ANCC PMHNP Exam (2026) 100%VERIFIED |complete QUESTIONS AND ANSWERS | GRADED A+.

mesocortical pathway

executive function: attention, focus, depression

nigrostriatal pathway

from substantia nigra (brainstem) to striatum (muscles): Parkinson's

mesolimbic pathway

projects to nucleus accumbens (part of limbic system). Pleasure, reward, positive symptoms of schizophrenia: Addiction, gambling

Tuberoinfundibular pathway

regulation of prolactin (acts on pituitary). Hypersexuality in mania

Dopamine

produced in substania nigra and VTA. D2 & D4 receptors most important. Elevated in the mesolimbic pathway associated with pleasure and psychosis. Antispychotics block dopamine. travels through mesocoritcal, mesolimbic, nigrostriatal, and tuberinfundibular pathways

Serotonin

5-HT. produced in raphe nucleus. emotion, impulses, dreams. 5HT2A receptors = atypical antipsychotics.

Norepinephrine

produced in locus coeruleus. arousal and vigilance

GABA

inhibitory. produces calm in conjunction with benzodiazepines.

ACTH

motor control, learning, memory, sleep, and dreams. Helps with balance. Decrease in Alzheimer's disease

hypothalamus-pituitary-adrenal axis (HPA)

CRH, ACTH, then cortisol. Worsens with stress and depression

hypothalamus-pituitary-thyroid (HPT)

TRH, TSH, T4. Hypothyroid causes depression, weight gain, slow metabolism. Hyperthyroid is opposite.

hypothalamus-pituitary-gonadal (HPG)

GnRH, FSH, LH. Malfunctions cause infertility problems.

gray matter

neurons are found

frontal lobe

executive function, voluntary movement, speech (Broca's area)

Temporal lobe

memory, cognition, speech, emotions (aka limbic area)

parietal lobe

receive and process sensory input

Wernicke's area

temporal and parietal lobes; speech

amygdala

fear response.

hippocampus

memory. Make up limbic system with amydgala

HIPAA

1. education about privacy protection, 2. access to own medical records, 3. request amendment to health information to which they object, 4. require permission for disclosure of medical issues

forensic nursing

based on crime committed and investigational aspects

correctional nursing

offender's current mental health and medical condition

research utilization process

critique, synthesize, apply, measure

PICO question

patient, intervention, comparison, outcome

internal validity

when the independent variable (treatment) caused a change in the dependent variable (outcome)

external validity

when the sample is representative of the population and the results can be generalized

descriptive statistics

used to describe the basic features of the data in the study

standard deviation

indication of the possible deviations from the mean

variance

how the values are dispersed around the mean - the larger the variance, the larger the dispersion of scores

inferential statistics

numerical value that enable one to reach conclusions that extend beyond immediate data alone - generated by quantitative research designs

t-test

assess whether means of 2 groups are statistically different from each other

ANOVA

analysis of variance - tests difference of 3 or more groups

Pearson's r-correlation

relationship between 2 variables

probability

0-1: likelihood of an event occurring

p value

level of significance: describes the probability of a particular result occurring by chance alone

HOPE

sources of hope, organized religion, personal spirituality, effects on medical care/end of life

OLDCARTS for HPI

onset, location, duration, character, alleviating/aggravating factors, radiation, time of occurrence, severity

Cranial Nerves

Olfactory, optic, ocular motor, trochlear, trigeminal, abducens, facial, acoustic, glossopharyngeal, vagus, accessory spinal, hypoglossal

dysdiadochokinesia

inability to perform rapid alternating movements (finger to thumb), cerebellar lesion

astereognosis

inability to distinguish objects (such as paperclip) based on touch, parietal lesion

Free T4

0.8-2.8

TSH

0.4-0.5 - decreases when T3 & T4 are high, increases when T3 & T4 are low. Elevated in primary hypothyroidism. Values may decrease with aspirin, steroids, and heparin. Values may increase with lithium.

calcium

8.8-10.5. 99% found in bone. major cation for bones and teeth. higher in kids because of bone growth.

sodium

135-148

magnesium

1.3-2.1.

chloride

98-106

potassium

3.5-5.1. value decrease with lithium, diuretics. marijuana use can elevate K

ALT

5-35.

AST

5-40

GGT

gamma glutamyl transpeptidase - 10-38. Used to evaluate alcohol abuse because levels rise after only a small ingestion of alcohol.

teratogenic risks of benzodiazepines

floppy baby, cleft palate

teratogenic risks of tegretol

neural tube defects

teratogenic risks of lithium

Epstein anomaly

teratogenic risks of depakote

neural tube defects such as spina bifida

Rogers

Humanistic theory: person centered therapy

Beck

CBT

Lazarus

Behavioral therapy

Marsha Linehan

DBT

Frankle

Existentialism: reflection on life and encouragement of self-confrontation. "Why am I here? What is my purpose?"

Klerman and Weissman

Interpersonal therapy: time limited, problem focused

Shapiro

EMDR: used to treat PTSD

Yalom

Group therapy: 10 guiding principles for group

Bowen

Family systems theory

Minuchin

Structured family therapy

Satir

Experiential therapy: behavior is determined by personal experience. Focus is on being authentic

Haley

Strategic therapy: symptoms are metaphors and reflect problems in the hierarchal structure

deShazer, O'Hanlon, Berg

Solution-focused therapy: miracle questions, exception finding questions, scaling questions

PANDAS

pediatric autoimmune neuropsychiatric disorders associated with strep: consider with children who have OCD symptoms

schizophrenia

excess dopamine in the mesolimbic pathway and decreased dopamine in the mesocoritcal pathway. Excess glutamate, decreased GABA, decreased serotonin

atypical antipsychotics

D2 and 5HT2a blockade: treat both positive and negative symptoms of schizophrenia

Neuroleptic malignancy syndrome

Elevated CPK, elevated WBC, elevated LFT. Autonomic instability.

Bromocriptine (Parlodel) and dantrolene (Dantrium)

Treatment for NMS

DELIRIUM

drugs, electrolytes, low 02 sat, infection, reduced sensory input, intracranial, urinary, myocardial

Pick's Disease

frontotemporal dementia: more common in men, personality/behavioral changes in early stages, cognitive changes later

Kluver-Bucy syndrome

hypersexuality, hyperorality, and placidity

Creutzfeld-Jakob disease

fatal, rapidly progressing, fatigue and flu like symptoms, cognitive impairment. Later aphasia, apraxia, emotional lability

Huntington's disease

subcortical type of dementia characterized by choreoathetoid movements

Lewy body disease

Lewy bodies in cortex, Parkinson's features, adverse reaction of antipsychoticsMeman

BUN

6-20

creatinine

0.6-1.2