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PMHNP Exam Questions With Verified
Answers
What do you provide for a patient if they lost their job or house - answer✔Brief supportive
therapy
Cultural expected responses to a stressor = meaning/context - answer✔Cultural syndrome
3 steps to cultural formulation of interviews - answer✔Clarify meaning of illness/predicament
Contextualize their situation in their local world
Empower the patient
Somatic complaints of pain interpret patient symptoms based on what - answer✔Cultural
Context
Serving multicultural population is called multicultural teaching what should you use -
answer✔Ethno specific assessment parameters
Seen in the Latino population. Result from a shocking, unpleasant or frightening experience that
is believed to cause the soul to leave the body - answer✔Susto (fright)
Attack of nerves, uncontrollable shouting, attacks of crying, trembling, heat in chest that raises to
the head, verbal/physical aggression - answer✔Ataque de nervios aka Puerto rican syndrome
What is considered the evil eye causing fatigue, HA, weight loss, exhaustion, and malaise -
answer✔Mal de ojo
Empacho means what - answer✔Blocked intestine, indigestion (bloating/nausea)
mollera caida - answer✔sunken fontanel
A patient develops symptoms with eye contact due to culture syndrome. How do you tx them? -
answer✔Brief supportive therapy
Education to multicultural population you must provide ________ teaching -
answer✔multicultural
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What culture can have an imbalance between an individual relationship with the world -
answer✔Native Americans
What ethnicity has the highest risk of suicide - answer✔Native Americans
If a nurse tries to take away a healing stick what should you do - answer✔Teach the nurse
cultural competency
What must an NP do before releasing information to a traditional healer - answer✔Get informed
consent
It is culturally sensitive to provide a _____ if a patient does not speak english -
answer✔interpreter
S/S of hypothyroidism can mimic - answer✔depression
S/S of hyperthyroidism can mimic - answer✔mania
If the T3 and T4 ar high the TSH will be - answer✔Low
low TSH is indicative of - answer✔hyperthyroidism
S/S of hyperthyroidism - answer✔Heat intolerance, agitation, anxiety, irritability, tachycardia,
mood swings, weight loss
S/S of hypothyroidism - answer✔Cold intolerance, lethargy, weight gain, decreased libido
TSH levels - answer✔0.5 - 5 is normal
TSH is 0.4 - answer✔Hyperthyroidism
TSH of 7 - answer✔Hypothyroidism
A patient on Depakote presents with abdominal pain in the RUQ, reddish/brown urine, yellowing
of skin, fatigue - answer✔Signs of hepatotoxicity
Intervention for a pt on depakote and presenting with hepatotoxicity - answer✔D/C, check LFT
(AST, ALT)
AST and ALT levels - answer✔AST: 5-40
ALT: 5-35
Therapeutic range for depakote - answer✔50-125, toxicity starts at what level
S/S of depakote toxicity? - answer✔Disorientation, lethargy, decreased respiratory rate, and N/V
Intervention for depakote toxicity - answer✔DC, check depakote level, LFT, and ammonia
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A patient on depakote presents with upper abd pain radiating to back, abd tenderness, fever,
rapid pulse, NV, oily stools - answer✔Pancreatitis
What can depakote cause if a pregnant patient is taking it - answer✔Spina Bifida NT defect
What can KAVA cause - answer✔liver damage
Why do people take KAVA - answer✔anxiety, stress, insomnia
What happens if you take xanax and kava - answer✔Drowsiness
What medications can you not take KAVA with - answer✔Sedatives like CNS depressants
Clonazepam, lorazepam, phenobarbital, zolipedm
What are s/s of steven johnson syndrome which can occur with lamotrigine - answer✔Fever,
boxy aces, red rash, peeling of skin, face/tongue swelling
What mood stabilizer causes the least amount of weight gain - answer✔Lamotrigine
What mood stabilizers cause the least amount of weight gain - answer✔Ziprasidone, aripiprazole
(least sedating) and lurasidone (ZAL)
What labs should be checked for pt's who are taking antipsychotics that can cause weight gain -
answer✔BMI, his waist ratio (checks abd obesity) glucose and lipids
Management of antipsychotic induced weight gain - answer✔Exercise, nutritional counseling, or
switch to a different one like ZAL
What black bow warning comes with carbamazepine (tegritol) - answer✔Agranulocytosis and
aplastic anemia
S/S of aplastic anemia - answer✔Pallpr, fatiuge, HA, fever, nosebleeds, bleeding gums, skin
rash, SOB
What medication should you screen the HLAB 1502 allel for and for what population -
answer✔Carbamazepine and asians
Antiepileptics such as tegretol, topamax, and dilantin are well known for - answer✔Decreasing
effectiveness of oral contraceptives
Monitor pt who take carbamazepine and clozapine together: - answer✔For infection, sudden
fever, chills, sore throat, weakness
When should you D/C carbamazepine or clozapine for ANC level - answer✔1000, weather a pt
has infection or not
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Besides agranulocytosis and aplastic anemia, carbamazepine can also cause what blood issue -
answer✔Neutropenia
At what level can lithium toxicity occur - answer✔0.6-1.2
What medication is the neuroprotective treatment of choice for bipolar disorder -
answer✔Lithium
Gold standard for treating manic episodes - answer✔Lithium
What mood stabilizer has evidence of anti suicidal effects - answer✔Lithium
What medication has been scientifically shown to reduce the sick of suicide in pt's with
schizophrenia - answer✔Clozapine
What labs should you assess for lithium (5) - answer✔TSH- 0.5-5.0
CRT: 0.6-1.2
BUN:10-20
UA: assess for proteins (large = +4) can ID kidney disease
Pregnancy test: HCG 12-51 yr old
Side effects of lithium - answer✔Hypothyroidism, fine hand tremor, maculopapular rash, GI
upset (diarrhea, vomiting, cramps, anorexia) DI (polyurua, polydipsia, t wave inversion,
leukocytosis
What can lithium cause in pregnancy - answer✔Epstein anomaly (congenital heart defect)
S/S of lithium toxicity - answer✔Severe N/V/D, confusion, drowsiness, muscle weakness, heart
palpitations, coarse hand tremors, unsteadiness while standing/walking (ataxia)
Intervention for Li toxicity - answer✔D/C and check a level
What medication can reduce renal clearance - answer✔NSAIDs, thiazides, ACEs (prils)
Reduced renal clearance can cause what - answer✔Increased serum concentration levels, toxicity
If a pt is on lithium and going on a hike remind them to do what - answer✔Drink lots of water,
dehydration can increase Li levels
What would hyponatremia cause in a patient on lithium - answer✔Increase lithium level
Pt on medication presents with
- Mutism
