PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
1. Which patient is at highest risk for SI D. 68 y/o single white male with depression *5
A. 30y/o married AA female with previ- risk factors (age, male, white, depression)
ous SI attempt *1 risk factor
B. 35 y/o single Asian male with previ- Count the risk factors
ous SI attempt *3 risk factors
C. 38 y/o single AA male who is a man-
ager of a bank *2 risk factors
D. 68 y/o single white male with de-
pression *5 risk factors (age, male,
white, depression)
2. COWS scale components · Opioid W/D
Pulse, sweating, restlessness, pupil size- dila-
tion (if pinpoint= opioid intoxication, not w/d),
body aches, Rhinorrhea (running nose), Lacrima-
tion (eye tearing), GI upset (N/V/D), yawning,
tremors, anxiety/irritability, Piloerection (goose-
flesh skin), insomnia
3. What does COWS stand for? Clinical Opiate Withdrawal Scale
4. What does CIWA stand for? Clinical Institute Withdrawal Assessment
5. What does CIWA assess for? --used to determine likelihood of ETOH withdraw-
al or DTs
--usually occur within the first 24-72 hours after
cessation
o used to determine when to administer medica-
tions for ETOH withdrawal
6. What does CIWA NOT test for? Alcohol Use Disorder
7. What are the CIWA scale components?
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
· N/V, tremor, paroxysmal sweats, anxiety, agita-
tion, tactile disturbances, auditory disturbances,
visual disturbances, H/A, orientation
Each component is scored from 0(none)-7(se-
vere) except orientation wh/ is (0 (AA0x4)-4 (dis-
oriented)
Score:
<10: Very mild Start PRN meds at score of 8
>10 to 15: Mild scheduled + PRN meds
>16 to 20: Moderate
>21: Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that interview them separately from parents.
arrive with their parents what should -This helps Build therapeutic rapport with teens
you do? by telling them the info is confidential. Parents
may be upset but remember you are advocating
for the child.
9. Which Ethnic group has the highest Native Americans
rate of suicide?
10. Example A patient is being treated for D. Metabolic Syndrome (UMBRELLA ANSWER)
schizophrenia with olanzapine. Which
of the following is the most common
side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical
antipsychotics d/t 5HT2A)-receptor an-
tagonism
C. Increased Lipids
D. Metabolic Syndrome
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
11. Which antipsychotics have the least Latuda, Abilify, (also least sedating), Geodon-if
weight gain? patient has metabolic syndrome consider switch-
ing to one of the medications above. Or if the
patient is overly sedated try switching to ABILIFY
12. Which mood stabilizer have the least Lamictal
weight gain? -But remember all mood stabilizers cause some
weight gain
13. When presented with a question about atypical
typical vs atypical antipsychotic the an-
swer is usually to start of a
14. A client presents with complains of Hypothalamus
changes in appetite, feeling fatigued, A, B, & D are all part of the limbic system so you
problems with sleep-rest cycle, and can rule that out
changes in libido. What is the neu-
roanatomical area of the brain that is
responsible for the normal regulation
of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
15. When a patient is hesitant to partici- Bring a support person like a husband
pate in treatment you should encour-
age?
16. Thyroid-Stimulating hormone normal 0.5-5.0 Mu/L
level
17.
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
When T4 and T3 are high and TSH is HYPERTHYROIDISM, TSH secretion decreases:
low what is the diagnosis TSH LOW à key symptoms HEAT INTOLERANCE
18. Key symptoms of Heat Intolerance Hyperthyroidism
19. When T4 and T3 are Low and TSH is (HYPOTHYROIDISM) TSH secretion increased:
high what is the diagnosis TSH HIGH à COLD INTERANCE
20. Key symptoms of Cold Intolerance Hypothyroidism
21. Hyperthyroid can mimic Mania
22. Hypothyroid can mimic Depression
23. A patient on depakote complains of Hepatoxicity
RUQ pain and has reddish/brown -Check LFTs
urine
24. Signs of Depakote toxicity Disorientation, confusion, lethargy
25. You suspect depakote toxicity what do Check
you do? -LFT
-Ammonia
-Depakote Level
26. What herbal supplement can cause he- Kava Kava
patoxicity?
27. When taking Kava Kava in combi- Risk of Hepatoxicity and Sedation
nations with other medications you
should caution about
28. TCAs carry a risk of Hepatotoxicity
29. Signs of Stevens-Johnson Syndrome
Study online at https://quizlet.com/_bpfu9u
1. Which patient is at highest risk for SI D. 68 y/o single white male with depression *5
A. 30y/o married AA female with previ- risk factors (age, male, white, depression)
ous SI attempt *1 risk factor
B. 35 y/o single Asian male with previ- Count the risk factors
ous SI attempt *3 risk factors
C. 38 y/o single AA male who is a man-
ager of a bank *2 risk factors
D. 68 y/o single white male with de-
pression *5 risk factors (age, male,
white, depression)
2. COWS scale components · Opioid W/D
Pulse, sweating, restlessness, pupil size- dila-
tion (if pinpoint= opioid intoxication, not w/d),
body aches, Rhinorrhea (running nose), Lacrima-
tion (eye tearing), GI upset (N/V/D), yawning,
tremors, anxiety/irritability, Piloerection (goose-
flesh skin), insomnia
3. What does COWS stand for? Clinical Opiate Withdrawal Scale
4. What does CIWA stand for? Clinical Institute Withdrawal Assessment
5. What does CIWA assess for? --used to determine likelihood of ETOH withdraw-
al or DTs
--usually occur within the first 24-72 hours after
cessation
o used to determine when to administer medica-
tions for ETOH withdrawal
6. What does CIWA NOT test for? Alcohol Use Disorder
7. What are the CIWA scale components?
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
· N/V, tremor, paroxysmal sweats, anxiety, agita-
tion, tactile disturbances, auditory disturbances,
visual disturbances, H/A, orientation
Each component is scored from 0(none)-7(se-
vere) except orientation wh/ is (0 (AA0x4)-4 (dis-
oriented)
Score:
<10: Very mild Start PRN meds at score of 8
>10 to 15: Mild scheduled + PRN meds
>16 to 20: Moderate
>21: Severe Diazepam, Librium, Ativan
8. When interview teenagers (16 y/o) that interview them separately from parents.
arrive with their parents what should -This helps Build therapeutic rapport with teens
you do? by telling them the info is confidential. Parents
may be upset but remember you are advocating
for the child.
9. Which Ethnic group has the highest Native Americans
rate of suicide?
10. Example A patient is being treated for D. Metabolic Syndrome (UMBRELLA ANSWER)
schizophrenia with olanzapine. Which
of the following is the most common
side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical
antipsychotics d/t 5HT2A)-receptor an-
tagonism
C. Increased Lipids
D. Metabolic Syndrome
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
11. Which antipsychotics have the least Latuda, Abilify, (also least sedating), Geodon-if
weight gain? patient has metabolic syndrome consider switch-
ing to one of the medications above. Or if the
patient is overly sedated try switching to ABILIFY
12. Which mood stabilizer have the least Lamictal
weight gain? -But remember all mood stabilizers cause some
weight gain
13. When presented with a question about atypical
typical vs atypical antipsychotic the an-
swer is usually to start of a
14. A client presents with complains of Hypothalamus
changes in appetite, feeling fatigued, A, B, & D are all part of the limbic system so you
problems with sleep-rest cycle, and can rule that out
changes in libido. What is the neu-
roanatomical area of the brain that is
responsible for the normal regulation
of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
D. Hippocampus
15. When a patient is hesitant to partici- Bring a support person like a husband
pate in treatment you should encour-
age?
16. Thyroid-Stimulating hormone normal 0.5-5.0 Mu/L
level
17.
, PMHNP certification Exam 22
Study online at https://quizlet.com/_bpfu9u
When T4 and T3 are high and TSH is HYPERTHYROIDISM, TSH secretion decreases:
low what is the diagnosis TSH LOW à key symptoms HEAT INTOLERANCE
18. Key symptoms of Heat Intolerance Hyperthyroidism
19. When T4 and T3 are Low and TSH is (HYPOTHYROIDISM) TSH secretion increased:
high what is the diagnosis TSH HIGH à COLD INTERANCE
20. Key symptoms of Cold Intolerance Hypothyroidism
21. Hyperthyroid can mimic Mania
22. Hypothyroid can mimic Depression
23. A patient on depakote complains of Hepatoxicity
RUQ pain and has reddish/brown -Check LFTs
urine
24. Signs of Depakote toxicity Disorientation, confusion, lethargy
25. You suspect depakote toxicity what do Check
you do? -LFT
-Ammonia
-Depakote Level
26. What herbal supplement can cause he- Kava Kava
patoxicity?
27. When taking Kava Kava in combi- Risk of Hepatoxicity and Sedation
nations with other medications you
should caution about
28. TCAs carry a risk of Hepatotoxicity
29. Signs of Stevens-Johnson Syndrome
