: Getting the research information out to those who need to know it! Publication - highest level Presenting at National Conference Presenting at Local Conference Journal Club where one person reviews an article What does a 17 on MMSE mean? Correct Answer: Moderate cognitive impairment What is Tegretol in the CYP450 system? Correct Answer: Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? Correct Answer: Inducer - will lower dose of Lamictal What is a Type I research error? Correct Answer: There IS a difference but you say there isn't a difference. 5 By adulthood, PFC involved as well When do males typically present with schizophrenia? Correct Answer: 10-25 yo When do females typically present with schizophrenia? Correct Answer: 25-35 yo What does Erythromycin to trileptal? Correct Answer: You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? Correct Answer: Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct Answer: Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? Correct Answer: Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? Correct Answer: CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? Correct Answer: CKMB What is the risk of a seriously elevated CKMB? Correct Answer: Polymyositis Rhabdo What is a normal CKMB? Correct Answer: 0.3 mcg/L What psychoactives does Detrol interact with? Correct Answer: Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? Correct Answer: CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? Correct Answer: CD4 <200 Viral Load is high <20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? Correct Answer: Self- Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? Correct Answer: Helps rule-out disease = True Positive = Snout 7 What is specificity? Correct Answer: Helps rule-in disease = True Negative = Spin What does a sed rate measure? Correct Answer: Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? Correct Answer: 0-22 males 0-29 females What is a retic count? Correct Answer: Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow. What does a decreased retic count indicate? Correct Answer: Anemia - acute or chronic bleeding What does an increased retic count indicate? Correct Answer: Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? Correct Answer: Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? Correct Answer: Increase tegretol levels. What happens if a pregnant women takes Accutane? Correct Answer: Birth defects. Who sets the minimum requirements for NP's? Correct Answer: Board of Nursing State 11 What are the various controlled substance classes? Correct Answer: Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes. Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate Schedule III - Moderate Abuse Potential - hydrocodone, codeine Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine Schedule V - Very low abuse potential - anti-tussives, lomotil What classes of CS's is the NP approved to prescribe? Correct Answer: Schedules III-V ONLY. Where does 50% of healthcare funds come from? Correct Answer: The government Who is eligible for Medicare? Correct Answer: >65 or under 65 with diability, ANY age with renal disease. What is incident to billing? Correct Answer: Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD. Allows NP to get reimbursed at 100% rather than 85%. How are Medicaid benefits determined? Correct Answer: State determines qualification - Partnership between State and Fed Govt. Must be impoverished Must be US resident and low or very low income. Can you have Medicare and Medicaid? Correct Answer: Yes, impoverished elderly but Medicaid is always payor of last resort. Is dental care included in Medicaid? Correct Answer: Yes, <21 gets basic dental as part of the Medicaid plan. What is the purpose of HIPAA? Correct Answer: National standards for electronic HC transactions 15 What is the neurotransmitter problem in ADHD? Correct Answer: Dopamine, norepinephrine and serotonergic dysfunction What is the benefit of play therapy? Correct Answer: Don't have to confront emotions head on. What neurotransmitters are involved in the bioamine hypothesis of depression? Correct Answer: Noradrenaline Serotonin Dopamine MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse. How do you test CN XII? Correct Answer: Stick out your tongue. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? Correct Answer: CN V - Trigeminal What are two important things to measure when using Zyprexa? Correct Answer: Lipid level and abdominal circumference What is included in the mini-cognitive exam? Correct Answer: Clock, memory questions from MSE. What is HIV related dementia often mistaken for, especially at the beginning? Correct Answer: Depression What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000? Correct Answer: Stop and repeat lab. Normal is 1500-8000 mm3 Can you take Buspar during pregnancy? Correct Answer: Category B - ok if really needed. Can you take Klonopin during pregnancy? Correct Answer: Category C - avoid if possible; does excrete into breast-milk and infant could get withdrawal symptoms. What is the concern when prescribing Lamictal with Depakote? Correct Answer: Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? Correct Answer: Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? Correct Answer: Microalbumin? What is often common to patients with fibro? Correct Answer: Sexual abuse 17 How is telepsychiatry evaluated? Correct Answer: Outcome based - measure at intervals. What happens with a patient taking Lithium and who gets dehydrated? Correct Answer: Levels increase What happens with a patient taking Lithium who decreases sodium intake? Correct Answer: Levels increase What happens with a patient taking Lithium and drinks a lot of water? Correct Answer: Levels decrease If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? Correct Answer: Zyprexa What happens when taking Lithium and NSAIDS? Correct Answer: NSAIDS can cause Lithium levels to increase and for the patient to become toxic! What medications are at risk to cause SJS in the Asian population? Correct Answer: HLAB-1502 Allele increase risks of SJS. Trileptal, Tegretol and other AED's. Amgdyla Correct Answer: Fear, Anxiety, and Aggression Neurotransmitter for Addiction Correct Answer: Dopamine and GABA Pt wants to stop medications Correct Answer: explore reason for stopping Its their right 16 year old falls with the wrong crowd Correct Answer: Conduct disorder change agent Correct Answer: the person formally in charge of guiding a change effort Administrator 14 year old girl clenching her teeth Correct Answer: Cranial Nerve V-Trigeminal nerve Infant dying Correct Answer: Give child to parents and comfort parents borderline personality disorder Treatment Correct Answer: dialectical behavior therapy Aggressive patient give Correct Answer: IM geodon *SIGECAPS* of Depression Correct Answer: Sleep Interest Guilt Energy 21 Concentration Appetite psychomotor retardation Suicide DIGFAST for mania Correct Answer: Distractibility Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talking increase 5 year old tells u his brother sodomized him Correct Answer: Tell mom don't leave him alone with patient and call CPS implement crisis Just culture Correct Answer: "Just culture" model: proposed to reconcile the twin needs for no-blame and appropriate accountability The focus is on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors while maintaining individual accountability by establishing zero tolerance for reckless behavior. Distinguishes between Human error (e.g. slips), At-risk behavior (e.g. taking shortcuts), Reckless behavior (e.g. ignoring required safety steps). In a just culture, the response to an error or near-miss is predicated on the type of behavior associated with the error, not the severity of the event. Child reports Sexual Abuse Correct Answer: Interview the young child and infants child with parent First sign of temprofrontal Dementia Correct Answer: Behavior and personalty changes Tow amines related to depression Correct Answer: Serotonin and norepinephrine Want to start an consulting firm what tool would be needed to show economic viability Correct Answer: Revenue and expenses Patient stopped smoking (Cessation) Correct Answer: Decreased Zyprexia Promote resilience in schizophrenia for a patient that lives alone and doing well Correct Answer: Refer to peer support Spirit stick Correct Answer: Teach staff about culture competence Problems in the parietal lobe can lead Correct Answer: Sensory-perceptual disturbances and agnosia(inability to perceive objects) 25 How do you assess the competency of a medical procedure Correct Answer: Identify a pen and recall 3 words Patient thinks someone has infiltrated the church because he watched it on TV 2 years ago, what diagnosis Correct Answer: Delusional disorder Increase ICP (signs and symptoms) Correct Answer: Baby Neuro cry Menopausal woman Correct Answer: Hormone therapy and replacement Patient on antidepressants for 3 weeks and attempted Suicide Correct Answer: Stop medication immediately You want to decrease seclusion on your unit who considered the primary change agent Correct Answer: Unit staff You are a lead NP over other NPs in a rural setting how would you go about the change Correct Answer: Make online form and have them vote on it 16 year old refuse treatment Correct Answer: Send to psych specialist for acting out kids Positive Trendelenburg Sign Correct Answer: Refer to Ortho/specialist Pelvis drops to when patient raises one foot off the floor. Drug affects Flonase Correct Answer: Zantac (Histamine 2 Blocker) Antagonist Little boy wet his sheets, What kind of therapy would you suggest Correct Answer: Behavior therapy DDVAP acts in much the same manner as antidiuretic hormone. Correct Answer: Makes less urine Lithium level 1.2u what are you concerned with Correct Answer: 4+ Ketones What does depakote do to Lamictal Correct Answer: Increase laminate 200% Inducers of Cytochrome P450 (CYP450) Correct Answer: Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort A substance that speeds up a chemical reaction Inhibitor Correct Answer: A substance that slows down or stops a chemical reaction cytochrome p450 inhibitors Correct Answer: CRACK AMIGOS Cimetidine Ritonavir Acute Alcohol Ciprofloxacin Ketoconazole Amiodarone Macrolides Isoniazid 27 Grapefruit juice Omeprazol Sulfonamides Carb and Barb Correct Answer: decrease INR Deapkote and Disulfruram Correct Answer: Increase INR GAL-Renall metabolized Correct Answer: Gabapentin Acamprostate Lithium Grapefruit juice Correct Answer: One glass can reduce absorption by 47% Blood levels will be Increased Trazodone (Desyrel) Correct Answer: Get EKG. Trazodone (Desyrel) Correct Answer: Get an eye exam can cause Glaucoma Grapefruit juice or grapefruit Correct Answer: Increase trazodone PICOT Correct Answer: Patient population of interest Intervention of interest Comparison of interest Outcome Time limbic system Correct Answer: A doughnut-shaped system of neural structures at the border of the brainstem and cerebral hemispheres; associated with emotions PDSA model Correct Answer: PLAN- Do-carry out Study -examine results Act-decide what action Tanner's stages Correct Answer: Tanner stages Correct Answer: MMSE (Mini Mental State Examination)- Correct Answer: Stage May be Normal 25-30 Mild/Early 21-24 Moderate 10-21 Severe 0-9 A pt states that she has been raped. What do you do Correct Answer: ensure safety Hamilton D score of 28 Correct Answer: Assess for Suicide Hamilton Depression Rating Scale Correct Answer: 17-21 questions 0-7 Normal 31 14-18 Moderate > 20 Severe Depression Beck Depression Inventory (BDI) Correct Answer: 0-13 Minimal depression 14-19 Mild Depression 20-28 Moderate Depression 29-63 Severe Depression Patient Health Questionnaire (PHQ-9) Correct Answer: 1-4 minimal 5-9 Mild depression 10-14 Moderate Depression 15-19 Moderate Severe Depression 20-27 Severe Depression A brief 9-item self-report questionnaire used as a screening tool to assess severity of depression; widely used by health care providers, in validity is well established, particularly for identifying severe depression. Hamilton Anxiety Rating Scale (HAM-A) Correct Answer: 14-17 Mild Anxiety 18-24 Moderate Anxiety 25-30 Severe Anxiety Yale-Brown Obsessive Compulsive Scale (Y-BOCS) Correct Answer: OCD 0-7 subclinical 8-15 Mild 16-23 Moderate 24-31 Severe 32-40 Extreme PTSD (Post Traumatic Stress Disorder) Correct Answer: EMDR EMDR (eye movement desensitization and reprocessing) Correct Answer: eye movement desensitization and reprocessing Dilated pupils Correct Answer: Stimulant intoxication constricted (pinpoint) pupils Correct Answer: Opiods nystagmus Correct Answer: Phencyclidine conjuctival injection, muchies (super hungry), psychomotor slowness? Correct Answer: Marijuana Marijuana Correct Answer: a drug, often smoked, whose effects include euphoria, impairment of judgment and concentration and occasionally hallucinations; rarely reported as addictive Boy states that he wishes to be a girl and tells you not to tell his parent s Correct Answer: Don't tell 35 WATCHERS for GAD 3 of these *** for 6 months Correct Answer: worry anxiety tension in muscles concentration hyperarousal energy loss, fatigue restlessness sleep trouble Transtheoretical Model of Change Correct Answer: 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance Man working at the Gym and his urine is Cherry color Correct Answer: order myoglobinuria Latino women wanting prenatal class Correct Answer: Consult with cultural group in community Anorexia Correct Answer: Set up family therapy quasi-experimental design Correct Answer: Research method similar to an experimental design except that it makes use of naturally occurring groups rather than randomly assigning subjects to groups. The ventricle enlargement observed in clients with Correct Answer: schizophrenia is most often accompanied by Encopresis Treatment Correct Answer: Behavior management: toilet refusal behavior, scheduled toileting time, incentives. Prevention of constipation Counseling Medication that contradicts albuterol Correct Answer: Adderall (amphetamine / dextroamphetamine) Advair Diskus (fluticasone / salmeterol) amoxicillin (Amoxil, Trimox, Apo-Amoxi, Moxatag, Amoxicot, DisperMox, Biomox, Moxilin, Wymox) Ativan (lorazepam) Atrovent (ipratropium) azithromycin (Zithromax, Azithromycin Dose Pack, Z-Pak, Zmax) Benadryl (diphenhydramine) caffeine Flonase (fluticasone nasal) ibuprofen ipratropium (Atrovent, Ipratropium Inhalation Solution, Atrovent HFA, Ipratropium Inhalation Aerosol) Lasix (furosemide) metoprolol (Metoprolol Succinate ER, Metoprolol Tartrate, Lopressor, Toprol-XL, 37 Kapspargo Sprinkle) Mucinex (guaifenesin) oxycodone (OxyContin, Roxicodone, Xtampza ER, OxyIR, Oxaydo, Dazidox, Oxyfast, Oxecta, RoxyBond, Oxydose, Percolone, M-Oxy, ETH-Oxydose, Endocodone, Roxicodone Intensol) prednisone (Deltasone, Rayos, Sterapred, Prednicot, Sterapred DS, Liquid Pred, Meticorten, Orasone, Prednicen-M) Singulair (montelukast) Spiriva (tiotropium) Symbicort (budesonide / formoterol) Tylenol (acetaminophen) Vitamin B12 (cyanocobalamin) Vitamin D3 (cholecalciferol) Zyrtec (cetirizine) t-tests Correct Answer: statistical measure: test means of 2 independent samples, significantly different? ANOVA (analysis of variance) Correct Answer: 3 OR MORE an inferential statistical test for comparing the means of three or more groups Pearson's r Correct Answer: a statistic that measures the direction and strength of the linear relation between two variables that have been measured on an interval or ratio scale Metobolic syndrome Correct Answer: group of signs and symptoms including insulin resistance, obesity characterized by excessive fat around the waist and abdomen, hypertension, hyperglycemia, elevated triglycerides, and low levels of HDL NAMI Correct Answer: national alliance on mental illness help families of mentally ill: education, support groups health literacy Correct Answer: a person's capacity to learn about and understand basic health information and services, and to use these resources to promote one's health and wellness health literacy Correct Answer: Man taking insulin asking him to read blood glucose level inferential statistics Correct Answer: numerical data that allow one to generalize- to infer from sample data the probability of something being true of a population Mood Disorder Questionnaire (MDQ)-SCREENING Correct Answer: Mood Disorder Questionnaire Patient Name Date of Visit Please answer each question to the best of your ability 1. Has there ever been a period of time when you were not your usual self and... ...you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? 41 ...you were so irritable that you shouted at people or started fights or arguments? ...you felt much more self-confident than usual? ...you got much less sleep than usual and found that you didn't really miss it? ...you were more talkative or spoke much faster than usual? ...thoughts raced through your head or you couldn't slow your mind down? ...you were so easily distracted by things around you that you had trouble concentrating or staying on track? ...you had more energy than usual? ...you were much more active or did many more things than usual? ...you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night? ...you were much more interested in sex than usual? ...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky? ...spending money got you or your family in trouble? 2. If you checked YES to more than one of the above, have several of these ever happened during the same period of time? 3. How much of a problem did any of these cause you - like being unable to work;having family, money or legal troubles; getting into arguments or fights? No problems Minor problem Moderate problem Serious problem This instrument is designed for screening purposes only and not to be used as a diagnostic tool. Permission for use granted by RMA Hirschfeld, MD YES NO Patient comes with vague symptoms depression irritability Correct Answer: BECK Depression scale DISSEMINATED ENCEPHALOMYELITIS Correct Answer: Assess for asymmetry of extremities Along with this pattern, the patients usually get neurological symptoms which may include: Confusion, drowsiness, and even coma Unsteadiness and falling Visual blurring or double vision (occasionally) Trouble swallowing Weakness of the arms or legs Fever HA CBT (cognitive behavioral therapy) Correct Answer: Anxiety popular integrative therapy that combines cognitive (thinking) and behavior therapy Impulsivity (ADHD) Correct Answer: Pre-Frontal Cortex 45 - Encourage clients who are pregnant to participate in prenatal care and Special Supplemental Nutrition Program for Women, Infants and Children to increase the number of healthy babies and reduce the costs related to preterm baby care. - Use case finding to identify existing health problems in your caseload and the population served by your agency. Timely, holistic assessments and interventions can slow disease trajectories and promote healing and health. - Assess disaster victims and triage for care. - Investigate an outbreak of flulike illness in a local school. - Provide programs in child development and behavior management for families who have not yet abused their children but whose children are brought to the attention of social authorities for aggressive behavior problems. - Develop a way for homeless individuals to read their TB skin test, if necessary, and to transfer the results back to the facility at which the skin test was administered. - To prevent the spread of disease - Notify partners and trace contacts (HIV) Collab with OB NP questions Correct Answer: wants to establish a relationship so Mental Health can be reached by more people anorexia nervosa Correct Answer: BMI less than 18.5 an eating disorder in which an irrational fear of weight gain leads people to starve themselves Anorexia admission Criteria for hospitalization includes: Correct Answer: weight loss over 30% over 6 months, severe hypothermia (temperature lower than 36°C or 96.8°F), heart rate less than 40 beats per minute, systolic blood pressure less than 70 mm Hg, and hypokalemia (less than 3 mEq/L). Culture question: A man injects himself Correct Answer: "tell me more about the medications" Acute Stress Disorder (ASD) Correct Answer: can be 2-4 weeks a disorder resulting from exposure to a major stressor, with symptoms of anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to "relive" the event in dreams and flashbacks for as long as 1 month following the event Scope of Practice in Nursing Correct Answer: State Standards of Practice Correct Answer: ANA ADPIE - Nursing Process Correct Answer: Assessment Diagnosis Planning Implementation Evaluation Adult panic disorder Correct Answer: Buspar 47 Kids panic disorder Correct Answer: Clonidine Guafacine OCD (Obsessive Compulsive Disorder) Correct Answer: TCA Clomipramical Clomipramine (Anafranil) Correct Answer: OCD, depression (tricyclic) agoraphobia Correct Answer: fear of open spaces Agoraphobia treatment Correct Answer: *BZDs* - short term symptom relief *SSRIs* - long-term maintenance fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) *SNRIs* - long-term maintenance venlafaxine (Effexor) *TCAs* - long-term maintenance imipramine social anxiety disorder Correct Answer: BetaBlocker Propanolol Tourette syndrome Correct Answer: involuntary, spasmodic, twitching movements; uncontrollable vocal sounds; and inappropriate words - leader - surrogate - conselor Paplau's Interpersonal Theory Correct Answer: Process recording Give Ativan Correct Answer: For Alcoholic with Liver problems detailed physical exam Correct Answer: Pt states that God did this to me Correct Answer: Assess spiritual needs Mini-Cog Correct Answer: is another screening tool that can be administered in 5 minutes or less and requires minimal training. 3 item recall, clock drawing test (CDT) 51 women in military and she saw her friend die Correct Answer: PTSD Man had appt, wife came and he didnt Correct Answer: Tell wife to reschedule appt Tagement (Cimetidine) Correct Answer: ^ Benzo ^ Coumadin Erythromycin Correct Answer: ^ Xanax levels Disulfiram Correct Answer: ^ Coumadin Pt with Eating disorder states getting full Correct Answer: Bloating delayed Gastric emptying Realiability Correct Answer: consistency Biggest Concern with EHR Correct Answer: Confidentiality Qualiatative Correct Answer: Measures in natural setting i.e ?, observation Quantitative Correct Answer: Data that is in numbers internal validity Correct Answer: Was research done right? extent to which we can draw cause-and-effect inferences from a study I don't know answers Correct Answer: pseudo dementia interferon Correct Answer: decrease Wellbutrin ^ prolactin Correct Answer: stop prolactin EPS Correct Answer: ^ risk for TD Assess when someone ready to quit drinking Correct Answer: See what stage they in Ask when ready to start tx 55 Alprostadil (PGE1) Correct Answer: • Ductal-dependent Congenital Heart Disease (all forms) • 0.05-0.1 µg/kg/min IV/IO infusion initially, then 0.01-0.05 µg/kg/min IV/IO Females more likely to become an alcoholic than man Correct Answer: due to hormones Apoptosis Correct Answer: cell death in aging/elderly solution therapy Correct Answer: conducted through direct observation of clients' responses to a series of precisely constructed questions. Np wants to implement a certain policy in nursing. Correct Answer: start with nurse manager Turner Syndrome Correct Answer: A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted. delayed puberty, short id, 10-16 years old amenorrhea web neck, osteoporosis, lymphemeda, poor social skills Prozac causes what? Correct Answer: increased anxiety in elderly Prazosin (Minipress) Correct Answer: nightmares ACE inhibitors Correct Answer: HTN Recovery Model Correct Answer: A model that is patient/consumer-centered, is hopeful and empowering, and emphasizes the person and the future rather than the illness and the present. Recovery Model Intervention Correct Answer: motivational interviewing Correct Answer: a collaborative, person-centered form of guiding to elicit and strengthen motivation for change MOTIVATIONAL INTERVIEWING Correct Answer: MAY WE TALK ABOUT YOUR TEST SHOWS YOU ARE VERY COURAGEOUS YOU WANT TO CHANGE, BUT LETS SEE IF I GOT IT KIDS receive to many calories ue to staff letting him eat food Correct Answer: Meet with dietiacan , discuss with manager