Free PMH-BC Exam Flashcards

A structured snapshot of current appearance, behavior, speech, mood and affect, thought, perception, cognition, insight, and judgment. It supports assessment but does not by itself establish a psychiatric diagnosis.

An acute, fluctuating change with impaired attention and awareness. Treat it as a possible medical emergency and assess for causes such as infection, medication effects, withdrawal, or metabolic disturbance.

Infection, thyroid disease, neurologic illness, medication effects, intoxication, withdrawal, and metabolic problems can mimic or worsen psychiatric illness. New or atypical symptoms require medical as well as psychiatric assessment.

Ask about suicidal thoughts, plan, intent, access to means, prior suicidal or self-harm behavior, current risk factors, and protective factors. Use an evidence-based process and clinical judgment to determine the overall risk level.

A hallucination is a perception without an external stimulus, such as hearing a voice no one else hears. A delusion is a fixed false belief that persists despite evidence inconsistent with it.

It describes whether the observed emotional expression fits the patient's stated mood and the situation. Congruence is documented separately from affect range, intensity, stability, and appropriateness.

Attributing one's own unacceptable feelings, impulses, or motives to someone else. For example, a person who feels hostile may insist that another person is hostile toward them.

Establish safety, explain why information is requested, ask permission, let the patient control pacing, and avoid pressing for unnecessary detail. Pause when distress rises and follow the patient's choices whenever safety permits.

It requires timely, direct follow-up assessment of suicidal thoughts and self-harm risk. The item is a screening signal; it does not alone determine diagnosis, intent, or the final level of suicide risk.

The patient has limited recognition of symptoms, illness, consequences, or need for care. Insight can vary by topic and over time, so document the specific evidence rather than using the label alone.

Ego integrity versus despair. Reviewing life with acceptance and a sense of coherence supports integrity; pervasive regret and lack of meaning can contribute to despair.

It is Specific, Measurable, Achievable, Relevant, and Time-bound. A SMART goal states the observable outcome and time frame rather than a vague aim such as “feel better.”

Begin with the patient's priorities, strengths, preferences, culture, and personally meaningful goals. Clinical recommendations are developed collaboratively around those goals and current safety needs.

Planning that identifies abilities, coping skills, resources, successes, and supports that can advance recovery. It addresses risks and symptoms without defining the person only by deficits.

With the capable patient's permission, identify whom the patient wants involved and define each supporter's role. Follow privacy law, consent, and safety exceptions rather than assuming family participation.

It replaces assumptions with respectful inquiry about identity, beliefs, explanatory models, preferences, and structural barriers. The nurse reflects on personal bias and adapts the plan with the patient.

Arrange a qualified medical interpreter and translated materials when available. Speak to the patient directly, use short clear statements, and avoid relying on a child or untrained family member except during a true emergency.

Ask the patient to explain the plan in their own words to check how clearly it was taught. If understanding is incomplete, rephrase, reduce the information into smaller pieces, and check again without blaming the patient.

Severe anxiety, psychosis, intoxication, withdrawal, cognitive impairment, pain, and fatigue can limit learning. Match timing, format, pace, and repetition to the patient's current ability and motivation.

It uses shared patient-centered goals, assigns clear responsibilities, reconciles recommendations, and identifies how the team will communicate changes. Parallel discipline notes alone do not ensure coordination.

Personal warning signs, internal coping strategies, supportive people and places, professional and crisis contacts, and steps to reduce access to lethal means. It should be individualized, accessible, and reviewed with the patient.

Specify follow-up appointments, medications and access, crisis contacts, warning signs, transportation, housing or social needs, and who will complete each next step. Confirm understanding and close gaps before transition.

CBT links thoughts, emotions, and behaviors. Patients learn to identify unhelpful patterns, test them against evidence, and practice more adaptive thinking and behavior.

Care emphasizes hope, self-direction, strengths, choice, meaningful roles, and multiple paths to recovery. Symptom management supports the person's own life goals rather than becoming the only outcome.

Realize trauma's impact, Recognize its signs, Respond by integrating that knowledge into practice, and actively Resist retraumatization.

To orient attention to present-moment sensory experience when anxiety, dissociation, or intrusive memories are overwhelming. It is a coping tool, not a substitute for safety assessment or needed treatment.

Monitor airway, breathing, circulation, vital signs, and recovery from anesthesia; then assess orientation and common effects such as confusion, headache, or nausea. Follow the facility's post-anesthesia and ECT protocol.

rTMS uses targeted magnetic pulses and generally does not require anesthesia or intentionally induce a seizure. ECT uses anesthesia and a controlled therapeutic seizure.

Situation, Background, Assessment, and Recommendation or request. The receiving clinician should have an opportunity to ask questions and confirm critical information.

It provides predictable structure, clear expectations, consistent boundaries, respectful relationships, meaningful activity, and the least restrictive level of supervision needed for current risk.

Use one calm communicator, maintain personal space and an exit path, reduce stimulation, listen, validate emotion, and offer simple choices. Continually reassess for medical causes and increasing danger.

Only for immediate physical safety after less restrictive interventions fail. Never use it for coercion, discipline, convenience, or retaliation. Use the least restrictive effective option, follow current law, orders, and policy, and stop at the earliest possible time.

Restating the feeling or meaning in the patient's message so the patient can clarify and explore it. Reflection is not parroting every word or shifting attention to the nurse's experience.

Acknowledge the emotion and present a calm, reality-based perspective without arguing or endorsing the belief. Assess whether the belief is directing unsafe behavior.

A collaborative, nonconfrontational style that uses open questions, affirmations, reflective listening, and summaries to elicit the patient's own reasons and confidence for change.

Creating the best possible medication list and comparing it with current orders at care transitions. Resolve unintended omissions, duplications, dose errors, interactions, and discrepancies with the prescribing team.

New vomiting or diarrhea, drowsiness, muscle weakness, poor coordination, coarse or worsening tremor, slurred speech, confusion, or ataxia require prompt evaluation. Hold further doses and escalate according to the prescription, current findings, and facility protocol.

They may signal severe neutropenia and life-threatening infection. Notify the prescribing team promptly and obtain evaluation and ANC monitoring per current labeling. FDA removed the Clozapine REMS on June 13, 2025; enrollment and REMS reporting ended, but ANC monitoring remains.

Mental-status change plus autonomic instability and neuromuscular hyperactivity, especially clonus or hyperreflexia; fever and gastrointestinal symptoms may occur. Suspected cases need urgent medication review and medical evaluation.

Neuroleptic malignant syndrome (NMS). This potentially fatal reaction features hyperthermia, severe muscle rigidity, altered mental status, and autonomic instability after exposure to a dopamine-blocking drug; treat it as a medical emergency and escalate immediately.

Track weight and body mass index, blood pressure, glucose or A1C, and lipids according to the medication and care protocol. Monitoring supports early intervention for weight gain, dysglycemia, and dyslipidemia.

Implement constant qualified one-to-one visual observation that permits immediate intervention and remove or mitigate accessible hazards. Follow the ordered precautions, organizational policy, and documented risk-mitigation plan.

Set a clear goal, establish respectful ground rules, invite participation without coercion, keep content understandable, check learning, and redirect discussion to the group's purpose.

Ask about tobacco use, Advise quitting, Assess readiness, Assist the quit attempt, and Arrange follow-up. Tailor assistance to readiness rather than withholding support from someone not ready today.

A direct connection to the next clinician or service while the patient is present, with essential information and responsibility clearly transferred. It reduces reliance on the patient to navigate a referral alone.

It provides a consistent trend that can supplement the interview, functional assessment, adverse-effect review, and patient goals. A score change informs care but does not replace clinical judgment.

Reassess symptoms, safety, adherence, adverse effects, barriers, supports, and the patient's priorities. Collaborate with the treatment team if a working diagnosis or intervention needs reconsideration, then revise the nursing plan or goal and document the rationale and follow-up.

The patient receives understandable information about the proposed intervention, material risks and benefits, alternatives, and the option to refuse; has decision-making capacity; and chooses voluntarily. Follow state law and facility policy.

A covered provider may disclose necessary information in good faith to someone reasonably able to prevent or lessen a serious and imminent threat. The disclosure must also be consistent with applicable law and ethical standards.

It supports internal safety review and process improvement after an unusual event. Document objective clinical facts and the patient's response in the health record; complete the separate report according to policy without using it to assign blame.