PMHNP Certification Exam questions and correct answers 2024

SYCHOSOCIAL STAGES OF DEVELOPMENT - PHALLIC STAGE - 3-6 years old - ANSWER • 3-year-old masturbates, play with self, says naughty things • This is NORMAL for children this age. What do you do when a patient has an increased prolactin level? - ANSWER • Stop prolactin (stop the agent that cause increase prolactin) • ACUTE STRESS DISORDER - ANSWER • A d/o resulting from exposure to a major stressor, with SX of ANX, depression, dissociation, recurring nightmares, sleep disturbances, problems in concentrations, reliving the event, dreams, flashbacks - UP to ONE MONTH - Less than 1 month. • If LONGER than 1 month = PTSD - Symptoms that occur immediately after the event but resolve in less than 3 days would not meet criteria for acute stress disorder What would you do if a 5-year-old tells you his brother sodomized him? - ANSWER • Tell mom don't leave him alone with patient and call CPS implement crisis If a child is playing with doll in a sexual way, what do you do first? - ANSWER • You SUSPECT sexual abuse - Perform FURTHER ASSESSMENT and GATHER ENOUGH INFO BEFORE Calling CPS to report suspected Sexual Abuse - You HAVE to report but you have to have something (assessment data) to report - Assess = FIRST If a 13-year-old tells you he want to smoke, what would be an appropriate response? - ANSWER • Ask him of his plan to stop smoking If a 14-year-old girl clenching her teeth, what cranial nerve would you suspect? - ANSWER • Cranial nerve V-Trigeminal nerve (FIVE) What cranial nerve is responsible for Bells Palsy? - ANSWER 7 = Facial Paralysis What cranial nerves do you assess for corneal sensation - ANSWER Nerves 5 & 7 What cranial nerves do you assess for papillary reaction to light and accommodation? - ANSWER Nerves 3,4,& 6 What cranial nerves do you assess for 6 cardinal fields of gaze & extra-ocular movements? - ANSWER Nerves 3, 4, & 6 What cranial nerves do you assess for corneal light reflex? - ANSWER 3, 4, & 6 Cranial Nerve 1 - ANSWER Olfactory (smell) Cranial Nerve 2 - ANSWER Optic - vision Cranial Nerve 3 - ANSWER Oculomotor (eye movement): The occulomotor nerve is responsible for motor enervation of upper eyelid muscle, extraocular muscle and pupillary muscle. Cranial Nerve 4 - ANSWER Trochlear (eye movement): The trochlear nerve controls an extraocular muscle. Cranial Nerve 5 - ANSWER Trigeminal: The trigeminal nerve is responsible for sensory enervation of the face and motor enervation to muscles of mastication (chewing). Cranial Nerve 6 - ANSWER Abducens (motor): The abducent nerve enervates a muscle, which moves the eyeball. Cranial Nerve 7 - ANSWER Facial nerve: The facial nerve enervates the muscles of the face (facial expression). Cranial Nerve 8 - ANSWER Vestibulocochlear (hearing and balance): The vestibulocochlear nerve is responsible for the sense of hearing and balance (body position sense). Cranial Nerve 9 - ANSWER Glossopharyngeal: The glossopharyngeal nerve enervates muscles involved in swallowing and taste. Lesions of the ninth nerve result in difficulty swallowing and disturbance of taste. Cranial Nerve 10 - ANSWER vagus nerve: The vagus nerve enervates the gut (gastrointestinal tract), heart and larynx. Cranial Nerve 11 - ANSWER accessory: The accessory nerve enervates the sternocleidomastoid muscles and the trapezius muscles. Cranial Nerve 12 - ANSWER Hypoglossal (tongue movement): The hypoglossal nerve enervates the muscles of the tongue. What is the best action for a 16 y/o with conduct disorder that refuses tx? - ANSWER • Send to psych specialist for acting out kids - Referrals - Have to see if you are going to refer the same patient to the same provider - Cannot refer the patient to another provider that is the same as you (ie psych) - you must refer to a neurologist or another specialist or PCP What is a priority consideration for a 16-year-old that shows up with mother for first therapy? - ANSWER • Confidentiality (ex. mom sits in lobby) What is important to know about ACE inhibitors (Meds for Heart failure/HTN) - ANSWER • This medication can cause increased lithium levels to toxic levels - must collaborate with PCP to determine whether to change ACE or change Lithium - Can't use both What medication INCREASES Lithium serum level up to double - ANSWER Ibuprofen Why is Lithium used? - ANSWER • First-line neuro-protective for bipolar • Lab Values concerning for patient on Lithium: - ANSWER • Leukocytosis • Creatinine • BUN • NA+ • 4 + PORTEIN in Urine • + Pregnancy Test • Lithium (Eskalith/Lithobid) Toxicity - ANSWER • Normal Range of LITHIUM LEVEL - 0.5 - 1.2 mEq/L • MONITOR for TOXICITY: Toxicity = > 1.