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ANCC PMHNP PSYCH MENTAL HEALTH EXAM (ACTUAL EXAM) WITH CORRECT 180+ QUESTIONS AND CORRECTLY WELL DEFINED ANSWERS LATEST 2024 ALREADY GRADED A+ $12.99
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ANCC PMHNP PSYCH MENTAL HEALTH
EXAM (ACTUAL EXAM) WITH CORRECT
180+ QUESTIONS AND CORRECTLY WELL
DEFINED ANSWERS LATEST 2024 ALREADY
GRADED A+
What does a narrow pulse pressure indicate? - ANSWERS-The person is
having trouble getting blood out of their heart.
If a heart murmur radiates to the axilla, what valve is it likely to have
come off of? - ANSWERS-Mitral Valve.
That is a bicuspid valve between the left atrium and the left ventricle.
Describe an appropriate Fluoxetine taper? - ANSWERS-A taper for
Fluoxatine/ Prozac is not needed due to its long half-life (up to 144
hours). It takes about 5 weeks to achieve steady state and will self-
taper
,What is Serotonin Syndrome? - ANSWERS-Toxic levels of serotonin. Can
be due to doses of SSRIs (including attempted overdoses), interactions
between SSRIs and MAOIs or SSRIs and Tramadol
These symptoms are distinct to Serotonin Syndrome: clonus, agitated
confusion, hyper reflexia & bowel sounds; diarrhea
What is the lactation risk for Vibrid? - ANSWERS-currently unknown.
What warning do all anti-depressants carry? - ANSWERS-Black box
warning about suicide
Describe Neonatal effects of antidepressants? - ANSWERS-if Mom is on
an SSRI baby will have 'discontinuation syndrome' crankiness, irritability
for up to a few days
What are lactation risk categories? - ANSWERS-L1, safest; L2, safer; L3,
moderately safe; L4, possibly hazardous there is positive evidence of
risk; L5, contraindicated - significant documented risk.
,Are there any drugs in the L1 category? - ANSWERS-Acetaminophen
('cause everyone can take tylenol), some of the penicillin (moldy bread;
gross but relatively safe), depo-provera (injectable or implantable BC
only)
What psychiatric drugs are L4 - ANSWERS-Lithium (crosses breast milk),
some of the older antipsychotics (so just think 'use SGAs in lactation')
Are any drugs in the L5 category? - ANSWERS-Ziprasadone/ Geodon
(some question of it being L4), Doxepine /Sinequan (TCA) and cocaine.
Fetal exposure to Lithium as been associated with what birth defects? -
ANSWERS-1-polyhydramnios which is excessive amniotic fluid;
2-reversible changes in thyroid function;
3-fetal and neonatal cardiac arrhythmias;
4-hypoglycemia;
5-nephrogenic diabetes insipidus;
6-premature delivery; and
7-floppy infant syndrome similar to that seen with benzodiazepine
exposure
, List symptoms of neonatal Lithium toxicity - ANSWERS-1-flaccidity, 2-
lethargy, and 3-poor suck reflexes, which may persist for more than 7
days.
What are the risk categories from drugs use in pregnancy - ANSWERS-A-
controlled studies show no risk, B-no evidence of risk in humans; C-risk
cannot be ruled out; D-positive evidence of risk; X-contraindicated in
pregnancy.
List some SSRIs - ANSWERS-Citalopram/ celexa, Escitalopram/ lexapro,
Paroxetine/ paxil, Sertraline/ zoloft, Fluoxetine/ prozac, Fluvoxamine/
luvox.
What SSRIs would you consider first for an elderly patient and why? -
ANSWERS-Escitalopram/ lexapro and Sertraline/ zoloft because of
minimal cytochrome P450 2D6 inhibition.
List the more common SSRI side effects - ANSWERS-Agitation; bowel
changes; HA; fatigue; Nausea. Then longer term: sexual dysfunction
including delayed or no orgasm, erectile dysfunction (usually chronic;
up to 75% and people will tend not to mention it) [there is off-label use
of SSRIs for premature ejaculation].
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