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PMHNP Boards - Purple book Exam/460 Questions and Answers
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PMHNP Boards - Purple bookExam/460 Questions and Answers
Asterixis - -involuntary flapping movements of the hands
-Akinesia - -inability to initiate movement
-Why are older adults more sensitive to psych meds? - -They have lower
muscle mass and higher body fat concentration, also decreased intracellular
water, decreased protein binding, and decreased metabolism
-Etiology of ODD - -Temperament
Parents who model extreme ways of expressing emotions
Trauma
Unresolved conflict
-Erikson's Psychosocial Stages - -1. Trust vs. Mistrust (birth-1 year) - if
needs are met, infants develop basic trust
2. Autonomy vs. Shame and Doubt (2-3 years) - toddlers learn to exercise
will and do things for themselves, or doubt their abilities
3. Initiative vs. Guilt (3-6 years) - preschoolers learn to initiate tasks and
carry out plans, or feel guilty about efforts to be independent
4. Industry vs. Inferiority (6-11 years) - children learn the pleasure of
applying themselves to tasks, or feel inferior
5. Identity vs. Identity Diffusion (12-18 years) - teens work at redefining
sense of self by testing roles and integrating them to form a single identity,
or become confused about who they are
6. Intimacy vs. Isolation (early adulthood: 19-mid 20s) - young adults
struggle to form close relationships and gain capacity for intimate love, or
feel socially isolated
7. Generativity vs. Stagnation/Self-Absorbtion (middle age: late 20s-50s)
middle aged discover a sense of contributing to the world, usually through
family and work, or they may feel lack of purpose
8. Integrity vs. Dispair (old age: 60s and beyond) - when reflecting on his or
her life, the older adult may feel a sense of satisfaction or failure
-Phases of a therapeutic relationship - -Introduction,
Working - clarify expectations, identify mutual goals; implement tx plan;
monitor pt health; preventative healthcare; measure/evaluate outcomes
Termination
-Freud's Psychosexual Stages - -1. Oral Stage - (birth to 1 year) pleasure
centers around mouth (sucking, biting, swallowing)
,2. Anal Stage - (1-3 years) withholding elimination/ultimate release =
pleasure, toilet training
3. Phallic Stage - (4-6 years) pleasure around genitals, identifies with same-
sex parent, attraction toward opposite sex parent
4. Latency Stage - (6-puberty) pleasure around social-interactions with
others, represses all interest in sexuality
5. Genital Stage - (puberty to death) sexual reawakening, pleasure outside of
family
-Gray matter - -composed largely of nerve cell bodies and unmyelinated
interneurons and dendrites; working area of the brain and contains the
synapses, the area of neuronal connection
-White matter - -myelinated axons of neurons
-Anticholinergic intoxication - -psychosis, dry mouth, hyperpyrexia,
mydriasis, restlessness, tachycardia
-Nurse practitioner core competencies - -scientific foundation
leadership
quality
practice inquiry
technology and information literacy
policy
health delivery system
ethics
independent practice
-Confidentiality - --clients right to assume that info given to provider will not
be disclosed
-protected through Medical Record Confidentiality Act of 1995
-requires signed medical authorization and consent to release medical info
-HIPAA - -guarantees clients 4 fundamental rights:
1. to be educated about HIPAA rights
2. to have access to their own medical records
3. to request amendment of their health info to which they object
4. to require their permission for disclosure of their personal info
-Health Information Technology for Economic and Clinical Health Act
(HITECH) - --incentive payments for sharing specific EMR data
-meaningful use incentives
-EHR's can improve both individual and population based health outcomes
-EHR's can improve quality, safety, efficiency, effectiveness, and outcomes
-Ethical principles - -Justice: doing what is fair
,Beneficence: promoting well being and doing good
Nonmaleficence: doing no harm
Fidelity: Being true and loyal
Autonomy: doing for self
Veracity: Telling the truth
Respect: treating everyone with equal respect
-Mental illness in homeless population - --50% homeless people have co-
occurring substance and mental illness
-Schizophrenia 15-45% of US homeless
-greater risk risk for violence and noncompliance
-Migrant worker - -persons who leave their permanent residences to take
agricultural jobs in different locations
-seasonal worker - -worker who travels from their permanent residences
seasonally for agricultural employment
-sexual identity - -How people identify psychologically on a continuum
between female and male and to whom they are sexually and/or
affectionately attracted.
-gender identity - -a person's identity along a continuum between
normative constructs of masculinity and femininity
-biological factors may include pre/postnatal hormone levels and gene
expression
-social factors may include gender messages from family, mass media, and
cultural attitudes
-gender dysphoria - -the formal diagnosis to describe a marked
incongruence between one's experienced and expressed gender and the
gender assigned at birth
-sexual orientation - -direction of sexual attraction
-asexual
-bisexual
-heterosexual
-homosexual
-transgender
-transsexual
-LGBTQ
-sexual behavior - -The manner in which humans experience and express
their sexuality, including attracting partners, sexual interactions and social
interactions between individuals
, -forensic - -the application of scientific knowledge to legal problems
-forensic science - -application of a broad range of sciences to answer
questions of interest to the legal system
-forensic nursing - -Practice of nursing when health and legal systems
intersect; the forensic nurse provides direct services to individual clients;
consultation services to nursing, medical, and legal agencies; and expert
court testimony in areas dealing with trauma and/or investigations of
questioned deaths, adequacy of services delivery, and specialized diagnoses
of specific conditions as related to nursing.
-forensic risk assessment - -Protects the public from individuals with known
mental disorders having dangerous, violent and criminal histories
-risk assessment - -psychiatric evaluation performed in ED after arrest and
before person is confined to a correctional facility
-transference - -displacement of feelings for significant people in the client's
past on the PMHNP in the present relationship
-countertransference - -the nurse's emotional reaction to the client based
on her or his past experiences
-Signs of countertransference - --intense emotional reactions (positive or
negative) on first contact
-recurrent anxiety or uneasiness while dealing with the client
-uncharacteristic carelessness in interaction and follow up
-difficulty empathizing
-resistance to others treating/interacting with client
-preoccupation with or dreaming about the client
-frequently running overtime or cutting time short
-depression or other strong emotions during or after interaction with the
client
-feedback from others over involvement with the client
-Psychodynamic (psychoanalytic) theory - --focus on concepts of
intrapsychic conflict among structure of the mind
-designed to explain neurosis and high anxiety such as phobias and hysteria
-later expanded to include normal and abnormal development and
personality development
-assumes all behavior is purposeful and meaningful
-most mental activity is unconscious- urges, feelings, adn fantasies that
would be unacceptable to the person's values if consciously experienced
-conscious behavior and choices are affected by unconscious mental content
-childhood experiences shape adult personality
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