PMHNP Exam Reported Questions and Answers 2023
What is dissemination? - ANSWER Getting the research information out to those who need to
know it!
Publication - highest level
Presenting at National Conference
Presenting at Local Conference
Journal Club where one person reviews an article
What does a 17 on MMSE mean? - ANSWER Moderate cognitive impairment
What is Tegretol in the CYP450 system? - ANSWER Inducer -->will lower dose of Lamictal and
BCP's
What do BCP's do to Lamictal? - ANSWER Inducer - will lower dose of Lamictal
What is a Type I research error? - ANSWER There IS a difference but you say there isn't a
difference.
What is a Type II research error? - ANSWER There is NO difference but you say there is a
difference.
What is pseudo-dementia? - ANSWER Cognitive impairment secondary to depression that clears
when treated in the elderly. Dementia won't improve.
Is it normal for a 1 month old to have a palmar grasp? - ANSWER Yes.
What is a drug 1/2 life? - ANSWER The time it takes for 50% of a drug to be eliminated from the
body.
What 3 atypicals can be used with teens? - ANSWER Zyprexa, Abilify, Seroquel - low doses
What is a risk of using Tramadol? - ANSWER Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS? - ANSWER HLAB-1502
When might you see toxic epidermal necrolysis? - ANSWER With worsening of SJS
How many generations do you include for a genogram? - ANSWER 1st degree - mother, father,
siblings
2nd degree - grandparents & cousins
3rd degree -
What does messenger RNA code for? - ANSWER Amino Acids
What is epigenetics? - ANSWER Factors that affect genes - environmental, smoking, stress, etc...
,What part of the brain is involved with OCD? - ANSWER Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence? - ANSWER Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? - ANSWER 10-25 yo
When do females typically present with schizophrenia? - ANSWER 25-35 yo
What does Erythromycin to trileptal? - ANSWER You will need to decreases the level because
Trileptal(inducer) and erythromycin is a inhibitor
ACE Inhibitors are the drug of choice for what? - ANSWER Heart Failure
HTN
What are some psychiatric side effects seen with some asthma drugs - ANSWER Leukotriene
receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations,
depression, insomnia, SI, tremor
What should you watch for with Tegretol? - ANSWER Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests? - ANSWER CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac muscle damage? - ANSWER CKMB
What is the risk of a seriously elevated CKMB? - ANSWER Polymyositis
Rhabdo
What is a normal CKMB? - ANSWER 0.3 mcg/L
What psychoactives does Detrol interact with? - ANSWER Topamax
KCL
Zonegran
What CN are you assessing when you have the patient shrug their shoulders? - ANSWER CN XI -
Spinal Accessory
What do you see in labs with HIV & Dementia? - ANSWER CD4 <200
Viral Load is high
<20% get it with antiretroviral treatment
What is the scoring with the Beck Depression Inventory? - ANSWER Self-Report - 0-63
0-13 - minimal
,14-19 - mild
20-28 - moderate
29-63 - severe
What is sensitivity? - ANSWER Helps rule-out disease = True Positive = Snout
What is specificity? - ANSWER Helps rule-in disease = True Negative = Spin
What does a sed rate measure? - ANSWER Inflammation (ESR - Erythrocyte Sedimentation Rate) =
distance in mm RBC's have descended in 1 hour.
What is a normal sed rate or ESR? - ANSWER 0-22 males
0-29 females
What is a retic count? - ANSWER Measures % of reticulocytes in blood (immature RBC's) Indicates
whether enough RBC's are being produced by bone marrow.
What does a decreased retic count indicate? - ANSWER Anemia - acute or chronic beeding
What does an increased retic count indicate? - ANSWER Bone marrow disorder or Vitamin
Deficiency
What does an abnormal retic ount indicate in general? - ANSWER Doesn't diagnose anything. First
step is ID source of the issue.
What happens when you mix tegretol and macrolides? - ANSWER Increase tegretol levels.
What happens if a pregnant women takes Accutane? - ANSWER Birth defects.
What labs do you get with RA? - ANSWER Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP -
helps confirm diagnosis.
CRP and ESR are both increased in RA but NOT in osteoarthritis.
Where does the NP Code of Ethics come from? - ANSWER ANA
When do you assume informed consent? - ANSWER Unconscious
Incompetent
Life Threatening Situation
What are the legal ramifications of treating w/o informed consent? - ANSWER Same as with
informed consent
Who can declare a patient incompetent and appoint a guardian? - ANSWER Only a court
Does impaired judgment mean one is incompetent? - ANSWER No.
Can an advanced directive ever be revoked? - ANSWER Yes, at any time.
What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? -
ANSWER Nothing. They are all the same.
, Does the de facto rule of proxy apply in same sex marriages? - ANSWER No.
How do Asians see HC providers? - ANSWER As in a position of authority.
Expect to give instructions and help make decisions
What does it mean when an Asian patient does not make eye contact with the NP? - ANSWER SIgn
of respect
What is the evil eye? - ANSWER When a stronger or more powerful person looks at a weaker
person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea,
disturbed sleep, increased fussiness.
How do you protect from the evil eye? - ANSWER Red ribbon on an infant
Amulet for adults
How do you treat for evil eye? - ANSWER Access traditional healer + traditional care.
For there to be a duty to a patient, what must exist? - ANSWER Relationship
What is a proximate cause? - ANSWER Connection between A + B.
For there to be damages, what must exist first? - ANSWER Negligence
What is an occurrence basis liability insurance? - ANSWER "occurred" during the policy period,
no matter when the claim is brought against the insured
What is a claims made/based liability insurance? - ANSWER provides coverage for a claim that is
brought within the policy period, no matter when the loss occurred.
Who sets the minimum requirements for NP's? - ANSWER Board of Nursing
State
What are the various controlled substance classes? - ANSWER Schedule I - nobody has these -
not good for health - heroin, PCP, MDMA, researchers can get it sometimes.
Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate
Schedule III - Moderate Abuse Potential - hydrocodone, codeine
Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine
Schedule V - Very low abuse potential - anti-tussives, lomotil
What classes of CS's is the NP approved to prescribe? - ANSWER Schedules III-V ONLY.
Where does 50% of healthcare funds come from? - ANSWER The government
Who is eligible for Medicare? - ANSWER >65 or under 65 with diability, ANY age with renal
disease.
What is incident to billing? - ANSWER Means MD initiates treatment and NP is an extension of the
care and directly under the supervision of the MD.
What is dissemination? - ANSWER Getting the research information out to those who need to
know it!
Publication - highest level
Presenting at National Conference
Presenting at Local Conference
Journal Club where one person reviews an article
What does a 17 on MMSE mean? - ANSWER Moderate cognitive impairment
What is Tegretol in the CYP450 system? - ANSWER Inducer -->will lower dose of Lamictal and
BCP's
What do BCP's do to Lamictal? - ANSWER Inducer - will lower dose of Lamictal
What is a Type I research error? - ANSWER There IS a difference but you say there isn't a
difference.
What is a Type II research error? - ANSWER There is NO difference but you say there is a
difference.
What is pseudo-dementia? - ANSWER Cognitive impairment secondary to depression that clears
when treated in the elderly. Dementia won't improve.
Is it normal for a 1 month old to have a palmar grasp? - ANSWER Yes.
What is a drug 1/2 life? - ANSWER The time it takes for 50% of a drug to be eliminated from the
body.
What 3 atypicals can be used with teens? - ANSWER Zyprexa, Abilify, Seroquel - low doses
What is a risk of using Tramadol? - ANSWER Serotonin Syndrome as it is very serotonergic.
What is the allele seen in Asians that increase the risk of SJS? - ANSWER HLAB-1502
When might you see toxic epidermal necrolysis? - ANSWER With worsening of SJS
How many generations do you include for a genogram? - ANSWER 1st degree - mother, father,
siblings
2nd degree - grandparents & cousins
3rd degree -
What does messenger RNA code for? - ANSWER Amino Acids
What is epigenetics? - ANSWER Factors that affect genes - environmental, smoking, stress, etc...
,What part of the brain is involved with OCD? - ANSWER Basal Ganglia
Occipito-Frontal
What happens to the brain during adolescence? - ANSWER Dendritic pruning
Emotions are controlled by amygdala
By adulthood, PFC involved as well
When do males typically present with schizophrenia? - ANSWER 10-25 yo
When do females typically present with schizophrenia? - ANSWER 25-35 yo
What does Erythromycin to trileptal? - ANSWER You will need to decreases the level because
Trileptal(inducer) and erythromycin is a inhibitor
ACE Inhibitors are the drug of choice for what? - ANSWER Heart Failure
HTN
What are some psychiatric side effects seen with some asthma drugs - ANSWER Leukotriene
receptor agonists - singulair, accolade, zyflo = agitation, aggression, anxiety, hallucinations,
depression, insomnia, SI, tremor
What should you watch for with Tegretol? - ANSWER Agranulocytosis and Hyponatremia
What are the 3 CK muscle enzyme tests? - ANSWER CKBB, CKMM, CKMB
Which one of the 3 muscle enzymes are related to cardiac muscle damage? - ANSWER CKMB
What is the risk of a seriously elevated CKMB? - ANSWER Polymyositis
Rhabdo
What is a normal CKMB? - ANSWER 0.3 mcg/L
What psychoactives does Detrol interact with? - ANSWER Topamax
KCL
Zonegran
What CN are you assessing when you have the patient shrug their shoulders? - ANSWER CN XI -
Spinal Accessory
What do you see in labs with HIV & Dementia? - ANSWER CD4 <200
Viral Load is high
<20% get it with antiretroviral treatment
What is the scoring with the Beck Depression Inventory? - ANSWER Self-Report - 0-63
0-13 - minimal
,14-19 - mild
20-28 - moderate
29-63 - severe
What is sensitivity? - ANSWER Helps rule-out disease = True Positive = Snout
What is specificity? - ANSWER Helps rule-in disease = True Negative = Spin
What does a sed rate measure? - ANSWER Inflammation (ESR - Erythrocyte Sedimentation Rate) =
distance in mm RBC's have descended in 1 hour.
What is a normal sed rate or ESR? - ANSWER 0-22 males
0-29 females
What is a retic count? - ANSWER Measures % of reticulocytes in blood (immature RBC's) Indicates
whether enough RBC's are being produced by bone marrow.
What does a decreased retic count indicate? - ANSWER Anemia - acute or chronic beeding
What does an increased retic count indicate? - ANSWER Bone marrow disorder or Vitamin
Deficiency
What does an abnormal retic ount indicate in general? - ANSWER Doesn't diagnose anything. First
step is ID source of the issue.
What happens when you mix tegretol and macrolides? - ANSWER Increase tegretol levels.
What happens if a pregnant women takes Accutane? - ANSWER Birth defects.
What labs do you get with RA? - ANSWER Sed rate, RF, ANA, C reactive protein, CBC, CMP, CRP -
helps confirm diagnosis.
CRP and ESR are both increased in RA but NOT in osteoarthritis.
Where does the NP Code of Ethics come from? - ANSWER ANA
When do you assume informed consent? - ANSWER Unconscious
Incompetent
Life Threatening Situation
What are the legal ramifications of treating w/o informed consent? - ANSWER Same as with
informed consent
Who can declare a patient incompetent and appoint a guardian? - ANSWER Only a court
Does impaired judgment mean one is incompetent? - ANSWER No.
Can an advanced directive ever be revoked? - ANSWER Yes, at any time.
What is the different between a Healthcare Agent, Proxy, Surrogate, and Attorney in Fact? -
ANSWER Nothing. They are all the same.
, Does the de facto rule of proxy apply in same sex marriages? - ANSWER No.
How do Asians see HC providers? - ANSWER As in a position of authority.
Expect to give instructions and help make decisions
What does it mean when an Asian patient does not make eye contact with the NP? - ANSWER SIgn
of respect
What is the evil eye? - ANSWER When a stronger or more powerful person looks at a weaker
person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea,
disturbed sleep, increased fussiness.
How do you protect from the evil eye? - ANSWER Red ribbon on an infant
Amulet for adults
How do you treat for evil eye? - ANSWER Access traditional healer + traditional care.
For there to be a duty to a patient, what must exist? - ANSWER Relationship
What is a proximate cause? - ANSWER Connection between A + B.
For there to be damages, what must exist first? - ANSWER Negligence
What is an occurrence basis liability insurance? - ANSWER "occurred" during the policy period,
no matter when the claim is brought against the insured
What is a claims made/based liability insurance? - ANSWER provides coverage for a claim that is
brought within the policy period, no matter when the loss occurred.
Who sets the minimum requirements for NP's? - ANSWER Board of Nursing
State
What are the various controlled substance classes? - ANSWER Schedule I - nobody has these -
not good for health - heroin, PCP, MDMA, researchers can get it sometimes.
Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate
Schedule III - Moderate Abuse Potential - hydrocodone, codeine
Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine
Schedule V - Very low abuse potential - anti-tussives, lomotil
What classes of CS's is the NP approved to prescribe? - ANSWER Schedules III-V ONLY.
Where does 50% of healthcare funds come from? - ANSWER The government
Who is eligible for Medicare? - ANSWER >65 or under 65 with diability, ANY age with renal
disease.
What is incident to billing? - ANSWER Means MD initiates treatment and NP is an extension of the
care and directly under the supervision of the MD.
