MH709 EXAM QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
A patient who has been stable for 2 years on lithium shares with you that she
wants to get pregnant. What are your recommendations?
The options to discuss with the patient include: 1. The possibility of discontinuing the
medication 2. The possibility of continuing to take the medication during pregnancy.
Some providers might consider a medication switch, which could also be a part of
option 1, if a discontinuation of medication wasn't successful, a new medication could
be initiated. A specific anomaly associated with Lithium is Ebstein's anomaly, which is a
defect that causes tricuspid insufficiency. A pregnant woman taking lithium would need
careful monitoring of lithium levels, symptoms and the overall pregnancy. Lithium
crosses the placenta and the fetus receives 100% of the drug. Dosage changes are
expected in different trimesters.
What is the difference between PMHNPs screening of versus assessment of
suicide?
-Screening will identify if there is an issue that needs further assessment, whereas
assessment helps to determine the actual level of risk.
Which is the MOST important in the PMHNP assessment of suicide risk factors?
-Clinical judgement.
How are chronic suicidal risk factors different than acute suicide risk factors?
,-Chronic factors are unchangable and non-modifiable.
Age, sex, ACES
What are five examples of chronic suicide risk factors?
History of psychiatric illness; Substance abuse (etoh=10x greater risk, IV drug use=14x
greater risk); Age; Gender (men =4x greater risk); Chronic medical condition or pain;
Single/unmarried; Family history of suicide; History of psychiatric hospitalizations;
History of child abuse.
Which is the MOST potent chronic risk factor for suicide?
-Previous suicide attempt. The more lethal the past attempt, the greater the risk.
What are five examples of suicide mitigating factors?
No recent history of suicide attempts; Good social supports/married; No substance
abuse; No weapons in the home; Willing & motivated to engaged in treatment; Non-
psychotic; Able to state reasons for living; Employment; Faith beliefs against suicide.
moral beliefs, able to make safety plan
Should the PMHNP quantify risk of suicide through the use of assessment tools
alone?
No. Assessment tools can be used as one measure in addition to clinical judgment.
Suicide risk is difficult to quantify and suicides are difficult to predict with accuracy.
What are the two areas of focus for the PMHNP to determine level of suicide risk?
SDI: Suicidal Desire and Ideation (reasons for living, lack of deterrents to attempt), and
RPP: Resolved Plans and Preparation (availability of means, specificity of plans).
A patient with a history of multiple suicide attempts would be considered what
level of risk?
, -Chronic high risk.
What are three factors that create an "acute" risk of suicide?
-Presence of a crisis; Significant life stressors; Increased symptomatology.
What steps would the PMHNP take next if a patient has been determined to have a
severe suicide risk?
-Immediate hospitalization, involve family and possibly law enforcement.
How often should the PMHNP assess suicide risk?
Every visit.
What steps could the PMHNP take if a patient has been determined to have a
moderate suicide risk?
Increased frequency of visits; Create a crisis plan; Provide 24 hour crisis service
availability.
How effective are "no harm contracts" in reducing suicide?
-Not effective.
What are three facets of a suicide crisis response plan?
Concrete & specific; Collaborative; Documented.
Which factor is important in the assessment of homicide risk?
-Is the patient's judgement impaired by the presence of psychiatric illness (knowing the
difference between right and wrong) versus poor coping (law enforcement issue).
violence risk factors:
male,
15-24
COMPLETE SOLUTIONS VERIFIED LATEST UPDATE
A patient who has been stable for 2 years on lithium shares with you that she
wants to get pregnant. What are your recommendations?
The options to discuss with the patient include: 1. The possibility of discontinuing the
medication 2. The possibility of continuing to take the medication during pregnancy.
Some providers might consider a medication switch, which could also be a part of
option 1, if a discontinuation of medication wasn't successful, a new medication could
be initiated. A specific anomaly associated with Lithium is Ebstein's anomaly, which is a
defect that causes tricuspid insufficiency. A pregnant woman taking lithium would need
careful monitoring of lithium levels, symptoms and the overall pregnancy. Lithium
crosses the placenta and the fetus receives 100% of the drug. Dosage changes are
expected in different trimesters.
What is the difference between PMHNPs screening of versus assessment of
suicide?
-Screening will identify if there is an issue that needs further assessment, whereas
assessment helps to determine the actual level of risk.
Which is the MOST important in the PMHNP assessment of suicide risk factors?
-Clinical judgement.
How are chronic suicidal risk factors different than acute suicide risk factors?
,-Chronic factors are unchangable and non-modifiable.
Age, sex, ACES
What are five examples of chronic suicide risk factors?
History of psychiatric illness; Substance abuse (etoh=10x greater risk, IV drug use=14x
greater risk); Age; Gender (men =4x greater risk); Chronic medical condition or pain;
Single/unmarried; Family history of suicide; History of psychiatric hospitalizations;
History of child abuse.
Which is the MOST potent chronic risk factor for suicide?
-Previous suicide attempt. The more lethal the past attempt, the greater the risk.
What are five examples of suicide mitigating factors?
No recent history of suicide attempts; Good social supports/married; No substance
abuse; No weapons in the home; Willing & motivated to engaged in treatment; Non-
psychotic; Able to state reasons for living; Employment; Faith beliefs against suicide.
moral beliefs, able to make safety plan
Should the PMHNP quantify risk of suicide through the use of assessment tools
alone?
No. Assessment tools can be used as one measure in addition to clinical judgment.
Suicide risk is difficult to quantify and suicides are difficult to predict with accuracy.
What are the two areas of focus for the PMHNP to determine level of suicide risk?
SDI: Suicidal Desire and Ideation (reasons for living, lack of deterrents to attempt), and
RPP: Resolved Plans and Preparation (availability of means, specificity of plans).
A patient with a history of multiple suicide attempts would be considered what
level of risk?
, -Chronic high risk.
What are three factors that create an "acute" risk of suicide?
-Presence of a crisis; Significant life stressors; Increased symptomatology.
What steps would the PMHNP take next if a patient has been determined to have a
severe suicide risk?
-Immediate hospitalization, involve family and possibly law enforcement.
How often should the PMHNP assess suicide risk?
Every visit.
What steps could the PMHNP take if a patient has been determined to have a
moderate suicide risk?
Increased frequency of visits; Create a crisis plan; Provide 24 hour crisis service
availability.
How effective are "no harm contracts" in reducing suicide?
-Not effective.
What are three facets of a suicide crisis response plan?
Concrete & specific; Collaborative; Documented.
Which factor is important in the assessment of homicide risk?
-Is the patient's judgement impaired by the presence of psychiatric illness (knowing the
difference between right and wrong) versus poor coping (law enforcement issue).
violence risk factors:
male,
15-24
