RPN LICENSING EXAM STUDY GUIDE
Transference - Answers- the patient's transfer to the analyst of emotions linked with
other relationships
Countertransference - Answers- Circumstances in which a psychoanalyst develops
personal feelings about a client because of perceived similarity of the client to significant
people in the therapist's life.
Joan Piaget - Answers- cognitive development: Sensorimotor, preoperational, concrete
operational, formal operational (objects & understanding of the world around them)
DBT (dialectical behavior therapy) - Answers- a form of therapy used to treat borderline
personality disorder that combines elements of the behavioral and cognitive treatments
with a mindfulness approach based on Eastern meditative practices
➔ Effective treatment for depression, SI, hopelessness, anger, substance dependence,
and dissociation
Nursing Process - Answers- Assessment
Diagnosis
Planning
Implementation
Evaluation
consent - Answers- What is the problem,
Purpose of tx,
Risks & benefits,
Alternatives,
Success Probability,
Risk of not consenting
The nature of their problem/condition
-> Do they understand? A family can say no to tx if not!
Involuntary criteria - Answers- 1)Suffering from a mental disorder that seriously impairs
their ability to react appropriately to the environment and with others
2)requires psychiatric treatment
3)requires care, supervision, and control to prevent mental or physical deterioration for
pts own protection or others, and is 4)not suitable as a voluntary
(Mental disorder, needs tx, prevent deterioration, not voluntary)
Judge can bring someone in involuntarily with what two forms? - Answers- 9 & 10
Order of least restrictive care - Answers- Verbal-> Chemical -> Physical
Confidentiality is broken when - Answers- Suspected harm to other or a child, suicide
risk, reportable communicable disease (duty to protect)
,Intergenerational trauma - Answers- Happens when the effects of trauma are not
resolved in one generation. When trauma is ignored and there is no support for dealing
with it, the trauma will be passed from one generation to the next.
Barriers for muliticultural mental health care - Answers- ➔ Stigma and discrimination
➔ Communication barriers
➔ Misdiagnosis
➔ Ethnic variations in pharmacodynamics
Dopamine - Answers- A neurotransmitter associated with movement, attention and
learning and the brain's pleasure and reward system.
Norepinephrine - Answers- A neurotransmitter involved in arousal, as well as in learning
and mood regulation
Acetylcholine - Answers- A neurotransmitter that enables learning and memory and
also triggers muscle contraction (parasympathetic)
Glutamate - Answers- A major excitatory neurotransmitter; involved in memory
brainstem and hypothalamus - Answers- Part of the brain which unconsciously
functions to maintain homeostasis using feedback loops (lizard brain-> most primative)
Cerebellum - Answers- A large structure of the hindbrain that controls fine motor skills.
Cerebrum - Answers- Area of the brain responsible for all voluntary activities of the
body (consciousness)
Benzo's, alcohol, & sedatives - Answers- GABA
Buspirone - Answers- Buspar- short term anxiety relief without sedating effects
SSRI's & SNRI's - Answers- For anxiety treatment & depression!
SSRI - Answers- ● Fluoxetine, Paroxetine, Citalopram, Escitalopram, and Fluvoxamine
block the reuptake of serotonin from the synaptic cleft
● Sertraline inhibits the neuronal reuptake of serotonin but to a lesser degree also
inhibits norepinephrine and dopamine neuronal reuptake
● Have fewer SE than TCAs because they poorly bind to acetylcholine receptors
● Side effects are insomnia, low libido, failure to orgasm, nausea, vomiting due to
increased serotonin levels
● Much less likely to cause death in OD situation but can cause ventricular arrhythmia
in high doses which can lead to death
, tricyclic antidepressants - Answers- Amitriptyline, nortriptyline, imipramine,
desipramine, clomipramine, doxepin, amoxapine.
Blocks reuptake of serotonin and norepinephrine
->Not first line treatment as more serious side effects (
SNRI's - Answers- Venlafaxine, duloxetine
Blocks reuptake of norephinephrine and serotonin
SNDIs - Answers- class that only has one drug, Mirtazapine
increases norepinephrine, dopamine, and serotonin (5-HT) (Slowly wean)
MAOIs - Answers- monoamine oxidase inhibitors
● Phenelzine, Tranylcypromine, and Selegiline
Liver breaks down MAO so this drug blocks causing a increase of tyramine if eating
foods such as cheeses, tofu, beer, wine, chocolate. Too much tyramine = hypertension
Theory of Psychosocial Development (Erikson) - Answers- considers how individuals
come to understand themselves and the meaning of others and their own behavior
● Infancy (0-1 ½): attachement to mom and trust
● Early Childhood (1 ½-3): Gaining basic control (bathroom)
● Late Childhood (3-6): Becoming purposeful and directive
● School Age (6-12): Developing social, physical, and social skills
● Adolescence (12-20): Child to adult = identity
● Early Adulthood (20-35): Intimate relationships
● Middle Adulthood (35-65): Goals
● Later years (65-death): Accepting lifes meaning
Stages of Moral development (Kohlberg) - Answers- preconventional, conventional,
postconventional
(What's in it for me?-> Others might see it differently-> Rightness and wrongness->
Rules are rules-> Obligation to fix unjust & unethical circumstances
Serotonin Syndrome - Answers- hyperactivity or restlessness, tachycardia, fever,
elevated BP, altered mental status, irrationality and mood swings, seizures,
incoordination, abdominal pain, apnea
(moving around, increase HR, increased temp, increased BP, abdo pain, stop breathing
when severe)
Serotonin syndrome tx - Answers- hold dose, cooling blankets, diazepam,
anticonvulsants
Cyproheptadine (serotonin antagonist)
Bipolar treatment - Answers- Lithium-> Carbamazepine -> valporic acid -> lamotrigine
Lithium level - Answers- 0.6-1.2 mEq/L
Transference - Answers- the patient's transfer to the analyst of emotions linked with
other relationships
Countertransference - Answers- Circumstances in which a psychoanalyst develops
personal feelings about a client because of perceived similarity of the client to significant
people in the therapist's life.
Joan Piaget - Answers- cognitive development: Sensorimotor, preoperational, concrete
operational, formal operational (objects & understanding of the world around them)
DBT (dialectical behavior therapy) - Answers- a form of therapy used to treat borderline
personality disorder that combines elements of the behavioral and cognitive treatments
with a mindfulness approach based on Eastern meditative practices
➔ Effective treatment for depression, SI, hopelessness, anger, substance dependence,
and dissociation
Nursing Process - Answers- Assessment
Diagnosis
Planning
Implementation
Evaluation
consent - Answers- What is the problem,
Purpose of tx,
Risks & benefits,
Alternatives,
Success Probability,
Risk of not consenting
The nature of their problem/condition
-> Do they understand? A family can say no to tx if not!
Involuntary criteria - Answers- 1)Suffering from a mental disorder that seriously impairs
their ability to react appropriately to the environment and with others
2)requires psychiatric treatment
3)requires care, supervision, and control to prevent mental or physical deterioration for
pts own protection or others, and is 4)not suitable as a voluntary
(Mental disorder, needs tx, prevent deterioration, not voluntary)
Judge can bring someone in involuntarily with what two forms? - Answers- 9 & 10
Order of least restrictive care - Answers- Verbal-> Chemical -> Physical
Confidentiality is broken when - Answers- Suspected harm to other or a child, suicide
risk, reportable communicable disease (duty to protect)
,Intergenerational trauma - Answers- Happens when the effects of trauma are not
resolved in one generation. When trauma is ignored and there is no support for dealing
with it, the trauma will be passed from one generation to the next.
Barriers for muliticultural mental health care - Answers- ➔ Stigma and discrimination
➔ Communication barriers
➔ Misdiagnosis
➔ Ethnic variations in pharmacodynamics
Dopamine - Answers- A neurotransmitter associated with movement, attention and
learning and the brain's pleasure and reward system.
Norepinephrine - Answers- A neurotransmitter involved in arousal, as well as in learning
and mood regulation
Acetylcholine - Answers- A neurotransmitter that enables learning and memory and
also triggers muscle contraction (parasympathetic)
Glutamate - Answers- A major excitatory neurotransmitter; involved in memory
brainstem and hypothalamus - Answers- Part of the brain which unconsciously
functions to maintain homeostasis using feedback loops (lizard brain-> most primative)
Cerebellum - Answers- A large structure of the hindbrain that controls fine motor skills.
Cerebrum - Answers- Area of the brain responsible for all voluntary activities of the
body (consciousness)
Benzo's, alcohol, & sedatives - Answers- GABA
Buspirone - Answers- Buspar- short term anxiety relief without sedating effects
SSRI's & SNRI's - Answers- For anxiety treatment & depression!
SSRI - Answers- ● Fluoxetine, Paroxetine, Citalopram, Escitalopram, and Fluvoxamine
block the reuptake of serotonin from the synaptic cleft
● Sertraline inhibits the neuronal reuptake of serotonin but to a lesser degree also
inhibits norepinephrine and dopamine neuronal reuptake
● Have fewer SE than TCAs because they poorly bind to acetylcholine receptors
● Side effects are insomnia, low libido, failure to orgasm, nausea, vomiting due to
increased serotonin levels
● Much less likely to cause death in OD situation but can cause ventricular arrhythmia
in high doses which can lead to death
, tricyclic antidepressants - Answers- Amitriptyline, nortriptyline, imipramine,
desipramine, clomipramine, doxepin, amoxapine.
Blocks reuptake of serotonin and norepinephrine
->Not first line treatment as more serious side effects (
SNRI's - Answers- Venlafaxine, duloxetine
Blocks reuptake of norephinephrine and serotonin
SNDIs - Answers- class that only has one drug, Mirtazapine
increases norepinephrine, dopamine, and serotonin (5-HT) (Slowly wean)
MAOIs - Answers- monoamine oxidase inhibitors
● Phenelzine, Tranylcypromine, and Selegiline
Liver breaks down MAO so this drug blocks causing a increase of tyramine if eating
foods such as cheeses, tofu, beer, wine, chocolate. Too much tyramine = hypertension
Theory of Psychosocial Development (Erikson) - Answers- considers how individuals
come to understand themselves and the meaning of others and their own behavior
● Infancy (0-1 ½): attachement to mom and trust
● Early Childhood (1 ½-3): Gaining basic control (bathroom)
● Late Childhood (3-6): Becoming purposeful and directive
● School Age (6-12): Developing social, physical, and social skills
● Adolescence (12-20): Child to adult = identity
● Early Adulthood (20-35): Intimate relationships
● Middle Adulthood (35-65): Goals
● Later years (65-death): Accepting lifes meaning
Stages of Moral development (Kohlberg) - Answers- preconventional, conventional,
postconventional
(What's in it for me?-> Others might see it differently-> Rightness and wrongness->
Rules are rules-> Obligation to fix unjust & unethical circumstances
Serotonin Syndrome - Answers- hyperactivity or restlessness, tachycardia, fever,
elevated BP, altered mental status, irrationality and mood swings, seizures,
incoordination, abdominal pain, apnea
(moving around, increase HR, increased temp, increased BP, abdo pain, stop breathing
when severe)
Serotonin syndrome tx - Answers- hold dose, cooling blankets, diazepam,
anticonvulsants
Cyproheptadine (serotonin antagonist)
Bipolar treatment - Answers- Lithium-> Carbamazepine -> valporic acid -> lamotrigine
Lithium level - Answers- 0.6-1.2 mEq/L
