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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Advanced Practice Skills | 24% | - Psychotherapy Modalities
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| Topic 2: Professional Role and Policy | 14% | - Collaboration and Consultation
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| Topic 3: Scientific Foundation | 19% | - Research and Evidence-Based Practice
|
| Topic 4: Diagnosis and Treatment | 43% | - Treatment Planning
|
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NEW QUESTION # 1292
A patient is prescribed memantine to treat moderate to severe Alzheimer's disease. Which of the following medications is frequently prescribed with memantine?
Answer: D
Explanation:
Memantine is an N-methyl-D-aspartate (NMDA) receptor antagonist that is FDA-approved for the treatment of moderate to severe Alzheimer's disease. It is believed to work by regulating the activity of a neurotransmitter called glutamate, which is involved in learning and memory. The prescribing guidelines for memantine include using it in combination with a cholinesterase inhibitor as it is more effective than monotherapy in treating moderate to severe Alzheimer's disease.
Memantine should not be used as monotherapy. It should not be used in combination with an antidepressant or antipsychotic, as these are not evidence-based treatment options for Alzheimer's disease.
NEW QUESTION # 1293
As a nurse practitioner, you are responsible for assessing cranial nerves as part of a neurological exam. What cranial nerve assessment tests the patient's gag reflex?
Answer: C
Explanation:
Olfactory nerve (CN I)
The olfactory nerve transmits information to the brain regarding a person's sense of smell. This cranial nerve assessment is performed by having the client close their eyes to identify familiar odors.
Optic nerve (CN II)
The optic nerve transmits information to the brain regarding a person's vision.
Oculomotor nerve (CN III)
The oculomotor nerve helps control muscle movements of the eyes. The oculomotor nerve provides movement to most of the muscles that move the eyeball and upper eyelid, known as extraocular muscles. The oculomotor nerve also helps with involuntary functions of the eye.
Trochlear nerve (CN IV)
The trochlear nerve is also involved in eye movement. The trochlear nerve, like the oculomotor nerve, originates in the midbrain. It powers the contralateral superior oblique muscle, which allows the eye to point downward and inward.
Trigeminal nerve (CN V)
The trigeminal nerve is the largest cranial nerve and has both motor and sensory functions. Its motor functions help a person to chew and clench the teeth and give sensation to muscles in the tympanic membrane of the ear. This test is performed by touching the face and corneal reflex of the eye with a wisp of cotton and pin-pricking the skin and mucosa to test touch.
Abducens nerve (CN VI)
The abducens nerve also helps control eye movements. It helps the lateral rectus muscle, which is one of the extraocular muscles, to turn the gaze outward.
Facial nerve (CN VII)
The facial nerve functions to produce facial expressions and has both motor and sensory functions.
Vestibulocochlear nerve (CN VIII)
The vestibulocochlear nerve is involved with a person's hearing and balance. It is assessed by checking the client's hearing using an audiometer or by simply whispering in the client's ear. Hearing loss is tested with the Weber and Rinne tests.
Glossopharyngeal nerve (CN IX)
The glossopharyngeal nerve possesses both motor and sensory functions. It is involved with the sensation of taste on the back of the tongue.
Vagus nerve (CN X)
The vagus nerve has a range of functions, providing motor, sensory, and parasympathetic functions. It plays a role in taste sensation, provides movement to the throat and soft palate, and regulates heart rhythm.
Accessory nerve (CN XI)
The accessory nerve provides motor function to the neck. It controls muscles that allow a person to rotate, extend, and flex the neck and shoulders. The cranial part of the accessory nerve combines with the vagus nerve.
Hypoglossal nerve (CN XII)
The hypoglossal nerve is a motor nerve that supplies the tongue muscles.
NEW QUESTION # 1294
Which practice should the PMHMP avoid when using email to communicate therapeutic information and observations to other healthcare providers?
Answer: D
Explanation:
Emails should not contain passwords or information that could be intercepted and compromise patient information.
Any email that contains any patient identifier, clinical observations, or opinions should be sent securely. The document should be treated as if it is a public document. All emails sent regarding patient care should be printed and attached to the medical record.
NEW QUESTION # 1295
If a patient threatens to commit suicide, what legal doctrine allows a nurse practitioner to admit them involuntarily to a psychiatric hospital?
Answer: B
Explanation:
The criteria for involuntary admission comes from the legal doctrines of police power (state as protector) and parens patriae (state as parent). Parens patriae allows the state to intervene and act as a surrogate parent for those who are unable to care for themselves or who may harm themselves. Police power allows the state to intervene if the patient is a danger to others.
NEW QUESTION # 1296
You are a new nurse practitioner opening a clinic specifically to treat children and adolescents. You have an initial evaluation appointment today with the mother of a six-year-old who is concerned about her daughter's inability to keep up with schoolwork. You decide to screen for autism spectrum disorder (ASD).
Which of the following assessments is least appropriate for screening this patient for ASD?
Answer: B
Explanation:
Although this is an evidence-based and adequate tool, it is for toddlers only; this patient is too old for this assessment tool.
Screening for developmental delays is a critical component of assessing for ASD. Checklists for this include the following:
* Modified Checklist for Autism in Toddlers (Age-Specific)
* Autism Diagnostic Observation Schedule-Generic (ADOS-G)
* Ages and Stages Questionnaires
Parents may also report the following symptoms:
* No cooing by age one year, no single words by age 16 months, no two-word phrases by age 24 months
* Loss of language skills
* No imaginary play
* Little interest in playing with other children
* Extremely short attention span
* No response when called by name
* Little or no eye contact
* Intense tantrums
* Fixations on single objects
* Unusually strong resistance to changes in routines
* Oversensitivity to certain sounds, textures, or smells
* Appetite or sleep-rest disturbance, or both
* Self-injurious behavior
NEW QUESTION # 1297
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