PMHNP certification Exam 22 (Latest 2022/2023) Download to Score A+

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PMHNP certification Exam 22 (Latest 2022/2023) Download to Score 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 sin... gle 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) - CORRECT ANSWERD. 68 y/o single white male with depression *5 risk factors (age, male, white, depression) Count the risk factors COWS scale components - CORRECT ANSWER• Opioid W/D Pulse, sweating, restlessness, pupil size- dilation (if pinpoint= opioid intoxication, not w/d), body aches, Rhinorrhea (running nose), Lacrimation (eye tearing), GI upset (N/V/D), yawning, tremors, anxiety/irritability, Piloerection (gooseflesh skin), insomnia What does COWS stand for? - CORRECT ANSWERClinical Opiate Withdrawal Scale What does CIWA stand for? - CORRECT ANSWERClinical Institute Withdrawal Assessment What does CIWA assess for? - CORRECT ANSWER--used to determine likelihood of ETOH withdrawal or DTs --usually occur within the first 24-72 hours after cessation o used to determine when to administer medications for ETOH withdrawal What does CIWA NOT test for? - CORRECT ANSWERAlcohol Use Disorder What are the CIWA scale components? - CORRECT ANSWER• N/V, tremor, paroxysmal sweats, anxiety, agitation, tactile disturbances, auditory disturbances, visual disturbances, H/A, orientation Each component is scored from 0(none)-7(severe) except orientation wh/ is (0 (AA0x4)-4 (disoriented) Score: <10: Very mild Start PRN meds at score of 8 >10 to 15: Mild scheduled + PRN meds >16 to 20: Moderate >21: Severe Diazepam, Librium, Ativan When interview teenagers (16 y/o) that arrive with their parents what should you do? - CORRECT ANSWERinterview 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? - CORRECT ANSWERNative 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 Syndrome - CORRECT ANSWERD. Metabolic Syndrome (UMBRELLA ANSWER) Which antipsychotics have the least weight gain? - CORRECT ANSWERLatuda, 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? - CORRECT ANSWERLamictal -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 a - CORRECT ANSWERatypical 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. Hippocampus - CORRECT ANSWERHypothalamus 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? - CORRECT ANSWERBring a support person like a husband Thyroid-Stimulating hormone normal level - CORRECT ANSWER0.5-5.0 Mu/L When T4 and T3 are high and TSH is low what is the diagnosis - CORRECT ANSWERHYPERTHYROIDISM, TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE Key symptoms of Heat Intolerance - CORRECT ANSWERHyperthyroidism When T4 and T3 are Low and TSH is high what is the diagnosis - CORRECT ANSWER(HYPOTHYROIDISM) TSH secretion increased: TSH HIGH à COLD INTERANCE Key symptoms of Cold Intolerance - CORRECT ANSWERHypothyroidism Hyperthyroid can mimic - CORRECT ANSWERMania Hypothyroid can mimic - CORRECT ANSWERDepression A patient on depakote complains of RUQ pain and has reddish/brown urine - CORRECT ANSWERHepatoxicity -Check LFTs Signs of Depakote toxicity - CORRECT ANSWERDisorientation, confusion, lethargy You suspect depakote toxicity what do you do? - CORRECT ANSWERCheck -LFT -Ammonia -Depakote Level What herbal supplement can cause hepatoxicity? - CORRECT ANSWERKava Kava [Show More]

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