PMHNP Certification Exam Study
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Pain and bloating after eating is caused by... - correct answer...✔✔delayed gastric
emptying
Medications that cause delayed gastric emptying? - correct answer...✔✔PPIs;
ranitidine, famotidine, omeprazole
What instructions should you give your patient if they are prescribed antacids/PPIs and
psychotropics? - correct answer...✔✔Give medications at least 2 hours apart b/c
antacids/PPIs decrease absorption of psychotropics
Normal BMI range - correct answer...✔✔18.5-25
Criteria for admission for ED bx: - correct answer...✔✔BMI <15; 25% total body weight
loss in 3 months; severe dehydration, infection, bradycardia, hypothermia,
hematemesis, hypokalemia
What neurotransmitters are implicated in ADHD? - correct answer...✔✔DA, NE, 5HT -
DNS
What brain structures are involved in ADHD? - correct answer...✔✔Reticular activating
system, basal ganglia, frontal cortex - RBF
Abnormalities in this part of the brain cause inattentive ADHD: - correct answer...✔✔
Prefrontal cortex
Amphetamines are FDA approved for children beginning at _ years old - correct
answer...✔✔3
Methamphetamines are FDA approved for children beginning at _ years old - correct
answer...✔✔6
Alpha agonists clonidine and guanfacine are FDA approved to treat ADHD in patients
ages ___ - correct answer...✔✔6-17
Strattera is FDA approved to treat ADHD in patients ages ___ - correct answer...✔✔6
and up (including adults)
AGRADESOLUTIONS
,Adults diagnosed with both ADHD and depression would benefit from being prescribed:
- correct answer...✔✔Wellbutrin
Conduct disorder can be diagnosed in: - correct answer...✔✔Both children and adults
Conduct disorder diagnostic criteria: - correct answer...✔✔Violating rights of others or
societal norms; aggression towards people/animals; destruction of property; no remorse
Treatment for conduct disorder: - correct answer...✔✔Targets aggression and mood;
SGA, mood stabilizer, SSRI, alpha agonists
ODD diagnostic criteria: - correct answer...✔✔Argumentative, defiant for at least 6
months and with 4 sx
Treatment of ODD: - correct answer...✔✔Focused on family therapy, child
management skills, teaching parents reinforcement/boundaries/problem solving
DMDD diagnostic criteria: - correct answer...✔✔Childhood depressive d/o between
ages 6-17; chronic dysregulated mood, frequent tantrums, severe irritability; typically
DMDD rather than bipolar d/o in children
Neurotransmitters implicated in ASD: - correct answer...✔✔Glutamate, GABA, 5HT -
GGS
Echolalia - correct answer...✔✔Meaningless repetition of words; often seen in ASD
Broken mirror theory - correct answer...✔✔Dysfunction of the mirror neuron system
results in poor social interaction and cognition in ASD patients
Parallel play is developmentally appropriate at which ages? - correct answer...✔✔1-3
years old
Parallel play continuing beyond the age of 3 years old may be indicative of... - correct
answer...✔✔ASD dx d/t social deficits
M-CHAT - correct answer...✔✔Modified Checklist for Autism in Toddlers; ASD scale
ADOS-G - correct answer...✔✔Autism Diagnostic Observation Schedule - Generic;
ASD scale
ASQ - correct answer...✔✔Ages and Stages Questionnaire; development and
social/emotional screening
AGRADESOLUTIONS
,Pharmacological treatment of ASD: - correct answer...✔✔Stimulants (increase DA to
help with impulsivity, hyperactivity, inattention; Antipsychotics (target aggressive bx,
tantrums, self-injury, stereotyped bx)
Nightmares in children can be the result of: - correct answer...✔✔Genetic factors;
assess family patterns of nightmares
Features of children diagnosed with Fragile X - correct answer...✔✔LARGE features:
large head, elongated face, hyperextensible joints, abnormally large testes, short
stature
Features of children diagnosed with fetal alcohol syndrome - correct answer...✔✔small
features: small head, small eye opening, low nasal bridge, flat midface, smooth
philtrum, thin upper lip
Clock drawing test assesses function of which brain lobe? - correct answer...✔✔
Parietal
What does the clock drawing test assess for? - correct answer...✔✔Executive/cognitive
fx, impairments associated w/ damage to right parietal lobe, constructional apraxia
(inability to draw or assemble objects)
Important labs to draw for patients presenting with dementia? - correct answer...✔✔
B12, folic acid
Dementia presents with mental decline that is ___ - correct answer...✔✔Chronic; if
acute sx, consider other dx
Symptoms of subcortical dementia: - correct answer...✔✔Motor sx, lack of
coordination, tremors, depression, irritability, apathy
Example of subcortical dementia diagnosis - correct answer...✔✔Huntington's disease
Symptoms of cortical dementia: - correct answer...✔✔Language and memory
impairments (aphasia and amnesia)
Example of cortical dementia diagnosis: - correct answer...✔✔Alzheimer's
Presentation of dementia d/t HIV disease - correct answer...✔✔Subcortical effects;
motor abnormalities, bx abnormalities, cognitive decline
Presentation of dementia with Lewy bodies - correct answer...✔✔Visual hallucinations,
Parkinsonian sx
AGRADESOLUTIONS
, Presentation of frontal lobe dementia (e.g. Pick's disease) - correct answer...✔✔
Personality/bx changes, language changes, inappropriate social bx, aggression
Presentation of Huntington's disease - correct answer...✔✔Subcortical dementia; motor
abnormalities, psychomotor slowing; high incidence of depression, psychosis; begins
ages 30-45; affects males and females equally
What is the most effective test to determine if someone will develop Huntington's
disease? - correct answer...✔✔Direct genetic test (no risk)
What is the likelihood a child of a parent with Huntington's will develop it? - correct
answer...✔✔50% chance
Dementia etiology - correct answer...✔✔Cerebral atrophy, enlarged ventricles;
decreased Ach and NE; genetic loading
What neurotransmitters are implicated in dementia, and how? - correct answer...✔✔
Decreased Ach and NE
What is the first line treatment for psychosis and agitation in dementia? - correct
answer...✔✔SGAs - but try nonpharmacological therapies first
What is delirium? - correct answer...✔✔ACUTE disturbance of LOC, cognition,
attention
What pharmacological treatment do you use for delirium-induced agitation or
psychosis? - correct answer...✔✔Low dose haldol
What pharmacological treatment do you use for alcohol-induced delirium? - correct
answer...✔✔BNZ
Anytime a patient presents with delirium, what labs should you order? - correct
answer...✔✔UA with culture and specificity d/t infx being a potential cause for delirium,
esp in older adults
What is pseudodementia? - correct answer...✔✔Cognitive sx r/t depression in older
adults
Dementia vs. pseudodementia - correct answer...✔✔Dementia: premorbid hx of slowly
declining cognition
Pseudodementia: acute onset of significant cognitive changes
How would someone with dementia vs. pseudodementia answer a question? - correct
answer...✔✔Dementia: confabulates, lacks answer
Pseudodementia: "I don't know"
AGRADESOLUTIONS
