ANCC4 ACTUAL TEST PAPER WITH COMPLETE ANSWERS
◍ Freud stages of psychosexual development. Answer: PNEUMOIC -
Old Age Parents Love Grandchildren
Oral (0-18 months)
Anal (18 months - 3 years)
Phallic (3 years to 6 years)
Latent (6 to 12)
Genital (12 +)
◍ ACUTE STRESS DISORDER. Answer: Depression, dissociation,
recurring nightmares, sleep disturbances, problems in concentrations,
reliving the event, dreams, flashbacks -
UP to ONE MONTH - Less than 1 month.
if LONGER than 1 month=PTSD
◍ 5-year-old tells you his brother sodomized him. Answer: Tell mom
don't leave him alone with patient and call CPS implement crisis
◍ Child is playing with doll in a sexual way - You SUSPECT sexual
abuse. Answer: Perform FURTHER ASSESSMENT and GATHER
ENOUGH INFO BEFORE Calling CPS to report
,suspected Sexual Abuse - You HAVE to report but you have to have
something
(assessment data) to report - Assess = FIRST
◍ 13-year-old want to smoke. Answer: ask him of his plan to stop
smoking
◍ MMSE/ FOLSTEIN. Answer: MMSE/FOLSTEIN
Mr. Folstein had Benjamin Button's disease where he was normal
from 30-25 yrs old, then deteriorated mildly from 24-21 yrs old,
became moderately demented from 20-13 yrs old, until he reached
age 11 where it was too severe to stay at home.
◍ Beck Depression Inventory. Answer: Beck was 20 yrs old when he
started medication & therapy. Unfortunately, at age 31 it became too
SEVERE and was hospitalized.
◍ HAM-A. Answer: Hamilton A started medication & therapy at 24
yrs old for moderate anxiety. Sadly, when he turned 27 yrs old he was
hospitalized for SEVERE anxiety.
◍ HAM-D. Answer: Hamilton D began medication & therapy at 14
yrs old. He later had a dose increase at age 17 for
MODERATE/SEVERE depression. But soon after, it became
SEVERE at age 23 & he was hospitalized.
,◍ PHQ-9 (Patient Health Questionnaire). Answer: Penelope Q was
just 10 yrs old when she started antidepressants & therapy. At age 15,
she required a dose increase due to moderate/severe depression. It
helped her until she turned 20 when it became SEVERE, and she had
to be hospitalized.
◍ GAD-7 scale. Answer: Gary was just 10 yrs old when he was
treated with meds & therapy for anxiety. Yet his symptoms still
worsened and at 15 yrs old he was hospitalized for SEVERE anxiety.
◍ HAM-D score of 19?. Answer: Severe. Assess for SI, treat with
meds & therapy.
◍ Beck score of 20. Answer: Moderate. Confirm diagnosis and treat
with meds & therapy.
◍ PHQ-9 score of 15?. Answer: Moderate. Confirm diagnosis & start
therapy & meds
◍ PHQ-9 score of 21?. Answer: Severe. Assess for SI, start therapy &
meds.
◍ HAM-D score of 23?. Answer: Severe. Assess SI, treat with meds
& therapy.
◍ ZUNG Score of 70?. Answer: Severe. Assess SI, treat with meds &
therapy
, ◍ SLUM > Score. Answer: 0 - 20 indicate dementia; 21 - 26 = mild
neurocognitive disorder; 27 - 30 =
normal.
◍ What is the WHODAS scale?. Answer: (World Health Organization
Disability Assessment Scale)? It is used instead of GAF.
Measures multiple disabilities in multiple areas (cognition, work,
social and interpersonal relations).
The LOWER the number, the MORE SEVERE the impairment.
For example, a score of 50 through 30 indicates SI with intent; a score
of 30 and under indicates the need for
hospitalization.
◍ CIWA-Ar. Answer: Start symptom-treatment medication PRN at 8,
standing med at 15 (1st choice Diazepam lasts longer, UNLESS liver
compromised then give Ativan).
◍ COWS Score/treatment?. Answer: Start PRN meds (Clonidine) at
7, give suboxone or buprenorphine at 13.
◍ Mydriasis (of pupil). Answer: Dilated pupils (withdrawal sign, give
Clonidine)
◍ Freud stages of psychosexual development. Answer: PNEUMOIC -
Old Age Parents Love Grandchildren
Oral (0-18 months)
Anal (18 months - 3 years)
Phallic (3 years to 6 years)
Latent (6 to 12)
Genital (12 +)
◍ ACUTE STRESS DISORDER. Answer: Depression, dissociation,
recurring nightmares, sleep disturbances, problems in concentrations,
reliving the event, dreams, flashbacks -
UP to ONE MONTH - Less than 1 month.
if LONGER than 1 month=PTSD
◍ 5-year-old tells you his brother sodomized him. Answer: Tell mom
don't leave him alone with patient and call CPS implement crisis
◍ Child is playing with doll in a sexual way - You SUSPECT sexual
abuse. Answer: Perform FURTHER ASSESSMENT and GATHER
ENOUGH INFO BEFORE Calling CPS to report
,suspected Sexual Abuse - You HAVE to report but you have to have
something
(assessment data) to report - Assess = FIRST
◍ 13-year-old want to smoke. Answer: ask him of his plan to stop
smoking
◍ MMSE/ FOLSTEIN. Answer: MMSE/FOLSTEIN
Mr. Folstein had Benjamin Button's disease where he was normal
from 30-25 yrs old, then deteriorated mildly from 24-21 yrs old,
became moderately demented from 20-13 yrs old, until he reached
age 11 where it was too severe to stay at home.
◍ Beck Depression Inventory. Answer: Beck was 20 yrs old when he
started medication & therapy. Unfortunately, at age 31 it became too
SEVERE and was hospitalized.
◍ HAM-A. Answer: Hamilton A started medication & therapy at 24
yrs old for moderate anxiety. Sadly, when he turned 27 yrs old he was
hospitalized for SEVERE anxiety.
◍ HAM-D. Answer: Hamilton D began medication & therapy at 14
yrs old. He later had a dose increase at age 17 for
MODERATE/SEVERE depression. But soon after, it became
SEVERE at age 23 & he was hospitalized.
,◍ PHQ-9 (Patient Health Questionnaire). Answer: Penelope Q was
just 10 yrs old when she started antidepressants & therapy. At age 15,
she required a dose increase due to moderate/severe depression. It
helped her until she turned 20 when it became SEVERE, and she had
to be hospitalized.
◍ GAD-7 scale. Answer: Gary was just 10 yrs old when he was
treated with meds & therapy for anxiety. Yet his symptoms still
worsened and at 15 yrs old he was hospitalized for SEVERE anxiety.
◍ HAM-D score of 19?. Answer: Severe. Assess for SI, treat with
meds & therapy.
◍ Beck score of 20. Answer: Moderate. Confirm diagnosis and treat
with meds & therapy.
◍ PHQ-9 score of 15?. Answer: Moderate. Confirm diagnosis & start
therapy & meds
◍ PHQ-9 score of 21?. Answer: Severe. Assess for SI, start therapy &
meds.
◍ HAM-D score of 23?. Answer: Severe. Assess SI, treat with meds
& therapy.
◍ ZUNG Score of 70?. Answer: Severe. Assess SI, treat with meds &
therapy
, ◍ SLUM > Score. Answer: 0 - 20 indicate dementia; 21 - 26 = mild
neurocognitive disorder; 27 - 30 =
normal.
◍ What is the WHODAS scale?. Answer: (World Health Organization
Disability Assessment Scale)? It is used instead of GAF.
Measures multiple disabilities in multiple areas (cognition, work,
social and interpersonal relations).
The LOWER the number, the MORE SEVERE the impairment.
For example, a score of 50 through 30 indicates SI with intent; a score
of 30 and under indicates the need for
hospitalization.
◍ CIWA-Ar. Answer: Start symptom-treatment medication PRN at 8,
standing med at 15 (1st choice Diazepam lasts longer, UNLESS liver
compromised then give Ativan).
◍ COWS Score/treatment?. Answer: Start PRN meds (Clonidine) at
7, give suboxone or buprenorphine at 13.
◍ Mydriasis (of pupil). Answer: Dilated pupils (withdrawal sign, give
Clonidine)
