Exam 2: NUR208/ NUR 208 (New 2024/ 2025 Update) Mental Health Nursing Review| Q&A, Exams of Nursing

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Exam 2 : NUR20 8 / NUR 20 8 (New 2024/ 2025

Update) Mental Health Nursing Review|

Questions and Verified Answers| 100%

Correct| A Grade – Fortis

QUESTION

In Bulimia nervosa and anorexia nervosa what electrolyte imbalances are we looking for? Answer: Low K+ and low albumin

QUESTION

healthy teaching in bulimia focuses on what? Answer: meal planning, use of relaxation techniques, maintenance of a healthy diet and exercise, coping skills, and teaching about the physical and emotional effects of binging and purging, and the impact of cognitive distortions.

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Describe the milieu of an eating-disorder unit is purposefully organized to what? Answer: help a client establish more adaptive behavioral patterns, including normalizing eating. precise meal times, adherence to the selected menu, observation during and after meals, ad regularly scheduled weighing.

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What is the most important outcome in an anorexic patient?

Answer: A safe weight

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What are underweight or malnourished clients at risk for? Answer: electrolyte imbalances and death

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Fine downy hair on face and back of anorexic patient is called what? Answer: Lanugo

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Findings consistent with anorexia? Answer: cool mottled skin, low blood pressure, pulse, and temperature are findings consistent with a malnourished, dehydrated state noted in clients with anorexia nervosa.

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if diagnosed with anorexia nervosa clients need what? Answer: a highly structured environment that includes precise meal times, adherence to the selected menu, observation during and after meals, and regularly scheduled weighing.

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What is a way that a the nurse can give the client some freedom? Answer: make limited food choices as weight gain progresses.

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Thoughts and behaviors associated with anorexia nervosa Answer: terror of gaining weight, preoccupation with thoughts of food, view of the self as fat even when emaciated, peculiar handling of food. (cutting food into small bits, pushing pieces of food around the plate, possible development of rigorous exercise regimen, possible self-induced vomiting, use of laxatives or diuretics, and cognition so disturbed that the individual judges their self-worth by their weight.

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Rumination Disorder: Answer: undigested food being returned to the mouth - rechewed and reswallowed - neglect, intellectual disability, infants/ children

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Rumination Disorder Answer: the regurgitation of recently eaten food into the mouth followed by either rechewing, reswallowing, or spitting it out

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What are some predisposing factors for the development of rumination disorder?

Answer: intellectual disorder, neglect

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hypersomnolence Answer: excessive daytime sleepiness

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circadian rhythm disorder Answer: misalignment between the timing of normal circadian rhythm and external factors that affect the timing or the duration of sleep

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most common sleep test, used to diagnose and evaluate clients with sleep-related breathing disorders and nocturnal seizure disorders. One or two nights of sleep in a lab with electrodes on head, chest, legs. Answer: polysomnography

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a daytime nap test used to objectively measure sleepiness in a sleep conducive setting Answer: multiple sleep latency test (MSLT)

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When narcolepsy is suspected what 2 tests are suggested? Answer: MSLT and polysomnography

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this test evaluates a clients ability to remain awake in a situation conducive to sleep Answer: maintenance of wakefulness test (MWT)

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used to determine adequate alertness in pilots Answer: maintenance of wakefulness test (MWT)

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this sleep test involves using a wrist watch type tracker that records body movement over a period of time and is helpful in evaluating sleep patterns and sleep duration. - used for circadian rhythm disorder and insomnia Answer: actigraphy

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predisposing factors to insomnia Answer:

night owls, light sleepers, hx of depression and anxiety

QUESTION

a nursing diagnosis appropriate for gender dysphoria includes Answer: disturbed personal identity related to incongruence between expressed and assigned gender. outcomes: seek social support, use healthy coping behaviors to resolve sexual identity issues, acknowledging and accepting sexual identity

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dyspareunia Answer: pelvic pain during intercourse

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referential delusions Answer: client that believes they are receiving messages through the radio

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erotomaniac delusions Answer: when an individual believes falsely that another person is in love with him or her

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persecutory delusions

Answer: beliefs of being targeted by others

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Acute stress can lead to what? Answer: sad mood, loss of appetite, increased B/P, risk for clots/stroke, decreased memory and learning, impotence

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chronic stress can lead to what? Answer: anxiety/panic, major depressive disorder, lowered resistance, anorexia or overeating, insulin- resistant diabetes, greater risk for cardiac events/ respiratory issues immunodeficiency, and hypersensitivites.

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what can impact stress? Answer: perception, temperament, support systems, age, gender, culture/religion/spirituality

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interventions to stress? Answer: relaxation exercises, biofeedback, mindfulness, meditation, cognitive reframing, journaling, humor

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what stage of anxiety is trembling and a pounding heart? Answer: severe anxiety

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what stage of anxiety are tremors and tension? Answer: moderate anxiety

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what stage of anxiety are restlessness and irritability? Answer: mild anxiety

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withdrawal and hallucinations occur in relation to what stage of anxiety? Answer: panic

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Basic Level psychiatric-mental health registered nurses use counseling for what? Answer: reduce anxiety, enhance coping and communication skills, and intervene in crisis.

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When patients request or prefer to use integrative therapies, the nurse what? Answer: performs assessment and teaching as appropriate

QUESTION

Cognitive restructuring helps with what four things? Answer: helps the patient (1) ID automatic negative beliefs that cause anxiety, (2) explore the basis for these thoughts (3) reevaluate the situation realistically, and (4) replace negative self-talk with supportive ideas.

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involves teaching and physical practice of activities to decrease anxious or avoidant behavior Answer: behavioral therapy

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guided imagery Answer: focuses on pleasant images and replaces negative or stressful feelings. Guided imagery may be self-directed or led by a practitioner or a recording

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Progressive Relaxation

Answer: can be used anywhere and involves eliminating muscle contraction, which helps reduce anxiety.

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Biofeedback Answer: Involves using a recording device and cannot be used anywhere. Meditation helps a client relax but not by eliminating muscle contraction.

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defense mechanisms: sublimination is what? Answer: ALWAYS HEALTHY

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Defense mechanisms: Projection is Answer: ALWAYS UNHEALTHY

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is deterrent therapy used for clients with schizophrenia? Answer: no, this is a medication therapy to prevent a client from using a certain substance as alcohol

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appropriate nrsg intervention for an agitated client? Answer: reduce excess stimulation, increased supervision or isolating the client my increase agitation and the clients risk for violence

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frotteuristic disorder Answer: A paraphilic disorder consisting of repeated and intense sexual urges, fantasies, or behaviors that involve touching and rubbing against a non-consenting person.

QUESTION

The standard treatment for paraphilic disorders is what/ Answer: cognitive-behavioral therapy

QUESTION

Drugs that cause sexual disfunction methyldopa Answer: methyldopa-amenorrhea, breast enlargement, gynecomastia, lactation, impotence, decreased libido

QUESTION

thiazides cause Answer:

impotence

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clonidine causes Answer: erectile dysfunction, decreased libido

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propranolol causes Answer: impotence, peyronie disease

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digoxin causes Answer: gynecomastia

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clofibrate causes Answer: decreased libido, impotence

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priority outcome for a pt with exhibitionist disorder

Answer: identify feelings that lead to impulsive actions and consequences and ultimately learn to practice self-restraint of impulsive behaviors

QUESTION

first generation antipsychotics Answer: dopamine (D2) anagoniss in both limbidc and motor centers. Blockage of Dw receptors in motor areas causes extrapyramidal side effects target the POSITIVE symptoms of schizophrenia

QUESTION

haloperidol (Haldol) Answer: a sudden high fever is a sign of neuroleptic syndrome, a rare but serious complication of first-gen antipsychotics. Dry mouth, drowsiness, and hypotension are all potential side effects

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Second Gen antipsychotics Answer: atypical antipsychotics, lower risk of extrapyramidal side effects and tardive dyskinesia. serotonin receptor binding exceeds their affinity for dopamine d2 receptors

QUESTION

clozapine can cause Answer:

• Agranulocytosis, may cause elevated blood glucose; however, the level reported is within a normal range. no advers effect on the liver and the bilirubin is within an acceptable range.

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Risperidone can cause Answer: orthostatic hypotension. and should not be stopped abruptly. may cause fatigue. atypical antipsychotic

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positive symptoms of schizophrenia Answer: somatic delusions, hallucinations, disorganized speech.

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negative symptoms of schizophrenia Answer: social isolation and flat affect

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Aripiprazole Answer: thrid gen antipsychotic

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Aripiprazole (abilif) can cause what? Answer: neuroleptic malignant syndrome, temp of 101.9 goes to privider and this is life-threatening

QUESTION

Lisdexamfetamine dimesylate (Vyvanse) Answer: central nervous stimulant used to treate ADHD. also used to treat severe binge eating disorder.

QUESTION

if pt has psychotic polydipsia and delirium the nurse should check for what? Answer: hyponatremia

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Cluster A: Answer: Odd/eccentric

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schizoid personality disorder (cluster A) Answer: appear cold, aloof, indifferent to others, and prefer to work in isolation

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Schizotypal Personality Disorder (Cluster A) Answer:

a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior- magical mythical thinking

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Paranoid Personality Disorder (Cluster A) Answer: marked by a pervasive distrust of others and suspicion regarding their motives

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Cluster B: Answer: intrusive/erratic/inconsiderate

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borderline personality disorder Answer: impulsivity. self destructive. chronic suicidal ideation. nurses should provide clear and consistent boundaries and limits to this staff splitting behavior

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General anxiety disorder Answer: excessive or unrealistic worry about life circumstances that lasts for at least six months

QUESTION

what did Walter Cannon research in the sympathetic nervous system?

Answer: He described acute stress response, now commonly described as fight (aggression) and flight (withdrawl).

QUESTION

What are some things that dictate how we react to stressors? Answer: developmental stage, previous experiences, and sociocultural background.

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What are some psychological stressors? Answer: events like financial challenges, loss of a job, divorce, death of a loved one, and can also be related to changes that are considered positive like marriage and the birth of a new baby.

QUESTION

What are some physiological stressors? Answer: includes environmental conditions such as trauma, infection, hemorrhage, hunger and pain, excessive heat/cold.

QUESTION

HPA axis (hypothalamic-pituitary-adrenal axis) Answer: propels us to be alert. The pituitary secrets the hormone ACTH- the result is more cortisol is produced to increase glucose in blood and increase muscle endurance. Keeps us alert!

QUESTION

GAS (general adaptation syndrome)(Hans Selye) Answer: the ALARM stage is the initial, brief, and adaptive response (fight or flight) to the stressor. It begins with the eyes or ears sending information such as a car running a light or the sound of a fire alarm to the brain's amygdala.

QUESTION

If the amygdala interprets the stressor as a threat it tells the Answer: hypothalamus

QUESTION

If the threat subsides the other part of the autonomic nervous system puts on the brakes- its called what? Answer: Parasympathetic nervous system

QUESTION

If the threat continues, what stage follows? Answer: resistance

QUESTION

The third stage is what? where stress can become chronic and contribute to anxiety disorders, major depressive disorder, sleep disorders, digestive problems, heart disease, and wt gain

Answer: Exhaustion