PMHNP Certification Exam Study Questions and answers

Pain and bloating after eating is caused by... delayed gastric emptying Medications that cause delayed gastric emptying? PPIs; ranitidine, famotidine, omeprazole What instructions should you give your patient if they are prescribed antacids/PPIs and psychotropics? Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of psychotropics Normal BMI range 18.5-25 Criteria for admission for ED bx: BMI <15; 25% total body weight loss in 3 months; severe dehydration, infection, bradycardia, hypothermia, hematemesis, hypokalemia What neurotransmitters are implicated in ADHD? DA, NE, 5HT - DNS What brain structures are involved in ADHD? Reticular activating system, basal ganglia, frontal cortex - RBF Abnormalities in this part of the brain cause inattentive ADHD: Prefrontal cortex Amphetamines are FDA approved for children beginning at _ years old 3 Methamphetamines are FDA approved for children beginning at _ years old 6 Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients ages ___ 6-17 Strattera is FDA approved to treat ADHD in patients ages ___ 6 and up (including adults) Adults diagnosed with both ADHD and depression would benefit from being prescribed: Wellbutrin Conduct disorder can be diagnosed in: Both children and adults Conduct disorder diagnostic criteria: Violating rights of others or societal norms; aggression towards people/animals; destruction of property; no remorse Treatment for conduct disorder: Targets aggression and mood; SGA, mood stabilizer, SSRI, alpha agonists ODD diagnostic criteria: Argumentative, defiant for at least 6 months and with 4 sx Treatment of ODD: Focused on family therapy, child management skills, teaching parents reinforcement/boundaries/problem solving DMDD diagnostic criteria: 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: Glutamate, GABA, 5HT - GGS Echolalia Meaningless repetition of words; often seen in ASD Broken mirror theory Dysfunction of the mirror neuron system results in poor social interaction and cognition in ASD patients Parallel play is developmentally appropriate at which ages? 1-3 years old Parallel play continuing beyond the age of 3 years old may be indicative of... ASD dx d/t social deficits M-CHAT Modified Checklist for Autism in Toddlers; ASD scale ADOS-G Autism Diagnostic Observation Schedule - Generic; ASD scale ASQ Ages and Stages Questionnaire; development and social/emotional screening Pharmacological treatment of ASD: 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: Genetic factors; assess family patterns of nightmares Features of children diagnosed with Fragile X LARGE features: large head, elongated face, hyperextensible joints, abnormally large testes, short stature Features of children diagnosed with fetal alcohol syndrome 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? Parietal What does the clock drawing test assess for? 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? B12, folic acid Dementia presents with mental decline that is ___ Chronic; if acute sx, consider other dx Symptoms of subcortical dementia: Motor sx, lack of coordination, tremors, depression, irritability, apathy Example of subcortical dementia diagnosis Huntington's disease Symptoms of cortical dementia: Language and memory impairments (aphasia and amnesia) Example of cortical dementia diagnosis: Alzheimer's Presentation of dementia d/t HIV disease Subcortical effects; motor abnormalities, bx abnormalities, cognitive decline Presentation of dementia with Lewy bodies Visual hallucinations, Parkinsonian sx Presentation of frontal lobe dementia (e.g. Pick's disease) Personality/bx changes, language changes, inappropriate social bx, aggression Presentation of Huntington's disease Subcortical dementia; motor abnormalities, psychomotor slowing; high incidence of depression, psychosis; begins ages 30-45; affects males and females equally