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2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 11/58PMHNPCertificationExamwithcompletesolution2024/2025VERIFIED 100% CORRECTANSWERS GUARANTEED PASS1.WhatareassessedintheThoughtContentoftheMSE:SI/HI,Plan,Halluci-nations2.•PNEUMOIC-OldAgeParentsLoveGrandchildren:•Oral(0-18months),Anal(18months-3 years),Phallic(3yearsto6 years),Latent (6to12),Genital(12+)3.•FREUD'sPSYCHOSOCIALSTAGESOFDEVELOPMENT-PHALLICSTAGE-3-6yearsold:•3-year-oldmasturbates,playwithself,saysnaughtythings•ThisisNORMALforchildrenthisage.4.Whatdo youdowhenapatienthasanincreasedprolactinlevel?:•Stopprolactin (stop the agent that cause increase prolactin)5.• ACUTE STRESS DISORDER:• A d/o resulting from exposure to a majorstressor, with SX of ANX, depression, dissociation, recurring nightmares, sleepdisturbances,problemsinconcentrations,relivingtheevent,dreams,flashbacks-UP to ONE MONTH-Less than 1 month.•IfLONGERthan1month=PTSD-Symptomsthatoccurimmediatelyaftertheeventbutresolveinlessthan3dayswould not meet criteria for acute stress disorder6.Whatwouldyoudoifa5-year-oldtellsyouhisbrothersodomizedhim?:•Tell mom don't leave him alone with patient and call CPS implement crisis7.Ifachildisplayingwithdollinasexualway,whatdoyoudofirst?:•YouSUSPECTsexualabuse-PerformFURTHERASSESSMENTandGATHERENOUGH INFO BEFORE Calling CPS to report suspected Sexual Abuse-YouHAVE to report but you have to have something (assessment data) to report-

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 2

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 32/58Assess = FIRST8.Ifa13-year-oldtellsyouhewanttosmoke,whatwouldbeanappropriateresponse?:• Ask him of his plan to stop smoking9.Ifa14-year-oldgirlclenchingherteeth,whatcranialnervewouldyoususpect?:• Cranial nerve V-Trigeminal nerve (FIVE)10.WhatcranialnerveisresponsibleforBellsPalsy?:7=FacialParalysis11.Whatcranialnervesdoyouassessforcornealsensation:Nerves5&712.Whatcranialnervesdo youassessforpapillaryreactiontolightandaccommodation?:Nerves 3,4,& 613.Whatcranialnervesdoyouassessfor6cardinalfieldsofgaze&extra-oc-ular movements?:Nerves 3, 4, & 6

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 43/5814.Whatcranialnervesdoyouassessforcorneallightreflex?:3,4,&615.CranialNerve1:Olfactory(smell)16.CranialNerve2:Optic-vision17.CranialNerve3:Oculomotor(eyemovement):Theocculomotornerveisre-sponsible for motor enervation of upper eyelid muscle, extraocular muscle andpupillary muscle.18.CranialNerve4:Trochlear(eyemovement):Thetrochlearnervecontrolsanextraocular muscle.19.Cranial Nerve 5:Trigeminal: Thetrigeminal nerve is responsible for sensoryenervationofthefaceandmotorenervationtomusclesofmastication(chewing).20.CranialNerve6:Abducens(motor):Theabducentnerveenervatesamuscle,which moves the eyeball.21.CranialNerve7:Facialnerve:Thefacialnerveenervatesthemusclesoftheface (facial expression).22.Cranial Nerve 8:Vestibulocochlear (hearing and balance): The vestibulo-cochlearnerveisresponsibleforthesenseofhearingandbalance(bodypositionsense).23.CranialNerve9:Glossopharyngeal:Theglossopharyngealnerveenervatesmuscles involved in swallowing and taste. Lesions of the ninth nerve result indifficulty swallowing and disturbance of taste.24.CranialNerve10:vagusnerve:Thevagusnerveenervatesthegut(gastroin-testinal tract), heart and larynx.25.CranialNerve 11:accessory:Theaccessorynerveenervatesthesternoclei-domastoid muscles and the trapezius muscles.26.CranialNerve12:Hypoglossal(tonguemovement):Thehypoglossalnerveenervates the muscles of the tongue.27.What is the best action for a 16 y/o with conduct disorder that refusestx?:•Sendtopsychspecialistforactingoutkids-Referrals-Havetoseeifyouaregoing to refer the same patient to the same provider-Cannot refer the patient toanotherproviderthatisthesameasyou(iepsych)-youmustrefertoaneurologistoranother specialist or PCP28.Whatisapriorityconsiderationfora16-year-oldthatshowsupwithmother for first therapy?:• Confidentiality (ex.mom sits in lobby)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 54/5829.What is important to know about ACE inhibitors (Meds for Heart fail-ure/HTN):• This medication can cause increased lithium levels to toxic levels-mustcollaboratewithPCPtodeterminewhethertochangeACEorchangeLithium-Can'tuseboth30.WhatmedicationINCREASESLithiumserumleveluptodouble:Ibuprofen31.WhyisLithiumused?:•First-lineneuro-protectiveforbipolar32.•LabValuesconcerningforpatientonLithium::•Leukocytosis•Creatinine•BUN•NA+•4+PORTEINinUrine•+PregnancyTest33.•Lithium(Eskalith/Lithobid)Toxicity:•NormalRangeofLITHIUMLEVEL-0.5-1.2mEq/L•MONITORforTOXICITY:Toxicity=>1.2mEq/l•Slurredspeech,confusion,severeGIeffect-diarrhea/nausea/vomiting,metallictaste and SEVERE tremor.34.CommonsideeffectsofLithium(Eskalith/Lithobid):Nausea,fine-handtremors (start monitoring for toxicity), increased urination and thirst35.WhatpregnancycategoryisLithium(Eskalith/Lithobid):CATEGORYD:AVOID in pregnancy, especially 1st trimester-Ebstein anomaly, cardiac defect36.Whatincreasesriskoflithium(Eskalith/Lithobid)toxicity?:NSAID,dehy-dration and Thiazides37.Whatco-morbidriskinincreasedwithLithium(Eskalith/Lithobid)?:•Riskof Hypothyroidism38.Whatdosymptomsofhypothyroidism(decreasedT4&increasedTSH)mimic?:Unipolar mood disorders:-confusion-decreasedlibido-impotence-decreasedapetite-memoryloss-lethargy-constipation-headaches

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 65/58-sloworclumsymovements-syncope-weightgain-fluidretention-muscleachesandstiffness-slowedreflexes-somaticdiscomfortincludingachingandjointstiffness-slowedspeechandthinking-sensorydisturbancesincludinghearing-cerebellarataxia(maypresentwithsymptomsofaninabilitytocoordinatebalance, gait, extremity and eye movements)-lossofamplitudeinECG39.Whatdosymptomsofhyperthyroidism(decreasedTSH&increasedT4)mimic?:Bipolar affective disorders-motorrestlessness-emotionallability-shortattentionspan-compulsivemovements-fatigue-tremor-insomnia-impotence-weightloss-increasedappetite-abdominalpain-excessivesweating-flushing-elevateduppereyelidleadingtodecreasedblinking,starring,andfinetremor-tachycardia-dysrhythmias40.WhatdoesADPIEstandfor?:•Assessment•Diagnosis•Planning•Implementation•Evaluation41.RecommendCBTfor:Depression&Anxiety(keepadailylog)42.pg209andeveryPBpagesforeachdx:allthingforeachdisorder43.Whatmedicationisbestforanaggressivepatient?:IMGeodon

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 76/5844.Medicationstoimproveanxiety...:actdirectlyorindirectlyonGABAsystem-SSRIs-Benzodiazepines-Tricyclics(TCA)-Buspirone-Tiagabine(Gabitril)-gabapentin-propranololinchildren:-alphaagonists:clonidine(catapres)&guanfacine(tenex)45.advantagesofBenzodiazepineswithshorthavelives:-lessdaytimese-dation-lessdrugaccumulation-quickonset-usefulfortxofinsomnia46.disadvantagesofBenzodiazepineswithshorthavelives:increaseriskofaddiction47.non-pharmacologicalManagementforanxiety:-behavioraltherapy-CBT-interpersonaltherapies-communityselfhelpgroups-alternatetherapiesasadjuncttx48.SSRI's:-firstlinetxforanxiety-actonserotoninandindirectlyonGABA-takes3-4weekstoreachsymptomcontrol-blackboxwarningforkidsisSI49.Agoraphobiatreatment:•BZs:Shorttermsymptomrelief•SSRIs:longtermmaintenance•Fluoxetine(Prozac)•Paroxetine(Paxil)•Sertraline(Zoloft)•SNRIs:longtermmaintenance•Venlafaxine(Effexor)TCAs:longtermmaintenance

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 87/58•Betablockers(off-labeluse)usedfordiscreteepisodesofsocialanxiety-contraindicated for clients with asthma50.Alprostadil(PGE1):•Ductal-dependentCongenitalHeartdisease(allforms)•Prostaglandin E1 (PGE1), also known as alprostadil, is a naturally occurringprostaglandin which is used as a medication. In babies with congenital heartdefects, it is used by slow injection into a vein to open the ductus arteriosus untilsurgerycanbecarriedout.Byinjectionintothepenisorplacementintheurethra,it is used to treat erectile dysfunction.•0.05-0.1mg/kg/minIV/IOinfusioninitially,then0.01-0.05mg/kg/minIV/IO51.Amygdala:•Alimbicsystemstructureinvolvedinmemoryandemotion,anxiety, particularly fear and aggression52.Anorexianervosa:•Anorexia(SAFETY=KEY)•BMIlessthan18.5•BMI<16=AUTOMATICADMISSION•Aneatingdisorderinwhichanirrationalfearofweightgainleadspeopletostarvethemselves•Anorexiaadmissioncriteriaforhospitalization-Weightloss over30%over 6months,severehypothermia(temp lowerthan36Cor96.8F),heartratelessthan40beatsperminute,systolicbloodpressurelessthan 70 mm hg, and hypokalemia (less than 3 mEq/L).•Setupfamilytherapy(especiallyadolescentptssincetheyhavenocontroloverfood choices)53.•ANOVA(analysisofvariance):•3ormore•Aninferentialstatisticaltestforcomparingthemeansofthreeormoregroups54.PROZACCausesWhat?:•IncreaseAnxietyinElderly55.•Apoptosis:•Celldeathinaging/elderly56.• Appreciative inquiry:• An organizational change philosophy and processbuildingorganizationsaroundwhatworks,ratherthanfocusingonandtryingtofixwhat doesn't work•Anorganizationalchangestrategythatdirectsthegroup'sattentionawayfromits own problems and focuses participants on the group's potential and positiveelements

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 98/58•Discovery(bestofwhatis)•Dream(wishesordreamsoforganization)•Design(decidewhatyouwanttochange)•Destiny(makeithappen,implantingchange)•Identifytheproblem•Analyzetheproblem•Generatesolutions•Implementbestsolution57.•AssertiveCommunityTreatment(ACT):•Community-basedprogramsthatprovide many of the services that are necessary for successful community living;includecasemanagement,problemsolving,socialskillstraining,supportteachingon a 24/7 basis58.• Assertive questions:• Use "I want", "I need", or "I feel" to convey basicassertionsandgetyourpointacrossfirmly.Forexample"Ifeelstronglythatweneed to bring in a third party to medicate this disagreement" another example"Dave,yourrequesthascaughtmeoffguard.I'llgetbacktoyouwithinthehalfhour".59.TranstheoreticalModelofChange:•Statesthatchangesuchasinhealthbehaviors occurs in six predictable stages•Precontemplation:Thepersonhasnointentiontochange.•Contemplation:Thepersonisthinkingaboutchanging;isawarethatthereisaproblem but not committed to changing.•Preparation:Thepersonhasmadethedecisiontochange;isreadyforaction.•Action:Thepersonisengaginginspecific,overtactionstochange.•Maintenance:Thepersonisengaginginbehaviorstopreventrelapse.60.erectiledysfunctionmedications:•Avanafil(Stendra)15minutespriortosex•Tadalafil(Cialis)45minutespriortosex•Vardenafil(Levitra)45minutespriortosex•Sildenafil(Viagra)1hourpriortosex-brand-nameversionofthegenericdrug.It is a phosphodiesterase type 5 (PDE5) inhibitor.61.•Beckdepressioninventory:•Aquestionnaireusefulfordeterminingthelevel of depression•0-13minimaldepression•14-19milddepression

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 109/58•19-29Moderatedepression•30-63severedepressionIntimatetherapyforchildwithascore1062.BigFreakingProblems:•BupropionFluoxetinePaxil•Thosearestronginhibitorsof2D663.•Borderlinepersonalitydisordertreatment:•Dialecticalbehaviortherapy64.Ifaboypatientstatesthathewishestobeagirlandtells younottotellhis parent, what do you do?:Don't tell65.Ifyouseeabruiseonthepaddedpartofpatient'sarm,whatdoyoudo?:•Say I see you have bruises on your arm•Askwhathappened66.•Cananadvanceddirectiveeverberevoked?:•Yes,atanytime67.Canasthmamedicationscausedepression?:•Yes•Examples:INTERFERON68.•CanyoutakeBusparduringpregnancy?:•CategoryB:OKifreallyneeded69.•CanyoutakeKlonopinduringpregnancy?:•CategoryC:Avoidifpossible;does excrete into breast-milk and infant could get withdrawal symptoms•Floppybaby70.•CarbandBarb(CarbamazepineandPhenobarbital):•Stronginducersof3A4•DecreaseINR71.•Changeagent:•Thepersonformallyinchargeofguidingachangeeffort•Administrator-Usuallythepersonontopinthefacilityisresponsibleforbeingthe change agent.72.•ChargeofDEA:•Stateandfederal73.Achildinfosterhome5yearspooreyecontact,isolatedself,eatwithoutdifficulty.. what is dx:autism74.A child in foster home since birth, eats without interest, shows littleemotion..whatisdx?:REACTIVEATTACHMENTDISORDER=LookforNOEmotion75.•ChildreportsSexualabuse:•Interviewtheyoungchildandinfantswithparent

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1110/5876.TRICYCLIC ANTIDEPRESSANTS (TCAs):Not commonly used due to sideeffectsandoverdosetoxicityrisk;however,TCAsshouldbeconsideredforappro-priate patients who do not respond to other antidepressants.TherearenineTCAsapprovedbytheFDAfordepression(amitriptyline,amoxap-ine,desipramine,doxepin,imipramine,maprotiline,nortriptyline,protriptyline,trim-ipramine), and one approved for OCD-clomipramine (Anafranil).TertiaryTCAs(moresedating):Amitriptylinetablets(G):10mg,25mg,50mg,75mg,100mg,150mg.Imipraminetabletsandcapsules(G):10mg,25mg,50mg,75mg,100mg,125mg,150mg.SecondaryTCAs(lesssedating):Desipraminetablets(Norpramin,[G]):10mg,25mg,50mg,75mg,100mg,150mg.Nortriptylinecapsules(Pamelor,[G]):10mg,25mg,50mg,75mg,and10mg/5mL oral solution.SideEffects:Mostcommon:Sedation,drymouth,constipation,weightgain,sexualsideeffects,urinary hesitation, blurred vision.Seriousbutrare:Seizure;cardiaceffectsincludingorthostasis,arrhythmias,QTprolongation, AV block.77.Clozaril(Clozapine):•DCClozapineat-ANC<1000-WBC2000-3000ANC&WBCWEEKLYfor6months:•WhenapatientisonClozapinemonitorforsignsforagranulocytosissuchas:•Soresinthemouth,throat,•Chronicinfectionsofthegums,throat,orskin,•Fever•Chills78.•Co-morbiditiesofbipolar:•Anxiety,alcoholandsubstanceabuse79.•Inducer;Pushesthesubstrateoutoftheexitpathways,<theserumlevelof other drugs, < therapeutic effect.:I'll Come See Pumpkin Pie Tomorrow orMonday And Chow

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1211/58•Carbamazepine/Oxcarba(1A2,2C19and3A4)•St.John'sWart(3A4)•Phenytoin•Phenobarbital•Tobacco(1A2)•OCP(1A4)(watchwithuseofTopamax/Tegretol)•Methadone(1A2)•Antiretroviral•CyclosporineOrBullShitCRAPGPS•Barbiturates•St.JohnsWart•Carbamazepine•Rifampin•Alcohol(chronicuse)•Phenytoin•Griseofulvin•Phenobarbital•Sulfonylureas80.•Inhibitors:Blockstheenzymaticpathways,limitingsubstrateexcretion,Increase the serum level of other drugs,Increase toxic risk:Sickfaces.com•SodiumValproate•Isoniazid•Cimetidine•Ketoconazole•Fluconazole•Alcohol•Chloramphenicol•Erythromycin•Sulfonamides•Ciprofloxacin•Omeprazole•MetronidazolePlusGrapefruitjuice81.•DBT(Dialecticalbehaviortherapy):•RelaxationmusclepriortoDBT•BorderlinePatients-NOmeds-DBTtherapy

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1312/5882.whattherapyusesadiarylog:•CBT83.whatmedicationisusedforENURESIS:•DDAVP(Desmopressin)Works in the SAME manner of ANTIDIEURTIC HORMONE•Makeslessurine-UsedforENURESIS84.whatmedicationsincreaseINR?:DepakoteandDisulfiram85.WhatmedicationcausesSpinabifida?:Depakote,socheckHCGlevel86.•DIGFASTforMania:•Distractibility•Indiscretion•Grandiosity•Flightofideas•Activityincrease•Sleepdeficit•Talkingincrease87.•DisseminatedEncephalomyelitis:•Assessforasymmetryofextremities•Alongwiththispattern,thepatientusuallygetneurologicalsymptomswhichmayinclude•Confusion,drowsiness,andevencoma•Unsteadinessandfalling•Visualblurringordoublevision(occasionally)•Troubleswallowing•Weaknessofthearmsorlegs•Fever•Headache88.Disulfiram:Disulfiram(soldunderthetradenameAntabuse)isadrugusedtosupportthe treatment of alcohol use disorderbyproducing an acute sensitivitytoethanol(drinkingalcohol).Disulfiramworksbyinhibitingtheenzymeacetaldehydedehydrogenase,causingmanyof theeffectsofahangovertobefeltimmediatelyfollowing alcohol consumption.•IncreaseCoumadin89.•Doesimpairedjudgementmeanoneisincompetent?:No90.•Doesthedefactoruleofproxyapplyinsamesexmarriages?:•No91.DrugaffectswithFlonase:(justknowthatFlonasehasinteractionwithZan-tac & Tegretol)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1413/58•Zantac(histamine2blocker)antagonist•Per ANCC study material-Flonase (ALL Steroids) can induce MANIA andDEPRESSION-Ifyouhaveapatientwithbipolardisorderwhoisstableonamoodstabilizer and becomes manic after prescription of a steroid, the mood stabilizerwill need to be increased. If you have a patient with MDD who is stable on anantidepressantandbecomesdepressedafterstartingasteroid, you mayneedtoincrease theantidepressant-just remember though, make sure you understandwhat the question is asking-safety first92.•EarlyonsetofHIVdementia:•Apathy:lackofinterest•AbnormalofMRI_slow•Cognitivefunctions:memory,reasoning,judgment,concentration,andproblemsolving•Other common symptoms are changes in personality and behavior, speechproblems,andmotor(movement)problemssuchasclumsinessandpoorbalance•Showbrainatrophy(shrinkage)93.therapies&dx:•EMDR-PTSD-Shapiro•DBT-BorderlinePersonalityD/O-Linehan•Interpersonaltherapy-Interpersonalconflict-KlermanandWeismann•CBT-ifnothingfitsCBTworksformost.94.•EncopresisTreatment:Behaviormanagement:•Toiletrefusalbehavior,•scheduledtoiletingtime,•incentives•preventionofconstipation95.EPS:•ClientswhoexperienceanyformofEPSareatincreasedriskofTD-Acutedystonia:isthefirstsymptomthatanindividualwilldevelop,anditcanoccur within hours of taking the medication. It usually presents as involuntarycontractions of the face and neck muscles and can be painful.-akathisia:Oncethepatienthasbeentakinganantipsychoticforafewdays,theycan start to experience another side effect of consistently feeling restlessness orjittery-Parkinsonism:typicallyoccurwithingafewweeksafterstartinganantipsychotic.Parkinsonism can include muscle motor deficits such as rigidity, postural shuffle,tremors, a shuffling gait, and difficulty initiating movements

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1514/58-tardivedyskinesia:Longtermcontinuationofantipsychoticsforthreemonthsormore, whichcan sometimes beirreversibleifitisnotattendedtoquicklyenough.Symptomsoftardivedyskinesiacanincludeinvoluntaryrhythmicmovementssuchas grimacing, lip smacking, chewing, tongue flicking, as well as excessive eyeblinking96.whatmoodstabilizerisleastcausemetabolicsyndrome:lamictal97.depakotecancause:hepatoxicity(liver)=RUQpain&reddishbrownurine98.valproicacid:rangeis50-125,toxicityisgreaterthan15099.depakotetoxicity:confusion,lethargy,andrespiratorydepression-doyouliverfunctiontest-checkammonialevels-increaseammoniacausesconfusion100.patientstakingKavaforanxietyorinsomnianeed?:Aliverfunctiontest,can cause hepatoxicitythereisadrugtodruginteractionwithkavaandBenzodiazepines101.TCAcancause:hepatoxicity102.WhatcanStevenJohnsonsyndrome:lamictalandcarbamazepine(tegre-tal)TegretalincreasesriskforSJSinAsiansS/S: fever and rash103.Tegretal(Carbamazepine)andclozaril:cancauseagranulocytosisd/c for ANC for less than 1,000 and monitor for s/s of infection104.Clozaril(Clozapine)can..:decreaseSIinPTswithschizophrenia105.whatisgoldstandardmedicationforbipolar:Lithium-itcandecreaseSIfor bipolar PT's106.checkwhatlevelswithlithium:TSH,HCG,bun,creatinine,UA107.whatmedicationcanincreaselithiumtoxicity:NSAIDS,thiazides,andACE inhibitors (lisinopril)theyreducerenalclearance108.whyshouldyounottakelithiuminpregnancy?:causesebsteinanomaly(especially in the first trimester)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1615/58109.lithiumcancause:leukocytosis,hypothyroidism,maculopapularrash,t-wave inversion, tremors (fine handTremors), GI upset,-coursehandtremors=canindicatetoxicity110.Signsoflithiumtoxicity:muscleweakness,confusion,incoordination,pal-pitations, severe GI upset, drowsiness, find hand tremorspriorityaction-d/clithiumandcheckserumlevels111.NMS(neurolepticmalignantsyndrome):Canbecausedbyantipsychotics-extramusclerigiditythatcanleadtomutism-increaseCPKlevels-myoglobinuria(musclecontractionsandmuscledestructionwhichiswhatisresponsible for increase CPK levels-increaseWBC&LFT*Ifthepatientgoestothegymalotwithareddish/cherrycolorthatwouldindicatemyoglobinuriaTx:-stopmed-givebromocriptine(dopamineagonsit)-givedantrolene(musclerelaxant)112.SerotoninSyndrome:Causedbyantidepressants-SSRIs,TCA,SNRIs,MAOIs-Triptans-migrainemedications,alsoareriskforSS-hyperflexia(myoclonicjerks)TX:-stopmed-givecyproheptadine*NDRIs(Wellbutrin)donotincreaseserotoninlevels113.Howlongshouldyouwaittoswitchmedicationsthatareserotoninmeds:2 weeks (ex.SSRIs to MAOI)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1716/58wait5-6weeksforfluoxetinetoMAOI*prozachasalonghalflife114.WhyareSSRIsfirstline?:Theyaresaferandlesspotentialforcausinginjurywith potential overdose115.depression+cancer,givewhatmeds:GiveaSSRIlikecitalopramorescitalopram because they have less potential for drug to drug interactions116.depressed+neuropathicpain:SNRI-duloxetine(Cymbalta)TCAsGabapentin117.Schizophrenia:Ageononset:18-25inmales25-35infemales-thedxhasthehighestrateofdx'sthatincreasesriskforselfharm-evenmorethan depression or bipolar-canaggression,impulsivity,abstractthinkingproblems,-changes or abnormalities in the prefrontal cortex, amygdala, basal ganglia,hippocampus,andlimbicregionsofthebraincancauseaggression&impulsivity-MRI/PETwillshowadecreaseinsizeofthelobesofthebrain,andanINCREASEis the ventricles d/t increased cerebral blood flow-Donotgivestimulants-increaseddopamine-positivesymptomsofschizoisduetotoomuchdopamine-Tx:-assertivecommunitytreatment-Longtermnon-complianceofmedsthenshouldrefertoACTteam(ACTisaformor rehabilitation post hospitalization in the home)-socialskillsrehabilitation(isatertiarylevelofprevention)

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    2023-2024 PMHNP Certification Exam with Answers (479 Solved Questions), page 1817/58-refertoexerciseprogram(aerobicexercisescanhelpimprovecognitionandquality of life and long term health118.whatisthedxthatincreasesHIthemost:antisocialpersonalitydisorder119.HowdoyoucalculatedoseofmonthlyIMhaldol:Youmultiplytheirdailydose by 20ex.ifaPTistaking5mgBID,youwouldmultiply10X20=200butyoucanonlygive100mg, so give 100mg and tell them to come back in two weeks for their other100mg120.Whatisadelusion?:Isthefalsebelieffirmlymaintaineddespitetheevi-dence to the contrary (ex.their family member is part of a cult)121.MiniMentalStatusExam:Thoughtprocess-youwanttoassessyourPT'sthoughts if they are normal or abnormal-organization of thoughts122.Tangentialthinking-Thoughtprocess:thepatientnevergetstothepoint.they move from thought to thought with never getting to the point123.Circumstantialthinking-thoughtprocess:aPTgoesincircleandprovideunnecessary details before getting to the point124.WhatisanothernamefortheMMSE:FolsteinScale125.Whatareasofthebraindoestheclockfunctiontesttarget?:Ifcannotdrawtheclockitcanindicateaproblem withthe righthemisphere/rightparietallobe126.Hyperactivityofdopamineinthemesolimbicpathwaymediateswhattype of psychotic symptoms:positive symptoms = mesolimbic pathway127.decreaseddopamineinthemesocorticalprojection to the dorsolateralprefrontal cortex is postulated to be responsible for what types of schizo-phreniasymtoms?:negativeanddepressivesymptoms=mesocorticalpathway128.Whatarethepositivesymptomsofschizophrenia?:delusions,hallucina-tions, disorganized speech, disorganized or catatonic behavior129.Whatarethenegativesymptomsofschizophrenia?:flataffect,socialwithdrawal, lack of motivation, lack of speech or thought, anhedonia130.NigrostraitalPathway:-mediatesmotormovements-whendopamineisblockedinthispathwayitcanleadtoincreasedacetylcholinelevels-blockeddopaminecanleadtoEPS-longstandingD2blockadeinthispathwaycanleadtotardivedyskinesia

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