PMHNP Exam Prep

Question 1

Mnemonic for History of Present Illness (HPI):

Answer 1

OLDCARTS or COLDSPA (Characteristics (of symptoms), Onset, Lingering (symptoms how long–days, weeks…?), Duration (how long do symptoms last?), Stressors, Precipitating factors/triggers, Alleviating factors

Question 2

Examples of Autosomal dominant diseases (2)?

Answer 2

Huntington’s, Neurofibromatosis type 1

Question 3

Diseases that will present in MORE than one generation; 50% will pass on trait:

Answer 3

Autosomal dominant

Question 4

Diseases expressed in ONE generation as inherited from the unaffected parent; 2 copies must be present; parents could be carriers but not affected

Answer 4

Autosomal recessive

Question 5

3 examples of Autosomal recessive diseases:

Answer 5

CF, Sickle cell, Tay-Sachs

Question 6

Stages of sleep:

Answer 6

Non-REM (three stages-N1, N2, N3); then REM sleep occurs around 90 mins after falling asleep; cycle repeats 3-4 times per night

Question 7

Mnemonic to remember Mental Status Exam:

Answer 7

“All Borderline Subjects Are Tough Troubled Characters”: (Appearance, Behavior, Speech, Affect, Thought process, Thought content, Cognitive exam)

Question 8

Name some ways to test a patient’s memory:

Answer 8

Recall short sentences 5 mins later; Name last three presidents; 3-object recall after a few mins

Question 9

Mini-Mental State Exam (MMSE) components (11):

Answer 9

ORAL R23 RWD: 
Orientation: (place, time)
Recognition: (repeat three objects right now)
Attention: (serial 7's)
Language

Recall: (3 objects 5 mins later)

2: identify 2 objects (i.e. clock, chair)
3: Follow a 3-step command: (i.e. take this paper, fold in half, put on the ground)

Reading: (read a statement to yourself, do what it says, but don’t say it out loud; i.e. “close your eyes”)
Writing: (write a sentence)
Drawing: (copy a design)

Question 10

The maximum score for MMSE?

Answer 10

30

Question 11

MMSE score that may indicate delirium/dementia?

Answer 11

18-23 (mild); 0-7 (severe impairment)

Question 12

Highest score on SLUMS (St. Louis University Mental Status)?

Answer 12

30

Question 13

Scores on SLUMS that can indicate a disorder?

Answer 13

27-30 (normal); 21-26 (suggests mild NCD); 0-20 (indicate dementia)

Question 14

Assessing suicidality: SLAP mnemonic means what?

Answer 14

Social support, Lethal (plan), Access (to the means to end life), Plan/Previous attempts… also family history

Question 15

Suicidal risk: IS PATH WARM mnemonic means what?

Answer 15

Ideation, Substances (abuse), Purpose (for living seems lost), Anxiety, Trapped (feeling), Hopelessness, Withdrawing (from friends/fam), Anger (with rage), Reckless (behavior), Mood changes (dramatic ones)

Question 16

Per DSM-V, depression must last how long?

Answer 16

most of the day, nearly every day, for at least two weeks

Question 17

SIGECAPS mnemonic for depression:

Answer 17

Sleep disorder, Interest deficit (anhedonia, sexual desire), Guilt (worthlessness, hopeless, regret), Energy (deficit), Concentration (deficit), Appetite disorder, Psychomotor retardation, Suicidality

Question 18

The highest score on the Hamilton Depression Rating Scale (HDRS; HAM-D) is what?

Answer 18

76 (worst score)

Question 19

What score represents a very severe score on the HDRS (aka HAM-D)?

Answer 19

more than 23 (up to max of 76)

Question 20

What score represents no depression on the HDRS (aka HAM-D)?

Answer 20

0-7 (max is 76)

Question 21

What is the worst score on the Beck Depression Inventory (BDI)?

Answer 21

63

Question 22

What score on the BDI indicates no depression?

Answer 22

0-9 (max 63)

Question 23

What score on the BDI indicates severe depression?

Answer 23

30-63 (63 is max)

Question 24

What is the highest score on the Patient Health Questionnaire (PHQ-9)?

Answer 24

27

Question 25

What scores indicate severe depression on the PHQ-9?

Answer 25

15-19=moderately severe; 20-27=severe depression (27 is max)

Question 26

What is the scoring range for the Hamilton Anxiety Rating Scale?

Answer 26

0-56 (worst)

Question 27

What scores on the Hamilton Anxiety Rating Scale indicate moderate to severe anxiety?

Answer 27

25-30 and above (up to 56 max)

Question 28

What score indicates severe anxiety on the Generalized Anxiety Disorder Screening (GAD-7)?

Answer 28

15-21

Question 29

What are two screening questions for Bipolar Disorder?

Answer 29

“Have you ever felt so happy that others told you that you were talking too fast or behaving strangely/differently?”…. “Have you ever been in arguments due to feeling hyper and irritable?”

Question 30

DIGFAST mnemonic for Bipolar disorder:

Answer 30

Distractibility, Indiscretion, Grandiosity, Flight (of ideas), Activities (increased), Sleep (deficit), Talkativeness (pressured speech)