Georgette’s LMR Psychiatric-Mental Health Review – Verified Clinical Q&A for PMHNP Preparation

Georgette’s LMR Psychiatric-Mental Health Review – Verified Clinical Q&A for PMHNP Preparation Description: This document presents a clinically-focused, verified question-and-answer guide for the LMR PMHNP exam, compiled by Georgette. It covers adolescent and adult psychiatry, neuroanatomy, psychopharmacology, diagnostic timelines, therapeutic modalities, legal and cultural considerations, and evidence-based treatments. Ideal for nurse practitioners preparing for board certification, this review emphasizes clinical decision-making and foundational psychiatric principles. 16 yo comes into office with parents showing s/s of anorexia. What is your tx? - -Refer for medical evaluation 3-6 year old is masturbating? - -Normal. This is the phallic stage 4 components of health policy? - -Process, policy reform, policy environment, POLICY MAKERS (assess/address barriers and facilitators [assess baseline knowledge, beliefs, and practices among providers with a survey], brainstorm with stakeholders) 5 mg oral haldol BID = ? IM - -200 mg 9-16 yo boy with tenderness, swelling, and breast enlargement? - -Normal for up to 6 months A mother states her child is experiencing a cultural illness. What is your initial action? - -Respect the mother's cultural understanding of illness prior to assessment A patient assaults you at work and you don't want to return to work for 2-3 weeks. This can be an example of? - -Acute stress disorder Accutane can cause? - -Birth defects Acetylcholine produced in? - -Nucleus of Meynert Acupuncture = ? - -Pain and depression Acute stress disorder timeline? - -4 weeks or less ADHD medication wears off - intervention? - -Multiple dosing or extended release ADHD neurotransmitters? - -DA, NE, and serotonin Adjustment disorder presents after? Timeline? - -Stressful event like loss of pet or parent; within 3 months of event Adolescent with ADHD = ? - -Increased risk of SUDs Screen all adolescents for SUDs & vice-versa Alcohol dehydragenase? - -Women have lower quantity compared to men = women are more likely to get drunk = more likely to have liver problems Alcohol is a form of _______-_________ and a __________ to the treatment of depression. - -self medication; barrier Altruism - -Helping another Amygdala = ? - -Aggression Anorexia s/s? - -Low BMI 18, amenorrhea, emaciation, bradycardia, and hypotension Anterior cingulate = ? - -Cognitive functions, decision making, empathy, impulse control, and emotions Anxiety with hx of SUD? - -Start on buspar or hydroxyzine outpt and refer Apoptosis? - -Neuronal loss or cell death Appreciative inquiry? - -Approach to organizational change which focuses on strengths rather than weaknesses Area of brain indicated in ADHD? Its functions? - -1. Dorsolateral prefrontal cortex; executive function, cognitive processes, and attention 2. Basal ganglia 3. Abnormalities of reticular activating system 4. Abnormalities of prefrontal cortex = inattentive type Ask what kinds of questions? - -Open-ended Asking patient to name president of governor assesses? - -Fund of knowledge Autoimmune diseases = ? - -Increased cytokine levels Babinski reflex normal until? - -2 years Fans toes Beck moderate? - -19-29 Behavioral therapy? - -Skills training, problem solving, modeling, exposure, role playing, and relaxation Benefits of assertive community treatment (ACT)? - -Rehab post-hospitalization, case management approach, and good for long term hx of noncompliance Benefits of lithium? - -Gold standard for mania, neuroprotective, and antisuicidal effects Birth defect caused by depakote? - -Spina Bifida Black box warning for SSRIs in children, adolescents, and young adults? Intervention for this? - Increased risk of SI; always assess SI, frequency, and severity C/I for Wellbutrin? - -Seizure disorder or hx or present eating disorder C/I to beta blockers? - -Asthma (can cause bronchospasms) Carbamazepine can cause? - -Agranulocytosis and aplastic anemia Catharsis - -Opening express feelings which were previously suppressed CBT? - -Cognitive restructuring and JOURNALING Cerebellum = ? - -Maintenance of balance and posture Childrens motor tics are? - -Fairly common and can be temporary Choice of BZD for liver disease/hepatitis? - -Ativan Cigarette cessation in patients taking clozaril requires increased or decreased doses? - -Decreased Cigarette smoking in patients taking clozaril requires increased or decreased doses? - -Increased Cigarettes are inducers of what CYP450 enzyme? - -1A2 Circumstantial speech? - -Go in circles but eventually answers CIWA moderate (scheduled + prns) - -16-20 Cognitive therapy? - -Replace distorted thoughts with rational ones Conduct disorder s/s? - -Think juvenile detention, AGGRESSION, NO REMORSE Conflict of interest? - -Policy to address 1st assess industry provided samples and industry sponsored education Conversion disorder presents after? S/S? - -Stressful event like losing sibling; blindness, mutism, paralysis, paresthesia all medically unexplained Cortical dementia? - -Language and memory impairments COWS mild (clonidine) - -5-12 COWS moderate (buprenorphine, suboxone) - -13-24 Delerium s/s? - -ACUTE ONSET, LOC disturbance, cognition, and inattention Dementia s/s? - -Slow progression, mental decline, irritability, personality changes Dementia vs pseudodementia? - -Dementia is chronic (years) & they confabulate Pseudodementia is acute (can be months) and the give IDK answers Desmopressin tx for? - -Enuresis Differentiation between OCD with tics as compulsion and Tourette's? - -OCD also has intrusive thoughts Disorder that most greatly increases homicidal ideation? - -Antisocial personality Disorder that most greatly increases thoughts of self-harm? - -Depression Disseminated encephalomyelitis = ? - -Paresthesia, fatigue, and asymmetrical body movements especially of the extremities. NEED NEURO EXAM DMDD ages & s/s? - -6-17 yo; chronic dysregulated mood and frequent intense temper outbursts Don't violate patient's trust - -Social media Donalson Vs. O'Connor - -Protects against confinement Dopamine produced in? - -Substantia nigra (regulates motor movements), VTA, and nucleus accumbens Drug choice for patient that is depressed and also has cancer? - -Celexa or lexapro d/t fewer drug to drug interactions Drug choice for patient with low energy and fatigue with depression? - -Wellbutrin Drug choice for patient with sexual problems d/t medication or depression? - -Wellbutrin Drug choices for patient with chronic neuropathic pain and depression? - -1. SNRI (cymbalta) 2. TCA (amitriptyline) 3. Alpha 2 delta ligand (gabapentin or lyrica) Dx of Tourette's syndrome? - -2 motor tics and 1 vocal tic lasting 1 year+ Education for patient taking both psychotropics and antacids/PPIs? - -Take 2 hours apart EMDR stages? - -1. Desensitization 2. Instillation 3. Body scan Example of a delusion? - -Believing church members or class members are a cult Existential factors - -Deal with meaning of their own existence Factitious disorder imposed on another? - -ABUSE - report to CPS Factitious disorder s/s? - -Foreign substances introduced into body with NO SECONDARY GAIN Family system therapy? - -TRIANGL