PMHNP Psychopharm Exam 6 2024
j j j j
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aljtimesjandjalwaysjreceivesjthejsamejresults,jthejtestjisjreliable.
internaljvalidityj-jRefersjtojhowjwelljanjexperimentjisjdone,
WasjitjdonejRIGHT
extentjtojwhichjwejcanjdrawjcause-and-effectjinferencesjfromjajstudy
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Datajinjnumbers
BiggestjconcernjwithjEMRj-jPrivacyjconfidentiality
ScopejofjPracticej-jSTATE
StandardsjofjPracticej-jANA
Thejstandardjofjpracticejlimitationsjimposedjuponjajhealthcarejproviderjarejbasedjonjlocaljregulatio
nsjandjwhichjofjthejfollowingjelements?
BeckjDepressionj-j0-
9:jindicatesjminimaljdepressionj10-
18:jindicatesjmildjdepression
19-
29:jindicatesjmoderatejdepressionj30-
63:jindicatesjseverejdepression.
HamiltonjDepressionjScalej-jTOTALjITEMSj1jTOj17:
j0-7=Normal
8j-j13j=jMildjDepression
j14-
18j=jModeratejDepressionj19j-
j22j=jSeverejDepression
>j23j=jVeryjSeverejDepression
PHQ9j-jScorejDepressionjseverityjComments
0-4jMinimaljdepression
5-9jMildjdepression
10-14jModeratejdepression
15-
19jModeratejSeverejdepressionj20-
27jSevere
,0-4jMinimaljorjnonejMonitor;jNojTX
5-
9jMildjUsejclinicaljjudgmentj(symptomjduration,jfunctionaljimpairment)jtojdeterminejnecessityjofjt
reatment
10-14jModerate
15-19jModeratelyjsevere
Warrantsjactivejtreatmentjwithjpsychotherapy,jmedications,jorjcombination
20-27jSevere
Anorexia/BulimiajAdmissionjtojHospitaljforjPediatricsj-
jAmericanjAcademyjofjPediatricsjCriteriajforjInpatientjHospitalizationjinjEatingjDisorders
Anorexiajnervosa
Heartjratej<j50jbeats/minjdaytime;j<j45jbeats/minjnighttimejSys
tolicjbloodjpressurej<j90jmmjHg
Orthostaticjchangesjinjpulsej(>j20jbeats/min)jorjbloodjpressurej(>j10jmmjHg)jArrhythmia
Temperaturej<j96°F
<j75%jidealjbodyjweightjorjongoingjweightjlossjdespitejintensivejmanagementjBodyjfa
tj<j10%
Refusaljtojeat
Failurejtojrespondjtojoutpatientjtreatment
BulimiajnervosajSync
ope
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chloridej<j88jmmol/LjEsophagealjtear
s
CardiacjarrhythmiasjincludingjprolongedjQTcjHypoth
ermia
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ejvomitingjHemateme
sis
Failurejtojrespondjtojoutpatientjtreatment
AnorexiajAdmissionj-
Howjlongjdoesjantidepressantsjworkj-j4-6jweeks
Yalomj-
jYalom'sjelevenjtherapeuticjfactorsjthatjinfluencejchangejandjhealingjinjgroupjtherapy:
1. Thejinstillationjofjhopejcreatesjajfeelingjofjoptimism.
2. Universalityjhelpsjgroupjmembersjrealizejthatjtheyjarejnotjalonejinjtheirjimpulses,jpro
blems,jandjotherjissues.
,3. Impartingjinformationjhelpsjtojeducatejandjempowerjpeoplejwithjknowledgejpertainingjtojthei
rjspecificjpsychologicaljsituation.
4. Altruismjallowsjclientsjtojgainjajsensejofjvaluejandjsignificancejbyjhelpingjotherjgroupjme
mbers.
5. Correctivejrecapitulationjprovidesjforjthejresolutionjofjfamilyjandjchildhoodjeventsjwithinjthej
safetyjofjthejgroupjfamily.
6. Socializingjtechniquesjpromotejsocialjdevelopment,jtolerance,jempathy,jandjotherjint
erpersonaljskills.
7. Throughjimitativejbehaviorjgroupjmembersjlearnjtojadoptjthejcopingjstrategiesjandjper
spectivesjofjotherjgroupjmembers.
8. Interpersonaljlearningjteachesjclientsjhowjtojdevelopjsupportivejinterpersonaljrel
ationships.
9. Groupjcohesivenessjgivesjmembersjajsensejofjacceptance,jbelonging,jvalue,jandjsecurity.
10. Catharsisjreleasesjsuppressedjemotionsjandjpromotesjhealingjbyjdisclosingjinformationjtojgro
upjmembers.
11. Existentialjfactorsjincorporatejlearningjhowjtojjustjexistjasjpartjofjsomethingjlargerjthanjonese
lf.jThisjfactorjbringsjajclientjintojthejawarenessjthatjlifejwilljcontinuejon,jwithjpain,jdeath,jsadness,
jregret,jandjjoy.jByjlivingjexistentially, jclients jlearnjhowjtojacceptjthesejconditionsjwithoutjescapi
ngjfromjthem.jInstead,jtheyjlearnjhowjtojlivejwithjthemjandjthroughjthem.
Tegretolj-jCheckjANCjandjWBC-jCausesjAgranulocytosis
DeliriumjversusjDementiaj-
jDeliriumjisjAcutejDementiajisjprogressive
SteroidsjTriggerj-jMania
PositivejTrendelenburgjtestj-jREFERjtojOrtho
AjpositivejTrendelenburgjtestjusuallyjindicatesjweaknessjinjthejhipjabductorjmuscles:jgluteusjmedi
usjandjgluteusjminimus.[1]jThesejfindingsjcanjbejassociatedjwithjvariousjhipjabnormalitiesjsuchjasj
congenitaljhipjdislocation,jrheumaticjarthritis,josteoarthritis.
TegretoljandjErythromycinj-
jErythromycinjinhibitor.jYoujwouldjdecreasejTegretol.jErythromycin jwouldjcausesjtoxicjTegretoljl
evels.
CYPjInducers
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jDecreasejotherjmedicationjBarbituates
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oljPhentoinjGris
eofluvinjPheno
barbitaljSulfony
ureas
CYPjInhibitors
SICKFACE.COMj-
jSodiumjValproatejIsoniazid
CimetidinejKetoc
onazolejFluconaz
olejAlcoholjChlor
amphenicoljEryth
romycinjSulfona
midesjCiprojOme
prazolejMetronid
azole
CarbjandjBarbjinducersj-jDecreasejCoumadin
DepakotejandjDisulframjInhibitorsj-jIncreasejCoumadin
NicotinejInducer-1Aj-jDecreases/metabolizesjZyprexiajquicker
GALj(Gabapentin,jAcamprosate,jLithium)j-jRenallyjMetabolized
STOPjSMOKINGj-jDecreasejZyprexia
NSAIDSjandjACEjinhibitorsj-jIncreasejLithiumjLevels
Nigrostriataljpathwaysj-jEPS
DilatedjPupilsjandjHypertensionj-jOpiatejWithdrawal
BehavioraljTherapyj-jForjajChildjWhojBedjWets
DDVAPj-jDecreasesjamountjofjurine
OTLj(Oxazepam,jTemazepam,jLorazepam)j-
jMetabolizedjoutsidejthejliverjbyjconjugation.j1/2jlivesjarejthejsamejevenjwithjadvancedjliverjdise
ase
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Beneficence-jDojgood
Non-maleficence-
DojnojharmjValidity-Faithful
j j j j
NSAIDSj-jIncreasesjLithiumjLevels
Reliabilityj-jconsistencyjofjmeasurement
Reliabilityjisjanotherjtermjforjconsistency.jIfjonejpersonjtakesjthejsamejpersonalityjtestjsever
aljtimesjandjalwaysjreceivesjthejsamejresults,jthejtestjisjreliable.
internaljvalidityj-jRefersjtojhowjwelljanjexperimentjisjdone,
WasjitjdonejRIGHT
extentjtojwhichjwejcanjdrawjcause-and-effectjinferencesjfromjajstudy
Qualitativej-jDatajinjthejformjofjrecordedjdescriptionsjratherjthanjnumericaljmeasurements.
Quantitativej-
jrelatingjto,jmeasuring, jorjmeasuredjbyjthejquantityjofjsomethingjratherjthanjitsjquality.
Datajinjnumbers
BiggestjconcernjwithjEMRj-jPrivacyjconfidentiality
ScopejofjPracticej-jSTATE
StandardsjofjPracticej-jANA
Thejstandardjofjpracticejlimitationsjimposedjuponjajhealthcarejproviderjarejbasedjonjlocaljregulatio
nsjandjwhichjofjthejfollowingjelements?
BeckjDepressionj-j0-
9:jindicatesjminimaljdepressionj10-
18:jindicatesjmildjdepression
19-
29:jindicatesjmoderatejdepressionj30-
63:jindicatesjseverejdepression.
HamiltonjDepressionjScalej-jTOTALjITEMSj1jTOj17:
j0-7=Normal
8j-j13j=jMildjDepression
j14-
18j=jModeratejDepressionj19j-
j22j=jSeverejDepression
>j23j=jVeryjSeverejDepression
PHQ9j-jScorejDepressionjseverityjComments
0-4jMinimaljdepression
5-9jMildjdepression
10-14jModeratejdepression
15-
19jModeratejSeverejdepressionj20-
27jSevere
,0-4jMinimaljorjnonejMonitor;jNojTX
5-
9jMildjUsejclinicaljjudgmentj(symptomjduration,jfunctionaljimpairment)jtojdeterminejnecessityjofjt
reatment
10-14jModerate
15-19jModeratelyjsevere
Warrantsjactivejtreatmentjwithjpsychotherapy,jmedications,jorjcombination
20-27jSevere
Anorexia/BulimiajAdmissionjtojHospitaljforjPediatricsj-
jAmericanjAcademyjofjPediatricsjCriteriajforjInpatientjHospitalizationjinjEatingjDisorders
Anorexiajnervosa
Heartjratej<j50jbeats/minjdaytime;j<j45jbeats/minjnighttimejSys
tolicjbloodjpressurej<j90jmmjHg
Orthostaticjchangesjinjpulsej(>j20jbeats/min)jorjbloodjpressurej(>j10jmmjHg)jArrhythmia
Temperaturej<j96°F
<j75%jidealjbodyjweightjorjongoingjweightjlossjdespitejintensivejmanagementjBodyjfa
tj<j10%
Refusaljtojeat
Failurejtojrespondjtojoutpatientjtreatment
BulimiajnervosajSync
ope
Serumjpotassiumj<j3.2jmmol/LjSerumj
chloridej<j88jmmol/LjEsophagealjtear
s
CardiacjarrhythmiasjincludingjprolongedjQTcjHypoth
ermia
SuicidejriskjIntractabl
ejvomitingjHemateme
sis
Failurejtojrespondjtojoutpatientjtreatment
AnorexiajAdmissionj-
Howjlongjdoesjantidepressantsjworkj-j4-6jweeks
Yalomj-
jYalom'sjelevenjtherapeuticjfactorsjthatjinfluencejchangejandjhealingjinjgroupjtherapy:
1. Thejinstillationjofjhopejcreatesjajfeelingjofjoptimism.
2. Universalityjhelpsjgroupjmembersjrealizejthatjtheyjarejnotjalonejinjtheirjimpulses,jpro
blems,jandjotherjissues.
,3. Impartingjinformationjhelpsjtojeducatejandjempowerjpeoplejwithjknowledgejpertainingjtojthei
rjspecificjpsychologicaljsituation.
4. Altruismjallowsjclientsjtojgainjajsensejofjvaluejandjsignificancejbyjhelpingjotherjgroupjme
mbers.
5. Correctivejrecapitulationjprovidesjforjthejresolutionjofjfamilyjandjchildhoodjeventsjwithinjthej
safetyjofjthejgroupjfamily.
6. Socializingjtechniquesjpromotejsocialjdevelopment,jtolerance,jempathy,jandjotherjint
erpersonaljskills.
7. Throughjimitativejbehaviorjgroupjmembersjlearnjtojadoptjthejcopingjstrategiesjandjper
spectivesjofjotherjgroupjmembers.
8. Interpersonaljlearningjteachesjclientsjhowjtojdevelopjsupportivejinterpersonaljrel
ationships.
9. Groupjcohesivenessjgivesjmembersjajsensejofjacceptance,jbelonging,jvalue,jandjsecurity.
10. Catharsisjreleasesjsuppressedjemotionsjandjpromotesjhealingjbyjdisclosingjinformationjtojgro
upjmembers.
11. Existentialjfactorsjincorporatejlearningjhowjtojjustjexistjasjpartjofjsomethingjlargerjthanjonese
lf.jThisjfactorjbringsjajclientjintojthejawarenessjthatjlifejwilljcontinuejon,jwithjpain,jdeath,jsadness,
jregret,jandjjoy.jByjlivingjexistentially, jclients jlearnjhowjtojacceptjthesejconditionsjwithoutjescapi
ngjfromjthem.jInstead,jtheyjlearnjhowjtojlivejwithjthemjandjthroughjthem.
Tegretolj-jCheckjANCjandjWBC-jCausesjAgranulocytosis
DeliriumjversusjDementiaj-
jDeliriumjisjAcutejDementiajisjprogressive
SteroidsjTriggerj-jMania
PositivejTrendelenburgjtestj-jREFERjtojOrtho
AjpositivejTrendelenburgjtestjusuallyjindicatesjweaknessjinjthejhipjabductorjmuscles:jgluteusjmedi
usjandjgluteusjminimus.[1]jThesejfindingsjcanjbejassociatedjwithjvariousjhipjabnormalitiesjsuchjasj
congenitaljhipjdislocation,jrheumaticjarthritis,josteoarthritis.
TegretoljandjErythromycinj-
jErythromycinjinhibitor.jYoujwouldjdecreasejTegretol.jErythromycin jwouldjcausesjtoxicjTegretoljl
evels.
CYPjInducers
BULLSHITjCRAPjGPSj-
jDecreasejotherjmedicationjBarbituates
St.jJohnsjWart
, Carbamazepinej
RifampinjAlcoh
oljPhentoinjGris
eofluvinjPheno
barbitaljSulfony
ureas
CYPjInhibitors
SICKFACE.COMj-
jSodiumjValproatejIsoniazid
CimetidinejKetoc
onazolejFluconaz
olejAlcoholjChlor
amphenicoljEryth
romycinjSulfona
midesjCiprojOme
prazolejMetronid
azole
CarbjandjBarbjinducersj-jDecreasejCoumadin
DepakotejandjDisulframjInhibitorsj-jIncreasejCoumadin
NicotinejInducer-1Aj-jDecreases/metabolizesjZyprexiajquicker
GALj(Gabapentin,jAcamprosate,jLithium)j-jRenallyjMetabolized
STOPjSMOKINGj-jDecreasejZyprexia
NSAIDSjandjACEjinhibitorsj-jIncreasejLithiumjLevels
Nigrostriataljpathwaysj-jEPS
DilatedjPupilsjandjHypertensionj-jOpiatejWithdrawal
BehavioraljTherapyj-jForjajChildjWhojBedjWets
DDVAPj-jDecreasesjamountjofjurine
OTLj(Oxazepam,jTemazepam,jLorazepam)j-
jMetabolizedjoutsidejthejliverjbyjconjugation.j1/2jlivesjarejthejsamejevenjwithjadvancedjliverjdise
ase
Negligencej-jAutonomy-
IndependentjJusticej-Fair
Beneficence-jDojgood
Non-maleficence-
DojnojharmjValidity-Faithful