PMHNP ACTUAL EXAM 2024 UPDATE QUESTIONS WITH ANSWERS GUARANTEED PASS 100%
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Course
PMHNP
Institution
PMHNP
PMHNP ACTUAL EXAM 2024 UPDATE QUESTIONS WITH ANSWERS GUARANTEED PASS 100%
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 single Asian male with previous SI attempt *3 risk factors
C. 38 y/o single AA male who is a man...
PMHNP ACTUAL EXAM 2024 UPDATE QUESTIONS
WITH ANSWERS GUARANTEED PASS 100%
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 single 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)answer== D. 68 y/o single white male with depression *5 risk factors (age, male,
white, depression)
Count the risk factors
When interview teenagers (16 y/o) that arrive with their parents what should you do?
answer== interview 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?answer== Native 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 Syndromeanswer== D. Metabolic Syndrome (UMBRELLA ANSWER)
Which antipsychotics have the least weight gain?answer== Latuda, 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
Which mood stabilizer have the least weight gain?answer== Lamictal
-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 aanswer== atypical
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. Hippocampusanswer== Hypothalamus
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? answer==
Bring a support person like a husband
Thyroid-Stimulating hormone normal level answer== 0.5-5.0 Mu/L
When T4 and T3 are high and TSH is low what is the diagnosis answer== HYPERTHYROIDISM,
TSH secretion decreases: TSH LOW à key symptoms HEAT INTOLERANCE
Key symptoms of Heat Intolerance answer== Hyperthyroidism
When T4 and T3 are Low and TSH is high what is the diagnosis answer== (HYPOTHYROIDISM)
TSH secretion increased: TSH HIGH à COLD INTERANCE
Key symptoms of Cold Intolerance answer== Hypothyroidism
Hyperthyroid can mimic answer== Mania
Hypothyroid can mimic answer== Depression
A patient on depakote complains of RUQ pain and has reddish/brown urine answer== Hepatoxicity
-Check LFTs
Signs of Depakote toxicity answer== Disorientation, confusion, lethargy
You suspect depakote toxicity what do you do? answer== Check
-LFT
-Ammonia
-Depakote Level
What herbal supplement can cause hepatoxicity? answer== Kava Kava
When taking Kava Kava in combinations with other medications you should caution about
answer== Risk of Hepatoxicity and Sedation
Ace inhibitors are treatment of choice for? answer== Heart Failure
Certain medications are known to increase lithium level, but HOW? answer== by
reducing renal clearance
When educating a patient about lithium teach them about answer== Hyponatremia
Dehydration-hot days, exercise
Normal Lithium Level answer== 0.6-1.2
Lithium Toxicity answer== 1.5 or above
Discontinue and re-order lithium level
Lithium level of 1.4 answer== Monitor for toxicity
Labs before starting lithium answer== TSH, BUN, CREATININE, HCG, U/A to check for
presence of protein in the urine (4+ protein is concerning for renal impairment)à4+ protein in
urine=MONITOR FOR TOXICITY
4+ protein in the urine of a patient on lithium answer== 4+ protein is concerning for renal
impairment
4+ protein in urine=MONITOR FOR TOXICITY
Lithium side effects answer== hypothyroid, leukocytosis, maculopapular rash, t- wave
inversion, Coarse Hand Tremor, GI upset (nausea, vomiting, anorexia)
, -Some of these are also signs of toxicity
Signs of lithium toxicity answer== confusion, ataxia, GI upset, palpitation, tremor
NMS answer== muscle rigidity, mutism (because of muscle rigidity), increased CPK
(caused by muscle contraction and muscle destruction), increase WBC, increased
WBC, myoglobinuria (also from muscle destruction)
Cherry colored urine in a patient that exercises a lot answer== test for myoglobinuria may
be a sign of rhabdo
Serotonin Syndrome answer== With any drug that increases 5-HT (e.g., MAO
inhibitors, SNRIs, TCAs) hyperthermia, confusion, myoclonus, cardiovascular
instability, flushing, diarrhea, seizures.
-Treatment: cyproheptadine (5-HT2 receptor antagonist).
Treatment for NMS answer== Stop Offending Medication
-Dantrolene (muscle relaxer)
-Bromocriptine (Dopamine D2 agonist).
*In question focus on what they are asking for...........dopamine agonist vs muscle relaxer
Treatment for Serotonin Syndrome answer== Stop Med (1 or more SSRI, SSNRI, TCA,
MOAI)
-Cyproheptadine
Triptans answer== Used for MIGRAINES
-These meds increase serotonin example
SUMATRIPTAN
patient taking Prozac and started on sumatriptan answer== -call PCP to ask them to switch
the migraine med if patient already on SUMATRIPTAN do not start antidepressant
without talking to PCP
How long do you wait when switching between an SSRI to an MAOI? answer== 2 weeks
How long do you wait when switching between Prozac and MAOI? answer== 5-6 weeks
wash out period
What is the first line treatment for depression and why? answer== SSRI-First line
treatment for depression due to less risk of injury from OVERDOSE
If a cancer patient has depression what should you consider? answer== Treating with a
medication with minimal drug/drug side effects like Lexapro
Patient with depression worries about sexual dysfunction what would be the medication of
choice? answer== Wellbutrin
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