PMHNP Tessy Exam Questions and Answers with Verified Solutions 2023

Reflexes expected at 1 month - Moro until 4 months, Palmer until 4 months, Plantar util 8 months, Babinski (2 years is disease) Signs of fetal alcohol syndrome - small head, shoey palpebral fissure, inner epicanthal folds. Do IEP and early intervention specialist Rhett Syndrome - a rare disorder found virtually exclusively in girls, is a neurodevelopmental disorder in which the child usually develops normally unitl about 6 to 18 months of age at which characteristics of the syndrome emerge; characteristics include: hypotonia (loss of muscle tone), reduced eye contact, decelerated head growth, and disinterest in play activities EPS types - Tardive dyskinesia happen after years (eps is a precursor). Acute dystonia (hours), Parkinsons (weeks), Akathisia (days) Where do EPS originate - nigrostiatal tract. How does tegretol interact with cipro - cipro and erythromycin are inhibitors. Cause increased level of Tegretol. Black box warning Tegretol side effects - Aplastic anemia, agranulocytosis, steven johnsons, hyponatremia. Watch with cipro and erythro nuchal rigidity - stiffness in cervical neck area, meningitis ACE inhibitors - -pril, CHF signs of serotonin syndrome - -shivering -anxiety -diaphoresis -hyperthermia Shits and Shivers diarrhea, shivering, hyperreflexia/myoclonis, increased temperature, vital sign instability, encephalopathy, restlessness, sweating Serotonin Discontinuation Syndrome - syndrome caused by abrupt withdrawal of an antidepressant drug, resulting in sensory disturbances, sleeping disturbances, disequilibrium, flu-like symptoms, dizzy, vertigo, paresthesia (brain zaps), nausea/vomiting, and gastrointestinal effects NMS - neuroleptic malignant syndrome *S*evere fever *C*hanging LOC *A*utonomic instability *R*igidity *S*weating and drooling FEVERS- fever, encephalopathy, vitals instability, elevated white blood cell count/cpk, rigidity Levels of Prevention - Primary: prevent/promotion, classes, safety initiatives, education, classes, modifying environment Secondary: screen-early detection, crisis hotlines, disaster Tertiary: treat- to prevent further deterioration, rehab, restoration, day treatment, social skills Risk factors for serotonin syndrome - more than 1 SSRI, st johns wart, tramadol, demerol, ultram, maperidone, 5HT Grade 2/5 hoarse systolic heart murmur - aortic stenosis Woman with GAD advise on medication - stop benzos because can cause floppy baby syndrome and cleft palate, cotinue buspar What to give to agitated pt in seclusion - IM Geodon Labs for macrocytic anemia - Folic acid, vitamin B12, ESR/CRP, HGB, MCV (liver) When to assess a patient in restraints for face/face - 1 hour then 8 hours therapeutic communication - open ended, 'tell me' Reluctant/silent patient - open ended questions Patients husband shows up but not the patient - both people need to be present, reschedule Abnormal Trendelenburg Test - Hip disease, refer child out, assessed during head to toe Hamilton Depression Scale - i. Severe 19- 23 (monitor for SI) ii. Moderate 14 - 18 iii. Mild 8 -13