PMHNP Exam Reported Questions and Answers Latest 2022 Test with complete solutions

What is dissemination? Correct Answer- 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? Correct Answer- Moderate cognitive impairment What is Tegretol in the CYP450 system? Correct Answer- Inducer -->will lower dose of Lamictal and BCP's What do BCP's do to Lamictal? Correct Answer- Inducer - will lower dose of Lamictal What is a Type I research error? Correct Answer- There IS a difference but you say there isn't a difference. What is a Type II research error? Correct Answer- There is NO difference but you say there is a difference. What is pseudo-dementia? Correct Answer- 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? Correct Answer- Yes. What is a drug 1/2 life? Correct Answer- The time it takes for 50% of a drug to be eliminated from the body. What 3 atypicals can be used with teens? Correct Answer- Zyprexa, Abilify, Seroquel - low doses What is a risk of using Tramadol? Correct Answer- Serotonin Syndrome as it is very serotonergic. What is the allele seen in Asians that increase the risk of SJS? Correct Answer- HLAB-1502 When might you see toxic epidermal necrolysis? Correct Answer- With worsening of SJS How many generations do you include for a genogram? Correct Answer- 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - What does messenger RNA code for? Correct Answer- Amino Acids What is epigenetics? Correct Answer- Factors that affect genes - environmental, smoking, stress, etc... What part of the brain is involved with OCD? Correct Answer- Basal Ganglia Occipito-Frontal What happens to the brain during adolescence? Correct Answer- Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well When do males typically present with schizophrenia? Correct Answer- 10-25 yo When do females typically present with schizophrenia? Correct Answer- 25-35 yo What does Erythromycin to trileptal? Correct Answer- You will need to decreases the level because Trileptal(inducer) and erythromycin is a inhibitor ACE Inhibitors are the drug of choice for what? Correct Answer- Heart Failure HTN What are some psychiatric side effects seen with some asthma drugs Correct Answer- Leukotriene receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations, depression, insomnia, SI, tremor What should you watch for with Tegretol? Correct Answer- Agranulocytosis and Hyponatremia What are the 3 CK muscle enzyme tests? Correct Answer- CKBB, CKMM, CKMB Which one of the 3 muscle enzymes are related to cardiac muscle damage? Correct Answer- CKMB What is the risk of a seriously elevated CKMB? Correct Answer- Polymyositis Rhabdo What is a normal CKMB? Correct Answer- 0.3 mcg/L What psychoactives does Detrol interact with? Correct Answer- Topamax KCL Zonegran What CN are you assessing when you have the patient shrug their shoulders? Correct Answer- CN XI - Spinal Accessory What do you see in labs with HIV & Dementia? Correct Answer- CD4 <200 Viral Load is high <20% get it with antiretroviral treatment What is the scoring with the Beck Depression Inventory? Correct Answer- Self-Report - 0-63 0-13 - minimal 14-19 - mild 20-28 - moderate 29-63 - severe What is sensitivity? Correct Answer- Helps rule-out disease = True Positive = Snout What is specificity? Correct Answer- Helps rule-in disease = True Negative = Spin What does a sed rate measure? Correct Answer- Inflammation (ESR - Erythrocyte Sedimentation Rate) = distance in mm RBC's have descended in 1 hour. What is a normal sed rate or ESR? Correct Answer- 0-22 males 0-29 females What is a retic count? Correct Answer- 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? Correct Answer- Anemia - acute or chronic bleeding What does an increased retic count indicate? Correct Answer- Bone marrow disorder or Vitamin Deficiency What does an abnormal retic ount indicate in general? Correct Answer- Doesn't diagnose anything. First step is ID source of the issue. What happens when you mix tegretol and macrolides? Correct Answer- Increase tegretol levels. What happens if a pregnant women takes Accutane? Correct Answer- Birth defects. What labs do you get with RA? Correct Answer- 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? Correct Answer- ANA When do you assume informed consent? Correct Answer- Unconscious Incompetent Life Threatening Situation What are the legal ramifications of treating w/o informed consent? Correct Answer- Same as with informed consent Who can declare a patient incompetent and appoint a guardian? Correct Answer- Only a court Does impaired judgment mean one is incompetent? Correct Answer- No. Can an advanced directive ever be revoked? Correct Answer- Yes, at any time. What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? Correct Answer- Nothing. They are all the same. Does the de facto rule of proxy apply in same sex marriages? Correct Answer- No. How do Asians see HC providers? Correct Answer- 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? Correct Answer- SIgn of respect What is the evil eye? Correct Answer- 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? Correct Answer- Red ribbon on an infant Amulet for adults How do you treat for evil eye? Correct Answer- Access traditional healer + traditional care. For there to be a duty to a patient, what must exist? Correct Answer- Relationship What is a proximate cause? Correct Answer- Connection between A + B. For there to be damages, what must exist first? Correct Answer- Negligence What is an occurrence basis liability insurance? Correct Answer- "occurred" during the policy period, no matter when the claim is brought against the insured What is a claims made/based liability insurance? Correct Answer- 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? Correct Answer- Board of Nursing State What are the various controlled substance classes? Correct Answer- 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 What classes of CS's is the NP approved to prescribe? Correct Answer- Schedules III-V ONLY. Where does 50% of healthcare funds come from? Correct Answer- The government Who is eligible for Medicare? Correct Answer- >65 or under 65 with diability, ANY age with renal disease. What is incident to billing? Correct Answer- Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD. Allows NP to get reimbursed at 100% rather than 85%.