PMHNP certification Exam 2025(Actualtest verified A+) 1,052 Questions and Verified Answers

PMHNP certification Exam 2025(Actualtest verified A+) 1,052 Questions and Verified Answers .10 common alcohol withdrawal symptoms - ANSWER--n/v -tremors -proxysmal sweats -anxiety -agitaiton -tactile disturbances -auditory disturbances -visual disturbances -headaches -altered sensorium .1mg of xanex equals how many mg of Ativan - ANSWER-2 .2 sample t test - ANSWER-analyze continuous data from two separate samples with normal distributions .2 schizoaffective dx subtypes - ANSWER--depressive -bipolar .3 phases of EMDR - ANSWER-desensitization phase installation phase body scan .3yo milestones - ANSWER-says up to 1000 words uses 3-4 word sentences balances on 1 foot plays make believe .5 As for health behavior change - ANSWER-Assess Advise Agree Assist Arrange .9 dimensions of temperament - ANSWER--Stella chess and Alexander Thomas -approach or withdrawal -adaptability -attention span and persistence (not quality of sleep) .a 20 year old asian man who was recently diagnosed with schizophrenia comes to your office for a follow up appointment. during the assessment, he talks about his experience in the group home, thinking that the television is sending him messages through news anchors during the 10pm evening news. what symptom is the client describing - ANSWER-ideas of reference .a 23 year old women is brought into the ER after attempting suicide by cutting her wrists. which nursing action by the PMHNP would be of highest priority initially. - ANSWER-take her vital signs .a 74 year old married women was referred to you by her pcp for a psych eval. she had a normal medical and neurological exam in the last 2 months. the client presents with her husband of 45 years who states "my wife is just not the same anymore, she is irritable and asks the same question several times, even though I've answered it many times. the client responds, oh Henry, you do the same thing, its just a normal part of getting older, and the kids think everything is fine. during the assessment you complete the MMSE and the client scores 18. as the pmhnp treating the client, you know the results of her MMSE indicate which level of cognitive impairment. - ANSWER-moderate cognitive impairment .a 74 year old woman presents for an evaluation. the pmhnp has her complete a MMSE and a clock drawing. the pt is unable to correctly draw the face of the clock. what area of the brain is most likely to have compromised functioning? - ANSWER-the right hemisphere (involved with facial expression recognition, music and visual images causing disturbances in drawing) .a client comes into the clinic with a longstanding history of depression and chronic renal failure. he is on an antidepressant and a diuretic and complains of increased depression, mild confusion, irritability, and overall apathy from being too tired to do anything. the best initial PMHNP action at this time is - ANSWER-order a comprehensive metabolic panel .a client is displaying low self-esteem, poor self-control, self-doubt, and a high level of dependancy. these behaviors indicate developmental failure of which stage of development? - ANSWER-early childhood .a client presents with complaints of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. what is the neuroanatomical area of the brain that is responsible for the normal regulation of these functions? - ANSWER-hypothalamus .a client returns for a follow-up appointment 3 weeks after starting on fluoxetine 20mg. during this appointment you notice that her speech is a little rapid, in marked contrast to the psychomotor retardation and paucity of spontaneous speech she displayed on her first visit. instead of looking at the floor, she now makes normal eye contact. her affect has gone from constricted to expansive. she continues to have difficulty sleeping, but her energy has improved and she states she feels so much better! what should you conclude about the shift in the clients presentation? - ANSWER-she is becoming hypomanic .a client says to the pmhnp "some days life is just not worth it. all my wife and I ever do is fight and scream. things at home would be calmer and simpler if I just wasn't there anymore". the most therapeutic response for the PMHNP to make is - ANSWER-tell me what you mean by "it would be simpler if you just weren't there anymore"? .a client who is experiencing difficulties with working memory, planning and prioritizing, insight into his problems, and impulse control presents for assessment. in planning his care, the PMHNP should apply his or her knowledge that these symptoms represent problems with the... - ANSWER-frontal lobe .a client with bipolar I disorder presents to your PMHNP office for a follow up visit. during the visit the client informed you that he no longer wants to be treated with medication., and he does not have bipolar disorder, that was a misdiagnosis. he further informs you he stopped all his medication 2 months ago and is here to thank you for your care and tell you that he no longer needs follow up appointments. understanding the ethical conflict, you use which of the following ethical principles in working with this client? - ANSWER-autonomy .a community has an unusually high incidence of depression and drug use among the teenage population. the public health nurses decide to address the problem, in part, by modifying the environment and strengthening the capacities of families to prevent the development of new cases of depression and drug use. what is this an example of? - ANSWER-primary prevention .a new client reveals to the PMHNP that her boyfriend screams at her and has repeatedly slapped and pushed her in front of her 3 year old son. she goes on to say that the boyfriend has thrown things at her and on one occasion threw a glass of water at her and hit her son in the back. should the pmhnp report this to CPS? - ANSWER-yes, the pmhnp has a duty to report .a patient with medicare qualifies for hospice care if - ANSWER--the pt has medicare part a -has a terminal diagnosis -2 physicians certify that the pt has less than 6 months to live if the illness runs its typical course .a pmhnp who is working on the consult liaison service is referred to a patient in the medical intensive care unit by the attending hospitalist. the consult note read evaluate the patient for competency to make independent medical decisions and consent for a surgical procedure. based on the scope of practice of a PMHNP, which response would be most appropriate. - ANSWER-call the hospitalist and provide education that competency is a legal concept and explain that you can assess the patient for the capacity to make medical decisions .a pt who has borderline personality disorder experiences intense anxiety when the PMHNP goes on vacation. the most appropriate explanation for this reaction is that the pt... - ANSWER-has not developed object constancy .a WBC count of 4,000 on clozapine would prompt the PMHNP to do what - ANSWER-closely monitor CBC with diff twice a week while continuing clozapine in absence of any other signs or symptoms. .AACAP practice parameter for forensic evaluations - ANSWER-all states require a response to a subpoena request .abnormal movement rating scales - ANSWER--AIMS -Dyskinesia identification system condensed user scale (DISCUS) -simpson-Angus rating scale (SAS) .abstraction in children - ANSWER--children ages 12 and younger are not expected to have abstractive thought abilities -young children have concrete thinking .acamprosate (campral) for treating caving and maintaining sobriety - ANSWER-homotaurine decreases craving .according to the APA practice guidelines on bipolar disorder, what is the completed suicide rates in patients with BP I - ANSWER-10-15% .according to the CDC, what % of school aged kids are diagnosed with ADHD - ANSWER-9-12% .according to the DSM 5, how many non-overlapping symptoms must be present to include the "mixed features" specifier in the diagnosis of an episode of MDD, mania, or hypomania? - ANSWER-3 .according to the DSM5, which is true - ANSWER-a culturally expected response to a stressor is not a mental disorder .acetylcholine - ANSWER-synthesized by the basal nucleus of Meynert -precursors are acetylcoenzyme A and choline -nicotinic and muscarinic receptors .acetylcholine general function - ANSWER-attention, memory, thirst, mood regulation, REM sleep, sexual behavior, muscle tone .acetylcholine symptoms of deficit - ANSWER-lack of inhibition, decreased memory, euphoria, antisocial action, speech decrease, dry mouth, blurred vision, constipation alzheimers dx .acetylcholine symptoms of excess - ANSWER-overinhibition, anxiety, depression, somatic complaints, self-consciousness, drooling, EPS parkinsonian symptoms .Acute intermittent porphyria - ANSWER--phenothiazines are safe to treat psychosis -onset is between 20 and 50 years -classic triad: episodic/acute/colicky abdominal pain, motor polyneuropathy, psychosis .ADHD - ANSWER--a persistent pattern of inattention or hyperactivity, impulsivity, or both that interferes with functioning and development -inattention, 6+ of the following (fails to give attention to details, difficulty sustaining attention, does not listen when spoken to, does not follow through on instructions, disorganized, avoids or dislikes tasks requiring sustained mental effort, loses things, distracted, forgetful) -hyperactive and impulsive 6+ of the following (fidgets, leaves seat, runs or climbs, unable to engage in quiet activities, on the go, talks excessively, blurts out information, difficulty waiting turn, interrupts others) -several symptoms present before 12yo .ADHD into adulthood - ANSWER--symptoms of inattention usually remain with a decrease in impulsive and hyperactive symptoms .ADHD physical exam findings - ANSWER--minor physical anomalies at higher rates in people with ADHD than in the general population (hypertelorism, highly arched palate, low-set ears) .ADHD polygenic neurobiological deficits - ANSWER--abnormalities of pronto-subcortical pathways in frontal cortex and basal ganglia -abnormalities of reticular activating system -dopamine dysfunciton -norepinephrine dysfunction .ADHD prevention - ANSWER--secondary prevention is important in young clients .ADHD standard rating scales - ANSWER--Conners parent and teacher rating scales -vanderbilt ADHD diagnostic pedant and teacher rating scales .ADHD subtypes - ANSWER--inattentive type -hyperactive type -combined type .ADHD typical age onset - ANSWER-early childhood (per DSM by age 12) .adolescent manic episodes present differently than in adults - ANSWER-more psychotic features often associated with antisocial bx often associated with substance abuse prodromal period of significant bx problems (School truancy, failing grades) .adrenergic meds in acute withdrawal - ANSWER--used to decrease blood pressure and pulse rate associated with withdrawal .adverse reaction with mirtazipine use - ANSWER-agranulocytosis .agonist effect - ANSWER-Drug binds to receptors and activates a biological response .agoraphobia diagnostic criteria - ANSWER--presence of anxiety related to fear of developing panic-like symptoms -never met criteria for panic disorder -avoidant bx as a result of anxiety .agoraphobia pharm - ANSWER--SSRIs -benzos for short term use -beta blockers off label for discrete episodes of social anxiety .AIMs screening schedule for clients on FGAs - ANSWER-Q6months .akinesia - ANSWER-absence of movement difficulty initiating motion subjective feeling of lack of motivation to move often mistaken for laziness or lack of interest .alcohol abuse dx screening - ANSWER--administered by asking 4 questions -each positive answer = 1 point -negative answers = 0 points -the more points the greater the likelihood of alcohol abuse dx -clients scoring 2+ are at mild-mod risk for alcohol dependency and the score is considered clinically significant -clients scoring 3 or 4 are considered high risk for alcohol dependency .alcohol dependence and abuse produce characteristic lab findings - ANSWER--blood alcohol level 100mg/dL outpatient; 150mg/dL anytime with symptoms; 300mg/dL any time -aspartate transaminase (AST)/ alanine transaminase (ALT) ration 2.0 -elevated glutamyltransferase, mean corpuscular volume, prothrombin time, uric acid, total cholesterol, and triglycerides -decreased magnesium, calcium, potassium, BUN, hemoglobin, hematocrit, platelet count, and albumin .ALT normal range - ANSWER-7-56 u/L .Amantadine (Symmetrel) for EPSE - ANSWER--100-200mg PO BID -dopamine agonist -treats akinesia and pseudo-parkinson's only .ambiphilia - ANSWER-combination of both androphilia and gynephilia .amiloride is used to treat what side effects of lithium - ANSWER-renal side effects .amino acids - ANSWER-glutamate, aspartate, gamma-aminobutyric acid (GABA), glycine .Amitriptyline (Elavil) - ANSWER--TCA -tablet or IM -50-300mg/day -also used for chronic pain (particularly neuropathic pain), insomnia -Prego C -Lact L2 .amphetamine, dextroamphetamine (Adderall XR) - ANSWER--ADHD -schedule II -5-60mg/day .amphetamine, dextroamphetamine (Adderall) - ANSWER--ADHD -Schedule II -5-40mg/day .an example of a mature, healthy defense mechanisms is... - ANSWER-suppression (the client channels conflicting energies into growth-promoting activities) .an initial psych eval of a pt reveals a normal mental status and appropriate bx, despite parents report of disobedience, poor grades, and laziness. to further assess the pt's functioning, the PMHNP... - ANSWER-meets with the parent and pt together to explore the discrepant report .analysis of variance (ANOVA) - ANSWER-tests the difference among three or more groups .androphilia - ANSWER-sexual attraction to men or masculinity .anorexia nervosa lab changes - ANSWER--normochromic, normocytic anemia -leukopenia -neutropenia -anemia -thrombocytopenia -hypokalemia -hypomagnesemia -hypoglycemia -decreased LH and FSH .anorexia nervosa physical exam findings - ANSWER--bradycardia -hypotension -ECG changes (inversion of t-waves, ST segment depression, prolonged QT interval) -peripheral edema -hypertrophy of salivary glands -russells sign .ANOVA - ANSWER-used to compare the means of multiple groups to determine if all are equal, thereby generalizing the 2 sample t test to several groups .antagonist effect - ANSWER-Drug binds to the receptor but does not activate a biological response .antiadrenergic side effects - ANSWER-orthostatic hypothension from alpha 1 receptor blockade .anticholinergic side effects - ANSWER-dry mouth blurred vision constipation memory problems from muscarinic receptor blockade .antidepressants for sleep dx - ANSWER--used for sedation properties -amitriptyline (Elavil), doxepin (Sinequan, Silenor); generally avoid in older adults -mirtazapine (Remeron) -Trazodone .antihistaminergic side effects - ANSWER-sedation and weight gain from histamine receptor blockade .antihypertensive sexual side effects - ANSWER-impaired vaginal lubrication due to antiadrenergic effects .antipsychotic sexual side effect - ANSWER--erectile dysfunction and impaired vaginal lubrication secondary to anticholinergic as well as alpha 2 receptor effects -impaired arousal and orgasm through dopamine blocking .antiretrovirals and protease inhibitors can interact with psych meds - ANSWER--metabolized by P450 system or are CYP3A4 inhibitors .antiseizure meds in acute withdrawal - ANSWER--such as carbamazepine (tegretol) and valproic acid (depakene) -sometimes used to decrease seizure potential .antisocial personality disorder - ANSWER--failure to conform to social norms -repeated acts that are grounds for arrest -deceitfulness, lying, and use of aliases for profit or pleasure -impulsivity and failure of future planning -reckless disregard for the welfare of others -consistent irresponsibility -lack of remorse, indifference to the feelings of others