Question Bank for PMHNP Boards Latest 2022 Rated A+

Question Bank for PMHNP Boards Latest 2022 Rated A+ Document Content and Description Below Question Bank for PMHNP Boards Latest 2022 Rated A+ What is true of interprofessionality? Correct Answer-All health professionals have individual professional competencies What is the significance of an experimental p-value of 0.05 Correct Answer-There is a 5% chance of a similar result occurring by chance alone What percentage of children with oppositional defiance disorder will develop conduct disorder? Correct Answer-30% In the DSM-5, selective mutism is now considered what type of disorder? Correct Answer-anxiety disorder Symptoms of selective mutism must persist for at least Correct Answer-1 month Common competencies Correct Answer-overlap more than one health care professional, although not necessarily all health care professionals, and are competencies expected of all health care professionals Complementary competencies Correct Answer-enhance the qualities of other professions in provision of care Collaborative competencies Correct Answer-those that each individual profession must possess to work with others, including those who practice within different specialties within a profession. Interpersonal collaboration is _______ centered Correct Answer-patient Cognitive therapy is recommended for patients that have Correct Answer-negative cognitive distortions irrational beliefs faulty conceptionsHumanistic Therapy focuses on assisting patients with Correct Answer-self-actualization and self-directed growth Behavioral Therapy focuses on Correct Answer-changing maladaptive behaviors through the use of behavioral modification techniques Existential therapy is for Correct Answer-reflection on life confronting self 120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing diarrhea? Correct Answer-6 ((120X160)/(80x40)) The New Freedom Commission on Mental Health (NFCMH) released a report that suggested Correct Answer-implementation a national campaign to reduce the stigma of seeking care Focusing on promoting recovery and building resilience The efficacy of mental health treatments was found to be well documented in Correct Answer-influential report issued by US Surgeon General in 1999 State of high negative emotion and pessimism Correct Answer-neuroticism Commonly known as an optimistic outlook on life They are are outgoing, like social interaction, respond to external rewards, have more active dopamine networks, and are responsive to positive reinforcement. Correct Answer-Extraversion (high levels protect from psychiatric illness) Introverts are more likely to be _______ motivated and more likely to respond to _______ reinforcement Correct Answer-internally negative (more likely to interact with internal motivation/self-image) Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at the expense of self-assertion Correct Answer-AgreeablenessAssociated with self-control and a focused, organized approach to life. Are achievement-oriented goal setters who can delay immediate gratification to obtain their long term desired outcome. They are considered responsible, reliable, and dependable. Correct Answer-conscientiousness In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior (FAB). What is true about FAB? Correct Answer-FAB is concerned only with observable stimuli connected to operant behavior FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and consequent stimuli) The goal of FAB is modifying willful operant behavior Gestalt theory deals with _____, not _____ Correct Answer-perceptual psychology behavior Medication that can delay ejaculation in patients with premature ejaculation Correct Answer-Paroxetine (and other SSRIs) (others include: Topical anesthetic Tramadol Phosphodiesterase-5 inhibitors) First line treatment for lithium induced diabetes insipidus Correct Answer-Amiloride (K potassium diuretic) in addition to dc lithium when possible. Ways to reduce polyuria associated with lithium toxicity Correct Answer-reduce lithium dose to minimum effective dose take once daily at night (may be 5-30% lower than when given in divided doses over the day) Encourage adequate fluid intake What is true about ECT in Parkinson's disease Correct Answer-it's more likely to cause transient delirium (worsened dyskinesias induced by l-dopa)Lithium effects with Parkison's disease Correct Answer-may worsen tremor nonselective MAOIs decrease the efficacy of ______ and increase the risk of a __________ Correct Answer-l-dopa products hypertensive crisis Selegiline is selective for Correct Answer-MAO-B (after 10mg there is an increase in risk of serotonin syndrome if given with other meds that increase serotonin) SSRI's can _______ Parkinsonism tremor Correct Answer-worsen (and decrease 'off time') Process describes the mechanism by which the hippocampus stores memories Correct Answer-long-term potentiation loss of memory relating to a particular category of information (inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting) Correct Answer-systematized amnesia Lack of memories from a circumscribed period of time, usually immediately following a traumatic event Correct Answer-localized amnesia Person can recall some but not all of events from a particular time period Correct Answer-selective amnesia Lack of memory of the patient's entire life Correct Answer-generalized amnesia The drugs that are FDA approved for GAD Correct Answer-Paroxetine Citalopram EscitalopramVenlafaxine Duloxetine Buspar A surrogate has the right to terminate pregnancy if Correct Answer-the pregnancy threatens her health or life or she is a genetic parent If the surrogate receives both ovum and sperm from couple, she loses the right to Correct Answerdetermine whether or not child will be aborted (this is up to the couple) Which medication is most effective for treating social phobia/social anxiety disorder, especially when refractory? Correct Answer-Phenelzine A 55-year-old female patient has Stg II HTN. On exam, she has trace pedal edema bilaterally, but her lungs are clear. Her ECG reveals 2nd degree heart block. Which of the following BP medications should be avoided? Correct Answer-Calcium Channel Blockers 3 Contraindications to use a calcium channel blocker Correct Answer-1st or second degree heart block Bradycardia CHF 4 Side effects of calcium channel blockers Correct Answer-Headache Lower extremity edema Bradycardia Heart Block An NP is evaluating a 78 year old female with depression. She suspects the patient may have Parkinson's disease. Which of the following is consistent with that diagnosis? Correct Answer-Postural instability Pill-rolling tremorShuffling Gait Difficulty initiating movement Mask-like facies (difficulty initiating movement) Writhing movements occur with Correct Answer-Huntington's chorea 10 Non-motor manifestations of Parkinsons Correct Answer-Autonomic dysfunction Gastrointestical dysfunction Rhinorrhea Sleep disturbance Fatigue Mood disorder Cognitive dysfunction Dementia Psychosis Hallucinations What type of therapy is most useful in depressed HIV positive outpatients? Correct Answer-Interpersonal psychotherapy What type of therapy is most useful in patients with borderline personality disorder? Correct AnswerDialectical behavioral therapy The NP is caring for a patient dying of lymphoma. The pt's wife states that the pt has been mismanaged and that another practitioner must be assigned to the patient for him to improve. This NP suspects that this individual is in which stage of grief according to Elizabeth Kugler-Ross? Correct Answer-Bargaining Involves resisting or refusing to remember information that has been supplied Correct Answer-Denial Pica and spoon shaped nails are associated with Correct Answer-Iron-deficiency anemia (microcytic) 2 common causes of microcytic anemia Correct Answer-iron deficiencyanemia of inflammation/chronic disease (TB, HIV, endocarditis, RA, Chrohn's DM, kidney disease, CA) (Other causes: lead toxicity, alcohol/drug use, zinc excess (copper deficiency)) Initial symptoms of B12 deficiency Correct Answer-Generalized weakness Paresthesias Possible ataxia Late symptoms of B12 deficiency Correct Answer-Memory impairment Depressed mood 5 P's of Vitamin B12 deficiency Correct Answer-Pancytopenia (Peripheral and Posterior spinal cord) neuropathy Pyramidal tract signs Papillary atrophy of tongue (atrophic glossitis) 2 causes of megaloblastic macrocytic anemias Correct Answer-Vitamin B12 deficiency Folate deficiency What neurotransmitter is thought to play the most significant role in social phobia? Correct Answerdopamine What neurotransmitter is thought to mediate social interest, gregariousness, confidence and sensitivity to rejection? Correct Answer-dopamine According to Gonzalez-Jaimes and Turnbull-Plaza (2003, which type of therapy with psychocorporal, cognitive, and neurolinguistic components and a holistic focus is significantly more effective in patients diagnosed with adjustment disorder? Correct Answer-mirror psychotherapyThe ________ is part of the treatment to encourage a patient to accept his physical condition Correct Answer-mirror Discussing medical diagnoses and the reaction to it, as well as treatment modalities Correct Answermedical conversation Therapy that emphasizes personal responsibility, focusing on the individual's experience at the present moment, the therapist-patient relationship, the context of the person's life, and adjustments people make as a result of their overall situation Correct Answer-Gestalt Therapy PANDAs is associated with _________ infections and results in _______ symptoms Correct Answer-Group A beta-hemolytic strep OCD After camping trip, pt began to have a petechial rash on her legs/trunk, parts of which are turning dark red and purple, temp 102.8, HR 1115, BP 88/50, mm pain, neck stiffness, severe HA. What is the dx? Correct Answer-meningococcemia 1 mg of Xanax = _____ mg of Ativan Correct Answer-2 1mg of Xanax = ____mg of phenobarbital Correct Answer-30 1mg Xanax = ____ mg of Clonazepam (Klonopin) Correct Answer-1 1mg Xanax = ____ mg of chlordiazepoxide (Librium) Correct Answer-25 1mg of Xanax = ____ mg of diazepam (Valium) Correct Answer-10 Pt wanting something immediate and non-addictive for breakthrough anxiety Correct AnswerHydroxyzine How long do GAD symptoms need to occur to make the diagnosis? Correct Answer-6 monthsFirst lab test to check for Sjogren's Correct Answer-Anti-nuclear antibody tests To diagnose Cyclothymic disorder, it must be present for _______ in adults Correct Answer-2 years To diagnose Cyclothymic disorder, it must be present for _______ in pediatrics Correct Answer-1 year 4 physiological disturbances that may explain some of the symptoms of panic Correct Answer-impaired lactate metabolism abnormality of locus coeruleus (Ser, NE, GABA, Dop, cholecystokinin) carbon dioxide hypersensitivity (hyperventilation) A 45-year-old man presents to the ER for "panic attack". He appears agitated, confused, and dizzy. He became more agitated and combative with staff upon further questioning. He states he was prescribed Xanax 0.5mg 3x daily by outpatient psychiatrist. His vitals are WNL. What is most likely his dx Correct Answer-Benzodiazepine intoxication Anxiety, tremors, nightmares, insomnia, anorexia, nausea, vomiting, hypotension, seizures, delirium and hyperprexia are sx of. ______ which can result in _______ Correct Answer-Benzodiazepine withdrawal (serious medical complications including death) Confusion, AH, VH following a period of insomnia can be a sx of Correct Answer-withdrawal delirium Female patients with PTSD commonly have this comorbid diagnoses Correct Answer-Major depressive disorder (50%) Percentage of people with PTSD who have alcohol use disorder Correct Answer-male 50% female 27% Percentage of people with PTSD who have simple or social phobias Correct Answer-30% both male and femalePercentage of people with PTSD who have persistent depressive disorder ( previously dysthymia) Correct Answer-20% for both male and female Treatment plan for OCD Correct Answer-SSRI or Clomipramine Psychotherapy Normal Rinne test is for this nerve Correct Answer-CN VIII What ethnic groups are at higher risk for social phobia Correct Answer-Native American What ethnic groups are at lower risk for social phobia Correct Answer-Asian Black Latino Onset of social phobia is Correct Answer-Usually begins in late adolescence or early adulthood (13-20 years) 3 CBT techniques for social phobias Correct Answer-exposure cognitive restructuring social skills training Medication used to help with social phobia for public speaking Correct Answer-propranolol FDA approved SSRI for social phobia Correct Answer-paroxetine What type of fracture is a red flag for child abuse? Correct Answer-Spiral of long bone (caused by twisting of extremity) Bruises on the torso in different stages of healing often indicate Correct Answer-abuse Tanner Stage: Breast buds undeveloped with papilla elevation only. Villus hair only Correct Answer-ITanner Stage: Breast buds palpable, straight pubic hair mostly on labia Correct Answer-II Tanner Stage: Areola begins to enlarge and pubic hair becomes darker, coarser, and curly Correct AnswerIII Tanner Stage: Areola forms a secondary mound on the breast and hair is of adult quality Correct AnswerIV Tenderness at McBurney's point is suggestive of Correct Answer-appendicitis About 30% of patients with this disorder have OCD thoughts Correct Answer-Tourette's disorder Rx that can cause anxiety Correct Answer-Steroids (prednisone) Albuterol Amphetamines Appetite suppressants Medical conditions that can cause anxiety Correct Answer-Adrenal tumors Alcohol use disorder Hypoglycemia Hyperthyroidism Cushing's disease Arrhythmias Parathyroid Tumors Some types of seizures Depression screening tool used specifically for pregnancy and postpartum Correct Answer-Edinburg Depression Scale How long do symptoms have to be present to diagnose PTSD Correct Answer-1 monthLab value that would indicate that parathyroid was removed during thyroidectomy Correct Answer-Low Calcium For PCOS, which medication will help with hirsutism? Correct Answer-Spironolactone Lab that is an indicator of inflammation Correct Answer-C-reactive protein Pain medication that inhibitis serotonin and NE reuptake (risk of serotonin syndrome if also on antidepressants) Correct Answer-Tramadol an over-the-counter nonnarcotic drug found in cough preparations which inhibits serotonin reuptake and could cause serotonin syndrome in patients on SSRI's Correct Answer-Dextromethorphan (Delsym) Pre-cursor for Serotonin production Correct Answer-L-tryptophan In panic disorder, 1 of the attacks is followed by at least ______ of persistent worry about having additional attacks, worry about implications of attacks or its consequences, or significant change in behavior related to attacks. Correct Answer-1 month The origins of panic disorder include Correct Answer-childhood trauma With delayed onset of PTSD, how much time must have past from trauma to onset of symptoms Correct Answer-6 months First line medication for polymyalgia rheumatica Correct Answer-oral prednisone Acute stress disorder is diagnosed if the characteristic symptoms present within what period of time after experiencing the traumatic event? Correct Answer-1 month In what Tanner's stage will a male's penis grow more in length than width Correct Answer-IIIIn what Tanner's stage will a male's scrotum begins to grow and redden. Where pubic hair will be straight, fine and sparse Correct Answer-II In what Tanner's stage will a male's pubic hair look more like an adult, but will not cover as much area. Where penis will thicken, testes and scrotum continue to grow. Correct Answer-IV Brain structure R/T development of GAD Correct Answer-Amygdala What circumstance(s) are often correlated to the onset of panic disorder Correct Answer-separation from family serious illness of friend/family accident major relationship loss/change abusing substances postpartum Lifetime prevalence of anxiety disorders in the US Correct Answer-25-35% (18% prevalence) Buspar needs ______ to have similar efficacy to benzodiazepines Correct Answer-4 weeks How many panic symptoms must be present for diagnoses. Correct Answer-4 Part of Brain responsible for smell Correct Answer-Limbic Part of brain (lobe) responsible for visual functions Correct Answer-Occipital Part of brain (lobe) responsible for sensory integration and somatosensory function Correct AnswerParietal Part of brain (lobe) responsible for executive function, social conduct, judgement, and some motor function Correct Answer-FrontalOccasional crossing of eyes is not normal after the infant is older than ___________ Correct Answer-2 months If strabismus is left untreated, what may result? Correct Answer-ambylopia (affected eye decrease in vision) What would be the normal testosterone level of a Tanner V male Correct Answer-265-800 ng/dl Bactrim is contraindicated in Correct Answer-Glucose-6-phosphatase deficiency Folate deficiency anemia patients with significant hepatic impairment pregnant patiens Pt has severe headache behind right eye with eye pain and tearing, sees halos around light fixtures. C/o N/V. R pupil fixed more oval than round, mid-dilated and cloudy. What might be happening Correct Answer-Acute angle closure glaucoma (Emergency) What STD is not reportable in all 50 states Correct Answer-HPV Romberg test is a test of Correct Answer-balance A child will recognize faces and smile appropriately at familiar faces by age ____ Correct Answer-3 A typical _____ can count up to 20 with minimal assistance of an older child or parent Correct Answer-4 year old A typical _____ can run/walk up and down the stairs Correct Answer-21 month old A typical _____ is beginning to acquire language skills Correct Answer-14 month old What herbal supplement is effective for a pt with an adjustment disorder with anxiety according to RCT Correct Answer-Kava KavaWhat herbal supplement is effective for somatoform disorders according to RCT Correct Answer-St. John's Wort Recurrent spontaneous episodic vertigo, hearing loss. Must have aural fullness or tinnitis on one size to make dx. Correct Answer-Meniere's Disease ADPIE stands for Correct Answer-Assessment Diagnosis Planning Implementation Evaluation If diagnosed with an adjustment disorder, which dx is most guarded: that of an adult or that of an adolescent? Correct Answer-adolescent (more likely to develop major psychiatric illness) Gastrointestinal lithium toxicity symptoms can overlap with Correct Answer-normal side effects (N/V) What is FDA approved for suicidality in schizophrenia Correct Answer-Clozapine Clozapine can cause this CBC abnormality Correct Answer-leukopenia (agranulocytosis) What is the dependent variable of a study examining the effects of a certain medication on hypertension? Correct Answer-Blood pressure What is the independent variable of a study examining the effects of a certain medication on hypertension? Correct Answer-Medication Effect of a variable that is not controlled Correct Answer-Confounding effect Type of error that results in the way the experiment is conducted, often due to the expectations of the researcher Correct Answer-BiasPharmacological treatment of alcohol use disorder Correct Answer-Start Naltrexone at 25mg PO daily (1- hour observation for rxn). Naltrexone maintenance dose is usually 50mg PO q day or 380mg IM q 4 weeks Naltrexone side effects Correct Answer-Elevated LFTs Mild dysthymia GI upset Resembles GABA and is possibly an NMDA antagonist Correct Answer-Acamprosate Aldehyde dehydrogenase inhibitor Correct Answer-Disulfiram (Antabuse) Modest efficacy, may work better in combination with Naltrexone for alcohol use disorder Correct Answer-Acamprosate No convincing efficacy found for use of this Alcohol Use Disorder pharmacological treatment Correct Answer-Disulfiram (Antabuse) Most commonly reported side effect of ECT Correct Answer-Retrograde amnesia Neurodevelopmental disorder of biological origin that manifests in learning difficulties and problems in acquiring academic skills markedly below age level and manifested in the early years for at least 6 months that is not attributed to intellectual disabilities, development disorders or neurological or motor disorders Correct Answer-Specific Learning Disorder Specific Learning Disorders can be specified as impairment in Correct Answer-Reading Written Expression Mathematics The MOST important component when developing evidence based guidelines Correct Answer-An evidence reviewHow does botox improve depression? Correct Answer-Reducing frown lines when injected into glabellar region According to a study in the 1990s mothers of anorexic pts have an increased prevalence of this disorder Correct Answer-Obsessive-compulsive disorder The AST:ALT ratio in patients with Alcoholic liver disease Correct Answer-0.8 1.5 Liver biopsy reveals fibrosis, necrosis of liver cells, and nodule formation Correct Answer-Liver cirrhosis Acute condition with nystagmus, ataxia, confusion, and opthalmoplegia Correct Answer-WernickeKorsacoff syndrome Elevated bilirubin level is often found in Correct Answer-Alcoholic hepatitis Which drug's mechanism of action includes blockage of the voltage dependent sodium channel blockers, augmentation of gamma amino butyrate activity of GABA-A receptors, antagonism of AMPA/kainate subtype of glutamate receptor, and inhibition of carbonic anydrase enzyme? Correct Answer-Topiramate Ex of drugs that are partial agonists at postsynaptic serotonin receptors Correct Answer-Hallucinogens like LSD and MDMA Drug associated with inhibition of catecholamine reuptake in neurons and blockage of NMDA glutamate receptors Correct Answer-PCP Individuals with panic disorder are most commonly affected by which other psychiatric disorder Correct Answer-Agoraphobia When is the use of transdermal selegiline not beneficial? Correct Answer-For patients with pheochromocytoma (excess NE can cause HTN crisis) and with planned surgery (need to dc patch for 10 days prior to elective surgery)Responsible for the catabolism of serotonin, norepinephrine and dopamine Correct Answer-Monoamine oxidase (MAO) Medication that is an irreversible MAO inhibitor that works by selectively inhibiting both MAO-A and MAO-B in the CNS with preservation of MAO-A in the gut. Unless high dosed, little need to follow tyramine restricted diet. Correct Answer-Selegiline Adverse effect of carbamazepine that can be an emergency Correct Answer-hyponatremia toxic epidermal necrolysis Erythema multiform Steven's Johnson Thrombocytopenia Aplastic Anemia Agranulocytosis SLE arrhythmias Hepatitis An NP advises a patient with a significant family hx of breast cancer to perform monthly self-examinations. What term helps to identify this measure? Correct Answer-Secondary Prevention Prevention type designed for early detection of a disease so that morbidity and mortality may be reduced Correct Answer-Secondary Prevention Preventing the disease or condition from occurring Correct Answer-Primary Prevention WIC and promotion of workplace safety laws designated by OSHA are this type of prevention Correct Answer-Primary Prevention Rehabilitation and prevention of complications of disease Correct Answer-Tertiary preventionA support group for a disease or condition is this type of prevention Correct Answer-Tertiary Prevention Exercise for an obese patient is this type of prevention Correct Answer-Tertiary Antisocial personality disorder criteria must show a pattern of disregard of others since age ______ Correct Answer-15 How many criteria does a pt who meets criteria for an Antisocial personality disorder have to have