LMR part 2

Question 1

Irvin Yalom characteristics of group therapy includes what
6 characteristics?

Answer 1

a. Instillation of hope
b. Universality
c. Group cohesiveness
d. Altruism
e. Interpersonal Learning
f. Appreciative Inquiry

Question 2

Participants develop hope for creating a different life. Members are at different levels of hope, so they gain from others

Answer 2

Instillation of hope definition

Question 3

Discover that others have similar problems, thoughts, feelings – they are not alone

Answer 3

Universality Definition

Question 4

Attraction to group and others – sense of belonging

Answer 4

Group cohesiveness Definition

Question 5

Sharing oneself with another and helping others

Answer 5

Altruism Definition

Question 6

Interacting with others increases adaptive interpersonal relationships

Answer 6

Interpersonal learning definition

Question 7

An approach to organization changes which focus on strengths rather than weaknesses

Answer 7

Appreciative Inquiry definition

Question 8

What is PICA?

Answer 8

Eating things that are not food such as paint chips. (may be a sign of lead poisoning)

Question 9

What are two neurotransmitters in Addiction?

Answer 9

GABA and Dopamine

Question 10

Delusion definition

Answer 10

a. Firm belief maintained despite of evidence of the contrary
b. Cult
c. Church members are part of cult

Question 11

What does it mean when a patient with anorexia complains of pain after eating/bloated/fullness?

Answer 11

Delayed Gastric Emptying

Question 12

What three medications can delay gastric emptying?

Answer 12

a. Ranitidine
b. Famotidine
c. omeprazole

Question 13

What medications can decrease the absorption of psychotropics? How long to wait between these two medications?

Answer 13

a. Antacids + PPI
b. Wait 2 hours between psychotropic and antacid administration

Question 14

SSRIs can cause what in older adults?

Answer 14

It can cause increased anxiety

Question 15

Make sure to avoid certain medications that cause paradoxical effect, what is an example of paradoxical effect?

Answer 15

This means that it causes the opposite effect.
Benzos is a medication that can have a paradoxical effect.

Question 16

Citalopram can cause what?

Answer 16

Can cause QT prolongation

Question 17

Citalopram:
a. Do not give adults more than how many mg daily?
b. What about older adults?

Answer 17

a. Adults more than 40mg a day.
b. Older adults no more than 20mg a day

Question 18

Apoptosis definition

Answer 18

Death of a cell/neuronal loss

Question 19

What is one way to assess depressed mood, emotional lability, and irritability?

Answer 19

Administer Mood Questionnaire

Question 20

Sleep disorders or nightmares in children: What to assess and why?

Answer 20

Assess family patterns of nightmares due to genetic factors.

Question 21

What are signs of lead poisoning? (Just read)

Answer 21

Developmental delay, learning difficulties, irritability, loss of appetite, weight loss, sluggishness/fatigue, abdominal pain, vomiting, constipation, hearing loss, seizures, PICA

Question 22

What do you do for lead poisoning?

Answer 22

Order test for lead.
Lead is found in rural 1970s houses

Question 23

When taking care of an infant that is about to die, it is important to what?

Answer 23

Give child to parents to allow to grieve for their loss.

Question 24

Normal grief and loss in children (just read)

Answer 24

a. Psychoeducation on grief reactions/response
b. Encourage support group
c. Grief responses vary = no protocol on how to grieve.

Question 25

Normal grief and loss in children example

Answer 25

a. If child lost mom, do not tell dad how child should grieve. b. It's most important to have intact family to make child adapt easily.

Question 26

What are the neurotransmitters in mood disorders?

Answer 26

a. Dopamine, Norepi, Serotonin (DNS) b. GABA c. Glutamate

Question 27

What are risk factors for osteoporosis?

Answer 27

a. smoking, caffeine, b. Lack of weight bearing exercise, c. Lack of diet rich in calcium and Vit D.

Question 28

Enmeshment definition

Answer 28

The relationship between two or more people in which personal boundaries are unclear.

Question 29

Enmeshment example

Answer 29

This can occur during countertransference- Therapist might be too emotionally attached to patient where boundaries are unclear.

Question 30

What are the key elements of mindfulness meditation technique?

Answer 30

a. Breathe awareness b. Awareness of body sensation, thoughts or sounds

Question 31

What can help build resilience in children?

Answer 31

Self esteem building exercises

Question 32

When are yes/no, close ended questions appropriate? Example?

Answer 32

a. Unable to construct a chronological narrative b. Ex: 10-year-old child who cannot construct a chronological narrative – use yes/no

Question 33

You scheduled an appointment with a couple but only one showed up. What do you do next?

Answer 33

Reschedule appointment until both can be present

Question 34

You are working in an office setting and you find out that a patient’s 5-year old son got sodomized/raped by 16 sister, what are the steps you have to do to handle this?

Answer 34

Do not let 5 year old alone with sibling, report to CPS, and arrange crisis therapy.

Question 35

What is the Freud Phallic stage and what age?

Answer 35

The stage where 3-6 year olds play with their genitals and it's normal

Question 36

Boys develop enlargement/swellings/tenderness under nipples: What are the ages and when does it disappear?

Answer 36

They are ages 9-16 years old. It disappears within 6 months.

Question 37

What increases in rheumatoid arthritis?

Answer 37

Erythrocyte sedimentation rates (ESR)

Question 38

An infant has a shrill/high pitched cry. What do you suspect?

Answer 38

They have increased intracranial pressure

Question 39

An elderly female patient/post-menopausal woman is complaining of a decreased sex drive. What can this indicate?

Answer 39

a. Decreased levels of testosterone. b. Decreased blood flow of the pelvic region

Question 40

Alcohol dehydrogenase definition

Answer 40

ETOH tolerance? This means that women are more likely to get drunk compared to men because they have a decreased amount.

Question 41

Men are more likely to develop ETOH induced liver compared to women: True or false

Answer 41

False Women are more likely to develop ETOH induced liver problems copared to men.

Question 42

When psychiatric care provider added to a non- psych practice like OBGYN = increase mental health access

Answer 42

Just read

Question 43

Palmar reflex/grasp = until how many months?

Answer 43

This is when they grab someone's finger. 5-6 months

Question 44

Moro reflex/grasp = until how many months?

Answer 44

This is when they startle because they feel like they are falling. Until 5-6 months

Question 45

Babinski reflex/plantar = until how long? When should toes go inwards? How old for outwards?

Answer 45

a. Until 2 years- This is when toes go outwards b. After 2 years is when toes go inwatds

Question 46

What is Phosphodiesterase (PDE5)? What it’s used for?

Answer 46

a. Viagra b. Used for sexual dysfunction c. It is rapidly absorbed

Question 47

What to check if a patient has Macrocytic normochromic anemia?

Answer 47

Check Vit B12 and folic acid

Question 48

Adolescents ADHD = substance use. Ex: you read an article and found out that adolescents with ADHD have a higher substance use – apply in your practice by screen all adolescent ADHD patients for substance use OR screen all substance use patients for ADHD

Answer 48

Just read

Question 49

What is acupuncture used for?

Answer 49

Used for pain and depression.

Question 50

What does Habeas corpus mean?

Answer 50

It's the legal principal that protects patients against unlawful hospitalizations (mental illness)

Question 51

Symptoms for disseminated encephalomyelitis? Common in who?

Answer 51

Symptoms = a. weakness b. ataxia c. confusion d. paresthesia. Common in children

Question 52

What does a provider do who someone who has asymmetrical body movements on extremities?

Answer 52

The complete a neuro exam for diagnosis

Question 53

PICOT- What level is evidence from systematic review or meta-analysis of all relevant RCTs?

Answer 53

Level 1

Question 54

PICOT- What level is evidence obtained from at least one well-designed RCT

Answer 54

Level 2

Question 55

What to review to establish patient diagnosis? What to do if unable to remember?

Answer 55

Review timeline of their symptoms. If unable to remember, use anchor memory technique/link memorable events

Question 56

What is an example of something that is based on evidence?

Answer 56

Current journal articles

Question 57

What to do before you start a patient on a medication?

Answer 57

Assess patient's knowledge and beliefs

Question 58

What can cause iatrogenic disease?

Answer 58

If adverse effects are not treated, this can cause iatrogenic disease

Question 59

Iatrogenic is common in what population?

Answer 59

Older adults, so assess medication history.

Question 60

What do you do if you are trying to create a policy for NPs worldwide?

Answer 60

Host online forum/survey for feedback

Question 61

What do you do if you are trying to implement a new policy at a job site but your colleagues are against you?

Answer 61

Discuss with them how new policy can improve quality of patient care

Question 62

How to ensure continuous improvement of quality care outpatient clinic?

Answer 62

Develop an instrument to monitor clinical outcomes

Question 63

How to ensure continuous quality improvement when treating patient with mental illness like depression/anxiety?

Answer 63

Use a rating scale to determine baseline scores and at regular intervals during treatment

Question 64

Autoimmune diseases increase what?

Answer 64

Increased cytokine levels

Question 65

Desmopressin can cause what?

Answer 65

Can cause enuresis (decreases urine production)

Question 66

Why can’t you look at a patient’s social media?

Answer 66

It's violating patient's trust

Question 67

What is an example of conflict of interest policy?

Answer 67

pharmaceutical companies promise to pay off student loans for NPs if they prescribe their medications

Question 68

If a patient is on a medication but then the FDA releases a black box warning on medication and the patient is asking you about the BB warning. What should you do?

Answer 68

Research benefits and risks of continued use of medication

Question 69

How to apply using off label use of medication?

Answer 69

Full disclosure documentation (benefits/risks) and evidence that supports off label use.

Question 70

Risk factors for sleep apnea?

Answer 70

Excess weight obesity DM smoking HTN narrowed airways

Question 71

What does reflective practice mean?

Answer 71

Debriefing strategies after event/cause

Question 72

What some legal issues of telemed?

Answer 72

confidentiality and medical errors.

Question 73

Jurisdiction authority over what?

Answer 73

jurisdiction authority over licensure

Question 74

A SUD is attending intensive, structured outpatient program. What if they are still blaming other for their issues?

Answer 74

If they are still blaming others for their issues, they may not be ready to transfer to less intensive/less structured program.

Question 75

If SUD are able to identify coping skills?

Answer 75

They are able to transfer to less intensive program

Question 76

Tarasoff principle: What is it?

Answer 76

It is Duty to warn. This means we can notify potential victims of imminent danger of HI clients.

Question 77

Rennie v Klein case: What is it?

Answer 77

An involuntary committed patient who has not been found competent, absent of emergency, has a qualified right to refuse psychotropic medications.

Question 78

What is Donaldson v O'connor?

Answer 78

a. Confinement b. It is unconstitutional to commit a person involuntary (for the longest time) who is not DTO/DTS. *Donald duck can't be confined

Question 79

Erikson's: Appreciation of independence and relatedness

Answer 79

Trust vs Mistrust

Question 80

Erikson's: Acceptance of the cycle of life, from integration to disintegration.

Answer 80

Autonomy vs shame

Question 81

Erikson's: Humor, empathy, resilience

Answer 81

Initiative vs guilt

Question 82

Erikson's: Humility, acceptance of the course of one's life and unfulfilled hopes

Answer 82

Industry vs Inferiority

Question 83

Erikson's: Sense of complexity of relationships; value of tenderness and loving freely

Answer 83

Intimacy vs Isolation

Question 84

Erikson's: Caritas, caring for others and agape, empathy and concern

Answer 84

Generativity vs stagnation

Question 85

Erikson's: Existential identify; a sense of integrity strong enough to withstand physical disintegration

Answer 85

Integrity/Ego vs Despair

Question 86

Ability to learn how things work to understand and organize. School age: 6-12

Answer 86

Industry vs Inferiority (1)

Question 87

Ability to work, sense of competency and achievement

Answer 87

Industry vs Inferiority (2)

Question 88

Friends and classmates play a role in how children progress through this stage.

Answer 88

Industry vs Inferiority (3)

Question 89

Through proficiency at play and schoolwork, children are able to develop a sese of competency and pride in their abilities

Answer 89

Industry vs Inferiority (4)

Question 90

Unfavorable outcome; A sense of inferiority to understand and organizing

Answer 90

Industry vs Inferiority (5)

Question 91

a. Ages 2-7 b. Magical thinking is normal c. Normal to dream about monsters

Answer 91

Piaget's Theory: Pre-operational

Question 92

Piaget's Theory: Formal Operational

Answer 92

a. 11+ years old b. Abstract logic Ex: science project, test hypothesisi.