PMHNP ANCC Exam Study Guide Latest 2022 (Verified) A+ (169 Study Questions)

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PMHNP ANCC Exam Study Guide Latest 2022 (Verified) A+ (169 Study Questions) Descriptive Vividness - ✔✔The researcher describes the data gathering process in sufficient detail that the reader ca... n personally experience it. The data collected, often in the form of personal statements, should be quoted directly and extensively, because this is the raw data from the study. Methodological Congruence - ✔✔The researcher presents the philosophical and methodological approach used and cites references to support their approach. The subjects, sampling method, datagathering and data-analysis strategies, and processes for informed consent are clearly and concisely described. Theoretical Conectedness - ✔✔Any theory developed from the study is clearly stated, logically consistent, reflective of the data, and in accord with other available knowledge. Analytical Precision - ✔✔Is not concerned with statistics and instruments. If refers to the decisionmaking process by which the researchers synthesize concrete data (words of the subjects) into an abstract that clarifies the meaning and the importance of the study. The last of the 5 criteria is Heuristic Relevance - The researcher clarifies the significance of the study, its applicability to public health or community nursing, and its likely influence o the future research. Phenelzine - ✔✔An MAOI that patients with atypical depression respond particularly well to. Atomoxetine - ✔✔A norepinephrine reuptake inhibitor approved for the treatment of ADHD. Loxapine - ✔✔A typical, tetracyclic antipsychotic with antidepressant properties. Its active metabolite is amoxapine, which is a secondary amine tricyclic antidepressant. HITECH - ✔✔Implementation of EHR for information exchanges and improving population health. This was done by Obama and the ARRA. Suppression - ✔✔The intentional or conscious exclusion of painful or disturbing thoughts or emotions from awareness.A healthy defense mechanism because the client channels conflicting energies into growth-promoting activities. Medications that can induce depression - ✔✔beta blockers, steroids, interferon, Accutane, benzodiazepines, progesterone, some antivirals, and antineoplasmics. Medications that can induce mania - ✔✔Steroids, Isoniazid, antidepressants (in people who already have bipolar disorder), and Antabuse. Medigap Insurance Policies - ✔✔Private insurance policies purchased by elderly individuals to cover some or all of their medical expenses not paid for by Medicare. Medicare Advantage Plan - ✔✔Formerly Medicare + Choice, this created regional Preferred Provider Organizations (PPOs) and gave Medicare enrollees the option of enrolling in private insurance plans. Medicare + Choice - ✔✔Was a part of the Balanced Budget Act of 1997 that significantly increase the number of managed care insurance plans available to recipients. This was replaced with the Medicare Advantage Plan in 200. List of the Second Generation (atypical) Antipsychotics (9) - ✔✔Clozaril (clozapine), Zyprexa (olanzapine), Latuda (lurasidone), ziprasidone, Risperdal (risperidone), Invega Sustenna (palperidone), Fanapt (iloperidone), Seroquel (quetiapine), Saphris (asenapine), List of First Generation (typical) Antipsychotics (10) - ✔✔Haldol (haloperidol), Prolixin (fluphenazine), Navane (thiothixene), Thorazine (chlorpromazine), Loxitane (loxapine), Mellaril (thioridazine), Trilafon (perphenazine), Orap (pimozide), Solian amisulpride), Stellazine (trifluoperazine) List the 6 common benzodiazepines in order from shortest to longest half-life - ✔✔Xanax (alprazolam): 6-10 hrs Serax (oxazepam): 8 hrs Ativan (lorazepam): 12-18 hrs Klonopin (clonazepam): 30-40 hrsValium (diazepam): 100 hrs Librium (chlordiazepoxide): 36-200 hrs List of SNRIs (6) - ✔✔Cymbalta (duloxetine), Pristiq (desvenlafaxine), Effexor (venlafaxine), Fetzima (levomilnacipran), Savella (milnacipran), Strattera (atomoxetine) Action of Tricyclic Antidepressants (TCAs) - ✔✔They target serotonin, norepinephrine, and histamine-1 receptors List the Tricyclic Antidepressants (9) - ✔✔Pamelor (nortriptyline), Elavil (amitriptyline), amoxapine (no branded), Anafranil (clomipramine), Norpramin (desipramine), Tofranil (imipramine), Vivactil (protriptyline), Sinequan/Silenor (doxepin), Surmontil (trimipramine) FINISH acronym for SSRI withdrawal - ✔✔Flu-like symptoms Irritability Nausea Imbalance/instability/incoordination/dizzy (motor) Sensory disturbances Headache, hyperarousal (anxiety/agitation) Signs of NMS (Neuroleptic Malignant Syndrome) - ✔✔Initial Symptoms: altered sensorium, hyperreflexia, fever Then signs of autonomic instability: extreme muscle rigidity, hypotension, tachycardia, diaphoresis, tachypnea, hyperthermia, coma, death. Check for increased WBCs (leukocytosis)/LFTs/CPK Signs of Lithium toxicity - ✔✔Confusion, diplopia, nausea/diarrhea, ataxia, lethargy, fatigue, clumsiness, weakness, muscle cramping, severe tremor, blurred vision, nystagmus, increased DTRs, altered mental status, cardiac dysrhythmiasSigns of Serotonin Snydrome - ✔✔agitation, restlessness, rapid heart rate, blood pressure elevation, headache, sweating, shivering, goose bumps, myoclonic jerking and loss of coordination, confusion, fevers, unconsciousness, seizures Medications that can increase lithium level - ✔✔NSAIDs, ACE Inhibitors (-prils), ARBs (-sartans), tetracyclines, metronidazole Medications that can decrease lithium level - ✔✔potassium-sparing diuretics, thiazide diuretics, theophylline Clozaril - monitoring considerations - ✔✔Monitor ANC (absolute neutrophil count); pt needs an ANC of at least 1500 to start clozaril therapy; watch for Benign Ethnic Neutropenia (BED); Monitor ANC weekly x6 months, every 2 weeks x6 months, then monthly if ANC is at least 1500. Substances that can cause a false + drug test for PCP & methadone - ✔✔Niquil, OTC cough meds Substances that can cause a false + drug test for heroin & morphine - ✔✔rifampin, fluoroquniolones Substances that can cause a false + drug test for cocaine - ✔✔NSAIDs, amoxicillin, most antibiotics Substances that can cause a false + drug test for amphetamines - ✔✔Prozac, Wellbutrin, Trazodone, Nefazodone, Sudafed, OTC decongestants. Schizophrenia Prevalence: Non-twin siblings of a schizophrenic parent Dizygotic twins of a schizophrenic parent Monozygotic twins of a schizophrenic parent - ✔✔8% 12% 47% Birth defects caused by benzodiazepines - ✔✔Cleft palate, floppy baby syndromeBirth defects caused by carbamazepine - ✔✔Neural tube defects Birth defects caused by depakote - ✔✔Neural tube defects (spina bifida), cleft palate, atrial-septal defects, long-term developmental deficits CYP450 Inhibitors - ✔✔bupropion, clomipramine, cimetidine, clarithromycin, fluoroquinolone, grapefruit, ketoconazole, nefazodone, SSRIs CYP450 Inducers - ✔✔carbamazepine, nicotine, hypericum (St. John's wort), phenytoin, phenobarbital Normals lab value for AST (aspartate aminotransferase) - ✔✔5-40 Normal lab value for ALT (alanine aminotransferase) - ✔✔5-35 Normal lab value for Alkaline Phosphastase - ✔✔44-147; male be increased in gallbladder disease & with bone injury /rapid bone growth Creatine Kinase (normal range) - ✔✔<240. Measures muscle injury (heart, brain, and skeletal). Increased in MI (CK-MO), myositis, NMS BUN (normal range) - ✔✔10-20. Creatinine - ✔✔0.4-0.8 or less than 1.5 Normal GFR - ✔✔>90 mL/min. If a patient is on psychotropics, as long as their GRF is >60, no dose adjustments need to be made. What is the best measure of kidney function? - ✔✔GFR (glomerular filtration rate)Normal Plate Count - ✔✔140,000-340,000 Normal hemoglobin value for males and females - ✔✔Males: 13.5-18 Females: 12.5-14 Normal MCV (mean corpuscular volume) value - ✔✔78-100 Normal TSH Range - ✔✔0.4-4 Normal Free T4 range - ✔✔10-27 Substances that can cause a false + drug test for codeine - ✔✔poppy seeds Substances that can cause a false + drug test for benzodiazepines - ✔✔Zoloft Gamma glutamyl transpeptidase (GGT) normal range - ✔✔10-38 Drug Category A and examples - ✔✔Controlled studies show no risk Vitamins within RDA, insulin, thyroxine Drug Category B and examples - ✔✔No evidence of risk in humans Buspirone, zolpidem, clozapine, lurasidone Beta-lactam antimicrobials (PCNs, cephalosporins, select macrocodes,azithromycin, erythromycin), acetaminophen, ibuprofen (1st & 2nd trimesters) Drug Category C and examples - ✔✔Risk cannot be ruled out bupropion, lamotrigine, SSRIs (except paroxetine), TCAs, duloxetine, mirtazapine, trazodone, venlafaxine, aripiprazole, Haldol, ziprasidone, risperidoneDrug Category D and examples - ✔✔Positive evidence of risk paroxetine, valproate, carbamazepine, lithium alprazolam, chlordiazepoxide, clonazepam, diazepam, lorazepam, oxazepam ACE Inhibitors (-prils), ARBs (-sartans), ibuprofen (3rd trimester), tetracyclines Drug Category X and examples - ✔✔Absolutely Contraindicated in pregnancy Accutane, misoprostol, thalidomide, flurazepam, temazepam, triazolam Types of inferential statistics - ✔✔p-value, Pearson's r correlation, t-test,ANOVA T-test - ✔✔Compares whether the means of two groups are statistically different ANOVA - ✔✔tests the differences of 3 or more groups Pearson's r correlation - ✔✔tests the relationship between 2 variables HLB-B*1502 - ✔✔Allele that some asian's have which makes them unable to metabolize carbamazepine, increasing their risk for Steven's-Johnson syndrome which can lead to toxic epithelial necrolysis. Asians must be tests for this gene prior to beginning therapy. TIGER - ✔✔technology competencies for NPs to improve access to quality & patient experience Who is covered by Medicare? - ✔✔Adults >65 who have worked at least 4 quarters and paid Medicare taxes End stage renal disease those who need a kidney transplant those with ALS Some younger people with disabilities Those receiving SSDIWho is covered by Medicaid? - ✔✔Low-income children Low-income pregnant women Elderly & disable individuals who qualify for the supplemental security income program HAM-D (Hamilton Depression Scale) - ✔✔17-21 questions. Each question with 3-5 possible responses that increase in severity. 0-7 normal > or = 20 moderately severe depression BDI (Beck Depression Inventory) - ✔✔21 questions, scores range 0-63. 0-13: minimal depression 14-19: mild depression 20-28: moderate depression 29-63: severe depression Edinburgh Postnatal Depression Scale (EPDS) - ✔✔10 questions. > or = possible depression SLUMS (St. Louis University Mental Status Exam) - ✔✔HS Education: Normal: 27-30 MCI: 20-27 Dementia: 1-19 Less than HS education: Normal: 20-30 MCI: 14-19 Dementia: 1-14 CIWA - ✔✔Very mild: 0-9 Mild: 10-15Moderate: 16-20 Severe: 21-26 PHQ-9 (Patient Health Questionnaire 9) - ✔✔9 questions 1-4 minimal depression 5-9 mild depression 10-14 moderate depression 15-19 moderately severe depression 20-27 severe depression MADRS (Montgomery Asberg Depression Rating Scale) - ✔✔10 questions 44= very severe 31= severe 25= moderate 15= mild 7= recovered Mini-cog - ✔✔Screens for cognitive impairment. 3-item recall with a clock-drawing test (CDT). 0/3 word recall=cognitive impairment 1-2 word recall and abnormal CDT=cognitive impairment 1-2 word recall and normal CDT= no cognitive impairment 3/3 word recall= negative screen for dementia MMSE (Mini mental status exam) - ✔✔Screens for cognitive impairment and used to follow cognitive function over time. High education may score falsely high. 30-point questionnaire: Intact 25-30 Mild 21-24 Moderate 10-20 Severe < or =9MoCA (Montreal Cognitive Assessment) - ✔✔Screens for mild cognitive decline. 30-point questionnaire. > or = 26 considered normal Which therapy uses straight-forward directives, paradoxical d [Show More]

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