PMHNP Board Prep 1 - 12 (Answered) Complete Solution
symptom presentation
affective, cognitive, physical
autosomal dominant
genetic inheritance. will present in more than one generation. 50/50 chance of passing on trait (Huningtons)
autosomal recessive
two copies must be present (cystic fibro...
PMHNP Board Prep 1 - 12 (Answered)
Complete Solution
symptom presentation
affective, cognitive, physical
autosomal dominant
genetic inheritance. will present in more than one generation. 50/50 chance of passing
on trait (Huningtons)
autosomal recessive
two copies must be present (cystic fibrosis
prior to MSE
assessment includes ROS, VS, heart tone, lung sounds, neuro exam, muscle tone,
rigidity
SLUMS
11 items. Max 30, 27-30 normal for high school education, 21-60 mild neurocognitive
disorder, 0-20 dementia
MMSE
11 components. Max 30, no impairment 24-30
Delirium/dementia 18-23 mild, 0-7 severe
SLAP
suicide assessment. Social support, Lethality, Access to means, Plan/Previous attempt
Hamilton Anxiety Rating scale
most popular anxiety scale
Vanderbilt Assessment Scale
free ADHD assessment tool
Abnormal Involuntary Movement Scale (AIMS)
total score is less important than monitoring areas of the body. 2 or more is positive.
Question 7 examines trunk movements
WHODAS
36 item, measures six domains, understanding and communicating, getting around, self
care, getting along with people, life activities and participation with society. 0=no
disability, 100=full disability
Metabolic syndrome
abdominal obesity and any two of the following: triglycerides >150, HDL >40/50, BP
>130/85, FSBS >100 or prior type 2 diabetes
general screening labs
CBC, chemistry panel, thyroid labs, hepatic panel, B12/folate and vitamin D
PET scan
localizes mental activities, primarily as experimental basis and is very expensive
cranial nerves
olfactory=smell, sensory
optic=vision, sensory
oculomotor=most EOM, motor
trochlear=downward and inward eye movement, motor
trigeminal=mastication muscles, sensation of face, both
,abducens=lateral eye movmement, motor
facial=move face, close eyes, taste, saliva, tears, both
acoustic=hearing and balance, sensory
glossopharyngeal=phonation, gag, carotid, swallowing, taste, both
vagus=talk, swallow, carotid, both
spinal accessory=shrug shoulders, motor
hypoglossal=moves the tounge, motor
tender lymph node
classic sign of infection
rubbery lymph node
classic sign of lymphoma
soft lymph node
insignificant
nontender lymph node
classic sign of potential malignancy
lymph node size
insignificant if less than 2cm, 3cm in axilla and inguinal. but if supraclavicular fossa,
>1cm is significant
lasts longest in the urine
cannabis. 3 days to 4 weeks
pneumococcal vaccine
give to 19-64 year old smoker or if have asthma
Pap smear
every 3 years, HPV every 5 years. discontinue at age 65-70 if have 3 consecutive
negative and no abnormal tests in 10 years
prostate exam
digital begin at age 40 and PSA at age 40 if have family history of prostate cancer or
AA. ALL males 50 years and older should get screening
colorectal screening
starting at 50 years old, annual fecal occult blood test, flex sig every 5 years and
colonoscopy every 10 years
Medicare B screening coverage
for cervical, breast, prostate, colorectal cancer
top 4 killers of adults in US
heart disease, cancer, lower resp disease, CVA
lung cancer
highest cancer mortality in women and men,
primary prevention
PROMOTES health PRIOR. healthy diet, exercise, avoiding things
secondary prevention
focuses on early identification and treatment of existing problems. includes REGULAR
exams and screening like pap
tertiary prevention
rehab and restoration of health
hepatitis A vaccine
for military, travelers to endemic areas, men who have sex with men
, diabetes screening
impaired if FSBS 100-125
diabetes if >126 on two separate occasions
cholesterol screening
evaluate serum lipid levels
Total cholesterol <200
Triglycerides <150
HDL 40-60
LDL <100 (<70 if heart disease)
Joint National Committee Classifications (JNC) to treat hypertension
AA start of thiazide diuretics, Ca channel blockers
mitral regurgitation
S3 at 5th ICS MCL, musical
TSH >20
weight gain is more likely
>4.2 indicates hypothyroid
low T4
indicates disease state is due to thyroid gland
hyperthyroid
low TSH, high or normal T4
mimics mania
hypothyroid
high TSH, low T4
mimics depression
management of hypothyroid in adults
levothyroxine (synthroid) if less than 60, generally healthy, start 100mcg or 1.7mcg/kg
daily. geriatric start at 25mcg daily
synthroid adjustments
monitor levels every 4-6 weeks and increase until therapeutic
HIV transmission via needle stick
1:350
HIV screening
ELISA for initial screening
western blot is confirmatory
Chlamydia treatment
zithromax OR doxy. report to health department
Gonorrhea
rocephin 250mg IM one dose + ziethromax 1gm one dose
Syphilis
benzathine penicillin G 2.4 million units IM. how often depends on the stage. doxy if
allergic
Structure of the mind
Id: unconscious instinctual drives, pleasure principle
Ego: rational, maintains harmony between id and superego
Superego: perfection principles, forms the conscious
relief behaviors
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