Introduction to PMHNP Comprehensive Final Exam Guide;
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CMN 548
Introduction to PMHNP Comprehensive Final Exam Guide
Questions & Answers (Verified Answers)
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Complete A+ Guide
,CMN 548 Introduction to PMHNP Comprehensive Final Exam
Guide; Questions & Answers (Verified Answers), 100%
Guaranteed Success ||Complete A+ Guide
Module 1 – Collecting the Psychiatric History and Performing a Psychiatric Assessment
1. Differentiate the following Disorders of Speech: aphonia, dysarthria, and aphasia.
• Aphonia: loss of ability to speak through disease of or damage to the larynx or mouth.
• Dysarthria: where you have difficulty speaking because the muscles you use for speech are weak.
• Aphasia: loss of ability to understand or express speech, caused by brain damage.
2. What is the Mini Mental State Exam?
• The MMSE is effective as a screening tool for cognitive impairment with older, community dwelling,
hospitalized and institutionalized adults. Assessment of an older adult’s cognitive function is best
achieved when it is done routinely, systematically and thoroughly.
• The Mini Mental State Examination (MMSE) is a tool that can be used to systematically and thoroughly
assess mental status. It is an 11-question measure that tests five areas of cognitive function: orientation,
registration, attention and calculation, recall, and language. The maximum score is 30. A score of 23 or
lower is indicative of
cognitive impairment. The MMSE takes only 5-10 minutes to administer and is therefore practical to use
repeatedly and routinely
3. What are the core skills of Motivational Interviewing? Bickley 166
• Open-ended questions, affirmations, reflective listening, and summaries
4. Differentiate: static tremors, athetosis, chorea, and dystonia.
• Static tremors: *tremors that are most prominent at rest, and that may decrease or disappear with
voluntary movement
*ex: pill-rolling tremor of parkinsonism
• Athetosis: *movement disorder characterized by involuntary convoluted, writhing movements
, *most commonly involve the face and distal extremities
*often associated with spasticity
*causes: cerebral palsy
• Chorea: *movement disorder characterized by brief, rapid, jerky, irregular, and unpredictable
movements
*occur at rest or interrupt normal coordinated movements
*seldom repeat themselves (unlike tics) and appear to flow from one muscle to the next
*"dance-like" movements
*hyperkinesia- movements occur on their own without conscious movement
*usually involves the face, head, lower arms, and hands
*causes: Sydenham's chorea (with rheumatic fever) and Huntington's disease
• Dystonia: *movement disorder in which sustained muscle contractions cause twisting and repetitive
movements of abnormal postures, often involving larger portions of the body, including the trunk
*may result in grotesque, twisted postures
*causes: drugs, such as phenothiazines, primary torsion, spasmodic torticollis
5. What are ways to assess a patient’s level of attention?
• Attention span is tested by giving a set of instructions to the patient and observing whether the patient follows
them properly. Recent memory can be tested by asking a question the nurse can corroborate, such as asking the
patient what he or she had for breakfast.
6. What is the name of cranial nerve 5? How would you assess CN5?
• Trigeminal nerve
• It has three sensory branches (ophthalmic, maxillary and mandibular), and it is tested by lightly touching th
face with a piece of cotton wool followed by a blunt pin in each division on each side of the face
7. What are the symptoms of Bell’s Palsy? Which cranial nerve is involved?
• Bell's palsy is an unexplained episode of facial muscle weakness or paralysis. It begins suddenly and worsens
over 48 hours. This condition results from damage to the facial nerve (the 7th cranial nerve). Pain and
discomfort usually occur on one side of the face or head.
8. What information would you include in: Past Psychiatric History, Chief
Complaint, Past Medical History, Identifying Data, and Social and
Developmental History.
• Past psych hx: 2480 explores psychiatric illness prior to the current presentation
including the nature of symptoms, course, and treatment. Details of past episodes
including age of onset, context,nature and duration of episodes, the diagnosis offered, treatment
applied and its setting, degree of response, treatment adherence, and attitudes toward treatment.
Table 7.1-2
• CC: 2479 the chief complaint is recorded in the patient’s own words, for example, “I
have been depressed for months” or, “I have a lot of anxiety in public speaking.”
• PMH: 2484 A well-developed past medical history archives both current and past
major medical disorders, surgeries, hospitalizations and significant physical trauma, such
as head injuries. In psychiatry, neurological and endocrine disorders are of particular interest
because of the significant overlap in symptoms and signs with psychiatric syndromes. For
female patients, obtaining a reproductive and menstrual history is important, as well as a
careful assessment of potential for current pregnancy and plans for future pregnancy.
• ID: including age, gender,(and race if clinically relevant)
, • Social/dev hx: 2485 The developmental and social history reviews the stages of the
patient’s life from gestation to the present with an eye toward understanding the
important exposures, relationships, and events that shaped the person’s life story. One is
interested in understanding the nature of the person’s temperament and character and the
degree to which the person has achieved developmentally appropriate role functions such as
academic progress, work, peer and romantic relationships, and parenting capacity. Gestational
and birth history, developmental milestones and early childhood development, family of
origin, cultural identifications, educational, occupational, legal and military histories are all
areas to be explored. Histories of abuse (emotional, physical, and sexual), neglect (emotional
and physical) and specific traumatic exposures are important areas for specific inquiry. The
nature of the patient’s current social environment is defined including financial status,
housing, and current relationships.
9. Define these types of amnesia: anterograde, global, retrograde, and proximal.
• Anterograde: Anterograde amnesia is a type of memory loss that occurs when you can't form new memories. In
the most extreme cases, this means you permanently lose the ability to learn or retain any new information. On i
own, this type of memory loss is rare. Anterograde amnesia is often temporary.
• Global: Transient global amnesia (TGA) is a temporary, anterograde amnesia with an acute onset that usually
occurs in middle-aged and older individuals. It is often precipitated by particularly strenuous activity, high-stress
events, or coitus, but it can be seen with migraines as well.
• Retrograde: Retrograde amnesia (RA) refers to loss of memory for information acquired before the onset of
amnesia. The condition is commonly observed after medial temporal lobe or diencephalic pathology,
• Proximal: proximal cause of amnesia: when the hippocampus is damaged leading to memory loss (temporal extent
global nature of deficit, spared memory skills)
10. Differentiate between primary, secondary,
and tertiary prevention. What are some
examples of each?
- Primary: The goal is to protect healthy people
from developing a disease or experiencing an
injury
o Education about good nutrition,
exercise, dangers of tobacco, alcohol,
drugs, Regular exams and screening
tests to monitor risk factors for illness,
Education and legislation about proper
seatbelt and helmet use
- Secondary: Interventions that happen after an
illness or serious risk factors have already been
diagnosed. Goal is to slow or stop progress of
disease in early stages; to limit long-term
disability and prevent re-injury
o Telling people to take daily, low-dose
aspirin to prevent a first or second heart
attack or stroke, Recommending regular
exams and screening tests in people with
known risk factors for illness, Providing
suitably modified work for injured
workers
- Tertiary: Focus on helping people manage