Reviewed Correct Detailed Answers
2025 New Update
Priority with current mania - Answer - ✔✔ Assess MSE for cognitive function and
judgement
- helps determine need for hospitalization
- AFTER MSE: urine drug test and support and stressors assessed
Patient confesses SI with plan and note written. What is the priority? - Answer - ✔✔
Collaborate with the patient to develop a safety plan, including identifying support
systems, and contacting crisis services if necessary.
- involves assessing the level of risk, identifying coping strategies, and creating a plan
for patient safety
- this includes notifying emergency services if neccessary
Patient reports stopping mood stabilizer for 3 weeks and having recent mania episode
with risky behaviors, decreased sleep. What is priority? - Answer - ✔✔ Assess patient
physical safety!
-harm to self or others (think risky behaviors)
-MSE is next step, very important but physical safety takes priority.
Recovery oriented Model - Answer - ✔✔ -a person centered and strength based
approach
-focuses on patients to set thier own goals and work towards a fulfilling life, rather than
symptom management
-"let's work together to identify your personal goals and strengths for a meningful life"
-includes empahsis on personal growth and and meaning beyond symptom
management
-holistic and supports autonomy
-emphasized least restrictive, community care whenever possible
ex:
"let's work together to identify your personal goals and strengths for a meningful life"
"Let's explore what led to this setback, learn from it, and adjust your recovery plan
accordingly"
"let's explore your reasoning for wanting to discontinue your medication and develop a
plan together"
"Let's collaboratively create a safety plan that includes coping strategies and support
networks"
traditional medical model - Answer - ✔✔ generally focuses on symptom management
, the patient expresses a desire to establish a personal relationship outside of therapy.
What does PMHNP say? - Answer - ✔✔ decline the patient's invitation, explaining the
importance of maintaining professional boundaries in the therapeutic relationship.
-ensures the relationship maintains focused on patient recovery and well being without
conflicts or ethical concerns
Patient is stressed at work and requests increase in mood stabilizer. what should
pmhnp do? - Answer - ✔✔ -discuss the patient's stressors and explore alternative
coping strategies before considering a medication adjustment
-medication adjustments should not be made solely in response to increased stressors;
only after comprehensive assessment of mental health not just increased stress
Patient is worked up and crying about traumatic event. Actively experiencing intense
emotions. How do you respond? - Answer - ✔✔ "I am so sorry that this happened to
you, it must be really difficult."
-expresses empathy, validation and support
-acknowledges emotions and conveys understanding: patient will feel heard and
validated
-DO NOT use this time to gather more information about event. DO NOT discuss
guilt/blame. Start by acknowleding their current distress
Patient appears anxious and hesitant to share. What is best response to get him to
open up? - Answer - ✔✔ "tell me more about what's been bothering you."
-openended
-encourages narrative response
ex. "Tell me more about what you mean by 'not knowing how to deal with your anxiety'"
Primary purpose of using CIWA - Answer - ✔✔ -to assess the severity of alcohol
withdrawal
What medication is appropriate to treat alcohol withdrawal in a patient with liver
disease? - Answer - ✔✔ -Lorazepam (Ativan)
-shorter half life and undergoes less hepatic metabolism
Benzos metabolized by the liver - Answer - ✔✔ -Diazepam (Valium)
-chlordiazepoxide (librium)
-both can be used in alcohol withdrawal with liver disease however require monitoring.
Gabapentin - Answer - ✔✔ adjunct for alcohol withdrawal
-renal excreation and does not undergo hepatic metabolism
Best medication for treating extreme alcohol withdrawal symptoms including
hallucinations and seizures - Answer - ✔✔ Lorazepam (Ativan)
-Rapid onset of action to treat symptoms