NURS 751 NEUROBIOLOGY & MENTAL DISORDERS COMPLETED EXAM 2024, Exams of Nursing

Download NURS 751 NEUROBIOLOGY & MENTAL DISORDERS COMPLETED EXAM 2024 and more Exams Nursing in PDF only on Docsity! NURS 751 Neurobiology & Mental Disorders COMPLETED EXAM 2024 1. What are the three main types of bipolar disorder and how do they differ in terms of symptoms, duration, and severity? Provide examples of each type. - Bipolar I disorder is characterized by at least one manic episode, which is a period of abnormally elevated, expansive, or irritable mood and increased activity or energy, lasting at least a week or requiring hospitalization. Manic episodes may be preceded or followed by major depressive episodes, which are periods of low mood and loss of interest or pleasure in most activities, lasting at least two weeks. Bipolar I disorder can cause severe impairment in functioning and increase the risk of suicide and other complications. - Bipolar II disorder is similar to bipolar I disorder, but the manic episodes are less severe and are called hypomanic episodes. Hypomanic episodes last at least four days and do not require hospitalization. However, they still cause noticeable changes in mood and behavior that may affect the person's ability to function normally. Bipolar II disorder also involves major depressive episodes that may be more frequent and longer than in bipolar I disorder. - Cyclothymic disorder is a milder form of bipolar disorder that involves chronic fluctuations between hypomanic and depressive symptoms that do not meet the criteria for full-blown episodes. The symptoms last for at least two years in adults or one year in children or adolescents and cause significant distress or impairment in functioning. 2. What are some of the risk factors for developing schizophrenia and how can they be modified or prevented? Provide at least three examples of each category. - Schizophrenia is a complex mental disorder that affects how a person thinks, feels, and behaves. It involves psychotic symptoms such as hallucinations, delusions, disorganized speech, and abnormal motor behavior, as well as negative symptoms such as reduced emotion, motivation, and social interaction. Schizophrenia usually emerges in late adolescence or early adulthood and can cause lifelong disability and reduced quality of life. - Some of the risk factors for developing schizophrenia are genetic, environmental, and developmental. Genetic factors include having a family history of schizophrenia or other psychotic disorders, having certain gene variants or mutations that affect brain development or neurotransmission, or having a rare chromosomal abnormality such as 22q11.2 deletion syndrome. Environmental factors include exposure to prenatal infections, malnutrition, hypoxia, or stress; exposure to childhood trauma, abuse, neglect, or bullying; exposure to cannabis or other psychoactive substances; or exposure to urbanicity, migration, or social isolation. Developmental factors include having low birth weight, prematurity, complications during delivery, or head injury; having early- onset puberty, dyslexia, autism spectrum disorder, or attention-deficit/hyperactivity disorder; or having impaired cognitive functioning, social skills, or emotional regulation. - Some of the ways to modify or prevent these risk factors are early identification and intervention, prenatal and perinatal care, childhood protection and support, substance use prevention and treatment, social integration and inclusion, and cognitive enhancement and rehabilitation. Early identification and intervention involve screening for high-risk individuals and providing them with psychoeducation, psychosocial support, medication management, and psychotherapy to reduce the likelihood or severity of psychotic episodes. Prenatal and perinatal care involve ensuring adequate nutrition, infection control, oxygen supply, and stress reduction for pregnant women and newborns to prevent brain damage or inflammation that may predispose to schizophrenia. Childhood protection and support involve preventing or treating trauma, abuse, neglect, or bullying that may trigger stress responses or epigenetic changes that may increase the vulnerability to schizophrenia. Substance use prevention and treatment involve educating 4. What are the main types of anxiety disorders and how do they differ in terms of symptoms, causes, and treatments? Provide examples of each type. - Anxiety disorders are a group of mental disorders that involve excessive fear, nervousness, or worry that interfere with the person's daily life and functioning. Anxiety disorders can cause physical symptoms such as palpitations, sweating, trembling, shortness of breath, nausea, dizziness, or chest pain. Anxiety disorders can also cause psychological symptoms such as panic, dread, avoidance, hypervigilance, or catastrophizing. Anxiety disorders can affect various aspects of the person's life such as social, occupational, academic, or personal domains. - Some of the main types of anxiety disorders are: - Generalized anxiety disorder (GAD) is characterized by chronic and pervasive worry about various aspects of life such as health, work, family, finances, or future events. The worry is difficult to control and causes significant distress or impairment in functioning. The person may also experience restlessness, fatigue, difficulty concentrating, irritability, muscle tension, or sleep problems. - Panic disorder is characterized by recurrent and unexpected panic attacks, which are sudden and intense surges of fear or discomfort that peak within minutes and involve physical symptoms such as palpitations, sweating, trembling, shortness of breath, nausea, dizziness, chest pain, choking sensation, or fear of dying. The person may also experience agoraphobia, which is a fear of situations where escape might be difficult or help might not be available in case of a panic attack. The person may avoid places such as crowds, public transportation, open spaces, or enclosed spaces that may trigger or worsen their panic attacks. - Social anxiety disorder (SAD) is characterized by marked and persistent fear of social situations where the person may be exposed to possible scrutiny, judgment, rejection, or embarrassment by others. The person may fear situations such as speaking in public, meeting new people, eating in front of others, or performing certain tasks. The person may experience physical symptoms such as blushing, sweating, trembling, nausea, or difficulty speaking. The person may avoid social situations that cause them anxiety or endure them with intense distress. - Specific phobias are characterized by excessive and irrational fear of specific objects or situations that pose little or no actual danger. The person may fear objects such as animals, insects, blood, needles, heights, water, storms, etc. The person may experience physical symptoms such as palpitations, sweating, trembling, nausea, dizziness, etc. The person may avoid the feared object or situation that cause them anxiety or endure them with intense distress. - Some of the possible causes of anxiety disorders are: - Genetic factors that influence the susceptibility to anxiety disorders by affecting brain structure, function, chemistry, or regulation. - Environmental factors that trigger or exacerbate anxiety disorders by exposing the person to stressful life events, trauma, abuse, neglect, loss, illness, etc. What are the four main categories of the DSM-5, and what are some examples of disorders in each category? (4 points) - The four main categories of the DSM-5 are neurodevelopmental disorders, schizophrenia spectrum and other psychotic disorders, bipolar and related disorders, and depressive disorders. Some examples of disorders in each category are autism spectrum disorder, schizophrenia, bipolar I disorder, and major depressive disorder, respectively. (Rationale: The DSM-5 is the most widely used diagnostic manual for mental disorders, and it organizes them into broad categories based on common features and symptoms.) What is the difference between a mental disorder and a mental health problem? (2 points) - A mental disorder is a clinically significant disturbance in an individual's cognition, emotion regulation, or behavior that reflects a dysfunction in the psychological, biological, or developmental processes underlying mental functioning. A mental health problem is a broader term that encompasses any difficulty or challenge that affects one's mental well-being, such as stress, grief, or trauma. Not all mental health problems are mental disorders, but some may develop into or co-occur with mental disorders. (Rationale: It is important to distinguish between mental disorders and mental health problems, as they have different implications for diagnosis, treatment, and prevention.) What are some common sources of information that can be used to assess a client's mental status? (3 points) - Some common sources of information that can be used to assess a client's mental status are self- report measures, such as questionnaires or interviews; behavioral observations, such as appearance, speech, mood, or affect; psychological tests, such as intelligence or personality tests; and biological data, such as blood tests or brain scans. (Rationale: A comprehensive assessment of a client's mental status requires multiple sources of information that can capture different aspects of their functioning.) What are some advantages and disadvantages of using standardized diagnostic criteria for mental disorders? (4 points) - Some advantages of using standardized diagnostic criteria for mental disorders are that they provide a common language and framework for communication among clinicians, researchers, and clients; they facilitate the identification of risk factors and treatment options for specific disorders; and they enable the comparison and evaluation of outcomes across different settings and populations. Some disadvantages of using standardized diagnostic criteria for mental disorders are that they may oversimplify the complexity and diversity of human experience; they may ignore the cultural and contextual factors that influence the expression and interpretation of symptoms; and they may create stigma and discrimination for people who are labeled with a disorder. (Rationale: Standardized diagnostic criteria for mental disorders have both strengths and limitations that need to be considered when applying them in practice.) What are some ethical principles that guide the diagnosis of mental disorders? (4 points) - Some ethical principles that guide the diagnosis of mental disorders are respect for autonomy, beneficence, nonmaleficence, justice, and fidelity. Respect for autonomy means respecting the client's right to make informed decisions about their own care. Beneficence means promoting the client's well-being and best interests. Nonmaleficence means avoiding or minimizing harm to the client. Justice means treating the client fairly and equitably. Fidelity means being faithful and loyal to the client and maintaining confidentiality. (Rationale: Ethical principles are essential for ensuring that the diagnosis of mental disorders is conducted in a responsible and respectful manner.) 1. If you suspect someone may be at risk for suicide, what two major questions should you ask? a. Ask the person directly whether they are suicidal b. Ask the person whether they have plans b.i. If the person answers yes: b.i.1. Have you decided how you are going to do it? b.i.2. Have you decided when you would do it? b.i.3. Have you collected the things you need to carry out your plan? c. We also discussed two additional factors you should explore to assess risk. What questions can you ask to know about these extra risk factors? c.i. Has the person been using alcohol or other drugs? c.ii. Has he or she made a suicide attempt in the past? 2. It may be difficult to distinguish between a panic attack and a heart attack. Identify three symptoms of a panic attack that may be similar to a heart attack a. Rapid heartbeat b. Chest pain c. Shortness of breath 3. A traditional way to treat a person having a panic attack was to have them breathe into a paper bag. Describe three reasons this may not be appropriate a. One may not be available b. Person may not be having a heart attack rather than an anxiety attack and they need c.i. The care of the person is managed by a team of various kinds of health professionals, such as psychiatrist, nurse, psychologist and social worker. Care is available 24 hours a day and is tailored to the person’s individual needs c.ii. Assertive community treatment has been found to reduce relapses and the need for hospitalization. d. Psychoeducation 15. List four of the short-term problems caused by alcohol addiction a. Physical injuries – more likely to engage in risk behavior which can lead to injury or death b. Aggression and antisocial behavior c. Sexual risk taking d. Suicide and self-injury – more likely to act on these thoughts (acts as a mood intensifier) 16. List 8 symptoms associated with alcohol intoxication and poisoning that indicate you should call an ambulance or get other medical help. a. Cannot be awakened or is unconscious b. Has irregular, shallow, or slow breathing/pulse c. Cold, clammy, pale or bluish skin d. Continuous vomiting e. Shows signs of possible head injury (talking incoherently_ f. Having seizures g. The person has delirium—a state of confusion and visual hallucinations h. Overheating, dehydration, and overhydration 17. What is the recovery position and why is it important? Describe how to put a person who is intoxicated into the recovery position (include the leg, arm, and head positions). a. Kneel beside the person b. Put their arm that’s farthest from you out at right angles to their body c. Place their nearer arm across their chest d. Bend their nearer leg up at the knee; the other leg should be straight e. While supporting their head and neck, roll the person away from you f. When they are on their side, keep their top leg bent at the knee, with the knee touching the ground f.i. Then tilt the head slightly backwards and downwards to let anything that’s in the airway (such as vomit) drain out, and then clear the airway with your fingers g. If you leave the person on their back, they can suffocate on their vomit or their tongue can block the airways. The recovery position will keep their airways open 18. What does the term co-occurring disorder mean in the field of behavioral health? a. Substance use disorder co-occurring with mental illness a.i. For example, people with mood or anxiety disorders are two to three times more likely to have a substance use disorder 19. Identify the major characteristics associated with anorexia and bulimia a. Anorexia b. Maintaining a very low body weight c. Intense fear of gaining weight d. Loss of at least three consecutive menstrual periods 20. Bulimia a. Repeated episodes of uncontrolled overeating combines with purging behaviors 21. Eating disorders are typically long-term problems that are not easily overcome. What are three main crises associated with eating disorders? a. Slowing of growth and puberty b. Loss of tooth enamel c. Brain changes that can lead to cognitive problems d. Loss of bone density 22. List 5 specific actions you can take when using ALGEE to try to de-escalate someone’s aggressive behavior. a. Assess the risk of suicide or harm a.i. Ask the person what has upset them a.ii. Be aware of what may exacerbate the persons aggression b. Listen nonjudgmentally b.i. Understand the symptoms for what they are b.i.1. Listen carefully to what the person says and don’t respond in a hostile or challenging manner (body language included) b.ii. Empathize with how the person is feeling about their beliefs and experiences b.ii.1. This makes the person feel understood and not judged which, in turn, makes it easier to ask for help (reflective listening) b.iii. Key attitudes: acceptance, genuineness, and empathy b.iv. Key nonverbal skills: attentiveness, open body posture, not fidgeting, and using a calm voice c. Give reassurance and information c.i. Treat the person with dignity and respect c.ii. Offer consistent emotional support and understanding c.iii. Give the person hope for recovery c.iv. Offer information c.v. Provide practical help c.vi. Do not make any promises that you cannot keep d. Encourage person to get appropriate professional help d.i. Encourage the person to call 911 and get professional help from a doctor, psychiatrist, or other MH professional e. Encourage self-help strategies 23. Outline a Mental Health Action Plan for a person with a substance abuse disorder. List each ALGEE step and identify some specific actions you would take for each of these steps. Be sure to include specific actions related to substance abuse in your plan. a. Assess the risk of intoxication, unsupervised severe withdrawal, which can lead to a seizure, aggression, suicidal thoughts and behaviors, non-suicidal self-injury, and suffocation b. Listen nonjudgmentally b.i. Try to b.i.1. Listen without judging as a bad or immoral person b.i.2. Avoid expressing moral judgments about his/her drinking b.i.3. Show you are concerned for their well-being b.ii. Try not to b.ii.1. Be critical of the person b.ii.2. Label or accuse the person of being an addict c. Give reassurance and information c.i. Changing substance abuse habits aren’t easy c.ii. Willpower and self-resolve aren’t always enough to stop the problem c.iii. Not everyone wants abstinence as a goal—reducing the quantity of use can be worthwhile c.iii.1. A person may stop or try to stop substance use more than once before being successful c.iii.1.a. Stages of change d. Encourage appropriate professional help d.i. Brief intervention or therapy d.ii. Withdrawal management d.iii. Medication d.iv. 911 if necessary e. Encourage self-help and other support strategies e.i. Support groups e.ii. AA e.iii. Family, friends, and faith networks e.iv. Avoid friends and social settings involving drugs