PMHNP Exam Reported Questions & Answers, 100% Accurate, Questions bank. Graded A+.

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PMHNP Exam Reported Questions & Answers, 100% Accurate, Questions bank. Graded A+. What is dissemination? - ✔✔-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? - ✔✔-Moderate cognitive impairment What is Tegretol in the CYP450 system? - ✔✔-Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? - ✔✔-Inducer - will lower dose of Lamictal What is a Type I research error? - ✔✔-There IS a difference but you say there isn't a difference. What is a Type II research error? - ✔✔-There is NO difference but you say there is a difference. What is pseudo-dementia? - ✔✔-Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve. Is it normal for a 1 month old to have a palmar grasp? - ✔✔-Yes. What is a drug 1/2 life? - ✔✔-The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? - ✔✔-Zyprexa, Abilify, Seroquel - low doses What is a risk of using Tramadol? - ✔✔-Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? - ✔✔-HLAB-1502 When might you see toxic epidermal necrolysis? - ✔✔-With worsening of SJS How many generations do you include for a genogram? - ✔✔-1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? - ✔✔-Amino Acids What is epigenetics? - ✔✔-Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? - ✔✔-Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? - ✔✔-Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? - ✔✔-10-25 yo When do females typically present with schizophrenia? - ✔✔-25-35 yo What does Erythromycin to trileptal? - ✔✔-You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? - ✔✔-Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs - ✔✔-Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? - ✔✔-Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? - ✔✔-CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? - ✔✔-CKMB What is the risk of a seriously elevated CKMB? - ✔✔-Polymyositis Rhabdo What is a normal CKMB? - ✔✔-0.3 mcg/L What psychoactives does Detrol interact with? - ✔✔-Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? - ✔✔-CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? - ✔✔-CD4 <200 Viral Load is high <20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? - ✔✔-Self-Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? - ✔✔-Helps rule-out disease = True Positive = Snout What is specificity? - ✔✔-Helps rule-in disease = True Negative = Spin What does a sed rate measure? - ✔✔-Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? - ✔✔-0-22 males 0-29 females What is a retic count? - ✔✔-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? - ✔✔-Anemia - acute or chronic bleeding What does an increased retic count indicate? - ✔✔-Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? - ✔✔-Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? - ✔✔-Increase tegretol levels. What happens if a pregnant women takes Accutane? - ✔✔-Birth defects. What labs do you get with RA? - ✔✔-Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis. CRP and ESR are both increased in RA but NOT in osteoarthritis. Where does the NP Code of Ethics come from? - ✔✔-ANA When do you assume informed consent? - ✔✔-Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? - ✔✔-Same as with informed consent Who can declare a patient incompetent and appoint a guardian? - ✔✔-Only a court Does impaired judgment mean one is incompetent? - ✔✔-No. Can an advanced directive ever be revoked? - ✔✔-Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? - ✔✔- Nothing. They are all the same. Does the de facto rule of proxy apply in same sex marriages? - ✔✔-No. How do Asians see HC providers? - ✔✔-As in a position of authority. Expect to give instructions and help make decisions What does it mean when an Asian patient does not make eye contact with the NP? - ✔✔-SIgn of respect What is the evil eye? - ✔✔-When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness. How do you protect from the evil eye? - ✔✔-Red ribbon on an infant Amulet for adults How do you treat for evil eye? - ✔✔-Access traditional healer + traditional care. For there to be a duty to a patient, what must exist? - ✔✔-Relationship What is a proximate cause? - ✔✔-Connection between A + B. For there to be damages, what must exist first? - ✔✔-Negligence What is an occurrence basis liability insurance? - ✔✔-"occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? - ✔✔-provides coverage for a claim that is brought within the policy period, no matter when the loss occurred. Who sets the minimum requirements for NP's? - ✔✔-Board of Nursing State What are the various controlled substance classes? - ✔✔-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? - ✔✔-Schedules III-V ONLY. Where does 50% of healthcare funds come from? - ✔✔-The government Who is eligible for Medicare? - ✔✔->65 or under 65 with diability, ANY age with renal disease. What is incident to billing? - ✔✔-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? - ✔✔-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? - ✔✔-Yes, impoverished elderly but Medicaid is always payor of last resort. Is dental care included in Medicaid? - ✔✔-Yes, <21 gets basic dental as part of the Medicaid plan. What is the purpose of HIPAA? - ✔✔-National standards for electronic HC transactions National ID for providers, health plans and employers. Not SIMPLY Confidentiality. What must be signed prior to any healthcare in the state - ✔✔-Notice of Privacy Practices Statement What happens if a patient refuses to sign an ROI? - ✔✔-Can decline to treat Health plan may condition enrollment on provision of consent When is HIPAA not required? - ✔✔-Emergency treatment Substantial communication barriers and consent is inferred Involuntary committment Is it ok to announce a patient's name in a waiting room? - ✔✔-Yes, no other way to give care. Is it ok to leave a message on a patient's vm? - ✔✔-Yes, but should be limited. What is the impact of steroid inhalers on children? - ✔✔-Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? - ✔✔-Cataracts, glaucoma, thinning of bones and skin What is included in the treatment of fibromyalgia? - ✔✔-Sleeping meds Antidepressants Pain meds What psychoactives are first line treatment for fibro? - ✔✔-Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's What is the purpose of telepsychiatry? - ✔✔-Increase the ability to reach rural and underserved areas. What is the purpose of Motivational Interviewing? - ✔✔-Explore ambiguity Maintain passive position What is required for Medicare submission? - ✔✔-ICD 10 and narrative or CPT What is the neurotransmitter problem in Schizophrenia? - ✔✔-Excess dopamine in mesolimbic pathway. What is the neurotransmitter problem in ADHD? - ✔✔-Dopamine, norepinephrine and serotonergic dysfunction What is the benefit of play therapy? - ✔✔-Don't have to confront emotions head on. What neurotransmitters are involved in the bioamine hypothesis of depression? - ✔✔-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? - ✔✔-Stick out your tongue. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? - ✔✔- CN V - Trigeminal What are two important things to measure when using Zyprexa? - ✔✔-Lipid level and abdominal circumference What is included in the mini-cognitive exam? - ✔✔-Clock, memory questions from MSE. What is HIV related dementia often mistaken for, especially at the beginning? - ✔✔-Depression What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000? - ✔✔- Stop and repeat lab. Normal is 1500-8000 mm3 Can you take Buspar during pregnancy? - ✔✔-Category B - ok if really needed. Can you take Klonopin during pregnancy? - ✔✔-Category C - avoid if possible; does excrete into breastmilk and infant could get withdrawal symptoms. What is the concern when prescribing Lamictal with Depakote? - ✔✔-Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? - ✔✔-Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? - ✔✔-Microalbumin? What is often common to patients with fibro? - ✔✔-Sexual abuse How is telepsychiatry evaluated? - ✔✔-Outcome based - measure at intervals. What happens with a patient taking Lithium and who gets dehydrated? - ✔✔-Levels increase What happens with a patient taking Lithium who decreases sodium intake? - ✔✔-Levels increase What happens with a patient taking Lithium and drinks a lot of water? - ✔✔-Levels decrease If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? - ✔✔-Zyprexa What happens when taking Lithium and NSAIDS? - ✔✔-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? - ✔✔-HLAB-1502 Allele increase risks of SJS. Trileptal, Tegretol and other AED's. Amgdyla - ✔✔-Fear, Anxiety, and Aggression Neurotransmitter for Addiction - ✔✔-Dopamine and GABA Neurotransmitter for Mood Disorder - ✔✔-Serotonin and norepinephrine Which drug affects Carbamazepine/tegretol - ✔✔-Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol Signs and Symptoms of stimulant abuse - ✔✔-insomnia and tremor Depakote check - ✔✔-HCG level [Show More]

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