PMHNP certification Exam 22 (Latest 2022/2023) Download to Score A+
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with
...
PMHNP certification Exam 22 (Latest 2022/2023) Download to Score A+
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white, depression) - CORRECT ANSWERD. 68 y/o single white male with depression *5 risk factors (age, male, white, depression)
Count the risk factors
COWS scale components - CORRECT ANSWER• Opioid W/D
Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication, not w/d), body aches, Rhinorrhea (running nose), Lacrimation (eye tearing), GI upset (N/V/D), yawning, tremors, anxiety/irritability, Piloerection (gooseflesh skin), insomnia
What does COWS stand for? - CORRECT ANSWERClinical Opiate Withdrawal Scale
What does CIWA stand for? - CORRECT ANSWERClinical Institute Withdrawal Assessment
What does CIWA assess for? - CORRECT ANSWER--used to determine likelihood of ETOH withdrawal or DTs
--usually occur within the first 24-72 hours after cessation
o used to determine when to administer medications for ETOH withdrawal
What does CIWA NOT test for? - CORRECT ANSWERAlcohol Use Disorder
What are the CIWA scale components? - CORRECT ANSWER• N/V, tremor, paroxysmal sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, H/A, orientation
Each component is scored from 0(none)-7(severe) except orientation wh/ is (0 (AA0x4)-4 (disoriented)
Score:
<10: Very mild Start PRN meds at score of 8
>10 to 15: Mild scheduled + PRN meds
>16 to 20: Moderate
>21: Severe Diazepam, Librium, Ativan
When interview teenagers (16 y/o) that arrive with their parents what should you do? - CORRECT ANSWERinterview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confidential. Parents may be upset but remember you are advocating for the child.
Which Ethnic group has the highest rate of suicide? - CORRECT ANSWERNative Americans
Example A patient is being treated for schizophrenia with olanzapine. Which of the following is the most common side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antagonism
C. Increased Lipids
D. Metabolic Syndrome - CORRECT ANSWERD. Metabolic Syndrome (UMBRELLA ANSWER)
Which antipsychotics have the least weight gain? - CORRECT ANSWERLatuda, Abilify, (also least sedating), Geodon-if patient has metabolic syndrome consider switching to one of the medications above. Or if the patient is overly sedated try switching to ABILIFY
Which mood stabilizer have the least weight gain? - CORRECT ANSWERLamictal
-But remember all mood stabilizers cause some weight gain
When presented with a question about typical vs atypical antipsychotic the answer is usually to start of a - CORRECT ANSWERatypical
A client presents with complains of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the brain that is responsible for the normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus - CORRECT ANSWERHypothalamus
A, B, & D are all part of the limbic system so you can rule that out
When a patient is hesitant to participate in treatment you should encourage? - CORRECT ANSWERBring a support person like a husband
Thyroid-Stimulating hormone normal level - CORRECT ANSWER0.5-5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosis - CORRECT ANSWERHYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE
Key symptoms of Heat Intolerance - CORRECT ANSWERHyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis - CORRECT ANSWER(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance - CORRECT ANSWERHypothyroidism
Hyperthyroid can mimic - CORRECT ANSWERMania
Hypothyroid can mimic - CORRECT ANSWERDepression
A patient on depakote complains of RUQ pain and has reddish/brown urine - CORRECT ANSWERHepatoxicity
-Check LFTs
Signs of Depakote toxicity - CORRECT ANSWERDisorientation, confusion, lethargy
You suspect depakote toxicity what do you do? - CORRECT ANSWERCheck
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity? - CORRECT ANSWERKava Kava
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