PMHNP EXAM QUESTIONS AND ANSWERS

PMHNP EXAM QUESTIONS AND ANSWERS 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 ANSWERHLAB-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 ANSWERNo. 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