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PMHNP-BC Exam Questions With Complete Solutions

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PMHNP-BC Exam Questions With Complete Solutions A child who has difficulty feeling safe with a caregiver and unable to feel comfort. What theorist's theory would help explain the behavior and guide treatment? - Answer-Bowlby- attachment theory. Children who come from parents with high expressed emotion and unresolved losses tend to develop disorganized attachment /.A medication that can induce mania - Answer-Corticosteroids /.action stage - Answer-stage of change in the transtheoretical model in which the individual is actively changing a negative behavior or adopting a new, healthy behavior /.Acute dystonia in the eyes - Answer-Oculogyric crisis. Eyes roll up. Treat by discontinuing offending agent. Administer IM Cogentin (benztropine). Not as common with atypicals as with first generation antipsychotics. /.Anticholinergic drugs used for EPS - Answer-Benztropine (cogentin) Trihexyphenidyl (Artane) /.arcus senilis (gray opaque band in the cornea) prior to age 40 is associated with what disorder? - Answer-Hyperlipidemia /.Asians are poor metabolizers of which enzyme? (Will have exaggerated response to diazepam) - Answer-CYP 2C19 /.Attachment between infant and mother facilitates: - Answer-Self-regulation of emotions /.brain changes in schizophrenia - Answer-increase in ventricular volume (enlarged cerebral ventricles) Hippocampus volume decrease, 4% smaller Decreased electrical activity in frontal lobes Decrease glutamate and GABA release. Decreased total brain volume /.Capgras syndrome - Answer-person believes someone he or she knows has been replaced by an imposter (hallmark of the syndrome) /.Characteristics of schizotypal personality disorder - Answer-Ideas of reference and magical thinking /.Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to their alpha 1-adrenergic blockade? - Answer-Orthostatic hypotension. Manage by raising dose of chlorpromazine and clozapine slowly. /.Circumstantiality - Answer-delay in reaching the point of a communication because of unnecessary and tedious details /.Classic symptoms of NMS - Answer-Acute mental status change, muscular rigidity, autonomic instability /.Cognitive executive function ADLS - Answer-Higher-order activities such as balancing a check book, assembling tax records, filing taxes. /.Communication techniques that are helpful when working with avoidant patient with a history of trauma - Answer-Techniques to increase arousal. Activation is needed to allow memories stored in the amygdala to be processed. /.Contemplation stage of change - Answer-2nd stage - aware of problem, thinking about making a change /.Core values that underlie advanced practice nursing and culturally competent care: - Answer-Respect, advocacy, partnership /.Displacement - Answer-psychoanalytic defense mechanism that shifts sexual or aggressive impulses toward a more acceptable or less threatening object or person, as when redirecting anger toward a safer outlet /.dopamine and norepinephrine - Answer-neurotransmitters involved in ADHD /.Dopamine antagonism in the tuberoinfundibular pathway can cause what side effect? (Antipsychotic drugs) - Answer-Galactorrhea /.Dopamine pathways in relation to clinical symptoms of schizophrenia - Answer-Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms are related to DA excess in the nucleus accumbens and mesolimbic system. /.ego - Answer-the largely conscious, "executive" part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain. It would say "I think. I evaluate". /.Existentialism (Humanism) Yalom 2005 - Answer-a philosophical theory or approach that emphasizes the existence of the individual person as a free and responsible agent determining their own development through acts of the will. 1. Life is at times unfair and unjust 2. Ultimately there is no escape from some of life's pain or from death 3. No matter how close a person gets to another, they must still face life alone 4. Facing basic issues of life and death, thus living life more honestly and less caught up on trivialities 5. Learning to take ultimate responsibility for your life and how you live it /.Facial characteristics of child with fetal alcohol syndrome - Answer-Small head Short eyelid opening Flat midface Smooth philtrum Underdeveloped jaw Thin upper lip Short nose (Can also have inner epicanthal folds, short palpebral fissure) /.Family hx risk of schizophrenia - Answer-10x risk with 1st degree relative /.family life cycle - Answer-A sequence of stages that families tend to progress through. /.Family systems theory homeostasis - Answer-Families seek equilibrium /.Federal Law 42 CFR - Answer-Requires a separate release of information for chemical dependency /.Females with bipolar: - Answer-Higher rates of rapid cycling Higher rates of comorbid alcohol use and eating disorders More likely to experience depressive episodes /.Five A's for behavioral counseling and health behavior change - Answer-Assess, advise, agree, assist, arrange /.Fluoxetine and bupropion are approved for ADHD at what ages? - Answer-Age 8 or older /.Fluoxetine metabolized by: - Answer-2D6 /.Functional ADLs - Answer-include aspects of self-care, such as dressing, bathing, toileting and continence, transfer, mobility, and eating. /.functional neuroimaging findings of schizophrenia - Answer-Abnormal function of frontal cortical regions Including for solo lateral prefrontal and anterior cingulate cortices /.GABA in terms of anxiety disorders - Answer-Most abundant inhibitory neurotransmitter. Decreasing GABA would increase anxiety. Benzos are used to bind with GABA to potentiate the anxiolytic effects of GABA

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A child who has difficulty feeling safe with a caregiver and unable to feel comfort. What
theorist's theory would help explain the behavior and guide treatment? - Answer-
Bowlby- attachment theory. Children who come from parents with high expressed
emotion and unresolved losses tend to develop disorganized attachment

/.A medication that can induce mania - Answer-Corticosteroids

/.action stage - Answer-stage of change in the transtheoretical model in which the
individual is actively changing a negative behavior or adopting a new, healthy behavior

/.Acute dystonia in the eyes - Answer-Oculogyric crisis. Eyes roll up. Treat by
discontinuing offending agent. Administer IM Cogentin (benztropine). Not as common
with atypicals as with first generation antipsychotics.

/.Anticholinergic drugs used for EPS - Answer-Benztropine (cogentin)
Trihexyphenidyl (Artane)

/.arcus senilis (gray opaque band in the cornea) prior to age 40 is associated with what
disorder? - Answer-Hyperlipidemia

/.Asians are poor metabolizers of which enzyme? (Will have exaggerated response to
diazepam) - Answer-CYP 2C19

/.Attachment between infant and mother facilitates: - Answer-Self-regulation of emotions

/.brain changes in schizophrenia - Answer-increase in ventricular volume (enlarged
cerebral ventricles)
Hippocampus volume decrease, 4% smaller
Decreased electrical activity in frontal lobes
Decrease glutamate and GABA release.
Decreased total brain volume

/.Capgras syndrome - Answer-person believes someone he or she knows has been
replaced by an imposter (hallmark of the syndrome)

/.Characteristics of schizotypal personality disorder - Answer-Ideas of reference and
magical thinking

/.Chlorpromazine (Thorazine) and clozapine cause what troublesome side effect due to
their alpha 1-adrenergic blockade? - Answer-Orthostatic hypotension. Manage by
raising dose of chlorpromazine and clozapine slowly.

, /.Circumstantiality - Answer-delay in reaching the point of a communication because of
unnecessary and tedious details

/.Classic symptoms of NMS - Answer-Acute mental status change, muscular rigidity,
autonomic instability

/.Cognitive executive function ADLS - Answer-Higher-order activities such as balancing
a check book, assembling tax records, filing taxes.

/.Communication techniques that are helpful when working with avoidant patient with a
history of trauma - Answer-Techniques to increase arousal. Activation is needed to
allow memories stored in the amygdala to be processed.

/.Contemplation stage of change - Answer-2nd stage - aware of problem, thinking about
making a change

/.Core values that underlie advanced practice nursing and culturally competent care: -
Answer-Respect, advocacy, partnership

/.Displacement - Answer-psychoanalytic defense mechanism that shifts sexual or
aggressive impulses toward a more acceptable or less threatening object or person, as
when redirecting anger toward a safer outlet

/.dopamine and norepinephrine - Answer-neurotransmitters involved in ADHD

/.Dopamine antagonism in the tuberoinfundibular pathway can cause what side effect?
(Antipsychotic drugs) - Answer-Galactorrhea

/.Dopamine pathways in relation to clinical symptoms of schizophrenia - Answer-
Negative symptoms are related to DA deficit in the cerebral cortex; positive symptoms
are related to DA excess in the nucleus accumbens and mesolimbic system.

/.ego - Answer-the largely conscious, "executive" part of personality that, according to
Freud, mediates among the demands of the id, superego, and reality. The ego operates
on the reality principle, satisfying the id's desires in ways that will realistically bring
pleasure rather than pain. It would say "I think. I evaluate".

/.Existentialism (Humanism) Yalom 2005 - Answer-a philosophical theory or approach
that emphasizes the existence of the individual person as a free and responsible agent
determining their own development through acts of the will.

1. Life is at times unfair and unjust
2. Ultimately there is no escape from some of life's pain or from death
3. No matter how close a person gets to another, they must still face life alone

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