LMR GEORGETTE PMHNP FINAL EXAM 2024/2025
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
A 72 year old is brought in by her husband with increasing forgetfulness,
decreased activity, and decreased appetite for 2 months. She has a history
of hypertension and is being treated with lisinopril. The exam is normal and
the mini mental status exam provides a score of 24 but she declines to
answer some questions and needs to be urged to participate in the
assessment. What is the most likely diagnosis?
A. Alzheimers disease
B. Vascular dementia
C. Depression
D. Delirium - ANSWER depression
During patient education on sertraline, the PMHNP focuses upon the
potential side effect of
A. agranulocytosis
B. hypernatremia
C sexual dysfunction
D weight loss - ANSWER sexual dysfunction
A 23 year old woman is Brought in to to the ER after attempting to commit
suicide by cutting her wrists. Which action by the PMHNP would be of
highest priority initially?
A. Assess her coping behaviors
B. Assess her current level of suicidality
C. Take her vital signs
D. Asess her health history - ANSWER take her vital signs
Bipolar Mnemonic (DIG FAST) - ANSWER Distractibility
impulsivity
grandiosity
flight of ideas
agitation, psychomotor
sleep need decreased
talkativeness, pressured speech
What is the gold standard treatment for mania - ANSWER lithium
,What is neuroprotective treatment for bipolar I - ANSWER lithium
Normal Free T4 - ANSWER 0.8-2.8
Normal TSH - ANSWER 0.5-5.0
When T4 and T3 are high, and TSH is low - ANSWER hyperthyroidism
When T4 and T3 are low, and TSH is high - ANSWER hypothyroidism
Hypothyroidism mimics - ANSWER depression
hyperthyroidism mimics - ANSWER mania
sensitive to cold, cold intolerant - ANSWER hypothyroid
heat intolerant - ANSWER hyperthyroid
Normal AST and ALT - ANSWER AST 5-40
ALT 5-35
with liver damage ALT - ANSWER rises to 50x normal
Argues with authority - ANSWER oppositional defiant disorder
defiant but not aggressive - ANSWER oppositional defiant disorder
treatment for ODD - ANSWER therapy
Person is aggressive, lack of remorse, destruction of property, deceit or
theft - ANSWER conduct disorder
treatment for conduct disorder - ANSWER target mood and aggression.
person has sudden: blindness, mutism, paralysis, paresthesia, neurological
symptoms - ANSWER conversion disorder
emotional or behavioral reaction to a stressful event or change in person's
life within 3 months of it happening. - ANSWER adjustment disorder
,A male patient informs as adult PMHNP that he has not slept in three days,
has poor concentration, and denies fatigue. The patient's diagnosis is:
A. ADHD
B. Bipolar disorder
C. Panic disorder
D. Primary insomnia - ANSWER bipolar disorder
The neuroprotective treatment of choice for bipolar disorder is - ANSWER
lithium
According to the current clinical guidelines for treating a patient with bipolar
I disorder mania with psychotic features, an adult psychiatric and mental
health nurse practitioner prescribes:
A.) Lithium
B. Citalopram
C. Lamotrigine
D. Quetiapine - ANSWER quetiapine
intrusive reexperiencing of a traumatic event - ANSWER PTSD
symptoms of PTSD - ANSWER hyperarousal, avoidance of stimuli
associated with trauma, intrusive symptoms
Pharm treatment for pTSD - ANSWER SSRI (Zoloft)
TCA
Prazosin
AVOID BENZOS
Risk factors for OCD - ANSWER first degree relative and PANDAS--
associated with strep infection,
Tourette's - ANSWER At least 2 motor tics and at least one vocal tic have
been present.
Cause of tourettes - ANSWER dopamine --hyperactivity of the dopamine
system.
use of external agents that mimic disease (patient ingests foreign body) -
ANSWER factitious disease
, excessive worry more than 6 months - ANSWER GAD
Age of onset of schizophrenia in males - ANSWER 18-25
Age of onset of schizophrenia in females - ANSWER 25-35
Cause of schizophrenia - ANSWER intrauterine insults
prenatal exposure to toxins, including viral agents
Problem in the brain in schizophrenia - ANSWER enlarged ventricles,
everything else decreases
Things to monitor and labs while on antispychotic - ANSWER serum
glucose, serum lipid panel, weight, BMI, waist to hip ratio.
liver and kidney function
CBC
non-harm treatment for schizophrenia - ANSWER ACT (assertive
community treatment)
Person has psychotic symptoms similar to schizophrenia as well as mood
symptoms seen in depression and bipolar - ANSWER schizoaffective
trust vs mistrust - ANSWER birth to one year
virtue in trust vs mistrust - ANSWER hope
autonomy vs shame and doubt - ANSWER early childhood 1-3 years
virtue for autonomy vs shame and doubt - ANSWER will (they seek will
power, independence)
Inititiative vs. guilt - ANSWER late childhood 3-6 years
virtue of initiative vs guilt - ANSWER purpose
Ability to be a self-starter, to initiate one's own activities.
Industry vs inferiority (VERY HIGH YIELD) - ANSWER school age
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
A 72 year old is brought in by her husband with increasing forgetfulness,
decreased activity, and decreased appetite for 2 months. She has a history
of hypertension and is being treated with lisinopril. The exam is normal and
the mini mental status exam provides a score of 24 but she declines to
answer some questions and needs to be urged to participate in the
assessment. What is the most likely diagnosis?
A. Alzheimers disease
B. Vascular dementia
C. Depression
D. Delirium - ANSWER depression
During patient education on sertraline, the PMHNP focuses upon the
potential side effect of
A. agranulocytosis
B. hypernatremia
C sexual dysfunction
D weight loss - ANSWER sexual dysfunction
A 23 year old woman is Brought in to to the ER after attempting to commit
suicide by cutting her wrists. Which action by the PMHNP would be of
highest priority initially?
A. Assess her coping behaviors
B. Assess her current level of suicidality
C. Take her vital signs
D. Asess her health history - ANSWER take her vital signs
Bipolar Mnemonic (DIG FAST) - ANSWER Distractibility
impulsivity
grandiosity
flight of ideas
agitation, psychomotor
sleep need decreased
talkativeness, pressured speech
What is the gold standard treatment for mania - ANSWER lithium
,What is neuroprotective treatment for bipolar I - ANSWER lithium
Normal Free T4 - ANSWER 0.8-2.8
Normal TSH - ANSWER 0.5-5.0
When T4 and T3 are high, and TSH is low - ANSWER hyperthyroidism
When T4 and T3 are low, and TSH is high - ANSWER hypothyroidism
Hypothyroidism mimics - ANSWER depression
hyperthyroidism mimics - ANSWER mania
sensitive to cold, cold intolerant - ANSWER hypothyroid
heat intolerant - ANSWER hyperthyroid
Normal AST and ALT - ANSWER AST 5-40
ALT 5-35
with liver damage ALT - ANSWER rises to 50x normal
Argues with authority - ANSWER oppositional defiant disorder
defiant but not aggressive - ANSWER oppositional defiant disorder
treatment for ODD - ANSWER therapy
Person is aggressive, lack of remorse, destruction of property, deceit or
theft - ANSWER conduct disorder
treatment for conduct disorder - ANSWER target mood and aggression.
person has sudden: blindness, mutism, paralysis, paresthesia, neurological
symptoms - ANSWER conversion disorder
emotional or behavioral reaction to a stressful event or change in person's
life within 3 months of it happening. - ANSWER adjustment disorder
,A male patient informs as adult PMHNP that he has not slept in three days,
has poor concentration, and denies fatigue. The patient's diagnosis is:
A. ADHD
B. Bipolar disorder
C. Panic disorder
D. Primary insomnia - ANSWER bipolar disorder
The neuroprotective treatment of choice for bipolar disorder is - ANSWER
lithium
According to the current clinical guidelines for treating a patient with bipolar
I disorder mania with psychotic features, an adult psychiatric and mental
health nurse practitioner prescribes:
A.) Lithium
B. Citalopram
C. Lamotrigine
D. Quetiapine - ANSWER quetiapine
intrusive reexperiencing of a traumatic event - ANSWER PTSD
symptoms of PTSD - ANSWER hyperarousal, avoidance of stimuli
associated with trauma, intrusive symptoms
Pharm treatment for pTSD - ANSWER SSRI (Zoloft)
TCA
Prazosin
AVOID BENZOS
Risk factors for OCD - ANSWER first degree relative and PANDAS--
associated with strep infection,
Tourette's - ANSWER At least 2 motor tics and at least one vocal tic have
been present.
Cause of tourettes - ANSWER dopamine --hyperactivity of the dopamine
system.
use of external agents that mimic disease (patient ingests foreign body) -
ANSWER factitious disease
, excessive worry more than 6 months - ANSWER GAD
Age of onset of schizophrenia in males - ANSWER 18-25
Age of onset of schizophrenia in females - ANSWER 25-35
Cause of schizophrenia - ANSWER intrauterine insults
prenatal exposure to toxins, including viral agents
Problem in the brain in schizophrenia - ANSWER enlarged ventricles,
everything else decreases
Things to monitor and labs while on antispychotic - ANSWER serum
glucose, serum lipid panel, weight, BMI, waist to hip ratio.
liver and kidney function
CBC
non-harm treatment for schizophrenia - ANSWER ACT (assertive
community treatment)
Person has psychotic symptoms similar to schizophrenia as well as mood
symptoms seen in depression and bipolar - ANSWER schizoaffective
trust vs mistrust - ANSWER birth to one year
virtue in trust vs mistrust - ANSWER hope
autonomy vs shame and doubt - ANSWER early childhood 1-3 years
virtue for autonomy vs shame and doubt - ANSWER will (they seek will
power, independence)
Inititiative vs. guilt - ANSWER late childhood 3-6 years
virtue of initiative vs guilt - ANSWER purpose
Ability to be a self-starter, to initiate one's own activities.
Industry vs inferiority (VERY HIGH YIELD) - ANSWER school age
