GEORGETTE REVIEW PMHNP ACCURATE EXPERT
VERIFIED ACTUAL QUESTIONS & ANSWERS FOR
GUARANTEED PASS | NEWEST UPDATE
When many answers are remarkably similar, they are usually _____________
wrong
What is encouraged in advanced practice leadership? It is better to collaborate
or delegate?
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Normal lithium levels
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, blurred vision,
slurred speech, muscle weakness, heart palpitation, coarse hand tremors,
ataxia
Lithium is gold standard for what bipolar condition?
MANIA
Lithium has evidence shown to
,reduce suicidal ideation
Most excitatory neutransmitter
glutamate
Increased level of corticotropin releasing hormone in the amygdala,
hippocampus and locus coeruleus
increases symptoms of anxiety.
Autism
deficits in social communication and social interaction across multiple settings
Parents of kids with autism may report
No response when called by name
Little or no eye contact
Children with autism often like to line up, stack, or organize objects and toys.
Screenings for autism
Autism Diagnostic Observation Schedule ADOS
Modified Checklist for Autism in Toddlers M-CHAT
Ages and Stages Questionnaire ASQ
Pharm management for autism
antipsychotics are effective for symptoms such as tantrums, aggressive
behaviors, self-injurious behaviors
cogentin (IM first then oral)
Restlessness, inability to sit still. Pacing.
Mistaken for anxiety.
Akathisia
Commonly used rating scale for akathisia is
Barnes Akathisia rating scale and extrapyramidal symptom rating scale.
,Treatment for akathisis
1st line
2nd line
3rd line
1st: beta blocker
2nd: Cogentin
3rd: bnzodiazepine
Absence of movement or difficulty initiating movement and treatment
akinesia
Treatment: cogentin
Presence of symptoms of Parkinson's produced by D2 blockade in the
nigrostriatal pathway
Pseudo-Parkinsonism
Signs of Parkinsons
muscle rigidity
shuffling gait
mask like facial expression
pill rolling tremors
cogwheel rigidity
Treatment for pseudo parkinsonism
cogentin
Involuntary abnormal muscle movement of the mouth tongue face and jaw
that may progress to limbs. Can take 1-2 years to occur.
Tardive dyskinesia
Signs of tar dive dyskinesia
lip smacking
protrusion of the tongue
chewing motion
, facial dyskinesia
involuntary movement.
Screening tool for early detection of tardive dyskinesia
AIMS (Abnormal Involuntary Movement Scale)
Treatment for TD
Stop offending antipsychotic, reduce the dose, or switch to atypical agent
COGENTIN WORSENS IT
Ingrezza or Austedo approved
Non-psych med that can cause TD
Reglan
A patient has been treated for the past several years with fluphenazine
(Prolixin). You tonic that he is drooling and has a slight pill rolling movement of
the fingers. These are EPS symptoms known as
A. pseudo parkinsonism
b. anticholinergic effects
C. Tardive dyskinesia
D. Acute dystonia
A. Pseudoparkinsonism
A patient is diagnosed with schizophrenia. Which of the following would be the
appropriate question for the PMHNP to ask when assessing side effects
produced by dopamine antagonism in the nigrostriatal pathway?
A. Are you experiencing constipation?
B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial
expression?
C. Are you experiencing increased thirst?
D. Are you experiencing breast discharge?
Are you experiencing pill rolling tremors, shuffling gait, and mask like facial
expression
VERIFIED ACTUAL QUESTIONS & ANSWERS FOR
GUARANTEED PASS | NEWEST UPDATE
When many answers are remarkably similar, they are usually _____________
wrong
What is encouraged in advanced practice leadership? It is better to collaborate
or delegate?
Collaborate is usually right.
Delegate is usually wrong.
ADPIER
Assessment, diagnosis, Plan, intervention, evaluate, refer out last.
Normal lithium levels
Normal 0.6-1.2
Lithium toxicity occurs at levels
> 1.5
Signs of Lithium toxicity
severe nausea, diarrhea, vomiting, confusion, drowsiness, blurred vision,
slurred speech, muscle weakness, heart palpitation, coarse hand tremors,
ataxia
Lithium is gold standard for what bipolar condition?
MANIA
Lithium has evidence shown to
,reduce suicidal ideation
Most excitatory neutransmitter
glutamate
Increased level of corticotropin releasing hormone in the amygdala,
hippocampus and locus coeruleus
increases symptoms of anxiety.
Autism
deficits in social communication and social interaction across multiple settings
Parents of kids with autism may report
No response when called by name
Little or no eye contact
Children with autism often like to line up, stack, or organize objects and toys.
Screenings for autism
Autism Diagnostic Observation Schedule ADOS
Modified Checklist for Autism in Toddlers M-CHAT
Ages and Stages Questionnaire ASQ
Pharm management for autism
antipsychotics are effective for symptoms such as tantrums, aggressive
behaviors, self-injurious behaviors
cogentin (IM first then oral)
Restlessness, inability to sit still. Pacing.
Mistaken for anxiety.
Akathisia
Commonly used rating scale for akathisia is
Barnes Akathisia rating scale and extrapyramidal symptom rating scale.
,Treatment for akathisis
1st line
2nd line
3rd line
1st: beta blocker
2nd: Cogentin
3rd: bnzodiazepine
Absence of movement or difficulty initiating movement and treatment
akinesia
Treatment: cogentin
Presence of symptoms of Parkinson's produced by D2 blockade in the
nigrostriatal pathway
Pseudo-Parkinsonism
Signs of Parkinsons
muscle rigidity
shuffling gait
mask like facial expression
pill rolling tremors
cogwheel rigidity
Treatment for pseudo parkinsonism
cogentin
Involuntary abnormal muscle movement of the mouth tongue face and jaw
that may progress to limbs. Can take 1-2 years to occur.
Tardive dyskinesia
Signs of tar dive dyskinesia
lip smacking
protrusion of the tongue
chewing motion
, facial dyskinesia
involuntary movement.
Screening tool for early detection of tardive dyskinesia
AIMS (Abnormal Involuntary Movement Scale)
Treatment for TD
Stop offending antipsychotic, reduce the dose, or switch to atypical agent
COGENTIN WORSENS IT
Ingrezza or Austedo approved
Non-psych med that can cause TD
Reglan
A patient has been treated for the past several years with fluphenazine
(Prolixin). You tonic that he is drooling and has a slight pill rolling movement of
the fingers. These are EPS symptoms known as
A. pseudo parkinsonism
b. anticholinergic effects
C. Tardive dyskinesia
D. Acute dystonia
A. Pseudoparkinsonism
A patient is diagnosed with schizophrenia. Which of the following would be the
appropriate question for the PMHNP to ask when assessing side effects
produced by dopamine antagonism in the nigrostriatal pathway?
A. Are you experiencing constipation?
B. Are you experiencing pill rolling tremors, shuffling gait, and mask like facial
expression?
C. Are you experiencing increased thirst?
D. Are you experiencing breast discharge?
Are you experiencing pill rolling tremors, shuffling gait, and mask like facial
expression
