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PMHNP Clinical Review and Board Prep
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PMHNP Clinical Review and Board Prep
PMHNP Clinical Review and Board Prep
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1
Question
What is the appropriate action when a board exam question uses the words 'Initially' or 'Priority'?
Page 1
Answer
Follow the nursing process (ADPIE): Assessment, Diagnosis, Planning, Implementation, and Evaluation.
2
Question
What is the clinical management for a patient on Lamictal (Lamotrigine) who develops a benign rash?
Page 1
Answer
The clinician should document the rash and continue the medication as prescribed.
3
Question
Which symptoms necessitate the immediate discontinuation of Lamictal (Lamotrigine)?
Page 1
Answer
The medication must be stopped immediately if the patient develops a fever or angioedema.
4
Question
How is the monthly dose for a Haldol Decanoate conversion calculated?
Page 1
Answer
Monthly dose = Daily oral dose \(\times 20\text{ mg}\).
5
Question
What is the administration protocol for the first month of Haldol Decanoate treatment?
Page 1
Answer
Give 100 mg for the first injection and administer the remaining balance 14 days later.
6
Question
What is the primary objective of family therapy in psychiatric care?
Page 1
Answer
The primary objective is self-differentiation of the individual within the family unit.
7
Question
Which SSRI is preferred for treating depression in cancer patients due to its low interaction profile?
Page 2
Answer
Lexapro (Escitalopram) is considered the best option for oncology patients.
8
Question
What is the priority action when a child demonstrates sexualized play and alleges abuse by a relative?
Page 2
Answer
Report the allegation immediately to Child Protective Services (CPS) or the appropriate state agency.
9
Question
What is the PMHNP's first action when a patient makes a specific threat to harm someone?
Page 2
Answer
Ensure safety by taking protective action, such as calling the police.
10
Question
What theory links Autism Spectrum Disorder deficits to imitation and empathy problems?
Page 2
Answer
The Mirror Neuron Theory.
11
Question
How is Factitious Disorder defined in terms of patient motivation?
Page 2
Answer
The patient intentionally fabricates symptoms to assume the 'sick role' without external incentives.
12
Question
Under which section of the Mental Status Exam should Homicidal Ideation and Suicidal Ideation be documented?
Page 2
Answer
They must be documented under the Thought Content section.
13
Question
Where are loose associations and flight of ideas documented in the Mental Status Exam?
Page 2
Answer
They are documented under the Thought Process section.
14
Question
In which MSE category is Echolalia primarily documented?
Page 2
Answer
It is primarily documented under the Speech section.
15
Question
How long must psychotic symptoms persist without mood symptoms for a Schizoaffective Disorder diagnosis?
Page 4
Answer
Psychotic symptoms must persist for \(\ge 2\text{ weeks}\) in the absence of prominent mood symptoms.
16
Question
What distinguishes Bipolar Disorder with Psychotic Features from Schizoaffective Disorder?
Page 4
Answer
Psychotic symptoms occur only during a manic or depressive episode and resolve as the mood improves.
17
Question
Which antipsychotic is specifically shown to reduce suicidality in patients with Schizophrenia?
Page 4
Answer
Clozaril (Clozapine) is the only antipsychotic shown to reduce suicidality.
18
Question
What mood stabilizer is considered the gold standard for long-term suicide prevention in Bipolar Disorder?
Page 4
Answer
Lithium is the only mood stabilizer consistently shown to reduce suicidality.
19
Question
What are the hallmark characteristics of Schizoid Personality Disorder?
Page 4
Answer
Voluntary social isolation, preference for solitary activities, and a cold or detached affect.
20
Question
What are the defining signs of Schizotypal Personality Disorder?
Page 4
Answer
Interpersonal deficits, eccentricity, ideas of reference, and magical thinking.
21
Question
What is the result of combining Lithium with NSAIDs like Indocin (indomethacin)?
Page 4
Answer
It decreases renal clearance, leading to increased lithium levels and potential toxicity.
22
Question
What are the components of the Mini-Cog assessment tool?
Page 4
Answer
The assessment consists of a 3-word recall and a clock-drawing test.
23
Question
What clinical priority should be considered when a Bulimia Nervosa patient presents with sweating, nausea, and shaking?
Page 6
Answer
The clinical priority is to check blood glucose immediately for hypoglycemia.
24
Question
What is the primary contraindication for administering Vivitrol (Naltrexone) in a patient with substance use issues?
Page 6
Answer
Vivitrol cannot be administered if the patient has used heroin or opioids in the last 7 to 10 days.
25
Question
What was the legal ruling in the case of O’Connor v. Donaldson regarding involuntary confinement?
Page 6
Answer
A non-dangerous person who can survive safely in freedom cannot be involuntarily confined due to mental illness alone.
26
Question
What legal issue arises if a voluntary patient is blocked from leaving without a legal hold?
Page 6
Answer
The legal issue is false imprisonment.
27
Question
What is the function of a Writ of Habeas Corpus in a psychiatric setting?
Page 6
Answer
It allows an involuntarily hospitalized patient to challenge their confinement in court to determine its lawfulness.
28
Question
Under what condition does a patient with Schizophrenia retain the right to refuse medication?
Page 8
Answer
They retain the right if they have decision-making capacity and no court order or emergency applies.
29
Question
What is the most appropriate social intervention for a stable Schizophrenia patient after a myocardial infarction prevents them from working?
Page 8
Answer
The most appropriate recommendation is referral for Financial Counseling.
30
Question
What does dizziness upon waking indicate in a patient taking Prazosin for nightmares?
Page 8
Answer
Dizziness indicates orthostatic hypotension as a side effect of the medication.