CMN 548
Module 2 Study Guide 2025-2026 Update; Questions And
Answers (Verified Answers), 100% Guaranteed Pass
University of South Alabama (CMN 548)
Course level: Graduate. The course is for students pursuing an advanced
nursing degree, specifically for those specializing in psychiatric mental health.
Psychiatric-Mental Health Nurse Practitioner (PMHNP)
, CMN 548 Module 2 Study Guide
1. What is the most reliable indicator of a patient’s blood sugar status if they
have been taking a 2nd generation antipsychotic? Dr. Baker PPT, Sadock p.
1063-1064,
Fishbach page 335
a. Fasting blood glucose levels and glycosylated hemoglobin levels
(hemoglobin A1C) should be followed regularly as some of these
medications can cause abnormal glucose tolerance and may lead to
diabetes.
b. A1C shows the mean serum glucose concentration over the preceding 8-12
weeks, with a normal A1c level below 5.7 percent. A level of 6.5 or above
indicated diabetes mellitus. A good target range for diabetics is an A1c of 7.0 or
below
Pg. 141 (pdf CMN 548 readings), 1064 Sadock
Atypical antipsychotic agents have been associated with abnormalities in serum glucose
levels, including the development of diabetes mellitus. Many clinicians monitor their
patients who take atypical antipsychotic agents for the development of hyperglycemia
by obtaining fasting blood glucose levels and glycosylated hemoglobin levels on a
quarterly or semiannual basis.
Sadock, Chapter 7.6, Table 7.6-2, page 1063
Hemoglobin A1C, fasting blood glucose. Monitor at 12 weeks, 1 year, then annually.
2. How long can the following be detected in urine? Sadock Table 7.6-1 p.1059
c. Alcohol – 7-12 hours
d. Marijuana – 2-7 days
e. Benzodiazepines – 3 days
f. Amphetamines – 48-72 hours
Reference for table?? Answers are different than
Drugs Tested Screening Length of
Cutoff levels Detection
above
Alcohol 20 ng/mL 12 h
Ethanol (all methods)
Amphetamines 1,000 ng/mL 2–3 d
Δ-Amphetamine
Methamphetamine
Barbiturates 200 ng/mL Up to 30 d
Secobarbital
Benzodiazepines 200 ng/mL Up to 40 d
Nordiazepam
Marijuana 50 ng/mL 30–60 d
,3. What are some likely causes of a decrease in blood urea nitrogen
(BUN)? Fischbach p.407 (Page 355 in 11th edition)
Decreased BUN levels are associated with the following conditions:
a. Liver failure (severe liver disease), such as that resulting from hepatitis,
drugs, or poisoning
b. Acromegaly
c. Malnutrition, low-protein/ high carb diets
d. Impaired absorption (celiac disease)
e. Nephrotic syndrome (occasional)
f. Syndrome of inappropriate antidiuretic hormone (SIADH)
Interfering Factors:
· Women and children because they have less muscle mass than adult men
· Overhydration (Exclusive IV feedings)
· Late pregnancy r/t increased plasma volume (physiologic hydremia)
· Many drugs
·
Fishbach, Table E.1, page 1117
See table for specific drugs leading to increase/decrease
4. What symptoms may be present due to an elevated blood urea nitrogen
(BUN)? Fischbach p. 406 (Page 355 in 11th edition)
Increased BUN levels (azotemia) occur in the following conditions:
a. Impaired renal function caused by the following conditions:
1. Congestive heart failure
2. Salt and water depletion
3. Shock
4. Stress
5. Acute MI
b. Chronic renal disease such as glomerulonephritis and pyelonephritis
c. Urinary tract obstruction
d. Hemorrhage into GI tract
e. Diabetes mellitus with ketoacidosis
f. Excessive protein intake or protein catabolism as occurs in burns or cancer
g. Anabolic steroid use
Interfering factors: Older persons may have an increased BUN when kidneys are not
able to concentrate urine adequately.
Elevated BUN can indicate kidney dysfunction, and symptoms may include
fatigue, swelling (edema), frequent urination, confusion, dry mouth and
excessive thirst, pale skin, and rapid heart rate as the body compensates for
reduced kidney function.
Sadock, Chapter 7.6, page 1051
, Elevated BUN is common in dehydration
Fishbach, Table E.1, page 1117
See table for specific drugs leading to increase/decrease
5. What do basophils do? Fischbach p. 146 (Chapter 2, page 74-45 in 11th edition)
· Basophils constitute a small percentage of the total leukocyte count and are
considered phagocytic. The basophilic granules contain heparin, histamines,
and serotonin. Tissue basophils are called mast cells and are similar to blood
basophils. Normally, mast cells are not found in peripheral blood and are
rarely seen in healthy bone marrow.
· Basophil counts are used to study chronic inflammation - There is a
positive correlation between high basophil counts and high
concentrations of blood histamines, although this correlation does not
imply cause and effect.
· Normal Findings:
a. Absolute count: 15 to 50/mm3 or 0.02 to 0.05 × 10 9 /L
b. Differential: 0% to 1.0% of total WBC count
Clinical Implications
Basophilia (>50)
Common associations: granulocytic leukemia, acute basophilic leukemia, myeloid
metaplasia, meta proliferative disorders, Hodkin disease.
Less common associations: Inflammation, allergy, sinusitis, polycythemia vera,
chronic hemolytic anemia, post-splenectomy, post-ionizing radiation,
hypothyroidism, infections (TB, smallpox, chickenpox, influenza), foreign protein
injection
Basopenia (<20, difficult to diagnose)
Acute phase of infection, hyperthyroidism, stress reactions (pregnancy, MI),
prolonged steroid therapy, chemotherapy, radiation, hereditary absence, acute
rheumatic fever in children
6. Identify what might create a false positive blood sugar value above 140? Fishbach
p.385 (Chapter 6, page 333 in 11th Edition)
· Elevated glucose can occur with:
a. Steroids, diuretics, other drugs (see Appendix E)
b. Pregnancy (a slight blood glucose elevation normally occurs)
c. Surgical procedures, anesthesia, and hospitalization in intensive care unit (ICU)
d. Obesity or sedentary lifestyle
e. Parenteral glucose administration (e.g., from total parenteral nutrition)
Module 2 Study Guide 2025-2026 Update; Questions And
Answers (Verified Answers), 100% Guaranteed Pass
University of South Alabama (CMN 548)
Course level: Graduate. The course is for students pursuing an advanced
nursing degree, specifically for those specializing in psychiatric mental health.
Psychiatric-Mental Health Nurse Practitioner (PMHNP)
, CMN 548 Module 2 Study Guide
1. What is the most reliable indicator of a patient’s blood sugar status if they
have been taking a 2nd generation antipsychotic? Dr. Baker PPT, Sadock p.
1063-1064,
Fishbach page 335
a. Fasting blood glucose levels and glycosylated hemoglobin levels
(hemoglobin A1C) should be followed regularly as some of these
medications can cause abnormal glucose tolerance and may lead to
diabetes.
b. A1C shows the mean serum glucose concentration over the preceding 8-12
weeks, with a normal A1c level below 5.7 percent. A level of 6.5 or above
indicated diabetes mellitus. A good target range for diabetics is an A1c of 7.0 or
below
Pg. 141 (pdf CMN 548 readings), 1064 Sadock
Atypical antipsychotic agents have been associated with abnormalities in serum glucose
levels, including the development of diabetes mellitus. Many clinicians monitor their
patients who take atypical antipsychotic agents for the development of hyperglycemia
by obtaining fasting blood glucose levels and glycosylated hemoglobin levels on a
quarterly or semiannual basis.
Sadock, Chapter 7.6, Table 7.6-2, page 1063
Hemoglobin A1C, fasting blood glucose. Monitor at 12 weeks, 1 year, then annually.
2. How long can the following be detected in urine? Sadock Table 7.6-1 p.1059
c. Alcohol – 7-12 hours
d. Marijuana – 2-7 days
e. Benzodiazepines – 3 days
f. Amphetamines – 48-72 hours
Reference for table?? Answers are different than
Drugs Tested Screening Length of
Cutoff levels Detection
above
Alcohol 20 ng/mL 12 h
Ethanol (all methods)
Amphetamines 1,000 ng/mL 2–3 d
Δ-Amphetamine
Methamphetamine
Barbiturates 200 ng/mL Up to 30 d
Secobarbital
Benzodiazepines 200 ng/mL Up to 40 d
Nordiazepam
Marijuana 50 ng/mL 30–60 d
,3. What are some likely causes of a decrease in blood urea nitrogen
(BUN)? Fischbach p.407 (Page 355 in 11th edition)
Decreased BUN levels are associated with the following conditions:
a. Liver failure (severe liver disease), such as that resulting from hepatitis,
drugs, or poisoning
b. Acromegaly
c. Malnutrition, low-protein/ high carb diets
d. Impaired absorption (celiac disease)
e. Nephrotic syndrome (occasional)
f. Syndrome of inappropriate antidiuretic hormone (SIADH)
Interfering Factors:
· Women and children because they have less muscle mass than adult men
· Overhydration (Exclusive IV feedings)
· Late pregnancy r/t increased plasma volume (physiologic hydremia)
· Many drugs
·
Fishbach, Table E.1, page 1117
See table for specific drugs leading to increase/decrease
4. What symptoms may be present due to an elevated blood urea nitrogen
(BUN)? Fischbach p. 406 (Page 355 in 11th edition)
Increased BUN levels (azotemia) occur in the following conditions:
a. Impaired renal function caused by the following conditions:
1. Congestive heart failure
2. Salt and water depletion
3. Shock
4. Stress
5. Acute MI
b. Chronic renal disease such as glomerulonephritis and pyelonephritis
c. Urinary tract obstruction
d. Hemorrhage into GI tract
e. Diabetes mellitus with ketoacidosis
f. Excessive protein intake or protein catabolism as occurs in burns or cancer
g. Anabolic steroid use
Interfering factors: Older persons may have an increased BUN when kidneys are not
able to concentrate urine adequately.
Elevated BUN can indicate kidney dysfunction, and symptoms may include
fatigue, swelling (edema), frequent urination, confusion, dry mouth and
excessive thirst, pale skin, and rapid heart rate as the body compensates for
reduced kidney function.
Sadock, Chapter 7.6, page 1051
, Elevated BUN is common in dehydration
Fishbach, Table E.1, page 1117
See table for specific drugs leading to increase/decrease
5. What do basophils do? Fischbach p. 146 (Chapter 2, page 74-45 in 11th edition)
· Basophils constitute a small percentage of the total leukocyte count and are
considered phagocytic. The basophilic granules contain heparin, histamines,
and serotonin. Tissue basophils are called mast cells and are similar to blood
basophils. Normally, mast cells are not found in peripheral blood and are
rarely seen in healthy bone marrow.
· Basophil counts are used to study chronic inflammation - There is a
positive correlation between high basophil counts and high
concentrations of blood histamines, although this correlation does not
imply cause and effect.
· Normal Findings:
a. Absolute count: 15 to 50/mm3 or 0.02 to 0.05 × 10 9 /L
b. Differential: 0% to 1.0% of total WBC count
Clinical Implications
Basophilia (>50)
Common associations: granulocytic leukemia, acute basophilic leukemia, myeloid
metaplasia, meta proliferative disorders, Hodkin disease.
Less common associations: Inflammation, allergy, sinusitis, polycythemia vera,
chronic hemolytic anemia, post-splenectomy, post-ionizing radiation,
hypothyroidism, infections (TB, smallpox, chickenpox, influenza), foreign protein
injection
Basopenia (<20, difficult to diagnose)
Acute phase of infection, hyperthyroidism, stress reactions (pregnancy, MI),
prolonged steroid therapy, chemotherapy, radiation, hereditary absence, acute
rheumatic fever in children
6. Identify what might create a false positive blood sugar value above 140? Fishbach
p.385 (Chapter 6, page 333 in 11th Edition)
· Elevated glucose can occur with:
a. Steroids, diuretics, other drugs (see Appendix E)
b. Pregnancy (a slight blood glucose elevation normally occurs)
c. Surgical procedures, anesthesia, and hospitalization in intensive care unit (ICU)
d. Obesity or sedentary lifestyle
e. Parenteral glucose administration (e.g., from total parenteral nutrition)
