PMHNP Comprehensive Exam
Get a hint
Stages of Change (Transtheoretical Model) - ✔✔(Prochaska & DiClemente)
● Precontemplation—little to no awareness of the problem or intent to change
● Contemplation—thinking about making a change in the next 6 months, weigh pros and cons
● Preparation—prepare to make change within the next month, start to make small changes
● Action—enacted the change for 1 day-6 months
● Maintenance—maintained behavior/change for 6 months or longer
Maslow's Hierarchy of Needs - ✔✔● Physiological (food, water, shelter, warmth)
● Safety (security, stability, freedom from fear)
● Belonging/love (friends, family, spouse, lover)
● Self-esteem (achievement, mastery, recognition, respect)
● Self-actualization (pursue, inner talent, creativity, fulfillment)
Benner's Model - ✔✔● Novice—unconscious incompetence, no experience, governed by rules and
regulations
● Advanced beginner—able to analyze and deliberately act
● Competency/proficiency—2-5 yrs experience, able to synthesize info/coordinate
● Expert—flexible, intuitive, efficient
MMSE Scoring - ✔✔○ 23-30 normal
○ 19-23 borderline
○ <19 impaired
,MMSE components - ✔✔● Orientation
● Registration (repeat 3 words)
● Attention and Calculation (count backwards from 100 by 7, spell words backward)
● Recall (repeat the same 3 words from immediate recall)
● Language (name an object, repeat a phrase, read a sentence, write a sentence, copy intersecting
pentagons)
Levels of Prevention - ✔✔· Primary prevention—methods to avoid occurrence of disease (most
population-based health promotion efforts)
· Secondary prevention—methods to diagnose and treat existent disease in early stages before it causes
significant morbidity
· Tertiary prevention—methods to reduce negative impact of existent disease by restoring function and
reducing disease-related complications
· Quaternary prevention—methods to mitigate or avoid results of unnecessary or excessive
interventions in the health system
frontal lobe - ✔✔A region of the cerebral cortex that has specialized areas for movement, abstract
thinking, planning, memory, and judgement
-prefrontal, motor strip, EPS, basal ganglia
temporal lobe - ✔✔hearing, language (Wernicke's), memory, emotion
parietal lobe - ✔✔sensory processing and input
components of the limbic system - ✔✔interpreting significance of sensory input; hippocampus,
amygdala, hypothalamus, cingulate gyrus, thalamus
anterior cingulate cortex - ✔✔integrating complex external information; empathy, emotion processing
,posterior cingulate cortex - ✔✔participates in memory and visual processing; day dreaming, values,
relevance to self
hypothalamus & what NTs does it balance - ✔✔homeostasis (food, water, temperature), controls
pituitary release, balance of DA and 5HT
posterior pituitary - ✔✔ADH and oxytocin
thalamus - ✔✔relay station for incoming sensory information, allowing for processing and
interpretation according to other structures' input
cerebellum - ✔✔control center for controlling voluntary movement, fine tunes movement
cerebellar lesion symptoms - ✔✔ataxia, awkward, tremor with effort, difficulty with sequential
movements, balance
brainstem - ✔✔responsible for automatic survival functions; midbrain, pons, medulla
where is dopamine produced - ✔✔substantia nigra
where is serotonin produced - ✔✔raphe nuclei
where is norepinephrine produced - ✔✔locus coeruleus in the pons
where is acetylcholine produced - ✔✔Nucleus basalis of Meynert
, cranial nerves - ✔✔Olfactory—smell
Optic—vision
Oculomotor—eye movement
Trochlear—eye movement
Trigeminal—face sensation & chewing
Abducens—eye movement
Facial—facial movements and taste
Vestibulocochlear—hearing
Glossopharyngeal—taste, swallowing
Vagus—movement, sensation, visceral organs
Accessory—spinal, neck movement
Hypoglossal—tongue movement
preganglionic NT of SNS - ✔✔ACh
postganglionic NT of SNS - ✔✔NE
preganglionic NT of PNS - ✔✔ACh
postganglionic NT of PNS - ✔✔ACh
origin of SNS - ✔✔thoracolumbar
origin of PNS - ✔✔craniosacral
