ANCC PMHNP Exam Prep questions and answers verified for accuracy 2023 update

mesocortical pathway executive function: attention, focus, depression nigrostriatal pathway from substantia nigra (brainstem) to striatum (muscles): Parkinson's mesolimbic pathway projects to nucleus accumbens (part of limbic system). Pleasure, reward, positive symptoms of schizophrenia: Addiction, gambling Tuberoinfundibular pathway regulation of prolactin (acts on pituitary). Hypersexuality in mania Dopamine produced in substania nigra and VTA. D2 & D4 receptors most important. Elevated in the mesolimbic pathway associated with pleasure and psychosis. Antispychotics block dopamine. travels through mesocoritcal, mesolimbic, nigrostriatal, and tuberinfundibular pathways Serotonin 5-HT. produced in raphe nucleus. emotion, impulses, dreams. 5HT2A receptors = atypical antipsychotics. Norepinephrine produced in locus coeruleus. arousal and vigilance GABA inhibitory. produces calm in conjunction with benzodiazepines. ACTH motor control, learning, memory, sleep, and dreams. Helps with balance. Decrease in Alzheimer's disease hypothalamus-pituitary-adrenal axis (HPA) CRH, ACTH, then cortisol. Worsens with stress and depression hypothalamus-pituitary-thyroid (HPT) TRH, TSH, T4. Hypothyroid causes depression, weight gain, slow metabolism. Hyperthyroid is opposite. hypothalamus-pituitary-gonadal (HPG) GnRH, FSH, LH. Malfunctions cause infertility problems. gray matter neurons are found frontal lobe executive function, voluntary movement, speech (Broca's area) Temporal lobe memory, cognition, speech, emotions (aka limbic area) parietal lobe receive and process sensory input Wernicke's area temporal and parietal lobes; speech amygdala fear response. hippocampus memory. Make up limbic system with amydgala HIPAA 1. education about privacy protection, 2. access to own medical records, 3. request amendment to health information to which they object, 4. require permission for disclosure of medical issues forensic nursing based on crime committed and investigational aspects correctional nursing offender's current mental health and medical condition research utilization process critique, synthesize, apply, measure PICO question patient, intervention, comparison, outcome internal validity when the independent variable (treatment) caused a change in the dependent variable (outcome) external validity when the sample is representative of the population and the results can be generalized descriptive statistics used to describe the basic features of the data in the study standard deviation indication of the possible deviations from the mean variance how the values are dispersed around the mean - the larger the variance, the larger the dispersion of scores inferential statistics numerical value that enable one to reach conclusions that extend beyond immediate data alone - generated by quantitative research designs t-test assess whether means of 2 groups are statistically different from each other ANOVA analysis of variance - tests difference of 3 or more groups Pearson's r-correlation relationship between 2 variables probability 0-1: likelihood of an event occurring p value level of significance: describes the probability of a particular result occurring by chance alone HOPE sources of hope, organized religion, personal spirituality, effects on medical care/end of life OLDCARTS for HPI onset, location, duration, character, alleviating/aggravating factors, radiation, time of occurrence, severity Cranial Nerves Olfactory, optic, ocular motor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, accessory spinal, hypoglossal dysdiadochokinesia inability to perform rapid alternating movements (finger to thumb), cerebellar lesion astereognosis inability to distinguish objects (such as paperclip) based on touch, parietal lesion Free T4 0.8-2.8 TSH 0.4-0.5 - decreases when T3 & T4 are high, increases when T3 & T4 are low. Elevated in primary hypothyroidism. Values may decrease with aspirin, steroids, and heparin. Values may increase with lithium. calcium 8.8-10.5. 99% found in bone. major cation for bones and teeth. higher in kids because of bone growth. sodium 135-148 magnesium 1.3-2.1. chloride 98-106 potassium 3.5-5.1. value decrease with lithium, diuretics. marijuana use can elevate K ALT 5-35. AST 5-40 GGT gamma glutamyl transpeptidase - 10-38. Used to evaluate alcohol abuse because levels rise after only a small ingestion of alcohol. teratogenic risks of benzodiazepines floppy baby, cleft palate teratogenic risks of tegretol neural tube defects teratogenic risks of lithium Epstein anomaly teratogenic risks of depakote neural tube defects such as spina bifida Rogers Humanistic theory: person centered therapy Beck CBT Lazarus Behavioral therapy Marsha Linehan DBT Frankle Existentialism: reflection on life and encouragement of self-confrontation. "Why am I here? What is my purpose?" Klerman and Weissman Interpersonal therapy: time limited, problem focused Shapiro EMDR: used to treat PTSD Yalom Group therapy: 10 guiding principles for group Bowen Family systems theory Minuchin Structured family therapy Satir Experiential therapy: behavior is determined by personal experience. Focus is on being authentic Haley Strategic therapy: symptoms are metaphors and reflect problems in the hierarchal structure deShazer, O'Hanlon, Berg Solution-focused therapy: miracle questions, exception finding questions, scaling questions PANDAS pediatric autoimmune neuropsychiatric disorders associated with strep: consider with children who have OCD symptoms