PMHNP certification Exam 2022(Actual test verified A+)
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PMHNP certification
Institution
PMHNP Certification
PMHNP certification Exam 2022(Actual test
verified A+)
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk fac...
PMHNP certification Exam 2022(Actual test
verified A+)
Which patient is at highest risk for SI
A. 30y/o married AA female with previous SI attempt *1 risk factor
B. 35 y/o single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a manager of a bank *2 risk factors
D. 68 y/o single white male with depression *5 risk factors (age, male, white,
depression)answer== D. 68 y/o single white male with depression *5 risk factors (age,
male, white, depression)
Count the risk factors
When interview teenagers (16 y/o) that arrive with their parents what should you
do?answer== interview them separately from parents.
-This helps Build therapeutic rapport with teens by telling them the info is confidential.
Parents may be upset but remember you are advocating for the child.
Which Ethnic group has the highest rate of suicide?answer== Native Americans
Example A patient is being treated for schizophrenia with olanzapine. Which of the
following is the most common side effect of olanzapine?
A. Increased waist circumference
B. EPS (not as common in atypical antipsychotics d/t 5HT2A)-receptor antagonism
C. Increased Lipids
D. Metabolic Syndromeanswer== D. Metabolic Syndrome (UMBRELLA ANSWER)
Which antipsychotics have the least weight gain?answer== Latuda, Abilify, (also least
sedating), Geodon-if patient has metabolic syndrome consider switching to one of the
medications above. Or if the patient is overly sedated try switching to ABILIFY
Which mood stabilizer have the least weight gain?answer== Lamictal
-But remember all mood stabilizers cause some weight gain
When presented with a question about typical vs atypical antipsychotic the answer is
usually to start of aanswer== atypical
A client presents with complains of changes in appetite, feeling fatigued, problems with
sleep-rest cycle, and changes in libido. What is the neuroanatomical area of the brain
that is responsible for the normal regulation of these functions?
A. Thalamus
B. Hypothalamus
C. Limbic System
,D. Hippocampusanswer== Hypothalamus
A, B, & D are all part of the limbic system so you can rule that out
When a patient is hesitant to participate in treatment you should encourage?answer==
Bring a support person like a husband
Thyroid-Stimulating hormone normal levelanswer== 0.5-5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosisanswer==
HYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT
INTOLERANCE
Key symptoms of Heat Intoleranceanswer== Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosisanswer==
(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intoleranceanswer== Hypothyroidism
Hyperthyroid can mimicanswer== Mania
Hypothyroid can mimicanswer== Depression
A patient on depakote complains of RUQ pain and has reddish/brown urineanswer==
Hepatoxicity
-Check LFTs
Signs of Depakote toxicityanswer== Disorientation, confusion, lethargy
You suspect depakote toxicity what do you do?answer== Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity?answer== Kava Kava
When taking Kava Kava in combinations with other medications you should caution
aboutanswer== Risk of Hepatoxicity and Sedation
two psychotropics known to cause steven johnson syndromeanswer== lamictal and
tegretol
,What nationality is most suseptible of getting steven johnson?answer== Asians
When treating asians with tegretal screen for?answer== HLAB-1502 Allele
What two medications cause agranulocytosis?answer== Clozaril & Tegretal
Agranulocytosis when to discontinue medicationanswer== Less than 1000
When monitoring for agranulocytosis in patients look for s/s of what?answer== Infection
-Fever, sore throat, fatigue, chills
Before starting any mood stabilizer in a female of childbearing age be sure to
check?answer== HCG
Which two medications may decrease the risk of suicide?answer== clozaril and lithium
Medications that increase lithium levelanswer== NSAID-ibuprofen, INDOCIN
THIAZIDES-hydrochlorithiazide ACE INHIBITORS-lisinopril
Ace inhibitors are treatment of choice for?answer== Heart Failure
Certain medications are known to increase lithium level, but HOW?answer== by
reducing renal clearance
When educating a patient about lithium teach them aboutanswer== Hyponatremia
Dehydration-hot days, exercise
Normal Lithium Levelanswer== 0.6-1.2
Lithium Toxicityanswer== 1.5 or above
Discontinue and re-order lithium level
Lithium level of 1.4answer== Monitor for toxicity
Labs before starting lithiumanswer== TSH, BUN, CREATININE, HCG, U/A to check for
presence of protein in the urine (4+ protein is concerning for renal impairment)à4+
protein in urine=MONITOR FOR TOXICITY
4+ protein in the urine of a patient on lithiumanswer== 4+ protein is concerning for renal
impairment
4+ protein in urine=MONITOR FOR TOXICITY
Lithium side effectsanswer== hypothyroid, leukocytosis, maculopapular rash, t-wave
inversion, Coarse Hand Tremor, GI upset (nausea, vomiting, anorexia)
,
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