LMR Georgette’s PMHNP Certification
Exam Questions And Answers Verified
100% Correct
a form of rehabilitation post hospitalization, in home treatment What
level of prevention is ACT?
Tertiary
What adjunctive treatment is important in schizophrenia
-social skills training
-Exercise
Exercise for mental health patients can promote
Cognition
Quality of Life
Long-term health
ACT is ideal for patients with a history of
Treatment non-compliance
-Think about making the treatment convenient for them-->bringing it to their home
What diagnosis has the highest risk of Homicidality
Antisocial
In the MMSE how do you test for abstraction? proverb interpretation
(everyone that lives in glass houses shouldn’t throw stones) Are they able
to think abstractly Thought Process-Tangential means that their response
has nothing to do with the question Circumstantial means that their
response goes in circles instead of getting to the point of the question
Mental Status-Thought Content includes
,SI/HI/AH/VH
Another name for MMSE
Folstein Scale
How to assess concentration on MMSE
Serial 7s or perform an activity backwards i.e list the days of the week backwards
Assess ability to learn new material repeat 3 words after me Assess ability to
recall repeat 3 words after 5 minutes
Assess fund of knowledge
Who is the president
What is a quick and easy way to assess for neurological issues
Clock drawing test
If patient is unable to draw a clock this indicates
Problem with the right hemisphere, cerebrum, or parietal lobe mesolimbic
pathway
Hyperactivity of dopamine in the this pathway mediates positive psychotic
symptoms
-Antagonism of D2 receptors in this pathway treats positive psychotic
symptoms mesocortical pathway
-Decreased dopamine in the this projection to the dorsolateral prefrontal
cortex is postulated to be responsible for negative and depressive symptoms of
schizophrenia Nigrostriatal Pathway
-This pathway mediates motor movements
-Dopamine blockade in this pathway can lead to increase acetylcholine levels
-Blockade of dopamine (D2) receptors in this pathway can lead to EPS, i.e
dystonia, parkinsonian symptoms and akathisia
Low Dopamine in the nigrostriatal pathway increases which neurotransmitter
-Dopamine has a reciprocal relationship with acetylcholine (Ach) (LOW
,DOPAMINE INCREASE Ach)
Long-standing D2 blockade in the nigrostriatal pathway can lead to
tardrive dyskinesia Tuberoinfundibular pathway
-Blockade of D2 receptors in this pathway can lead to increase prolactin levels
leading to hyperprolactinemia which clinically manifests as amenorrhea,
galactorrhea, and sexual dysfunction, gynecomastia
-DECREASE DOPAMINE INCREASED PROLACTIN
Long-term hyperprolactinemia can be associated with what condition
osteoporosis
Normal Prolactin Level in Men level
less than 20ng/ml
Normal Prolactin Level in Women less
than 25ng/ml
Which medication is the highest offender for increasing prolactin
Risperdal
Acute Dystonia + Treatment
neck stiffness, muscle spasm of upper body especially neck/face/tongue
-Treatment is IM COGENTIN + continue PO COGENTIN for several days
Akathisia + Treatment
may mimic anxiety, restlessness, can’t sit still, rocking, pacing
-First line Treatment is BETA-BLOCKERS like PROPANOLOL (Inderal)
-Second line treatment is COGENTIN
-Third line treatment is benzos
Beta-Blockers such as Inderal are contraindicated with what type of asthma
medication
-DO NOT GIVE WITH BROCHODIALATOR such as ALBUTERAL this
combination can cause bronchospasm akinesia/bradykinesia + treatment
, A. difficulty initiating movement; slowness of movement -Treatment
Cogentin
PSEUDOPARKINSON or PARKINSONIAN + Treatment
caused by dopamine blockade, results in muscle rigidity, mask like facial
expression, may look blunted, pill rolling tremors in fingers, shuffling gait,
motor slowing
-Treatment COGENTIN
tardive dyskinesia + Treatment abnormal facial movements, grinding teeth, lip
smacking, protruding tongue
-Treatment DECREASE DOSE OF MED, DISCONTINUE MED, Switch to
CLOZARIL, Switch to different med, VINPAT
Does Cogentin Treat TD
COGENTIN MAKES TD WORSE
Typical onset of TD
OCCURS 1-2 years TYPICALLY, but can be ACUTE ONSET ALSO
What non-psych med can cause TD?
REGLAN (Metoclopramide) can CAUSE Tardive Dyskinesia must educate
patient that this med or the combination of this PLUS antipsychotic can
increase risk of TD*** encourage them to discontinue reglan if TD develops
InDucers CYP450
DECREASE
Carbamazepine
Rifampin
Alcoholics (chronic)
Phenytoin
Grisiofulvin
Phenobarb
Exam Questions And Answers Verified
100% Correct
a form of rehabilitation post hospitalization, in home treatment What
level of prevention is ACT?
Tertiary
What adjunctive treatment is important in schizophrenia
-social skills training
-Exercise
Exercise for mental health patients can promote
Cognition
Quality of Life
Long-term health
ACT is ideal for patients with a history of
Treatment non-compliance
-Think about making the treatment convenient for them-->bringing it to their home
What diagnosis has the highest risk of Homicidality
Antisocial
In the MMSE how do you test for abstraction? proverb interpretation
(everyone that lives in glass houses shouldn’t throw stones) Are they able
to think abstractly Thought Process-Tangential means that their response
has nothing to do with the question Circumstantial means that their
response goes in circles instead of getting to the point of the question
Mental Status-Thought Content includes
,SI/HI/AH/VH
Another name for MMSE
Folstein Scale
How to assess concentration on MMSE
Serial 7s or perform an activity backwards i.e list the days of the week backwards
Assess ability to learn new material repeat 3 words after me Assess ability to
recall repeat 3 words after 5 minutes
Assess fund of knowledge
Who is the president
What is a quick and easy way to assess for neurological issues
Clock drawing test
If patient is unable to draw a clock this indicates
Problem with the right hemisphere, cerebrum, or parietal lobe mesolimbic
pathway
Hyperactivity of dopamine in the this pathway mediates positive psychotic
symptoms
-Antagonism of D2 receptors in this pathway treats positive psychotic
symptoms mesocortical pathway
-Decreased dopamine in the this projection to the dorsolateral prefrontal
cortex is postulated to be responsible for negative and depressive symptoms of
schizophrenia Nigrostriatal Pathway
-This pathway mediates motor movements
-Dopamine blockade in this pathway can lead to increase acetylcholine levels
-Blockade of dopamine (D2) receptors in this pathway can lead to EPS, i.e
dystonia, parkinsonian symptoms and akathisia
Low Dopamine in the nigrostriatal pathway increases which neurotransmitter
-Dopamine has a reciprocal relationship with acetylcholine (Ach) (LOW
,DOPAMINE INCREASE Ach)
Long-standing D2 blockade in the nigrostriatal pathway can lead to
tardrive dyskinesia Tuberoinfundibular pathway
-Blockade of D2 receptors in this pathway can lead to increase prolactin levels
leading to hyperprolactinemia which clinically manifests as amenorrhea,
galactorrhea, and sexual dysfunction, gynecomastia
-DECREASE DOPAMINE INCREASED PROLACTIN
Long-term hyperprolactinemia can be associated with what condition
osteoporosis
Normal Prolactin Level in Men level
less than 20ng/ml
Normal Prolactin Level in Women less
than 25ng/ml
Which medication is the highest offender for increasing prolactin
Risperdal
Acute Dystonia + Treatment
neck stiffness, muscle spasm of upper body especially neck/face/tongue
-Treatment is IM COGENTIN + continue PO COGENTIN for several days
Akathisia + Treatment
may mimic anxiety, restlessness, can’t sit still, rocking, pacing
-First line Treatment is BETA-BLOCKERS like PROPANOLOL (Inderal)
-Second line treatment is COGENTIN
-Third line treatment is benzos
Beta-Blockers such as Inderal are contraindicated with what type of asthma
medication
-DO NOT GIVE WITH BROCHODIALATOR such as ALBUTERAL this
combination can cause bronchospasm akinesia/bradykinesia + treatment
, A. difficulty initiating movement; slowness of movement -Treatment
Cogentin
PSEUDOPARKINSON or PARKINSONIAN + Treatment
caused by dopamine blockade, results in muscle rigidity, mask like facial
expression, may look blunted, pill rolling tremors in fingers, shuffling gait,
motor slowing
-Treatment COGENTIN
tardive dyskinesia + Treatment abnormal facial movements, grinding teeth, lip
smacking, protruding tongue
-Treatment DECREASE DOSE OF MED, DISCONTINUE MED, Switch to
CLOZARIL, Switch to different med, VINPAT
Does Cogentin Treat TD
COGENTIN MAKES TD WORSE
Typical onset of TD
OCCURS 1-2 years TYPICALLY, but can be ACUTE ONSET ALSO
What non-psych med can cause TD?
REGLAN (Metoclopramide) can CAUSE Tardive Dyskinesia must educate
patient that this med or the combination of this PLUS antipsychotic can
increase risk of TD*** encourage them to discontinue reglan if TD develops
InDucers CYP450
DECREASE
Carbamazepine
Rifampin
Alcoholics (chronic)
Phenytoin
Grisiofulvin
Phenobarb
