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NRSG 340 0 Final Exam Questions With
Accurate Answers
What are the cultural considerations when it comes to eating disorders? - ANSWER Family's diet, view on food, food surrounding celebrations, etc. What is the DSM criteria of Anorexia Nervosa? - ANSWER -Intense fear of weight gain -Body dysmorphia -Restricting calories with low BMI -Binge/purging -Perfectionism What is the heritability of Anorexia Nervosa? - ANSWER 60% What are the comorbidities associated with Anorexia Nervosa? - ANSWER Anxiety and trauma Signs and symptoms of Anorexia Nervosa - ANSWER -Low weight -Amenorrhea -Hypercarotenemia -Lanugo -Cold extremities -Weakness -Constipation -Abnormal labs and EKG -Hypotension and bradycardia -Impaired kidney function -Anemia -Low bone density Anorexia Nervosa assessment - ANSWER -Physical assessment -Dietary habits -Family supports -Stressful events Who is usually the reason an anorexic patient is admitted: patient or others? - ANSWER Others - patient may not believe they have a problem What is the DSM criteria for Bulimia? - ANSWER Binge eating then self inducing vomiting or using laxatives
Signs and symptoms of Bulimia - ANSWER -Less physically ill-looking -Dental caries -Parotid swelling -Gastric dilation -Calluses on hands -Electrolyte imbalances -Cardiac issues Why are we worried about electrolyte imbalances in eating disorders? - ANSWER Potential for cardiac arrhythmias What are the differences in assessment of Bulimia and Anorexia Nervosa? - ANSWER Bulimia: -Tend to seek out own help -85% are of ideal body weight What is the DSM criteria for Binge Eating Disorder? - ANSWER Eating larger portions of food in smaller amounts of time than others What are the associated health problems with Binge Eating Disorder? - ANSWER Hypertension and Diabetes What is the medical management for Binge Eating Disorder? - ANSWER Topamax, Prozac, Vivance What are the guidelines to hospitalize a patient with an eating disorder? - ANSWER -Weight loss over 30% in 6 months -Not gaining weight in outpatient treatment -Hypothermia -HR <40bpm -SBP <70mmHg -Hypokalemia -EKG depressions -Suicidal or out of control behaviors What is refeeding? - ANSWER Metabolic condition in the beginning of Anorexia Nervosa treatment in which the introduction of calories after a period of starvation causes electrolyte imbalances What are the causes of Delirium? - ANSWER Fever, UTI, medication changes Signs and symptoms of Delirium - ANSWER Confusion, slurred speech, movement disorders, personality changes What is the biggest safety concern for a delirious patient? - ANSWER Fall risk
In what stages is the patient's family most likely to seek out treatment? - ANSWER Own - depression Family - mania What are the causes of Bipolar Disorder? - ANSWER Genetic (#1), environment, hormones, stress What is required in the assessment of Bipolar Disorder? - ANSWER - Determination of the phase (acute, continuation, maintenance) -Mood diary -Sleep, dietary, and sexual patterns -Safety and assessment of risk -Thought process -Adherence to medications Psychopharmacology of Bipolar Disorder - ANSWER Mood stabilizers (Lithium) - narrow therapeutic window, watch for N&V, polydipsia/uria, slurred speech, diaphoresis Anticonvulsants - Trilipetal, Tegetal, Depakote Atypical antipsychotics - Seroquel Caution with SSRIs - rapid cycling Goals of treating Bipolar Disorder - ANSWER -Encourage medication and therapy (group, individual, family) adherence -Maintain safety -Remain hopeful and non-judgmental What is Major Depressive Disorder? - ANSWER Prolonged sad or depressive mood that lasts longer than 6 weeks Signs and symptoms of Major Depressive Disorder - ANSWER Oversleeping, overeating, depressed mood, difficulty with concentration Who is most at risk for Major Depressive Disorder? - ANSWER Adolescents and the elderly How do you assess MDD? - ANSWER -Prior, family, and medical hx -Social support -Substance abuse -Mood/affect -Thought content -Energy level/sleep
-Sex drive -Appetite/weight changes What are some specific assessments for MDD related to adolescents? - ANSWER -Anhedonia -School phobia -Irritability Psychopharmacology of MDD - ANSWER SSRIs - BBW for adolescents (suicidal ideation) SNRIs - caution in those with seizures TCAs - risk for arrhythmias MAOIs - dietary restrictions (meat, cheese, wine) What is responsible for the development of Schizophrenia? - ANSWER Decrease in gray matter in the brain and neurotransmitter imbalances Genetic predisposition, 1st break occurs in early 20's around stressful event or milestone Positive symptoms of Schizophrenia - ANSWER Delusions, hallucinations, disorganized speech, disorganized behavior Negative symptoms of Schizophrenia - ANSWER Affective blunted, ambivalence, alogia (thought-blocking), avolition (lack of motivation), anhedonia How is social cognition impaired in those with Schizophrenia? - ANSWER Difficulty reading others which leads to isolation and loneliness What are the subtypes of Schizophrenia? - ANSWER Paranoid: preoccupied with delusions Disorganized: difficult time planning and executive function, including medication and treatment compliance Psychopharmacology of Schizophrenia - ANSWER IM may be necessary Atypical antipsychotics: Zyprexa, Risperdal, Geodon, Seroquel, Abilify, Clozaril (last resort - agranulocytosis) 1st generation antipsychotics: Haldol, Prolixen, Trilafon, Thorazine What side effects are we looking for with 1st generation antipsychotics? - ANSWER Extrapyramidal side effects: muscle stiffness, tardive dyskinesia, sedation, akathesia, tremor, shuffling gait
Systems theory: effect of media and school Stages of development (Erikson)/Psychosexual stages (Freud): failure to develop past certain stage What is the DSM criteria for ADHD? - ANSWER -Lifespan diagnosis -Symptoms What are nursing diagnoses associated with Odd Eccentric personality disorders? - ANSWER Social isolation, defensive coping, ineffective individual coping What personality disorders fall under the category "Dramatic Emotional Erratic"? - ANSWER Antisocial, borderline, histrionic, narcissistic What are nursing diagnoses associated with Dramatic Emotional Erratic disorders? - ANSWER Self-mutilation, risk for violence, powerlessness, altered family processes What personality disorders fall under the category "Anxious Fearful"? - ANSWER Avoidant, dependent, obsessive compulsive What are nursing diagnoses associated with Anxious Fearful personality disorders? - ANSWER Anxiety, self-esteem disturbance, powerlessness
