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NURS 6635 FINAL EXAM 2024/2025 ACTUAL EXAM 3 LATEST VERSIONS 2024-2025 (VERSION A, B AND C) COMPLETE 300 QUESTIONS AND CORRECT DETAILED ANSWERS
Typology: Exams
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Select the time frame for symptoms of schizophreniform disorder. A. 2 to 6 weeks B. 1 to 5 months C. 6 to 8 months D. 1 year - CORRECT ANSWERS Symptoms are short term lasting at least 1 month but less than 6 months. p. 342 Select two comorbid factors common in schizophrenic patients - CORRECT ANSWERS obesity, DM, substance use disorders, complex partial epilepsy, cardiovascular disease, HIV, COPD Select the medical condition that occurs less frequently in schizophrenic patients than in the general population - CORRECT ANSWERS rheumatoid arthritis Select the percentage of remission that results from correct antipsychotic drug therapy of schizophrenic patients A. 15 B. 30 C. 45 D. 70 - CORRECT ANSWERS p. 354 Approximately 60% will improve to the extent that they will achieve remission or only mild symptoms Select the most distinguishing feature in the course and prognosis of schizophrenia - CORRECT ANSWERS worsening after each relapse Select the two behaviors of schizophrenic patients that occur more frequently than in the general population. - CORRECT ANSWERS p.339 little impulse control, decreased social sensitivity, impulsive behavior, suicide, violent behavior
Select the characteristic that is greater in childhood than adult onset schizophrenia - CORRECT ANSWERS Social withdrawal p. 349 typically quiet introverted, no close friends, may have sudden onset of ocd Select the most reliable method to make a diagnosis of schizophrenia - CORRECT ANSWERS a patient's history is essential for the diagnosis of schizophrenia; clinicians cannot diagnose schizophrenia simply by results of a mental status examination, which may vary. Select the dysfunction that is common to 50% to 85% of schizophrenic patients. - CORRECT ANSWERS Various studies have reported abnormal eye movements in 50 to 85 percent of patients with schizophrenia compared with about 25 percent in psychiatric patients without schizophrenia and fewer than 10 percent in nonpsychiatrically ill control participant. p. 359 Select two of the "Four A's" symptoms of schizophrenia described by Bleuler A. autism B. ambivalence C. anhedonia D. abstract - CORRECT ANSWERS the four As: associations, affect, autism, and ambivalence Select the age range for 90% of patients treated for schizophrenia - CORRECT ANSWERS p. 358 90% of patients in treatment for schizophrenia are between 15 and 55 years old. (peak age of onset women - 25 to 35, men 10-25). Late onset refers to over 45. cannabis raises risk by 40% The most common type of hallucination in schizophrenia - CORRECT ANSWERS Auditory
Cognition of patient's with schizophrenia - CORRECT ANSWERS Usually oriented to person, time, and place. they do have cognitive deficiencies in attention, executive function, working memory, and episodic memory leading cause of premature death in schizphrenia? - CORRECT ANSWERS Suicide Positive and negative syndrome scale (PANNS) Brief psychiatric rating scale (BPRS) EPS symptoms - Simpson angus scale (SAS), Abnormal involuntary movement scale (AIMS), Barnes akathisia rating scale (BARS) - CORRECT ANSWERS diagnostic and rating scales for schizophrenia What percentage of schizophrenia patients have substance use disorder throughout lifetime? - CORRECT ANSWERS 74% neurotransmitters involved in schziophrenia - CORRECT ANSWERS excessive dopamine = positive symptoms increased glutamate = overexcites brain decreased gaba = reduces neuron excitability decreased muscarinic and nicotinic receptors = dec cognition Select the negative symptom of schizophrenia - CORRECT ANSWERS Affective flattening or blunting Alogia (poverty of speech, blocking) avolition (apathy) anhedonia Attention (inattentiveness)
Positive symptoms of schizophrenia - CORRECT ANSWERS hallucinations and delusions, bizarre behavior, formal thought disorder Select the disorder that is often comorbid with brief psychotic disorder - CORRECT ANSWERS p. 344 Common in patients with personality disorders lasts one day and not more than one month By definition, patients with delusional disorders do not have what? - CORRECT ANSWERS prominent or sustained hallucinations. Persecutory and jealous are most common delusional disorders Select the diagnostic criterion for catatonia resulting from a medical condition. - CORRECT ANSWERS waxy flexibility Select the two factors that are not applicable to diagnosing schizoaffective disorder - CORRECT ANSWERS Medical condition, Substance abuse As with most psychiatric diagnoses, schizoaffective disorder should not be used if the symptoms are caused by substance abuse or a secondary medical condition Select the lifetime prevalence of schizophrenia in the United States - CORRECT ANSWERS. 0.1-1.0% Select the subtype of schizophrenia in which auditory hallucinations are frequent - CORRECT ANSWERS paranoid type Select the percentage range of schizophrenic patients that remain significantly impaired throughout their lives. - CORRECT ANSWERS p. 350 40-60% remain significantly impaired 20 - 30% percent are moderately impaired 20 - 30 percent somewhat normal
Select the youngest age by which early-onset schizophrenia occurs. - CORRECT ANSWERS p. 358 peak onset for males is 10 - 25 13? Select the neurotransmitter that is most implicated in schizophrenia based on the effectiveness of antipsychotic drug therapy. A. Norepinephrine B. Dopamine C. GABA D. Glutamate - CORRECT ANSWERS B. Dopamine Select two psychiatric disorders that are often misdiagnosed as childhood-onset or early onset schizophrenia A. Autism spectrum B. Obsessive-compulsive disorder C. Bipolar II D. Bipolar I - CORRECT ANSWERS a and d Select the two factors that are not applicable to diagnosing schizoaffective disorder. A.
Manic episodes B. Major depression C. Medical condition D. Substance abuse - CORRECT ANSWERS c and d what are side effects of 1st generation antipsychotics? 2nd generation - CORRECT ANSWERS 1st - EPS, sedation, postural hypotension (reduce dose, add antiparkinson med or change) can use propanolol 2nd - weight gain and metabolic derangements All antipsychotics elevate prolactin level (shrink gonads) Which antipsychotic is considered the most effective? - CORRECT ANSWERS Clozapine - problems agranulocytosis, hypersalivation, sedation, tachy, weight gain, postural hypotension) Select the personality disorder in which patients are continually in crisis and exhibit unpredictable behavior - CORRECT ANSWERS borderline personality disorder personality disorder with excessive suspiciousness and distrust? - CORRECT ANSWERS paranoid personality disorder. use projection to give impulses and emotions to others that they cannot accept in themselves personality disorder with pervasive disrespect for rights of others - CORRECT ANSWERS antisocial - has to be over 18 and demonstrated since 15
personality disorder with high degree of attention-seeking behavior - CORRECT ANSWERS Histrionic Select the personality disorder in which patients are preoccupied with perfectionism and interpersonal control. A. Passive-aggressive B. Obsessive compulsive C. Narcissistic D. Avoidance - CORRECT ANSWERS B Select the neurotransmitter for which the metabolite 5-HIAA in CSF is evident and predictive of suicide. A. Serotonin B. Dopamine C. Norepinephrine D. GABA - CORRECT ANSWERS p. 575 A serotonin low metabolite In the diagnosis of schizophrenia, symptoms must persist for how long? A. 1-2 months B. 3-4 months C. 6-8 months D. 8-10 months - CORRECT ANSWERS
What substance is known to decrease blood concentrations of antipsychotics, yet improve cognitive impairments and parkinsonism in schizophrenia illnesses? A. Alcohol B. Benzodiazepines C. Marijuana D. Nicotine - CORRECT ANSWERS Select the drug that is most likely to cause parkinsonian movement symptoms. A. Lorazepam B. Propranolol C. Benztropine D. Haloperidol - CORRECT ANSWERS Schizophrenia is equally prevalent in men and women. A. True B. False - CORRECT ANSWERS Bleuler identified "Four As" as fundamental symptoms of schizophrenia to frame his theory of internal mental schisms of patients that include all the following EXCEPT: A. Ambivalence B. Affective disturbances C. Arrogance D. Autism - CORRECT ANSWERS C. Arrogance Select the two defense mechanisms used commonly by patients with personality disorders. A. Introjection
B. Repression C. Splitting D. Projection - CORRECT ANSWERS What is the term for patients who mimic mental health symptoms without having the disorder for secondary gain? A. Schizophrenia B. Borderline C. Fictitious D. Maladaptation - CORRECT ANSWERS What is known as the peak age of onset for schizophrenia in males? A. 3-9 years old B. 10-25 years old C. 25-40 years old D. 40+ years old - CORRECT ANSWERS B 10- 25 Select the most common error by the provider in the practice of family-oriented therapy for persons with schizophrenia. A. Reducing drug dosage to eliminate adverse effects too quickly B. Encouraging family to promote patients to resume normal activity too quickly C. Controlling emotional intensity of family sessions with patients with schizophrenia D. Open discussion by practitioner with family about the patient's frightening psychotic symptoms - CORRECT ANSWERS B. Select the epidemiologic characteristic of tardive dyskinesia symptoms. A. Absence during sleep B. Most common in men C. Absence in age less than 50 D. 5% to 10% of patients require hospitalization - CORRECT ANSWERS p. 597 respiratory dyskinesia is exacerbated by stress and disappears during sleep. Women more likely to be affected Children and those over 50 more likely
other risks - pt's w/brain damage or mood disorders clozapine has minimal risk of tardive Select the personality disorder in which patients exhibit covert obstructionism, procrastination and pessimism. A. Obsessive compulsive B. Sadomasochistic C. Borderline D Passive-. aggressive - CORRECT ANSWERS D. passive aggressive p. 567 an other specified personality disorder that does not fit into categories. others depressive, oppositional, sadism, masochism. What is the terminology term for the dream-like state of patients with schizophrenia who are engaged in their hallucinations and exclude involvement in the real world? A. Oneiroid B. Euphoria C. Imaginati ve D. Paraphre nia - CORRECT ANSWERS Select the psychiatric disorder in which patients refuse mental health care and deny their problems. A. Obsessive compulsive B. Depressive C. Personality D. Anxiety - CORRECT ANSWERS Personality disorders Select the personality disorder that is assigned to Cluster B in DSM- 5 - TR. A. Dependent B. Paranoid C. Histrionic D. Schizoid - CORRECT ANSWERS Cluster B - dramatic Antisocial Borderline Histrionic Narcissistic Select the main goal of psychosocial therapies for persons with schizophrenia. A. Reduce frequency of auditory hallucinations B. Develop coping skills for adverse effects of antipsychotic drugs C. Develop skills for independent living D. Reduce exacerbations and re- hospitalizations - CORRECT ANSWERS
Select the type of neurochemical receptor that is blocked by caffeine. A. GABA B. Glutamate C. Adenosine D. Norepinephr ine - CORRECT ANSWERS C. Adenosine Caffeine causes most of its biological effects via antagonizing all types of adenosine receptors. Select the personality disorder in which patients are most likely to tolerate spousal abuse to avoid losing sense of attachment. A. Dependent B. Narcissistic C. Passivea ggressive D. Depressive - CORRECT ANSWERS A. Dependent Because persons with the disorder do not like to be alone, they seek out others on whom they can depend; their relationships, thus, are distorted by their need to be attached to another person. In a shared psychotic disorder (folie à deux), one member of the pair usually has dependent personality disorder; the submissive partner takes on the delusional system of the more aggressive, assertive partner on whom he or she depends. Pessimism, self-doubt, passivity, and fears of expressing sexual and aggressive feelings all typify the behavior of persons with a dependent personality disorder. An abusive, unfaithful, or alcoholic spouse may be tolerated for long periods to avoid disturbing the sense of attachment. What group is at highest risk for neuroleptic induced parkinsonism? - CORRECT ANSWERS p. 594 elderly and female at highest risk. adverse effects typically occur within 5 to 90 days of treatment. Most notable Haldol. Treatment for parkinsonism? - CORRECT ANSWERS benzotropine (cogentin), amantadine (Symmetrel), or benadryl. can use propanolol, clonidine, Most affected by Neuroleptic malignant syndrome? - CORRECT ANSWERS Life-threatening. increased wbc, creatinine phosphokinase, liver enzymes, myoglobulin. Men more affected and young more affected
medication for neuroleptic malignant syndrome - CORRECT ANSWERS dantrolene, bromocriptine. Haldol poses greatest risk Who is most likely to get medication induced dystonias? - CORRECT ANSWERS Men and young. treatment IM benadryl, valium Who is most at risk for acute akathisia? (restlessness,) - CORRECT ANSWERS Middle aged women. Treat by changing drug when does tardive dyskinesia arise Tx? - CORRECT ANSWERS months to years after a typical antipsychotic med is initiated switch to an Atypical Antipsychotic. Clozaril does not cause tardive What are the four principles for treating medication induced postural tremor? - CORRECT ANSWERS 1. use lowest possible does of psych drug
two antipsychotics with highest risk of increasing glucose levels - CORRECT ANSWERS Clozapine and olanzapine which drug can cause hyponatremia in elderly? - CORRECT ANSWERS oxcarbazepine (trileptal) severe perspiration as side effect from SSRIs, venlafaxine, and TCAs can be treated with what medications? - CORRECT ANSWERS terazosin, oxybutynin What is the therapeutic index? - CORRECT ANSWERS ratio of median toxic dose to median effective dose median toxic dose - dose at which 50% will experience a certain toxic effect median effective dose - dose at which 50% will experience therapeutic effect when high can use varying dose, when low requires monitoring (e.g. lithium) What is the definition of remission? - CORRECT ANSWERS Disappearance of sx, but not necessary the presence of disease. Below syndromal threshold. What are responders? - CORRECT ANSWERS Patients who improve but do not experience a full resolution. response is usually defined as a 50 percent or more decrease from baseline on a standard rating scale like HAM-D. which two disorders are more likely to be associated with residual manifestations of illness? - CORRECT ANSWERS OCD and schizophrenia. (OCD less than 12% for full remission, partial is 47%) Treatment failure guidelines? - CORRECT ANSWERS change meds reassess for correct dx are truly still not being helped and just seeing adverse effects
check dosage investigate interactions patient compliance cross tolerance - CORRECT ANSWERS development of tolerance to one drug causes tolerance to related drugs sensitization effect - CORRECT ANSWERS an increase in sensitivity to drug over time. Same dose produces more profound effects as treatment progresses. drugs with highest withdrawal reactions? - CORRECT ANSWERS sedative-hypnotics and opiates *alprazolam and triazolam more immediate and intense withdrawals *SSRI paroxetine (Paxil) most severe, then venalfaxine Paroxetine is a - CORRECT ANSWERS auto inhibitor. It's metabolized by CYP 2d6 but is potent inhibitor of CYP 2D6 causing steep changes in plasma concentration Does sustained release versions of drug reduce severity of withdrawal? - CORRECT ANSWERS No. the increased half-life is due to delayed absorption rather than prolonging elimination phase. difference between augmentation and combination therapy? - CORRECT ANSWERS Two psychotropics use w/same indications concurrently - combination therapy adding drug with another indication - augmentation combining drugs create a broad spectrum effects and changes ratio of metabolites which antidepressant carries warning from FDA regarding increased risk of cardiac malformation? - CORRECT ANSWERS Paroxetine
Agents with risk of specific congenital abnormalities? - CORRECT ANSWERS Lithium, valproate, carbamazepine, lamotrigine may cause cleft palate Two major concerns with elderly and medication - CORRECT ANSWERS more susceptible to adverse effects, especially cardiac metabolize and excrete slower Dosage of haldol for agitated elderly patients w dementia and for delirium - CORRECT ANSWERS 0.5 to 1 mg haldol What type of patient should receive benzo rather than DRA? - CORRECT ANSWERS One psychotic from drugs, in ETOH w/d DRA may increase risk of seizure which drugs are useful for premature ejaculation? - CORRECT ANSWERS fluoxetine and sertraline SSRIs used in autism? - CORRECT ANSWERS sertraline and fluvoxamine mitigate aggressiveness fluoxetine useful for features of autism in children, adolescents, and adults medications to counteract sexual side effects of ssri - CORRECT ANSWERS add or switch buproprion (mirtazepine) , sildenafil which ssri causes greater risk of causing fatal heart rhythm abnormalities? - CORRECT ANSWERS citalopram
What percent of patients with Substance abuse dependence meet criteria for antisocial personality disorder? - CORRECT ANSWERS 35 to 60% Select the percentage of substance-addicted persons with a concurrent psychiatric disorder How many more times likely are people with substance abuse to commit suicide? - CORRECT ANSWERS 20 times more likely than general population Select the psychoactive substance that is most frequently consumed worldwide - CORRECT ANSWERS Select the age range of the highest rate of substance dependence or abuse - CORRECT ANSWERS Select the substance that is most commonly abused by adolescents - CORRECT ANSWERS Select the neurotransmitter system that is most associated with the addictive rewarding properties of opioids - CORRECT ANSWERS p. 274 Select the percentage of substance-addicted persons with a concurrent psychiatric disorder - CORRECT ANSWERS p. 271 up to 50% Select the hepatic enzyme that performs the initial metabolism of alcohol - CORRECT ANSWERS Select the preferred drug used to treat alcohol withdrawal - CORRECT ANSWERS Select the brain region that is associated with substance addiction - CORRECT ANSWERS Select the substance of abuse with the strongest evidence for genetic association - CORRECT ANSWERS Alcohol p.
Select the personality disorder in which patients seek social withdrawal - CORRECT ANSWERS schizotypal Select the percentage of the U.S. population with a substance dependence problem as of year 2012
Select the brain region devoid of cannabinoid receptors. A. Brain stem B. Basal ganglia C. Cerebellu m D. Hippocam pus - CORRECT ANSWERS Select the brain region that is associated with substance addiction. A. Prefrontal cortex B. Caudate nucleus C. Basal ganglia D. Ventral tegmental - CORRECT ANSWERS D. The dopaminergic neurons in the ventral tegmental area (VTA) project to cortical and limbic regions causing reward pathway p. Select the neurotransmitter system that is most associated with the addictive rewarding properties of opioids. A. Dopaminergic B. Serotonergic C. Adrenergic D. Glutamatergic - CORRECT ANSWERS A. Dopaminergic The opioid, catecholamine (dopamine), and gaba classic sign of etoh withdrawal - CORRECT ANSWERS tremulousness What are the two broad categories of sexual disorders? - CORRECT ANSWERS sexual dysfunction and paraphilias Essential features of sexual dysfunctions? - CORRECT ANSWERS inability to respond to sexual stimulation or experience of pain during sexual activity SSRIs that inhibit female orgasm - CORRECT ANSWERS fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram