Exam 3: NUR208/ NUR 208 (New 2024/ 2025 Update) Mental Health Nursing Review| Q&A, Exams of Nursing

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Exam 3 : NUR208/ NUR 208 (New 2024/ 2025

Update) Mental Health Nursing Review|

Questions and Verified Answers| 100%

Correct| A Grade – Fortis

QUESTION

How does light therapy work? Answer: It suppresses the production of melatonin

QUESTION

Somatic symptom disorder Answer: characterized by a focus on somatic (physical) symptoms, such as pain or fatigue to the point of excessive concern, preoccupation, and fear. Client suffering is authentic, high levels of functional impairment. some are care seekers and some are care avoiders

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factitious disorders Answer: a person intentionally causes or perpetuates he illness. "by proxy" imposed on another is a condition where a person intentionally causes or perpetuates the illness of a loved one.

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factitious "by proxy"

Answer: imposed on another is a condition where a person intentionally causes or perpetuates the illness of a loved one.

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what three things are we accessing for in a suicidal pt? Answer: ideation, plan, lethality of plan

QUESTION

SBIRT

Answer: Screening, Brief Intervention, and Referral to Treatment

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why do we use SBIRT Answer: evidence based practice used in healthcare settings to ID, reduce, and prevent problematic use, abuse, and dependence on alcohol and illicit drugs. encourages mental health and substance abuse screenings as a routine preventative surface

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PHQ

Answer: Screens for depression in primary care populations with medical co-morbidities

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Minnesota Multiphasic Personality Inventory (MMPI) Answer: a psychological test that assesses personality traits and psychopathology. It is primarily intended to test people who are suspected of having mental health or other clinical issues.

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AUDIT- Alcohol Use Disorders Identification Test Answer: 10 item screening test developed by the World Health Organization and is sensitive for deterring alcohol dependence and abuse

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Compensation Answer: a strategy whereby one covers up weakness, frustrations, desires, or feelings of inadequacy.

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Suppression Answer: unwanted thoughts or emotions

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codependency Answer:

an emotional and behavioral condition tat affects an individual's ability to have a healthy, mutually satisfying relationship.

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denial Answer: when a client justifies their reasons for substance abuse

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inhalant abuse concerns Answer: CNS depressants. Excessive amts can cause cardiac and respiratory depression. No way to control amount. visions, hallucinations, feelings of euphoria.

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when do you experience delirium during alcohol withdrawl? Answer: anytime in the 1st 72 hours.

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What are s/s of someone in alcohol withdrawl? Answer: autonomic hyperactivity: tachycardia, diaphoresis, fever, anxiety, insomnia, hypertension. delusions and visual and tactile hallucinations

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treatment for alcohol withdrawl Answer: therapy, education and instructions to help the person learn to manage triggers and craving for continued abuse.

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What can we do to to reduce confusion/frustration in the Alzheimer's disease? Answer: structured routine

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agnosia Answer: the inability to recognize familiar objects.

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apraxia Answer: inability to perform particular purposive actions, as a result of brain damage.

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Aphasia Answer: impairment of language, usually caused by left hemisphere damage either to Broca's area (impairing speaking) or to Wernicke's area (impairing understanding).

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extinction Answer: the gradual weakening and disappearance of a conditioned response tendency

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PAINAD scale Answer: the best tool for assessing pain in the elderly adult with dementia

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what is the PAINAD scale assessing? Answer: breathing, independent of vocalization, negative vocalization, facial expression, body language, consolability

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a client in seclusion in restraints should be assessed for what? Answer: toileting, nutrition, hydration, circulation, ROM for each extremity, level of comfort.

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the two most significant predictors of violence Answer: a history of violence and a history of impulsivity

QUESTION

SANEs (sexual assault nurse examiners) collect evidence how? Answer: a camera, DNA swabs, body maps are used to collect/preserve bodily fluids and other forensic evidence.

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reactions during the acute phase of PTSD after a sexual assult Answer: shock, disbelief, confusion, dulled sensory and memory functions

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intrusive symptoms of PTSD Answer: Recurrent, intrusive, involuntary memories; distressing dreams; dissociative reactions (flashbacks); intense distress at cues of events (internal or external); physiological reactions to cues

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Dissociative symptoms (PTSD) Answer: altered sense of reality and an inability to remember parts of the traumatic event. Avoidance: changing routines to escape situations similar to the trauma.

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Some other symptoms of PTSD Answer: decreased ability to feel certain emotions, unable to remember major parts of the trauma, bleak future, arousal symptoms, difficulty concentrating or falling asleep, easily startled, tense, angry outbursts.

QUESTION

what three symptoms are strongly suggestive of opioid overdose? Answer: coma, pinpoint pupils, respiratory depression

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This drug is used for alcohol withdrawal Answer: Ativan (lorazepam)

QUESTION

Disulfiram (Antabuse) is used as an effective tx for chronic alcoholism by discouraging alcohol consumption. Clients will experience what s/s withing mins of consuming alcohol? Answer: headaches, nausea, vomiting, hypotension, tachycardia

QUESTION

What may St. Johns wort interact with? Answer: other meds used to tx depression or mood disorders such as tricyclic antidepressants, SSRIs, monoamine oxidase inhibitors

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clinical manifestations of Bipolar I: mania Answer: clanging speech patterns, psychosis, claim of superpower or hallucinations.

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Importance of medication therapy in bipolar I? Answer: priority goal is safety during manic phases and med adherence.

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Bipolar II includes Answer: symptoms of hypomania without psychosis followed by major depression.

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How should we communicate with a pt that has mania? Answer: therapeutic communication, telling the client to calm down may escalate the behavior. set limits/boundaries

QUESTION

In bipolar I, what is an issue that is associated with an increased risk for suicide?

Answer: more than 50% have an alcohol use disorder and more than half have a substance use disorder.

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what increases the risk for suicide when depression is present? Answer: hopelessness, substance abuse problems, A recent loss or separation, a hx of past suicide attempts, acute suicidal ideation

QUESTION

Objective assessment finding of depression Answer: pt will appear socially withdrawn, may have disheveled appearance, exhibit anhedonia (inability to feel pleasure)

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When do we use ECT? Answer: when a rapid, definitive response is needed to prevent suicide

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why are vagal nerve stimulators used? Answer: for depression to boost levels of neurotransmitters to improve mood.

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Trans Magnetic Stimulation (TMS) Answer: a non-invasive tx which exposes the cerebral cortices to an electromagnetic field and is effective for pts who have been unresponsive to other treatments.

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deep brain stimulation Answer: boosts levels of neurotransmitters by implanting electrodes directly into the brain to modify brain activity. DBS poses more risk bc it is invasive. not as immediate ECT, TMS, or VNS

QUESTION

adverse effects of light therapy Answer: jitteriness and headache

QUESTION

Stages of grief Answer: denial, anger, bargaining, depression, acceptance

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who outlined the stages of grief? Answer: Kubler-Ross

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Does personal growth cease in the last stages of life? Answer: no, it often accelerates

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disenfranchised grief Answer: A situation in which certain people, although they are bereaved, are prevented from mourning publicly by cultural customs or social restrictions. This could include the grief felt by healthcare workers over the loss of a patient.

QUESTION

why are opioids used with caution in the elderly? Answer: metabolized in the liver and excreted by the kidney either unchanged or as metabolites. in normal aging, renal insufficiency often occurs, making older adults susceptible to drug effects and metabolite accumulation

QUESTION

How can we protect the elderly from opioids? Answer: reduced initial doses, longer dosing intervals should be scheduled.

QUESTION

What are the risks of NSAIDS in the elserly?

Answer: increase the risk of heart attack, stroke, gastro bleeding. can occur as early as the first weeks of using these drugs but increases as time goes on

QUESTION

how can we improve communication and establish trust with the elderly? Answer: face the client and look directly at them.

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reminiscence Answer: a cognitive stimulation activity that engages seniors in socialization and rapport building by encouraging discussion about past pleasant events or memories such as a first car.... improves mood

QUESTION

severe mental illness (SMI) Answer: a group of psychiatric disorders, most of which are primarily biological in origin, that can significantly affect functioning and one's quality of life.

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terms used interchangeably with SMI Answer: broad-based mental illness, severe and persistent mental illness, biologically based mental illness

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SMI's include Answer: major depressive disorder, bipolar disorder, schizophrenia, schizoaffective disorder, panic disorder, posttraumatic stress disorder, borderline and antisocial disorder, obsessive compulsive disorder.

QUESTION

what percentage of adults in 2014 has an SMI? Answer: 4%

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Group therapy objectives Answer: validate feelings, allow clients to expand on what they are feeling are priorities. Removing a disruptive member is a LAST RESORT

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Symptom-management groups: Answer: the most effective treatment strategy for schizophrenia involves a combination of medication, therapy, lifestyle changes, and social support.

QUESTION

the most effective way to calm the nervous system and relieve stress

Answer: regularly connecting with others face-to-face is also the most effective way

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Types of groups: heterogeneous group Answer: a group in which a range of differences exists among members

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Types of groups: hemogeneous group Answer: all members share central traits (men's group, group clients with bipolar disorder)

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Types of groups: closed group Answer: membership is restricted; no new members are added when others leave

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open group Answer: new members are added as others leave. (inpatient group with transient membership)

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types of groups: subgroup

Answer: an individual or a small group that is isolated within a larger group and functions separately. greater loyalty, more similar goals, more perceived similarities to one another than they do to the larger group.

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altruism Answer: unselfish regard for the welfare of others- occurs when group members provide assistance and support to each other creating a positive self-image and promoting self-growth.

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humanistic theory Answer: client centered, existential, experiential with a focus on self actualization, the awareness oof subjective experience. the leader demonstrates nondirective, active listening, and Socratic dialogue

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psychodynamic theory Answer: using insight, resolution and intrapsychic conflict through listening, interpreting, confronting, probing, working through, directing enactments.

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all members in a group must agree to what? Answer:

client confidentiality

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psychoeducational theory Answer: relates to info on specific topics: coping, emotional and practical support where the group leaders teaches, modeling, organizing, leading discussions, and assessing.

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acceptance Answer: serves to enhance the self-worth of a client

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denial Answer: refusing to believe the diagnosis

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manipulation Answer: influencing one's thoughts or behavior

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repression

Answer: suppressing a thought or desire to the point that it remains unconscious

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blended family Answer: couples entering into a relationship with their own bio children

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nuclear family Answer: does not include stepchildren

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extended families Answer: Households made up of several generations

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adoptive families Answer: have an adoptive child in the home.

QUESTION

How does yoga help to relieve stress?

Answer: increasing dopamine and gamma-aminobutyric acid (GABA) levels in the brain and stabilizing the hypothalamic-pituitary-adrenal axis, thereby decreasing depression, anxiety, and pain

QUESTION

acupuncture: according to Taoists, qi is a life force that circulates throughout the universe and in our bodies in precise channels called Answer: meridians

QUESTION

Reiki Answer: energy-based therapy

QUESTION

ginseng has what? Answer: anticoagulant effects and ginseng tea may increase the effects of anticoagulants

QUESTION

St. John's Wort Answer: used for depression but can result in serotonin syndrome when combined with pro-serotonergic meds such as antidepressants, triptans, and methadone

QUESTION

elderberry syrup Answer: used to fight infection

QUESTION

Saw Palmetto Answer: used to treat symptoms associated with an enlarged prostate

QUESTION

light therapy accepted as a first-line treatment for. Answer: SAD

QUESTION

Wellbutrin (bupropion) Answer: Classification: Antidepressant Smoking deterrent Therapeutic Effects: Diminished depression Decreased craving for cigarettes Adverse Reactions & side effects: SEIZURES, agitation, HA, dry mouth, nausea, vomiting, tremor Nursing Implications & teaching: Monitor mood changes. Assess for suicidal tendencies. Monitor hepatic and renal function in pts with liver or kidney impairments to prevent increased serum levels.

QUESTION

Mild lithium toxicity Answer: serum level 1.5

• apathy
• lethargy
• diminished concentration
• mild ataxia
• coarse hand tremors
• slight muscle weakness

QUESTION

moderate lithium toxicity Answer: serum level 1.5-2.5

• nausea, vomiting, severe diarrhea
• mild-mod ataxia & incoordination
• slurred speech
• tinnitus
• blurred vision
• muscle twitching
• irregular tremors

QUESTION

Severe lithium toxicity Answer: 2 to 2.5 mEq/L

• Ataxia
• Serious EEG changes
• Blurred vision
• Clonic movements
• Large output of dilute urine
• Tinnitus
• Seizures
• Stupor

• Severe hypotension
• Coma
• Death is usually secondary to pulmonary complications Interventions: There is no known antidote for lithium poisoning. The drug is stopped, and excretion is hastened. If patient is alert, an emetic is administered. Otherwise, gastric lavage and treatment with urea, mannitol, and aminophylline hasten lithium excretion.

QUESTION

Methadone use Answer:

• Opioid abuse
• Increasingly Recognized as a useful analgesic (can be used in opioid rotation)

QUESTION

Narcan (naloxone) Answer:

1. Opioid antagonist that reverses the effects of opioid drugs
2. Used to treat opioid overdose (heroin)
3. Found in dental emergency kits