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Georgette Review PMHNP Test Questions and Answers
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Georgette Review PMHNP Test Questions and Answers
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Georgette Review PMHNP Test Questions and Answers When switching to an SSRI to MAOI, - Answer -wait 14 days When switching from Prozac to MAOI or TCA - Answer -wait 5 -6 weeks When switching from MAOI back to prozac - Answer -wait 2 weeks. Non psych med that can cause serotonin syndrome - Answer -triptans Serotonin discontinuation syndrome - Answer -remember similar to alcohol withdrawal flu like symptoms False belief firmly maintained despite evidence to the contrary - Answer -delusion Do you try to convince them the delusion is wrong or isn't real? - Answer -No Patient believes that certain news bulletins have a direct reference to them - Answer -referential thinking MSE: Though process - Answer -organization of the patient's thoughts and ideas. MSE: Thought content - Answer -refers to themes that occupy the patient's thoughts and perceptual disturbances. Suicidal ideation/plan homicidal ideation/plan Exam ised to quantify cognitive status in adults - Answer -mini mental status exam or may say Folstein Component of Folstein/mini mental status - Answer -I would like you to could backwards from 100 by 7s or do serial 7s Folstein/mini mental status registration/ability to learn new material - Answer -repeat after me, bed, bat, ball Suiciidal risk factors - Answer -previous attempt Male 45+ Female 55+ Divorced, single, separated white living alone psychiatric disorder physical illness substance abuse family history recent loss male gender Characteristics of therapeutic relationship - Answer -Genuineness Acceptance Nonjudgment Authenticity Empathy Respect Professional boundaries displacement of feelings for significant people int he client's past onto the PMHNP - Answer -transference Nurses's emotional reaction to the client based on past experiences. - Answer -
Countertransference Sarah presents for her initial intake appointment with complaints of depression. She is being treated for hypertension and asthma by her primary care provider. Knowing that certain medications can cause or exacerbate depression, you obtain a complete medic ation history. Which of the following medications is known to exacerbate or cause depression? A. Omeprazole B. Propranolol C. Levothyroxine D. Clarithromycin - Answer -Propranolol A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of manic symptoms and insomnia. Your patient has been stable on lithium for the past six months To determine if a medication change or increase is warranted, it is i mportant to gather more information. You suspect a possible medication -induced manic episode when the patient endorses what? A. She was recently placed on a beta blocker for anxiety. B. She was recently prescribed a benzo C. She recently had a flare up of her rheumatoid arthritis and received treatment for one week (aka a steroid) D. She recently began a new retroviral agent for hepatitis - Answer -recently treated for RA Scale to test for alcohol withdrawal - Answer -CIWA Score on CIWA that warrants PRN - Answer -greater than 8 Medication that will make patient physically ill if combined with alcohol - Answer -
disulfiram (Antabuse) Antabuse shouldn't be taken for at leas ________________ after drinking - Answer -12 hours. Signs and symptoms of alcohol withdrawal - Answer -N/V/D tremors sweats anxiety agitation tactile disturbances auditory disturbances visual disturbances headache altered sensorium agitation Rating scale of opiate withdrawal - Answer -COWS Signs and symptoms of opioid withdrawal - Answer -yawning, irritability, pupillary dilation piloerection muscle aches lacrimation rhinorrhea Treat COWS when score is greater than - Answer -7 Moderate withdrawal on COWS - Answer -13-24 Moderate withdrawal on CIWA - Answer -scoring 15 Treatment for COWS - Answer -Buprenorphine (Suboxone) Treatment for CIWA - Answer -scheduled meds plus diazepam SBIRT stands for - Answer -Screening, Brief Intervention, and Referral to Treatment SBIRT FRAMES - Answer -Feedback --tell them about their risk of their current alcohol use Responsibility --reinforce their responsibility for change Advice --based on facts about their drinking, offer simple and direct advice Menu --provide a menu of options for behavior change Empathetic interviewing --consider their perspective. Be non -judgemental Self-efficacy --encourage person to believe they can change. CAGE screening tool - Answer -cut down, annoyed, guilty, eye opener Acute onset altered level of consciousness inattenion poor prognosis --1 year mortality rate of is up to 40% - Answer -delirium Treatment of choice for delirium - Answer -haloperidol Avoid which class in delirium as it tends to prolong it - Answer -benzos impaired executive functioning, impaired problem solving, impaired organizational skills, altered memory. slow onset - Answer -dementia John is a 58 year old male patient with Bipolar 1 disorder and has been stable for 5 years on valproate and Seroquel. He was recently started on Flonase by his primary care. As the PMHNP, you are concerned that the addition of the Flonase may cause A. A hypertensive crisis B. SJS C. NMS D. a manic episode - Answer -a manic episode A 16-year off boy presents with a long head, large ears, and hyper extensible joints, is very shy, and starts rocking and flapping his hands when he is upset. Which of the following is your most likely diagnosis? A. Tourette disorder B. Autism C. Fragile X D. Rett disorder - Answer -Fragile X What muscle relaxant is recommended to be used in treatment of NMS? A. Bromocriptine B. Trihexyphenidyl C. Dantrolene D. Benztropine - Answer -Dantrolene A week after raising the dose of clomipramine, a patient treated for depression presents to the clinic with reports of change in mental status, fever, and hyperreflexxia. As the treating PMHNP, you know these symptoms are consistent with which of the follo wing? A. NMS B. EPS C. Hypertensive crisis D. Serotonin syndrome - Answer -serotonin syndrome
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