PMHNP Exam Reported Questions images, pmhnp Questions With Complete Solutions

DBT (dialectical behavior therapy) correct answer: relaxation muscle prior to DBT Greatest patient at risk for Violence correct answer: Substance abuse EMDR (eye movement desensitization and reprocessing) correct answer: eye movement desensitization and reprocessing 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%. How are Medicaid benefits determined? correct answer: State determines qualification - Partnership between State and Fed Govt. Must be impoverished Must be US resident and low or very low income. Can you have Medicare and Medicaid? correct answer: Yes, impoverished elderly but Medicaid is always payor of last resort. Is dental care included in Medicaid? correct answer: Yes, <21 gets basic dental as part of the Medicaid plan. What is the purpose of HIPAA? correct answer: National standards for electronic HC transactions National ID for providers, health plans and employers. Not SIMPLY Confidentiality. What must be signed prior to any healthcare in the state correct answer: Notice of Privacy Practices Statement What happens if a patient refuses to sign an ROI? correct answer: Can decline to treat Health plan may condition enrollment on provision of consent When is HIPAA not required? correct answer: Emergency treatment Substantial communication barriers and consent is inferred Involuntary committment Is it ok to announce a patient's name in a waiting room? correct answer: Yes, no other way to give care. Is it ok to leave a message on a patient's vm? correct answer: Yes, but should be limited. What is the impact of steroid inhalers on children? correct answer: Slows bone growth and may decrease ultimate height. What is the long-term impact of using steroid inhalers? correct answer: Cataracts, glaucoma, thinning of bones and skin What is included in the treatment of fibromyalgia? correct answer: Sleeping meds Antidepressants Pain meds What psychoactives are first line treatment for fibro? correct answer: Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's What is the purpose of telepsychiatry? correct answer: Increase the ability to reach rural and underserved areas. What is the purpose of Motivational Interviewing? correct answer: Explore ambiguity Maintain passive position What is required for Medicare submission? correct answer: ICD 10 and narrative or CPT What is the neurotransmitter problem in Schizophrenia? correct answer: Excess dopamine in mesolimbic pathway. What is the neurotransmitter problem in ADHD? correct answer: Dopamine, norepinephrine and serotonergic dysfunction What is the benefit of play therapy? correct answer: Don't have to confront emotions head on. What neurotransmitters are involved in the bioamine hypothesis of depression? correct answer: Noradrenaline Serotonin Dopamine MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse. How do you test CN XII? correct answer: Stick out your tongue. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles? correct answer: CN V - Trigeminal What are two important things to measure when using Zyprexa? correct answer: Lipid level and abdominal circumference What is included in the mini-cognitive exam? correct answer: Clock, memory questions from MSE. What is HIV related dementia often mistaken for, especially at the beginning? correct answer: Depression What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) <1000? correct answer: Stop and repeat lab. Normal is mm3 Can you take Buspar during pregnancy? correct answer: Category B - ok if really needed. Can you take Klonopin during pregnancy? correct answer: Category C - avoid if possible; does excrete into breast-milk and infant could get withdrawal symptoms. What is the concern when prescribing Lamictal with Depakote? correct answer: Both are CYP450 inducers of the other and therefore together will lower the level of both drugs. Can asthma medications cause depression? correct answer: Yes. If a patient has muscle pain and red urine with an elevated leukocyte esterase. What lab do you order? correct answer: Microalbumin? What is often common to patients with fibro? correct answer: Sexual abuse How is telepsychiatry evaluated? correct answer: Outcome based - measure at intervals. What happens with a patient taking Lithium and who gets dehydrated? correct answer: Levels increase What happens with a patient taking Lithium who decreases sodium intake? correct answer: Levels increase What happens with a patient taking Lithium and drinks a lot of water? correct answer: Levels decrease If a patient takes Risperdal and develops NMS, which other atypical should you avoid in the future? correct answer: Zyprexa What happens when taking Lithium and NSAIDS? correct answer: NSAIDS can cause Lithium levels to increase and for the patient to become toxic! What medications are at risk to cause SJS in the Asian population? correct answer: HLAB-1502 Allele increase risks of SJS. Trileptal, Tegretol and other AED's. Amgdyla correct answer: Fear, Anxiety, and Aggression Neurotransmitter for Addiction correct answer: Dopamine and GABA Neurotransmitter for Mood Disorder correct answer: Serotonin and norepinephrine Which drug affects Carbamazepine/tegretol correct answer: Erythromycin will cause toxic levels. Decrease Carbamazepine/tegretol Signs and Symptoms of stimulant abuse correct answer: insomnia and tremor Depakote check correct answer: HCG levels Depakote causes correct answer: Spinal bifida Grasp reflex. correct answer: an infantile reflex in which an infant closes her hand into a fist when her palm is touched Stroking the palm of a baby's hand causes the baby to close his or her fingers in a grasp. The grasp reflex lasts until about 5 to 6 months of age. Moro reflex. correct answer: The Moro reflex is often called a startle reflex because it usually occurs when a baby is startled by a loud sound or movement. In response to the sound, the baby throws back his or her head, extends out the arms and legs, cries, then pulls the arms and legs back in. A baby's own cry can startle him or her and trigger this reflex. This reflex lasts about 5 to 6 months. pincer grasp correct answer: 9 months Uses thumb and index finger (pincer grasp) to pick up small objects like Cheerios. Pt has MI looses his job stable on psych medications correct answer: Provide brief supportive therapy Latida and Geodon correct answer: Take with food Moro reflex absent correct answer: Do xray Health Care Policy Model correct answer: Access, Cost, Quality Pt wants to stop medications correct answer: explore reason for stopping Its their right 16 year old falls with the wrong crowd correct answer: Conduct disorder change agent correct answer: the person formally in charge of guiding a change effort Administrator 14 year old girl clenching her teeth correct answer: Cranial Nerve V-Trigeminal nerve Infant dying correct answer: Give child to parents and comfort parents borderline personality disorder Treatment correct answer: dialectical behavior therapy Aggressive patient give correct answer: IM geodon *SIGECAPS* of Depression correct answer: Sleep Interest Guilt Energy Concentration Appetite psychomotor retardation Suicide DIGFAST for mania correct answer: Distractibility Indiscretion Grandiosity Flight of ideas Activity increase Sleep deficit Talking increase 5 year old tells u his brother sodomized him correct answer: Tell mom don't leave him alone with patient and call CPS implement crisis Just culture correct answer: "Just culture" model: proposed to reconcile the twin needs for no-blame and appropriate accountability The focus is on identifying and addressing systems issues that lead individuals to engage in unsafe behaviors while maintaining individual accountability by establishing zero tolerance for reckless behavior. Distinguishes between Human error (e.g. slips), At-risk behavior (e.g. taking shortcuts), Reckless behavior (e.g. ignoring required safety steps). In a just culture, the response to an error or near-miss is predicated on the type of behavior associated with the error, not the severity of the event. Child reports Sexual Abuse correct answer: Interview the young child and infants child with parent First sign of temprofrontal Dementia correct answer: Behavior and personalty changes Tow amines related to depression correct answer: Serotonin and norepinephrine Want to start an consulting firm what tool would be needed to show economic viability correct answer: Revenue and expenses Patient stopped smoking (Cessation) correct answer: Decreased Zyprexia Promote resilience in schizophrenia for a patient that lives alone and doing well correct answer: Refer to peer support Spirit stick correct answer: Teach staff about culture competence Problems in the parietal lobe can lead correct answer: Sensory-perceptual disturbances and agnosia(inability to perceive objects) R-L confusion Difficulty writing (agraphia) Aphasia(difficulty of language) PDSA cycle correct answer: For Plan-Do-Study-Act. Describes how to test a change: by trying it, observing the consequences, and then learning from those consequences. Appreciative Inquiry correct answer: an organizational change strategy that directs the group's attention away from its own problems and focuses participants on the group's potential and positive elements Appreciative Inquiry correct answer: an organizational change philosophy and process building organizations around what works, rather than focusing on and trying to fix what doesn't work Appreciative Inquiry (AI) correct answer: Identify the problem Analyze the problem Generate Solutions Implement Best Solutions Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change) Destiny (Make it happen, Implenting Change) Appreciative Inquiry correct answer: Discovery (Best of what is ) Dream (Wishes or dreams of Org) Design (Decide what you want to change) Destiny (Make it happen, Implenting Change) CIWA-Ar correct answer: Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised 9 item symptom rating scale, max score 67; <10 does not warrant intervention Hispanic patient lost his parent complain stomach ache his pop couldn't fix what do you do correct answer: Validate his experience and provide care in a culturally specific way to that patient Native American wants his healer present correct answer: Involve mother of the patient and healer, mom was cleared for you to involve her 16 year old shows up with mother for first therapy is correct answer: confidential mom sits in lobby Patient acts out due to missing session what do you do correct answer: You relate to childhood abandonment and talk about it with the patient How do you assess the competency of a medical procedure correct answer: Identify a pen and recall 3 words Patient thinks someone has infiltrated the church because he watched it on TV 2 years ago, what diagnosis correct answer: Delusional disorder Increase ICP (signs and symptoms) correct answer: Baby Neuro cry Menopausal woman correct answer: Hormone therapy and replacement Patient on antidepressants for 3 weeks and attempted Suicide correct answer: Stop medication immediately You want to decrease seclusion on your unit who considered the primary change agent correct answer: Unit staff You are a lead NP over other NPs in a rural setting how would you go about the change correct answer: Make online form and have them vote on it 16 year old refuse treatment correct answer: Send to psych specialist for acting out kids Positive Trendelenburg Sign correct answer: Refer to Ortho/specialist Pelvis drops to when patient raises one foot off the floor. Drug affects Flonase correct answer: Zantac (Histamine 2 Blocker) Antagonist Little boy wet his sheets, What kind of therapy would you suggest correct answer: Behavior therapy DDVAP acts in much the same manner as antidiuretic hormone. correct answer: Makes less urine Lithium level 1.2u what are you concerned with correct answer: 4+ Ketones What does depakote do to Lamictal correct answer: Increase laminate 200% Inducers of Cytochrome P450 (CYP450) correct answer: Barbiturates, phenytoin, carbamazepine, rifampin, St. John's Wort A substance that speeds up a chemical reaction Inhibitor correct answer: A substance that slows down or stops a chemical reaction cytochrome p450 inhibitors correct answer: CRACK AMIGOS Cimetidine Ritonavir Acute Alcohol Ciprofloxacin Ketoconazole Amiodarone Macrolides Isoniazid Grapefruit juice Omeprazol Sulfonamides Carb and Barb correct answer: decrease INR Deapkote and Disulfruram correct answer: Increase INR GAL-Renall metabolized correct answer: Gabapentin Acamprostate Lithium Grapefruit juice correct answer: One glass can reduce absorption by 47% Blood levels will be Increased Trazodone (Desyrel) correct answer: Get EKG. Trazodone (Desyrel) correct answer: Get an eye exam can cause Glaucoma Grapefruit juice or grapefruit correct answer: Increase trazodone PICOT correct answer: Patient population of interest Intervention of interest Comparison of interest Outcome Time limbic system correct answer: A doughnut-shaped system of neural structures at the border of the brainstem and cerebral hemispheres; associated with emotions such as fear and aggression and drives such as those for food and sex. Includes the hippocampus, amygdala, and hypothalamus. Amygdala correct answer: A limbic system structure involved in memory and emotion, anxiety, particularly fear and aggression. PANDAS correct answer: Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections OCD Mental Health Parity Act 1996 correct answer: ensure equal coverage for mental and physical illness equal life time and annual limits charge of DEA correct answer: state and federal Stereogenesis correct answer: identify an object without sight a sense that allows a person to recognize the size, shape, and texture of an object Sterogenesis abnormality in correct answer: parietal lobe Clozaril (Clozapine) correct answer: WBC-2500 ANC LESS than 1000 (950) dc medication how treat child with depression correct answer: Zoloft and therapy 3 year old masturbates, plays with self, says naught things correct answer: normal for Piaget NMS treatment correct answer: Dantrolene: MUSCLE RELAXTION D2 agonists (e.g., bromocriptine). For NMS, think FALTER: Fever AMS Autonomic instability Leukocytosis Tremors Elevated CPK Rigidity mesolimbic system correct answer: POSITIVE symptoms of schizophrenia due to high dopamine negative symptoms of schizophrenia correct answer: the absence of appropriate behaviors (expressionless faces, rigid bodies) negative symptoms of schizophrenia correct answer: Decreased dopamine -mesocorticol pathway mesocortical pathway correct answer: VTA to prefrontal cortex negative symptoms Nigrostriatal pathway correct answer: EPS DUE TO LOW DOPAMINE IN THIS AREA Communication from SnPC of the basal ganglia to the striatum (caudate + putamen) of the BG via DA; used to initiate movement PDSA model correct answer: PLAN- Do-carry out Study -examine results Act-decide what action Tanner's stages correct answer: Tanner stages correct answer: MMSE (Mini Mental State Examination)- correct answer: Stage May be Normal 25-30 Mild/Early 21-24 Moderate 10-21 Severe 0-9 A pt states that she has been raped. What do you do correct answer: ensure safety Hamilton D score of 28 correct answer: Assess for Suicide Hamilton Depression Rating Scale correct answer: 17-21 questions 0-7 Normal 14-18 Moderate > 20 Severe Depression Beck Depression Inventory (BDI) correct answer: 0-13 Minimal depression 14-19 Mild Depression 20-28 Moderate Depression 29-63 Severe Depression Patient Health Questionnaire (PHQ-9) correct answer: 1-4 minimal 5-9 Mild depression 10-14 Moderate Depression 15-19 Moderate Severe Depression 20-27 Severe Depression A brief 9-item self-report questionnaire used as a screening tool to assess severity of depression; widely used by health care providers, in validity is well established, particularly for identifying severe depression. Hamilton Anxiety Rating Scale (HAM-A) correct answer: 14-17 Mild Anxiety 18-24 Moderate Anxiety 25-30 Severe Anxiety Yale-Brown Obsessive Compulsive Scale (Y-BOCS) correct answer: OCD 0-7 subclinical 8-15 Mild 16-23 Moderate 24-31 Severe 32-40 Extreme PTSD (Post Traumatic Stress Disorder) correct answer: EMDR Dilated pupils correct answer: Stimulant intoxication constricted (pinpoint) pupils correct answer: Opiods nystagmus correct answer: Phencyclidine conjuctival injection, muchies (super hungry), psychomotor slowness? correct answer: Marijuana Marijuana correct answer: a drug, often smoked, whose effects include euphoria, impairment of judgment and concentration and occasionally hallucinations; rarely reported as addictive Boy states that he wishes to be a girl and tells you not to tell his parent s correct answer: Don't tell ODD what will you do to prevent it from becoming Conduct disorder correct answer: Therapy to target mood and aggression Herpes rooster 3 weeks later sleep difficulties and sad mood correct answer: Depression Schizophrenia in males correct answer: 18-25 years old Schizophrenia in Women correct answer: 25-35 years old signs of amphetamine intoxication correct answer: Tears, Runny nose, restlessness, HTN, Tremors, Insomnia Co-morbidities of bipolar correct answer: Anxiety, alcohol and substance abuse Big Freaking Problems correct answer: Bupropion Fluoxetine Paxil Medicare correct answer: A federal program of health insurance for persons 65 years of age and older Medicare Advantage correct answer: a program by which eligible Medicare beneficiaries may choose to receive their health care through a qualified managed care plan, which in turn receives capitation payments from Medicare for each enrollee Medicare A, B, C, D correct answer: A: Inpatient services B: Outpt services C: Private insurance can provide medicare benefits D: Drugs WATCHERS for GAD 3 of these *** for 6 months correct answer: worry anxiety tension in muscles concentration hyperarousal energy loss, fatigue restlessness sleep trouble Transtheoretical Model of Change correct answer: 1. Precontemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance Man working at the Gym and his urine is Cherry color correct answer: order myoglobinuria Latino women wanting prenatal class correct answer: Consult with cultural group in community Anorexia correct answer: Set up family therapy quasi-experimental design correct answer: Research method similar to an experimental design except that it makes use of naturally occurring groups rather than randomly assigning subjects to groups. The ventricle enlargement observed in clients with correct answer: schizophrenia is most often accompanied by Encopresis Treatment correct answer: Behavior management: toilet refusal behavior, scheduled toileting time, incentives. Prevention of constipation Counseling Medication that contradicts albuterol correct answer: Adderall (amphetamine / dextroamphetamine) Advair Diskus (fluticasone / salmeterol) amoxicillin (Amoxil, Trimox, Apo-Amoxi, Moxatag, Amoxicot, DisperMox, Biomox, Moxilin, Wymox) Ativan (lorazepam) Atrovent (ipratropium) azithromycin (Zithromax, Azithromycin Dose Pack, Z-Pak, Zmax) Benadryl (diphenhydramine) caffeine Flonase (fluticasone nasal) ibuprofen ipratropium (Atrovent, Ipratropium Inhalation Solution, Atrovent HFA, Ipratropium Inhalation Aerosol) Lasix (furosemide) metoprolol (Metoprolol Succinate ER, Metoprolol Tartrate, Lopressor, Toprol-XL, Kapspargo Sprinkle) Mucinex (guaifenesin) oxycodone (OxyContin, Roxicodone, Xtampza ER, OxyIR, Oxaydo, Dazidox, Oxyfast, Oxecta, RoxyBond, Oxydose, Percolone, M-Oxy, ETH-Oxydose, Endocodone, Roxicodone Intensol) prednisone (Deltasone, Rayos, Sterapred, Prednicot, Sterapred DS, Liquid Pred, Meticorten, Orasone, Prednicen-M) Singulair (montelukast) Spiriva (tiotropium) Symbicort (budesonide / formoterol) Tylenol (acetaminophen) Vitamin B12 (cyanocobalamin) Vitamin D3 (cholecalciferol) Zyrtec (cetirizine) t-tests correct answer: statistical measure: test means of 2 independent samples, significantly different? ANOVA (analysis of variance) correct answer: 3 OR MORE an inferential statistical test for comparing the means of three or more groups Pearson's r correct answer: a statistic that measures the direction and strength of the linear relation between two variables that have been measured on an interval or ratio scale p-value correct answer: The probability of results of the experiment being attributed to chance. LEVEL OF SIGNGNIFICANCE Early onset of HIV dementia correct answer: Apathy Lack of Interest Abnormal of MRI-SLow But cognitive," functions such as memory, reasoning, judgment, concentration, and problem solving. Other common symptoms are changes in personality and behavior, speech problems, and motor (movement) problems such as clumsiness and poor balance. show brain atrophy (shrinkage) Yalom correct answer: Universality: Members recognize that other members share similar feelings, thoughts and problems Altruism: Members gain a boost to self concept through extending help to other group members Instillation of hope: Member recognizes that other members' success can be helpful and they develop optimism for their own improvement Imparting information: Education or advice provided by the therapist or group members Corrective:Opportunity to reenact critical family dynamics with group members in a corrective manner Development of socializing techniques: The group provides members with an environment that fosters adaptive and effective communication Imitative behavior: Members expand their personal knowledge and skills through the observation of Group members' self-exploration, working through and personal development Cohesiveness: Feelings of trust, belonging and togetherness experienced by the group members Existential factors: Members accept responsibility for life decisions Catharsis: Members release of strong feelings about past or present experiences Interpersonal learning- input Members gain personal insight about their interpersonal impact through feedback provided from other members Interpersonal learning- output Members provide an environment that allows members to interact in a more adaptive manner Self-understanding: m embers gain insight into psychological motivation underlying behavior and emotional reactions Metobolic syndrome correct answer: group of signs and symptoms including insulin resistance, obesity characterized by excessive fat around the waist and abdomen, hypertension, hyperglycemia, elevated triglycerides, and low levels of HDL NAMI correct answer: national alliance on mental illness help families of mentally ill: education, support groups health literacy correct answer: a person's capacity to learn about and understand basic health information and services, and to use these resources to promote one's health and wellness health literacy correct answer: Man taking insulin asking him to read blood glucose level inferential statistics correct answer: numerical data that allow one to generalize- to infer from sample data the probability of something being true of a population Mood Disorder Questionnaire (MDQ)-SCREENING correct answer: Mood Disorder Questionnaire Patient Name ______________________________________ Date of Visit ________________ Please answer each question to the best of your ability 1. Has there ever been a period of time when you were not your usual self and... ...you felt so good or so hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? ...you were so irritable that you shouted at people or started fights or arguments? ...you felt much more self-confident than usual? ...you got much less sleep than usual and found that you didn't really miss it? ...you were more talkative or spoke much faster than usual? ...thoughts raced through your head or you couldn't slow your mind down? ...you were so easily distracted by things around you that you had trouble concentrating or staying on track? ...you had more energy than usual? ...you were much more active or did many more things than usual? ...you were much more social or outgoing than usual, for example, you telephoned friends in the middle of the night? ...you were much more interested in sex than usual? ...you did things that were unusual for you or that other people might have thought were excessive, foolish, or risky? ...spending money got you or your family in trouble? 2. If you checked YES to more than one of the above, have several of these ever happened during the same period of time? 3. How much of a problem did any of these cause you - like being unable to work; having family, money or legal troubles; getting into arguments or fights? No problems Minor problem Moderate problem Serious problem This instrument is designed for screening purposes only and not to be used as a diagnostic tool. Permission for use granted by RMA Hirschfeld, MD YES NO Patient comes with vague symptoms depression irritability correct answer: BECK Depression scale DISSEMINATED ENCEPHALOMYELITIS correct answer: Assess for asymmetry of extremities Along with this pattern, the patients usually get neurological symptoms which may include: Confusion, drowsiness, and even coma Unsteadiness and falling Visual blurring or double vision (occasionally) Trouble swallowing Weakness of the arms or legs Fever HA CBT (cognitive behavioral therapy) correct answer: Anxiety popular integrative therapy that combines cognitive (thinking) and behavior therapy Impulsivity (ADHD) correct answer: Pre-Frontal Cortex Involves hasty actions taken without consideration of possible negative consequences to self or others; it often shows up as a kind of social intrusiveness, such as excessively interrupting others. Patient shows symptoms of dizziness, tremors, sweating, What Medical Diagnosis correct answer: Hypogylcemia NSAIDS correct answer: Lithium toxicity Interferon correct answer: Causes depression Beck Depression Inventory (BDI) correct answer: Intimate therapy for a child with a score of 10 a questionnaire useful for determining the level of depressive symptoms that a person is reporting Zantac (ranitidine) correct answer: affects Flonase Pt on Lithium correct answer: Prescribe Synthroid Zantac (ranitidine) correct answer: H2 antagonist H2 BLOCKER Tegretol (carbamazepine) correct answer: INDUCES Flonase primary prevention correct answer: Actions that change overall background conditions to prevent some unwanted event or circumstance, such as injury, disease, or abuse. Secondary prevention examples correct answer: - Implement blood pressure and cholesterol screening; give a treadmill stress test. - Health screenings - Skin screenings for cancer - teach an asthmatic client to recognize and avoid exposure to asthma triggers and assist the family to implement specific protection strategies such as replacing carpets, keeping air systems clean and free of mold, staying inside when the pollution level is high, and avoiding pets. - mammography to detect breast cancer, Papanicolaou (Pap) smears to detect cervical cancer, colonoscopy for early detection of colon cancer, prenatal screening of pregnant women to screen for gestational diabetes - Provide mental health interventions after stressful events. - The public health nurse provides toxin screenings for migrant workers who may be exposed to pesticides. - Implement a family-planning program to prevent unintended pregnancies for young couples who attend the local community health center. - Encourage clients who are pregnant to participate in prenatal care and Special Supplemental Nutrition Program for Women, Infants and Children to increase the number of healthy babies and reduce the costs related to preterm baby care. - Use case finding to identify existing health problems in your caseload and the population served by your agency. Timely, holistic assessments and interventions can slow disease trajectories and promote healing and health. - Assess disaster victims and triage for care. - Investigate an outbreak of flulike illness in a local school. - Provide programs in child development and behavior management for families who have not yet abused their children but whose children are brought to the attention of social authorities for aggressive behavior problems. - Develop a way for homeless individuals to read their TB skin test, if necessary, and to transfer the results back to the facility at which the skin test was administered. - To prevent the spread of disease - Notify partners and trace contacts (HIV) Collab with OB NP questions correct answer: wants to establish a relationship so Mental Health can be reached by more people anorexia nervosa correct answer: BMI less than 18.5 an eating disorder in which an irrational fear of weight gain leads people to starve themselves Anorexia admission Criteria for hospitalization includes: correct answer: weight loss over 30% over 6 months, severe hypothermia (temperature lower than 36°C or 96.8°F), heart rate less than 40 beats per minute, systolic blood pressure less than 70 mm Hg, and hypokalemia (less than 3 mEq/L). Culture question: A man injects himself correct answer: "tell me more about the medications" Acute Stress Disorder (ASD) correct answer: can be 2-4 weeks a disorder resulting from exposure to a major stressor, with symptoms of anxiety, dissociation, recurring nightmares, sleep disturbances, problems in concentration, and moments in which people seem to "relive" the event in dreams and flashbacks for as long as 1 month following the event Scope of Practice in Nursing correct answer: State Standards of Practice correct answer: ANA ADPIE - Nursing Process correct answer: Assessment Diagnosis Planning Implementation Evaluation Adult panic disorder correct answer: Buspar Kids panic disorder correct answer: Clonidine Guafacine OCD (Obsessive Compulsive Disorder) correct answer: TCA Clomipramical Clomipramine (Anafranil) correct answer: OCD, depression (tricyclic) agoraphobia correct answer: fear of open spaces Agoraphobia treatment correct answer: *BZDs* - short term symptom relief *SSRIs* - long-term maintenance fluoxetine (Prozac) paroxetine (Paxil) sertraline (Zoloft) *SNRIs* - long-term maintenance venlafaxine (Effexor) *TCAs* - long-term maintenance imipramine social anxiety disorder correct answer: BetaBlocker Propanolol Tourette syndrome correct answer: involuntary, spasmodic, twitching movements; uncontrollable vocal sounds; and inappropriate words TICS for 1 year Has to occur by 18 years old Usually occurs by 3-9 years old Steroids correct answer: Cause mania Assertive Question (2) correct answer: Use "I want", "I need" or "I feel" to convey basic assertions and get your point across firmly. For example, "I feel strongly that we need to bring in a third party to mediate this disagreement." For example, you might say "Dave, your request has caught me off guard. I'll get back to you within the half hour." Testing for fungal infections correct answer: shavings of toes Pt on Lithium with temp, right flank pain, brown colored urine, What do you? correct answer: LFT Medication Management correct answer: By state and federal Kid with night mares screaming out doesn't remember the next morning what do you do correct answer: Ask about sleep disorder in family PT taking a breathing treatment albuterol/proventil correct answer: Do not take MAOI or TCA Pt in with Sob, Fatigue. When you assess the thinnest part of the skin , you notice s/s correct answer: Sensitivity correct answer: Sensitivity = TP / (TP + FN) Specifity correct answer: TN peer consultation correct answer: Mutual Benefit Critical and Supportive Shared discussion and accountability The regular engagement of two or more colleagues to give and receive feedback Tegretol (carbamazepine) correct answer: ANC/WBC Papleu correct answer: what nurses do WITH pts not TO pts - nurse as a therapeutic tool - therapeutic use of self - care for the person as well as the illness - think exclusively of patients as persons, not as a dx phases: 1. orientation 2. working 3. termination roles of the nurse - stranger - resource person - teacher - leader - surrogate - conselor Paplau's Interpersonal Theory correct answer: Process recording Give Ativan correct answer: For Alcoholic with Liver problems detailed physical exam correct answer: Pt states that God did this to me correct answer: Assess spiritual needs Mini-Cog correct answer: is another screening tool that can be administered in 5 minutes or less and requires minimal training. 3 item recall, clock drawing test (CDT) women in military and she saw her friend die correct answer: PTSD Man had appt, wife came and he didnt correct answer: Tell wife to reschedule appt Tagement (Cimetidine) correct answer: ^ Benzo ^ Coumadin Erythromycin correct answer: ^ Xanax levels Disulfiram correct answer: ^ Coumadin Pt with Eating disorder states getting full correct answer: Bloating delayed Gastric emptying Realiability correct answer: consistency Biggest Concern with EHR correct answer: Confidentiality Qualiatative correct answer: Measures in natural setting i.e ?, observation Quantitative correct answer: Data that is in numbers internal validity correct answer: Was research done right? extent to which we can draw cause-and-effect inferences from a study I don't know answers correct answer: pseudo dementia interferon correct answer: decrease Wellbutrin ^ prolactin correct answer: stop prolactin EPS correct answer: ^ risk for TD Assess when someone ready to quit drinking correct answer: See what stage they in Ask when ready to start tx To check for Dementia correct answer: Have the patient tell you risk/benefits test capacity dairy log correct answer: CBT treating a 6 y/o pt WHO HAS dx with Luekemia 1 month ago. What do you expect correct answer: He would think he is being punished fro doing something wrong antidepressant takes correct answer: 5 weeks 13 year old want to smoke correct answer: ask him of his plan to stop smoking placement of chronically mental ill correct answer: ACT Assertive Community Treatment Assertive Community Treatment (ACT) correct answer: community-based programs that provide many of the services that are necessary for successful community living; includes case management, problem-solving, social skills training, support, teaching on a 24/7 basis BRUISE on the padded part of his arms correct answer: Say I see you have bruises on your arm Ask what happened medication errors on a new floor when NP starts working. correct answer: educate the staff on policies on how to handle med errors. ECT THERAPY correct answer: GET CERTIFIED lesion in frontal cortex correct answer: Impaired cogitate functions child in foster homer 5 years poor eye contact, isolated self, eat without difficulty correct answer: autism A man states his wife was so good if he could only be like her. what is this correct answer: Intellectualization or deflecting rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. correct answer: decreased gastric motility check measure the stomach Tagement (Cimetidine) correct answer: Prevents acid from backing up into the esophagus and causing heartburn Pt moving to another state correct answer: Give enough meds Pt on Zoloft BMI 26 correct answer: BMI Sildenafil (Viagra) correct answer: 1 hour prior to sex Tadalafil (Cialis) correct answer: 45 minutes prior to sex Vardenafil (Levitra) correct answer: 45 minutes prior to sex Avanafil (Stendra) correct answer: 15 minutes prior to sex Alprostadil (PGE1) correct answer: • Ductal-dependent Congenital Heart Disease (all forms) • 0.05-0.1 µg/kg/min IV/IO infusion initially, then 0.01-0.05 µg/kg/min IV/IO Females more likely to become an alcoholic than man correct answer: due to hormones Apoptosis correct answer: cell death in aging/elderly solution therapy correct answer: conducted through direct observation of clients' responses to a series of precisely constructed questions. Np wants to implement a certain policy in nursing. correct answer: start with nurse manager Turner Syndrome correct answer: A chromosomal disorder in females in which either an X chromosome is missing, making the person XO instead of XX, or part of one X chromosome is deleted. delayed puberty, short id, 10-16 years old amenorrhea web neck, osteoporosis, lymphemeda, poor social skills Prozac causes what? correct answer: increased anxiety in elderly Prazosin (Minipress) correct answer: nightmares ACE inhibitors correct answer: HTN Recovery Model correct answer: A model that is patient/consumer-centered, is hopeful and empowering, and emphasizes the person and the future rather than the illness and the present. Recovery Model Intervention correct answer: motivational interviewing correct answer: a collaborative, person-centered form of guiding to elicit and strengthen motivation for change MOTIVATIONAL INTERVIEWING correct answer: MAY WE TALK ABOUT YOUR TEST SHOWS YOU ARE VERY COURAGEOUS YOU WANT TO CHANGE, BUT LETS SEE IF I GOT IT KIDS receive to many calories ue to staff letting him eat food correct answer: Meet with dietiacan , discuss with manager Moro until 4 months, Palmer until 4 months, Plantar util 8 months, Babinski (2 years is disease) correct answer: Reflexes expected at 1 month small head, shoey palpebral fissure, inner epicanthal folds. Do IEP and early intervention specialist correct answer: Signs of fetal alcohol syndrome a rare disorder found virtually exclusively in girls, is a neurodevelopmental disorder in which the child usually develops normally unitl about 6 to 18 months of age at which characteristics of the syndrome emerge; characteristics include: hypotonia (loss of muscle tone), reduced eye contact, decelerated head growth, and disinterest in play activities correct answer: Rhett Syndrome Tardive dyskinesia happen after years (eps is a precursor). Acute dystonia (hours), Parkinsons (weeks), Akathisia (days) correct answer: EPS types nigrostiatal tract. correct answer: Where do EPS originate Fluoxetine correct answer: FDA approved antidepressant for children and adolescents SSRI inhibit cytochrome P-450 correct answer: Which class of antidepressant is a potent inhibitor cipro and erythromycin are inhibitors. Cause increased level of Tegretol. Black box warning correct answer: How does tegretol interact with cipro Aplastic anemia, agranulocytosis, steven johnsons, hyponatremia. Watch with cipro and erythro correct answer: Tegretol side effects stiffness in cervical neck area, meningitis correct answer: nuchal rigidity -pril, CHF correct answer: ACE inhibitors -shivering -anxiety -diaphoresis -hyperthermia Shits and Shivers diarrhea, shivering, hyperreflexia/myoclonis, increased temperature, vital sign instability, encephalopathy, restlessness, sweating correct answer: signs of serotonin syndrome syndrome caused by abrupt withdrawal of an antidepressant drug, resulting in sensory disturbances, sleeping disturbances, disequilibrium, flu-like symptoms, dizzy, vertigo, paresthesia (brain zaps), nausea/vomiting, and gastrointestinal effects correct answer: Serotonin Discontinuation Syndrome neuroleptic malignant syndrome *S*evere fever *C*hanging LOC *A*utonomic instability *R*igidity *S*weating and drooling FEVERS- fever, encephalopathy, vitals instability, elevated white blood cell count/cpk, rigidity correct answer: NMS Primary: prevent/promotion, classes, safety initiatives, education, classes, modifying environment Secondary: screen-early detection, crisis hotlines, disaster Tertiary: treat- to prevent further deterioration, rehab, restoration, day treatment, social skills correct answer: Levels of Prevention more than 1 SSRI, st johns wart, tramadol, demerol, ultram, maperidone, 5HT correct answer: Risk factors for serotonin syndrome aortic stenosis correct answer: Grade 2/5 hoarse systolic heart murmur stop benzos because can cause floppy baby syndrome and cleft palate, cotinue buspar correct answer: Woman with GAD advise on medication IM Geodon correct answer: What to give to agitated pt in seclusion Folic acid, vitamin B12, ESR/CRP, HGB, MCV (liver) correct answer: Labs for macrocytic anemia 1 hour then 8 hours correct answer: When to assess a patient in restraints for face/face open ended, 'tell me' correct answer: therapeutic communication open ended questions correct answer: Reluctant/silent patient both people need to be present, reschedule correct answer: Patients husband shows up but not the patient Hip disease, refer child out, assessed during head to toe correct answer: Abnormal Trendelenburg Test i. Severe 19- 23 (monitor for SI) ii. Moderate 14 - 18 iii. Mild 8 -13 0-7 normal correct answer: Hamilton Depression Scale More than 15 severe correct answer: GAD-7 scale Hamilton Anxiety Scale, most commonly used 14 domains, 14=mild, 18-24= moderate, 25-30=severe Anxiety 25/15 severe correct answer: HAM-A comes from the state, board of nursing/american nurse association correct answer: Scope of practice Able to repeat back risks and benefits elements= nature/pupose of tx, risks/benefits of tx, risks/benefits not doing tx, alternatives, diagnosis/prognosis correct answer: Elderly patient with dementia how do you know id can give consent send enough medication is standard of practice correct answer: Patient moving states, what do you do with medication? refers to an organization's commitment to accountability and a focus supporting universal safety in health care. Find out the error ad where went wrong correct answer: just culture Ace inhibitors and ARBs together correct answer: 2 classes of medications that should not be used together? ACT model correct answer: Keeping chronically mentally ill in the community? Parity Laws correct answer: Law that makes sure people with mental health issues get the same financial treatment? make sure that he is not left alone with her and call CPS, mandatory reporter, arrange crisis therapy correct answer: Brother sexually abusing sister male with more than one X chromosome (XXY), little to no sperm, fertility treatment correct answer: Kleinfelter's Syndrome If less than 950 discontinue the medication and get a repeat level, 1000 is the cutoff 1.5-2 cbc biweekly 1-1.5 hold, cbc q dayx 3 weeks less than 1- Stop medication 12.5initial, target 300-900mg/d once or bid schizophenrenia/pscyhosis agranulocytosis, seizures, myocarditis (inflammed heart muscle -chest pain,diff breath) wg, increase lipids/glucose REMS pharmacy need clozaril registry to dispense to start: WBC must be >_3500 and ANC >_2000 WBC + ANC weekly q6months, then every 2w q6months, then monthly correct answer: clozaril wbc+anc . ESR erythrocyte sedimentation rate elevation. Synovial fluid analysis. X ray of joints. Rheumatoid factor titer, CRP, Hgb correct answer: Labs for rheumatoid arthritis prazosin correct answer: PTSD nightmares reaction to a specific life event (identified stressor), symtoms within 3 monhts but no more than 6 months. Think about a patient move correct answer: adjustment disorder Synthesized in locus coeruleus arousal and other functions like mood, hunger, and sleep correct answer: Norepinephrine (NE) a small nucleus in the reticular formation that is involved in directing attention correct answer: locus coeruleus raphe nucleus correct answer: 5HT a string of nuclei in the midline of the midbrain and brainstem that contain most of the serotonergic neurons of the brain correct answer: raphe nuclei midbrain structure where dopamine is produced; involved in control of movement correct answer: substantia nigra substantia nigra and ventral tegmental area correct answer: dopamine production midbrain structure where dopamine is produced: associated with mood, reward, and addiction correct answer: ventral tegmental area (VTA) nucleus basalis of meynert correct answer: Acetylcholine (ACh) Alzheimer disease cognitive and memory function correct answer: Nucleus basalis of Meynert P: Population/problem I: Intervention/issue C: Comparison O: Outcome T: Time correct answer: PICOT Increased cranial pressure correct answer: shrill cry Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. OCD- recent strep throat correct answer: PANDAS Acute stress disorder- less than 1 month PTSD- after 1 month correct answer: PTSD steroids/prenisolone, antabuse, isoniazid, correct answer: Medicine that can cause mania ask family if anyone else has sleep problems correct answer: patient wakes up screaming at night OCD/trichotillomania correct answer: pulling hair out CPT current procedural code correct answer: how do you get paid for medicare perform an MRI, labs to rule out substances correct answer: patient in hospital with no family and failing cognitive test Check TSH. correct answer: Patient cold what labs to get? Cyproheptadine correct answer: What medication to give for serotonin syndrome Dantrolene and bromocriptine correct answer: Medication for NMS? from 25-100, 25-49 is normal, 70+ is severe correct answer: Zung scale Eight, separate, self-report inventories designed to assess different areas. Scores from 0-63 over 30 is severe correct answer: Beck Scales score 1-27, over 20 is severe correct answer: PHQ9 70, 30, 20, 25 correct answer: zung, beck, PHQ9, HAM State and Federal, PMP correct answer: DEA regulation monitoring Stimulation of the amygdala results in augmented aggressive behavior hypothalamus, is believed to serve a regulatory role in aggression correct answer: Aggression in brain Acute Stress Disorder, as it happened less than 1 month ago correct answer: nurse attacked 3 weeks ago and now scared to go to work Phallic stage is normal 3-6 years old correct answer: masturbating 3 year old check testosterone level correct answer: Elderly female with decreased sex drive increased access to mental health access correct answer: OB/PMHNP in same clinic -NMS is like S&M; -you get hot (hyperpyrexia) -stiff (increased muscle tone) -sweaty (diaphoresis) -BP, pulse, and respirations go up & -you start to drool correct answer: NMS increased CPK, WBC correct answer: NMS labs monitor for toxicity, toxicity=1.5, nausea, vomiting correct answer: Lithium level is 1.4 1.5, 3 is an emergency, severe diarrhea/nausea/vomiting, metallic taste, tremor, slurred speech, number one intervention, give fluids, sweating give electrolytes too correct answer: Lithium toxicity can double lithium levels correct answer: NSAIDs & ACE inhibitors effect increases the serum level of lithium up to double correct answer: ibuprofen + lithium 4+ protein in urine, Leukocytosis, creatinine, BUN, Na, correct answer: Lab values concerning for patients on lithium Erythromycin is an inhibitor (H=high level). If on Tegretol and Erythromycin together would want to reduce the dose of Tegretol correct answer: Erythromycin and Tegretol Normal tanner stage, start by 16 correct answer: 14 year old with no axillary hair, has not gotten her period yet Interferon can cause depression, increase Lexapro correct answer: On Interferon and Lexapro can cause depression and birth defects correct answer: Accutane stop or decrease the medication, tubin tract correct answer: Patient on risperdal and elevated prolactin dopamine and gaba correct answer: Neurotransmitters involved in alcoholism Insomnia and tremor, irritability, weight loss, nervous, hypertension, tachycardia correct answer: Patient abusing stimulants, what does NP assess for refeeding syndrome causes delayed gastric emptying correct answer: Anorexic teenager with pain when eating 0-63, over 30 severe, dont start medication just start therapy correct answer: Beck inventory score of 10? stimulant and therapy together correct answer: Treatment for ADHD may experience an increase in anxiety in elderly, expect increased side effects, do an EKG correct answer: 65 year old started on a SSRI Antacids, can decrease antispsychotic effects correct answer: What medication can alter absorption of antipsychotics? check LFT, correct answer: Dark brown urine Tardive dyskinesia correct answer: Person with EPS will most likely experience what neuron loss because of suffocation, enzyme breakdown correct answer: Apoptosis? conversion syndrome, repression of unconscious intrapsychic conflicts correct answer: Patient lost a friend now experiences paralysis depression, not dementia correct answer: patient continues to say "I dont know" 24-30 no cognitive impairment 18-23 mild cognitive impairment 0-17 severe cognitive impairment correct answer: MMSE scores memory, inattention, concentration changes, worry over decreased cognition correct answer: Early signs of aids dementia A form of dementia characterized by personality changes/social changes , correct answer: Frontal lobe dementia delirium correct answer: Wandering, disoriented person on the streets for 2 days quality correct answer: The health care policy is access, cost and ____ formulation, implementation, evaluation correct answer: Phases of policy making Tegretol (inhibitor) correct answer: Flonase interacts with what mood stabilizer? decrease the level of Zyprexa, smoking is an inducer causing decreased levels of the medication. When stop smoking re-increase the medication correct answer: Smoking cessation and antipsychotic CN 5 Trigeminal (masseter or masticatory muscle). correct answer: Clenched teeth? CN 7 facial (sensory and motor) correct answer: Puff cheeks Increase the dose after 1-2 weeks, therapeutic effects 4-6 weeks correct answer: Started on a medication then comes back in 2 weeks? H2 inhibitor correct answer: Zantac is for what? CBT, all or nothing thinking catastrophic thinking Humanistic therapy-self Existential- reflection/self control/personal responsibility correct answer: Best therapy for negative thinking DBT, goal to decrease emotional reactivity/crisis bxs and self validation. correct answer: Patient is borderline and suicidal what therapy? fairly common in children and will often remit on its own, ADHD concomittant correct answer: Tics what advise? help the parents with positive reinforcement and parenting skills, limit setting, logical consequences, consistency, power stuggle/control issues problematic, parenting/family dysfunction exacerbates correct answer: ODD child scrape toenail and sent for testing correct answer: Fungus on toenial 25-35 correct answer: Age for schizophrenia female "tell me how the medication works in your body" correct answer: bipolar not taking medication Alpha 2 delta, pregabalin- lyrica correct answer: patient has neuropathic pain, what medication will help? gabapentin not helping consider cost and revenue, must calculate the time spent with patient vs time spent on risk called indirect vs direct processing correct answer: When opening independent practice correct answer: Can disclose info to medicare /CMS without consent lithium correct answer: First line neuro-protective for bipolar check HCG, blackbox for pregnancy, can cause spinal bifida-tetrogenic, also check LFTs, CBC correct answer: What to check in terms of depakote in young girl correct answer: assertive inquiry strengths and competencies. What is being done currently and assessment of strenghts, no problem focused, 3 steps are discovery, understanding, amplifying correct answer: Appreciate Inquiry collaborate with ER to provide a psych assessment correct answer: Np notices teen with DKA leaving without eval proverb interpretation, abstract vs concrete interpretations correct answer: MMSE part for thought disorder to teens in order to normalize the grieving process correct answer: Teen commits suicide, NP does presentation educate friends/peers correct answer: To reduce stigma among teens seeking mental health... best assessment is mood questionnaire for bipolar, 7/13 bipolar likely correct answer: Experiencing irritability/depression/edginess? Licensing jurisdiction for the np correct answer: Telemedicine asking a legal question?? urine is red colored- hematuria, concerned for rhabdomyolysis (muscle breakdown), correct answer: Adolescent with substance abuse and working out has muscle aches ability to manage a checkbook, instrumental ADLs go first (meds, phone, drive, house week, balancing check book), then ADLs eating/dressing, Exec functions=judgement, planning, taxes correct answer: What are you looking at when you are assessing the function of an elderly individual large waist circumference correct answer: First symptom of metabolic syndrome? this is normal, repetitive patterns of bx, impaired social interactions, verbal/nonverbal communication common correct answer: Autistic child not responding to your verbal commands stop and address her anxiety correct answer: Women is anxious about administering medication to a child tests looking at reticulocytes hep evaluate conditions affecting RBCs such as anemia, low reticulocytes may be seen with iron deficiency anemia, pernicious anemia, folic acid deficiency, aplastic anemia correct answer: Why would you be concerned about immature retuculocytes? lithium correct answer: First line neuro-protective for bipolar correct answer: What medication can alter absorption of antipsychotics?