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92 Cards in this Set
- Front
- Back
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Q: Collateral sources of data are useful with individuals with:
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A: Impaired insight
Cognitive deficits Substance abuse problems Unstable behavior Children and adolescents |
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Q: Clues to developmental behavioral problems in children include:
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A: Enuresis/encopresis
Night terrors Thumb sucking Frequent tantrums Excessive Isolation Fire Setting Cruelty to animals Frequent school truancy |
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Q: Functions of the functional assessment include:
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A: Looks at degree to which an individual's abilities/perfomrance match the demands of his life
Determines impact of illness on overall functioning Used to differentiate depression from dementia in elderly Used to track client improvement or decline form his baseline |
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A: The Romberg tests for equilibrium. If there is more than slight swaying, this suggests:
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A: Cerebellar Ataxia or Vestibular Dysfunction
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Q: Dysdiadochokinesia is the result of a lesion to the posterior:
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A: lobe of the cerebellum
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Q: Astereognosis is the result of a lesion in the:
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A: Parietal lobe
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Q: What is the difference between flight of ideas and loose association (aka derailment)
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A: Flight of ideas is a disorganized and difficult to follow speech that is rapid and shifts rapidly in topic but syntax and vocabulary are intact (Seen in mania)
Loose association is shifting in thinking in which ideas move from one apparently unrelated topic to another where the person is unaware of how their speech is conveyed(Seen in psychosis) |
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Q: True or false: When testing cognition, clients with dementia will say "I don't know" and depressed clients will confabulate
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A: False, demented clients will confabulate and depressed clients will answer "I don't know"
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Q: Which portion of thyroid hormones is the true determinant of thyroid status?
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A: Free portion
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Q: Which test is commonly done to determine thyroid status?
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A: FreeT4
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Q: Which lab is commonly tested to establish the diagnosis of primary hypothryoidism?
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A: TSH
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Q: TSH levels can increase with lithium therapy?
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A: True, TSH levels can rise denoting decrease in thyroid hormone that preceeds hypothyroidism
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Q: Systemic effects of hyperthyroidism mimic symptoms of which disorder?
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A: Bipolar disorder
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Q: Calcuim is mediated by which three hormones?
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A: Parathyroid hormone, vitamin D, calcitonin
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Q: Which psychopharm drug can potentially increase calcium levels?
Which psychopharm drugs can potentially decrease calcium? |
A: Lithium
Anticonvulsants |
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Q: What are some systemic effects of hypocalcemia?
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A: Increase in neuromuscular excitability, tetany
Muscle spasms Hyperreflexia Convulsions Intestinal cramping Paraesthesias around the mouth |
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Q: What are systemic effects of hypercalcemia?
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A: Fatigue, lethargy, weakness, constipation, bradycardia, impaired renal function
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Q: What are some systemic effects of hyponatremia?
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A: Headache, Lethargy, Edema, Confusion, Seizures, Coma
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Q: What are some systemic effects of hypernatremia?
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A: Convulsions, Thirst, Fever, Dry Mucous Membranes
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Q: What 2 CV symptoms does both hypo and hypernatremia share?
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A: Hypotension and tachycardia
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Q: What can lithium do to magnesium levels?
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A: Can elevate Mg
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Q: Hypomagnesemia is commonly seen in which disorder and what are some common systemic effects?
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A: Seen in chronic alcoholism
Effects include: Depression, irritability, confusion, nystagmus, (**THINK MUSCULAR): Muscle weakness, ataxia, tetany, increased reflexes, convulsions |
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Q: True or false: No specific symptoms are associated with chloride increase or decrease
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A: True
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Q: Potassium balance is regulated by what four entities?
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A: Kidneys, aldosterone levels, insulin secretion, and changes in pH
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Q: Lithium can do what to potassium levels?
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A: Decrease potassium levels
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Q: Which illegal substance can elevate potassium levels?
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A: Marijuana
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Q: What are some systemic effects of hyperkalemia?
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A: Tingling of lips and fingers, intestinal crapming, diarrhea, paralysis, restlessness, EKG changes
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Q: What are some systemic effects of hypokalemia?
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A: (Think like diabetes): Impaired carbohydrate metabolism, polyuria, polydipsia, impaired renal function, cardiac dysrhythmias
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Q: What symptom does hyper and hypokalemia share?
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A: Muscle weakness
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Q: Which liver enzyme can be elevated from IM injections, trauma, infection, seizures?
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A: ALT
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Q: Which two psychopharm drugs can elevate ALT levels?
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A: Carbamazepine and propanolol
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Q: Which lab value is used to evaluate and monitor clients with known or suspected alcohol abuse?
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A: GGT
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Q: Which generally causes GGT to rise more pronounced in early stages: hepatitis or cirrhosis?
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A: Hepatitis.
There is usually only a modest elevation of GGT in cirrhosis, pancreatic or renal disease |
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Q: Dyskinesia is present if movements were 2 in at least two body areas or 3 in one area. A score greater than ___ warrants a diagnosis of tardive dyskinesia for AIMS scale.
What should the Psych NP do if you have either above scores? |
A: 2
Psych Np should discontinue or reduce the dose of the antipsychotic medication |
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Q: How ofthen should AIMS testing be done for pts. receiving antipsychotics?
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A: Every 3-6 months
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Q: What is the most widely used scale to measure akathisia?
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A: Barnes Akathisia Rating Scale
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Q: True or false: the questions in the Adult ADHA Self-Report Scale (ASRS-1) meet DSM-IV criteria for diagnosis
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A: True
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Q: How many symptoms must be present to be indicative of adult ADHD in the Adult Self-Report Scale?
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A: At least four
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Q: How many points indicate clinically significant substance use and may indicate dependence in the CAGE-AID (Altered to Include Drugs)?
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A: There is one point for each "yes" answer. Two or more points
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Q: What is the acronym for the screening scale used for adolesence and alcohol use?
How many points suggest alcohol abuse? |
A: CRAFFT / Two points
Have you ridden in a Car driven by someone high or drunk Do you use to Relax Do you use when you are Alone Do you Forget when using Do Family and Friends tell you to stop Have you ever gotten into Trouble when using |
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Q: Which scale is best in predicting panic disorder?
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A: Beck Anxiety Inventory
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Q: True or false: Hamilton Anxiety Scale (HAM-A) is the common used anxiety rating scale?
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A: True, it is best used in the evaluation of symptoms severity and treatment efficacy over time
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Q: True or false: MMSE will detect subtle memory loss in well-educated individuals
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A: False
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Q: True or false: The MMSE is sensitive for frontal lobe impairment (i.e. executive dysfunction)
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A: False
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Q: MMSE does not diagnose dementia or delirium
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A: True
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Q: An 82 year old female received a score of 20 on the MMSE. Which of the following would be correct in general cognition for this pt.?
A. Severe cognitive impairment B. No cognitive impairment C. Mild cognitive impairment |
A: Mild cognitive impairment
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Q: True or false: the MMSE does not underestimate cognitive impairment among those with moderate to severe psychiatric illness
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A: False
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Q: What does the Geriatric Depression Scale (GDS) not assess for?
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A: Somatic Complaints
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Q: This rating scale is the standard depression outcome measure for the FDA and the National Institute of Mental Health
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A: Hamlton Rating Scale for Depression (HAM-D)
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Q: What multipurpose instrument is used for screening, diagnosing, monitoring, and measuring the severity of depression during the past 2 weeks?
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A: PHQ-9
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Q: True or False: the PHQ-2 is a diagnostic tool for depression like the PHQ-9
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A: False, it is a screening tool only. If positive with a score of 3, then the PHQ-9 is administered
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Q: The Zung Self-Rating Depression Scale assesses what in pts.
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A: It assesses mood appetite, and suicidal thoughts.
It also measures the degree of depression in previously diagnosed individuals |
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Q: The Sheehan Disability Scale assesss the degree of functional impairment in which three domains?
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A: Work/school, social, and family life
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Q: Which of the following assessements would the Psych NP least likely administer to a child/adolescent due to being technical, complex rating and scoring, and time consuming?
A. Children's Yale-Brown Obsessive Compulsive Scale B. Reynolds Adolescent Depression Inventory C. Leibowitz Social Anxiety Scale D. Kiddie Schedule for Affective Disorders and Schizophrenia |
A: Kiddie Schedule for Affective Disorders & Schizophrenia
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Q: What is the one disadvantage of using the Suicide Probability Scale?
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A: It does not consider lethality or intent
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Q: This scale is considered the "gold standard" in studies of treatment efficacy in psychosis and schizophrenia
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A: Positive and negative syndrome Scale(PANSS)
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Q: The Young Mania Rating Scale is used to assess the severity of mania in those previously diagnosed. The Psych NP knows in adults this reflects the severity over what time period?
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A: Over last 48 hours
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Q: The Mood Disorder Questionnaire is an efficient method to screen for mania and hypomania but works better when scoring for which bipolar type disorder?
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A: Better when scoring Bipolar I than Bipolar II or Bipolar NOS
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Q: What is the name of the scale considered the "gold standard" for assessment of OCD symptoms?
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A: Yale-Brown Obsessive Compulsive Scale
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Q: Overall, what is the most widely used rating scale in psychiatry and what does it assess?
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A: Brief Psychiatric Rating Scale. It assesses psychopathology (including positive, negative, and affective psychopathology) in individuals suspected of having schizophrenia
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Q: True or False: The sole purpose of the Brief Psychiatric Rating Scale is rating the current clinical picture through evaluation of symptom severity over time
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A: True. The evaluation is based on the clinical interview and behavior observation during the prior 2-3 days
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Q: The Brief Psychiatric Rating Scale is used for screening and diagnosis with individuals with schizophrenia
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A: False. It is not used for screeening or diagnosis
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Q: What is the name of the scale that quantifies the severity of alcohol withdrawal syndrome, establishes medication dosing, and monitors individual response to treatment over time?
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A: Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA)
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Q: Name the scale that is used in the same format as the CIWA except for Opiates and used for the induction of Suboxone
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A: Clinical Opiate Withdrawal Scale (COWS)
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Q: What are some stress related physical symptoms?
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A: Urinary frequency, diarrhea, sweating, stomach ache, headache, difficulty breathing, lum in the throat, muscle pain
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Q: What kinds of things are assessed in the developmental history of a child?
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A: Relevant birth and infancy history (prenatal drugs, temperament, social stressors, motor development)
Losses of close family members Abuse history, sexual activity Physical Illnesses Physical Development and Maturation Sub-Threshold or childhood mental disorders |
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Q: What are four things the PMHNP would assess in terms of cognitive developmental achievment in the child?
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A: milestones, language, school performance, chronological age vs mental (Intellecutal) age
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Q: True or false: Child development proceeds along a predictable pathway governed by the maturing brain, marked by developmental milestones where all children mature at the same rate
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A: False, yes, child development usually proceeds along a predictable pathway, however, children mature at different rates
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Q: What kinds of factors affect child development and health?
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A: Physical, disease-related, psychological, social, and environmental factors
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Q: The genogram or pedigree assesses _______ and _______ of a particular trait.
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A: Genetic risk and pattern of inheritance
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Q: What are the three items that a functional assessment examines?
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A: Physical activities of daily living, instrumental activities, and executive functions (judgment and planning)
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Q: What is the difference between a skill deficity and a performance deficit from a functional assessment?
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A: Skill deficit: Inability to perform a functional skill despite intact musculature
Performance deficit: Ability to perform a functional skill, but lacks the motivation to do so |
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Q: True or false: Clients of diverse cultures, the PMNHP should always assess the meaning of illness symptoms within the patient's culture
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A: True
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Q: What things should the PMNHP assess in terms of the patient's medication history?
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A: Current medications with referring provider, past medications and their efficacy, allergies, drug interactions, perception of compliance and/or fears about medications, use of OTC meds or herbal remedies, reason for stopping medications, which medications worked best and which they absolutely do not want to take, side effects and adverse events
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Q: True or False: There are no effective lab tests to measure the status of nutrition
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A: True
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Q: About how long should the patient make entries into a food diary for the PMHNP to review for nutritional assessment?
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A: 3-7 days
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Q: With high fever and sore throat, the PMHNP would assess for agranulocytosis. What other problems would the PMNHP assess for with this patient situation?
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A: NMS, Serotonin Syndrome, Delirium
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Q: By 12 months, acuity reaches which level?
A. 20/100 B. 20/50 C. 20/20 D. 20/80 |
A: 20/50
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Q: How old will a child be when there normal eye acuity reaches 20/30?
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A: 4 years old
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Q: Which atypical antipsychotic can have an adverse effect of cataracts?
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A: Quetiapine
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Q: Checking lateralization in auditory acuity is what test?
Comparing air conduction to bone conduction in auditory acuity is what test ? |
A: Lateralization : (Weber)
Air conduction to bone conduction: (Rinne) |
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Q: Which two types of psychotropics can cause EKG changes?
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A: TCA's, Antipsychotics
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Q: Whenn performing a vaginal exam on a 9 year old girl you notice that her hymenal notch or cleft extends 80-90% of the hymenal rim? What would you need to investigate?
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A: If hymenal nnotch ro cleft extends greater than 50% of the hymenal rim, this may indicate sexual abuse
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Q: Provide Cranial Nerves I-XII in order
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A: Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducens, Facial, Accoustic, Glossopharyngeal, Vagus, Spinal Accessory, Hypoglossal
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Q: Which cranial nerves are assessed in a triad?
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A: Oculomotor, Trochlear, and Abducens
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Q: Which cranial nerves are assessed in a dyad?
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A: Glossopharyngeal and Vagus
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Q: A patient with psychosis makes a statement that his inner world is being destroyed. This denotes which type of delusion?
A. Persecution B. Religious C. Grandiose D. Nihilistic |
A: Nihilistic
Can also include destruction of self or body part |
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Q: What is the difference between echolalia and perseveration?
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A: Echolalia is repetition of other peoples' words or phrases
Perseveration is tedious repetition of the same words or ideas regardless of stimuli |
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Q: What is the major differnce between a patient who is tangential and one who is circumstantial in their speech?
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A: In tangentality, the speaker never gets to desired goal
In circumstantiality, there is over-inclusion of details, but eventually the speaker gets to the desired goal |
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Q: Match the type of hallucinations commonly found with the different disorders:
1. Visual hallucinations A.Drug use, medical conditions 2. Auditory hallucinations B. Cognitive, organic d/o 3. Olfactory, tactile hallucinations C. Psychiatric d/o |
A: Visual hallucinations--Cognitive, organic disorders
Auditory hallucinations--Psychiatric Disorders Olfactory/tactile hallucinations--Drug use, medical cond |
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Q: True or false: The St. Louis University Mental Status (SLUMS) exam has great sensitivity than the MMSE
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A: True
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Q: What are two major differences between the SLUMS and the MMSE exams?
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A: The SLUMS incorporates the Clock Drawing Task and Standardized scoring for High school and below High school education
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