PMHNP CERTIFICATION EXAM AND STUDY GUIDE LATEST 2025 ACTUAL EXAM 136 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES(VERIFIED ANSWERS)|ALREADY GRADED A+

PMHNP CERTIFICATION EXAM AND STUDY GUIDE LATEST 2025 ACTUAL EXAM 136 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES(VERIFIED ANSWERS)|ALREADY GRADED A+ 5HT2C - ANSWER--activation of this recent inhibits dopamine and norepinephrine -antagonists: quetiapine, olanzapine, fluoxetine, mirtazapine. .Abnormal Potassium levels - ANSWER-Increased: amiloride, spirolactone, lithium, propranolol. Decreased .Abnormal sodium levels - ANSWER--increased: dehydration, methyldopa, -decreased: SIADH, heart failure, nephrotic syndrome, hepatic disease. .absolute neurophil count calculations - ANSWER-total WBC x percentage of neurophil in differential=ANC .Advance directive - ANSWER--a legal document that can be in the form of a living will, power of attorney, healthcare proxy .age-associated changes in pharmacodynamics and pharmacokinetics - ANSWER--distribution: more adipose tissue; less water -SSRI can induce hyponatriemia -more sensitive to the effects of benzodiazepines -decreased dopamine and acetylcholine synthesis in elderly and thus they are more sensitive to D2 antagonists and antimuscarinics. .Alcohol withdrawal treatment - ANSWER-100mg Thiamine PO for 5 days -multivitamin that includes folate -1st day-- q6hr librium 50mg -for the next two days-- q6hr librium 25mg. OR -1st day--Q6hr lorazepam 2-4mg -for the next two days-Q6hr lorazepam 1-2 mg .alpha 1 antagonists - ANSWER--vasodilator and used for hypertension -raynauds -PTSD and GAD -benign prostatic hyperplasia (tamsulosin) -agonism: vasoconstrictor -trazadone and many antipsychotics .alzheimers - ANSWER--altered processing of amyloid processing protein, rendering it toxic. Amyloid plaques prompt a cascade of intracellular events resulting in microtubules being converted into neurofibrillary tangles -MRI usually not utilized as a diagnostic tool but should used to rule out diseases like chronic subdural hematoma .anion gap - ANSWER-the difference between cations and anion. -is calculated to identify reason for metabolic acidosis -cations: sodium and potassium -anions: chloride and bicarbonate -normal anion gap: 8-16mEq/L -high anion gap: high levels of lactate (an anion) prompt an increase in excretion of bicarbonate to maintain electroneutrality -normal anion gap: drop in bicarbonate but an increase in chloride .antidepressants with minimal effect on cyp 2D6 - ANSWER--effexor and escitalopram .Antipsychotics that cause the most hypotension - ANSWER-olanzapine, risperidone, quetiapine .aphasia, agnosia - ANSWER-aphasia: impairment in language function agnosia (ag-nosh-a): inability to process sensory information. Loss in the ability to recognize familiar objects. .aripiprazole long acting - ANSWER--maximum concentration is achieved 5 to 7 days after injection -starting dose is 400mg -continue oral abilify 10 to 20mg for 14 days -administered in the gluteal muscle .Assessment tools to screen for cognitive impairment - ANSWER--folstein mini-mental: perfect score is 30. 24 impairment. If only 9th grade education 17 .autism - ANSWER-appears before the age of 3. Difficulty with communication -pervasive failure to form social relationships -problems with communication -ritualistic behaviors -stereotyped behavior -circumscribed range of interests .autism pharmacology - ANSWER--greater sensitivity or idiosyncratic effects from medication -do not use anticonvusants .b12 deficiency - ANSWER--surgical removal of the stomach, pancreatic inflammation, -MCV100. symptoms of megaloblastic anemia are due to impaired DNA synthesis and are most apparent in rapidly dividing cells such as blood cells and gastrointestinal cell -absorbed in the distal ileum -h2 antagonist may inhibit the release of intrinsic factor -B12 and folate deficiency are not easily differentiated; accordingly, patients should be screened for both immediately upon admission. .Beck's Cognitive Theory - ANSWER--negative automatic thoughts are the cause of depression -Beck's Cognitive Triad: negative thoughts are revolve around the self, the future, and the world .Bioequivalence - ANSWER-When the active ingredient of two drug products have the same rate and extent of absorption. .biomedical psychiatry - ANSWER-mental illness is conceptualized as a disorder of the brain circuit caused by a complex interplay of genetic and environmental factor .Bowen's family system - ANSWER--differentiation--ego strength. Differentiation is how well can the individual think through a situation without be drawn into internal or external pressures. -emotional fusion: family members sharing the same response -triangles: When the relationship between two family members become stressed, a third member is brought in to reduce anxiety .bulimia Laboratory finding - ANSWER--induced vomiting may cause metabolic alkalosis: elevated bicarbonate, hypochloremia, hypokalemia -Increased BUN indicates dehydration .Buspirone - ANSWER- 5HT1a partial agonist. initial 15 mg BID -no sexual dysfunction .CAGE - ANSWER-items responses are scored either 1 or 0. A score 2 or higher is considered clinically significant .Calcium - ANSWER--increased: 10.8 caused by hyperparathyroidism from tumor of renal disease, lithium .Carbamazepine - ANSWER--Tegretol can be used for alcohol withdrawal -Obtain CBC, thyroid function panel, kidney and liver panel. First 3 months CBC every month. After first 6 months collect CBC, thyroid, liver, and kidney every 6 months. -monitor for Stevens-Johnson Syndrome: red macules, eye erythema and edema, fever, pain, weakness .CBT - ANSWER-Mitigate distressing emotions by challenging the thoughts and behaviors that perpetuate them. Helps the individual identify how their thoughts influence their emotions .Clinical Institute Withdrawal Assessment of Alcohol (CIWA-AR) - ANSWER-Recommended in early alcohol withdrawal as a tool to aid in the recognition of escalating symptom severity or development of delirium tremens. -15 indicates immediate need for pharmacological intervention. -8 to 14 consider pharmacological intervention. .Clonidine and Guanfacine - ANSWER-help with impulse control. -guanfacine has longer half-life but clonidine has patch form -clonidine can help with hypersalivation associated with clozaril therapy -bradycardia warrents a gradual taper of the drug -will need to be slowly taper down if decide to d/c (avoid rebound hypertension) -usual starting dose for guanfacine is 1mg .Complex-partial seizure - ANSWER--often preceded by an aura (macroscopia, microscopia, depersonalization). -caused by excessive and synchronous electrical brain activity. -May display automatisms -cause impaired consciousness and unresponsive -commonly arise from the mesial temporal lobe .concussion - ANSWER--amnesia, headache, ataxia, mental status changes, disorientation, blurred vision, irritability, light sensitivity .Creatine Kinase - ANSWER-is assayed in blood tests as a marker of damage to CK-rich tissue such as in myocardial infarction, rhabdomyolysis, muscular dystrophy -used as a marker for NMS .Criteria for psych disorders - ANSWER--Major depressive disorder: must be present for 2 weeks. Must have 5 symptoms. -ADHD must be prior to the age of seven -Mania: must have symptoms for 1 week. Must have 3 symptoms (four if mood is only irritable). .Cyp 2D6 inhibitors - ANSWER-fluoxetine, bupropion, quinidine, paroxetine .Cyp 3a4 inducer - ANSWER-Carbamazepine, phenobarbital, phenytoin, rifampin .Cyp 3a4 inhibitors - ANSWER-Clarithromycin, ketoconazole, several antiviral .deductive reasoning - ANSWER-when you reach specific conclusion from a general premise. all dogs are black, thus my dog is black -rogers theory of nursing