ANCC PMHNP flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Serotonin pathway origin

Serotonin is produced mainly in the raphe nuclei of the brainstem and projects widely to cortex and limbic areas, regulating mood, sleep, appetite, and aggression.

Mesolimbic dopamine pathway

Projects from the ventral tegmental area to the nucleus accumbens and limbic structures; overactivity is linked to positive psychotic symptoms and reward dysregulation.

HPA axis sequence

Hypothalamic CRH stimulates pituitary ACTH release, which stimulates adrenal cortisol; cortisol provides negative feedback to hippocampus, hypothalamus, and pituitary.

Kindling hypothesis

Repeated mood episodes progressively lower the threshold for future episodes, supporting early and continuous mood stabilization in bipolar disorder.

CYP2D6 poor metabolizer

Reduced CYP2D6 activity raises plasma levels of many antidepressants and antipsychotics, increasing adverse effect risk and warranting dose adjustment or alternative agents.

Erikson identity vs role confusion

Adolescent psychosocial stage (roughly 12-18 years) in which the task is forming a coherent sense of self; failure results in role confusion.

Object permanence stage

Piaget's sensorimotor stage (birth to about 2 years) is when infants learn that objects continue to exist when out of sight.

Disorganized attachment

An attachment pattern marked by contradictory or frozen behaviors toward the caregiver, associated with maltreatment and later dissociative and behavioral problems.

PHQ-9 cutoff

A score of 10 or more on the 9-item Patient Health Questionnaire suggests at least moderate depression and warrants further evaluation and treatment planning.

C-SSRS purpose

The Columbia Suicide Severity Rating Scale stratifies suicide risk by assessing ideation, intensity, intent, plan, and behavior to guide safety planning.

CIWA-Ar threshold

A score of roughly 8-10 or higher on the CIWA-Ar indicates clinically significant alcohol withdrawal that generally warrants benzodiazepine treatment.

Mental status exam domains

Standard components include appearance, behavior, speech, mood, affect, thought process and content, perception, cognition, insight, and judgment.

MoCA versus MMSE

The Montreal Cognitive Assessment is more sensitive than the MMSE for mild cognitive impairment; a MoCA score near 26 or below suggests impairment.

Informed consent capacity

Capacity requires the patient to understand information, appreciate its relevance, reason about options, and communicate a choice voluntarily.

Major depressive episode criteria

At least five symptoms for two weeks or more, including depressed mood or anhedonia, causing impairment and not attributable to another condition.

Bipolar I versus II

Bipolar I requires a full manic episode of at least one week or hospitalization; bipolar II requires hypomania of at least four days plus major depression.

Serotonin syndrome triad

Mental status change, autonomic instability, and neuromuscular hyperactivity such as clonus and hyperreflexia; management is stopping serotonergic agents and supportive care.

Neuroleptic malignant syndrome

A life-threatening reaction to dopamine antagonists with fever, rigidity, autonomic instability, altered mental status, and elevated creatine kinase.

Lithium therapeutic range

Serum lithium is typically maintained around 0.6-1.2 mEq/L; levels require monitoring along with renal, thyroid, and calcium function.

MDD first-line agents

SSRIs, SNRIs, mirtazapine, and bupropion are first-line antidepressants; bipolar disorder must be ruled out before starting monotherapy.

ADHD first-line medication

Stimulants such as methylphenidate and amphetamine formulations are first-line; atomoxetine, guanfacine, and clonidine are non-stimulant options.

CBT cognitive model

Cognitive behavioral therapy holds that thoughts mediate feelings and behaviors; interventions include cognitive restructuring, behavioral activation, and exposure with homework.

DBT four modules

Dialectical behavior therapy teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, targeting self-harm and emotional dysregulation.

Motivational interviewing OARS

Core skills are open questions, affirmations, reflections, and summaries; resistance is rolled with rather than confronted directly.

Behavioral activation rationale

Depression maintains avoidance and inactivity; scheduling mastery and pleasure activities increases reinforcement and improves mood.

Exposure therapy mechanism

Graded, repeated, prolonged contact with feared stimuli without avoidance permits habituation and extinction of conditioned fear responses.

Yalom therapeutic factors

Group therapy benefits include universality, altruism, instillation of hope, interpersonal learning, catharsis, and group cohesiveness.

Metabolic monitoring antipsychotics

Second-generation antipsychotics require baseline and periodic weight, waist circumference, blood pressure, fasting glucose, and lipid monitoring.

Tobacco cessation first-line

Varenicline, bupropion, and nicotine replacement are first-line pharmacotherapies; combining them with behavioral counseling improves quit rates.

Edinburgh Postnatal Depression Scale

A validated 10-item screening tool for perinatal depression; elevated scores warrant diagnostic assessment and treatment planning.

Tarasoff duty to protect

When a patient seriously threatens an identifiable victim, clinicians must take protective action such as warning the victim or notifying authorities per state law.

HIPAA psychotherapy notes

Psychotherapy notes receive stricter protection than general records and generally require specific patient authorization for disclosure, separate from treatment, payment, and operations.