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PMHNP Comprehensive Exam

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Stages of Change (Transtheoretical Model) - (Prochaska & DiClemente) ● Precontemplation—little to no awareness of the problem or intent to change ● Contemplation—thinking about making a change in the next 6 months, weigh pros and cons ● Preparation—prepare to make change within the next month, start to make small changes ● Action—enacted the change for 1 day-6 months ● Maintenance—maintained behavior/change for 6 months or longer Maslow's Hierarchy of Needs - ● Physiological (food, water, shelter, warmth) ● Safety (security, stability, freedom from fear) ● Belonging/love (friends, family, spouse, lover) ● Self-esteem (achievement, mastery, recognition, respect) ● Self-actualization (pursue, inner talent, creativity, fulfillment) Benner's Model - ● Novice—unconscious incompetence, no experience, governed by rules and regulations ● Advanced beginner—able to analyze and deliberately act ● Competency/proficiency—2-5 yrs experience, able to synthesize info/coordinate ● Expert—flexible, intuitive, efficient MMSE Scoring - ○ 23-30 normal ○ 19-23 borderline ○ 19 impaired

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PMHNP Comprehensive Exam
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Stages of Change (Transtheoretical Model) - ✔✔(Prochaska & DiClemente)

● Precontemplation—little to no awareness of the problem or intent to change

● Contemplation—thinking about making a change in the next 6 months, weigh pros and cons

● Preparation—prepare to make change within the next month, start to make small changes

● Action—enacted the change for 1 day-6 months

● Maintenance—maintained behavior/change for 6 months or longer



Maslow's Hierarchy of Needs - ✔✔● Physiological (food, water, shelter, warmth)

● Safety (security, stability, freedom from fear)

● Belonging/love (friends, family, spouse, lover)

● Self-esteem (achievement, mastery, recognition, respect)

● Self-actualization (pursue, inner talent, creativity, fulfillment)



Benner's Model - ✔✔● Novice—unconscious incompetence, no experience, governed by rules and
regulations

● Advanced beginner—able to analyze and deliberately act

● Competency/proficiency—2-5 yrs experience, able to synthesize info/coordinate

● Expert—flexible, intuitive, efficient



MMSE Scoring - ✔✔○ 23-30 normal

○ 19-23 borderline

○ <19 impaired

,MMSE components - ✔✔● Orientation

● Registration (repeat 3 words)

● Attention and Calculation (count backwards from 100 by 7, spell words backward)

● Recall (repeat the same 3 words from immediate recall)

● Language (name an object, repeat a phrase, read a sentence, write a sentence, copy intersecting
pentagons)



Levels of Prevention - ✔✔· Primary prevention—methods to avoid occurrence of disease (most
population-based health promotion efforts)

· Secondary prevention—methods to diagnose and treat existent disease in early stages before it causes
significant morbidity

· Tertiary prevention—methods to reduce negative impact of existent disease by restoring function and
reducing disease-related complications

· Quaternary prevention—methods to mitigate or avoid results of unnecessary or excessive
interventions in the health system



frontal lobe - ✔✔A region of the cerebral cortex that has specialized areas for movement, abstract
thinking, planning, memory, and judgement

-prefrontal, motor strip, EPS, basal ganglia



temporal lobe - ✔✔hearing, language (Wernicke's), memory, emotion



parietal lobe - ✔✔sensory processing and input



components of the limbic system - ✔✔interpreting significance of sensory input; hippocampus,
amygdala, hypothalamus, cingulate gyrus, thalamus



anterior cingulate cortex - ✔✔integrating complex external information; empathy, emotion processing

,posterior cingulate cortex - ✔✔participates in memory and visual processing; day dreaming, values,
relevance to self



hypothalamus & what NTs does it balance - ✔✔homeostasis (food, water, temperature), controls
pituitary release, balance of DA and 5HT



posterior pituitary - ✔✔ADH and oxytocin



thalamus - ✔✔relay station for incoming sensory information, allowing for processing and
interpretation according to other structures' input



cerebellum - ✔✔control center for controlling voluntary movement, fine tunes movement



cerebellar lesion symptoms - ✔✔ataxia, awkward, tremor with effort, difficulty with sequential
movements, balance



brainstem - ✔✔responsible for automatic survival functions; midbrain, pons, medulla



where is dopamine produced - ✔✔substantia nigra



where is serotonin produced - ✔✔raphe nuclei



where is norepinephrine produced - ✔✔locus coeruleus in the pons



where is acetylcholine produced - ✔✔Nucleus basalis of Meynert

, cranial nerves - ✔✔Olfactory—smell

Optic—vision

Oculomotor—eye movement

Trochlear—eye movement

Trigeminal—face sensation & chewing

Abducens—eye movement

Facial—facial movements and taste

Vestibulocochlear—hearing

Glossopharyngeal—taste, swallowing

Vagus—movement, sensation, visceral organs

Accessory—spinal, neck movement

Hypoglossal—tongue movement



preganglionic NT of SNS - ✔✔ACh



postganglionic NT of SNS - ✔✔NE



preganglionic NT of PNS - ✔✔ACh



postganglionic NT of PNS - ✔✔ACh



origin of SNS - ✔✔thoracolumbar



origin of PNS - ✔✔craniosacral

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