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Pmhnp 2 > study PMHNP ANCC Review > Flashcards

study PMHNP ANCC Review Flashcards

1
Q

2 Classes of Medication that should NOT be used together?

A

Ace inhibitors and ARBs together

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2
Q

5HT AKA Serotonin

A

Raphe Nucleus

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3
Q

14-year-old with no Axillary hair, has not gotten her Period yet.:

A

This is Normal according to Tanner Stage, start by 16.

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4
Q

65-year-old Started on SSRI ?

A

May experience an increase in anxiety in elderly, expect increase side effects, DO An EKG

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5
Q

Abnormal Trendelenburg Test

A

Hip Disease, refer child out, Assessed during Head to toe.

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6
Q

Accutane Treatment for Acne

A

Can cause Depression and Birth defects.

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7
Q

ACE INHIBITORS

A

-PRIL, CHF

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8
Q

Acetylcholine (Ach)

A

nucleus basalis of meynert

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9
Q

Adjustment disorder

A

reaction to a specific life event (identified
stressor), symptoms within 3 months but no more than 6
months. Think about a patient move.

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10
Q

Adolescent with substance abuse and working out has
muscle aches

A

urine is red colored- hematuria, concerned for
rhabdomyolysis (muscle breakdown)

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11
Q

Age for schizophrenia female

A

25-35

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12
Q

Aggression in brain

A

Stimulation of the amygdala results in
augmented aggressive behavior hypothalamus, is believed to serve a regulatory role in aggression..

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13
Q

Anorexic teenager with pain when eating

A

refeeding syndrome causes delayed gastric emptying.

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14
Q

Apoptosis

A

neuron loss because of suffocation, enzyme
breakdown

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15
Q

Appreciate Inquiry

A

strengths and competencies. What is being
done currently and assessment of strengths, no problem
focused, 3 steps are discovery, understanding, amplifying.

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16
Q

Assertive inquiry

A

Appreciative Inquiry (AI) is a collaborative, strengths-based approach to change in organizations and other human systems.

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17
Q

Autistic child not responding to your verbal commands:

A

This is normal, repetitive patterns of bx, impaired Social
interactions, verbal/nonverbal communication common.

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18
Q

Beck inventory score of 10?

A

0-63, over 30 severe, Don’t start medication just start therapy.

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19
Q

Beck Scales

A

Eight, separate, self-report inventories designed to
assess different areas. Scores from 0-63 over 30 is severe.

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20
Q

Best therapy for negative thinking

A

CBT, all or nothing thinking catastrophic thinking.
Humanistic therapy-self
Existential- reflection/self-control/personal responsibility

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21
Q

Bipolar not taking medication:

A

“Tell me how the medication.
works in your body.”

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22
Q

Brother sexually abusing sister:

A

make sure that he is not left!
alone with her and call CPS, mandatory reporter, arrange.
crisis therapy

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23
Q

Can disclose info to Medicare /CMS without consent: ..

A

NO

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24
Q

Clenched teeth

A

CN 5 Trigeminal (masseter or masticatory
muscle).

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25
Q

Clozaril

A

wbc+anc: If less than 950 discontinue the medication
and get a repeat level, 1000 is the cutoff
1.5-2 cbc biweekly
1-1.5 hold, cbc q dayx 3 weeks
less than 1- Stop medication
12.5initial, target 300-900mg/d once or bid
schizophenrenia/pscyhosis
agranulocytosis, seizures, myocarditis (inflammed heart muscle
-chest pain,diff breath)
wg, increase lipids/glucose
REMS pharmacy need clozaril registry to dispense
to start: WBC must be >_3500 and ANC >_2000
WBC + ANC weekly q6months, then every 2w q6months, then
monthly

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26
Q

Dark brown urine

A

Check LFT from Depakote 

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27
Q

DEA regulation monitoring:

A

State and Federal, PMP

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28
Q

Dopamine production IS

A

substantia nigra and ventral tegmental
area
(The dope sub needed to vent)

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29
Q

Early signs of aids dementia

A

memory, inattention,
concentration changes, worry over decreased cognition.

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30
Q

Elderly female with decreased sex drive:

A

: check testosterone Level

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31
Q

Elderly patient with dementia how does you know it can give
consent:

A

Able to repeat back risks and benefits.
elements= nature/purpose of Tx, risks/benefits of Tx,
risks/benefits not doing Tx, alternatives, diagnosis/prognosis.

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32
Q

EPS types
Not Any Dopmine
from long-term use of antipsychotics 

A

Tardive dyskinesia(Tell daddy to smack his lip) happens after years
Treatment: D/c and can help if ask Clozaril

Acute dystonia( stone stuck in eyes up)(hours), anticholinergic

Parkinsonism(shuffling gates, ), anticholinergic 

Akathisia (Katha likes to pass so block her ass)=beta blockers

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33
Q

Erythromycin and Tegretol

A

Erythromycin is an inhibitor (H=high level).
If on Tegretol and Erythromycin together would
want to reduce the dose of Tegretol!

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34
Q

Experiencing irritability/depression/edginess?

A

best assessment is mood questionnaire for bipolar, 7/13 bipolar.
likely

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35
Q

First line neuro-protective for bipolar:

A

Lithium

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36
Q

First symptom of metabolic syndrome?

A

Large waist circumference

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37
Q

Flonase interacts with what mood stabilizer?

A

Tegretol (inhibitor)

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38
Q

Frontal lobe dementia:

A

A form of dementia characterized by
personality changes/social changes.

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39
Q

GAD-7 scale:

A

More than 15 severe!!
GENERAL Anxiety (Anxiety 25/15 severe)

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40
Q

HAM-A:

A

Hamilton Anxiety Scale most commonly used.
14 domains, 14=mild, 18-24= moderate, 25-30=severe
(Anxiety 25/15 severe)

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41
Q

Fungus on toenail:

A

Scrape toenail and sent for testing.

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42
Q

Grade 2/5 hoarse systolic heart murmur:

A

Aortic stenosis Hyperthyroidism

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43
Q

Hamilton Depression Scale HAM-D

A

Severe 19- 23 (monitor for SI)
ii. Moderate 14 - 18
iii. Mild 8 -13
0-7 normal

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44
Q

The health care policy is access, cost and

A

Quality

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45
Q

How does Tegretol interact with cipro:

A

Cipro and erythromycins are inhibitors. Cause increased level of Tegretol.
Black box warning

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46
Q

How do you get paid for Medicare:

A

CPT current procedural code

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47
Q

Ibuprofen + lithium:
Idican

A

Increases the serum level of Lithium up to
double

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48
Q

Just Culture:

A

refers to an organization’s commitment to
accountability and a focus supporting universal safety in
health care. Find out the error ad where went wrong!

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49
Q

Keeping chronically mentally ill in the community?

A

ACT mode

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50
Q

Kleinfelter’s Syndrome:

A

male with more than one X
chromosome (XXY), little to no sperm, fertility treatment

51
Q

Labs for Macrocytic anemia:

A

Folic acid, vitamin B12, ESR/CRP,
HGB, MCV (liver

52
Q

Labs for rheumatoid arthritis:

A

ESR erythrocyte sedimentation
rate elevation. Synovial fluid analysis. X ray of joints.
Rheumatoid factor titer, CRP, Hgb

53
Q

Lab values concerning for patients on lithium:

A

4+ protein in urine,
Leukocytosis, creatinine, BUN, Na,

54
Q

Locus coeruleus

A

a small nucleus in the reticular formation that
is involved in directing Attention

55
Q

Masturbating 3-year-old:

A

Phallic stage is normal 3-6 years old.

56
Q

Parity Laws

A

Law that makes sure people with mental health issues get
the same financial treatment?

When we are having a party, everyone gets the same treatment

57
Q

Levels of Prevention

A

Primary: prevent/promotion, classes,
safety initiatives, education, classes, modifying environment
Secondary: screen-early detection, crisis hotlines, disaster
Tertiary: treat- to prevent further deterioration, rehab,
restoration, day treatment, social skills

58
Q

Lithium level is 1.4

A

monitor for toxicity, toxicity=1.5, nausea,
vomiting

59
Q

Lithium toxicity:

A

1.5, 3 is an emergency, severe
diarrhea/nausea/vomiting, metallic taste, tremor, slurred
speech, number one intervention, give fluids, sweating give.
Electrolytes too

60
Q

Medication for NMS?

A

Dantrolene and Bromocriptine (My BRO DAN)

61
Q

Medicine that can cause mania.

A

Steroids/prednisone
Antabuse, isoniazid

62
Q

MMSE part for thought disorder:

A

proverb interpretation,
abstract vs concrete interpretations
0-17 bad (MMSE &SLUM Are the only two That 0 is Bad)

63
Q

MMSE scores:

A

24-30 no cognitive impairment
18-23 mild cognitive impairment
0-17 severe cognitive impairment

64
Q

NMS is like S&M

A

NMS is like S&M;
-you get hot (hyperpyrexia)
-stiff (increased muscle tone)
-sweaty (diaphoresis)
-BP, pulse, and respirations go up &
-you start to drool

65
Q

NMS: neuroleptic malignant syndrome

A

Severe fever
Changing LOC
Autonomic instability
Rigidity
Sweating and drooling
FEVERS- fever, encephalopathy, vitals instability, elevated
white blood cell count/cpk, rigidity

66
Q

Neurotransmitters involved in alcoholism:

A

dopamine and Gaba

67
Q

Norepinephrine (NE): Were in the Brain

A

Synthesized in locus coeruleus arousal.
and other functions like mood, hunger, and sleep

68
Q

Nuchal rigidity:

A

stiffness in cervical neck area, meningitis

69
Q

NMS labs

A

NMS labs: increased CPK, WBC

70
Q

Np notices teen with DKA leaving without Eval:

A

Collaborate with ER to provide a psych assessment

71
Q

NSAIDs & ACE inhibitors effect:

A

can double lithium levels.

72
Q

Nucleus basalis of Meynert:

A

Alzheimer disease cognitive and memory function

73
Q

Nurse attacked 3 weeks ago and now scared to go to work:

A

Acute Stress Disorder, as it happened less than 1 month ago.

74
Q

. patient continues to say “I don’t know”:

A

Depression, not dementia

75
Q

OB/PMHNP in same clinic:

A

IT increased access to mental health
access

76
Q

ODD child:

A

help the parents with positive reinforcement and
parenting skills, limit setting, logical consequences,
consistency, power struggle/control issues problematic,
parenting/family dysfunction exacerbates.

77
Q

PANDAS:

A

Pediatric Autoimmune Neuropsychiatric Disorders
Associated with Streptococcal infections. OCD- recent strep
throat

78
Q

Patient abusing stimulants, what does NP assess for:

A

Insomnia and tremor, irritability, weight loss, nervous,
hypertension, tachycardia
79. Patient cold what labs to get?

79
Q

On Interferon and Lexapro:

A

Interferon can cause depression, increase Lexapro.

80
Q

Patient cold what labs to get?

A

Check TSH 0.5-5

81
Q

Patient has neuropathic pain, what medication will help, gabapentin not helping:

A

Alpha 2 delta, pregabalin- lyrica

82
Q

Patient is borderline and suicidal what therapy?

A

DBT, Goal IS to
decrease emotional reactivity/crisis bxs and self-validation.

82
Q

Patient lost a friend now experiences paralysis:

A

Conversion syndrome, repression of unconscious intrapsychic conflicts

83
Q

Patient in hospital with no family and failing cognitive test:

A

perform an MRI, labs to rule out substances.

84
Q
  1. Patient moving states, what do you do with medication?
A

Send enough medication is standard of practice

85
Q

Patient on Risperdal and elevated prolactin:

A

stop or decrease the medication, Tubin tract (hyperprolactemia)

86
Q

Patients husband shows up but not the patient:

A

both people need to be present, reschedule.

87
Q

Patient wakes up screaming at night:

A

ask family if anyone else has sleep problems.

88
Q

PICOT:
(A project)

A

P: Population/problem
I: Intervention/issue
C: Comparison
O: Outcome
T: Time
The population income out time 

89
Q

PHQ9:

A

score 1-27, over 20 is severe

90
Q

Person with EPS will most likely experience what:

A

Tardive dyskinesia

91
Q

Phases of policy making:

A

formulation, implementation,
evaluation

92
Q

PTSD: Acute stress disorder-

A

less than 1 month
PTSD- after 1 month

93
Q

PTSD nightmares:

A

Prazosin (PTSD- after 1 month)

94
Q

Puff cheeks

A

CN 7 facial (sensory and motor)

95
Q

Pulling hair out:

A

OCD/trichotillomania

Trichotillomania, also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one’s own hair

96
Q

Raphe nuclei:

A

A string of nuclei in the Midline of the midbrain
and brainstem that contain most of the serotonergic neurons of
the brain

97
Q

Reflexes expected at 1 month:

A

Moro until 4 months, Palmer
until 4 months, Plantar util 8 months, Babinski (2 years is
disease)

98
Q

Reluctant/silent patient:

A

open ended questions

99
Q

Rhett Syndrome:

A

A rare disorder found virtually exclusively in
Girls, is a neurodevelopmental disorder in which the child.
usually develops normally until about 6 to 18 months of age at
which characteristics of the syndrome emerge, characteristics
include:
Hypotonia (loss of muscle tone), reduced eye contact,
decelerated head growth, and disinterest in play activities

100
Q

Risk factors for Serotonin Syndrome:

A

more than 1 SSRI, st john’s wart, tramadol, Demerol, Ultram, meperidine, 5HT

101
Q

Scope of practice:

A

Comes from the state, board of Nursing/American nurse
association.

102
Q

Serotonin Discontinuation Syndrome:

A

syndrome caused by
abrupt withdrawal of an antidepressant drug, resulting in
sensory disturbances, sleeping disturbances, disequilibrium,
flu-like symptoms, dizzy, vertigo, paresthesia (brain zaps),
nausea/vomiting, and gastrointestinal effects

103
Q

Shrill CRY

A

Increased cranial pressure.

104
Q

Signs of fetal alcohol syndrome:

A

small head, shoey
palpebral fissure, inner epicanthal folds. Do IEP and early!
intervention specialist
small head, shoey
palpebral fissure, inner epicanthal folds. Do IEP and early
intervention specialist

105
Q

Signs of serotonin syndrome:

A

-shivering
-anxiety
-diaphoresis
-hyperthermia

Shits and Shivers
diarrhea, shivering, hyperreflexia/myoclonus, increased.
temperature, vital sign instability, encephalopathy, restlessness,
sweating

106
Q

Smoking cessation and antipsychotic:

A

Decrease the level of
Zyprexa, smoking is an inducer causing decreased levels of
the medication. When stop smoking re-increase the medication?

107
Q

Started on a medication then comes back in 2 weeks?

A

Increase the dose after 1-2 weeks, therapeutic effects 4-6
weeks

108
Q

Teen commits suicide, NP does presentation:

A

To teens in
order to normalize the grieving process.

108
Q

Substantia nigra IS

A

Midbrain structure where dopamine is
produced; involved in control of movement.

109
Q

Tegretol side effects:

A

Aplastic anemia, agranulocytosis, steven
Johnson’s, hyponatremia. Watch with cipro and Erythromycin.

110
Q

Telemedicine asking a legal question??

A

Licensing jurisdiction for the np

111
Q

therapeutic communication:

A

open ended, ‘tell me

112
Q

Tics what advice?

A

Fairly common in children and will often
remit on its own, ADHD concomitants

113
Q

To reduce stigma among teens seeking mental health..

A

Educate friends/peers

114
Q

Ventral tegmental area (VTA):

A

midbrain structure where dopamine is produced: associated with mood, reward, and addiction.

114
Q

Treatment for ADHD:

A

Stimulant and therapy together

115
Q

Wandering, disoriented person on the streets for 2 days:

A

Delirium

116
Q

What are you looking at when you are assessing the
function of an elderly individual:

A

ability to manage a
checkbook, instrumental ADLs go first (meds, phone, drive,
house week, balancing check book), then ADLs
eating/dressing, Exec functions=judgement, planning, taxes

117
Q

. What medication can alter absorption of antipsychotics?:

A

Antacids, can decrease antispsychotic effects

118
Q
  1. What medication to give for serotonin syndrome:
A

Cyproheptadine

119
Q

. What medication can alter absorption of antipsychotics?

A

?

120
Q

doxycycline is an abt which is an inhibitor and it takes precedence which Causes

A

Causes Toxic levels

InDucers= decrease other drugs
INhibitors= increase other drugs

121
Q

Benzodiazepines during pregnancy patient Teaching

A

Clonazepam klonopin causes floppy baby syndrome, and twice as many miscarriages 

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