ANCC Practice 2023 with verified questions and answers

Age for amphetamine approved in children 3 years or older Age for methylphenidate approved in children 6 years or older Arcus senilis (corneal arcus) gray-white arc or circle around the limbus of the iris that is common with aging It is present to some degree for people older than 60 years old. If present before 40 years old, related to hyperlipidemia negative symptoms of schizophrenia Decreased DA in mesoCORTICAL positive symptoms of schizophrenia Increased DA in mesoLIMBIC Existential therapy a therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value -on role of choice and responsibility, people can exercise freedom to make choices for their life Fragile X Syndrome (FXS) most commonly inherited cause of intellectual disability and occurs when a DNA series makes too many copies of itself and turns off a gene on the X chromosome -large, long head and ear -short stature -hyperextensible joint -postpubertal macroorchidism Vitamin B12 pernicious anemia -associated with dementia-like symptoms SIADH and antidepressants Hyponatremia common in elderly patients on antidepressants. If patient reports moderate s/s of hyponatremia, check the level and see what the cause is Torsades de pointes QTC 500-700 Cultural competent care Respect Advocacy Partnership homeostasis A tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as blood glucose, around a particular level -- equilibrium Pain med at risk for serotonin syndrome Tramadol Avoidant personality with trauma increase arousal therapy Normal serum creatinine 0.6-1.5 mg/dL Normal BUN levels 10-20 mg/dL Bowlby attachment theory -children who come from parents with highly expressed emotion and unresolved losses tend to form disorganized attachment characterized by not feeling safe with the caregiver Impulsive and motivational drive prefrontal cortex does not develop until mid 20-s or early 30-s Traits of a therapist Mindful Intentional Reflective Genuine Discontinuation of clozaril: WBC and ANC WBC less than 3000 ANC less than 1500 Required lab CMP Lipid profile Required lab for depression thyroid Vitamin D Required lab for PPI Vitamin B12 Required lab for atypical antipsychotic CBC "Atypical" Antagonist 5HT2A D2 Antagonism Acoustin Neuroma brain tumor that develops adjacent to the cranial nerve running for the brain to the inner ear - this is one of the most common types of brain tumors and can cause hearing loss, vertigo, and tinnitus -unilateral ringing of the ear Negative group outcome leader who is overly confrontational reminiscence therapy type of therapy that encourages people with Alzheimer's disease to remember and talk about the past -improve cognition -maintain self esteem Anabolic steroid Use -Involves consumption of synthetic androgens (sex hormones). -Excess testosterone is converted to estrogen -Can cause liver damage, increased cholesterol, testicular shrinkage, gynecomastia, behavioral changes (e.g., aggression, increased risk of suicide). -Increased irritability and aggression -Euphoria -Increased energy -Sex arousal -Mood Swing -Distractibility -Forgetfulness -Heart attack, HTN, high cholesterol, depression, restlessness, severe liver problem SSRI discontinuation syndrome A drug withdrawal syndrome associated with the use of at least some of the SSRI and SNRI antidepressants. The syndrome may consist of flu-like symptoms, dizziness, weakness, nausea, fatigue, feelings of "unreality," loss of balance, light-headedness, "electric-shock" sensations, and other symptoms. FLU LIKE SYMTPOMS Psychoeducation the teaching of patient and families about the patient's disorder in order to reduce familial distress and equip them to work effectively with the patient -normal the experience of grief and loss -instillation of hope and universality Repression vs. Suppression repression is involuntary/unconscious and suppression is voluntary/conscious Carbamazepine acute manic and mixed but not depressive phase right hemisphere of brain controls left side of the body and contains creativity and the arts left hemisphere of brain controls right side of the body and is logical, contains mathamatics, lauguage, & speech most therapeutic communication non-verbal Prefrontal cortex modulate pain and can help TMS to decrease pain bromocriptine D2 agonist Dantrolene Muscle relaxant: blocks Ca2+ release from sarcoplasmic reticulum of skeletal muscle. Used in muscle spasm (cerebral palsy, multiple sclerosis, cord injury) and in emergency treatment of malignant hyperthermia. Bipolar 1: manic more common in men women domestic violence African American/ Native American/ Alaska American -single/divorced/separated -pregnant -lower income and education -age/education/occupational DISPARITY rolling over 3-6 months sitting up 5-7 months text message okay; order only follow Joint Commission guidelines if psychiatric/chemical dependence two separate release of info d/t chemical dependence politics to allocate scarce resources and to meet all of the goals that policies require regardless of who the collaborating psychiatrist it is the psych NP responsibility when a patient commits suicide and etc psychotherapy note withhold unless consent from patient Autism refute no relationship with MMR vaccine REMS regulated by manufacturers of Clozaril outcome measurement 1) suggest changes in tx 2) analyze effectiveness of an intervention 3) profile practice pattern of providers up-coding Billing for procedures or services not provided to obtain a higher payment binge eating/population density no correlation Universal Bill of Rights for Mental Health Patients supports evaluation and treatment in the least restrictive setting (i.e. crisis stabilization unit) restraint and face-to-face within 1 hour Q8h American with Disabilities Act Law that prohibits employers from discriminating against people with physical disabilities and mental wide confidence interval small sample size few number of outcome events less precision pro bono for the public good Muslim male-male female-female avoid shellfish, cloven-hoofed animals, blood product, gelatin, alcohol Social Justice the defense of human dignity by ensuring that essential human needs are met and that essential human rights are protected for all people ex) providing free clinic services to the homeless Type 1 error (false positive) REALITY: null hypothesis is true But you reject the null hypothesis Type 2 error (false negative) REALITY: null hypothesis is false But you accept the null hypothesis Federal Law 42 CFR separate release of information for chemical dependency organizational change model do not include funding as its focus but rather including stakeholders, noting organizational barriers, and evaluation methods flashbacks grounding technique-bringing pt attention by noticing things in the present ex) rubbing against the chair pseudodementia "don't know" during pregnancy weight gain for normal BMI: 25-35 weight gain for underweight BMI: 28-40 150/300/500 caloric intake (first/second/third trimester) Asperger's Syndrome Behavioral syndrome characterized by varying degrees of difficulty in social and conversational skills but normal-to-above-average intelligence and language development; often accompanied by obsessive preoccupation with particular topics or routines. (SOCIAL INADEQUACY) Cortical vs subcortical dementias Decline in intellect vs decline in physical/motor aspects Alzheimer's vs Huntington's HIV dementia dementia that occurs due to cortical atrophy, inflammation, and demyelination caused by direct infection with HIV -indicative: acquired abnormality in MOTOR function manualized group intervention with motivational enhancement to reduce substance use Five A's for behavioral counseling Assess Advise Agree Assist Arrange