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ANCC Review Manual PMHNP Exam Questions And
100% Correct Answers
When was NP role introduced and by whom - ANSWER 1965 Loretta Ford University of Colorado State Legislative Statutes - ANSWER Grant legal authority for NP practice Are the Nurse Practice Act of every stateProvide title protection Define advanced practice Are prevailing state laws that define scope of practicePlace restrictions on practice Establishes NP credentialing requirements State grounds for disciplinary actionsMay determine collaborative agreements Collaborative agreement - ANSWER Document outlining what types of medications maybe prescribed and describes some type of oversight board for NP practice Statutory Law-ANSWER Laws and regulations vary from state to state May further define scope of practice and practice requirementsMay supply restrictions in practice unique to that state
Core Competencies - ANSWER Management of Health StatusMaintenance of Nurse-Patient Relationship Teaching/Coaching Professional Role
Managing and Negotiating Healthcare Delivery Systems Monitoring Quality of Care Providing Culturally Sensitive Care Licensure - ANSWER A process by which an agency of state government grantspermission to individuals accountable for the practice of a profession to engage in the practice of that profession Credentialing - ANSWER Process used to protect the public by ensuring a minimumlevel of professional competence
Certification - ANSWER Credential that provides title protection Determines scope of practice is the process by which a professional organization/association certifies that anindividual licensed to practice as a professional has met certain predetermined standards Assures the public that an individual has mastery of a body of knowledgeAssures that the individual has acquired the skills necessary to function in a particular specialty ANCC only one for psych Scope of practice - ANSWER Defines NP roles and actionsIdentifies competencies assumed to be held by all NPs who function in a particular role Has broad variations from state to state Standards of Practice - ANSWER Gives authoritative statements regarding the qualityand type of practice that should be provided Provides a way to judge the nature of care providedReflects the expectation for the care that should be provided to patients with various illnesses
Fidelity - ANSWER Being true and loyal Autonomy - ANSWER Doing for self Veracity - ANSWER Telling the truth Respect - ANSWER Treating everyone with equal respect Deontological Theory - ANSWER an act is labeled as good or bad based upon the actitself regardless of the consequences
Teleological Theory - ANSWER an act is labeled good or bad based upon theconsequence or outcome
Virtue Ethics - ANSWER actions are selected based upon the moral virtues [honesty,courage, compassion, wisdom, gratitude, self respect] or character of the individual making the decision Four elements of negligence to prove malpractice - ANSWER Duty: NP had a duty toexercise reasonable care when undertaking and providing treatment to the patient Breach of duty: NP violated the applicable standard of care in treating the patient'scondition Proximate cause: causal relationship between the breach in the standard of care andthe patient's injuries Damages:there are permanent and significant damages to the patient as a result of thebreach in the standard of care
Commitment Criteria - ANSWER Individual has an diagnosed psychiatric disorderIndividual is dangerous to self or others as a result of the disorder Individual is unaware of or unwilling to accept the nature and severity of the disorder
Treatment likely to improve functioning Primary Prevention - ANSWER Aimed at reducing the incidence # of new cases of mentaldisorders prevention
Secondary Prevention - ANSWER Aimed at reducing prevalence of mental disorders # ofexisting cases screening
Tertiary Prevention - ANSWER Aimed at reducing the disability and severity of a mentaldisorder rehab
Ethnicity - ANSWER Self identified race, tribe or nation with which a person or groupidentifies and which greatly influences beliefs and behaviors
Schizophrenia accounts for ____% of US homelessness - ANSWER 15-45% Sexual Identity - ANSWER How people identify psychologically on a continuum betweenfemale and male and to whom they are sexually or affectionately attracted
Gender Identity - ANSWER A person's identity along a continuum between normativeconstructs of masculinity and femininity
PICO - ANSWER P-patient, population, problem I-intervention C-comparisonO-outcome
Internal validity - ANSWER Treatment had an influence upon the outcome (dependentvariable)
Erikson: Early childhood - ANSWER 1-3 Autonomy vs Shame and Doubt Erikson: Late childhood - ANSWER 3-6 Initiative vs Guilt Erikson: School age - ANSWER 6-12 Industry vs Inferiority Erikson: Adolescence - ANSWER 12-20 Identity vs Role Confusion Erikson: Early adulthood - ANSWER 20-35 Intimacy vs Isolation Erikson: Middle adulthood - ANSWER 35-65 Generativity vs Self Absorption orStagnation
Erikson: Late adulthood - ANSWER over 65 Integrity vs Despair Principle of Psychic Determinism - ANSWER Even apparently meaningless, random, oraccidental behavior is actually motivated by underlying unconscious mental content
Freud Oral Stage - ANSWER 0-18 mths; sucking, chewing, feeding, crying(schizophrenia, substance abuse, paranoia)
Freud Anal Stage - ANSWER 18 mths-3 years; sphincter control, activities of expulsionand retention (Depressive)
Freud Phallic stage - ANSWER 3-6; Exhibitionism, masturbation, oedipal, castrationanxiety, female fear of lost maternal love (sexual identity disorders)
Freud Latency stage - ANSWER 6-puberty; peer relationships, learning, motor skills
development, socialization (inability to form social relationships) Freud genital stage - ANSWER puberty forward; integration and synthesis of behaviorsfrom early stages, primary genital based sexuality (Sexual perversion disorders)
Id - ANSWER primary drives or instincts, urges (hunger, sex, aggression)largely unconscious pleasure principle, immediate satisfactionpresent at birth "I want" Ego - ANSWER external reality rational mind; responsible for logical and abstract thinking adaptationreality principle defense mechanisms "I think, I evaluate" Superego - ANSWER ego idealsense of conscience or right vs wrong aspirations, ideals, moral values guilt and shame"I should or ought"
Denial - ANSWER Denying distasteful facts unconsciously by refusing to perceive theirexistence
Projection - ANSWER unconscious denial of emotional unacceptable personal
Piaget Preoperational - ANSWER 2-7; more extensive use of language and symbolism;magical thinking
Piaget concrete operations - ANSWER 7-12; child begins to use logic; developsconcepts of reversibility and conservation
Piaget formal operations - ANSWER 12-adult; ability to think abstractly; thinkingoperates in a formal, logical manner
Who developed interpersonal theory - ANSWER Harry Stack Sullivan Hierarchy of Needs - ANSWER Survival (water, air, food, sleep) Safety and security Love and belongingSelf esteem Self actualization Theory of Self Care creator - ANSWER Orem 1st significant psychiatric nursing theory - ANSWER Peplau therapeutic nurse patientrelationship/interpersonal
Somatic nervous system - ANSWER Transmits information from the CNS to skeletalmuscles; responsible for voluntary movement
autonomic nervous system ANSWER Regulates internal body functions to maintainhomeostasis; transmits information from the CNS to smooth muscle, cardiac muscle, and glands; responsible for involuntary movement; subdivided into the sympatheticnervous system and the parasympathetic nervous system
sympathetic nervous system ANSWER Excitory division; prepares the body forstress,fight or flight; stimulates or increases activity of organs
Parasympathetic nervous system - ANSWER Maintains or restores energy; inhibits ordecreases activity of organs
White matter - ANSWER Myelinated axons of neurons Gray matter - ANSWER composed of nerve cell bodies and dendrites; is working area ofthe brain; and contains the synapses or area of neuronal connection
Outermost surface of the brain - ANSWER organized to include grooves anddepressions of wrinkles corrugated into the brain tissue to provide anatomical landmarks or points of reference The brain is subdivided into the. - ANSWER cerebrum and brainstem Corpus callosum does what - ANSWER Sensorimotor information exchange between thetwo hemispheres
Frontal lobe functions - ANSWER Motor function-additional info (controlling voluntarymotor activity) Premotor-additional info (coordinates movement of multiple muscles) Association Cortex - allows multi-modal sensory input to act as cues for memory andlead to decision-making Seat of executive functions: working memory, reasoning, planning, prioritizing,sequencing behavior, insight, flexibility, judgment, impulse control, behavioral cueing, intelligence, abstractionLanguage - expressive speech, broca's area Personality variables
amygdala The hypothalamus. - ANSWER Plays a very major role in most regulatory functionsincluding appetite, sensations of Hunger and thirst, water balance, circadian rhythms, body temp, libido, and Hormonal regulation Thalamus. - ANSWER Sensory relay station except for smell, regulates the flow ofsensory information to prevent overwhelming of cortex; emotions, memory, and associated affective behaviors The hippocampus. - ANSWER Regulates memory, converts shot term memory to longterm memory Hippos never forget The amygdala. - ANSWER responsible for mediating mood, fear, emotion, andaggression; also responsible for connecting sensory smell information with emotions
The other name for the basal ganglia is the - ANSWER corpus striatum What is the function of the basal ganglia - ANSWER modulate and stabilize somaticmotor activity (info from CNS to skeletal muscles)Movement initiation Learning and automatic actions such as walking/driving extrapyramidal motor system or nerve trackinvoluntary motor activities Psychotropic meds affect this track and cause involuntary movements Contains caudate and putamen(Problems here can lead to bradykinesia, hyperkinesia and dystonia)
What does the brainstem include - ANSWER midbrain, pons, cerebellum, medulla,cerebellum, reticular formation
The midbrain. - ANSWER houses the ventral tegmental area and the substantia nigra(dopamine synthesis)
The middle of the brain and the nigras are dope The pons. - ANSWER Houses the locus ceruleus (norepinephrine synthesis) Ponies circle up around norris newton Medulla. - ANSWER with the pons, contains autonomic control centers that regulateinternal body functions
Cerebellum is responsible for. - ANSWER maintaining the equilibrium, acts as a grossmovement control center-movement balance posture
Each hemisphere of the cerebellum has.control - ANSWER ipsilateral-same side of body Problems with the cerebellum can lead to. - ANSWER ataxia-uncoordinated andinaccurate movements
What do you use to detect cerebellar functioning deficiencies - ANSWER Rhomberg test The reticular formation system. - ANSWER the primitive brain Regulatory functions of the reticular formation system include. - ANSWER Involuntarymovement, reflex, muscle tone, vital sign control, blood pressure, resp rate, consciousness, ability to mentally focus, alertness and attention to environmental
Four dopaminergic pathways - ANSWER Mesocortical Mesolimbic NigrostriatalTuberoinfundibular Norepinephrine also known as - ANSWER CatecholamineProduced in locus ceruleus of the pons Major neurotransmitter implicated in mood, anxiety, and concentration disorders Epinephrine also known as - ANSWER Catecholamine Produced by the adrenal glands Also referred to as the adrenergic system Serotonin is known as - ANSWER Indole Produced in raphe nuclei Precursor is trytophanMajor transmitter implicated in mood and anxiety
Amino acids include. - ANSWER glutamateGABA glycine aspartate Glutamate - ANSWER Universal excitatory neurotransmitter Involved in kindling (seizure d/o and bipolar)Mood disorders and schizophrenia if imbalanced
Aspartate - ANSWER Excitatory neurotransmitter that works with glutamate
GABA - ANSWER Universal inhibitory neurotransmitter Site of action of benzodiazepines, alcohol, barbiturates, and other CNS depressants Glycine - ANSWER Inhibitory neurotransmitter that works with GABA Cholinergics - ANSWER Acetylcholine Acetylcholine - ANSWER synthesized by the basal nucleus of MeynertPrecursors are aceylcoenzyme A and choline
Neuropeptides - ANSWER Nonopiod type: Substance P, somatostatinOpioid type: endorphins, enkephalins, dynorphins
Modulate pain, decreased amount is thought to cuase substance abuse Acetylcholine decrease thought to cause. - ANSWER Alzheimers and Impaired memory Acetylcholine increase thought to cause. - ANSWER Parkinsoian symptoms Dopamine increase thought to cause. - ANSWER Schizophrenia/psychosis Dopamine decrease thought to cause. - ANSWER Substance abuse, anhedonia,Parkinson's
Norepinephrine decrease thought to cause. - ANSWER depression Norepinephrine increase thought to cause. - ANSWER Anxiety
X linked disorders. - ANSWER Caused by faulty genes on an X chromosome What testing is required for individuals of Asian decent before carbamazepine isprescribed - ANSWER HLA B*1502 allele
Epidemiology - ANSWER Study of the distribution, incidence, prevalence, and durationof a disease
Incidence - ANSWER Number of new cases occurring over a specified time Prevalence - ANSWER Number of existing cases of a disorder at a specified time The initial psych assessment focuses on. - ANSWER Process of differential diagnosticassessment
Subsequent psych assessments focus on. - ANSWER monitoring client outcomes,general health status, modifying care practices based on clinical outcomes
Culturally bound syndromes - ANSWER Specific behaviors related to a person's cultureand not linked to a psychiatric disorder
Acculturation - ANSWER Process by which the person acquires the culture of thesociety that he or she inhabits
What reflexes are tested during neuro exam - ANSWER Biceps Triceps BrachioradialisPatellar
Achilles Plantar Babies: Head lagFlexion Rooting GraspingMoro Glabellar Babinski Cranial Nerve 1 - ANSWER Olfactory Test sense of smell and ensure patency of nasal passages Cranial Nerve 2 - ANSWER Optic Snellen chart or other suitable chart depending on the acuity and ability of the patient tocooperate Look at inner aspect of the eyes with the ophthalmoscopeConfrontation test for peripheral vision
Cranial Nerve 3 - ANSWER OculomotorFive extrinsic eye muscles; Test with cranial nerve 4 and 6 Extraocular movements PERRLACorneal light reflex
