Mental Health Assessment in Primary Care, Exams of Nursing

Download Mental Health Assessment in Primary Care and more Exams Nursing in PDF only on Docsity!

NURS 612 Mental Health/Exam 3 Maryville

questions with correct answers

What questions do you ask a patient with a chief complaint of a mood disorder? Correct Answer-abrupt or insidious onset, medications, associated health problems, and associated symptoms. What are some questions to ask for an HPI of depression? Correct Answer-any troubling thoughts or feelings, constant worry/ change in outlook on life of change in feelings, low energy level, agitation, thought or plans for hurting self and/or others, medications (antidepressants, steroids, beta-blockers, CCB, barbiturates, phenytoin, anabolic steroids). What are some questions to ask for an HPI of anxiety? Correct Answer-any sudden, unexplained episodes of intense fear, anxiety or panic for no apparent reason. Feels uncomfortable around people. Prior experience with a frightening or traumatic event. Panic attack, obsessive thoughts, or compulsive behaviors. What are the objective data that you collect when assessing the patient's mental health in primary care? Correct Answer-voice quality, memory, attention span, judgment, grooming, body language, and comprehension. What is the difference between a patient's mood and affect with a diagnosis of dementia or delirium. Correct Answer-with delerium their mood and affect includes rapid mood swings, fearful and suspicious. Dementia patients are depressed, apathetic, and uninterested. Name four differences between dementia and delirium. Correct Answer-Delerium the onset is sudden, with dementia it is insidious and relentless. Delirium causes misperceptions, illusions, hallucinations, and delusion. Dementia usually does not include misperceptions or hallucinations. Delirium can be reversible and dementia

is not. Delirium is associated with infections, medications, MODS, or brain injury. Dementia is usually related to structural diseases of the brain. How can you assess/test a patient's immediate recall or new learning? Correct Answer-ask the patient to listen and repeat a sentence or a series of numbers. 5- numbers forward or 4-6 numbers backward can usually be repeated. How can you assess/test a patient's recent memory? Correct Answer-give the patient four objects to remember and ask them about them in 10 minutes. They should be able to name them all. How can you assess/test a patient's remote memory? Correct Answer-Ask them about verifiable past events such as mother's maiden name, high school, or a subject of common knowledge. What does loss of immediate and recent memory with retention of remote memory suggest? Correct Answer-dementia. What are the main ways to test cognition? Correct Answer-analogies, abstract reasoning, arithmetic calculation, writing ability, execution of motor skills, memory, attention span, and juddgment. What are the main ways to test speech and language skills? Correct Answer-voice quality, articulation, comprehension, coherence. What are the main ways to test emotional stability? Correct Answer-mood and feelings, thought process and content, and perceptual distortions and hallucinations.

Give an example of an analogy and what does it test? Correct Answer-what is similar about objects and it tests cognitive abilities. Give an example of how to test abstract reasoning. Correct Answer-have the patient tell you the meaning a fable, proverb, or metaphor. A rolling stone gathers no moss. Tests cognition. What does an inadequate interpretation of abstract reasoning point to? Correct Answer-poor cognition, dementia, brain damage, or schizophrenia. How can you test arithmetic calculation and what is that testing? Correct Answer- ask the patient to do simple arithmetic, without paper and pencil. Example: subtract 7 from 50 and then cont. process. Tests cognition. What does impairment of arithmetic skills indicate? Correct Answer-depression and diffuse brain disease. What does the inability to interpret analogies indicate? Correct Answer-a lesion of the left or dominant cerebral hemisphere. What is aphasia? Correct Answer-impairment in language function. What is apraxia? Correct Answer-inability to translate an intention into action that is unrelated to paralysis or lack of comprehension. May indicate cerebral disorder. How do you test writing abilities? Correct Answer-Ask the patient to write their address and name. Or they could draw shapes.

What does the inability to write or draw pictures mean? Correct Answer-may indicate dementia, parietal lobe damage, a cerebellar lesion, or peripheral neuropathy. How do you test for execution of motor skills? Correct Answer-ask the patient to unbutton their shirt. What does the inability to execute motor skills mean? Correct Answer-may indicate a cerebral disorder. Explain the mini-cog test. Correct Answer-screens for dementia with 3-item recall test. Have the patient remember and repeat 3 unrelated words. Then have the patient draw a clock with the times and then draw hands to reflect a certain time. Then ask the patient to repeat the 3 words. Explain the mini-cog results. Correct Answer-give one point for each recalled word after the CDT distractor. 0: + for dementia, 1 or 2 with abnormal CDT + screen, 1 or 2 with normal CDT - screen, 3 indicates negative screen. Explain the mini-mental state examination. Correct Answer-assesses cognitive function over time. There are 11 items. Max score of 30. A score of 20 or less is associated with dementia. A score of 26 or more is negative. What is tested with the mini-mental state examination? Correct Answer- orientation, registration, attention and calculation, recall, and language. What is an example of testing registration? Correct Answer-saying three words and having the patient repeat them.

Name three types of aphasia. Correct Answer-Broca aphasia (expressive), Wernicke Aphasia (receptive), Global Aphasia (expressive and receptive). What are the characteristics of Broca Aphasia? Correct Answer-fair to good word comprehension, impaired speech flow; laborious effort, mostly nouns and verbs. Reading is intact and writing is impaired. What are the characteristics of Wernicke Aphasia? Correct Answer-can hear words but can't relate them to previous experiences, fluent speech but uses words inappropriately, and reading and writing are impaired. What are the characteristics of Global Aphasia? Correct Answer-absent or reduced to person's own name, few select words, spontaneous reduced to few words or sounds, reading and writing are severely impaired. How may mental function as a whole be evaluated in 10 minutes? Correct Answer- using the Isaac Set Test. Ask the patient to name 10 items in each of four groups: fruits, animals, colors, and towns/cities (FACT) without prompting. Expect a score