NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest, Exams of Nursing

Download NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest and more Exams Nursing in PDF only on Docsity! NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Most addictive substances - CORRECT ANSWERS Per Stahl question book is BATH SALTS (MDPV) is greater than meth. Heroin is greater than meth. heroin - per stiles caffeine - CORRECT ANSWERS most widely consumed Alcohol - CORRECT ANSWERS one of the most widely used Highest potential for abuse - CORRECT ANSWERS schedule 1 drugs - heroin, LSD, meth, fentanyl, MDMA, crack cocaine (super addictive) LSD is a - CORRECT ANSWERS schedule 1, has the highest potential for abuse, there is no medical reason for this drug. Risk of suicide in Alcohol - CORRECT ANSWERS 10-15% Risk of suicide in Opioid dependence - CORRECT ANSWERS 15% attempt at least once Risk of suicide in Heroin - CORRECT ANSWERS 20 times rate in general population Risk of suicide in Inhalants - CORRECT ANSWERS suicidal ideation Hallucinogens intoxication Barbiturates Stimulants - in withdrawal Steroids - in withdrawal SSRIs - black box warning NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Term for cocaine after it has been changed to a free base - CORRECT ANSWERS crack Heroin use and its immediate risk for death secondary to cardiac arrest - CORRECT ANSWERS The immediate risk for death for heroin is overdose, respiratory depression (most common opioid used Predictable risk factors for drug use - CORRECT ANSWERS Low socioeconomic class Poor parental support Drug availability Depression enabling Withdrawal symptoms for heroin - CORRECT ANSWERS Restlessness Muscle and bone pain Stomach issues Insomnia Cold flashes Uncontrolled kicking movements HEROIN IS THE HARDEST HABIT TO KICK Time frame to expect withdrawal symptoms in patients using heroin - CORRECT ANSWERS Onset - 6-8 hours Peak 48-72 Total time - 7-10 days Symptoms can persist 6+ months Drugs associated with date rape - CORRECT ANSWERS GHB, Rohypnol, Ketamine NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Physiological s/s of drug use in adolescents - CORRECT ANSWERS Change in academic performance, physical ailments, changes in relationship w/ family members, unexplained phone calls, changes in personal hygiene THC - memory & learning impairment, distorted perception, diminished problem- solving, loss of coordination, increased heart rate, panic attacks Cocaine - constriction of peripheral blood vessels, dilated pupils, hyperthermia, increased heart rate, hypertension Heroin - nausea, vomiting, flushed skin, itching, drowsiness, clouded thinking Statistics for inherited alcoholism - CORRECT ANSWERS Genetics = 60% 25% chance of becoming alcoholic if parents are alcoholics Threefold to fourfold increased risk in close relative Increases with the number of alcoholic relatives 30% of alcoholics have one parent who is also 20% of 8th graders have used illicit drugs 30% of grades 10-12th graders have used illicit drugs Up to 15% pf ETOH dependent persons commit suicide Which environmental factors contribute to drug use - CORRECT ANSWERS Low socioeconomic class Poor parental support Drug availability Depression Enabling Book says: Parent modeling of substance use Family conflict NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Lack of parent supervision Peer relationships Individual stressful life events Withdrawal sx for stimulants - CORRECT ANSWERS Peak 2-4 days Total time - 1 week Crash Anxiety Tremors Mood issues Lethargy Fatigue Nightmares Headache Sweating Cramps hunger Withdrawal sx for Cocaine - CORRECT ANSWERS Resolve 7-10 days Poor concentration Slowed thinking Slow activity Exhaustion Restlessness No sex arousal Anhedonia dep/anx SI NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Vivid/bad dreams Chills, tremors, aches, pains Cravings hunger Withdrawal sx for Heroin - CORRECT ANSWERS Onset - 6-8 hours Peak 48-72 Total time - 7-10 days Symptoms can persist 6+ months Restlessness Muscle and bone pain Stomach issues Insomnia Cold flashes Uncontrolled kicking movements Withdrawal sx for alcohol - CORRECT ANSWERS 6-8 hrs - shakes 8-12 hrs - psychosis 12-24 hrs seizures DT <72 hrs **Tremors delusions/AVH Seizures DTs Irritability GI distress Anxiety Arousal NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Take all serious Suicide - 3rd leading cause of death Homicide - 2nd leading cause of death Accidents - 1st leading cause of death All 3 are psych emergencies, may need hosp or involuntary tx. Drugs not associated with increased suicidal risks - CORRECT ANSWERS THC, Lithium, 2ng gen antipsychotics, Clozipine Drugs associated w/ increased suicide risks - CORRECT ANSWERS SSRIs, antidepressants including Strattera, Lamictal Inpatient recommended for: - CORRECT ANSWERS Suicide attempt with a highly lethal method (eg, firearm or hanging) Suicide attempt that included steps to avoid detection Ongoing suicidal ideation or disappointment that the suicide attempt was not successful Inability to openly and honestly discuss the suicide attempt and what precipitated it Inability to discuss safety planning Lack of alternatives for adequate monitoring and treatment Psychiatric disorders (eg, unipolar major depression, bipolar disorder, psychotic disorders, or substance use disorders) underlying suicidal ideation and behavior Agitation Impulsivity Severe hopelessness Know best course of action for suicidal patients - CORRECT ANSWERS Lock shit up! LOL Remove weapons Ask the family as a whole, child by themselves, other school staff and coaches if needed NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Ask the child to commit to safety plan is not just about the plan but an assessment of intention, for instance, passive suicide might say yes but one with a plan and intent would say no BEST PRACTICE do not chart contracts for safety or follow through with a safety contract but make a safety plan which can increase therapeutic relationship Level of treatment plan intervention depends on suicide intent= passive or active SI No confidentiality when patient is at risk Medical stabilization is first priority before suicide assessment suicidal precautions in adolescents - CORRECT ANSWERS Again - lock shit up! High risk needs 1:1 staffing and placed in gown to decrease elopement and safe room and restraints should be avoided if possible Unresolved conflicts, truancy and defiance as they relate to Erickson's stages of development - CORRECT ANSWERS Infant Trust vs Mistrust= hope if badly handled then insecure and mistrustful could lead to ODD and CD 18mos to 4yrs Autonomy vs Shame= will if not completed then stormy self-will, tantrums, stubbornness, and negativism Initiative vs guilt= don't think it would cause ODD or CD 5-13 years Industry vs inferiority by this time they have already been wired so would not be the direct cause but "relating with peers according to rules" could be where it seems ODD and CD would trigger behaviors 14-17 identity vs role confusion= once again already wired for ODD or CD probably but the behaviors will be seen at this time of "minor delinquency and rebellion flourishes" NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Normal behavioral and socioemotional milestones in a 6 year old child (Stiles PPT) - CORRECT ANSWERS May not realize every living thing dies and begin to understand death if final Begin to use coping strategies Sadock pp 1091 Identifies with adult to cope--learns coping from parents DON'T UNDERSTAND DEATH OR HEAVEN? Piaget stage is Concrete Operational and heaven is not a concrete concept (From discussion post week 14 also) Tasks of school age and pre-school age children - CORRECT ANSWERS School age- thinking more organized and logical. Write and draw, ability to concentrate, good motor tasks (can play in sports), accepts and follows rules, can internalize them. Pre-school age - physical & emotional growth, control their bowel and bladder, dress and feed themselves, not capable of empathy, Egocentric thinking (cant put themselves in someone else's shoes yet) can tell reality from fantasy DBT and sound sense of self (stages) (from Stiles - she said know 1 and 4) - CORRECT ANSWERS Stage 1 - focuses on prevention of SI, self-harm Stage 4 - focuses on getting a "good sense of self" around internal struggles PTSD and trauma focused therapy - CORRECT ANSWERS Recognize and emphasize understanding how the traumatic experience impacts the child's mental, behavioral, emotional, physical and spiritual wellbeing To understand the connection between the trauma and the child's emotional and behavioral response Offer skills to assist in better understanding, coping, processing emotions and memories tied to traumatic experiences. Goal - enable the child to create a healthier & adaptive meaning of the traumatic experience (remove uncomfortable emotions from memory) NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Perpetrators: - CORRECT ANSWERS Chose same race victims 51% are white 47% are black 7% are close relatives 10% have more than 1 attacker Considered crime of aggression not sexuality. Types: Sexual sadists aroused by pain of victim Exploitive predators using victim as owned object Inadequate men convinced no woman will have sex with them become obsessed with fantasies of sex Men who displace anger and rage through rape Juvenile offenders: - CORRECT ANSWERS Higher use of weapons and cause injuries Most are male Most rape male relatives Trick, threaten, or bribe relative -sexual coercion Aggressive/violent personality Have learning disability likely Substance use and CD, ODD or personality disorder comorbidity which include impulsivity and poor judgment Rape vs consensual act of sex vs sexual coercion vs sexual intolerance - CORRECT ANSWERS Coercion = unwanted sexual activity due to being pressured, tricked, threatened, or forced = non-physical but is mental Sexual coercion = incidents in which a person dominates another by force or compels the other person to perform a sexual act Rape = Unlawful sexual activity/intercourse that is forced under threat of injury or with a minor under age of consent, or can't consent due to mental illness, mental deficiency, intoxication, unconsciousness, or deception NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Sexual intolerance = intolerance towards LGBTQ persons Development of gender and sexual identity Sadock pp1094 - CORRECT ANSWERS Gender identity- conviction of gender starts at 18mos and is fixed by 30months Evidence suggests major part of gender is genetic Sexual identity- pp 565 is the physical characteristics of genitalia Gender identity and sexual identity are not always congruent, consider cognitive, social, emotional, cultural, and familiar complexities of the person's experience Jeffries - not associated with parents being gay Stigmas - what is commonly said vs what is actually true Characteristics of abusive parents - CORRECT ANSWERS "Characteristics of abusive parents often include a history of abuse in their own early lives, a lack of empathy for the child, unrealistic expectations of child, and an impaired parent-child attachment." Sadock pp 1316 Significant guilt Delay seeking treatment for injuries Story doesn't line up with injury Deny possibility of abuse/neglect/maltreatment Most common is neglect High rates of poverty, substance abuse, low education, mental illness, underemployed, single parent High domestic violence rate between parents Parents of lots of kids Per Jeffries: Controlling, strict NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Best interview techniques when domestic abuse is suspected - CORRECT ANSWERS Sadock pp 1319 Formal: Cognitive interview-encourages witnesses to search memories in various ways to recall the event such as forward and backward. -Step-wise interview-funnel approach with open-ended general questions towards details NICHD interview protocol-series of phases which uses scripts Informal: Experienced clinicians say flexibility and good-heartedness are key Make child comfortable with activity, food, comfort item, person etc. Important comments might be made during informal break times Jeffries: ask leave room/stay in room/take to other part of office Causes of reactive attachment disorders and the brains responses to it including the amyglada and insula - CORRECT ANSWERS Patho: Abnormal function of Amygdala and insula - decrease in brain structure S/S: No emotions Difficulty calming down Don't look to caregivers for comfort Don't interact with others in a normal way Causes: Caregiver deprivation Jeffries: kids look like = foster care, CPS vs child wanting hugs/loved/held NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Post-traumatic stress disorder (PTSD) and numbness/hyperarousal and avoidant behaviors - CORRECT ANSWERS Another critical symptom cluster of PTSD is avoidance, which in childhood may be displayed by making active physical efforts to avoid the places, people, or situations that would present traumatic reminders of the event. After a traumatic event, children may experience a sense of detachment from their usual play activities ("psychological numbing") or a diminished capacity to feel emotions. Psychosocial treatments should include cognitive-behavior therapy in treating children with PTSD - CORRECT ANSWERS Per Stiles = Trauma-focused CBT therapy Duration of symptoms in PTSD and diagnosing - CORRECT ANSWERS Symptoms 3 days to <1 month = acute PTSD Symptoms 1 month = PTSD Symptoms >3 months = chronic PTSD Whole syndrome emerges after 6 months = delayed onset S/s of PTSD in children and initial and ongoing treatment - CORRECT ANSWERS Sx: Crying, HA, thumb sucking, depression, bathroom accidents, clingy, nightmares, irritability, outbursts, aggression, difficulty concentrating, sexual bhx that are not developmentally expected, flashbacks, avoidance (avoid places, people, situations that remind of the event). Socially withdrawn, low interest in play, feelings of shame, fear, confusion, psychological amnesia, cant fall asleep Tx: Therapy - Trauma focused CBT, Cognitive Behavioral Intervention for Trauma in School (CBITS), Structured Psychotherapy for Adolescents Responding to CHronic Stress (SPARCS), Trauma Affect Regulation;Guide for Education and Therapy (TARGET) Tx: Meds - FDA Approved: Sertraline and Paroxetine, Non FDA Approved: Clonidine & Prazosin (nightmares), Guanfacine, Propranolol NURS663 Exam 3 Test Exam with questions and answers 100%Correctly verified answers latest update 2024/2025 RATED A+ Lab test needed for psychiatric workups - CORRECT ANSWERS CBC, CMP, UA, USD, HCG, TSH, ASA and ACET levels alcohol abuse - CORRECT ANSWERS daily use of large amounts of alcohol for adequate functioning, a regular pattern of heavy drinking limited to weekends, and long periods of sobriety interspersed with binges of heavy alcohol intake lasting for weeks or months strongly suggest alcohol dependence and alcohol abuse. Marijuana dependence - CORRECT ANSWERS People who use cannabis daily over weeks to months are most likely to become dependent. The risk of developing dependence is around one in ten for anyone who uses cannabis. The earlier the age of first use, the more often cannabis has been used, and the longer it has been used, the higher the risk of dependence. Alcohol Intoxication - CORRECT ANSWERS Slurred speech Dizziness Incoordination Unsteady gait Nystagmus Impairment in attention/memory Stupor & coma Double vision alcohol dependence - CORRECT ANSWERS marked impairment on cognition and performance tasks. Even modest doses of cannabis impair memory, reaction time, perception, motor coordination, and attention.