PMHNP exam prep questions and answers(verified for accuracy).

The NP is completing an intake interview with a 24 yo female with a hx of depression and anxiety. When discussing med options the pt states she is newly married and is trying to get pregnant. You discuss starting buspar dt "animal reproduction studies having failed to demonstrate a risk to fetus and no adequate and well-controlled studies to show the drug to cx birth defects if used in pregnant women." Which FDA est category to indicate potential risk of a drug to cx birth defects in pregnancy did the NP describe to this pt? A. Category A B. Category B C. Category C D. Category D B. Category B Category B described as animal reproduction studies have failed to demonstrate a risk to the fetus and there being no adequate and well-controlled studies to show the drug to cx birth defects if used in pregnant women. Pt taking selegiline may test urine positive for which drug? A. Benzo B. meth C. marijuana D. cocaine B. methamphetamine selegiline is metabolized by the body into I-methamphetamine and I-amphetamine. Selegiline is a substituted phenethylamine used for the tx of early-stage Parkinson's disease, depression, and dementia. In normal clinical doses, it is a selective irreversible MAO-B inhibitor. However, in larger doses it loses its specificity and also inhibits MAO-A. What is the best strategy to stop clonidine? A. increase dose, then taper B. Gradually decrease dose C. Change to another adrenergic blocker, then taper gradually D. stop at once B. gradually decrease dose. Discontinuation should be gradual to avoid rebounding autonomic sx of hypertensive crisis that have been reported in hypertensive pt who were suddenly withdrawn from the drug A np has a pt in his practice who has a hx of bipolar d/o and is tx with lithium. During a routine exam, the np decides to check a lithium level and it is elevated, but the results do not return to clinic until 2 days after pt visit. The NP calls pt with results. Which of the following is true? A. np should leave msg on answering machine with the abnormal results B. np can only leave msg with pt spouse or other family member if pt is not home C. np should leave msg with contact number for pt to call back D. access psych records cannot be denies to a pt C HIPPA rules are designed to protect the privacy of pt and their confidential medical info. Pt consent is required before releasing pt info to third parties, except in specific circumstances (having to do with third-party payers, reportable dx, minors). No one may receive info unless written consent for release is signed. Pt can be denies access to their psychotherapy records. You are asked to obtain consent for a LP from a 17yo female with suspected meningitis in the ER. The procedure will be performed under a fluoroscope, and the radiologist feels the pt is competent to make her own medical decisions. When you explain the procedure to the pt, she is disoriented and delirious. She is away from family, and you are unable to contact her parents who live in a different town. Which of the following is most appropriate? A. have pt sign consent form B. Cont to call pt parents to get consent C. Do LP and tx pt since she requires emergency care for a condition that could endanger life and limb D. call another close relative for consent if parents cannot be reached C Consent for emergency care is implied in the ER. If pt was not able to give informed consent d/t illness, the NP should proceed with procedure and tx. The dx will be made by LP so it would be inappropriate to guess and subsequently make decisions about whether suspected meningitis is bacterial or viral. Bacterial meningitis is one type of life-threatening emergency situation that may be tx even if the pt is not able to understand the procedure, unless there is a prior instruction or proxy appointed to make decisions when the pt is incapacitated. In those cases, the proxy is expected to make decisions based on the best knowledge of the pts healthcare preferences Acamprosate structurally resembles which neurotransmitter? A. serotonin B. GABA C. Dopamine D. norepinephrine B. GABA acamprosate structurally resembles GABA. It is modestly superior to placebo. A combination of naltrexone and acamprosate is more effective than either drug used alone In a therapy session, the pt states that "I get turned down for every job bc I'm overqualified." The therapist replies, "there are fewer jobs that call for your high level of education." What strategy does the therapist's reply demonstrate? A. Rationalizing B. Reframing C. Minimization D. Projection B. Reframing The therapist has reframed the situation to make the pt feel better. The statement by the therapist might also be considered "reducing distortion", as the therapist changes the patient's statement from "every job" to "fewer jobs". A. rationalizing by a therapist involves a comment that explains unacceptable impulses or behavior. C. minimization is a strategy the therapist uses to allow the patient to acknowledge some affect D. projection is a primitive defense mechanism put forth by ego psychology Which of the following is the most widely used tool for assessing the healthcare safety culture within an organization? a. vha culture survey b. premier data tool for managing results of AHRQ culture survey c. culture of patient safety assessment developed by AHRQ d. westat patient safety culture improvement tool c. culture of patient safety assessment developed by AHRQ This tool consists of three surveys on pt safety culture, including the nursing home survey on pt safety culture; the medical office survey on pt safety culture; and the hospital survey on pt safety culture. Healthcare organizations can use these tools to assess pt safety culture and track changes over time. They can also be used to evaluate the impact of pt safety interventions The NP is conducting a research study using pts in practice. He knows that which of the following are members of a vulnerable population? a. a 20yo man b. a prisoner c. adult with personality do d. man with testicular ca b. a prisoner A prisoner may feel that they have no choice as to whether or not to participate in research and may feel that they can gain privileges only if they participate A 19yo male presents with facial numbness and bl vision loss. He reports tingling, cold feet with bluish discoloration. His symptoms most likely resulted from inhalation of which substance? a. elemental mercury b. n-hexane c. acrylamide d. carbon disulfide B. n-hexane n-hexane exposure is most commonly due to recreational inhalation of household glues. It is metabolized to 2, 5-hexanedione, which has neurotoxic effects. These effects are potentiated by methyl ethyl ketone, which may also be contained in adhesives. Acute exposure leads to CNS depression. Repeated glue inhalation may cause "glue-sniffer neuropathy", a progressive, symmetric, ascending, sensorimotor, peripheral axonopathy. Motor sx may be predominant and similar to Guillain-Barre syndrome. The neuropathy may be associated wtih autonomic dysfunction, including bluish discoloration and decreased temp of the involved extremities. This neuropathy has been referred to as "central-peripheral-distal axonopathy, as it may also have central effects and lead to spasticity. Other symptoms may include facial numbness, maculopathy, and optic nuropathy. Coasting may occur when sx continue to worsen for some period of time following cessation of exposure. A. elemental mercury contained in dental fillings and thermometers , for example, may be inhaled. he liquid form may be ingested. Inhalation may result in "erethism," consisting of gingivitis, tremor, and behavioral changes. C. acute toxicity due to acrylamide (chemical used in ore processing, wastewater management, gel chromatography, and certain foods) leads to encephalopathy and ataxia. Acute exposure may also lead to delayed neuropathy. Chronic toxicity is marked by progressive, symmetric, large-fiber, axonal,