Georgette Review PMHNP. QUESTIONS WITH CORRECT SOLUTIONS, Exams of Nursing

Download Georgette Review PMHNP. QUESTIONS WITH CORRECT SOLUTIONS and more Exams Nursing in PDF only on Docsity! Georgette Review PMHNP. QUESTIONS WITH CORRECT SOLUTIONS When many answers are remarkably similar, they are usually _____________ - CORRECT ANSWERwrong Interprofessional collaboration is encouraged. - CORRECT ANSWERCollaborate is usually right. Delegate is usually wrong. ADPIER - CORRECT ANSWERAssessment, diagnosis, Plan, intervention, evaluate, refer out last. Lithium - CORRECT ANSWERNormal 0.6-1.2 Lithium toxicity occurs at levels - CORRECT ANSWER> 1.5 Signs of Lithium toxicity - CORRECT ANSWERsevere nausea, diarrhea, vomiting, confusion, drowsiness, muscle weakness, heart palpitation, coarse hand tremors, unsteady gait Lithium is gold standard for - CORRECT ANSWERMANIA Lithium has evidence shown to - CORRECT ANSWERreduce suicidal ideation What does lithium cause in neonate, especially 1st trimester - CORRECT ANSWEREbstein anomaly (congenital heart defect) dehydration and hyponatremia cause lithium levels to - CORRECT ANSWERrise Baseline labs before initiation of lithium - CORRECT ANSWERTSH creatinine (0.6-1.2) BUN (10-20) HCG (all psychotropics females 12-51) EKG 50+ Urinalysis (check for proteins, 4+ may indicate kidney disease) Side Effects of Lithium - CORRECT ANSWERhypothyroidism coase hand tremors with toxicity maculopapular rash diarrhea, vomiting, cramps--signs of toxicity. Monitor closely. anorexia t wave inversions leukocytosis Pt education for lithimum - CORRECT ANSWERstaying hydrated avoiding NSAIDS compliance Depakote normal level - CORRECT ANSWER50-125 Signs of SJS - CORRECT ANSWERFEVER --high yield sore throat facial swelling tongue swelling red rash skin sloughing body aches prodromal headache malaise arthralgia painful mucus membranes Lamotrigine is least likely to cause - CORRECT ANSWERsedation or weight gain Carbamazepine (tegretol) black box warning - CORRECT ANSWERagranulocytosis (decrease WBCs) aplastic anemia (pallor, fatigue, HA, fever, nosebleeds, bleeding gums, skin rash, SOA) Carbamazepine and asians - CORRECT ANSWERScreen for HLAB-1502 allele before initiating, due to high incidence of SJS if positive for allele. Child-bearing aged women - CORRECT ANSWERcheck for pregnancy before starting mood stabilizer start on folic acid to support neural tube development during the first month that a woman is pregnant Clozaril/clozapine can cause - CORRECT ANSWERagranulocytosis and neutropenia For monitoring neutropenia in Clozaril, monitor - CORRECT ANSWERANC DC clozarli if ANC - CORRECT ANSWERless than 1000 DC clozaril if WBC - CORRECT ANSWER2000-3000, risk of agranulocytosis When on clozaril monitor for - CORRECT ANSWERsigns and symptoms of infection: sudden fever, chills, sore throat, weakness Clozaril only known antipsychotic to - CORRECT ANSWERdecrease risk of suicide in patients with schizophrenia. Your patient with bipolar disorder is admitted to a medical hospital. The internist contacts your office and asks whether the lithium you prescribed him is effecting his ECG. How do you respond? A. Lithium can prolong the QT interval B. Lithium has no effect on his ECG C. Lithium can invert the t waves D. Lithium can shorten the PR interval - CORRECT ANSWERAnswer: Lithium can invert the t waves. Mary is a 45-year-old African American female who has been treated on Isocarboxazid (Marplan) for over 6 years. Mary is going in for a surgical procedure. Which medication is strictly contraindicated with Isocarboxazid? A. Morphine B. NSAIDS C. Methylphenidate D. Acetaminophen - CORRECT ANSWERAnswer: Methylphenidate You are treating a client with schizophrenia who takes clozapine. What lab values will indicate the client needs to discontinue treatment? A. WBC less than 1800 and ANC less than 1200 B. ANC less than 1,000 C. WBC less than 5,000 D. ANC less than 2000 - CORRECT ANSWERAnswer: ANC less than 1000 If given during pregnancy, socium valproate can cause which of the following medical problems in the baby? A. SJS B. Ebstein's anomaly C. Spina bifida D. Cleft palate - CORRECT ANSWERA. Spina bifida Which mood stabilizer is associated with potential life-threatening rash in the Asian population? A. Carbamazepine (tegretol) B. Depakote C. Lithium D. Lamictal - CORRECT ANSWERA. Carbamazepine Bulimia, weight is ___________ - CORRECT ANSWERwithin the normal range. Pharm treatment for bulimia - CORRECT ANSWERFluoxetine SSRIs and TCAs effective in reducing binging and purging SICKFACES.com for Inhibitors - CORRECT ANSWERSodium valproate Isoniazid Cimetidine Ketoconazole Alcohol Chloramphenicol Erythromycin Sulfonamine Cipro Omeprazole Metronidazole Which cytochrome enzyme is implicated as a tobacco inducer when an individual is treated with clozapine a. 2D6 b. 1A2 c. 2C19 d. 2C9 - CORRECT ANSWER1A2 (want A 2 cigarette break) When treating older adults, you should keep in mind that they are more sensitive to issues of drug toxicity because of which of the following reasons? A. Decreased body fat B. Increased liver capacity C. Decreased protein binding D. Increased muscle concentration - CORRECT ANSWERDecreased protein binding For 12 years, a 65 year old patient with bipolar affective disorder has been treated with lithium 900 mg daily. When oral HCTC 12.5 daily is added for hypertension, the patient develops nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0. The interaction of the lithium and the thiazide diuretic has induced: A. hypokalemia B. hyponatremia C. Increased renal clearance of lithium D. Decreased renal clearance of lithium - CORRECT ANSWERA. decreased renal clearance of lithium Where is norepinephrine produced - CORRECT ANSWERlocus coeruleus and medullary reticular formation Norepinephrine is associated with - CORRECT ANSWERmood disorders Serotonin is made where in the brain - CORRECT ANSWERraphe nuclei of the brainsteam Serotonin is associated with - CORRECT ANSWERsleep and mood disorder Dopamine is made in - CORRECT ANSWERsubstantia nigra, central tegmental area, ventral tegmental area, Dopamine is associated with - CORRECT ANSWERaddiction and psychosis Acetylcholine is made - CORRECT ANSWERbasal nucleus of Meynert Most abundant inhibitory neurotransmitter in the brain - CORRECT ANSWERGABA I don't have enough GABA, my anxiety is high Med used to increase GABA - CORRECT ANSWERbenzos Fred flinstone needs a Zanny, Gabba dabba do. Most excitatory neutransmitter - CORRECT ANSWERglutamate Increased level of corticotropin releasing hormone in the amygdala, hippocampus and locus coeruleus - CORRECT ANSWERincreases symptoms of anxiety. Autism - CORRECT ANSWERdeficits in social communication and social interaction across multiple settings Parents of kids with autism may report - CORRECT ANSWERNo response when called by name Little or no eye contact Children with autism often like to line up, stack, or organize objects and toys. Screenings for autism - CORRECT ANSWERADOS M-CHAT ASQ Pharm management for autism - CORRECT ANSWERantipsychotics are effective for symptoms such as tantrums, aggressive behaviors, self-injurious behaviors A. frontal lobe B. Temporal lobe C. Parietal lobe D. Occipital lobe - CORRECT ANSWERfrontal lobe Impairments in the clock drawing test can be associated with - CORRECT ANSWERdamage to the right parietal lobe What part of the brain is responsible for regulating emotions? A. Wernicke's area B. Occipital lobe C. Hippocampus D. Parietal lobe - CORRECT ANSWERHippocampus Limbic system responsible for - CORRECT ANSWERemotions and memory Hypothalamus - CORRECT ANSWERappetite, hunger, water balance, circadian rhythms, libido, hormonal regulation thalamus - CORRECT ANSWERsensory relay for smell emotions, memory, and regulated affective behaviors amygdala - CORRECT ANSWERregulated emotion mediates mood emotional memories/meanings, fear, anxiety, stress emotion, aggression substantia nigra - CORRECT ANSWERmotor movements amygdala= - CORRECT ANSWERemotional memory Which of these brain structures puts emotional meaning on a stimulus, forms, emotional memories and is involved with rage and fear - CORRECT ANSWERamygdala A client presents with complaints of changes in appetite, feeling fatigued, problems with sleep-rest cycle, and changes in libido. What is the neuroanatomical areas off the brain that is responsible for the regulation of these functions? - CORRECT ANSWERHypothalamus Which serotonin receptor antagonism makes an antipsychotic "atypical" - CORRECT ANSWER5HT2A Excess dopamine in this area causes positive schizophrenic symptoms - CORRECT ANSWERmeoslimbic pathway decreased dopamine leads to negative symptoms of schizophrenia - CORRECT ANSWERmesocortical pathway Increased blockade of dopamine here leads to EPS - CORRECT ANSWERnigrostriatal pathway Blockade of dopamine in this pathway can lead to increased prolactin levels - CORRECT ANSWERtuberoinfundibular pathway Muscle spasms ninth face, neck, tongue, back/neck muscles - CORRECT ANSWERacute dystonia Oculogyric crisis, which can lead to permanent injury. Patients have prolonged involuntary upwards deviation of the eyes bilaterally. - CORRECT ANSWERRare presentation of acute dystonia. Pharm treatment for dystonia - CORRECT ANSWERcogentin (IM first then oral) Restlessness, inability to sit still. Pacing. Mistaken for anxiety. - CORRECT ANSWERAkathisia Commonly used rating scale for akathisia is - CORRECT ANSWERBarnes Akathisia rating scale and extrapyramidal symptom rating scale. Treatment for akathisis 1st line 2nd line 3rd line - CORRECT ANSWER1st: beta blocker 2nd: Cogentin 3rd: bnzodiazepine Absence of movement or difficulty initiating movement - CORRECT ANSWERakinesia Treatment: cogentin Presence of symptoms of Parkinson's produced by D2 blockade in the nigrostriatal pathway - CORRECT ANSWERPseudo-Parkinsonism What the drug does to the body - CORRECT ANSWERpharmacodynamics The drug binds to the receptors and activates a biological response (opens the ion channel) - CORRECT ANSWERagonist effect drug causes the opposite effect of the agonist. Binds to the same receptor but closes the channel - CORRECT ANSWERinverse agonist drug does not fully activate the receptor - CORRECT ANSWERpartial agonist drug binds to the receptor but foes not activate a biological response - CORRECT ANSWERantagonist The study of what the drug does to the body. - CORRECT ANSWERPharmacodynamics When studying pharmacodynamics involving receptor, you know that an agonist produces the following effect? A. Does not fully activate the receptor B. Blocks the agonist from opening the channel C. Causes the opposite effect D. Activates a biological response and opens the ion channel. - CORRECT ANSWERActivates a biological response and opens the channel. Medications that can cause mania (very high yield) - CORRECT ANSWERSteroids Antabuse Isoniazid Antidepressants in persons with bipolar Flonase Medications causing depression - CORRECT ANSWERsteroids beta blockers interferon accutate some retroviral drugs antineoplastic drugs benzos progesterone Fragile X syndrome - CORRECT ANSWERall their facial structures are larger. Severe adverse effect caused by antipsychotics - CORRECT ANSWERneuroleptic malignant syndrome Extreme muscle regidity Mutism elevated CPK Myoglobinura (cherry colored urine) Elevated WBCs Elevated LFts - CORRECT ANSWERsigns of NMS Treatment for NMS - CORRECT ANSWERDC Offending agent Bromcriptine (parlodel) Dantrolene (muscle relaxant Serious effect of SSRIs - CORRECT ANSWERserotonin syndrome hyperreflexia, myoclonic jerks, sweating - CORRECT ANSWERserotonin syndromeq Treatment for serotonin syndrome - CORRECT ANSWERDC offending agent Cyprophentadine Drugs/classes that can cause serotonin syndrome - CORRECT ANSWERSSRI/TCA/MAOI/SNRI When switching to an SSRI to MAOI, - CORRECT ANSWERwait 14 days When switching from Prozac to MAOI or TCA - CORRECT ANSWERwait 5-6 weeks When switching from MAOI back to prozac - CORRECT ANSWERwait 2 weeks. Non psych med that can cause serotonin syndrome - CORRECT ANSWERtriptans Serotonin discontinuation syndrome - CORRECT ANSWERremember similar to alcohol withdrawal flu like symptoms False belief firmly maintained despite evidence to the contrary - CORRECT ANSWERdelusion A. Omeprazole B. Propranolol C. Levothyroxine D. Clarithromycin - CORRECT ANSWERPropranolol A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of manic symptoms and insomnia. Your patient has been stable on lithium for the past six months To determine if a medication change or increase is warranted, it is important to gather more information. You suspect a possible medication-induced manic episode when the patient endorses what? A. She was recently placed on a beta blocker for anxiety. B. She was recently prescribed a benzo C. She recently had a flare up of her rheumatoid arthritis and received treatment for one week (aka a steroid) D. She recently began a new retroviral agent for hepatitis - CORRECT ANSWERrecently treated for RA Scale to test for alcohol withdrawal - CORRECT ANSWERCIWA Score on CIWA that warrants PRN - CORRECT ANSWERgreater than 8 Medication that will make patient physically ill if combined with alcohol - CORRECT ANSWERdisulfiram (Antabuse) Antabuse shouldn't be taken for at leas ________________ after drinking - CORRECT ANSWER12 hours. Signs and symptoms of alcohol withdrawal - CORRECT ANSWERN/V/D tremors sweats anxiety agitation tactile disturbances auditory disturbances visual disturbances headache altered sensorium agitation Rating scale of opiate withdrawal - CORRECT ANSWERCOWS Signs and symptoms of opioid withdrawal - CORRECT ANSWERyawning, irritability, pupillary dilation piloerection muscle aches lacrimation rhinorrhea Treat COWS when score is greater than - CORRECT ANSWER7 Moderate withdrawal on COWS - CORRECT ANSWER13-24 Moderate withdrawal on CIWA - CORRECT ANSWERscoring 15 Treatment for COWS - CORRECT ANSWERBuprenorphine (Suboxone) Treatment for CIWA - CORRECT ANSWERscheduled meds plus diazepam SBIRT stands for - CORRECT ANSWERScreening, Brief Intervention, and Referral to Treatment SBIRT FRAMES - CORRECT ANSWERFeedback--tell them about their risk of their current alcohol use Responsibility--reinforce their responsibility for change Advice--based on facts about their drinking, offer simple and direct advice Menu--provide a menu of options for behavior change Empathetic interviewing--consider their perspective. Be non-judgemental Self-efficacy--encourage person to believe they can change. CAGE screening tool - CORRECT ANSWERcut down, annoyed, guilty, eye opener Acute onset altered level of consciousness inattenion poor prognosis--1 year mortality rate of is up to 40% - CORRECT ANSWERdelirium Treatment of choice for delirium - CORRECT ANSWERhaloperidol Avoid which class in delirium as it tends to prolong it - CORRECT ANSWERbenzos Appraisal of the patient's SI plan, intent and access to implement plan would be documented in which part of standard psychiatric evaluation A Review of symptoms. B. Diagnosis C. Mental status exam D. History of presenting illness - CORRECT ANSWERC mental status exam a 48 year off Caucasian male presents for his therapy appointment. He is sad about losing his wife recently to covid 19. He reports feeling thoughts of hurting himself. He has a past history of overdosing on propranolol several years ago. Which of the following places him at higher risk of suicide? A. Previous attempt B. Age C. Gender D. Marital Status - CORRECT ANSWERA previous attempt Which of the following patients is at higher risk of suicidie? A. 30 year old married African American female with previous attempt B. A 35 year old single Asian male with previous suicide attempt C. A 38 year old single African American male who is manager of a bank D. A 68 year off single Caucasian male with depression - CORRECT ANSWERD. 68 year old single, caucasian male, depression A 64 year old caucasian male referred for treatment of refractory depression by his PCP reports continued lack of purpose, insomnia, decreased energy, reduced interest in pleasurable activities since losing his wife hit by a drunk driver 3 months ago. Which of the following is an assessment priority? A. Prior and current meds, dose, clinical response, side effects. B. Thoughts of self-harm, plan, intent, access C. Extent of alcohol use, and motivation to reduce to safe levels D. Sleep patterns and hygiene - CORRECT ANSWERthoughts of self-harm, plan, intent, access A married female patient has been in therapy with an adult psychiatric and mental health nurse practitioner for 3 months. The patient's husband abuses alcohol and refuses treatment. The night before the next scheduled appointment, the patient telephones the clinical nurse specialist stating that her husband is drunk, violent, and threatening to kill her. The PMHNPs priority intervention is A. To arrange for an emergency psychiatric intervention B. Arrange for the woman's safety C. Request a restraining order D. Request to speak to the husband - CORRECT ANSWERArrange for the woman's safety. A client says to the PMHNP, Some days life is just not worth it. All my wife and I do is fight and scream. Things at home were be calmer and simpler if I just wasn't there anymore." The most therapeutic response is: A. Do you mean yo are thinking about leaving your wife to moving out?" B. Tell me what you mean by "it would be simpler if you weren't there anymore." C. So you are thinking suicide might be an option for you? D. Remain silent. - CORRECT ANSWERB. Tell me what you mean by "it would be simpler if you weren't there anymore" While working with an older male client, the nurse begins to think that the client reminds her of her grandfather and responds as if she is the granddaughter. The nurse is developing which of the following? A. Empathy B. Modeling C. Transference D. Countertransference - CORRECT ANSWERD Countertransferance Moderate level on the MMSE - CORRECT ANSWER10-20 Moderate level on the HAM-D - CORRECT ANSWER14-18 Moderate level on the PHQ-9 - CORRECT ANSWER10-14 Moderate level on the Beck - CORRECT ANSWER10-29 Moderate on GAD 7 - CORRECT ANSWER10-14 Moderate on COWS - CORRECT ANSWER13-24 Moderate on CIWA - CORRECT ANSWER15 Dementia is characterized by _____________ onset. - CORRECT ANSWERgradual Alzheimers is cortical or subcortical dementia - CORRECT ANSWERcortical Cortical dementia causes - CORRECT ANSWERlanguage and memory problems. Examples of subcortical dementia - CORRECT ANSWERHuntington's disease Any form of screening is what Level of prevention - CORRECT ANSWERsecondary Aimed at decaying disability and severity - CORRECT ANSWERtertiary decreased effects of the same dose over time - CORRECT ANSWERtolerance tendency of some regions of the brine to react to repeated low-level bioelectrical stimulation, by progressively boosting synaptic discharges, thereby lowering seizure threshold (alcohol and benzos) - CORRECT ANSWERkindling Where in the brain are abnormalities found causing ADHD - CORRECT ANSWERfrontal cortex --high yield basal ganglia abnormalities in the reticular activating system Neurotransmitters involved in ADHD - CORRECT ANSWERDNS dopamine norepineph serotonin ADHD causes DNS - CORRECT ANSWERdopamine noreip serotonin Hallmarks of ADHD - CORRECT ANSWERpersistent pattern of inattention or hyperactivity, impulsivity, or both. What to check prior to prescribing a stimulant? - CORRECT ANSWERcardiac history, family history of CVD and get an EKG prior to starting Amphetamines are approved in children as young as - CORRECT ANSWER3 Signs of stimulant abuse - CORRECT ANSWERinsomnia tremors heart palpiations increased BP and HR Rating scale for ADHD - CORRECT ANSWERConnors and Vanderbilt Must monitor in two settings Hallmarks of borderline personality disorder - CORRECT ANSWERimpulsivity with self-damaging behavior Recurrent suicidal behavior Treatment for Borderline - CORRECT ANSWERDBT Hallmarks of antisocial personality - CORRECT ANSWERreckless disregard for welfare of others lack of remorse indifference to the feelings of others INCREASED HOMICIDAL IDEATION --HIGH YIELD Primarily in girls normal development then decline loss of purposeful hand movements stereotypic hand movements --flapping of hands deceleration of head growth - CORRECT ANSWERRett syndrome Chronically moody, sad irritable for no reason - CORRECT ANSWERDisruptive mood dysregulation disorder patient reacts grossly out of proportion to situation sudden rage/anger outbursts - CORRECT ANSWERIntermittent explosive disorder Mnemonic for depression SIGECAPS - CORRECT ANSWERSleep disturbance interest reduced guilt and self-blame energy loss and fatigue concentration problems appetite changes psychomotor changes suicidial thoughts Neurotransmitters involved in depression - CORRECT ANSWERDNS A. Assess her coping behaviors B. Assess her current level of suicidality C. Take her vital signs D. Asess her health history - CORRECT ANSWERtake her vital signs Bipolar Mnemonic (DIG FAST) - CORRECT ANSWERDistractibility impulsivity grandiosity flight of ideas agitation, psychomotor sleep need decreased talkativeness, pressured speech What is the gold standard treatment for mania - CORRECT ANSWERlithium What is neuroprotective treatment for bipolar I - CORRECT ANSWERlithium Normal Free T4 - CORRECT ANSWER0.8-2.8 Normal TSH - CORRECT ANSWER0.5-5.0 When T4 and T3 are high, and TSH is low - CORRECT ANSWERhyperthyroidism When T4 and T3 are low, and TSH is high - CORRECT ANSWERhypothyroidism Hypothyroidism mimics - CORRECT ANSWERdepression hyperthyroidism mimics - CORRECT ANSWERmania sensitive to cold, cold intolerant - CORRECT ANSWERhypothyroid heat intolerant - CORRECT ANSWERhyperthyroid Normal AST and ALT - CORRECT ANSWERAST 5-40 ALT 5-35 with liver damage ALT - CORRECT ANSWERrises to 50x normal Argues with authority - CORRECT ANSWERoppositional defiant disorder defiant but not aggressive - CORRECT ANSWERoppositional defiant disorder treatment for ODD - CORRECT ANSWERtherapy Person is aggressive, lack of remorse, destruction of property, deceit or theft - CORRECT ANSWERconduct disorder treatment for conduct disorder - CORRECT ANSWERtarget mood and aggression. person has sudden: blindness, mutism, paralysis, paresthesia, neurological symptoms - CORRECT ANSWERconversion disorder emotional or behavioral reaction to a stressful event or change in person's life within 3 months of it happening. - CORRECT ANSWERadjustment disorder A male patient informs as adult PMHNP that he has not slept in three days, has poor concentration, and denies fatigue. The patient's diagnosis is: A. ADHD B. Bipolar disorder C. Panic disorder D. Primary insomnia - CORRECT ANSWERbipolar disorder The neuroprotective treatment of choice for bipolar disorder is - CORRECT ANSWERlithium According to the current clinical guidelines for treating a patient with bipolar I disorder mania with psychotic features, an adult psychiatric and mental health nurse practitioner prescribes: A.) Lithium B. Citalopram C. Lamotrigine D. Quetiapine - CORRECT ANSWERquetiapine intrusive reexperiencing of a traumatic event - CORRECT ANSWERPTSD virtue of initiative vs guilt - CORRECT ANSWERpurpose Ability to be a self-starter, to initiate one's own activities. Industry vs inferiority (VERY HIGH YIELD) - CORRECT ANSWERschool age 6-12 years Industry vs inferiority virtue - CORRECT ANSWERcompetence Identity vs role confusion - CORRECT ANSWERAdolescence 12-20 identity vs role confusion virtue - CORRECT ANSWERfidelity personal identity unfavorable: they're confused over who they are. Initimacy vs isolation - CORRECT ANSWEREarly adulthood 20-35 Intimacy vs isolation virtue - CORRECT ANSWERlove Generativity vs stagnation - CORRECT ANSWERmiddle adultgood 35-65 years generatively vs stagnation virtue - CORRECT ANSWERcare key event: parenting integrity vs despair (VERY HIGH YIELD) - CORRECT ANSWERlate adulthood greater than 65 years integrity vs despair virtue - CORRECT ANSWERwisdom fulfillment and comfort with life willing to face death, sense of integrity Piaget focuses on - CORRECT ANSWERbehavior Piaget Sensorimotor 0-2 - CORRECT ANSWERobject permanence and object constancy Piaget Preoperational (VERY HIGH YIELD) 2-7 years - CORRECT ANSWERmagical thinking egocentric pretend play Piaget Concrete operational 7-11 years - CORRECT ANSWERThinks logically about concrete objects Understands conservation and reversibility Piaget Formal Operational (VERY HIGH YIELD) 12+ years - CORRECT ANSWERReason abstractly Freud Oral Stage - CORRECT ANSWER0-1 Erogenous zone: mough Freud Anal Stage - CORRECT ANSWER1-3 years Erogenous zone: anus Freud Phallic Stage - CORRECT ANSWER3-6 years Erogenous zone is genitals Freud latent stage - CORRECT ANSWER6 to puberty Representation of sexual feelings Freud Genital stage - CORRECT ANSWER•puberty-adulthood •sexual urges reawaken & are directed to an individual outside the family circle •unresolved conflicts from previous stages arise •if conflict is resolved, capable of having a mature adult sexual relationship individuals are able to distinguish between self and non self - CORRECT ANSWERego boundaries way of coping with anxiety in which an object or person of ambivalence is viewed as perfect or has having exaggerated positive qualities - CORRECT ANSWERidealization used for borderline personality disorder Goal of DBT - CORRECT ANSWERreduce suicidal behaviors Emphasizes accepting freedom and making responsible choices - CORRECT ANSWERexistential therapy well suited to those facing issues of existence, for example those with terminal illness, those contemplating suicide, or going through transition in life Goal: focus on present and personal responsibility focus on a. patient's subjective world - CORRECT ANSWERExistential therapy therapy that is person centered self-directed growth self-actualization - CORRECT ANSWERHumanistic therapy therapy that focuses on interpersonal issues causing distress to understand manage relationship problems - CORRECT ANSWERinterpersonal therapy therapy used for PTSD Goal: achieve adaptive resolution relate trauma from a negative thought to a positive thought - CORRECT ANSWEREMDR process providing a personal with visual or auditory information about the autonomic physiologic functions of his or her body. - CORRECT ANSWERbiofeedback Family systems therapy (VERY HIGH YIELD) - CORRECT ANSWERtriangles, triangulation, self- differentiation triangles are not good for the family Structural family therapy - CORRECT ANSWERboundaries, hierarchies Strategic therapy - CORRECT ANSWERparadoxical intervention--tell the family member that they can worry for one hour of the day. Solution focused therapy - CORRECT ANSWERmiracle question patient attributes their own unacceptable thoughts feelings, and motives onto another person - CORRECT ANSWERprojection redirection of an impulse (usually aggression) onto a powerless substitute target - CORRECT ANSWERdisplacement displace our unacceptable emotions onto behaviors which are constructive and socially acceptable, rather than destructive healthy defense mechanism - CORRECT ANSWERsublimation concentrating on intellectual aspects to avoid emotional aspects of a difficult situation. Ex, cancer patient reading up on their disease - CORRECT ANSWERIntellectualization Justification for an uncceptable behavior - CORRECT ANSWERrationalization Yalom's Curative Factors - CORRECT ANSWER- Altruism: giving of oneself to help others - Catharsis: relieving of emotions by expressing one's feelings - Universality: recognizing shared feelings and that one's problems are not unique - Existential factors: address accepting the fact that respons. for change comes from w/in oneself - Self-understanding: discovering and accepting unknown parts of oneself - Family reenactment: understanding what is was like growing up in one's family through group exp. - Guidance: accepting advice from other members - Identification: benefiting from imitation of the positive behaviors of other group members - Instillation of hope: experiencing optimism through observing improvement of other members - Interpersonal learning: occurs when receiving feedback from grp members re: one's bx (input), learning successful ways of relating to group members (output) study of long term sequel of adverse childhood events found - CORRECT ANSWERpositive relationship between heart disease, obesity, DM, unintended pregnancy, depression, anxiety, cancer, COPD, sleep disorders, dissociative disorders, and substance use disorder. Dialectical behavioral therapy (DBT) draws on cognitive theory and behavioral theory, along with other theories. Elements of behavioral therapy in DBT include which of the following? A. Skills training and exposure B. Examination of feelings and relating feelings to visceral sensations C. Working through the transference with the therapist D. Cognitive interpretation of past traumatic events. - CORRECT ANSWERA skills training and exposure treatment approach that does not focus on full symptom resolution but emphasizes resilience and control over problems and life. telling the truth - CORRECT ANSWERveracity doing for self - CORRECT ANSWERautonomy Rennie v Klein Court Case - CORRECT ANSWERinvoluntary patient not found incompetent, has a right to refuse psychotropic medications, goal of case management - CORRECT ANSWERpromote quality and cost-effective outcomes. Stark Law - CORRECT ANSWERyou can't refer to family members for treatment of your patients. PICOT - CORRECT ANSWERPatient or problem intervention comparison outcome time evidence from systematic review or meta analysis of many RCTs - CORRECT ANSWERlevel 1 evidence evidence from at least one RCT - CORRECT ANSWERlevel 2 evidence Before implementing/creating change of policy - CORRECT ANSWERassess/address/identify potential organizational barriers and facilitators meet with stakeholders patient advocacy - CORRECT ANSWERreduce stigma of mental illness through education help patients receive available services Seeks to create an environment that encourages individuals to report mistakes so that the precursors to errors can be better understood in order to fix system issues - CORRECT ANSWERjust culture of safety Process for quality improvement - CORRECT ANSWERplan, do, study, act reflective practice - CORRECT ANSWERdebriefing strategies goal: to improve practice Highest rate of suicide in US - CORRECT ANSWERnative Americans True or false A culturally expected response to a stressor does not always mean a mental illness - CORRECT ANSWERtrue grasp palmar reflex disappear by - CORRECT ANSWER5-6 months moro startle reflex disappear by - CORRECT ANSWER5-6 months babinski reflex normal until - CORRECT ANSWERage 2 shrill cry in baby - CORRECT ANSWERintracranial pressure playing with genitals normal in ages 3-6 - CORRECT ANSWERtrue treatment for cultural syndrome - CORRECT ANSWERbrief supportive therapy