ANCC PMHNP Exam Questions With Answers (Question Bank) | Latest Updated 2023/2024 (GRADED)

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: SelfReport - 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