PMHNP Review for Boards - 1

What should you do if a child reports being abused? - answer-Interview the child separately and report to CPS. What should you do if you observe a child playing with a doll/toy in a sexual way? - answer-Immediately report to CPS. How should you conduct an interview with an inpatient? - answer-In a private area with the door open/partially open. Why is it important to build therapy rapport with adolescents? - answer-To establish trust and confidentiality, while informing them of exceptions. What can create an ethical dilemma when it comes to patient confidentiality? - answer-Parents feel entitled to information, but you must advocate for your patient and their confidentiality. What should you obtain before faxing labs to a referral? - answer-Informed consent. What should you do if a patient inhales acetone/nail polish and feels weird? - answer-Consider doing a urine drug screen and get involved. What is cultural expected response to a stressor? - answer-Interpret patient's symptoms based on their culture. · This does not mean your patient has a mental illness. · Ask the patient to interpret the patient's (cultural) symptoms. · Cultural assessment - Cultural Formulation Interview What is the purpose of cultural assessment? - answer-To understand the cultural context of the patient's symptoms. What is a cultural formulation interview? - answer-An interview to clarify the meaning of illness or predicament in the patient's cultural context. What is brief supportive therapy? - answer-Therapy offered to patients experiencing cultural syndromes, such as job loss or house loss. How should somatic complaints of pain be validated? - answer-Validate the patient's pain based on their cultural context. What is the goal of culture formulation interviews? - answer-To empower the patient and contextualize their situation in their local world. How should Native Americans' interpretation of mental illness be respected? - answer-Respect their belief that it is caused by an imbalance between an individual's relationship with the world. Which ethnic group has the highest rate of suicide/suicide attempts in the United States? - answer-Native Americans. What do Native Americans believe in for healing? - answer-They believe in a Healing stick with healing powers. What is susto? - answer-Folk illness in the Latino population caused by a shocking, unpleasant, or frightening experience that is believed to cause the soul to leave the body. What is ataque de nervios? - answer-Puerto Rican syndrome characterized by uncontrollable shouting and aggression. o Attack of nerves: Uncontrollable shouting, attacks of crying, trembling, heat in the cheat rising into the head, and verbal or physical aggression. What is mal de ojo? - answer-Illness caused by the evil eye, resulting in fatigue, headache, weight loss, exhaustion, and malaise What is empacho? - answer-Blocked intestine causing indigestion (feeling bloated and nausea). What is mollera caida? - answer-Sunken fontanel in infants. What is the role of a traditional healer? - answer-May be included in the patient's care plan with informed consent. What should be considered when providing psychoeducation to a patient from a specific culture? - answer-Information should be based on cultural context. What is the purpose of diverse population education? - answer-To provide multicultural teaching and education. What assessment parameters should be used when providing psychoeducation to a patient from a specific culture? - answer-Ethnospecific assessment parameters. What should be done if a patient cannot understand English? - answer-Provide an interpreter to be culturally sensitive. What should a staff nurse do if a Native American patient has a healing stick? - answer-Accommodate the patient and allow them to keep the healing stick. What should a staff nurse do if a Native American patient has a healing stick? - answer-Accommodate the patient and allow them to keep the healing stick. If a question has an answer that says, "It goes against our policies and procedures," is it right or wrong? - answer-Probably wrong What is Thyroid Stimulating Hormone (TSH)? - answer-Hormone that regulates thyroid function Therapeutic range for TSH - answer-0.5-5.0 Mu/L What are the symptoms of hypothyroidism? - answer-Mimic symptoms of depression Cold intolerance, lethargy, weight gain, decreased libido What are the symptoms of hyperthyroidism? - answer-Mimic symptoms of mania Heat intolerance, agitation, anxiety, irritability, tachycardia, mood swings, weight loss What happens to TSH secretion when T4 and T3 are high? - answer-Decreases What happens to TSH secretion when T4 and T3 are low? - answer-Increases What is the relationship between T4, T3, and TSH? - answer-Inverse What does a low TSH level indicate? - answer-Hyperthyroidism What does a high TSH level indicate? - answer-Hypothyroidism What is Divalproex sodium (Depakote)? - answer-Medication used for various conditions including epilepsy and bipolar disorder Also, Valproic Acid What is a potential pregnancy side effect of Depakote? - answer-Spina bifida (neural tube defect) What are the potential side effect of Depakote? - answer-Hepatotoxicity and pancreatitis What are the signs of hepatotoxicity in a patient taking Depakote? - answer-Abdominal pain in the upper right portion of the abdomen, reddish brown urine, yellowing of the skin and whites of the eye, fatigue What are the signs of pancreatitis in a patient taking Depakote? - answer-Pancreatitis