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PMHNP CERTIFICATION EXAM QUESTIONS AND VERIFIED ANSWERS | LATEST UPDATE | CORRECT MARKING SCHEME |

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PMHNP CERTIFICATION EXAM QUESTIONS AND VERIFIED ANSWERS | LATEST UPDATE | CORRECT MARKING SCHEME | /. Pain and bloating after eating is caused by... - Answer-delayed gastric emptying /.Medications that cause delayed gastric emptying? - Answer-PPIs; ranitidine, famotidine, omeprazole /.What instructions should you give your patient if they are prescribed antacids/PPIs and psychotropics? - Answer-Give medications at least 2 hours apart b/c antacids/PPIs decrease absorption of psychotropics /.Normal BMI range - Answer-18.5-25 /.Criteria for admission for ED bx: - Answer-BMI 15; 25% total body weight loss in 3 months; severe dehydration, infection, bradycardia, hypothermia, hematemesis, hypokalemia /.What neurotransmitters are implicated in ADHD? - Answer-DA, NE, 5HT - DNS /.What brain structures are involved in ADHD? - Answer-Reticular activating system, basal ganglia, frontal cortex - RBF /.Abnormalities in this part of the brain cause inattentive ADHD: - Answer-Prefrontal cortex /.Amphetamines are FDA approved for children beginning at _ years old - Answer-3 /.Methamphetamines are FDA approved for children beginning at _ years old - Answer-6 /.Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients ages ___ - Answer-6-17 /.Strattera is FDA approved to treat ADHD in patients ages ___ - Answer-6 and up (including adults) /.Adults diagnosed with both ADHD and depression would benefit from being prescribed: - Answer-Wellbutrin /.Conduct disorder can be diagnosed in: - Answer-Both children and adults /.Conduct disorder diagnostic criteria: - Answer-Violating rights of others or societal norms; aggression towards people/animals; destruction of property; no remorse /.Treatment for conduct disorder: - Answer-Targets aggression and mood; SGA, mood stabilizer, SSRI, alpha agonists /.ODD diagnostic criteria: - Answer-Argumentative, defiant for at least 6 months and with 4 sx /.Treatment of ODD: - Answer-Focused on family therapy, child management skills, teaching parents reinforcement/boundaries/problem solving /.DMDD diagnostic criteria: - Answer-Childhood depressive d/o between ages 6-17; chronic dysregulated mood, frequent tantrums, severe irritability; typically DMDD rather than bipolar d/o in children /.Neurotransmitters implicated in ASD: - Answer-Glutamate, GABA, 5HT - GGS /.Echolalia - Answer-Meaningless repetition of words; often seen in ASD /.Broken mirror theory - Answer-Dysfunction of the mirror neuron system results in poor social interaction and cognition in ASD patients /.Parallel play is developmentally appropriate at which ages? - Answer-1-3 years old /.Parallel play continuing beyond the age of 3 years old may be indicative of... - Answer-ASD dx d/t social deficits /.M-CHAT - Answer-Modified Checklist for Autism in Toddlers; ASD scale /.ADOS-G - Answer-Autism Diagnostic Observation Schedule - Generic; ASD scale /.ASQ - Answer-Ages and Stages Questionnaire; development and social/emotional screening /.Pharmacological treatment of ASD: - Answer-Stimulants (increase DA to help with impulsivity, hyperactivity, inattention; Antipsychotics (target aggressive bx, tantrums, self-injury, stereotyped bx) /.Nightmares in children can be the result of: - Answer-Genetic factors; assess family patterns of nightmares /.Features of children diagnosed with Fragile X - Answer-LARGE features: large head, elongated face, hyperextensible joints, abnormally large testes, short stature /.Features of children diagnosed with fetal alcohol syndrome - Answer-small features: small head, small eye opening, low nasal bridge, flat midface, smooth philtrum, thin upper lip /.Clock drawing test assesses function of which brain lobe? - Answer-Parietal /.What does the clock drawing test assess for? - Answer-Executive/cognitive fx, impairments associated w/ damage to right parietal lobe, constructional apraxia (inability to draw or assemble objects) /.Important labs to draw for patients presenting with dementia? - Answer-B12, folic acid /.Dementia presents with mental decline that is ___ - Answer-Chronic; if acute sx, consider other dx /.Symptoms of subcortical dementia: - Answer-Motor sx, lack of coordination, tremors, depression, irritability, apathy /.Example of subcortical dementia diagnosis - Answer-Huntington's disease /.Symptoms of cortical dementia: - Answer-Language and memory impairments (aphasia and amnesia) /.Example of cortical dementia diagnosis: - Answer-Alzheimer's /.Presentation of dementia d/t HIV disease - Answer-Subcortical effects; motor abnormalities, bx abnormalities, cognitive decline /.Presentation of dementia with Lewy bodies - Answer-Visual hallucinations, Parkinsonian sx /.Presentation of frontal lobe dementia (e.g. Pick's disease) - Answer-Personality/bx changes, language changes, inappropriate social bx, aggression /.Presentation of Huntington's disease - Answer-Subcortical dementia; motor abnormalities, psychomotor slowing; high incidence of depression, psychosis; begins ages 30-45; affects males and females equally /.What is the most effective test to determine if someone will develop Huntington's disease? - Answer-Direct genetic test (no risk) /.What is the likelihood a child of a parent with Huntington's will develop it? - Answer-50% chance /.Dementia etiology - Answer-Cerebral atrophy, enlarged ventricles; decreased Ach and NE; genetic loading /.What neurotransmitters are implicated in dementia, and how? - Answer-Decreased Ach and NE /.What is the first line treatment for psychosis and agitation in dementia? - Answer-SGAs - but try nonpharmacological therapies first /.What is delirium? - Answer-ACUTE disturbance of LOC, cognition, attention /.What pharmacological treatment do you use for delirium-induced agitation or psychosis? - Answer-Low dose haldol /.What pharmacological treatment do you use for alcohol-induced delirium? - Answer-BNZ /.Anytime a patient presents with delirium, what labs should you order? - Answer-UA with culture and specificity d/t infx being a potential cause for delirium, esp in older adults /.What is pseudodementia? - Answer-Cognitive sx r/t depression in older adults /.Dementia vs. pseudodementia - Answer-Dementia: premorbid hx of slowly declining cognition Pseudodementia: acute onset of significant cognitive changes /.How would someone with dementia vs. pseudodementia answer a question? - Answer-Dementia: confabulates, lacks answer Pseudodementia: "I don't know" /.How can depression present in older adults? - Answer-Cognitive deficits - irritability, agitation, hallucinations, delusions

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PMHNP CERTIFICATION EXAM
QUESTIONS AND VERIFIED ANSWERS |
LATEST UPDATE | CORRECT MARKING
SCHEME |


/. Pain and bloating after eating is caused by... - Answer-✅delayed gastric emptying

/.Medications that cause delayed gastric emptying? - Answer-✅PPIs; ranitidine,
famotidine, omeprazole

/.What instructions should you give your patient if they are prescribed antacids/PPIs and
psychotropics? - Answer-✅Give medications at least 2 hours apart b/c antacids/PPIs
decrease absorption of psychotropics

/.Normal BMI range - Answer-✅18.5-25

/.Criteria for admission for ED bx: - Answer-✅BMI <15; 25% total body weight loss in 3
months; severe dehydration, infection, bradycardia, hypothermia, hematemesis,
hypokalemia

/.What neurotransmitters are implicated in ADHD? - Answer-✅DA, NE, 5HT - DNS

/.What brain structures are involved in ADHD? - Answer-✅Reticular activating system,
basal ganglia, frontal cortex - RBF

/.Abnormalities in this part of the brain cause inattentive ADHD: - Answer-✅Prefrontal
cortex

/.Amphetamines are FDA approved for children beginning at _ years old - Answer-✅3

/.Methamphetamines are FDA approved for children beginning at _ years old - Answer-
✅6

/.Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients
ages ___ - Answer-✅6-17

,/.Strattera is FDA approved to treat ADHD in patients ages ___ - Answer-✅6 and up
(including adults)

/.Adults diagnosed with both ADHD and depression would benefit from being
prescribed: - Answer-✅Wellbutrin

/.Conduct disorder can be diagnosed in: - Answer-✅Both children and adults

/.Conduct disorder diagnostic criteria: - Answer-✅Violating rights of others or societal
norms; aggression towards people/animals; destruction of property; no remorse

/.Treatment for conduct disorder: - Answer-✅Targets aggression and mood; SGA,
mood stabilizer, SSRI, alpha agonists

/.ODD diagnostic criteria: - Answer-✅Argumentative, defiant for at least 6 months and
with 4 sx

/.Treatment of ODD: - Answer-✅Focused on family therapy, child management skills,
teaching parents reinforcement/boundaries/problem solving

/.DMDD diagnostic criteria: - Answer-✅Childhood depressive d/o between ages 6-17;
chronic dysregulated mood, frequent tantrums, severe irritability; typically DMDD rather
than bipolar d/o in children

/.Neurotransmitters implicated in ASD: - Answer-✅Glutamate, GABA, 5HT - GGS

/.Echolalia - Answer-✅Meaningless repetition of words; often seen in ASD

/.Broken mirror theory - Answer-✅Dysfunction of the mirror neuron system results in
poor social interaction and cognition in ASD patients

/.Parallel play is developmentally appropriate at which ages? - Answer-✅1-3 years old

/.Parallel play continuing beyond the age of 3 years old may be indicative of... - Answer-
✅ASD dx d/t social deficits

/.M-CHAT - Answer-✅Modified Checklist for Autism in Toddlers; ASD scale

/.ADOS-G - Answer-✅Autism Diagnostic Observation Schedule - Generic; ASD scale

/.ASQ - Answer-✅Ages and Stages Questionnaire; development and social/emotional
screening

,/.Pharmacological treatment of ASD: - Answer-✅Stimulants (increase DA to help with
impulsivity, hyperactivity, inattention; Antipsychotics (target aggressive bx, tantrums,
self-injury, stereotyped bx)

/.Nightmares in children can be the result of: - Answer-✅Genetic factors; assess family
patterns of nightmares

/.Features of children diagnosed with Fragile X - Answer-✅LARGE features: large
head, elongated face, hyperextensible joints, abnormally large testes, short stature

/.Features of children diagnosed with fetal alcohol syndrome - Answer-✅small features:
small head, small eye opening, low nasal bridge, flat midface, smooth philtrum, thin
upper lip

/.Clock drawing test assesses function of which brain lobe? - Answer-✅Parietal

/.What does the clock drawing test assess for? - Answer-✅Executive/cognitive fx,
impairments associated w/ damage to right parietal lobe, constructional apraxia (inability
to draw or assemble objects)

/.Important labs to draw for patients presenting with dementia? - Answer-✅B12, folic
acid

/.Dementia presents with mental decline that is ___ - Answer-✅Chronic; if acute sx,
consider other dx

/.Symptoms of subcortical dementia: - Answer-✅Motor sx, lack of coordination, tremors,
depression, irritability, apathy

/.Example of subcortical dementia diagnosis - Answer-✅Huntington's disease

/.Symptoms of cortical dementia: - Answer-✅Language and memory impairments
(aphasia and amnesia)

/.Example of cortical dementia diagnosis: - Answer-✅Alzheimer's

/.Presentation of dementia d/t HIV disease - Answer-✅Subcortical effects; motor
abnormalities, bx abnormalities, cognitive decline

/.Presentation of dementia with Lewy bodies - Answer-✅Visual hallucinations,
Parkinsonian sx

/.Presentation of frontal lobe dementia (e.g. Pick's disease) - Answer-✅Personality/bx
changes, language changes, inappropriate social bx, aggression

, /.Presentation of Huntington's disease - Answer-✅Subcortical dementia; motor
abnormalities, psychomotor slowing; high incidence of depression, psychosis; begins
ages 30-45; affects males and females equally

/.What is the most effective test to determine if someone will develop Huntington's
disease? - Answer-✅Direct genetic test (no risk)

/.What is the likelihood a child of a parent with Huntington's will develop it? - Answer-
✅50% chance

/.Dementia etiology - Answer-✅Cerebral atrophy, enlarged ventricles; decreased Ach
and NE; genetic loading

/.What neurotransmitters are implicated in dementia, and how? - Answer-✅Decreased
Ach and NE

/.What is the first line treatment for psychosis and agitation in dementia? - Answer-
✅SGAs - but try nonpharmacological therapies first

/.What is delirium? - Answer-✅ACUTE disturbance of LOC, cognition, attention

/.What pharmacological treatment do you use for delirium-induced agitation or
psychosis? - Answer-✅Low dose haldol

/.What pharmacological treatment do you use for alcohol-induced delirium? - Answer-
✅BNZ

/.Anytime a patient presents with delirium, what labs should you order? - Answer-✅UA
with culture and specificity d/t infx being a potential cause for delirium, esp in older
adults

/.What is pseudodementia? - Answer-✅Cognitive sx r/t depression in older adults

/.Dementia vs. pseudodementia - Answer-✅Dementia: premorbid hx of slowly declining
cognition
Pseudodementia: acute onset of significant cognitive changes

/.How would someone with dementia vs. pseudodementia answer a question? -
Answer-✅Dementia: confabulates, lacks answer
Pseudodementia: "I don't know"

/.How can depression present in older adults? - Answer-✅Cognitive deficits - irritability,
agitation, hallucinations, delusions

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