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PMHNP Comprehensive Questions and Answers| Graded A
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PMHNP ComprehensiveAIMS CORRECT ANSWERS: Abnormal Involuntary Movement Scale for 8 and older
12 item tool to assess symptoms of tardive dyskinesia for patients taking antipsychotics
Rating 0-4, >2 to diagnose TD and reduce dose
BARS CORRECT ANSWERS: Barnes Akathisia Rating Scale for 8 and older
4 item tool to assess objective and subjective symptoms of akathisia with antipsychotics and/or SSRIs
CRS-R CORRECT ANSWERS: Connors Rating Scales - Revised for 3-17
ADHD Parent (80 items) and Teacher Scales (59 items)
Low T-score of 61= mildly atypical; >70 = markedly atypical
Subscales for Oppositional Behaviors, Cognitive Problems, Hyperactivity, ADHD Index, Anxious-Shy,
Perfectionism, Social Problems, DSM-IV Subscales and Connors' Global Index
Vanderbilt ADHD Parent and Teacher CORRECT ANSWERS: 55 parent, 43 teacher items for 6-12
Initial assessment rates symptoms and impairment in academic and behavioral performance
ASRS-1 CORRECT ANSWERS: Adult ADHD Self-Report Scale, 16 and older
Two-part Screening
Part A: 6 questions, 4 symptoms suggest ADHD
Part B: 12 questions to clarify and quantify
AUDIT-C CORRECT ANSWERS: Alcohol Use Disorders Identification Test - Consumption, > 13
Documents use and frequency in prior year
0-4, F >3 = positive, M >4 = positive, >8 = hazardous drinking
CAGE-AID CORRECT ANSWERS: IDs problem drinking or druging, 13 and older
(C=cut down, A=annoy, G=guilty, E=Eye-opener, AID=altered to include drugs
CRAFFT CORRECT ANSWERS: 6-item screen for alcohol or drugs in adolescents, 14-18
(C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
BAI CORRECT ANSWERS: Beck Anxiety Inventory, 17 and older
Assesses 21 symptoms of anxiety, 0-36 scores
HAM-A CORRECT ANSWERS: Hamilton Anxiety Scale, most commonly used
,14 domains, 14=mild, 18-24= moderate, 25-30=severe
LSAS-CA CORRECT ANSWERS: Liebowitz Social Anxiety Scale-Child/Adolescent Version, 7 and older
24 items, social and performance
55-65=moderate social phobia, 65-80=marked, 80-95=severe, >95=very severe
MMSE CORRECT ANSWERS: Mini Mental Status Exam
30 items, 24-30= no cognitive impairment; 18-23=mild cognitive impairment; 0-17= severe cognitive
impairment
MOCA CORRECT ANSWERS: Montreal Cognitive Assessment
>26=normal, add point for <12th grade education
SPMSQ CORRECT ANSWERS: Short Portable Mental Status Questionnaire
10 items, more than 3 incorrect indicates dementia
BDI-2 CORRECT ANSWERS: Beck Depression inventory, 13 and older
presence and impact of depressive symptoms
21 items, <10=normal; 11-17=mild depression; 18-23=moderate; 24+=severe
CCSD CORRECT ANSWERS: Cornell Scale for Depression in Dementia
19 items, <6=no significant depression; 8-17=probable major depression; >18=definite depression
MDQ CORRECT ANSWERS: Mood Disorder Questionnaire
Screen for mania or hypomania
positive if 7 or more of 13 items in question #1 present and #2 is yes and #3 gets moderate or serious
problem response
YMRS CORRECT ANSWERS: Young Mania Rating Scale, 11 items (adult)
Range 0-60; adults with 12 or more=mania
CY-BOCS CORRECT ANSWERS: ...
YBOCS CORRECT ANSWERS: Yale-Brown Obsessive Compulsive Scale
10 items; age 14 and older
gold standard for OC symptoms
score indicates level of severity
BPRS CORRECT ANSWERS: Brief Psychiatric Rating Scale, 18 and older
Assesses psychopathology (+, - and affective) with schizophrenia, not for screening or DX
PANSS CORRECT ANSWERS: Positive and Negative Syndrome Scale, 18 and older
measures changes in symptom intensity in psychosis and schizophrenia
Gold standard in studies of treatment efficacy
SPS CORRECT ANSWERS: Suicide Probability Scale, 13 and older
Rapid measure of suicide risk
higher score indicates greater risk
,CIWA-Ar CORRECT ANSWERS: Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised
9 item symptom rating scale, max score 67; <10 does not warrant intervention
COWS CORRECT ANSWERS: Clinical Opiate Withdrawal Scale
Quantifies severity of withdrawal syndrome, guides dosing, monitors over time
Used for induction of Suboxone
5-12=mild; 13-24= moderate; 25-36=mod to severe; >36=severe
T4, FREE THYROXINE CORRECT ANSWERS: 0.8-2.8
Increased In Graves
Decreased In Hypothyroidism
TSH CORRECT ANSWERS: 2- 10 mu/l
Normal values can range from 0.4 - 4.0 mIU/L (milli-international units per liter),
Calcium, Ca++ CORRECT ANSWERS: 8.8-10.5
<7.0, tetany
>11.0, hyperparathyroidism
>13.5, hypercalcemic coma, metastatic cancer
Sodium, Na+ CORRECT ANSWERS: 135-148 mEq/L
hypernatremia CORRECT ANSWERS: dehydration
hypovolemia
diabetes insipidus
eating too much salt
gastroenteritis
drugs such as adrenocorticosteroids, methyldopa, hydrazine, cough meds
hyponatremia CORRECT ANSWERS: drugs such as lithium, vasopressin, diuretics
addisons
renal disorder
gi fluid loss
Magnesium, Mg CORRECT ANSWERS: 1.3 - 2.1 mEq/L
lithium can increase
hypomagnesemia CORRECT ANSWERS: depression, confusion, irritability,nystagmus, tetany,
convulsions, ataxia, increased reflexes, muscle weakness
hypermagnesemia CORRECT ANSWERS: N/V, respiratory depression, hypotension, depressed skeletal
muscle contraction and nerve function, bradycardia
Potassium, K+ CORRECT ANSWERS: 3.5-5.1 mEq/L
hyperkalemia CORRECT ANSWERS: chronic marijuana use can elevate potassium
, Chloride, Cl CORRECT ANSWERS: 98 - 106
passive transport through sodium
major anion in the extracellular fluid
Liver - ALT CORRECT ANSWERS: 5 - 35 U/L - depakote can increase, safe to use up to 2 times normal limit
Liver - AST CORRECT ANSWERS: 5 - 40 U/L
slight elevation can occur in DT's
depakote can increase, safe to use up to 2 times normal limit
Liver - GGT CORRECT ANSWERS: 10 - 38 IU/L
Thrombocytopenia CORRECT ANSWERS: Platelet count normal = 150,000-450,000
if below - bone marrow doesn't make enough platelets.
or bone marrow makes enough platelets, but the body destroys them or uses them up.
or - The spleen holds on to too many platelets. The spleen is an organ that normally stores about one-
third of the body's platelets. It also helps your body fight infection and remove unwanted cell material.
can be caused by Valproate
Neutropenia CORRECT ANSWERS: A normal ANC is above 1,500 cells per microliter. An ANC less than
500 cells/µL is defined as neutropenia and significantly increases the risk of infection. Neutropenia is the
condition of a low ANC,
Clozapine - WBC => 3500 to initiate therapy, ANC MUST BE =>2000/mm, ck wbc/anc weekly x 6 months,
then Q other week for 6 months; if stable then Q 4 weeks. after therapy test for at least 4 weeks,
LIVER PANEL CORRECT ANSWERS: ALP, AST, ASP, BILIRUBIN, ALBUMIN, TTL PROTEIN, CBC with WBC
DIFFERENTIAL, PLATELET COUNT. FOR VALPROATE THERAPY - CK BASELINE AND MONTHLY FOR SEVERAL
MONTHS
CREATININE CORRECT ANSWERS: 0.5-1.2 normal, kidney damage if elevated , athletes may be higher
BUN CORRECT ANSWERS: 10-20 mg/dL
LITHIUM THERAPY CORRECT ANSWERS: CREATININE/BUN, SERUM ELECTROLYTES, CBC W/WBC & DIFF,
URINALYSIS, EKG, ck levels (post dose 12 hrs trough), after 4 days on med, then q 4-5 days during initial
therapy
lithium levels during acute tx CORRECT ANSWERS: 0.8 -1.2, during maintenance 0.6 - 1.0
ALP CORRECT ANSWERS: 44-147
CK, creatine kinase CORRECT ANSWERS: <240, indicates muscle injury of heart, brain, skeletal muscle,
elevated in MI, myositis, rhabdomysitis
BUN CORRECT ANSWERS: 10-20, increased in impaired kidney function, significant dehydration, measure
with lithium
Creatinine CORRECT ANSWERS: 0.4-0.8, may vary with age gender, ethnicity, more sensitive then bun,
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