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PMHNP Certification Q & A
Fitzgerald Health Education Associates
98 episodes
21 hours ago
The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significant other, her mother, and even people at work she becomes very animated. In response to stressors...
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The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significant other, her mother, and even people at work she becomes very animated. In response to stressors...
Show more...
How To
Education,
Courses
Episodes (20/98)
PMHNP Certification Q & A
Personality Disorder Assessment
The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significant other, her mother, and even people at work she becomes very animated. In response to stressors...
Show more...
1 day ago
7 minutes

PMHNP Certification Q & A
Pharmacotherapy: Medication Avoidance
A 67-year-old female is being evaluated for complaints of depression. She has always struggled with times where she was down but never liked taking medication and has tried to treat herself with nutraceuticals. Her symptoms have gotten much worse lately because her husband died and she is struggling with that. She has been seeing a therapist for the last few months but is not feeling any real improvement. When considering pharmacotherapy for her, which of the following medications should be a...
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1 week ago
7 minutes

PMHNP Certification Q & A
Evaluating Child Attachment
The PMHNP is evaluating a family at the request of county social services. A mother, father, 8-year-old and 2-year-old are present for the evaluation. The NP notes that the 2-year-old clings excessively to the parents, despite the fact that the parents do not seem to be particularly responsive to the child’s caution. The 2-year-old does not exhibit typical curiosity about his new environment and does not express any curiosity about the PMHNP. These behaviors are consistent with: A...
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2 weeks ago
7 minutes

PMHNP Certification Q & A
Assessing Cognitive Changes
A 78-year-old man presents for a follow-up visit. Two months ago he was started on sertraline for major depressive disorder and has been titrated up to 100 mg daily. Today his daughter reports that she cannot really evaluate if his mood has improved because he seems to have become confused. The patient’s daughter reports a distinct new onset confusion and forgetfulness. The PMHNP considers the most likely cause of his confusion to be: A. Urinary tract infection. B. Hyp...
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3 weeks ago
6 minutes

PMHNP Certification Q & A
Piaget Sensorimotor Principles
Cognitive assessment in children characterizes stages of development consistent with Piaget’s developmental theory. One of the cognitive principles typically developed during the sensorimotor stage is: A. Object permanence B. Animalistic thinking C. Phenomenalistic causality D. Learning without reasoning.
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4 weeks ago
7 minutes

PMHNP Certification Q & A
Fluoxetine Adverse Effects
A 12-year-old patient is being seen today in follow-up after being started on fluoxetine 1 month ago for a diagnosis of generalized anxiety disorder. The patient and her father both report that while there does appear to be a mild improvement in anxiety, some adverse effects have developed about which they are concerned. Which of the following is not an expected adverse effect and is a cause for concern? A. Vivid nightmares B. Diaphoresis C. Restless legs ...
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1 month ago
6 minutes

PMHNP Certification Q & A
PTSD Clinical Evaluation
The PMHNP is evaluating a patient who presents complaining of panic attacks that occur for no identifiable reason. The patients has been treated for these previously with a variety of pharmacotherapies that did not provide any meaningful improvement. Upon further conversation, the NP learns that the patient experienced a near-fatal bicycle accident 4 years ago after being hit by a car. When considering a diagnosis of PTSD, the NP explores his history for all of the following diagn...
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1 month ago
6 minutes

PMHNP Certification Q & A
OCD SSRI Dose Escalation
J.B. is a 41-year-old female patient who is being managed for obsessive compulsive disorder. She has been in exposure response therapy (ERT) for several months with marginal improvement, but she has never approached true remission. At one time she was on fluvoxamine with notable improvement, but after a few months it ceased to produce any notable impact and after conferring with her therapist she was converted to fluoxetine 20 mg qd. After two months she was still struggling with symptoms, so...
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1 month ago
9 minutes

PMHNP Certification Q & A
Hypnopompic Hallucination Counseling
The PMHNP is evaluating a patient with significant anxiety and depressive symptoms. In the course of the evaluation the NP further appreciates that the patient is having hypnopompic hallucinations, and that the patient is very concerned about this because his uncle has schizophrenia. The PMHNP advises the patient that: A. There are a variety of pharmacologic options that can be helpful. B. The hallucinations are benign and not a cause for concern. C. There is no need for int...
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1 month ago
7 minutes

PMHNP Certification Q & A
Stimulant Therapy Growth Counseling
A.J. is an 8-year-old male who is under the care of the PMHNP for ADHD. His symptoms are profound, and the recommendation is to begin psychostimulant therapy along with behavioral therapy. The parents are concerned because they have read that psychostimulant therapy can impact growth and final adult height if the child starts taking it before the growth spurt of adolescence. The most appropriate response to the parents is to say that: A. The impact on growth can be minimized...
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2 months ago
8 minutes

PMHNP Certification Q & A
Adolescent Behavioral Assessment
A 14-year-old patient has been managed for the last year with fluoxetine 40 mg daily for a diagnosis of generalized anxiety disorder. She had been doing well, but today her mother reports that ever since returning to school after the summer break she has been distant, sullen, argumentative and defiant. She has been spending time with new friends from school and is always out somewhere with them. The PMHNP recognizes that today’s appointment should include use of which of the following objecti...
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2 months ago
9 minutes

PMHNP Certification Q & A
Treatment of Parkinson’s Psychosis
PMHNP is asked to evaluate a 71-year-old male patient who is reportedly having visual hallucinations. His adult daughter accompanies him to the appointment and reports that he was diagnosed with Parkinson’s disease approximately 2 years ago. It began with the classic motor symptoms, but over the last year he has developed more and more difficulty with memory loss, difficulty with decision making, and episodes of depression and apathy. Sinemet has helped his motor symptoms, but he has not resp...
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2 months ago
9 minutes

PMHNP Certification Q & A
Managing Lewy Body Hallucinations
A 71-year-old patient with neurocognitive disorder due to Lewy Body disease presents for a routine follow-up. His wife reveals that he seems to be hallucinating, sometimes at night becoming very agitated as a result of visual hallucinations, and she is afraid for his safety. The patient himself does not really seem to understand that there is a problem, but his wife is very concerned and firm that he seems to have visual hallucinations more and more frequently. Which of the follow...
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2 months ago
6 minutes

PMHNP Certification Q & A
Psychiatric Physical Assessment
A.G. is a 51-year-old female patient who is being managed for a variety of mental health conditions including bipolar disorder, opioid use disorder, generalized anxiety disorder, and adjustment disorder. Her medication regimen includes a buprenorphine-based medication for OUD, an antipsychotic, an SSRI, and antihistamine. The physical examination documentation for each encounter should include a(n) : A. A PHQ-9 B. An AIMS score C. A GAD-7 D. An ORT --- YouT...
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3 months ago
7 minutes

PMHNP Certification Q & A
Perinatal Cultural Care
A 31-year-old Middle Eastern female presents to establish care. She recently relocated to the United States with her husband and is struggling with living in an environment so different from that in which she grew up. She shares that her husband seems more comfortable because he is working and integrating outside of the home, but she does not have that experience and feels very isolated from everything she knows. She is in her first trimester of pregnancy with their first child, and clearly s...
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3 months ago
8 minutes

PMHNP Certification Q & A
Panic Attack Symptom Assessment
The PMHNP is conducting a new patient assessment with a patient who has self-referred for treatment of her panic attacks. The patient relates that she has had anxiety for years, and that she has episodes during which she gets very agitated, she can feel her heart pounding, feels as if she cannot breathe, feels very shaky, and has to sit down and wait for it to pass. These episodes can last for more than 15 minutes until she starts to calm down. Which of the following is inconsistent wit...
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3 months ago
8 minutes

PMHNP Certification Q & A
Bipolar Treatment Plan Adjustment
A 22-year-old female patient is transferred to your care after another provider in the practice retired. She has been managed for bipolar I disorder for 3 years and has had some challenging extremes of exacerbation. She is currently taking a mood stabilizer, an antipsychotic, and an antidepressant. Today she reports a worsening of her depression, admitting to true hopelessness about the future, worsening malaise to the extent that she is not attending to basic hygiene, and for the first time ...
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3 months ago
6 minutes

PMHNP Certification Q & A
Pharmacotherapeutic Options for Bipolar Depression
A patient with a history of rapid-cycling bipolar disorder presents for evaluation of her current, profound depressive symptoms. The patient has been maintained for the last two years on valproic acid and quetiapine, but now a major depressive episode has occurred and the patient is reporting passive suicidal ideation. Concerned that the suicidal ideation may progress, the PMHNP consider which of the following pharmacotherapeutic options? A. Cariprazine B. Lumateperone ...
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4 months ago
5 minutes

PMHNP Certification Q & A
Depression Pre-Treatment Assessment
The PMHNP is seeing a patient who presents for complaint of depressive symptoms. The patient reports a history of anhedonia, hopelessness, worthlessness, sleep dysfunction, marked decrease in appetite with an unplanned 5 lb wt loss in the last month, and a marked inability to concentrate on necessary tasks. Before diagnosing the patient with major depressive disorder and beginning antidepressive therapy, the PMHNP should: A. Document a Patient Health Questionnaire-9 B. Admin...
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4 months ago
6 minutes

PMHNP Certification Q & A
Countertransference Awareness
The PMHNP has a new patient who reminds her of a former teacher who played an important role in her life and whom she regards as a mentor. The NP is concerned that she may express countertransference and is especially watchful for all of the following except: A. Resistance and strong emotion from the patient B. Dreaming about the patient C. Extending appointments beyond normal time frame D. Offering small, inexpensive gifts occasionally to the patient
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4 months ago
6 minutes

PMHNP Certification Q & A
The PMHNP is evaluating a patient who has presented for care repeatedly reporting that she is bipolar and has manic episodes. She has been medicated in the past with a number of mood stabilizers without any meaningful improvement. Today a more detailed history reports that what she is calling manic episodes are actually periods of dramatic responses to stressors. When she argues with her significant other, her mother, and even people at work she becomes very animated. In response to stressors...