PMHNP Exam Reported Questions -

PMHNP Exam Reported Questions - What is dissemination? - Getting the research information out to those who need to know it! Publication - highest level Presenting at National Conference Presenting at Local Conference Journal Club where one person reviews an article What does a 17 on MMSE mean? - Moderate cognitive impairment What is Tegretol in the CYP450 system? - Inducer --will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? - Inducer - will lower dose of Lamictal What is a Type I research error? - There IS a difference but you say there isn't a difference. What is a Type II research error? - There is NO difference but you say there is a difference. What is pseudo-dementia? - Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve. Is it normal for a 1 month old to have a palmar grasp? - Yes. What is a drug 1/2 life? - The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? - Zyprexa, Abilify, Seroquel - low doses What is a risk of using Tramadol? - Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? - HLAB-1502 When might you see toxic epidermal necrolysis? - With worsening of SJS How many generations do you include for a genogram? - 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? - Amino Acids What is epigenetics? - Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? - Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? - Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? - 10-25 yo When do females typically present with schizophrenia? - 25-35 yo What does Erythromycin to trileptal? - You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? - Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs - Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? - Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? - CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? - CKMB What is the risk of a seriously elevated CKMB? - Polymyositis Rhabdo What is a normal CKMB? - 0.3 mcg/L What psychoactives does Detrol interact with? - Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? - CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? - CD4 200 Viral Load is high 20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? - Self-Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? - Helps rule-out disease = True Positive = Snout What is specificity? - Helps rule-in disease = True Negative = Spin What does a sed rate measure? - Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? - 0-22 males 0-29 females What is a retic count? - Measures % of reticulocytes in blood (immature RBC's) Indicates whether enough RBC's are being produced by bone marrow. What does a decreased retic count indicate? - Anemia - acute or chronic bleeding What does an increased retic count indicate? - Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? - Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? - Increase tegretol levels. What happens if a pregnant women takes Accutane? - Birth defects. What labs do you get with RA? - Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP - helps confirm diagnosis. CRP and ESR are both increased in RA but NOT in osteoarthritis. Where does the NP Code of Ethics come from? - ANA When do you assume informed consent? - Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? - Same as with informed consent Who can declare a patient incompetent and appoint a guardian? - Only a court Does impaired judgment mean one is incompetent? - No. Can an advanced directive ever be revoked? - Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? - Nothing. They are all the same. Does the de facto rule of proxy apply in same sex marriages? - No. How do Asians see HC providers? - As in a position of authority. Expect to give instructions and help make decisions What does it mean when an Asian patient does not make eye contact with the NP? - SIgn of respect What is the evil eye? - When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness. How do you protect from the evil eye? - Red ribbon on an infant Amulet for adults How do you treat for evil eye? - Access traditional healer + traditional care. For there to be a duty to a patient, what must exist? - Relationship What is a proximate cause? - Connection between A + B. For there to be damages, what must exist first? - Negligence What is an occurrence basis liability insurance? - "occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? - provides coverage for a claim that is brought within the policy period, no matter when the loss occurred. Who sets the minimum requirements for NP's? - Board of Nursing State What are the various controlled substance classes? - Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes. Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate Schedule III - Moderate Abuse Potential - hydrocodone, codeine Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine Schedule V - Very low abuse potential - anti-tussives, lomotil