PMHNP Comprehensive Exam
Questions With Complete Solutions
Stages of Change (Transtheoretical Model) (Prochaska & DiClemente)
● Precontemplation—little to no awareness of the problem or intent to change
● Contemplation—thinking about making a change in the next 6 months, weigh pros and cons
● Preparation—prepare to make change within the next month, start to make small changes
● Action—enacted the change for 1 day-6 months
● Maintenance—maintained behavior/change for 6 months or longer
Maslow's Hierarchy of Needs ● Physiological (food, water, shelter, warmth)
● Safety (security, stability, freedom from fear)
● Belonging/love (friends, family, spouse, lover)
● Self-esteem (achievement, mastery, recognition, respect)
● Self-actualization (pursue, inner talent, creativity, fulfillment)
Benner's Model ● Novice—unconscious incompetence, no experience, governed by rules and
regulations
● Advanced beginner—able to analyze and deliberately act
● Competency/proficiency—2-5 yrs experience, able to synthesize info/coordinate
● Expert—flexible, intuitive, efficient
MMSE Scoring ○ 23-30 normal
○ 19-23 borderline
○ <19 impaired
MMSE components ● Orientation
,● Registration (repeat 3 words)
● Attention and Calculation (count backwards from 100 by 7, spell words backward)
● Recall (repeat the same 3 words from immediate recall)
● Language (name an object, repeat a phrase, read a sentence, write a sentence, copy intersecting
pentagons)
Levels of Prevention · Primary prevention—methods to avoid occurrence of disease (most population-
based health promotion efforts)
· Secondary prevention—methods to diagnose and treat existent disease in early stages before it causes
significant morbidity
· Tertiary prevention—methods to reduce negative impact of existent disease by restoring function and
reducing disease-related complications
· Quaternary prevention—methods to mitigate or avoid results of unnecessary or excessive
interventions in the health system
frontal lobe A region of the cerebral cortex that has specialized areas for movement, abstract thinking,
planning, memory, and judgement
-prefrontal, motor strip, EPS, basal ganglia
temporal lobe hearing, language (Wernicke's), memory, emotion
parietal lobe sensory processing and input
components of the limbic system interpreting significance of sensory input; hippocampus, amygdala,
hypothalamus, cingulate gyrus, thalamus
anterior cingulate cortex integrating complex external information; empathy, emotion processing
posterior cingulate cortex participates in memory and visual processing; day dreaming, values,
relevance to self
,hypothalamus & what NTs does it balance homeostasis (food, water, temperature), controls pituitary
release, balance of DA and 5HT
posterior pituitary ADH and oxytocin
thalamus relay station for incoming sensory information, allowing for processing and interpretation
according to other structures' input
cerebellum control center for controlling voluntary movement, fine tunes movement
cerebellar lesion symptoms ataxia, awkward, tremor with effort, difficulty with sequential movements,
balance
brainstem responsible for automatic survival functions; midbrain, pons, medulla
where is dopamine produced substantia nigra
where is serotonin produced raphe nuclei
where is norepinephrine produced locus coeruleus in the pons
where is acetylcholine produced Nucleus basalis of Meynert
cranial nerves Olfactory—smell
Optic—vision
Oculomotor—eye movement
Trochlear—eye movement
Trigeminal—face sensation & chewing
Abducens—eye movement
Facial—facial movements and taste
, Vestibulocochlear—hearing
Glossopharyngeal—taste, swallowing
Vagus—movement, sensation, visceral organs
Accessory—spinal, neck movement
Hypoglossal—tongue movement
preganglionic NT of SNS ACh
postganglionic NT of SNS NE
preganglionic NT of PNS ACh
postganglionic NT of PNS ACh
origin of SNS thoracolumbar
origin of PNS craniosacral
pharmacokinetics what the body does to the drug
Components of pharmacokinetics absorption, distribution, metabolism, excretion (half-life, steady state
by 4 half-lives)
pharmacodynamics what the drug does to the body
examples of pharmacodynamics upregulation, downregulation, actions at receptors, therapeutic
index/margin of safety
dopamine drive, motivation, pleasure, psychosis, attention, motor, energy
Questions With Complete Solutions
Stages of Change (Transtheoretical Model) (Prochaska & DiClemente)
● Precontemplation—little to no awareness of the problem or intent to change
● Contemplation—thinking about making a change in the next 6 months, weigh pros and cons
● Preparation—prepare to make change within the next month, start to make small changes
● Action—enacted the change for 1 day-6 months
● Maintenance—maintained behavior/change for 6 months or longer
Maslow's Hierarchy of Needs ● Physiological (food, water, shelter, warmth)
● Safety (security, stability, freedom from fear)
● Belonging/love (friends, family, spouse, lover)
● Self-esteem (achievement, mastery, recognition, respect)
● Self-actualization (pursue, inner talent, creativity, fulfillment)
Benner's Model ● Novice—unconscious incompetence, no experience, governed by rules and
regulations
● Advanced beginner—able to analyze and deliberately act
● Competency/proficiency—2-5 yrs experience, able to synthesize info/coordinate
● Expert—flexible, intuitive, efficient
MMSE Scoring ○ 23-30 normal
○ 19-23 borderline
○ <19 impaired
MMSE components ● Orientation
,● Registration (repeat 3 words)
● Attention and Calculation (count backwards from 100 by 7, spell words backward)
● Recall (repeat the same 3 words from immediate recall)
● Language (name an object, repeat a phrase, read a sentence, write a sentence, copy intersecting
pentagons)
Levels of Prevention · Primary prevention—methods to avoid occurrence of disease (most population-
based health promotion efforts)
· Secondary prevention—methods to diagnose and treat existent disease in early stages before it causes
significant morbidity
· Tertiary prevention—methods to reduce negative impact of existent disease by restoring function and
reducing disease-related complications
· Quaternary prevention—methods to mitigate or avoid results of unnecessary or excessive
interventions in the health system
frontal lobe A region of the cerebral cortex that has specialized areas for movement, abstract thinking,
planning, memory, and judgement
-prefrontal, motor strip, EPS, basal ganglia
temporal lobe hearing, language (Wernicke's), memory, emotion
parietal lobe sensory processing and input
components of the limbic system interpreting significance of sensory input; hippocampus, amygdala,
hypothalamus, cingulate gyrus, thalamus
anterior cingulate cortex integrating complex external information; empathy, emotion processing
posterior cingulate cortex participates in memory and visual processing; day dreaming, values,
relevance to self
,hypothalamus & what NTs does it balance homeostasis (food, water, temperature), controls pituitary
release, balance of DA and 5HT
posterior pituitary ADH and oxytocin
thalamus relay station for incoming sensory information, allowing for processing and interpretation
according to other structures' input
cerebellum control center for controlling voluntary movement, fine tunes movement
cerebellar lesion symptoms ataxia, awkward, tremor with effort, difficulty with sequential movements,
balance
brainstem responsible for automatic survival functions; midbrain, pons, medulla
where is dopamine produced substantia nigra
where is serotonin produced raphe nuclei
where is norepinephrine produced locus coeruleus in the pons
where is acetylcholine produced Nucleus basalis of Meynert
cranial nerves Olfactory—smell
Optic—vision
Oculomotor—eye movement
Trochlear—eye movement
Trigeminal—face sensation & chewing
Abducens—eye movement
Facial—facial movements and taste
, Vestibulocochlear—hearing
Glossopharyngeal—taste, swallowing
Vagus—movement, sensation, visceral organs
Accessory—spinal, neck movement
Hypoglossal—tongue movement
preganglionic NT of SNS ACh
postganglionic NT of SNS NE
preganglionic NT of PNS ACh
postganglionic NT of PNS ACh
origin of SNS thoracolumbar
origin of PNS craniosacral
pharmacokinetics what the body does to the drug
Components of pharmacokinetics absorption, distribution, metabolism, excretion (half-life, steady state
by 4 half-lives)
pharmacodynamics what the drug does to the body
examples of pharmacodynamics upregulation, downregulation, actions at receptors, therapeutic
index/margin of safety
dopamine drive, motivation, pleasure, psychosis, attention, motor, energy
