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Exam (elaborations)

PMHNP Exam 2024 RATED A+

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Autosomal Dominant - Genetic inheritance, is more rare (i.e. Huntington's disease), is present in more than one generation. Autosomal Recessive - Expressed in one generation, inherited from unaffected parent, is more common. CAGE Questionnaire - For substance abuse, Cut, Annoyed, Guilty, Eye op...

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  • January 29, 2024
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  • 2023/2024
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PMHNP Exam 2024 RATED A+
Autosomal Dominant - ✔✔Genetic inheritance, is more rare (i.e. Huntington's disease), is present in
more than one generation.



Autosomal Recessive - ✔✔Expressed in one generation, inherited from unaffected parent, is more
common.



CAGE Questionnaire - ✔✔For substance abuse, Cut, Annoyed, Guilty, Eye opener



Suicidal Risk Assessment - ✔✔SLAP: Social support, Lethality, Access to means, Plan and previous
attempts, & family history



Suicidal Risk Assessment #2

ISPATHWARM - ✔✔ISPATHWARM: Ideation, Substance abuse, Purpose for living, Anxiety/agitation,
Trapped feeling, Hopelessness, Withdrawing from friends, Anger with rage, Reckless in behaviors, Mood
changes



Depression Assessment

SIGECAPS - ✔✔SIGECAPS: Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor
retardation, Suicidality



Mania Assessment

DIGFAST - ✔✔DIGFAST: Distractibility, Indiscretion, Grandiosity, Flight of ideas, Activity increase, Sleep
deficit, Talkativeness



Mental Status Exam Components

(All Borderline Subjects Are Tough Troubled Characters) - ✔✔Appearance, Behavior, Speech, Affect,
Thought Process, Thought Content, Cognitive Examination

,Hamilton Depression Rating (HDRS) for very severe depression - ✔✔more than 23



Hamilton Depression Rating (HDRS) for severe depression - ✔✔19-23



Hamilton Depression Rating (HDRS) for moderate depression - ✔✔14-18



Hamilton Depression Rating (HDRS) for mild depression - ✔✔8-13



Hamilton Depression Rating (HDRS) for no depression - ✔✔0-7



Hamilton Anxiety Rating for moderate to severe anxiety - ✔✔25-30



Hamilton Anxiety Rating for mild to moderate anxiety - ✔✔18-24



Hamilton Anxiety Rating mild anxiety - ✔✔<17



General screening labs - ✔✔CBC, Chem, Thyroid, Hepatic, b12, folate, drug levels



Lithium labs - ✔✔evaluate thyroid function, check creatinine clearance regularly



Depakote labs - ✔✔check hepatic function



Olfactory Nerve

(On) - ✔✔CN I: Sensory: (test by smell- coffee, tea, non astringent smells)

,Optic Nerve

(Old) - ✔✔CN II: Sensory- visual acuity test (confrontation method to assess visual fields)



Oculomotor

(Olympus) - ✔✔CN III: Motor- eye movement (follow penlight through six fields of gaze, test OD, OS
individually)



Trochlear Nerve

(Towering) - ✔✔CN IV: Motor- eye movement (superior oblique-same test as oculomotor)



Trigeminal Nerve

(Tops) - ✔✔CN V: Both- superficial and deep structures of head and face, mastification/corneal reflex
(test by show teeth)



Abducens Nerve

(A) - ✔✔CN VI: Motor- specific eye movements (test same as oculomotor)



Facial Nerve

(Fin) - ✔✔CN VII: Both- taste of anterior 2/3 of tongue, sensation in ear canal, facial movement (use
salt/sugar for taste, evaluate corneal reflex, raise eyebrows, keep eyes closed, and resist attempt to
open, puff cheeks)



Acoustic Nerve

(And) - ✔✔CN VIII: Sensory- Hearing/tickling watch and whisper (tuning fork with Rinne- positive as
normal, when air conduction persists twice as long as bone conduction)

, Glossopharyngeal Nerve

(German) - ✔✔CN IX: Both- Swallow, taste of posterior 1/3 of tongue, pain, touch, and temp of mucosa
and pharynx (check for deviation of uvula to unaffected side)



Vagus Nerve

(Viewed) - ✔✔CN X: Both- Elevation of the uvula (swallow, have patient say aaah and check uvula
elevation, gag reflex, and ability to swallow water)



Accessory Nerve

(A) - ✔✔CN XI: Motor- Innervates trapezius and sternocleidomastoid (shrug shoulders against
resistance, turn head against hand on cheek)



Hypoglossal

(Hop) - ✔✔CN XII: Motor- motor of the tongue (push tongue against the inside of cheek, stick out
tongue and check for fasciculation)



Lithium therapeutic levels (acute mania) - ✔✔0.6-1.2 mEq/L



Lithium therapeutic levels (maintenance) - ✔✔0.8-1.0 mEq/L



Lithium adverse effect level - ✔✔> 2 mEq/L >2.5 mEq/L = seizure, death



Valproic acid therapeutic levels - ✔✔50-120 ug/ml



Sensitivity - ✔✔true positives (the degree to which those who have a disease screen positive)



Specificity - ✔✔true negatives (the degree to which those who not have a disease test negative)

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