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These are the test questions that my cohort compiled that we remember from the exam.

1. TICS= contraindication for stimulants

2. Assessment before intervention- collecting data: taking vitals, ordering labs
3. Before discharging a patient, who is inpatient- they must have safety and be able to cope
4. Do NOT interview in a patient’s room
5. Do NOT interview in a dayroom
6. DO interview in a private office with the door ajar
7. Pt is a victim of abuse- 1st reassure them of their safety
8. Parent brings in child who’s has been sexually abused- interview the child away from their
parents THEN call CPS
9. Child plays with toys in a sexual manner and you SSUSPECT sexual abuse- immediately report to
CPS
10. To build report with an adolescent:
a. Let them know their info is confidential but explain the exceptions (ie danger to self or
others)
b. Do NOT interview adolescent patient with parents present unless they want their
parents there
c. If an adolescent tells you they are gay- DO NOT tell parents
d. If an adolescent tells you they are dating someone of the same age- do not tell parents
e. Advocate for the adolescent because they have the right to confidentiality (not privacy)
f. You discharge a patient and the rehab wants their lab work- get informed consent and
fax labs

11. You notice that women with postpartum are being discharged before getting a psych eval-
professional collaboration with OB to identify those at risk
12. A 15-year-old boy is feeling weird after taking (smoking) a substance at school-do a drug screen
before referring out
13. WE DO NOT DO MEDICAL EVALUATIONS
14. For cultural question, give a cultural answer- ask patient to interpret that that means in their
country; could be a cultural expected response
15. If patient has a culturally accepted response to losing a job/house (Cultural Syndrome)- Brief
Supportive Therapy
16. Cultural formulation interventions
a. Clarify meaning of illness or predicament
a. Contextualize their situation in their local world
b. Empower the patient
c. RESPECT
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d. There are people who live in an area where you want to teach are from different
cultures-
e. provide multicultural teaching
f. ethno specific assessment parameters
g. information should be based on cultural context (PSYCH EDUCATION)
h. Native American- believe there is an imbalance between an individual’s relationship
with the world- respect it
i. Native Americans have the highest rate of suicides/attempts
j. Native American- some believe in a healing stick. So, if a patient has a healing stick and
another staff member is trying to take it away from them- teach cultural competency to
that staff member and allow the patient to keep their stick
k. Native American- their traditional healer can be part of his treatment plan as long as you
have informed consent (ROI)

17. Patient is taking Seroquel and it is causing metabolic syndrome- start with non-pharmacological
strategies (exercise)
18. Closely monitor for toxicity (lithium) if patient has a large amount of protein in their urine (4+)
19. Which lab is most important to test with lithium- HCG
20. If the patient’s lithium level is 1.4- continue to monitor for toxicity
21. Once the level gets to 1.5 then STOP the lithium
22. If patient has signs and symptoms of lithium toxicity- STOP the lithium and check lithium level
23. If patient goes hiking and they are taking lithium- correct understanding is if they say they will
take extra water on their hike so they do not become dehydrated
24. With NMS- muscle contractions and muscle destruction are what cause elevated CPK
25. SSRIs are the first line treatment for depression because they are safer in an overdose
26. If a patient has depression and cancer- give them citalopram or Lexapro because there is
decreased potential for drug/drug interaction
27. If a patient is depressed and has neuropathic pain- give SNRI, TCA, or gabapentin (for the
neuropathic pain)
28. SSRIs can cause sexual problems- NDRI Wellbutrin will not cause sexual dysfunction
29. If a patient is depressed with no energy and fatigue- give Wellbutrin
30. DO NOT give to patient with (or history of); anorexia, bulimia or seizures
31. BBW on all antidepressants in children, adolescents, and young adults- assess thoughts of self-
harm, frequency, and severity
32. Prozac can cause insomnia so advise patient to take it in the morning.
33. Depressed patient- assess ETOH intake because patients can use ETOH to self-medicate
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34. DXs that cause increased thoughts of self-harm: depression, bipolar, ETOH abuse, eating D/O,
and schizophrenia
35. Homicidal ideation- antisocial is #1
36. There is less evidence on line for antidepressants in children compared to adults because kids
have a reduced placebo rate
37. A patient with schizophrenia gets an MRI/PET scan- you will see increased size of ventricles and
everything else is decreased because decreased blood flow
38. DO NOT give a patient with schizophrenia stimulants because it can potentiate dopamine
release.
39. A patient with schizophrenia can have abstract thinking and aggression, abnormalities or change
in PREFRONTAL CORTEX
40. No pharmacological treatment for schizophrenia- Assertive Community treatment (ACT)
41. Form of rehabilitation post hospitalization (AFTER discharge)
42. Case management approach
43. Long term history of noncompliance should get ACT
44. Social skills training for a schizophrenic patient is tertiary
45. If a patient has schizophrenia, aerobic exercise can- improve cognition, quality of life, and long-
term health
46. If a patient has had multiple hospitalizations or has tried multiple psych medications- they are at
high risk of relapse
47. If they are on oral Haldol, switch to IM (know how)
48. On the mental status exam part of charting-
49. Thought process- thoughts and ideas (NOT SPEECH)
50. Thought content- SI, HI, Hallucinations
51. On the MMSE- asking the patient to do anything backwards is CONCENTRATION
52. The clock drawing test is- a quick screening tool for dementia and only requires a minute or two.
If they cannot do this- DAMAGE TO RIGHT SIDE of brain
53. KNOW the positive and negative symptoms of schizophrenia
54. KNOW EPS
55. KNOW Acute dystonia
56. In EPS you will have- increased acetylcholine and decreased dopamine
57. If you are treating a patient with schizophrenia and it is their FIRST episode- give atypical
antipsychotic because it has decreased chance of EPS
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58. Typical antipsychotics- dopamine receptor antagonism

59. Atypical antipsychotics- dopamine receptor antagonist AND serotonin receptor antagonism
(5HT2A)
60. Atypicals that come in IM form- Invega, Abilify, Geodon
61. If patient is taking olanzapine then they start smoking- increase olanzapine dose
62. If patient is taking olanzapine then they stop smoking- decrease olanzapine dose
63. If patient is on an inducer and an inhibitor- the inhibitor always wins, so decrease the inducer
64. If a patient is on Depakote and Flonase and they say their medication is not affective- it is
because of the Flonase so increase the Depakote dose
65. A patient is depressed and on Lexapro and interferon and the patient says their medication is
not working- increase the Lexapro
66. Neurotransmitters involved in ADDICTION- GABA and Dopamine
67. Signs of stimulant abuse- agitation, anxiety, irritability, tremors, insomnia, heart palpitations,
HTN, tachycardia
68. An anorexic patient c/0 pain or feeling bloated after eating (stomach fullness)- delayed gastric
emptying
69. Meds that can cause delayed gastric emptying: Ranitidine, Famotidine, Omeprazole
70. Antacids like Protonix and Omeprazole can decrease the absorption of antipsychotic
medications- so do NOT give them within 2 hours of each other
71. If an older (65+) adult is taking an SSRI- monitor for anxiety
72. Paradoxical effect- opposite effect of what it is supposed to do
73. Apoptosis- cell death or neuronal loss
74. Bipolar disorder is VERY inheritable (family history)
75. If a patient is 45 years old or older when they have their first episode of bipolar it is most likely
due to a medical condition
76. Bipolar patients can be irritable and uncooperative
77. Mania lasts longer than hypomania

78. DBT (Marsha Linehan) – can decrease thoughts of self-harm

79. Journaling and diary entries done by the patient

80. Patient has borderline and a depressed mood- give Depakote

81. Children’s motor tics are fairly common and can be temporary
82. Stimulants can cause tics
83. Tourette’s- INCREASED DOPAMINE
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84. Know the functions of the frontal lobe

85. Dorsolateral Prefrontal cortex- helps with executive function, cognitive processes such as
planning, working memory, problem solving and attention
86. You work inpatient and see a 12 year old boy that you DX with ADHD- provide information about
aftercare planning (this starts at admission)
87. When educating parents, if they are anxious- stop talking about the education and address their
anxiety
88. A teacher states that the child who has ADHD and is on meds, that the ADHD symptoms comes
back after a few hours- that is because the medication has been “cleaned out” and you need to
either switch patient to extended release or place them on multiple daily doses
89. Risk factors for OCD- 1st degree relative, strep
90. PANDAS- sudden onset of OCD symptoms in kids (strep)
91. Factitious disorder- it is a form of abuse for a parent/caregiver to do this to a kid so we have to
call CPS
92. An abused kid living in a foster home who is withdrawn and has no emotion toward caregiver-
Reactive Attachment disorder
93. Patient presents with irritability, depressed mood, labile mood- administer mood questionnaire
94. If a child is having nightmares ask if there are others in the family who have nightmares too.
Nightmares can be inherited so don’t just assume abuse.
95. Do NOT give albuterol with a beta blocker because beta blockers can cause bronco spasms
96. Panic disorder- treat with SSRI
97. A 16 year old with low BMI, thin, BP low- send out for medical evaluation. Parent might not
want this- immediately report to CPS
98. An older (65+) female- a UTI can cause delirium so get a urinalysis with culture and sensitivity
99. The patient used IV drugs and shows dementia signs and symptoms- get HIV test, then send to
PCP to get them on antiretroviral
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1. Patients can have psychotic symptoms and agitation- start with no pharmacological treatment
then atypicals can be given
2. Early signs of HIV dementia include: dystonia, muscle rigidity, and lack of coordination
3. Frontal lobe tumor/dementia- affects social skills and aggression
4. If a patIent is showing signs of lead poisoning- test for lead in their blood
5. An infant is about to die- give infant to parents and allow them to grieve
6. Normalize grief and loss in children- Psychoeducation and supportive group therapy
7. Grief responses vary- so do not tell kids what/how to grieve. With kids the most important thing
is INTACT family support
8. Neurotransmitters in mood disorders- GABA, Glutamate and DNS
9. Osteoporosis risk factors- smoking, caffeine, lack of weight bearing exercise, lack of diet with
calcium and vitamin D
10. Interpersonal learning- patient is not comfortable sharing in group therapy, so we encourage
them to continue to attend groups but also provided private therapy sessions
11. Behavioral therapy- teaches behaviors; problem solving, role playing, skills training, exposure,
relaxation
12. If you have a questions and the answer choices are cognitive therapy and CBT- always pick CBT
13. CBT- cognitive restructuring and journaling
14. Humanistic Therapy- self-directed growth, self-actualization, actualize and find meaning
15. Interpersonal Therapy- if patient has problems with others (spouse/classmate) this tis the
therapy to use…use for relationship problems and it is usually for 12-16 weeks
16. Multisystem Family Therapy (MST)- is used with antisocial peeps
17. Know the population and goals with this therapy
18. Meditation- teach muscle relaxation
19. Physical activity in kids can help- improve body image, promote resilience, improve
relationships, and improve social anxiety
20. Use open ended questions- you only use close ended questions if the patient cannot provide a
NARRATIVE- if they cannot construct a narrative, you can use yes/no questions before asking the
parents for the information
21. If only one spouse shows up to a joint therapy session- reschedule the session
22. A 5-year-old said that his 15-year-old brother sodomized him- insist mom does not leave the 5-
year-old alone, call CPS, arrange crisis therapy
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23. Erythrocyte Sedimentation rate- check if patient has rheumatoid arthritis

24. P- patient, I-intervention, C-comparison, O-outcome, T-time
25. For levels of evidence-
a. Systemic review or meta-analysis
b. At least one RCT
c. The key word is EVIDENCE BASED
d. You should have access to current journal articles
26. Shrill cry from a baby – increased ICP
27. It is normal for a 3–6-year-old to play with their genitals (Phallic Stage)
28. It is normal for a 9–16-year-old boy to develop swelling and tenderness under their nipples- this
goes away in about 6 months (TANNER STAGES)
29. Decreased sex drive in older women can be caused by – decreased testosterone and decreased
blood flow to pelvic region
30. Alcohol dehydrogenase- women have less than men so they are more likely to get drunk and
more likely to develop ETOH induces liver problems
31. If medical and psych providers are working in the same office- it is to increase mental health
access
32. Phosphodiesterase type 5 (PDE5)- Viagra; is rapidly absorbed
33. If patient has normocytic macrocytic anemia- check their folic acid, B12, and iron levels
34. You read an article about teens with ADHD abusing drugs- so in practice you will screen
adolescent with ADHD for substance abuse or screen adolescents that are at risk for abusing
substances for ADHD
35. Acupuncture- can be used for pain or depression
36. Disseminated encephalomyelitis- fatigue, paresthesia, asymmetrical body movements of
extremities- DUE NEURO EXAM
37. You are trying to review the time line of the patient symptoms but they can’t remember- ask
questions to ANCHOR their memory or link to memorable events
38. To educate a patient about medications- 1st assess what they know/believe about that
medication
39. Iatrogenic S/S- give an antipsychotic to a schizophrenic patient and they get TD (it is a symptom
of a treatment) It is import to access the medication history of the patient
40. You are going to create a policy for NPs nationwide- create an online forum for the NPs to give
their responses
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41. You want to add/change a policy at work but your coworkers oppose it- explain to them how the
policy will improve quality of patient care
42. At an outpatient clinic you want continuous improvement of quality of patient care- develop an
instrument to monitor clinical outcomes
43. Autoimmune disease- can lead to increased cytokine levels
44. Desmopressin- used for enuresis because it decreases urine production
45. As providers we cannot look up our patients on social media- it is a violation of their trust
46. A pharmacy company says if you “push” their pill then they will “sponsor” your education and
you want to create a CONFLICT-of-INTEREST policy-1st before creating the policy check industry
providing the samples and industry sponsoring the education
47. There is a new BBW released for a medication your patient is receiving- the patient doesn’t have
to stop taking it, research benefits and risks of continued use
48. If you are giving a patient a medication “off use”- document full disclosure (ie trazodone can be
given off label for sleep so document priapism, document risks and benefits)
49. Risk factors for sleep apnea- obesity, DM, smoking, HTN
50. Tolerance is the decrease of effectiveness of a medication with continued use
51. Reflective Practice- debriefing strategies; like what you do after someone is in restraints
52. Opiate/ETOH withdrawal question- send patient to residential treatment center; DO NOT start
them on benzos