PMHNP Certification Exam m m
Which patient is at highest risk for SI
m m m m m m m
A. 30y/o married AA female with previous SI attempt *1 risk factor
m m m m m m m m m m m
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
m m m m m m m m m m m m
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
m m m m m m m m m m m m m m m
D. 68 y/o single white male with depression *5 risk factors (age, male, white, depr
m m m m m m m m m m m m m m
ession)
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
m m m m m m m m m m m m m m
depression)
Count the risk factors
m m m
When interview teenagers (16 y/o) that arrive with their parents what should you d
m m m m m m m m m m m m m
o?
interview them separately from parents.
m m m m
-
This helps Build therapeutic rapport with teens by telling them the info is confide
m m m m m m m m m m m m m
ntial. Parents may be upset but remember you are advocating for the child.
m m m m m m m m m m m m
Which Ethnic group has the highest rate of suicide?
m m m m m m m m m
Native Americans m
Example A patient is being treated for schizophrenia with olanzapine. Which of th
m m m m m m m m m m m m
e following is the most common side effect of olanzapine?
m m m m m m m m m
A. Increased waist circumference
m m m
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-
m m m m m m m m m
receptor antagonism m
C. Increased Lipids
m m
D. Metabolic Syndrome
m m
D. Metabolic Syndrome (UMBRELLA ANSWER)
m m m m
,Which antipsychotics have the least weight gain?
m m m m m m
Latuda, Abilify, (also least sedating), Geodon-
m m m m m
if patient has metabolic syndrome consider switching to one of the medications ab
m m m m m m m m m m m m
ove. Or if the patient is overly sedated try switching to ABILIFY
m m m m m m m m m m m
Which mood stabilizer have the least weight gain?
m m m m m m m m
Lamictal
-But remember all mood stabilizers cause some weight gain
m m m m m m m m
When presented with a question about typical vs atypical antipsychotic the answe
m m m m m m m m m m m
r is usually to start of a
m m m m m m
atypical
A client presents with complains of changes in appetite, feeling fatigued, problem
m m m m m m m m m m m
s with sleep-
m m
rest cycle, and changes in libido. What is the neuroanatomical area of the brain th
m m m m m m m m m m m m m m
at is responsible for the normal regulation of these functions?
m m m m m m m m m
A. Thalamus
m
B. Hypothalamus
m
C. Limbic System
m m
D. Hippocampus
m
Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
m m m m m m m m m m m m m m m m
When a patient is hesitant to participate in treatment you should encourage
m m m m m m m m m m m
? Bring a support person like a husband
m m m m m m m
Thyroid-Stimulating hormone normal level m m m
-0.5-5.0 Mu/L m
,When T4 and T3 are high and TSH is low what is the diagnosis
m m m m m m m m m m m m m
-
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HE
m m m m m m m m m
AT INTOLERANCE
m
Key symptoms of Heat Intolerance
m m m m
-Hyperthyroidism
Key symptoms of Cold Intolerance
m m m m
-Hypothyroidism
Hyperthyroid can mimic m m
-Mania
Hypothyroid can mimic m m
-Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine Hepat
m m m m m m m m m m m m
oxicity
-Check LFTs m
Signs of Depakote toxicity
m m m
-Disorientation, confusion, lethargy m m
You suspect depakote toxicity what do you do? Che
m m m m m m m m
ck
-LFT
-Ammonia
-Depakote Level m
What herbal supplement can cause hepatoxicity? Ka
m m m m m m
va Kava
m
, When taking Kava Kava in combinations with other medications you should cauti
m m m m m m m m m m m
on aboutm
Risk of Hepatoxicity and Sedation
m m m m
mTCAs carry a risk of Hepatotoxici
m m m m m
ty
Signs of Stevens-Johnson Syndrome
m m m
-
fever, mouth pain, swelling, burning eyes, blisters, skin pain t
m m m m m m m m m
wo psychotropics known to cause steven johnson syndrome la
m m m m m m m m
mictal and tegretol m m
What nationality is most suseptible of getting steven Johnson?
m m m m m m m m
Asians
m
When treating asians with tegretal screen for
m m m m m m
? HLAB-1502 Allele
m m
What two medications cause agranulocytosis? Cloza
m m m m m
ril & Tegretal
m m
Agranulocytosis when to discontinue medication Le m m m m m
ss than 1000
m m
When monitoring for agranulocytosis in patients look for s/s of what? Infec
m m m m m m m m m m m
tion
-Fever, sore throat, fatigue, chills
m m m m
Before starting any mood stabilizer in a female of childbearing age be sure to che
m m m m m m m m m m m m m m
ck?
-HCG
Which two medications may decrease the risk of suicide? cloz
m m m m m m m m m
aril and lithium
m m
Which patient is at highest risk for SI
m m m m m m m
A. 30y/o married AA female with previous SI attempt *1 risk factor
m m m m m m m m m m m
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
m m m m m m m m m m m m
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
m m m m m m m m m m m m m m m
D. 68 y/o single white male with depression *5 risk factors (age, male, white, depr
m m m m m m m m m m m m m m
ession)
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
m m m m m m m m m m m m m m
depression)
Count the risk factors
m m m
When interview teenagers (16 y/o) that arrive with their parents what should you d
m m m m m m m m m m m m m
o?
interview them separately from parents.
m m m m
-
This helps Build therapeutic rapport with teens by telling them the info is confide
m m m m m m m m m m m m m
ntial. Parents may be upset but remember you are advocating for the child.
m m m m m m m m m m m m
Which Ethnic group has the highest rate of suicide?
m m m m m m m m m
Native Americans m
Example A patient is being treated for schizophrenia with olanzapine. Which of th
m m m m m m m m m m m m
e following is the most common side effect of olanzapine?
m m m m m m m m m
A. Increased waist circumference
m m m
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-
m m m m m m m m m
receptor antagonism m
C. Increased Lipids
m m
D. Metabolic Syndrome
m m
D. Metabolic Syndrome (UMBRELLA ANSWER)
m m m m
,Which antipsychotics have the least weight gain?
m m m m m m
Latuda, Abilify, (also least sedating), Geodon-
m m m m m
if patient has metabolic syndrome consider switching to one of the medications ab
m m m m m m m m m m m m
ove. Or if the patient is overly sedated try switching to ABILIFY
m m m m m m m m m m m
Which mood stabilizer have the least weight gain?
m m m m m m m m
Lamictal
-But remember all mood stabilizers cause some weight gain
m m m m m m m m
When presented with a question about typical vs atypical antipsychotic the answe
m m m m m m m m m m m
r is usually to start of a
m m m m m m
atypical
A client presents with complains of changes in appetite, feeling fatigued, problem
m m m m m m m m m m m
s with sleep-
m m
rest cycle, and changes in libido. What is the neuroanatomical area of the brain th
m m m m m m m m m m m m m m
at is responsible for the normal regulation of these functions?
m m m m m m m m m
A. Thalamus
m
B. Hypothalamus
m
C. Limbic System
m m
D. Hippocampus
m
Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
m m m m m m m m m m m m m m m m
When a patient is hesitant to participate in treatment you should encourage
m m m m m m m m m m m
? Bring a support person like a husband
m m m m m m m
Thyroid-Stimulating hormone normal level m m m
-0.5-5.0 Mu/L m
,When T4 and T3 are high and TSH is low what is the diagnosis
m m m m m m m m m m m m m
-
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HE
m m m m m m m m m
AT INTOLERANCE
m
Key symptoms of Heat Intolerance
m m m m
-Hyperthyroidism
Key symptoms of Cold Intolerance
m m m m
-Hypothyroidism
Hyperthyroid can mimic m m
-Mania
Hypothyroid can mimic m m
-Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine Hepat
m m m m m m m m m m m m
oxicity
-Check LFTs m
Signs of Depakote toxicity
m m m
-Disorientation, confusion, lethargy m m
You suspect depakote toxicity what do you do? Che
m m m m m m m m
ck
-LFT
-Ammonia
-Depakote Level m
What herbal supplement can cause hepatoxicity? Ka
m m m m m m
va Kava
m
, When taking Kava Kava in combinations with other medications you should cauti
m m m m m m m m m m m
on aboutm
Risk of Hepatoxicity and Sedation
m m m m
mTCAs carry a risk of Hepatotoxici
m m m m m
ty
Signs of Stevens-Johnson Syndrome
m m m
-
fever, mouth pain, swelling, burning eyes, blisters, skin pain t
m m m m m m m m m
wo psychotropics known to cause steven johnson syndrome la
m m m m m m m m
mictal and tegretol m m
What nationality is most suseptible of getting steven Johnson?
m m m m m m m m
Asians
m
When treating asians with tegretal screen for
m m m m m m
? HLAB-1502 Allele
m m
What two medications cause agranulocytosis? Cloza
m m m m m
ril & Tegretal
m m
Agranulocytosis when to discontinue medication Le m m m m m
ss than 1000
m m
When monitoring for agranulocytosis in patients look for s/s of what? Infec
m m m m m m m m m m m
tion
-Fever, sore throat, fatigue, chills
m m m m
Before starting any mood stabilizer in a female of childbearing age be sure to che
m m m m m m m m m m m m m m
ck?
-HCG
Which two medications may decrease the risk of suicide? cloz
m m m m m m m m m
aril and lithium
m m
