PMHNP Exam Reported Questions with complete solutions.

PMHNP Exam Reported Questions with complete solutions. What is dissemination? - correct answer. 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? - correct answer. Moderate cognitive impairment What is Tegretol in the CYP450 system? - correct answer. Inducer --will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? - correct answer. Inducer - will lower dose of Lamictal What is a Type I research error? - correct answer. There IS a difference but you say there isn't a difference. What is a Type II research error? - correct answer. There is NO difference but you say there is a difference. What is pseudo-dementia? - correct answer. 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? - correct answer. Yes. What is a drug 1/2 life? - correct answer. The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? - correct answer. Zyprexa, Abilify, Seroquel - low doses What is a risk of using Tramadol? - correct answer. Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? - correct answer. HLAB-1502 When might you see toxic epidermal necrolysis? - correct answer. With worsening of SJS How many generations do you include for a genogram? - correct answer. 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? - correct answer. Amino Acids What is epigenetics? - correct answer. Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? - correct answer. Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? - correct answer. Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? - correct answer. 10-25 yo When do females typically present with schizophrenia? - correct answer. 25-35 yo What does Erythromycin to trileptal? - correct answer. You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? - correct answer. Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs - correct answer. Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? - correct answer. Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? - correct answer. CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? - correct answer. CKMB What is the risk of a seriously elevated CKMB? - correct answer. Polymyositis Rhabdo What is a normal CKMB? - correct answer. 0.3 mcg/L What psychoactives does Detrol interact with? - correct answer. Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? - correct answer. CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? - correct answer. CD4 200 Viral Load is high 20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? - correct answer. Self-Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? - correct answer. Helps rule-out disease = True Positive = Snout What is specificity? - correct answer. Helps rule-in disease = True Negative = Spin What does a sed rate measure? - correct answer. Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? - correct answer. 0-22 males 0-29 females What is a retic count? - correct answer. 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? - correct answer. Anemia - acute or chronic bleeding What does an increased retic count indicate? - correct answer. Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? - correct answer. Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? - correct answer. Increase tegretol levels. What happens if a pregnant women takes Accutane? - correct answer. Birth defects. What labs do you get with RA? - correct answer. 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? - correct answer. ANA When do you assume informed consent? - correct answer. Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? - correct answer. Same as with informed consent Who can declare a patient incompetent and appoint a guardian? - correct answer. Only a court Does impaired judgment mean one is incompetent? - correct answer. No. Can an advanced directive ever be revoked? - correct answer. Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? - correct answer. Nothing. They are all the same. Does the de facto rule of proxy apply in same sex marriages? - correct answer. No. How do Asians see HC providers? - correct answer. 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? - correct answer. SIgn of respect What is the evil eye? - correct answer. 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? - correct answer. Red ribbon on an infant Amulet for adults How do you treat for evil eye? - correct answer. Access traditional healer + traditional care. For there to be a duty to a patient, what must exist? - correct answer. Relationship What is a proximate cause? - correct answer. Connection between A + B. For there to be damages, what must exist first? - correct answer. Negligence What is an occurrence basis liability insurance? - correct answer. "occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? - correct answer. 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? - correct answer. Board of Nursing State What are the various controlled substance classes? - correct answer. 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? - correct answer. Schedules III-V ONLY. Where does 50% of healthcare funds come from? - correct answer. The government Who is eligible for Medicare? - correct answer. 65 or under 65 with diability, ANY age with renal disease. What is incident to billing? - correct answer. 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%.