PMHNP Certification Exam 2023 Latest Updates

PMHNP Certification Exam 2023 Tarasoff Principle - 1976 - duty to warn victims of potential harm from client Deontological Theory - Ethical theory that states an action is judged as good or bad based on the act itself regardless of the consequences Teleological Theory - Ethical theory that states an action is judged as good or bad based on the consequence or outcome Virtue ethics - ethical theory that states actions are chosen based on the moral virtues (eg. honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person making the decision Erikson's developmental stage infancy age range - birth-1 year Erikson's developmental stage infancy developmental tasks - trust vs. mistrust Erikson's developmental stage infancy indications of developmental mastery - Ability to form meaningful relationships, hope about the future trust in others Erikson's developmental stage infancy indication of developmental failure - poor relationships, lack of future hope, suspicious of others Erikson's developmental stage early childhood age - 1-3 yo Erikson's developmental stage early childhood developmental task - autonomy vs. shame and doubt Erikson's developmental stage early childhood indications of developmental mastery - self-control, self-esteem, willpower Erikson's developmental stage early childhood indications of developmental failure - poor self-control, low self esteem, self-doubt, lack of independence Erikson's developmental stage late childhood age - 3-6yo Erikson's developmental stage late childhood developmental task - initiative vs guilt Erikson's developmental stage late childhood indications of developmental mastery - self-directed behavior, goal formation, sense of purpose Erikson's developmental stage late childhood indications of developmental failure - lack of self-initiated behavior, lack of goal orientation Erikson's developmental stage school-age ages - 6-12yo Erikson's developmental stage school-age developmental task - industry vs. inferiority Erikson's developmental stage school-age indications of developmental mastery - ability to work; sense of competency and achievement Erikson's developmental stage school-age indications of developmental failure - sense of inferiority, difficulty with working, learning Erikson's developmental stage adolescence ages - 12-20yo Erikson's developmental stage adolescence developmental task - identity vs role confusion Erikson's developmental stage adolescence indications of developmental mastery - personal sense of identity Erikson's developmental stage adolescence indications of developmental failure - identity confusion, poor self-identification in group settings Erikson's developmental stage early adulthood ages - 20-35 years Erikson's developmental stage early adulthood developmental task - intimacy vs isolation Erikson's developmental stage early adulthood indications of developmental mastery - committed relationships, capacity to love Erikson's developmental stage early adulthood indications of developmental failure - emotional isolation, egocentrism Erikson's developmental stage middle adulthood ages - 35-65 yo Erikson's developmental stage middle adulthood developmental task - generativity vs. self-absorption or stagnation Erikson's developmental stage middle adulthood indications of developmental mastery - ability to give time and talents to others, ability to care for others Erikson's developmental stage middle adulthood indications of developmental failure - self-absorption, inability to row and change as a person, inability to care for others Erikson's developmental stage late adulthood age - 65yo Erikson's developmental stage late adulthood developmental task - integrity vs despair Erikson's developmental stage late adulthood indications of developmental mastery - fulfilment and comfort with life, willingness to face death, insight and balanced perspective on life's events Erikson's developmental stage late adulthood indications of developmental failure - bitterness, sense of dissatisfaction with life, despair over impending death Psychodynamic (Psychoanalytic) Theory - -Sigmund Freud -all bx is purposeful and meaningful -principle of psychic determinism -most mental activity is unconscious -conscious behaviors and choices are affected by unconscious mental content -childhood experiences shape adult personality -instincts, urges, or fantasies function as drives that motivate thoughts, feelings, and bx -Id, Ego, Superego -conflict is experienced consciously as anxiety Principle of psychic determinism - Even apparently meaningless, random, or accidental behavior is actually motivated by underlying unconscious mental content Intellectual disability typical age onset - infancy- usually evident at birth ADHD typical age onset - early childhood (per DSM by age 12) Schizophrenia typical age onset - 18-25 for men 25-35 for women Major Depression typical age onset - late adolescence to young adulthood dementia typical age onset - most common after age 85 Freud's Id - -contains primary drives or instincts -drives are largely unconscious -operates on the pleasure principle -"I want" pleasure principle - the id seeks immediate satisfaction freud's ego - -rational mind, logical and abstract thinking -"I think, I evaluate" Freud's superego - -sense of conscience or right vs wrong -develops around age 6 -"I should or ought" Freud's psychosexual stage of development oral stage age - 0-18 months Freud's psychosexual stage of development oral stage primary means of discharging drives and achieving gratification - sucking, chewing, feeding, crying Freud's psychosexual stage of development oral stage psych disorder linked to failure of stage - schizophrenia, substance abuse, paranoia Freud's psychosexual stage of development anal stage age - 18 months-3 years Freud's psychosexual stage of development anal stage primary means of discharging drives and achieving gratification - sphincter control, activities of expulsion and retention Freud's psychosexual stage of development anal stage psych disorder linked to failure of stage - depressive disorder Freud's psychosexual stage of development phallic stage age - 3-6 years Freud's psychosexual stage of development phallic stage primary means of discharging drives and achieving gratification - exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and female fear of lost maternal love Freud's psychosexual stage of development phallic stage psychiatric disorder linked to failure of stage - sexual identity disorders Freud's psychosexual stage of development latency stage age - 6years-puberty Freud's psychosexual stage of development latency stage primary means of discharging drives and achieving gratification - peer relationships, learning, motor-skills development, socialization Freud's psychosexual stage of development latency stage psych disorder linked to failure of stage - inability to form social relationships Freud's psychosexual stage of development genital stage age - puberty forward Freud's psychosexual stage of development genital stage primary means of discharging drives and achieving gratification - integration and synthesis of behaviors from early stages, primary genital-based sexuality Freud's psychosexual stage of development genital stage psych disorder linked to failure of sage - sexual perversion disorders Cognitive Theory - -Piaget - four stages of development Piaget developmental stage sensorimotor age - birth-2 years Piaget developmental stage sensorimotor - the critical achievement of this stage is object permanence Piaget developmental stage preoperational age - 2-7 years Piaget developmental stage preoperational - more extensive use of language and symbolism magical thinking Piaget developmental stage concrete operations age - 7-12 years Piaget developmental stage concrete operations - child begins to use logic develops concepts of reversibility and conservation Piaget developmental stage formal operations age - 12 years-adult Piaget developmental stage formal operations - ability to think abstractly thinking operates in a formal, logical manner interpersonal theory - -Harry Stack Sullivan -self-system -when the person's need for satisfaction and security is interfered with by the self system, mental illness occurs -humans experience anxiety and bx is directed toward relieving the anxiety, which then results in interpersonal security self system - interpersonal theory total components of personality traits two drives for behavior in interpersonal theory - -the drive for satisfaction -the drive for security Freud's defense mechanisms - -denial -projection -regression -repression -reaction formation -rationalization -undoing -intellectualization -suppression -sublimation -altruism Hierarchy of needs - -Maslow -survival -safety and security needs -love and belonging -self-esteem -self-actualizaiton Sullivan's stage of interpersonal development infancy age - birth-18 months Sullivan's stage of interpersonal development infancy developmental task - oral gratification, anxiety occurs for the first time Sullivan's stage of interpersonal development childhood age - 18 months- 6 years Sullivan's stage of interpersonal development childhood developmental task - delayed gratification Sullivan's stage of interpersonal development juvenile age - 6-9 years Sullivan's stage of interpersonal development juvenile developmental task - forming peer relationships Sullivan's stage of interpersonal development preadolescence age - 9-12 years Sullivan's stage of interpersonal development preadolescence developmental task - same-sex relationships Sullivan's stage of interpersonal development early adolescence age - 12-14 years Sullivan's stage of interpersonal development early adolescence developmental task - opposite- sex relationships Sullivan's stage of interpersonal development late adolescence age - 14-21 years Sullivan's stage of interpersonal development late adolescence developmental taks - self-identity developed Health Belief Model - Marshall Becker explains that healthy people do not always take advantage of screening or preventative programs because of certain variables: -perception of susceptibility -seriousness of illness -perceived benefits of tx -perceived barriers to change -expectations of efficacy transtheoretical model of change - states that change such as in health bx occurs in 6 predictable stages -precontemplation -contemplation -preparation -action -maintenance motivational interviewing - miller and rollnick -focused, goal-directive therapy -motivation is elicited from the client -nonconfrontational, nonadversarial self-efficacy and social learning theory - -albert bandura -behavior is the result of cognitive and environmental factors theory of cultural care - -madeline Leininger -regardless of the culture, care is the unifying focus and the essence of nursing theory of self-care - Dorothy orem -self care therapeutic nurse-client relationship theory or interpersonal theory - Hildegard Peplau -first significant psych nursing theory -sees nursing as an interpersonal process in which all interventions occur within the context of the nurse-client relationship phases of the nurse-client relationship - -orientation -working phase (identification, exploration) -termination phase (resolution) caring theory - jean Watson caring is an essential component of nursing t test - assesses whether the means of two groups are statistically different from each other analysis of variance (ANOVA) - tests the difference among three or more groups pearson's r correlation - tests the relationship between two variables probability - likelihood of an event occurring lies between 0 and 1 an impossible event has probability of 0 a certain event has a probability of 1 P value - aka level of significance describes the probability of a particular result occurring by change alone if P=0.1, there is a 1% probability of obtaining a result by chance alone Donabedian model - structure, process, outcome process of quality improvement PDSA cycle - Plan Do Study Act monoamines - -biogenic amines -dopamine -norepinephrine -epinephrine -serotonin dopamine - -catecholamine -produced in the substantia nigra and ventral tegmental area -precursor is tyrosine -removed from synaptic cleft by monoamine oxidase (MAO) enzyme action -D1-like and D2-like receptors four dopaminergic pathways - -mesocortical -mesolimbic -nigrostriatal -tuberoinfundibular norepinephrine - -catecholamine -produced in the locus ceruleus of the pons -precursor is tyrosine -major neurotransmitter implicated in mood, anxiety, and concentration disorders -Alpha 1 and 2 receptors epinephrine - -catecholamine -produced by the adrenal glands -referred to as the adrenergic system serotonin - -known as an indole -produced in the raphe nuclei of the brainstem -precursor is tryptophan -major neurotransmitter implicated in mood and anxiety disorders -5HT1a, 5HT1d, 5HT2, 5HT2a, 5HT3, 5HT4 receptors amino acids - glutamate, aspartate, gamma-aminobutyric acid (GABA), glycine glutamate - -universal excitatory neurotransmitter -major neurotransmitter involved in process of kindling (implicated in sz dx and bipolar dx) -imbalance implicated in mood dx and schizophrenia -AMPA and MNDA receptors aspartate - another excitatory neurotransmitter -works with glutamate GABA - universal inhibitory neurotransmitter -site of action of benzos, alcohol, barbiturates, and other CNS depressants -GABAa and GABAb receptors glycine - -another inhibitory neurotransmitter -works with GABA cholinergics - acetylcholine acetylcholine - synthesized by the basal nucleus of Meynert -precursors are acetylcoenzyme A and choline -nicotinic and muscarinic receptors neuropeptides - -nonopioid type (substance P, somatostatin) -opioid type (endorphins, enkephalines, dynorphins) -modulate pain -Decreased amount of neuropeptides is thought to cause substance abuse - opioid type receptors: mu, kappa, epsilon, delta, sigma dopamine general function - thinking decision making reward-seeking behavior fine muscle action integrated cognition dopamine symptoms of deficit - mild: pour impulse control, poor spatiality, lack of abstractive thought -severe: Parkinson's disease, endocrine alterations, movement disorders -substance abuse, anhedonia Dopamine symptoms of excess - -mild: improved creativity, improved ability for abstract thinking, improved executive functioning, improved spatiality -severe: disorganized thinking, loose association, tics, stereotypic bx -schizophrenia, psychosis norepinephrine general function - alertness focused attention