Georgette's LMR; Georgette's PMHNP Certification Exam Review 2023 V2.

Georgette's LMR; Georgette's PMHNP Certification Exam Review 2023 V2 What should you not do when advocating for a patient? {{Ans- Judge or confront What class of medication is contraindicated with tics? {{Ans- Stimulants What should you provide for prior to assessing abuse victims? {{Ans- A safe environment What are your actions if a child reports abuse? {{Ans- First interview separately from parents then report to CPS What should you do if a child plays with toys in a way that you suspect abuse? {{Ans- Report to CPS In what setting as an inpatient provider should you interview a patient? {{Ans- Use a private room with the door partially open How should you begin your interview with adolescents? {{Ans- By building rapport with them by ensuring confidentiality absent exceptions Should you interview adolescents with or without parents? {{Ans- Without What if an adolescent tells you they are homosexual and they don't want their parents to know? {{Ans- This is confidential The patient is being discharged and would like their labs faxed to the rehab facility. What is your initial action? {{Ans- Get informed consent/ROI What do you do if a medical evaluation is needed? {{Ans- Refer out - this is out of scope What do you do if a patient is takes something and is feeling really funny/unwell in your office? {{Ans- Collect UDS and then refer out Is it considered a mental illness if it is an expected response culturally? What do you offer as treatment? {{Ans- No; brief supportive therapy - not medication A mother states her child is experiencing a cultural illness. What is your initial action? {{Ans- Respect the mother's cultural understanding of illness prior to assessment Native Americans view mental illness and SUDs as? {{Ans- An imbalance between the individual and the world What ethnic group has the highest rate of suicidality in the US? {{Ans- Native Americans If a patient believes they need a healing stick in their room, but the staff nurses removed it from them - what should you do? {{Ans- Teach cultural sensitivity and make accommodations for patient to have healing stick available such as 1:1 Psychoeducation should be based on? {{Ans- Cultural context How do you promote health in a location with multiple ethnicities and education levels? {{Ans- Multiple cultural education and ethnospecific assessment parameters What if a patient wants a traditional healer? {{Ans- Allow this - remember ROI/informed consent Normal TSH? {{Ans- 0.5-5.0 TSH < 0.5 = ? {{Ans- Hyperthyroidism TSH > 5.0 = ? {{Ans- Hypothyroidism Relationship between TSH & T3/T4? {{Ans- Inverse Hyperthyroidism can present as? {{Ans- Mania Hypothyroidism can present as? {{Ans- Depression Normal depakote level? {{Ans- 50-125 Toxic depakote level? {{Ans- 150+ Birth defect caused by depakote? {{Ans- Spina Bifida S/S of depakote toxicity? {{Ans- Disorientation, lethargy, decreased respiratory rate, and N/V What to do if there is depakote toxicity? {{Ans- D/C depakote and check VPA level, LFTs, and ammonia S/S of hepatotoxicity? {{Ans- RUQ pain, reddish brown urine, jaundice, fatigue, and elevated LFTs Normal AST? {{Ans- 5-40 Normal ALT? {{Ans- 5-35 Kava kava can cause? {{Ans- Liver damage and heavy sedation Kava kava is c/i with? {{Ans- Benzos or sedatives Mood stabilizer most associated with SJS? {{Ans- Lamictal Mood stabilizer with least weight gain? {{Ans- Lamictal SGAs with least weight gain? {{Ans- ziprasidone, abilify, and latuda Least sedating SGA? {{Ans- Abilify Routine labs with SGAs? {{Ans- BMI, hip to waist ratio, glucose, A1C, and lipid panel Management of metabolic syndrome with SGAs? {{Ans- 1. Nonpharm = exercise or nutritional counseling 2. Pharm = switch to other SGA with lower chance of metabolic syndrome Carbamazepine can cause? {{Ans- Agranulocytosis and aplastic anemia What should you screen for prior to starting Asians on carbamazepine and why? {{Ans- HLAB1502 Allele; risk of SJS When should you d/c carbamazepine if agranulocytosis is suspected? {{Ans- If ANC is < 1000 with or without s/s of infection Lithium range? {{Ans- 0.6 - 1.2 What to do if lithium is 1.3 or 1.4? {{Ans- Monitor What to do if lithium is 1.5+? {{Ans- D/C Benefits of lithium? {{Ans- Gold standard for mania, neuroprotective, and antisuicidal effects S/S of lithium toxicity? {{Ans- Severe N/V, polydipsia, polyuria, leukocytosis, palpitations, coarse tremor What to do if lithium toxicity is suspected? {{Ans- D/C and check serum levels prior to checking VS