APEA PMHNP 31 FINAL PAPER QUESTIONS AND COMPLETE SOLUTIONS
✔✔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 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
