PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
AIMS - ANS✔✔-Abnormal Involuntary Movement Scale for 8 and older
12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics
Rating 0-4, >2 to diagnose TD and reduce dose
BARS - ANS✔✔-Barnes Akathisia Rating Scale for 8 and older
4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or
SSRIs
CRS-R - ANS✔✔-Connors Rating Scales - Revised for 3-17
ADHD Parent (80 items) and Teacher Scales (59 items)
Low T-score of 61= mildly atypical; >70 = markedly atypical
Subscales for Oppositional Behaviors, Cognitive Problems, Hyperactivity, ADHD Index,
Anxious-Shy, Perfectionism, Social Problems, DSM-IV Subscales and Connors' Global Index
Vanderbilt ADHD Parent and Teacher - ANS✔✔-55 parent, 43 teacher items for 6-12
Initial assessment rates symptoms and impairment in academic and behavioral performance
ASRS-1 - ANS✔✔-Adult ADHD Self-Report Scale, 16 and older
Two-part Screening
Part A: 6 questions, 4 symptoms suggest ADHD
Part B: 12 questions to clarify and quantify
AUDIT-C - ANS✔✔-Alcohol Use Disorders Identification Test - Consumption, > 13
Documents use and frequency in prior year
0-4, F >3 = positive, M >4 = positive, >8 = hazardous drinking
CAGE-AID - ANS✔✔-IDs problem drinking or druging, 13 and older
(C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs
CRAFFT - ANS✔✔-6-item screen for alcohol or drugs in adolescents, 14-18
(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
BAI - ANS✔✔-Beck Anxiety Inventory, 17 and older
Assesses 21 symptoms of anxiety, 0-36 scores
HAM-A - ANS✔✔-Hamilton Anxiety Scale, most commonly used
14 domains, 14=mild, 18-24= moderate, 25-30=severe
LSAS-CA - ANS✔✔-Liebowitz Social Anxiety Scale-Child/Adolescent Version, 7 and older
24 items, social and performance
55-65=moderate social phobia, 65-80=marked, 80-95=severe, >95=very severe
MMSE - ANS✔✔-Mini Mental Status Exam
30 items, 24-30= no cognitive impairment; 18-23=mild cognitive impairment; 0-17= severe
cognitive impairment
MOCA - ANS✔✔-Montreal Cognitive Assessment
>26=normal, add point for <12th grade education
SPMSQ - ANS✔✔-Short Portable Mental Status Questionnaire
10 items, more than 3 incorrect indicates dementia
BDI-2 - ANS✔✔-Beck Depression inventory, 13 and older
presence and impact of depressive symptoms
21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
CCSD - ANS✔✔-Cornell Scale for Depression in Dementia
19 items, <6=no significant depression; 8-17=probable major depression; >18=definite
depression
MDQ - ANS✔✔-Mood Disorder Questionnaire
Screen for mania or hypomania
positive if 7 or more of 13 items in question #1 present and #2 is yes and #3 gets moderate or
serious problem response
YMRS - ANS✔✔-Young Mania Rating Scale, 11 items (adult)
Range 0-60; adults with 12 or more=mania
CY-BOCS - ANS✔✔-...
YBOCS - ANS✔✔-Yale-Brown Obsessive Compulsive Scale
10 items; age 14 and older
gold standard for OC symptoms
score indicates level of severity
BPRS - ANS✔✔-Brief Psychiatric Rating Scale, 18 and older
Assesses psychopathology (+, - and affective) with schizophrenia, not for screening or DX
PANSS - ANS✔✔-Positive and Negative Syndrome Scale, 18 and older
measures changes in symptom intensity in psychosis and schizophrenia
Gold standard in studies of treatment efficacy
SPS - ANS✔✔-Suicide Probability Scale, 13 and older
Rapid measure of suicide risk
higher score indicates greater risk
CIWA-Ar - ANS✔✔-Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised
9 item symptom rating scale, max score 67; <10 does not warrant intervention
COWS - ANS✔✔-Clinical Opiate Withdrawal Scale
Quantifies severity of withdrawal syndrome, guides dosing, monitors over time
Used for induction of Suboxone
5-12=mild; 13-24= moderate; 25-36=mod to severe; >36=severe
T4, FREE THYROXINE - ANS✔✔-0.8-2.8
Increased In Graves
Decreased In Hypothyroidism
TSH - ANS✔✔-2- 10 mu/l
Normal values can range from 0.4 - 4.0 mIU/L (milli-international units per liter),
Calcium, Ca++ - ANS✔✔-8.8-10.5
<7.0, tetany
>11.0, hyperparathyroidism
>13.5, hypercalcemic coma, metastatic cancer
Sodium, Na+ - ANS✔✔-135-148 mEq/L
hypernatremia - ANS✔✔-dehydration
hypovolemia
diabetes insipidus
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
eating too much salt
gastroenteritis
drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds
hyponatremia - ANS✔✔-drugs such as lithium, vasopressin, diuretics
addisons
renal disorder
gi fluid loss
Magnesium, Mg - ANS✔✔-1.3 - 2.1 mEq/L
lithium can increase
hypomagnesemia - ANS✔✔-depression, confusion, irritability,nystagmus, tetany, convulsions,
ataxia, increased reflexes, muscle weakness
hypermagnesemia - ANS✔✔-N/V, respiratory depression, hypotension, depressed skeletal
muscle contraction and nerve function, bradycardia
Potassium, K+ - ANS✔✔-3.5-5.1 mEq/L
hyperkalemia - ANS✔✔-chronic marijuana use can elevate potassium
Chloride, Cl - ANS✔✔-98 - 106
passive transport through sodium
major anion in the extracellular fluid
Liver - ALT - ANS✔✔-5 - 35 U/L - depakote can increase, safe to use up to 2 times normal limit
Liver - AST - ANS✔✔-5 - 40 U/L
slight elevation can occur in DT's
depakote can increase, safe to use up to 2 times normal limit
Liver - GGT - ANS✔✔-10 - 38 IU/L
Thrombocytopenia - ANS✔✔-Platelet count normal = 150,000-450,000
if below - bone marrow doesn't make enough platelets.
or bone marrow makes enough platelets, but the body destroys them or uses them up.
or - The spleen holds on to too many platelets. The spleen is an organ that normally stores about
one-third of the body's platelets. It also helps your body fight infection and remove unwanted
cell material.
can be caused by Valproate
Neutropenia - ANS✔✔-A normal ANC is above 1,500 cells per microliter. An ANC less than
500 cells/µL is defined as neutropenia and significantly increases the risk of infection.
Neutropenia is the condition of a low ANC,
Clozapine - WBC => 3500 to initiate therapy, ANC MUST BE =>2000/mm, ck wbc/anc weekly
x 6 months, then Q other week for 6 months; if stable then Q 4 weeks. after therapy test for at
least 4 weeks,
LIVER PANEL - ANS✔✔-ALP, AST, ASP, BILIRUBIN, ALBUMIN, TTL PROTEIN, CBC
with WBC DIFFERENTIAL, PLATELET COUNT. FOR VALPROATE THERAPY - CK
BASELINE AND MONTHLY FOR SEVERAL MONTHS
CREATININE - ANS✔✔-0.5-1.2 normal, kidney damage if elevated , athletes may be higher
BUN - ANS✔✔-10-20 mg/dL
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
LITHIUM THERAPY - ANS✔✔-CREATININE/BUN, SERUM ELECTROLYTES, CBC
W/WBC & DIFF, URINALYSIS, EKG, ck levels (post dose 12 hrs trough), after 4 days on med,
then q 4-5 days during initial therapy
lithium levels during acute tx - ANS✔✔-0.8 -1.2, during maintenance 0.6 - 1.0
ALP - ANS✔✔-44-147
CK, creatine kinase - ANS✔✔-<240, indicates muscle injury of heart, brain, skeletal muscle,
elevated in MI, myositis, rhabdomysitis
BUN - ANS✔✔-10-20, increased in impaired kidney function, significant dehydration, measure
with lithium
Creatinine - ANS✔✔-0.4-0.8, may vary with age gender, ethnicity, more sensitive then bun,
GFR - ANS✔✔->90, best measurement of kidney function, no need to adjust dose depakote if
GFR > 60
SIGNS OF LITHIUM TOXICITY - ANS✔✔-nystagmus, ataxia, increased deep tendon reflexes,
altered mental status, cardiac arrhythmias
what meds do to lithium - ANS✔✔-ACE inhibitors, ARB's, nsaid, tetracyclines, metronidazole
can INCREASE LITHIUM
DECREASES LITHIUM LEVELS - ANS✔✔-potassium-sparing diuretics, thiazide diuretics,
theophyline decreases lithium
Examples of ARB's - ANS✔✔-ALL INCREASE LITHIUM
Valsartan
Telmisartan
Losartan
Irbesartan
Irbesartan
Azilsartan
Olmesartan
Olmesartan
Examples of Ace Inhibitors - ANS✔✔-ALL INCREASE LITHIUM
Enalapril (Vasotec/Renitec)
Ramipril (Altace/Prilace/Ramace/Ramiwin/Triatec/Tritace)
Quinapril (Accupril)
Perindopril (Coversyl/Aceon/Perindo)
Lisinopril (Listril/Lopril/Novatec/Prinivil/Zestril)
Benazepril (Lotensin)
Imidapril (Tanatril)
Trandolapril
examples of potassium-sparing diuretics - ANS✔✔-Epithelial sodium channel blockers
Amiloride
Triamterene
Aldosterone antagonists:
Spironolactone
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
AIMS - ANS✔✔-Abnormal Involuntary Movement Scale for 8 and older
12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics
Rating 0-4, >2 to diagnose TD and reduce dose
BARS - ANS✔✔-Barnes Akathisia Rating Scale for 8 and older
4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or
SSRIs
CRS-R - ANS✔✔-Connors Rating Scales - Revised for 3-17
ADHD Parent (80 items) and Teacher Scales (59 items)
Low T-score of 61= mildly atypical; >70 = markedly atypical
Subscales for Oppositional Behaviors, Cognitive Problems, Hyperactivity, ADHD Index,
Anxious-Shy, Perfectionism, Social Problems, DSM-IV Subscales and Connors' Global Index
Vanderbilt ADHD Parent and Teacher - ANS✔✔-55 parent, 43 teacher items for 6-12
Initial assessment rates symptoms and impairment in academic and behavioral performance
ASRS-1 - ANS✔✔-Adult ADHD Self-Report Scale, 16 and older
Two-part Screening
Part A: 6 questions, 4 symptoms suggest ADHD
Part B: 12 questions to clarify and quantify
AUDIT-C - ANS✔✔-Alcohol Use Disorders Identification Test - Consumption, > 13
Documents use and frequency in prior year
0-4, F >3 = positive, M >4 = positive, >8 = hazardous drinking
CAGE-AID - ANS✔✔-IDs problem drinking or druging, 13 and older
(C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs
CRAFFT - ANS✔✔-6-item screen for alcohol or drugs in adolescents, 14-18
(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
BAI - ANS✔✔-Beck Anxiety Inventory, 17 and older
Assesses 21 symptoms of anxiety, 0-36 scores
HAM-A - ANS✔✔-Hamilton Anxiety Scale, most commonly used
14 domains, 14=mild, 18-24= moderate, 25-30=severe
LSAS-CA - ANS✔✔-Liebowitz Social Anxiety Scale-Child/Adolescent Version, 7 and older
24 items, social and performance
55-65=moderate social phobia, 65-80=marked, 80-95=severe, >95=very severe
MMSE - ANS✔✔-Mini Mental Status Exam
30 items, 24-30= no cognitive impairment; 18-23=mild cognitive impairment; 0-17= severe
cognitive impairment
MOCA - ANS✔✔-Montreal Cognitive Assessment
>26=normal, add point for <12th grade education
SPMSQ - ANS✔✔-Short Portable Mental Status Questionnaire
10 items, more than 3 incorrect indicates dementia
BDI-2 - ANS✔✔-Beck Depression inventory, 13 and older
presence and impact of depressive symptoms
21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
CCSD - ANS✔✔-Cornell Scale for Depression in Dementia
19 items, <6=no significant depression; 8-17=probable major depression; >18=definite
depression
MDQ - ANS✔✔-Mood Disorder Questionnaire
Screen for mania or hypomania
positive if 7 or more of 13 items in question #1 present and #2 is yes and #3 gets moderate or
serious problem response
YMRS - ANS✔✔-Young Mania Rating Scale, 11 items (adult)
Range 0-60; adults with 12 or more=mania
CY-BOCS - ANS✔✔-...
YBOCS - ANS✔✔-Yale-Brown Obsessive Compulsive Scale
10 items; age 14 and older
gold standard for OC symptoms
score indicates level of severity
BPRS - ANS✔✔-Brief Psychiatric Rating Scale, 18 and older
Assesses psychopathology (+, - and affective) with schizophrenia, not for screening or DX
PANSS - ANS✔✔-Positive and Negative Syndrome Scale, 18 and older
measures changes in symptom intensity in psychosis and schizophrenia
Gold standard in studies of treatment efficacy
SPS - ANS✔✔-Suicide Probability Scale, 13 and older
Rapid measure of suicide risk
higher score indicates greater risk
CIWA-Ar - ANS✔✔-Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised
9 item symptom rating scale, max score 67; <10 does not warrant intervention
COWS - ANS✔✔-Clinical Opiate Withdrawal Scale
Quantifies severity of withdrawal syndrome, guides dosing, monitors over time
Used for induction of Suboxone
5-12=mild; 13-24= moderate; 25-36=mod to severe; >36=severe
T4, FREE THYROXINE - ANS✔✔-0.8-2.8
Increased In Graves
Decreased In Hypothyroidism
TSH - ANS✔✔-2- 10 mu/l
Normal values can range from 0.4 - 4.0 mIU/L (milli-international units per liter),
Calcium, Ca++ - ANS✔✔-8.8-10.5
<7.0, tetany
>11.0, hyperparathyroidism
>13.5, hypercalcemic coma, metastatic cancer
Sodium, Na+ - ANS✔✔-135-148 mEq/L
hypernatremia - ANS✔✔-dehydration
hypovolemia
diabetes insipidus
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
eating too much salt
gastroenteritis
drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds
hyponatremia - ANS✔✔-drugs such as lithium, vasopressin, diuretics
addisons
renal disorder
gi fluid loss
Magnesium, Mg - ANS✔✔-1.3 - 2.1 mEq/L
lithium can increase
hypomagnesemia - ANS✔✔-depression, confusion, irritability,nystagmus, tetany, convulsions,
ataxia, increased reflexes, muscle weakness
hypermagnesemia - ANS✔✔-N/V, respiratory depression, hypotension, depressed skeletal
muscle contraction and nerve function, bradycardia
Potassium, K+ - ANS✔✔-3.5-5.1 mEq/L
hyperkalemia - ANS✔✔-chronic marijuana use can elevate potassium
Chloride, Cl - ANS✔✔-98 - 106
passive transport through sodium
major anion in the extracellular fluid
Liver - ALT - ANS✔✔-5 - 35 U/L - depakote can increase, safe to use up to 2 times normal limit
Liver - AST - ANS✔✔-5 - 40 U/L
slight elevation can occur in DT's
depakote can increase, safe to use up to 2 times normal limit
Liver - GGT - ANS✔✔-10 - 38 IU/L
Thrombocytopenia - ANS✔✔-Platelet count normal = 150,000-450,000
if below - bone marrow doesn't make enough platelets.
or bone marrow makes enough platelets, but the body destroys them or uses them up.
or - The spleen holds on to too many platelets. The spleen is an organ that normally stores about
one-third of the body's platelets. It also helps your body fight infection and remove unwanted
cell material.
can be caused by Valproate
Neutropenia - ANS✔✔-A normal ANC is above 1,500 cells per microliter. An ANC less than
500 cells/µL is defined as neutropenia and significantly increases the risk of infection.
Neutropenia is the condition of a low ANC,
Clozapine - WBC => 3500 to initiate therapy, ANC MUST BE =>2000/mm, ck wbc/anc weekly
x 6 months, then Q other week for 6 months; if stable then Q 4 weeks. after therapy test for at
least 4 weeks,
LIVER PANEL - ANS✔✔-ALP, AST, ASP, BILIRUBIN, ALBUMIN, TTL PROTEIN, CBC
with WBC DIFFERENTIAL, PLATELET COUNT. FOR VALPROATE THERAPY - CK
BASELINE AND MONTHLY FOR SEVERAL MONTHS
CREATININE - ANS✔✔-0.5-1.2 normal, kidney damage if elevated , athletes may be higher
BUN - ANS✔✔-10-20 mg/dL
, PMHNP COMPREHENSIVE EXAM COMPLETE
TESTBANK QUESTIONS AND VERIFIED
ANSWERS UPDATED GRADED A+
LITHIUM THERAPY - ANS✔✔-CREATININE/BUN, SERUM ELECTROLYTES, CBC
W/WBC & DIFF, URINALYSIS, EKG, ck levels (post dose 12 hrs trough), after 4 days on med,
then q 4-5 days during initial therapy
lithium levels during acute tx - ANS✔✔-0.8 -1.2, during maintenance 0.6 - 1.0
ALP - ANS✔✔-44-147
CK, creatine kinase - ANS✔✔-<240, indicates muscle injury of heart, brain, skeletal muscle,
elevated in MI, myositis, rhabdomysitis
BUN - ANS✔✔-10-20, increased in impaired kidney function, significant dehydration, measure
with lithium
Creatinine - ANS✔✔-0.4-0.8, may vary with age gender, ethnicity, more sensitive then bun,
GFR - ANS✔✔->90, best measurement of kidney function, no need to adjust dose depakote if
GFR > 60
SIGNS OF LITHIUM TOXICITY - ANS✔✔-nystagmus, ataxia, increased deep tendon reflexes,
altered mental status, cardiac arrhythmias
what meds do to lithium - ANS✔✔-ACE inhibitors, ARB's, nsaid, tetracyclines, metronidazole
can INCREASE LITHIUM
DECREASES LITHIUM LEVELS - ANS✔✔-potassium-sparing diuretics, thiazide diuretics,
theophyline decreases lithium
Examples of ARB's - ANS✔✔-ALL INCREASE LITHIUM
Valsartan
Telmisartan
Losartan
Irbesartan
Irbesartan
Azilsartan
Olmesartan
Olmesartan
Examples of Ace Inhibitors - ANS✔✔-ALL INCREASE LITHIUM
Enalapril (Vasotec/Renitec)
Ramipril (Altace/Prilace/Ramace/Ramiwin/Triatec/Tritace)
Quinapril (Accupril)
Perindopril (Coversyl/Aceon/Perindo)
Lisinopril (Listril/Lopril/Novatec/Prinivil/Zestril)
Benazepril (Lotensin)
Imidapril (Tanatril)
Trandolapril
examples of potassium-sparing diuretics - ANS✔✔-Epithelial sodium channel blockers
Amiloride
Triamterene
Aldosterone antagonists:
Spironolactone
