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ANCC Domains > Domain 2 Advance Practice > Flashcards

Domain 2 Advance Practice Flashcards

1
Q

A patient is taking the mini-mental state examination (MMSE) and is copying the diagram of interlocking pentagons. What phenomenon is being tested with this task?

A

Constructional praxis

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2
Q

What does OARS in MI stand for?

A

Open questions
Affirming
Reflecting
Summarizing

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3
Q

During an initial evaluation, the PMHNP asks “what does the phrase A rolling stone gathers no moss mean?you assessing what?

A

Abstract reasoning

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4
Q

What are the 5As model for health behavior change?

A

Assess
Advise
Agree
Assist
Arrange

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5
Q

Circumstantiality

A

A patient digresses into unnecessary details before communicating the central idea.

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6
Q

What are instrumental activities of daily living?

A

Includes actions that facilitate or enhance the performance of ADLs , like shopping, using a telephone, using transportation.

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7
Q

What assessment tool can be used to measure severity and track symptom changes is?

A

Mini-mental state examination (MMSE)

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8
Q

SF_36

A

Focuses on functional status over a four-week timespan.

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9
Q

CAGE

A

Is alcohol screening tool

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10
Q

SCID-5

A

Is a diagnostic tool

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11
Q

After one minute, a patient is unable to recall the object asked to remember during a MMSE. The patient is showing impairment in which type of memory?

A

Immediate memory

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12
Q

Episodic memory

A

Pertains to specific life events

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13
Q

Declarative memory

A

Recallable information

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14
Q

Anterograde memory

A

Refers to the learning and remembering of new information and events following a brain injury.

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15
Q

Thought broadcasting

A

A delusion that one’s thoughts are projected and received by others

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16
Q

Thought insertion

A

The belief that thoughts are placed in the mind from outside.

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17
Q

Thought withdrawal

A

Is the belief that thoughts are being taken away from the person against their will.

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18
Q

Thought echo

A

A hallucination that one’s own thoughts are audible.

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19
Q

Suicidal ideation, intent, plan, method, and access are documented under what?

A

Thought content

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20
Q

Thought content

A

Refers to the specific ideas, beliefs, or themes on which a person focuses.

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21
Q

Which section of the mental status exam helps clinicians identify suicidal plans or intent?

A

Thought content

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22
Q

Thought process

A

Pertains to how a person thinks

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23
Q

Judgement

A

Assesses their ability to make sound decisions based on their situation

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24
Q

A patient began two weeks ago on antipsychotic and is now experiencing symptoms such as inability to sit still, frequent pacing, inner restlessness. What is the most appropriate rating scale to use to assess these symptoms?

A

BARS= Barnes akathisia rating scale

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25
Q

Which of the following screening tests has high sensitivity and specificity in identifying cognitive impairment in older adults while using the least amount of time?

A

Clock drawing test = CDT

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26
Q

How much time does CDT take to administer?

A

2-4min

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27
Q

Motivational interviewing involves bolstering an individuals motivation to change through the use of guiding principles, which are?

A

Expressing empathy
Developing discrepancy
Rolling with resistance
Supporting self-efficacy

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28
Q

What are guiding principles of MI?

A

Expressing empathy
Developing discrepancy
Rolling with resistance
Supporting self-efficacy

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29
Q

What are the stages of transtheoretical model

A

Precontemplation
Contemplation
Preparation
Action
Maintenance
Termination

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30
Q

Obsession thoughts

A

Intrusive , repetitive ideas

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31
Q

Compulsions

A

Ritualized behaviors performed to prevent anxiety or a feared outcome

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32
Q

Delusions

A

Are false fixed beliefs not shared with any others

33
Q

Hallucinations

A

Are perceptions that occur without corresponding external stimuli

34
Q

When a teenager girl is sexually active, what statement should be said to influence her behavior?

A

Provide specific steps for risk reduction is more effective than a generalized statement.

Ex: here are some condoms to use

Instead of , always use condoms when having sex.

35
Q

What do you use for symptoms checklist in substance abuse and alcohol use?

A

CIWA-AR
CLINICAL INSTITUTE WITHDRAWAL ASSESSMENT FOR ALCOHOL- revised

36
Q

What are alcohol withdrawal symptoms ?

A

Nausea, sweating, vomiting, tremors, anxiety, agitation, tactile, auditory, and visual disturbances, and clouding of sensorium.

37
Q

Summarizing in therapeutic communication

A

Recaps points for clarification and modifications.

38
Q

Reflection

A

Shows that the provider has listened and is interested

39
Q

Clarification

A

Ensures the correct interpretation of information, while reinforcements express ongoing provider interest.

40
Q

The MMSE designed for use on who?

A

Individuals age 18 and older to quantify cognitive status

41
Q

According to a seminal research study on adverse childhood experiences (ACE), a positive relationship exists bw ACE and the development of the following disorders in life?

A

Alcoholism, anxiety, depression, diabetes, and heart disease

42
Q

How do you test concentration ?

A

The ability to sustain focus on a task, when asked to count backward by seven, starting at 100.

43
Q

How do you test recent memory?

A

The ability to recall information from the last few minutes.

44
Q

How do you test remote memory?

A

Is the ability to recall information from the distant past

45
Q

How do you test fund of knowledge?

A

Is readily available information, such as on current events or simple geography.

46
Q

Derealization

A

Perceiving surroundings and events as detached, distorted, or unreal.

Ex: pt expresses self-description of fuzziness and losing touch with reality , and not feeling much at all.

47
Q

Depersonalization

A

Is the sensation of observing oneself from an external perspective, as in watching a movie.

48
Q

Illusions

A

Are misperceptions or misinterpretation of actual perceptions

49
Q

Hallucinations

A

Seemingly real perceptions without an external stimulus, occurring in any of the five senses.

50
Q

The phenomenon in which thoughts are associated according to word sounds rather than meaning is ?

A

Clang associations

Occurs when the patient connects thoughts based on word sounds, not meaning

51
Q

Circumstantiality

A

involves excessive trivial details that delay the patient from reaching the main point.

52
Q

Flight of ideas

A

Involves rapidly shifting thoughts that jump abruptly between ideas

53
Q

Tangentiality

A

Occurs when excessive, irrelevant details prevent the patient from ever reaching the point.

54
Q

What are first symptoms of schizophrenia?

A

Thought broadcasting
Thought withdrawal
Thought insertion

55
Q

What is a formal thought disorder, and example?

A

A disorder characterized by disruption in speech due to disorganized thoughts, typically linked to psychosis.

Ex: tangentiality= a type of formal thought disorder , involves the provision of excessive , irrelevant details that prevent the pt from reaching the conversation point .

56
Q

CRAFFT , what is this?

A

A screening tool for ages 1-21, assessing substance use disorders, substance use, and driving risk.

Medium risk includes no past 12month use with a yes to the CAR question , or any past 12month use with a crafft score of 0or1

Low= no past 12 month use and no to the CAR question.

High= involves any past 12month use with CEAFFT score of 2 or more.

57
Q

What’s under thought content?

A

Suicidal ideation, intent, plan, method, and access. This refers to the specific ideas, beliefs, or themes on which a person focuses .

This section helps clinicians identify suicidal plans or intent.

58
Q

Thought process

A

Pertains to how a person thinks

59
Q

Judgment

A

Assesses their ability to make sound decisions based on the situation.

60
Q

What are common side effects of olanzapine?

A

Metabolism syndrome= increased lipids, increased waist circumference , EPS, increase lipids

61
Q

Alexithymia

A

Inability to express emotions or differentiate emotions

62
Q

what is the purpose of using the CIWA?

A

tO ASSESS THE SEVERITY OF ALCOHOL WITHDRAWAL SYMPTOMS

63
Q

You are treating a patient with alcohol withdrawal who also has liver disease. Which medication would be the safest choice for managing alcohol withdrawal symptoms in this patient with liver disease?

A) Lorazepam (Ativan)
B) Diazepam (Valium)
C) Chlordiazepoxide ( Librium)
D) Gabapentin (Neurontin)

A

A) Lorazepam

This is often the preferred choice for managing alcohol withdrawal in patients with liver disease. It has a shorter half-life and undergoes minimal hepatic metabolism. This makes it a safer option for individuals with compromised liver function compared to medications that are extensively metabolized by the liver.

64
Q

You are managing a patient with severe alcohol withdrawal symptoms, including hallucinations and seizures. Which medication is typically the most appropriate initial choice for managing severe alcohol withdrawal in this patient?

A. Naltrexone (Vivitrol)
B. Lorazepam (Ativan)
C. Clonidine (Catapres)
D. Disulfiram (Antabuse)

A

B. Lorazepam (Ativan)

is a benzodiazepine with a rapid onset of action and is often the preferred choice for managing severe alcohol withdrawal, including seizures and hallucinations. Its quick onset can help control acute symptoms effectively.

65
Q

Which screening tool is specifically designed to identify alcohol use disorder and its severity?

PHG-9
CAGE
MAST-G (Michigan Alcoholism Screening Test-Geriatric Version)
DAST-10 (Drug Abuse Screening Test-10)

A

b. cage

66
Q

wHICH OF THE FOLLOWING SCREENING TOOLS IS specifically designed to assess alcohol consumption patterns, alcohol-related problems, and the risk of alcohol use disorder (AUD)?

A. HAM-A
B. MAST
C. GAD-7
D. AUDIT

A

D. AUDIT (Alcohol Use Disorder Identification Test)

Widely recognized and validated screening tool specifically designed to assess alcohol consumption patterns, alcohol-related problems, and the risk of AUD. it consists of 10 questions covering various aspects of alcohol use and consequences.

67
Q

which of the following medications works by reacting an aversive reaction to alcohol consumption and is used as a deterrent to drinking?

a. acamprosate
b. disulfiram
c. naltrexone
d. benzodiazepine

A

Disulfiram (Antabuse)

it creastes an aversive reaction to alcohol consumption. when a person taking disulfiram drinks alcohol, it leads to unpleasant symptoms such as nausea, vomiting, and palpitations, which serves as a deterrent to drinking.

68
Q

what is acomprosate (Campral) used for?

A

is one of the medications approved by FDA to treat alcohol use disorder. it works by reducing cravings and withdrawal symptoms, but it does not create an aversive reaction to alcohol.

reducing alcohol cravings and relapse prevention in patients with alcohol use disorder or dependence and is seeking pharmacological treatment.

69
Q

What are the manifestations associated with opioid withdrawal?

A

muscle aches, yawning, and rhinorrhea, irritability are symptoms of opioid withdrawal.

Also, symptoms include flue-like symptoms, muscle aches and pains, excessive yawning, and a runny nose (rhinorrhea), hot and cold flushes, sweating, and goosebumps, feeling anxious or irritable, nausea, vomiting, diarrhea, and loss of appetite, tremor 9shaking) water eyes, disturbed sleep.

70
Q

What size pupil, pinpoint or dilated, is associated with opioid withdrawal and consumption?

A

Dilated pupils are associated with withdrawal.

Pinpoint is associated with the consumption or intoxication of opioids.

71
Q

When should the Clinical Opiate Withdrawal Scale (COWS) be most appropriately used?

A

to monitor the progress of a patient’s opioid withdrawal symptoms.

it assesses various signs and symptoms associated with opioid withdrawal, helping healthcare providers determine the severity of withdrawal and make decisions regarding treatment and symptom management.

72
Q

As a PMHNP conducting a routine assessment, you administer the CAGE questionnaire to a patient. The patient scores a 2 on the CAGE questionnaire. What is the most appropriate interpretation and course of action based on these finding?

A

the score is clinically significant, and you should proceed with a more comprehensive substance use assessment and assess patient for coping skills.

a positive response to two or more CAGE questions indicates a higher likelihood of AUD or problematic alcohol use. It is essential to proceed with a more comprehensive assessment to determine the severity of the issue, any associated problems, the appropriate treatment plan, and to assess for comping skills.

73
Q

What is the CRAFT questionaire?

A

Designed to screen adolescents who may be engaging in substance use or experiencing related problems.

74
Q

What are the spirit and principles of motivational interviewing?

A

In motivational interviewing, the focus is on engaging the patient in a non-judgmental, collaborative conversation. This question explores the patient’s feelings and goals related to alcohol use, which is central to the spirit of motivational interviewing. You want the patient to explore their own thoughts and feelings about their alcohol use, facilitating a productive conversation about change.

ex: “How do you feel about your alcohol use, and what are your goals regarding it?”

ex: “Tell me more about your thoughts and feelings regarding your alcohol use.”

75
Q

what are the transtheoretical model of change (TTM) stages?

A

Precontemplation, contemplation, preparation, action, maintenance, relapse

76
Q

When a question asks “priority action of the pmhnp,” what is being asked?

A

Immediate response, initial action/focus

77
Q

What is conners’ rating scales-revised (CRS-R) used for?

A

comprehensive tools used to assess behavioral, emotional, and academic problems in children and adolescents. These scales are often used in the evaluation of Attention-Deficit/Hyperactivity Disorder (ADHD) and related disorders. The CRS-R includes various forms and scales tailored to different respondents (parents, teachers, and self-reports by children and adolescents) to provide a well-rounded view of the child’s behavior across multiple settings.

78
Q

What tests or screening tools are used to find ADHD in children?

A

vanderbilt ADHD diagnostic parent and teacher rating scales

Conners’ Rating scales-revised (crs-r)

79
Q
A

ANCC Domains (6 decks)

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