Georgette's
Test taking strategies Correct answers - read carefully and use info
provided by
examiner to answer
question
- narrow down options to 2 possible right
answers
- partially correct answers are not the correct
answers
- when 2 answer choices are the opposite of one another, one is usually
the correct
answer (hypoglycemia vs
hyperglycemia)
- the right answer might use the same word as the test
question
- we do not do medical evals, correct answer would be to refer in
-this
whencase
many response choices are remarkably similar, they are
usually wrong
Order of importance Correct answers - questions that use adjectives like
priority and test abilify to
initial action
prioritize
- most important is airway, breathing, and
circulation
- second is maslow's heirarchy of needs (physical needs, food, water,
warmth, rest,
safety,
security)
- then the nursing process (assessment before
intervention).
Assessment Correct answers collecting data to support the problem
towards a SAFETY BEFORE
resolution.
ASSESSMENT
Tics Correct answers If tics are noted, stimulants are
contraindicated
Safety Correct answers Safety for the patient and other is usually the
right answer.
Safety
first.
Abuse Correct answers If a patient is a victim of violence or abuse, assure
them of their
personal safety first and
foremost
Before discharging Correct answers Make sure patient is safe and can cope
affectively
Safety/no harm contract Correct answers most likely
incorrect answer
When does behavioral management and support start Correct answers once
the
is patient (not after
admitted
discharge)
Where to interview an patient? Correct answers In a private office with
door open
partially or NOT in their room or in the day room. Safety
open.
>>> privacy
Client comes in with parents and is reporting abuse. What should the
PMHNP do?
Correct answers Interview the child separately from the parents and then
the parentsfrom
separately
child.
,Then report to
CPS
Child comes into a follow up without parents. This child is holding and
playing
in withway.
a sexual a toyWhat to do? Correct answers Immediately contact CPS
(suspicion
alone is enough to report to
CPS)
How to build therapeutic rapport with adolescents Correct answers Letting
them know will be confidential except harm to themselves
everything
or others.
Try to see them without parents present
as well.
Confidential verse nonconfidential Correct answers Patient is attracted
to the same
gender-
confidential
Patient is in a consensual relationship with another person of their
same age-
confidenti
al
Suicidal- non
confidential
Delegating verse collaborating in a question Correct answers Delegating
will likely but
incorrect be collaborating is
good
Example- PMHNP notices a lot of women commiting suicide during post
partum care
because they're discharged without a risk assessment. The PMHNP
should use
interpersonal collaboration by collaborating with OB docs to do an
assessmentPMHNP
discharge. beforeidentified a gap in
care.
Always choose an answer where we are actively
involved.
A patient is being discharged and the rehab facility is requesting lab
results.the
should WhatPMHNP do? Correct answers PMHNP should obtain informed
consent
fax and (because this is the most actively involved
labs over
answer)
14yo boy comes to office and says he is "feeling weird/funny" because
he inhaled
acetone. What should the PMHNP do? Correct answers Urine drugs
screen. because
correct This is the PMHNP should chose to do what is in their scope of
practice.
does He
not necessarily need to be referred out. Before referring out, ask
yourself
an answer is there
than can be done within my scope of
practice
Culture related question (one that specifies ethnicity of ancestry) Correct
answers
thing First is culturally expected response to stressor (their response does
to note
not always
mean they have a mental
illness)
Cultural syndrome Correct answers Brief supportive
therapy
,Example, if someone lost their job or house they might just need brief
supportive
therapy. They might not need
meds.
Example, if a person is experiencing pain or somatic complaints,
interpret their
symptoms based on cultural
context
Cultural formulation interviews Correct answers Clarify meaning of
illness or
predicament, contextualize their situation in their local world, empower
the patient
Psychoeducation to a client with specific culture should be based on
cultural context
When serving a multicultural poputlation Correct answers it is
important to provide
multicultural teaching by using ethnospecific assessment parameters.
Respect is very
importa
nt
Example native americans might believe that substance use or mental
illness is an
answers Correct
imbalance between an individuals relationship with
the world
Healing sticks Correct answers Native americans believe that healing
sticks have
healing
powers.
A Native American patient on an inpatient unit has a healing stick and insists
on The
it. keeping
nurse is trying to take it. What does the PMHNP do? Correct
answers
nurse Teach
cultural
competence
If a cultural question has a judgmental answer Correct answers it is
usually incorrect
A Native American patient wants to send notes to his traditional healer.
What to answers
Correct do? Obtain clearance for informed consent then send
the notes
Susto ("fright") Correct answers One of the common folk illnesses seen in
the latino Illnesses from susto are believed to result from a shocking,
population.
unpleasant,
frightenin or
experience that is believed to cause the soul to
leave the body
Ataque de nervios (puerto rican syndrome) Correct answers Attack
of nerves.
Uncontrollable shouting, attacks of crying, tremling, heat in the chest
rising into
head, and the
verbal or physical
aggression
Mal de ojo (evil eye) Correct answers fatigue, headache, weight loss,
exhaustion, and
malais
e
Empacho (blocked intestine) Correct answers indigestion (feeling bloated or
nauseous)
Mollera caida Correct answers sunken
fontanel
Normal TSH level Correct answers
0.5- 5.0
, Symptoms of hyperthyroidism mimic Correct
answers mania
symptoms of hypothyroidism mimin Correct answers
depression
Hyperthyroidism Correct answers - T3 and
-T4 high
TSH
low
- symptoms include heat intolerance, agitation, anxiety, irritability,
tachycardia,
swings, mood
and weight
loss
Hypothyroidism Correct answers - T3 and T4
-areTSHlow
high
- cold intolerance, lethargy, weight gain,
decreased libido
Patient has a TSH of 0.4. What is this? Correct answers
Hyperthyroidism
Patient has a TSH of 7.0. What is this? Correct answers
Hypothyroidism
Divalproex sodium (Depakote) Correct answers -
Anticonvulsant
- can cause spina bifida (neural tube defect). do NOT prescribe to a
-pregnant
BBW for patient
hepatotoxicity (liver
toxicity)
A patient taking Depakote presents with signs of hepatotoxicity (abdominal
pain in RUQ,
reddish brown urine, yellowing of the skin and whites of eyes, fatigue).
What to answers
Correct do? Discontinue offending agent and do a liver function
test (LFT).
Check AST (range is 50-125) and ALT (range is
5-35)
Therapeutic range for Depakote Correct answers 50-125
mcg/mL
Toxicity from Depakote happens when levels are greater than Correct
answers 150
Signs of valproic acid toxicity Correct answers - disorientation, lethargy,
respiratory
depression,
nausea/vomiting
Intervention for valproic acid toxicity Correct answers Discontinue the
offending
and checkagent
valproic acid levels, LFTs, and ammonia
levels
Depakote can cause Correct answers pancreatitis (upper abdominal pain,
abdominal
pain that radiates to back, tenderness when touching the abdomen, fever,
rapid pulse,
nausea, vomiting, oily
stools)
Kava Kava Correct answers herbal supplement for
anxiety/stress
side effects include liver
damage
monitor for: liver
toxicity
Liver toxicity signs Correct answers abdominal pain in RUQ, reddish urine,
yellowing
the skin, of
fatigue
Test taking strategies Correct answers - read carefully and use info
provided by
examiner to answer
question
- narrow down options to 2 possible right
answers
- partially correct answers are not the correct
answers
- when 2 answer choices are the opposite of one another, one is usually
the correct
answer (hypoglycemia vs
hyperglycemia)
- the right answer might use the same word as the test
question
- we do not do medical evals, correct answer would be to refer in
-this
whencase
many response choices are remarkably similar, they are
usually wrong
Order of importance Correct answers - questions that use adjectives like
priority and test abilify to
initial action
prioritize
- most important is airway, breathing, and
circulation
- second is maslow's heirarchy of needs (physical needs, food, water,
warmth, rest,
safety,
security)
- then the nursing process (assessment before
intervention).
Assessment Correct answers collecting data to support the problem
towards a SAFETY BEFORE
resolution.
ASSESSMENT
Tics Correct answers If tics are noted, stimulants are
contraindicated
Safety Correct answers Safety for the patient and other is usually the
right answer.
Safety
first.
Abuse Correct answers If a patient is a victim of violence or abuse, assure
them of their
personal safety first and
foremost
Before discharging Correct answers Make sure patient is safe and can cope
affectively
Safety/no harm contract Correct answers most likely
incorrect answer
When does behavioral management and support start Correct answers once
the
is patient (not after
admitted
discharge)
Where to interview an patient? Correct answers In a private office with
door open
partially or NOT in their room or in the day room. Safety
open.
>>> privacy
Client comes in with parents and is reporting abuse. What should the
PMHNP do?
Correct answers Interview the child separately from the parents and then
the parentsfrom
separately
child.
,Then report to
CPS
Child comes into a follow up without parents. This child is holding and
playing
in withway.
a sexual a toyWhat to do? Correct answers Immediately contact CPS
(suspicion
alone is enough to report to
CPS)
How to build therapeutic rapport with adolescents Correct answers Letting
them know will be confidential except harm to themselves
everything
or others.
Try to see them without parents present
as well.
Confidential verse nonconfidential Correct answers Patient is attracted
to the same
gender-
confidential
Patient is in a consensual relationship with another person of their
same age-
confidenti
al
Suicidal- non
confidential
Delegating verse collaborating in a question Correct answers Delegating
will likely but
incorrect be collaborating is
good
Example- PMHNP notices a lot of women commiting suicide during post
partum care
because they're discharged without a risk assessment. The PMHNP
should use
interpersonal collaboration by collaborating with OB docs to do an
assessmentPMHNP
discharge. beforeidentified a gap in
care.
Always choose an answer where we are actively
involved.
A patient is being discharged and the rehab facility is requesting lab
results.the
should WhatPMHNP do? Correct answers PMHNP should obtain informed
consent
fax and (because this is the most actively involved
labs over
answer)
14yo boy comes to office and says he is "feeling weird/funny" because
he inhaled
acetone. What should the PMHNP do? Correct answers Urine drugs
screen. because
correct This is the PMHNP should chose to do what is in their scope of
practice.
does He
not necessarily need to be referred out. Before referring out, ask
yourself
an answer is there
than can be done within my scope of
practice
Culture related question (one that specifies ethnicity of ancestry) Correct
answers
thing First is culturally expected response to stressor (their response does
to note
not always
mean they have a mental
illness)
Cultural syndrome Correct answers Brief supportive
therapy
,Example, if someone lost their job or house they might just need brief
supportive
therapy. They might not need
meds.
Example, if a person is experiencing pain or somatic complaints,
interpret their
symptoms based on cultural
context
Cultural formulation interviews Correct answers Clarify meaning of
illness or
predicament, contextualize their situation in their local world, empower
the patient
Psychoeducation to a client with specific culture should be based on
cultural context
When serving a multicultural poputlation Correct answers it is
important to provide
multicultural teaching by using ethnospecific assessment parameters.
Respect is very
importa
nt
Example native americans might believe that substance use or mental
illness is an
answers Correct
imbalance between an individuals relationship with
the world
Healing sticks Correct answers Native americans believe that healing
sticks have
healing
powers.
A Native American patient on an inpatient unit has a healing stick and insists
on The
it. keeping
nurse is trying to take it. What does the PMHNP do? Correct
answers
nurse Teach
cultural
competence
If a cultural question has a judgmental answer Correct answers it is
usually incorrect
A Native American patient wants to send notes to his traditional healer.
What to answers
Correct do? Obtain clearance for informed consent then send
the notes
Susto ("fright") Correct answers One of the common folk illnesses seen in
the latino Illnesses from susto are believed to result from a shocking,
population.
unpleasant,
frightenin or
experience that is believed to cause the soul to
leave the body
Ataque de nervios (puerto rican syndrome) Correct answers Attack
of nerves.
Uncontrollable shouting, attacks of crying, tremling, heat in the chest
rising into
head, and the
verbal or physical
aggression
Mal de ojo (evil eye) Correct answers fatigue, headache, weight loss,
exhaustion, and
malais
e
Empacho (blocked intestine) Correct answers indigestion (feeling bloated or
nauseous)
Mollera caida Correct answers sunken
fontanel
Normal TSH level Correct answers
0.5- 5.0
, Symptoms of hyperthyroidism mimic Correct
answers mania
symptoms of hypothyroidism mimin Correct answers
depression
Hyperthyroidism Correct answers - T3 and
-T4 high
TSH
low
- symptoms include heat intolerance, agitation, anxiety, irritability,
tachycardia,
swings, mood
and weight
loss
Hypothyroidism Correct answers - T3 and T4
-areTSHlow
high
- cold intolerance, lethargy, weight gain,
decreased libido
Patient has a TSH of 0.4. What is this? Correct answers
Hyperthyroidism
Patient has a TSH of 7.0. What is this? Correct answers
Hypothyroidism
Divalproex sodium (Depakote) Correct answers -
Anticonvulsant
- can cause spina bifida (neural tube defect). do NOT prescribe to a
-pregnant
BBW for patient
hepatotoxicity (liver
toxicity)
A patient taking Depakote presents with signs of hepatotoxicity (abdominal
pain in RUQ,
reddish brown urine, yellowing of the skin and whites of eyes, fatigue).
What to answers
Correct do? Discontinue offending agent and do a liver function
test (LFT).
Check AST (range is 50-125) and ALT (range is
5-35)
Therapeutic range for Depakote Correct answers 50-125
mcg/mL
Toxicity from Depakote happens when levels are greater than Correct
answers 150
Signs of valproic acid toxicity Correct answers - disorientation, lethargy,
respiratory
depression,
nausea/vomiting
Intervention for valproic acid toxicity Correct answers Discontinue the
offending
and checkagent
valproic acid levels, LFTs, and ammonia
levels
Depakote can cause Correct answers pancreatitis (upper abdominal pain,
abdominal
pain that radiates to back, tenderness when touching the abdomen, fever,
rapid pulse,
nausea, vomiting, oily
stools)
Kava Kava Correct answers herbal supplement for
anxiety/stress
side effects include liver
damage
monitor for: liver
toxicity
Liver toxicity signs Correct answers abdominal pain in RUQ, reddish urine,
yellowing
the skin, of
fatigue
