PMHNP Certification Exam Comprehensive Questions And
Correct Answers
Pain and bloating after eating is caused by... - ANSWER - delayed gastric emptying
Medications that cause delayed gastric emptying? - ANSWER - PPIs; ranitidine, famotidine, omeprazole
What instructions should you give your patient if they are prescribed antacids/PPIs and psychotropics? -
ANSWER - Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of
psychotropics
Normal BMI range - ANSWER - 18.5-25
Criteria for admission for ED bx: - ANSWER - BMI <15; 25% total body weight loss in 3 months; severe
dehydration, infection, bradycardia, hypothermia, hematemesis, hypokalemia
What neurotransmitters are implicated in ADHD? - ANSWER - DA, NE, 5HT - DNS
What brain structures are involved in ADHD? - ANSWER - Reticular activating system, basal ganglia,
frontal cortex - RBF
Abnormalities in this part of the brain cause inattentive ADHD: - ANSWER - Prefrontal cortex
Amphetamines are FDA approved for children beginning at _ years old - ANSWER - 3
Methamphetamines are FDA approved for children beginning at _ years old - ANSWER - 6
,Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients ages ___ - ANSWER
- 6-17
Strattera is FDA approved to treat ADHD in patients ages ___ - ANSWER - 6 and up (including adults)
Adults diagnosed with both ADHD and depression would benefit from being prescribed: - ANSWER -
Wellbutrin
Conduct disorder can be diagnosed in: - ANSWER - Both children and adults
Conduct disorder diagnostic criteria: - ANSWER - Violating rights of others or societal norms; aggression
towards people/animals; destruction of property; no remorse
Treatment for conduct disorder: - ANSWER - Targets aggression and mood; SGA, mood stabilizer, SSRI,
alpha agonists
ODD diagnostic criteria: - ANSWER - Argumentative, defiant for at least 6 months and with 4 sx
Treatment of ODD: - ANSWER - Focused on family therapy, child management skills, teaching parents
reinforcement/boundaries/problem solving
DMDD diagnostic criteria: - ANSWER - Childhood depressive d/o between ages 6-17; chronic
dysregulated mood, frequent tantrums, severe irritability; typically DMDD rather than bipolar d/o in
children
Neurotransmitters implicated in ASD: - ANSWER - Glutamate, GABA, 5HT - GGS
Echolalia - ANSWER - Meaningless repetition of words; often seen in ASD
Broken mirror theory - ANSWER - Dysfunction of the mirror neuron system results in poor social
interaction and cognition in ASD patients
,Parallel play is developmentally appropriate at which ages? - ANSWER - 1-3 years old
Parallel play continuing beyond the age of 3 years old may be indicative of... - ANSWER - ASD dx d/t
social deficits
M-CHAT - ANSWER - Modified Checklist for Autism in Toddlers; ASD scale
ADOS-G - ANSWER - Autism Diagnostic Observation Schedule - Generic; ASD scale
ASQ - ANSWER - Ages and Stages Questionnaire; development and social/emotional screening
Pharmacological treatment of ASD: - ANSWER - Stimulants (increase DA to help with impulsivity,
hyperactivity, inattention; Antipsychotics (target aggressive bx, tantrums, self-injury, stereotyped bx)
Nightmares in children can be the result of: - ANSWER - Genetic factors; assess family patterns of
nightmares
Features of children diagnosed with Fragile X - ANSWER - LARGE features: large head, elongated face,
hyperextensible joints, abnormally large testes, short stature
Features of children diagnosed with fetal alcohol syndrome - ANSWER - small features: small head, small
eye opening, low nasal bridge, flat midface, smooth philtrum, thin upper lip
Clock drawing test assesses function of which brain lobe? - ANSWER - Parietal
What does the clock drawing test assess for? - ANSWER - Executive/cognitive fx, impairments associated
w/ damage to right parietal lobe, constructional apraxia (inability to draw or assemble objects)
Important labs to draw for patients presenting with dementia? - ANSWER - B12, folic acid
Dementia presents with mental decline that is ___ - ANSWER - Chronic; if acute sx, consider other dx
, Symptoms of subcortical dementia: - ANSWER - Motor sx, lack of coordination, tremors, depression,
irritability, apathy
Example of subcortical dementia diagnosis - ANSWER - Huntington's disease
Symptoms of cortical dementia: - ANSWER - Language and memory impairments (aphasia and amnesia)
Example of cortical dementia diagnosis: - ANSWER - Alzheimer's
Presentation of dementia d/t HIV disease - ANSWER - Subcortical effects; motor abnormalities, bx
abnormalities, cognitive decline
Presentation of dementia with Lewy bodies - ANSWER - Visual hallucinations, Parkinsonian sx
Presentation of frontal lobe dementia (e.g. Pick's disease) - ANSWER - Personality/bx changes, language
changes, inappropriate social bx, aggression
Presentation of Huntington's disease - ANSWER - Subcortical dementia; motor abnormalities,
psychomotor slowing; high incidence of depression, psychosis; begins ages 30-45; affects males and
females equally
What is the most effective test to determine if someone will develop Huntington's disease? - ANSWER -
Direct genetic test (no risk)
What is the likelihood a child of a parent with Huntington's will develop it? - ANSWER - 50% chance
Dementia etiology - ANSWER - Cerebral atrophy, enlarged ventricles; decreased Ach and NE; genetic
loading
What neurotransmitters are implicated in dementia, and how? - ANSWER - Decreased Ach and NE
Correct Answers
Pain and bloating after eating is caused by... - ANSWER - delayed gastric emptying
Medications that cause delayed gastric emptying? - ANSWER - PPIs; ranitidine, famotidine, omeprazole
What instructions should you give your patient if they are prescribed antacids/PPIs and psychotropics? -
ANSWER - Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of
psychotropics
Normal BMI range - ANSWER - 18.5-25
Criteria for admission for ED bx: - ANSWER - BMI <15; 25% total body weight loss in 3 months; severe
dehydration, infection, bradycardia, hypothermia, hematemesis, hypokalemia
What neurotransmitters are implicated in ADHD? - ANSWER - DA, NE, 5HT - DNS
What brain structures are involved in ADHD? - ANSWER - Reticular activating system, basal ganglia,
frontal cortex - RBF
Abnormalities in this part of the brain cause inattentive ADHD: - ANSWER - Prefrontal cortex
Amphetamines are FDA approved for children beginning at _ years old - ANSWER - 3
Methamphetamines are FDA approved for children beginning at _ years old - ANSWER - 6
,Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients ages ___ - ANSWER
- 6-17
Strattera is FDA approved to treat ADHD in patients ages ___ - ANSWER - 6 and up (including adults)
Adults diagnosed with both ADHD and depression would benefit from being prescribed: - ANSWER -
Wellbutrin
Conduct disorder can be diagnosed in: - ANSWER - Both children and adults
Conduct disorder diagnostic criteria: - ANSWER - Violating rights of others or societal norms; aggression
towards people/animals; destruction of property; no remorse
Treatment for conduct disorder: - ANSWER - Targets aggression and mood; SGA, mood stabilizer, SSRI,
alpha agonists
ODD diagnostic criteria: - ANSWER - Argumentative, defiant for at least 6 months and with 4 sx
Treatment of ODD: - ANSWER - Focused on family therapy, child management skills, teaching parents
reinforcement/boundaries/problem solving
DMDD diagnostic criteria: - ANSWER - Childhood depressive d/o between ages 6-17; chronic
dysregulated mood, frequent tantrums, severe irritability; typically DMDD rather than bipolar d/o in
children
Neurotransmitters implicated in ASD: - ANSWER - Glutamate, GABA, 5HT - GGS
Echolalia - ANSWER - Meaningless repetition of words; often seen in ASD
Broken mirror theory - ANSWER - Dysfunction of the mirror neuron system results in poor social
interaction and cognition in ASD patients
,Parallel play is developmentally appropriate at which ages? - ANSWER - 1-3 years old
Parallel play continuing beyond the age of 3 years old may be indicative of... - ANSWER - ASD dx d/t
social deficits
M-CHAT - ANSWER - Modified Checklist for Autism in Toddlers; ASD scale
ADOS-G - ANSWER - Autism Diagnostic Observation Schedule - Generic; ASD scale
ASQ - ANSWER - Ages and Stages Questionnaire; development and social/emotional screening
Pharmacological treatment of ASD: - ANSWER - Stimulants (increase DA to help with impulsivity,
hyperactivity, inattention; Antipsychotics (target aggressive bx, tantrums, self-injury, stereotyped bx)
Nightmares in children can be the result of: - ANSWER - Genetic factors; assess family patterns of
nightmares
Features of children diagnosed with Fragile X - ANSWER - LARGE features: large head, elongated face,
hyperextensible joints, abnormally large testes, short stature
Features of children diagnosed with fetal alcohol syndrome - ANSWER - small features: small head, small
eye opening, low nasal bridge, flat midface, smooth philtrum, thin upper lip
Clock drawing test assesses function of which brain lobe? - ANSWER - Parietal
What does the clock drawing test assess for? - ANSWER - Executive/cognitive fx, impairments associated
w/ damage to right parietal lobe, constructional apraxia (inability to draw or assemble objects)
Important labs to draw for patients presenting with dementia? - ANSWER - B12, folic acid
Dementia presents with mental decline that is ___ - ANSWER - Chronic; if acute sx, consider other dx
, Symptoms of subcortical dementia: - ANSWER - Motor sx, lack of coordination, tremors, depression,
irritability, apathy
Example of subcortical dementia diagnosis - ANSWER - Huntington's disease
Symptoms of cortical dementia: - ANSWER - Language and memory impairments (aphasia and amnesia)
Example of cortical dementia diagnosis: - ANSWER - Alzheimer's
Presentation of dementia d/t HIV disease - ANSWER - Subcortical effects; motor abnormalities, bx
abnormalities, cognitive decline
Presentation of dementia with Lewy bodies - ANSWER - Visual hallucinations, Parkinsonian sx
Presentation of frontal lobe dementia (e.g. Pick's disease) - ANSWER - Personality/bx changes, language
changes, inappropriate social bx, aggression
Presentation of Huntington's disease - ANSWER - Subcortical dementia; motor abnormalities,
psychomotor slowing; high incidence of depression, psychosis; begins ages 30-45; affects males and
females equally
What is the most effective test to determine if someone will develop Huntington's disease? - ANSWER -
Direct genetic test (no risk)
What is the likelihood a child of a parent with Huntington's will develop it? - ANSWER - 50% chance
Dementia etiology - ANSWER - Cerebral atrophy, enlarged ventricles; decreased Ach and NE; genetic
loading
What neurotransmitters are implicated in dementia, and how? - ANSWER - Decreased Ach and NE
