These PMHNP-BC practice questions target management — including Antabuse, Strongly Avoid, Beers Criteria, Desensitization Phase. The complete PMHNP-BC deck holds 1040 flashcards, 180 of them dedicated to this topic. Study the free samples below, then unlock the whole collection for a one-time $7.
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A patient presents with mutism, posturing, and waxy flexibility. After medical stabilization, what is the first-line pharmacological intervention and how is the response typically assessed?
Show answer →The first-line treatment for catatonia is the Lorazepam (Ativan) Challenge. Start with 1-2 mg IV/IM/PO; a positive response (50-100% reduction in symptoms within 30-60 mins) confirms the diagnosis and guides treatment. If successful, continue scheduled dosing (often 6-12 mg/day). If lorazepam fails or the patient is unstable (Malignant Catatonia), Electroconvulsive Therapy (ECT) is the definitive gold standard. Strategy: ANCC emphasizes the challenge as both diagnostic and therapeutic.
A patient on Disulfiram (Antabuse) accidentally consumes alcohol. Describe the biochemical mechanism and the resulting clinical symptoms expected.
Show answer →Disulfiram inhibits the enzyme aldehyde dehydrogenase, causing a toxic accumulation of acetaldehyde in the blood. The disulfiram-alcohol reaction includes flushing, throbbing headache, nausea, violent vomiting, chest pain, palpitations, dyspnea, and hypotension. Patient Education: Patients must avoid all hidden alcohol sources (mouthwash, vinegar, sauces, aftershave, hand sanitizer) for up to 2 weeks after the last Disulfiram dose, as the enzyme inhibition is irreversible and takes time to regenerate.
A 74-year-old male with MDD and BPH is taking Paroxetine. He reports worsening memory and urinary retention. Which pharmacological property makes Paroxetine a Strongly Avoid on the Beers Criteria for this patient?
Show answer →Paroxetine has significant anticholinergic properties. In geriatrics, anticholinergics increase risks of cognitive impairment, delirium, falls, and urinary retention (worsening BPH). Beers Criteria emphasizes anticholinergic burden. Exam Tip: For geriatric depression, Sertraline or Escitalopram are preferred due to lower anticholinergic profiles. When you see BPH + Confusion in a vignette, look for an anticholinergic culprit like Paroxetine or Amitriptyline.
In DBT, what is the 24-hour rule regarding telephone coaching after an act of self-injurious behavior?
Show answer →The therapist **cannot provide coaching/consultation for 24 hours** after the patient has engaged in self-harm. Rationale: This prevents the therapeutic attention from acting as a **positive reinforcer** for the self-harming behavior. The goal is to coach the patient *before* they act, not provide a reward (attention) after they act. This is a common point of confusion on exams.
During the Desensitization Phase (Phase 4) of EMDR, what metric is used to evaluate the emotional charge of the target memory, and what is the desired clinical goal?
Show answer →The Subjective Units of Disturbance (SUD) scale (0-10) is used. The goal is for the SUD to reach 0 (or an ecologically valid 1) regarding the target memory before moving to the next phase. The PMHNP continues sets of Bilateral Stimulation (BLS) until the patient reports the memory no longer carries an emotional charge. ANCC Strategy: Differentiate SUD (used in Phase 4 for distress) from VOC (used in Phase 5 for positive beliefs).
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Try 30 free PMHNP-BC cards firstThe full PMHNP-BC deck contains 1040 flashcards, and 180 of them focus on management. This page shows 5 free samples.
Our PMHNP-BC deck dedicates 180 of 1040 cards (17%) to management — always cross-check the official ANCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the PMHNP-BC preview page has 30 more free cards. Full access to all 1040 cards is a one-time $7.
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