PMHNP Exam Reported Questions and answers

PMHNP Exam Reported Questions and answers 1. What is dissemination?: Getting the research information out to those who need to know it! Publication - highest level Presenting at National Conference Presenting at Local Conference Journal Club where one person reviews an article 2. What does a 17 on MMSE mean?: Moderate cognitive impairment 3. What is Tegretol in the CYP450 system?: Inducer --will lower dose of Lam- ictal and BCP's 4. What do BCP's do to Lamictal?: Inducer - will lower dose of Lamictal 5. What is a Type I research error?: There IS a difference but you say there isn't a difference. 6. What is a Type II research error?: There is NO difference but you say there is a difference. 7. What is pseudo-dementia?: Cognitive impairment secondary to depression that clears when treated in the elderly. Dementia won't improve. 8. Is it normal for a 1 month old to have a palmar grasp?: Yes. 9. What is a drug 1/2 life?: The time it takes for 50% of a drug to be eliminated from the body. 10. What 3 atypicals can be used with teens?: Zyprexa, Abilify, Seroquel - low doses 11. What is a risk of using Tramadol?: Serotonin Syndrome as it is very seroton- ergic. 12. What is the allele seen in Asians that increase the risk of SJS?: - HLAB-1502 13. When might you see toxic epidermal necrolysis?: With worsening of SJS 14. How many generations do you include for a genogram?: 1st degree - mother, father, siblings 2nd degree - grandparents & cousins 3rd degree - 15. What does messenger RNA code for?: Amino Acids 16. What is epigenetics?: Factors that affect genes - environmental, smoking, stress, etc... 17. What part of the brain is involved with OCD?: Basal Ganglia Occipito-Frontal 18. What happens to the brain during adolescence?: Dendritic pruning Emotions are controlled by amygdala By adulthood, PFC involved as well 19. When do males typically present with schizophrenia?: 10-25 yo 20. When do females typically present with schizophrenia?: 25-35 yo 54. What is the evil eye?: When a stronger or more powerful person looks at a weaker person - often infant/child resulting in a hex which presents in illness such as HA, fever, diarrhea, disturbed sleep, increased fussiness. 55. How do you protect from the evil eye?: Red ribbon on an infant Amulet for adults 56. How do you treat for evil eye?: Access traditional healer + traditional care. 57. For there to be a duty to a patient, what must exist?: Relationship 58. What is a proximate cause?: Connection between A + B. 59. For there to be damages, what must exist first?: Negligence 60. What is an occurrence basis liability insurance?: "occurred" during the policy period, no matter when the claim is brought against the insured 61. What is a claims made/based liability insurance?: provides coverage for a claim that is brought within the policy period, no matter when the loss occurred. 62. Who sets the minimum requirements for NP's?: Board of Nursing State 63. What are the various controlled substance classes?: Schedule I - nobody has these - not good for health - heroin, PCP, MDMA, researchers can get it sometimes. Schedule II - Significant Abuse Potential - morphine, methadone, methyphenidate Schedule III - Moderate Abuse Potential - hydrocodone, codeine Schedule IV - Low Abuse Potential - benzo's, ambien, phentermine Schedule V - Very low abuse potential - anti-tussives, lomotil 64. What classes of CS's is the NP approved to prescribe?: Schedules III-V ONLY. 65. Where does 50% of healthcare funds come from?: The government 66. Who is eligible for Medicare?: 65 or under 65 with diability, ANY age with renal disease. 67. What is incident to billing?: Means MD initiates treatment and NP is an extension of the care and directly under the supervision of the MD. Allows NP to get reimbursed at 100% rather than 85%. 68. How are Medicaid benefits determined?: State determines qualification - Partnership between State and Fed Govt. Must be impoverished Must be US resident and low or very low income. 69. Can you have Medicare and Medicaid?: Yes, impoverished elderly but Med- icaid is always payor of last resort. 70. Is dental care included in Medicaid?: Yes, 21 gets basic dental as part of the Medicaid plan. 71. What is the purpose of HIPAA?: National standards for electronic HC trans- actions National ID for providers, health plans and employers. Not SIMPLY Confidentiality. 72. What must be signed prior to any healthcare in the state: Notice of Privacy Practices Statement 73. What happens if a patient refuses to sign an ROI?: Can decline to treat Health plan may condition enrollment on provision of consent 74. When is HIPAA not required?: Emergency treatment Substantial communication barriers and consent is inferred Involuntary committment 75. Is it ok to announce a patient's name in a waiting room?: Yes, no other way to give care. 76. Is it ok to leave a message on a patient's vm?: Yes, but should be limited. 77. What is the impact of steroid inhalers on children?: Slows bone growth and may decrease ultimate height. 78. What is the long-term impact of using steroid inhalers?: Cataracts, glau- coma, thinning of bones and skin 79. What is included in the treatment of fibromyalgia?: Sleeping meds Antidepressants Pain meds 80. What psychoactives are first line treatment for fibro?: Cymbalta, Effexor Elavil, Pamelor Lyrica, Gabapentin Ultram, Benzo's 81. What is the purpose of telepsychiatry?: Increase the ability to reach rural and underserved areas. 82. What is the purpose of Motivational Interviewing?: Explore ambiguity Maintain passive position 83. What is required for Medicare submission?: ICD 10 and narrative or CPT 84. What is the neurotransmitter problem in Schizophrenia?: Excess dopamine in mesolimbic pathway. 85. What is the neurotransmitter problem in ADHD?: Dopamine, norepineph- rine and serotonergic dysfunction 86. What is the benefit of play therapy?: Don't have to confront emotions head on. 87. What neurotransmitters are involved in the bioamine hypothesis of de- pression?: Noradrenaline Serotonin Dopamine MAOi's inhibit MAO's which break down neurotransmitters so allow increase in the amount in the synapse. 88. How do you test CN XII?: Stick out your tongue. 89. What CN are you testing when you have a patient clinch their jaw and assess temporal muscles?: CN V - Trigeminal 90. What are two important things to measure when using Zyprexa?: Lipid level and abdominal circumference 91. What is included in the mini-cognitive exam?: Clock, memory questions from MSE. 92. What is HIV related dementia often mistaken for, especially at the begin- ning?: Depression 93. What do you do when a patient is on tegretol and their ANC (Absolute Neutrophil count) 1000?: Stop and repeat lab. Normal is