PMHNP CERTIFICATION EXAM STUDY
QUESTIONS AND ANSWERS
Pain=and=bloating=after=eating=is=caused=by...=-=ans-✔✔delayed=gastric=emptying
Medications=that=cause=delayed=gastric=emptying?=-=ans-
✔✔PPIs;=ranitidine,=famotidine,=omeprazole
What=instructions=should=you=give=your=patient=if=they=are=prescribed=antacids/
PPIs=and=psychotropics?=-=ans-
✔✔Give=medications=at=least=2=hours=apart=b/c=antacids/
PPIs=decrease=absorption=of=psychotropics
Normal=BMI=range=-=ans-✔✔18.5-25
Criteria=for=admission=for=ED=bx:=-=ans-
✔✔BMI=<15;=25%=total=body=weight=loss=in=3=months;=severe=dehydration,=infection,=
bradycardia,=hypothermia,=hematemesis,=hypokalemia
What=neurotransmitters=are=implicated=in=ADHD?=-=ans-✔✔DA,=NE,=5HT=-=DNS
What=brain=structures=are=involved=in=ADHD?=-=ans-
✔✔Reticular=activating=system,=basal=ganglia,=frontal=cortex=-=RBF
Abnormalities=in=this=part=of=the=brain=cause=inattentive=ADHD:=-=ans-
✔✔Prefrontal=cortex
Amphetamines=are=FDA=approved=for=children=beginning=at=_=years=old=-=ans-✔✔3
Methamphetamines=are=FDA=approved=for=children=beginning=at=_=years=old=-=ans-
✔✔6
Alpha=agonists=clonidine=and=guanfacine=are=FDA=approved=to=treat=ADHD=in=patient
s=ages=___=-=ans-✔✔6-17
Strattera=is=FDA=approved=to=treat=ADHD=in=patients=ages=___=-=ans-
✔✔6=and=up=(including=adults)
,Adults=diagnosed=with=both=ADHD=and=depression=would=benefit=from=being=prescrib
ed:=-=ans-✔✔Wellbutrin
Conduct=disorder=can=be=diagnosed=in:=-=ans-✔✔Both=children=and=adults
Conduct=disorder=diagnostic=criteria:=-=ans-
✔✔Violating=rights=of=others=or=societal=norms;=aggression=towards=people/
animals;=destruction=of=property;=no=remorse
Treatment=for=conduct=disorder:=-=ans-
✔✔Targets=aggression=and=mood;=SGA,=mood=stabilizer,=SSRI,=alpha=agonists
ODD=diagnostic=criteria:=-=ans-
✔✔Argumentative,=defiant=for=at=least=6=months=and=with=4=sx
Treatment=of=ODD:=-=ans-
✔✔Focused=on=family=therapy,=child=management=skills,=teaching=parents=reinforcem
ent/boundaries/problem=solving
DMDD=diagnostic=criteria:=-=ans-✔✔Childhood=depressive=d/o=between=ages=6-
17;=chronic=dysregulated=mood,=frequent=tantrums,=severe=irritability;=typically=DMDD=
rather=than=bipolar=d/o=in=children
Neurotransmitters=implicated=in=ASD:=-=ans-✔✔Glutamate,=GABA,=5HT=-=GGS
Echolalia=-=ans-✔✔Meaningless=repetition=of=words;=often=seen=in=ASD
Broken=mirror=theory=-=ans-
✔✔Dysfunction=of=the=mirror=neuron=system=results=in=poor=social=interaction=and=cog
nition=in=ASD=patients
Parallel=play=is=developmentally=appropriate=at=which=ages?=-=ans-✔✔1-3=years=old
Parallel=play=continuing=beyond=the=age=of=3=years=old=may=be=indicative=of...=-=ans-
✔✔ASD=dx=d/t=social=deficits
M-CHAT=-=ans-✔✔Modified=Checklist=for=Autism=in=Toddlers;=ASD=scale
ADOS-G=-=ans-✔✔Autism=Diagnostic=Observation=Schedule=-=Generic;=ASD=scale
ASQ=-=ans-✔✔Ages=and=Stages=Questionnaire;=development=and=social/
emotional=screening
Pharmacological=treatment=of=ASD:=-=ans-
✔✔Stimulants=(increase=DA=to=help=with=impulsivity,=hyperactivity,=inattention;=Antipsy
chotics=(target=aggressive=bx,=tantrums,=self-injury,=stereotyped=bx)
,Nightmares=in=children=can=be=the=result=of:=-=ans-
✔✔Genetic=factors;=assess=family=patterns=of=nightmares
Features=of=children=diagnosed=with=Fragile=X=-=ans-
✔✔LARGE=features:=large=head,=elongated=face,=hyperextensible=joints,=abnormally=l
arge=testes,=short=stature
Features=of=children=diagnosed=with=fetal=alcohol=syndrome=-=ans-
✔✔small=features:=small=head,=small=eye=opening,=low=nasal=bridge,=flat=midface,=sm
ooth=philtrum,=thin=upper=lip
Clock=drawing=test=assesses=function=of=which=brain=lobe?=-=ans-✔✔Parietal
What=does=the=clock=drawing=test=assess=for?=-=ans-✔✔Executive/
cognitive=fx,=impairments=associated=w/
=damage=to=right=parietal=lobe,=constructional=apraxia=(inability=to=draw=or=assemble=o
bjects)
Important=labs=to=draw=for=patients=presenting=with=dementia?=-=ans-
✔✔B12,=folic=acid
Dementia=presents=with=mental=decline=that=is=___=-=ans-
✔✔Chronic;=if=acute=sx,=consider=other=dx
Symptoms=of=subcortical=dementia:=-=ans-
✔✔Motor=sx,=lack=of=coordination,=tremors,=depression,=irritability,=apathy
Example=of=subcortical=dementia=diagnosis=-=ans-✔✔Huntington's=disease
Symptoms=of=cortical=dementia:=-=ans-
✔✔Language=and=memory=impairments=(aphasia=and=amnesia)
Example=of=cortical=dementia=diagnosis:=-=ans-✔✔Alzheimer's
Presentation=of=dementia=d/t=HIV=disease=-=ans-
✔✔Subcortical=effects;=motor=abnormalities,=bx=abnormalities,=cognitive=decline
Presentation=of=dementia=with=Lewy=bodies=-=ans-
✔✔Visual=hallucinations,=Parkinsonian=sx
Presentation=of=frontal=lobe=dementia=(e.g.=Pick's=disease)=-=ans-✔✔Personality/
bx=changes,=language=changes,=inappropriate=social=bx,=aggression
, Presentation=of=Huntington's=disease=-=ans-
✔✔Subcortical=dementia;=motor=abnormalities,=psychomotor=slowing;=high=incidence=o
f=depression,=psychosis;=begins=ages=30-45;=affects=males=and=females=equally
What=is=the=most=effective=test=to=determine=if=someone=will=develop=Huntington's=dis
ease?=-=ans-✔✔Direct=genetic=test=(no=risk)
What=is=the=likelihood=a=child=of=a=parent=with=Huntington's=will=develop=it?=-=ans-
✔✔50%=chance
Dementia=etiology=-=ans-
✔✔Cerebral=atrophy,=enlarged=ventricles;=decreased=Ach=and=NE;=genetic=loading
What=neurotransmitters=are=implicated=in=dementia,=and=how?=-=ans-
✔✔Decreased=Ach=and=NE
What=is=the=first=line=treatment=for=psychosis=and=agitation=in=dementia?=-=ans-
✔✔SGAs=-=but=try=nonpharmacological=therapies=first
What=is=delirium?=-=ans-✔✔ACUTE=disturbance=of=LOC,=cognition,=attention
What=pharmacological=treatment=do=you=use=for=delirium-
induced=agitation=or=psychosis?=-=ans-✔✔Low=dose=haldol
What=pharmacological=treatment=do=you=use=for=alcohol-induced=delirium?=-=ans-
✔✔BNZ
Anytime=a=patient=presents=with=delirium,=what=labs=should=you=order?=-=ans-
✔✔UA=with=culture=and=specificity=d/
t=infx=being=a=potential=cause=for=delirium,=esp=in=older=adults
What=is=pseudodementia?=-=ans-✔✔Cognitive=sx=r/t=depression=in=older=adults
Dementia=vs.=pseudodementia=-=ans-
✔✔Dementia:=premorbid=hx=of=slowly=declining=cognition
Pseudodementia:=acute=onset=of=significant=cognitive=changes
How=would=someone=with=dementia=vs.=pseudodementia=answer=a=question?=-=ans-
✔✔Dementia:=confabulates,=lacks=answer
Pseudodementia:="I=don't=know"
How=can=depression=present=in=older=adults?=-=ans-✔✔Cognitive=deficits=-
=irritability,=agitation,=hallucinations,=delusions
What=neurotransmitters=are=implicated=in=mood=disorders?=-=ans-
✔✔DA,=NE,=5HT=(DNS),=GABA,=glutamate
QUESTIONS AND ANSWERS
Pain=and=bloating=after=eating=is=caused=by...=-=ans-✔✔delayed=gastric=emptying
Medications=that=cause=delayed=gastric=emptying?=-=ans-
✔✔PPIs;=ranitidine,=famotidine,=omeprazole
What=instructions=should=you=give=your=patient=if=they=are=prescribed=antacids/
PPIs=and=psychotropics?=-=ans-
✔✔Give=medications=at=least=2=hours=apart=b/c=antacids/
PPIs=decrease=absorption=of=psychotropics
Normal=BMI=range=-=ans-✔✔18.5-25
Criteria=for=admission=for=ED=bx:=-=ans-
✔✔BMI=<15;=25%=total=body=weight=loss=in=3=months;=severe=dehydration,=infection,=
bradycardia,=hypothermia,=hematemesis,=hypokalemia
What=neurotransmitters=are=implicated=in=ADHD?=-=ans-✔✔DA,=NE,=5HT=-=DNS
What=brain=structures=are=involved=in=ADHD?=-=ans-
✔✔Reticular=activating=system,=basal=ganglia,=frontal=cortex=-=RBF
Abnormalities=in=this=part=of=the=brain=cause=inattentive=ADHD:=-=ans-
✔✔Prefrontal=cortex
Amphetamines=are=FDA=approved=for=children=beginning=at=_=years=old=-=ans-✔✔3
Methamphetamines=are=FDA=approved=for=children=beginning=at=_=years=old=-=ans-
✔✔6
Alpha=agonists=clonidine=and=guanfacine=are=FDA=approved=to=treat=ADHD=in=patient
s=ages=___=-=ans-✔✔6-17
Strattera=is=FDA=approved=to=treat=ADHD=in=patients=ages=___=-=ans-
✔✔6=and=up=(including=adults)
,Adults=diagnosed=with=both=ADHD=and=depression=would=benefit=from=being=prescrib
ed:=-=ans-✔✔Wellbutrin
Conduct=disorder=can=be=diagnosed=in:=-=ans-✔✔Both=children=and=adults
Conduct=disorder=diagnostic=criteria:=-=ans-
✔✔Violating=rights=of=others=or=societal=norms;=aggression=towards=people/
animals;=destruction=of=property;=no=remorse
Treatment=for=conduct=disorder:=-=ans-
✔✔Targets=aggression=and=mood;=SGA,=mood=stabilizer,=SSRI,=alpha=agonists
ODD=diagnostic=criteria:=-=ans-
✔✔Argumentative,=defiant=for=at=least=6=months=and=with=4=sx
Treatment=of=ODD:=-=ans-
✔✔Focused=on=family=therapy,=child=management=skills,=teaching=parents=reinforcem
ent/boundaries/problem=solving
DMDD=diagnostic=criteria:=-=ans-✔✔Childhood=depressive=d/o=between=ages=6-
17;=chronic=dysregulated=mood,=frequent=tantrums,=severe=irritability;=typically=DMDD=
rather=than=bipolar=d/o=in=children
Neurotransmitters=implicated=in=ASD:=-=ans-✔✔Glutamate,=GABA,=5HT=-=GGS
Echolalia=-=ans-✔✔Meaningless=repetition=of=words;=often=seen=in=ASD
Broken=mirror=theory=-=ans-
✔✔Dysfunction=of=the=mirror=neuron=system=results=in=poor=social=interaction=and=cog
nition=in=ASD=patients
Parallel=play=is=developmentally=appropriate=at=which=ages?=-=ans-✔✔1-3=years=old
Parallel=play=continuing=beyond=the=age=of=3=years=old=may=be=indicative=of...=-=ans-
✔✔ASD=dx=d/t=social=deficits
M-CHAT=-=ans-✔✔Modified=Checklist=for=Autism=in=Toddlers;=ASD=scale
ADOS-G=-=ans-✔✔Autism=Diagnostic=Observation=Schedule=-=Generic;=ASD=scale
ASQ=-=ans-✔✔Ages=and=Stages=Questionnaire;=development=and=social/
emotional=screening
Pharmacological=treatment=of=ASD:=-=ans-
✔✔Stimulants=(increase=DA=to=help=with=impulsivity,=hyperactivity,=inattention;=Antipsy
chotics=(target=aggressive=bx,=tantrums,=self-injury,=stereotyped=bx)
,Nightmares=in=children=can=be=the=result=of:=-=ans-
✔✔Genetic=factors;=assess=family=patterns=of=nightmares
Features=of=children=diagnosed=with=Fragile=X=-=ans-
✔✔LARGE=features:=large=head,=elongated=face,=hyperextensible=joints,=abnormally=l
arge=testes,=short=stature
Features=of=children=diagnosed=with=fetal=alcohol=syndrome=-=ans-
✔✔small=features:=small=head,=small=eye=opening,=low=nasal=bridge,=flat=midface,=sm
ooth=philtrum,=thin=upper=lip
Clock=drawing=test=assesses=function=of=which=brain=lobe?=-=ans-✔✔Parietal
What=does=the=clock=drawing=test=assess=for?=-=ans-✔✔Executive/
cognitive=fx,=impairments=associated=w/
=damage=to=right=parietal=lobe,=constructional=apraxia=(inability=to=draw=or=assemble=o
bjects)
Important=labs=to=draw=for=patients=presenting=with=dementia?=-=ans-
✔✔B12,=folic=acid
Dementia=presents=with=mental=decline=that=is=___=-=ans-
✔✔Chronic;=if=acute=sx,=consider=other=dx
Symptoms=of=subcortical=dementia:=-=ans-
✔✔Motor=sx,=lack=of=coordination,=tremors,=depression,=irritability,=apathy
Example=of=subcortical=dementia=diagnosis=-=ans-✔✔Huntington's=disease
Symptoms=of=cortical=dementia:=-=ans-
✔✔Language=and=memory=impairments=(aphasia=and=amnesia)
Example=of=cortical=dementia=diagnosis:=-=ans-✔✔Alzheimer's
Presentation=of=dementia=d/t=HIV=disease=-=ans-
✔✔Subcortical=effects;=motor=abnormalities,=bx=abnormalities,=cognitive=decline
Presentation=of=dementia=with=Lewy=bodies=-=ans-
✔✔Visual=hallucinations,=Parkinsonian=sx
Presentation=of=frontal=lobe=dementia=(e.g.=Pick's=disease)=-=ans-✔✔Personality/
bx=changes,=language=changes,=inappropriate=social=bx,=aggression
, Presentation=of=Huntington's=disease=-=ans-
✔✔Subcortical=dementia;=motor=abnormalities,=psychomotor=slowing;=high=incidence=o
f=depression,=psychosis;=begins=ages=30-45;=affects=males=and=females=equally
What=is=the=most=effective=test=to=determine=if=someone=will=develop=Huntington's=dis
ease?=-=ans-✔✔Direct=genetic=test=(no=risk)
What=is=the=likelihood=a=child=of=a=parent=with=Huntington's=will=develop=it?=-=ans-
✔✔50%=chance
Dementia=etiology=-=ans-
✔✔Cerebral=atrophy,=enlarged=ventricles;=decreased=Ach=and=NE;=genetic=loading
What=neurotransmitters=are=implicated=in=dementia,=and=how?=-=ans-
✔✔Decreased=Ach=and=NE
What=is=the=first=line=treatment=for=psychosis=and=agitation=in=dementia?=-=ans-
✔✔SGAs=-=but=try=nonpharmacological=therapies=first
What=is=delirium?=-=ans-✔✔ACUTE=disturbance=of=LOC,=cognition,=attention
What=pharmacological=treatment=do=you=use=for=delirium-
induced=agitation=or=psychosis?=-=ans-✔✔Low=dose=haldol
What=pharmacological=treatment=do=you=use=for=alcohol-induced=delirium?=-=ans-
✔✔BNZ
Anytime=a=patient=presents=with=delirium,=what=labs=should=you=order?=-=ans-
✔✔UA=with=culture=and=specificity=d/
t=infx=being=a=potential=cause=for=delirium,=esp=in=older=adults
What=is=pseudodementia?=-=ans-✔✔Cognitive=sx=r/t=depression=in=older=adults
Dementia=vs.=pseudodementia=-=ans-
✔✔Dementia:=premorbid=hx=of=slowly=declining=cognition
Pseudodementia:=acute=onset=of=significant=cognitive=changes
How=would=someone=with=dementia=vs.=pseudodementia=answer=a=question?=-=ans-
✔✔Dementia:=confabulates,=lacks=answer
Pseudodementia:="I=don't=know"
How=can=depression=present=in=older=adults?=-=ans-✔✔Cognitive=deficits=-
=irritability,=agitation,=hallucinations,=delusions
What=neurotransmitters=are=implicated=in=mood=disorders?=-=ans-
✔✔DA,=NE,=5HT=(DNS),=GABA,=glutamate
