Psychiatric Disorders and Treatments, Exams of Nursing

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What is true of interprofessionality? - answer ✅✅All health professionals have individual professional competencies What is the significance of an experimental p-value of 0.05 - answer ✅✅There is a 5% chance of a similar result occurring by chance alone What percentage of children with oppositional defiance disorder will develop conduct disorder? - answer ✅✅30% In the DSM-5, selective mutism is now considered what type of disorder? - answer ✅✅anxiety disorder

Symptoms of selective mutism must persist for at least - answer ✅✅1 month Common competencies - answer ✅✅overlap more than one health care professional, although not necessarily all health care professionals, and are competencies expected of all health care professionals Complementary competencies - answer ✅✅enhance the qualities of other professions in provision of care Collaborative competencies - answer ✅✅those that each individual profession must possess to work with others, including those who practice within different specialties within a profession. Interpersonal collaboration is _______ centered - answer ✅✅patient Cognitive therapy is recommended for patients that have - answer ✅✅negative cognitive distortions

irrational beliefs faulty conceptions Humanistic Therapy focuses on assisting patients with - answer ✅✅self-actualization and self-directed growth Behavioral Therapy focuses on - answer ✅✅changing maladaptive behaviors through the use of behavioral modification techniques Existential therapy is for - answer ✅✅reflection on life confronting self 120 who got diarrhea ate lettuce. 80 with diarrhea did not eat lettuce. 40 without diarrhea ate lettuce. 160 without diarrhea ate lettuce. What is the odds ratio of eating lettuce and developing diarrhea? - answer ✅✅6 ((120X160)/(80x40)) The New Freedom Commission on Mental Health (NFCMH) released a report that suggested - answer

✅✅implementation a national campaign to reduce the stigma of seeking care Focusing on promoting recovery and building resilience The efficacy of mental health treatments was found to be well documented in - answer ✅✅influential report issued by US Surgeon General in 1999 State of high negative emotion and pessimism - answer ✅✅neuroticism Commonly known as an optimistic outlook on life They are are outgoing, like social interaction, respond to external rewards, have more active dopamine networks, and are responsive to positive reinforcement. - answer ✅✅Extraversion (high levels protect from psychiatric illness) Introverts are more likely to be _______ motivated and more likely to respond to _______ reinforcement - answer ✅✅internally negative (more likely to interact with internal motivation/self-image)

Interpersonal trait of cooperation, easy going nature. Tend to have smooth relationships often at the expense of self-assertion - answer ✅✅Agreeableness Associated with self-control and a focused, organized approach to life. Are achievement- oriented goal setters who can delay immediate gratification to obtain their long term desired outcome. They are considered responsible, reliable, and dependable. - answer ✅✅conscientiousness In behavioral couples therapy, the initial sessions are spent doing a functional analysis of behavior (FAB). What is true about FAB? - answer ✅✅FAB is concerned only with observable stimuli connected to operant behavior FAB is based on operant conditioning (identifying antecedent stimuli, operant behaviors, and consequent stimuli) The goal of FAB is modifying willful operant behavior

Gestalt theory deals with _____, not _____ - answer ✅✅perceptual psychology behavior Medication that can delay ejaculation in patients with premature ejaculation - answer ✅✅Paroxetine (and other SSRIs) (others include: Topical anesthetic Tramadol Phosphodiesterase-5 inhibitors) First line treatment for lithium induced diabetes insipidus - answer ✅✅Amiloride (K potassium diuretic) in addition to dc lithium when possible. Ways to reduce polyuria associated with lithium toxicity - answer ✅✅reduce lithium dose to minimum effective dose take once daily at night (may be 5-30% lower than when given in divided doses over the day) Encourage adequate fluid intake

What is true about ECT in Parkinson's disease - answer ✅✅it's more likely to cause transient delirium (worsened dyskinesias induced by l-dopa) Lithium effects with Parkison's disease - answer ✅✅may worsen tremor nonselective MAOIs decrease the efficacy of ______ and increase the risk of a __________ - answer ✅✅l- dopa products hypertensive crisis Selegiline is selective for - answer ✅✅MAO-B (after 10mg there is an increase in risk of serotonin syndrome if given with other meds that increase serotonin) SSRI's can _______ Parkinsonism tremor - answer ✅✅worsen (and decrease 'off time') Process describes the mechanism by which the hippocampus stores memories - answer ✅✅long- term potentiation

loss of memory relating to a particular category of information (inability to recall important autobiographical information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting) - answer ✅✅systematized amnesia Lack of memories from a circumscribed period of time, usually immediately following a traumatic event - answer ✅✅localized amnesia Person can recall some but not all of events from a particular time period - answer ✅✅selective amnesia Lack of memory of the patient's entire life - answer ✅✅generalized amnesia The drugs that are FDA approved for GAD - answer ✅✅Paroxetine Citalopram Escitalopram Venlafaxine

Duloxetine Buspar A surrogate has the right to terminate pregnancy if

• answer ✅✅the pregnancy threatens her health or life or she is a genetic parent If the surrogate receives both ovum and sperm from couple, she loses the right to - answer ✅✅determine whether or not child will be aborted (this is up to the couple) Which medication is most effective for treating social phobia/social anxiety disorder, especially when refractory? - answer ✅✅Phenelzine A 55-year-old female patient has Stg II HTN. On exam, she has trace pedal edema bilaterally, but her lungs are clear. Her ECG reveals 2nd degree heart block. Which of the following BP medications

should be avoided? - answer ✅✅Calcium Channel Blockers 3 Contraindications to use a calcium channel blocker - answer ✅✅1st or second degree heart block Bradycardia CHF 4 Side effects of calcium channel blockers - answer ✅✅Headache Lower extremity edema Bradycardia Heart Block An NP is evaluating a 78 year old female with depression. She suspects the patient may have Parkinson's disease. Which of the following is consistent with that diagnosis? - answer ✅✅Postural instability Pill-rolling tremor Shuffling Gait Difficulty initiating movement

Mask-like facies (difficulty initiating movement) Writhing movements occur with - answer ✅✅Huntington's chorea 10 Non-motor manifestations of Parkinsons - answer ✅✅Autonomic dysfunction Gastrointestical dysfunction Rhinorrhea Sleep disturbance Fatigue Mood disorder Cognitive dysfunction Dementia Psychosis Hallucinations What type of therapy is most useful in depressed HIV positive outpatients? - answer ✅✅Interpersonal psychotherapy

What type of therapy is most useful in patients with borderline personality disorder? - answer ✅✅Dialectical behavioral therapy The NP is caring for a patient dying of lymphoma. The pt's wife states that the pt has been mismanaged and that another practitioner must be assigned to the patient for him to improve. This NP suspects that this individual is in which stage of grief according to Elizabeth Kugler-Ross? - answer ✅✅Bargaining Involves resisting or refusing to remember information that has been supplied - answer ✅✅Denial Pica and spoon shaped nails are associated with - answer ✅✅Iron-deficiency anemia (microcytic) 2 common causes of microcytic anemia - answer ✅✅iron deficiency anemia of inflammation/chronic disease (TB, HIV, endocarditis, RA, Chrohn's DM, kidney disease, CA)

(Other causes: lead toxicity, alcohol/drug use, zinc excess (copper deficiency)) Initial symptoms of B12 deficiency - answer ✅✅Generalized weakness Paresthesias Possible ataxia Late symptoms of B12 deficiency - answer ✅✅Memory impairment Depressed mood 5 P's of Vitamin B12 deficiency - answer ✅✅Pancytopenia (Peripheral and Posterior spinal cord) neuropathy Pyramidal tract signs Papillary atrophy of tongue (atrophic glossitis)

2 causes of megaloblastic macrocytic anemias - answer ✅✅Vitamin B12 deficiency Folate deficiency What neurotransmitter is thought to play the most significant role in social phobia? - answer ✅✅dopamine What neurotransmitter is thought to mediate social interest, gregariousness, confidence and sensitivity to rejection? - answer ✅✅dopamine According to Gonzalez-Jaimes and Turnbull-Plaza (2003, which type of therapy with psychocorporal, cognitive, and neurolinguistic components and a holistic focus is significantly more effective in patients diagnosed with adjustment disorder? - answer ✅✅mirror psychotherapy The ________ is part of the treatment to encourage a patient to accept his physical condition - answer ✅✅mirror

Discussing medical diagnoses and the reaction to it, as well as treatment modalities - answer ✅✅medical conversation Therapy that emphasizes personal responsibility, focusing on the individual's experience at the present moment, the therapist-patient relationship, the context of the person's life, and adjustments people make as a result of their overall situation - answer ✅✅Gestalt Therapy PANDAs is associated with _________ infections and results in _______ symptoms - answer ✅✅Group A beta-hemolytic strep OCD After camping trip, pt began to have a petechial rash on her legs/trunk, parts of which are turning dark red and purple, temp 102.8, HR 1115, BP 88/50, mm pain, neck stiffness, severe HA. What is the dx? - answer ✅✅meningococcemia 1 mg of Xanax = _____ mg of Ativan - answer ✅✅ 2

1mg of Xanax = ____mg of phenobarbital - answer ✅✅ 30 1mg Xanax = ____ mg of Clonazepam (Klonopin) - answer ✅✅ 1 1mg Xanax = ____ mg of chlordiazepoxide (Librium) - answer ✅✅ 25 1mg of Xanax = ____ mg of diazepam (Valium) - answer ✅✅ 10 Pt wanting something immediate and non-addictive for breakthrough anxiety - answer ✅✅Hydroxyzine How long do GAD symptoms need to occur to make the diagnosis? - answer ✅✅6 months First lab test to check for Sjogren's - answer ✅✅Anti- nuclear antibody tests To diagnose Cyclothymic disorder, it must be present for _______ in adults - answer ✅✅2 years

To diagnose Cyclothymic disorder, it must be present for _______ in pediatrics - answer ✅✅1 year 4 physiological disturbances that may explain some of the symptoms of panic - answer ✅✅impaired lactate metabolism abnormality of locus coeruleus (Ser, NE, GABA, Dop, cholecystokinin) carbon dioxide hypersensitivity (hyperventilation) A 45-year-old man presents to the ER for "panic attack". He appears agitated, confused, and dizzy. He became more agitated and combative with staff upon further questioning. He states he was prescribed Xanax 0.5mg 3x daily by outpatient psychiatrist. His vitals are WNL. What is most likely his dx - answer ✅✅Benzodiazepine intoxication Anxiety, tremors, nightmares, insomnia, anorexia, nausea, vomiting, hypotension, seizures, delirium and hyperprexia are sx of. ______ which can result in _______ - answer ✅✅Benzodiazepine withdrawal (serious medical complications including death)

Confusion, AH, VH following a period of insomnia can be a sx of - answer ✅✅withdrawal delirium Female patients with PTSD commonly have this comorbid diagnoses - answer ✅✅Major depressive disorder (50%) Percentage of people with PTSD who have alcohol use disorder - answer ✅✅male 50% female 27% Percentage of people with PTSD who have simple or social phobias - answer ✅✅30% both male and female Percentage of people with PTSD who have persistent depressive disorder ( previously dysthymia) - answer ✅✅20% for both male and female Treatment plan for OCD - answer ✅✅SSRI or Clomipramine Psychotherapy

Normal Rinne test is for this nerve - answer ✅✅CN VIII What ethnic groups are at higher risk for social phobia - answer ✅✅Native American What ethnic groups are at lower risk for social phobia - answer ✅✅Asian Black Latino Onset of social phobia is - answer ✅✅Usually begins in late adolescence or early adulthood (13- years) 3 CBT techniques for social phobias - answer ✅✅exposure cognitive restructuring social skills training Medication used to help with social phobia for public speaking - answer ✅✅propranolol

FDA approved SSRI for social phobia - answer ✅✅paroxetine What type of fracture is a red flag for child abuse? - answer ✅✅Spiral of long bone (caused by twisting of extremity) Bruises on the torso in different stages of healing often indicate - answer ✅✅abuse Tanner Stage: Breast buds undeveloped with papilla elevation only. Villus hair only - answer ✅✅I Tanner Stage: Breast buds palpable, straight pubic hair mostly on labia - answer ✅✅II Tanner Stage: Areola begins to enlarge and pubic hair becomes darker, coarser, and curly - answer ✅✅III Tanner Stage: Areola forms a secondary mound on the breast and hair is of adult quality - answer ✅✅IV

Tenderness at McBurney's point is suggestive of - answer ✅✅appendicitis About 30% of patients with this disorder have OCD thoughts - answer ✅✅Tourette's disorder Rx that can cause anxiety - answer ✅✅Steroids (prednisone) Albuterol Amphetamines Appetite suppressants Medical conditions that can cause anxiety - answer ✅✅Adrenal tumors Alcohol use disorder Hypoglycemia Hyperthyroidism Cushing's disease Arrhythmias Parathyroid Tumors Some types of seizures

Depression screening tool used specifically for pregnancy and postpartum - answer ✅✅Edinburg Depression Scale How long do symptoms have to be present to diagnose PTSD - answer ✅✅1 month Lab value that would indicate that parathyroid was removed during thyroidectomy - answer ✅✅Low Calcium For PCOS, which medication will help with hirsutism? - answer ✅✅Spironolactone Lab that is an indicator of inflammation - answer ✅✅C-reactive protein Pain medication that inhibitis serotonin and NE reuptake (risk of serotonin syndrome if also on antidepressants) - answer ✅✅Tramadol an over-the-counter nonnarcotic drug found in cough preparations which inhibits serotonin

reuptake and could cause serotonin syndrome in patients on SSRI's - answer ✅✅Dextromethorphan (Delsym) Pre-cursor for Serotonin production - answer ✅✅L- tryptophan In panic disorder, 1 of the attacks is followed by at least ______ of persistent worry about having additional attacks, worry about implications of attacks or its consequences, or significant change in behavior related to attacks. - answer ✅✅1 month The origins of panic disorder include - answer ✅✅childhood trauma With delayed onset of PTSD, how much time must have past from trauma to onset of symptoms - answer ✅✅6 months First line medication for polymyalgia rheumatica - answer ✅✅oral prednisone

Acute stress disorder is diagnosed if the characteristic symptoms present within what period of time after experiencing the traumatic event? - answer ✅✅1 month In what Tanner's stage will a male's penis grow more in length than width - answer ✅✅III In what Tanner's stage will a male's scrotum begins to grow and redden. Where pubic hair will be straight, fine and sparse - answer ✅✅II In what Tanner's stage will a male's pubic hair look more like an adult, but will not cover as much area. Where penis will thicken, testes and scrotum continue to grow. - answer ✅✅IV Brain structure R/T development of GAD - answer ✅✅Amygdala What circumstance(s) are often correlated to the onset of panic disorder - answer ✅✅separation from family serious illness of friend/family

accident major relationship loss/change abusing substances postpartum Lifetime prevalence of anxiety disorders in the US - answer ✅✅25-35% (18% prevalence) Buspar needs ______ to have similar efficacy to benzodiazepines - answer ✅✅4 weeks How many panic symptoms must be present for diagnoses. - answer ✅✅ 4 Part of Brain responsible for smell - answer ✅✅Limbic Part of brain (lobe) responsible for visual functions

• answer ✅✅Occipital Part of brain (lobe) responsible for sensory integration and somatosensory function - answer ✅✅Parietal