PMHNP Certification Exam 1052 Questions with Verified Answers
Taras off Principle - CORRECT ANSWER 1976 - duty to warn victims of potential harm from
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Deontological Theory - CORRECT ANSWER Ethical theory that states an action is judged as good or bad based on the act itself regardless of the consequences
Teleological Theory - CORRECT ANSWER Ethical theory that states an action is judged as good or bad based on the consequence or outcome
Virtue ethics - CORRECT ANSWER ethical theory that states actions are chosen based on the moral virtues (eg. honesty, courage, compassion, wisdom, gratitude, self-respect) or the character of the person making the decision
Erikson's developmental stage infancy age range - CORRECT ANSWER birth-1 year
Erikson's developmental stage infancy developmental tasks - CORRECT ANSWER trust vs. mistrust
Erikson's developmental stage infancy indications of developmental mastery - CORRECT ANSWER Ability to form meaningful relationships, hope about the future trust in others
Erikson's developmental stage infancy indication of developmental failure - CORRECT ANSWER poor relationships, lack of future hope, suspicious of others
Erikson's developmental stage early childhood age - CORRECT ANSWER 1-3 yo
Erikson's developmental stage early childhood developmental task - CORRECT ANSWER autonomy vs. shame and doubt
Erikson's developmental stage early childhood indications of developmental mastery - CORRECT ANSWER self-control, self-esteem, willpower
Erikson's developmental stage early childhood indications of developmental failure - CORRECT ANSWER poor self-control, low self esteem, self-doubt, lack of independence
Erikson's developmental stage late childhood age - CORRECT ANSWER 3-6yo
Erikson's developmental stage late childhood developmental task - CORRECT ANSWER initiative vs guilt
Erikson's developmental stage late childhood indications of developmental mastery - CORRECT ANSWER self-directed behavior, goal formation, sense of purpose
Erikson's developmental stage late childhood indications of developmental failure - CORRECT ANSWER lack of self-initiated behavior, lack of goal orientation
Erikson's developmental stage school-age ages - CORRECT ANSWER 6-12yo
Erikson's developmental stage school-age developmental task - CORRECT ANSWER industry vs. inferiority
Erikson's developmental stage school-age indications of developmental mastery - CORRECT ANSWER ability to work; sense of competency and achievement
Erikson's developmental stage school-age indications of developmental failure - CORRECT ANSWER sense of inferiority, difficulty with working, learning
Erikson's developmental stage adolescence ages - CORRECT ANSWER 12-20yo
Erikson's developmental stage adolescence developmental task - CORRECT ANSWER identity vs role confusion
Erikson's developmental stage adolescence indications of developmental mastery - CORRECT ANSWER personal sense of identity
Erikson's developmental stage adolescence indications of developmental failure - CORRECT ANSWER identity confusion, poor self-identification in group settings
Erikson's developmental stage early adulthood ages - CORRECT ANSWER 20-35 years
Erikson's developmental stage early adulthood developmental task - CORRECT ANSWER intimacy vs isolation
Erikson's developmental stage early adulthood indications of developmental mastery - CORRECT ANSWER committed relationships, capacity to love
Erikson's developmental stage early adulthood indications of developmental failure - CORRECT ANSWER emotional isolation, egocentrism
Erikson's developmental stage middle adulthood ages - CORRECT ANSWER 35-65 yo
Erikson's developmental stage middle adulthood developmental task - CORRECT ANSWER generativity vs. self-absorption or stagnation
Erikson's developmental stage middle adulthood indications of developmental mastery - CORRECT ANSWER ability to give time and talents to others, ability to care for others
Erikson's developmental stage middle adulthood indications of developmental failure - CORRECT ANSWER self-absorption, inability to row and change as a person, inability to care for others
Erikson's developmental stage late adulthood age - CORRECT ANSWER >65yo
Erikson's developmental stage late adulthood developmental task - CORRECT ANSWER integrity vs despair
Erikson's developmental stage late adulthood indications of developmental mastery - CORRECT ANSWER fulfilment and comfort with life, willingness to face death, insight and balanced perspective on life's events
Erikson's developmental stage late adulthood indications of developmental failure - CORRECT ANSWER bitterness, sense of dissatisfaction with life, despair over impending death
Psychodynamic (Psychoanalytic) Theory - CORRECT ANSWER -Sigmund Freud
-all bx is purposeful and meaningful
-principle of psychic determinism
-most mental activity is unconscious
-conscious behaviors and choices are affected by unconscious mental content
-childhood experiences shape adult personality
-instincts, urges, or fantasies function as drives that motivate thoughts, feelings, and bx
-Id, Ego, Superego
-conflict is experienced consciously as anxiety
Principle of psychic determinism - CORRECT ANSWER Even apparently meaningless, random, or accidental behavior is actually motivated by underlying unconscious mental content
Intellectual disability typical age onset - CORRECT ANSWER infancy- usually evident at birth
ADHD typical age onset - CORRECT ANSWER early childhood (per DSM by age 12)
Schizophrenia typical age onset - CORRECT ANSWER 18-25 for men
25-35 for women
Major Depression typical age onset - CORRECT ANSWER late adolescence to young adulthood
dementia typical age onset - CORRECT ANSWER most common after age 85
Freud's Id - CORRECT ANSWER -contains primary drives or instincts
-drives are largely unconscious
-operates on the pleasure principle
-"I want"
pleasure principle - CORRECT ANSWER the id seeks immediate satisfaction
freud's ego - CORRECT ANSWER -rational mind, logical and abstract thinking
-"I think, I evaluate"
Freud's superego - CORRECT ANSWER -sense of conscience or right vs wrong
-develops around age 6
-"I should or ought"
Freud's psychosexual stage of development oral stage age - CORRECT ANSWER 0-18 months
Freud's psychosexual stage of development oral stage primary means of discharging drives and achieving gratification - CORRECT ANSWER sucking, chewing, feeding, crying
Freud's psychosexual stage of development oral stage psych disorder linked to failure of stage - CORRECT ANSWER schizophrenia, substance abuse, paranoia
Freud's psychosexual stage of development anal stage age - CORRECT ANSWER 18 months-3 years
Freud's psychosexual stage of development anal stage primary means of discharging drives and achieving gratification - CORRECT ANSWER sphincter control, activities of expulsion and retention
Freud's psychosexual stage of development anal stage psych disorder linked to failure of stage - CORRECT ANSWER depressive disorder
Freud's psychosexual stage of development phallic stage age - CORRECT ANSWER 3-6 years
Freud's psychosexual stage of development phallic stage primary means of discharging drives and achieving gratification - CORRECT ANSWER exhibitionism, masturbation with focus on Oedipal conflict, castration anxiety, and female fear of lost maternal love
Freud's psychosexual stage of development phallic stage psychiatric disorder linked to failure of stage - CORRECT ANSWER sexual identity disorders
Freud's psychosexual stage of development latency stage age - CORRECT ANSWER 6years-puberty
Freud's psychosexual stage of development latency stage primary means of discharging drives and achieving gratification - CORRECT ANSWER peer relationships, learning, motor-skills development, socialization
Freud's psychosexual stage of development latency stage psych disorder linked to failure of stage - CORRECT ANSWER inability to form social relationships
Freud's psychosexual stage of development genital stage age - CORRECT ANSWER puberty forward
Freud's psychosexual stage of development genital stage primary means of discharging drives and achieving gratification - CORRECT ANSWER integration and synthesis of behaviors from early stages, primary genital-based sexuality
Freud's psychosexual stage of development genital stage psych disorder linked to failure of sage - CORRECT ANSWER sexual perversion disorders
Cognitive Theory - CORRECT ANSWER -Piaget
- four stages of development
Piaget developmental stage sensorimotor age - CORRECT ANSWER birth-2 years
Piaget developmental stage sensorimotor - CORRECT ANSWER the critical achievement of this stage is object permanence
Piaget developmental stage preoperational age - CORRECT ANSWER 2-7 years
Piaget developmental stage preoperational - CORRECT ANSWER more extensive use of language and symbolism
magical thinking
Piaget developmental stage concrete operations age - CORRECT ANSWER 7-12 years
Piaget developmental stage concrete operations - CORRECT ANSWER child begins to use logic
develops concepts of reversibility and conservation
Piaget developmental stage formal operations age - CORRECT ANSWER 12 years-adult
Piaget developmental stage formal operations - CORRECT ANSWER ability to think abstractly
thinking operates in a formal, logical manner
interpersonal theory - CORRECT ANSWER -Harry Stack Sullivan
-self-system
-when the person's need for satisfaction and security is interfered with by the self system, mental illness occurs
-humans experience anxiety and bx is directed toward relieving the anxiety, which then results in interpersonal security
self system - CORRECT ANSWER interpersonal theory
total components of personality traits
two drives for behavior in interpersonal theory - CORRECT ANSWER -the drive for satisfaction
-the drive for security
Freud's defense mechanisms - CORRECT ANSWER -denial
-projection
-regression
-repression
-reaction formation
-rationalization
-undoing
-intellectualization
-suppression
-sublimation
-altruism
Hierarchy of needs - CORRECT ANSWER -Maslow
-survival
-safety and security needs
-love and belonging
-self-esteem
-self-actualizaiton
Sullivan's stage of interpersonal development infancy age - CORRECT ANSWER birth-18 months
Sullivan's stage of interpersonal development infancy developmental task - CORRECT ANSWER oral gratification, anxiety occurs for the first time
Sullivan's stage of interpersonal development childhood age - CORRECT ANSWER 18 months- 6 years
Sullivan's stage of interpersonal development childhood developmental task - CORRECT ANSWER delayed gratification
Sullivan's stage of interpersonal development juvenile age - CORRECT ANSWER 6-9 years
Sullivan's stage of interpersonal development juvenile developmental task - CORRECT ANSWER forming peer relationships
Sullivan's stage of interpersonal development preadolescence age - CORRECT ANSWER 9-12 years
Sullivan's stage of interpersonal development preadolescence developmental task - CORRECT ANSWER same-sex relationships
Sullivan's stage of interpersonal development early adolescence age - CORRECT ANSWER 12-14 years
Sullivan's stage of interpersonal development early adolescence developmental task - CORRECT ANSWER opposite- sex relationships
Sullivan's stage of interpersonal development late adolescence age - CORRECT ANSWER 14-21 years
Sullivan's stage of interpersonal development late adolescence developmental taks - CORRECT ANSWER self-identity developed
Health Belief Model - CORRECT ANSWER Marshall Becker
explains that healthy people do not always take advantage of screening or preventative programs because of certain variables:
-perception of susceptibility
-seriousness of illness
-perceived benefits of tx
-perceived barriers to change
-expectations of efficacy
transtheoretical model of change - CORRECT ANSWER states that change such as in health bx occurs in 6 predictable stages
-precontemplation
-contemplation
-preparation
-action
-maintenance
motivational interviewing - CORRECT ANSWER miller and rollnick
-focused, goal-directive therapy
-motivation is elicited from the client
-nonconfrontational, nonadversarial
self-efficacy and social learning theory - CORRECT ANSWER -albert bandura
-behavior is the result of cognitive and environmental factors
theory of cultural care - CORRECT ANSWER -madeline Leininger
-regardless of the culture, care is the unifying focus and the essence of nursing
theory of self-care - CORRECT ANSWER Dorothy orem
-self care
therapeutic nurse-client relationship theory or interpersonal theory - CORRECT ANSWER Hildegard Peplau
-first significant psych nursing theory
-sees nursing as an interpersonal process in which all interventions occur within the context of the nurse-client relationship
phases of the nurse-client relationship - CORRECT ANSWER -orientation
-working phase (identification, exploration)
-termination phase (resolution)
caring theory - CORRECT ANSWER jean Watson
caring is an essential component of nursing
t test - CORRECT ANSWER assesses whether the means of two groups are statistically different from each other
analysis of variance (ANOVA) - CORRECT ANSWER tests the difference among three or more groups
pearson's r correlation - CORRECT ANSWER tests the relationship between two variables
probability - CORRECT ANSWER likelihood of an event occurring
lies between 0 and 1
an impossible event has probability of 0
a certain event has a probability of 1
P value - CORRECT ANSWER aka level of significance describes the probability of a particular result occurring by change alone
if P=0.1, there is a 1% probability of obtaining a result by chance alone
Donabedian model - CORRECT ANSWER structure, process, outcome
process of quality improvement PDSA cycle - CORRECT ANSWER Plan
Do
Study
Act
monoamines - CORRECT ANSWER -biogenic amines
-dopamine
-norepinephrine
-epinephrine
-serotonin
dopamine - CORRECT ANSWER -catecholamine
-produced in the substantia nigra and ventral tegmental area
-precursor is tyrosine
-removed from synaptic cleft by monoamine oxidase (MAO) enzyme action
-D1-like and D2-like receptors
four dopaminergic pathways - CORRECT ANSWER -mesocortical
-mesolimbic
-nigrostriatal
-tuberoinfundibular
norepinephrine - CORRECT ANSWER -catecholamine
-produced in the locus ceruleus of the pons
-precursor is tyrosine
-major neurotransmitter implicated in mood, anxiety, and concentration disorders
-Alpha 1 and 2 receptors
epinephrine - CORRECT ANSWER -catecholamine
-produced by the adrenal glands
-referred to as the adrenergic system
serotonin - CORRECT ANSWER -known as an indole
-produced in the raphe nuclei of the brainstem
-precursor is tryptophan
-major neurotransmitter implicated in mood and anxiety disorders
-5HT1a, 5HT1d, 5HT2, 5HT2a, 5HT3, 5HT4 receptors
amino acids - CORRECT ANSWER glutamate, aspartate, gamma-aminobutyric acid (GABA), glycine
glutamate - CORRECT ANSWER -universal excitatory neurotransmitter
-major neurotransmitter involved in process of kindling (implicated in sz dx and bipolar dx)
-imbalance implicated in mood dx and schizophrenia
-AMPA and MNDA receptors
aspartate - CORRECT ANSWER another excitatory neurotransmitter
-works with glutamate
GABA - CORRECT ANSWER universal inhibitory neurotransmitter
-site of action of benzos, alcohol, barbiturates, and other CNS depressants
-GABAa and GABAb receptors
glycine - CORRECT ANSWER -another inhibitory neurotransmitter
-works with GABA
cholinergics - CORRECT ANSWER acetylcholine
acetylcholine - CORRECT ANSWER synthesized by the basal nucleus of Meynert
-precursors are acetylcoenzyme A and choline
-nicotinic and muscarinic receptors
neuropeptides - CORRECT ANSWER -nonopioid type (substance P, somatostatin)
-opioid type (endorphins, enkephalines, dynorphins)
-modulate pain
-Decreased amount of neuropeptides is thought to cause substance abuse
- opioid type receptors: mu, kappa, epsilon, delta, sigma
dopamine general function - CORRECT ANSWER thinking
decision making
reward-seeking behavior
fine muscle action
integrated cognition
dopamine symptoms of deficit - CORRECT ANSWER mild: pour impulse control, poor spatiality, lack of abstractive thought
-severe: Parkinson's disease, endocrine alterations, movement disorders
-substance abuse, anhedonia
Dopamine symptoms of excess - CORRECT ANSWER -mild: improved creativity, improved ability for abstract thinking, improved executive functioning, improved spatiality
-severe: disorganized thinking, loose association, tics, stereotypic bx
-schizophrenia, psychosis
norepinephrine general function - CORRECT ANSWER alertness
focused attention
orientation
primes fight or flight
learning
memory
norepinephrine symptoms of deficit - CORRECT ANSWER -dullness, low energy, depressive affect
-depression
norepinephrine symptoms of excess - CORRECT ANSWER -anxiety, hyper alertness, increase startle, paranoia, decreased appetite
-anxiety
serotonin general function - CORRECT ANSWER regulation of sleep
pain perception
mood states
temperature
regulation of aggression
libido
precursor for melatonin
serotonin symptoms of deficit - CORRECT ANSWER irritability, hostility, depression, sleep dysregulation, loss of appetite, loss of libido
OCD, anxiety disorders, schizophrenia
serotonin symptoms of excess - CORRECT ANSWER sedation, increased aggression, hallucinations (rare)
acetylcholine general function - CORRECT ANSWER attention, memory, thirst, mood regulation, REM sleep, sexual behavior, muscle tone
acetylcholine symptoms of deficit - CORRECT ANSWER lack of inhibition, decreased memory, euphoria, antisocial action, speech decrease, dry mouth, blurred vision, constipation
alzheimers dx
acetylcholine symptoms of excess - CORRECT ANSWER overinhibition, anxiety, depression, somatic complaints, self-consciousness, drooling, EPS
parkinsonian symptoms
GABA general function - CORRECT ANSWER reduces arousal, reduces aggression, reduces anxiety, reduces excitation
GABA symptoms of deficit - CORRECT ANSWER irritability, hostility, tension and worry, anxiety, seizure activity
anxiety disorders
GABA symptoms of excess - CORRECT ANSWER reduced cellular excitability
sedation
impaired memory
glutamate general function - CORRECT ANSWER memory, sustained automatic functions
glutamate symptoms of deficit - CORRECT ANSWER poor memory, low energy, distractible
learning difficulty, negative symptoms of schizophrenia
glutamate symptoms of excess - CORRECT ANSWER kindling, seizures, anxiety or panic
bipolar affective disorder, psychosis from ischemic neurotoxicity or excessive pruning
peptides opioid type general function - CORRECT ANSWER modulate emotions, reward center function, consolidation of memory, modulate reactions to stress
peptides opioid type symptoms of deficit - CORRECT ANSWER hypersensitivity to pain and stress
decreased pleasure sensation
dysphoria
substance abuse
peptides opioid type symptoms of excess - CORRECT ANSWER insensitivity to pain
catatonic-like movement disturbance
auditory hallucinations
decreased memory
structural imaging - CORRECT ANSWER provides evidence of size and shape of anatomical structure
-computed tomography CT
-Magnetic resonance imaging MRI
computed tomography CT - CORRECT ANSWER provides a three-dimensional view of the brain structures
-differentiates structures based on density
provides suggestive evidence of brain-based problems but not specific testing for psychiatric disorders
-advantage: widely available, relatively inexpensive
-disadvantage: lack of sensitivity, cannot differentiate white matter from gray mater; cannot view structures close to the bone tissue; underestimation of brain atrophy, inability to image sagittal and coronal views
magnetic resonance imaging (MRI) - CORRECT ANSWER provides a series of 2D images that represent the brain
-advantages: can view brain structures close to the skull and can separate white matter from gray matter; readily available; resolution of brain tissue superior to CT scanning
-disadvantages: expensive, many contras to use, claustrophobia
Functional imaging - CORRECT ANSWER measures function of areas of the brain and bases the resulting assessment on blood flow
-may use radioactive pharmaceuticals to cross blood-brain barrier
-mainly used for research
-EEG and evoked potentials testing
-magnetoencephalography MEG
-single photon emission computed tomography SPECT
-positron emission tomography PET
EEG and evoked potentials testing - CORRECT ANSWER least expensive test
convey info on electrical functioning of CNS
Magnetoencephalography MEG - CORRECT ANSWER similar to EEG
detects different electrical activities
used in complementary fashion with EEG testing
single photon emission computed tomography (SPECT) - CORRECT ANSWER information of cerebral blood flow
limited available
expensive
positron emission tomography PET - CORRECT ANSWER images of brain when positron-emitting radionuclei interact with an electron
expensive
combined structural and functional testing - CORRECT ANSWER examine structure in conjunction with function
mainly for research
functional MRI fMRI
3D, event realted functional MRI 3fEMRI
Fluorine magnetic spectroscopy
Dopamine D2 receptor binding
genetic testing FDA required in people of Asian descent - CORRECT ANSWER presence of HLA-B*1502 allel
inherited variant of HLA-B gene
prior to prescribing carbamazepine d/t risk of steven Johnson syndrome and toxic epidermal necrolysis TEN
normal BMI - CORRECT ANSWER 20-25
overweight BMI - CORRECT ANSWER 26-29
obese BMI - CORRECT ANSWER 30-35
what to watch for if on psychtropics such as carbamazepine (Tegretol) or clozapine - CORRECT ANSWER elevated temp
agranulocytosis
steven Johnson syndrome med risk - CORRECT ANSWER carbamazepine or lamotrigine
blurry vision side effect in psychotropics - CORRECT ANSWER anticholinergic side effect
Seroquel may cause cataracts
what can both lithium and anorexia nervosa cause - CORRECT ANSWER peripheral edema
Free thyroxine T4 normal levels - CORRECT ANSWER 0.8-2.8ng/dL
interfering factors of Free T4 - CORRECT ANSWER values can be increased during tx with heparin, aspirin, and propranolol
values can be decreased during tx with furosemide (Lasix) or Methadone
TSH values can be increased during therapy with what - CORRECT ANSWER lithium
systemic effects of hypothyroidism - CORRECT ANSWER decreased T4 and increased TSH
mimics symptoms of unipolar mood dx
systemic effects of hyperthyroidism - CORRECT ANSWER increased T4 and decreased TSH
may mimic symptoms of bipolar affective disorders
interfering factors of calcium levels - CORRECT ANSWER values can be increased by excessive ingestion of milk or during tx with lithium, thiazide diuretics, alkaline antacids, or vitamin D
-values can be decreased during tx with anticonvulsants, aspirin, calcitonin, corticosteroids, heparin, laxatives, diuretics, albuterol, and oral contraceptives
magnesium is a cause of neuromuscular what - CORRECT ANSWER excitability
interfering factors of magnesium levels - CORRECT ANSWER values can be increased by drugs such as antacids, laxatives containing mg, salicylates, and lithium
interfering factors of ALT levels - CORRECT ANSWER values can be increased with Tylenol, allopurinol, aspirin, ampicillin, carbamazepine, cephalosporins, codeine, digitalis, indomethacin, heparin, isoniazid, methotrexate, methyldopa, oral contraceptives, phenothiazines, propranolol, tetracycline, and verapamil
GGT is used to evaluate and monitor clients with what - CORRECT ANSWER known or suspected alcohol abuse
levels rise even after ingestion of small amounts of alcohol
primary preventions - CORRECT ANSWER aimed at decreasing the incidence (number of new cases) of mental disorders
helping people avoid stressors or cope with them more adaptively
secondary prevention - CORRECT ANSWER aimed at decreasing the prevalence (number of existing cases) of mental disorders
early case finding
screening
prompt and effective tx
tertiary prevention - CORRECT ANSWER aimed at decreasing the disability and severity of mental disorder
rehabilitative services
avoidance or postponement of complications
drug steady state - CORRECT ANSWER drugs usually are administered once every half-life to achieve this
it takes approx. 5 half lives to achieve a steady state and 5 half lives to completely eliminate a drug
enzyme inducers can - CORRECT ANSWER decrease the serum level of other drugs that are substrates of that enzyme
possibly causing subtherapeutic drug levels
CP450 inhibitors - CORRECT ANSWER bupropion
clomipramine
cimetidine
clarithromycin
fluoroquinolones
grapefruit
ketoconazole
nefazodone
SSRIs
CP450 inducers - CORRECT ANSWER carbamazepine
hypericum/ st johns wort
phenytoin
phenobarbital
tobacco
enzyme inhibitors can - CORRECT ANSWER increase the serum level of other drugs that are substrates of that enzyme
possibly causing toxic levels
agonist effect - CORRECT ANSWER Drug binds to receptors and activates a biological response
inverse agonist effect - CORRECT ANSWER Drug causes the opposite effect of agonist; binds to same receptor
partial agonist effect - CORRECT ANSWER drug does not fully activate the receptors
antagonist effect - CORRECT ANSWER Drug binds to the receptor but does not activate a biological response
schedule 1 drugs - CORRECT ANSWER nonmedicinal substances
high abuse potential
used for research only
not available by prescription
heroin and marijuana
typical antipsychotics - CORRECT ANSWER haloperidol (Haldol), haloperidol deconate (Haldol deconate)
loxapine (loxitane)
thioridazine (mallaril)
thiothixene (navane)
fluphenazine (prolixin), fluphenazine deconate (prolixin doconate)
mesoridazine (serentil)
trifluoperazine (stelazine)
chlorpromazine (thorazine)
perphenazine (trilafon)
second generation antipsychotics - CORRECT ANSWER clozapine (Clozaril)
ziprasidone (Geodon)
risperidone (Risperdal)
quetiapine (Seroquel)
olanzapine (Zyprexa)
aripiprazole (abilify)
paliperidone (Invega)
iloperidone (fanapt)
asenapine (saphris)
lurasidone (luatuda)
mood stabilizers - CORRECT ANSWER valproic acid (depakene)
divalproex sodium (Depakote)
lithium carbonate (eskalith, lithobid, lithonate, lithotabs)
lamotrigine (lamictal)
carbamazepine (tegretol)
carbamazepine ER (equetro)
oxcarbazepine (Trileptal; off label)
Tricyclics - CORRECT ANSWER clomipramine (anafranil)
amoxapine (asendin)
amitriptyline (Elavil)
desipramine (norpramin)
nortripyline (pamelor)
doxepin (sinequan)
trimipramine (surmontil)
imipramine e(tofranil)
protriptyline (vivactil)
Serotonin selective reuptake inhibitors SSRIs - CORRECT ANSWER citalopram (celexa)
fluvoxamine (Luvox)
paroxetine (paxil)
paroxetine mesylate (pexeva)
fluoxetine Prozac)
sertraline (Zoloft)
escitalopram (Lexapro)
Monoamine oxidase inhibitors MAOIs - CORRECT ANSWER phenelzine (nardil)
tranylcyprmie sulfate (parnate)
selegiline transdermal (EMSAM)
SNRIs and other agents - CORRECT ANSWER trazodone (Desyrel)
venlafaxine (Effexor)
desvenlafaxine (Pristiq)
mirtazapine (Remeron)
nefazodone (serzone)
bupropion (Wellbutrin, Forfivo, Aplenzin)
duloxetine (Cymbalta)
vilazodone (viibryd)
vortioxetine (brintellix)
levomilnacipran (Fetzima)
Benzodiazepines BNZs - CORRECT ANSWER lorazepam (Ativan)
clonazepam (klonopin)
chlordiazepoxide (Librium)
oxazepam (serax)
clorazepate (tranxene)
alprazolam (xanex)
anxiolytics - CORRECT ANSWER buspirone (buspar)
other agents to tx anxiety dx - CORRECT ANSWER propranolol (Inderal)
atenolol (Tenormin)
stimulants - CORRECT ANSWER amphetamine/destroamphetamine (Adderall)
dexmethylphenidate (focalin)
dextroamphetamine (Dexedrine)
methylphenidate (Ritalin)
lisdexamfetamine dimesylate (Vyvanse)
other ADHD and ADD agents - CORRECT ANSWER guanfacine (intuniv)
clonidine (kapvay)
atomoxetine (Strattera)
antidepressants such as desipramine (norpramin), venlafaxine (Effexor), and bupropion (Wellbutrin) are also used
schedule II drugs - CORRECT ANSWER medicinal drugs in current use
high potential for abuse and dependency
written script only
no telephone orders
no refills on script
morphine sulfate, codeine, fentanyl, methadone, hydromorphone (dilaudid), oxycodone (oxycontin, Percocet), hydrocodone (Vicodin etc), amphetamine salts, methylphenidate
schedule III drugs - CORRECT ANSWER medicinal drugs with less abuse than II
telephone orders if followed by written script
prescription must renew Q6months
refills limited to 5
appetite suppressants, butalbital, testosterone, buprenorphine/naloxone
schedule IV drugs - CORRECT ANSWER medicinal drugs with less abuse than III
dextropropoxyphene (Darvon), pentazocine (talwin), benzos, modafinil (Provigil), phenobarbital, zolpidem (ambien), eszopiclone (Lunesta), temazepam (Restoril), armodafinil (nuvigil)
schedule V drugs - CORRECT ANSWER lowest abuse potential
handled similar to noncontrolled drugs
buprenorphine (buprenex), cheratussin (robitussin) with codeine, promethazine (Phenergan) with codeine, diphenoxylate/atropine (Lomotil)
pregnancy category A - CORRECT ANSWER Controlled studies show no risk
pregnancy category B - CORRECT ANSWER no evidence of risk to humans
pregnancy category C - CORRECT ANSWER risk cannot be ruled out
pregnancy category D - CORRECT ANSWER Positive evidence of isk
Pregnancy category X - CORRECT ANSWER absolutely contraindicated
teratogenic risks of benzos - CORRECT ANSWER floppy baby syndrome
cleft palate
teratogenic risks of carbamazepine (tegretol) - CORRECT ANSWER neural tube defects
teratogenic risks of lithium (Eskalith) - CORRECT ANSWER Epstein anomaly
teratogenic risks of divalproex sodium (Depakote) - CORRECT ANSWER neural tube defects
specifically spina bifida
atrial septal defect
cleft palate
possible long term developmental deficits
med that can induce depression - CORRECT ANSWER beta blockers
steroids
interferon
isotretinoin (Accutane)
some retroviral drugs
antineoplastic drugs
benzos
progesterone
meds that can induce mania - CORRECT ANSWER steroids
disulfiram (Antabuse)
isoniazid (INH)
antidepressants in persons with BP
meds that can cause false positives for amphetamines - CORRECT ANSWER stimulants
Wellbutrin
Prozac
trazodone
ranitidine
nefazodone (serzone)
nasal decongestants
pseudoephedrine
meds that can cause false positives for alcohol - CORRECT ANSWER valium
meds that can cause false positives for benzos - CORRECT ANSWER zoloft
meds that can cause false positives for cocaine - CORRECT ANSWER amoxicillin
most antibiotics
NSAIDS
meds that can cause false positives for heroin or morphine - CORRECT ANSWER quinolones
rifampin
codeine
poppy seeds
meds that can cause false positives for methadone or PCP - CORRECT ANSWER OTC cough meds (Nyquil) dextromethorphan
psychoanalytic therapy - CORRECT ANSWER Freud
promotes change by development of greater insight and awareness of maladaptive defenses
Cognitive therapy - CORRECT ANSWER Aaron Beck
goal is to change clients irrational beliefs, faulty conceptions, and negative cognitive distortions
behavioral therapy - CORRECT ANSWER Arnold Lazarus
focus on changing maladaptive bx by participating in active bx techniques such as exposure, relaxation, problem solving, and role playing
Dialectical behavior therapy - CORRECT ANSWER Marsha Linehan
focuses on emotional regulation, tolerance for distress, self management skills, interpersonal effectiveness, mindfulness, with an emphasis on treating therapy-interfering bx
goals of DBT - CORRECT ANSWER decrease suicidal bx
decreased therapy interfering bx
decrease emotional reactivity
decrease self invalidation
decrease crisis-generating bx
decrease passivity
increase realistic decision making
increase accurate communication of emotions and competencies
existential therpay - CORRECT ANSWER viktor frankl
goal to live authentically and to focus on the present and on personal responsibility
humanistic therpay - CORRECT ANSWER carl rogers
person-centered therapy
self directed growth and self actualization
people are born with capacity to direct themselves toward self actualization
interpersonal therapy - CORRECT ANSWER Gerald klerman and myrna Weissman
evidence based therapy focus on interpersonal issues creating distress
time limited, active, focus on the present and on interpersonal distress
eye movement desensitization and reprocessing EMDR - CORRECT ANSWER Francine shapiro
behavioral and exposure therapy
PTSD
goal to achieve adaptive resolution
3 phases of EMDR - CORRECT ANSWER desensitization phase
installation phase
body scan
group phases - CORRECT ANSWER pregroup phase
forming phase
storming phase
norming phase
performing phase
adjourning phase
family systems therapy - CORRECT ANSWER Murray Brown
focus on chronic anxiety within families
tx goal to increase familys awareness of each members function within the family and to incrase levels of self determination
structural family therapy - CORRECT ANSWER Salvador minuchin
main tx goal to produce structural change in the family organization to more effectively manage problems
changing transactional patterns and family structure
experiential therapy - CORRECT ANSWER virginia satir
focus on being authentic, freedom of choice, human validation, and experiencing the moment
tx goals to develop authentic, nurturing communication and increased self worth of each family member
overall goal is growth rather than symptom reduction alone
does not focus on particular techniques
strategic therapy - CORRECT ANSWER jay haley
tx goal to help family embers behave in ways that will not perpetuate the problem bx
interventions are problem focused
solution focused therapy - CORRECT ANSWER steve deshaer bill ohanlon and insoo berg
focus to rework for the present situations that have worked previously
tx goal is effective resolution of problems through cognitive problem solving and use of personal resources and strengths
omega 3 fatty acid supplements - CORRECT ANSWER used for ADHD, dyslexia, cognitive impairment, dementia, CVD, asthma, lupus, and rheumatoid arthritis
interacts with warfarin
Sam-e supplement - CORRECT ANSWER used for depression, osteoarthritis, and liver dx
may cause hypomania, hyperactive muscle movements, and possible serotonin syndrome
tryptophan supplement - CORRECT ANSWER used for depression, obesity, insomnia, headaches, and fibromyalgia
increased risk of serotonin syndrome with use of SSRIs, MAOIs, and st johns wort
vitamin E supplement - CORRECT ANSWER used in enhancing immune system and protecting cells from effects of free radicals
used for neurological dx, diabetes, and PMS
interacts with warfarin, antiplatelet drugs, and statins increasing risk of rhabdomyolysis
melatonin supplement - CORRECT ANSWER used for insomnia, jet lag, shift work, and cancer
interacts with aspirin, NSAIDS, beta blockers, corticosteroids, valerian, kava kava, and alcohol
can inhibit ovulation in large doses
fish oil supplement - CORRECT ANSWER used for bipolar disorder, hypertension, lowering triglycerides, and decreasing blood clotting
interacts with warfarin, aspirin, NSAIDs, garlic, and ginkgo
may alter glucose regulation
black cohosh herbal uses - CORRECT ANSWER menopausal symptoms
PMS
dysmenorrhea
belladonna herbal use - CORRECT ANSWER anxiety
catnip herbal use - CORRECT ANSWER sedation
chamomile herbal use - CORRECT ANSWER sedation
anxiety
ginkgo herbal use - CORRECT ANSWER delirium, dementia, sexual dysfunction caused by SSRIs
Ginseng herbal use - CORRECT ANSWER depression
fatigue
valerian herbal use - CORRECT ANSWER sedation
MDD object loss theory - CORRECT ANSWER -early psychological developmental issues lay the foundation for depressive responses later in life
-the accomplishment of the first stage of development in which the child is able to form relationships is normal
-during the second stage of development, the child experiences traumatic separation from significant objects of attachment (usually a maternal object)
MDD aggression turned inward theory - CORRECT ANSWER -Freud
-assumes that early psychological developmental issues lay he foundation for depressive responses later in life
-the accomplishment of the first stage of development in which the child is able to form relationships is normal
-during the second stage of development, the child experiences the loss of the significant mothering person
MDD cognitive theory - CORRECT ANSWER -Beck
-represents cognitive diathesis- stress model in which developmental experiences sensitize a person to response to stressful life events in a depressed manner
-assumes that people with a tendency to be depressed think about the world differently than nondepressed people and that depressed people are more negative and believe that bad tings are going to happen to them because of their own personal shortcomings and inadequacies
MDD learned helplessness-hoplessness theory - CORRECT ANSWER Seligman
-modified aspect of cognitive theory
-a person becomes depressed due to perceptions of lack of control over life events and experiences
-these perceptions are learned over time, especially as the person perceives others seeing him or her as inadequate
MDD genetic predisposition theory - CORRECT ANSWER having a depressed parent is the single strongest predictor of depression
MDD endocrine dysfunction theory - CORRECT ANSWER HPA axis
result of abnormal stress response related to HPA dysregulation
MDD abnormalities of neurotransmitter function theory - CORRECT ANSWER dysregulation of dopamine, serotonin, and norepinephrine
MDD structural brain changes - CORRECT ANSWER hypovolemic hippocampus
hypovolemic prefrontal cortex-limbic striatal regions
MDD chronobiological theory - CORRECT ANSWER desynchronization of circadian rhythms produces the symptoms constellation collectively called MDD
DSM MDD diagnostic criteria - CORRECT ANSWER -anhedonia or depressed mood or both
-depressed mood most of the day, nearly every day, as indicated by subjective reports or observations of others (irritability in kids)
-marked anhedonia in all or almost all ADLs
-at least 3 or more significant symptoms present during the same 2 week period that represent a change in previous functioning
-weight loss/gain of more than 5% of body weight
-hypersomnia or insomnia nearly every day
-psychomotor agitation or retardation
-fatigue or loss of energy
-self-deprecating comments or thoughts
-feelings of worthlessness or excessive or inappropriate guilt nearly every day
-decreased concentration and memory
-symptoms that begin within 2 months of significant loss and do not persist beyond 2 months is bereavement not MDD
SSRIs act on - CORRECT ANSWER increasing serotonin levels
TCAs act on - CORRECT ANSWER elevating serotonin and norepinephrine [Show Less]