Exam 2

Question 1

client experiences excessive fear or anxiety when seperated from an individual to which the client is emotional attached

Answer 1

seperation anxiety

Question 2

client experiences irrational fear of certain situation or object

Answer 2

specific phobia

Question 3

extreme fear of certain places(outdoors, bridge) where client feels vulnerable or unsafe

Answer 3

agoraphobia

Question 4

client experiences excessive fear of social performance siutations

Answer 4

social anxiety

Question 5

client experiences recurring panic attacks

Answer 5

panic disorder

Question 6

client exhibits uncontrolled, excessive worry for at least 6 months

Answer 6

generalized anxiety disorder

Question 7

Is OCD an actual anxiety disorder?

Answer 7

NO! but has similar effects

Question 8

client has intrusive thoughts or unrealistic obsessions and tries to control these thoughts through compulsive behaviors

Answer 8

obsessive compulsive disorder

Question 9

client has difficult parting with possessions, resulting in extreme stress and functional impairments

Answer 9

hoarding disorder

Question 10

client has preoccupation with perceived flaws or defects in physical appearance

Answer 10

body dysmorphic disorder

Question 11

3 types of OCDS

Answer 11

• OCD
• Hoarding disorder
• Body dysmorphic disorder

Question 12

anxiety and OCD’s have a _______ and _____link

Answer 12

genetic and neurobiological

Question 13

need what to qualify as panic disorder?

Answer 13

4 or more of :

• palpitations
• shortness of breath
• choking/smothering feeling
• chest pain
• nausea
• depersonalization
• fear of dying or insanity
• chills/hot flashes

Question 14

manifestations of GAD

Answer 14

(majority of days for 6 months)

• restlessness
• muscle tension
• avoidance of stressful activities
• increased time to prepare for stressful events
• procrastination in decision making
• sleep disturbance

Question 15

first line meds for anxiety/OCD?

Answer 15

SSRI

Question 16

other meds for anxiety

Answer 16

SNRI, benzo, buspirone, beta blocker, antihistamine, anticonvulsant

Question 17

anxiety patient centered care interventions

Answer 17

• assess for comorbid condition of substance abuse
• panic needs calm quiet enviro
• remain with client during worst of anxiety
• relaxation techniques
• hope for positive outcomes
• enhance client self esteem
• postpone health teaching until after acute anxiety subsides

Question 18

use flooding for which kind of anxiety?

Answer 18

phobias

-large amount of undesireable stimulus in attempt to turn off anxiety response

Question 19

exposure to traumatic events causes anxiety, detachment, and other manfiestations about the event for at least 3 days but not more than 1 month following the event

Answer 19

acute stress disorder

Question 20

exposure to traumatic events causes anxiety, detachment, and other manifestations about the event for longer than 1 mo following the event

Answer 20

post-traumatic stress disorder

Question 21

a stressor triggers a reaction causing changes in mood/dysfunction in performing usual activities. The stressor and effects are less severe than with ASD or PTSD

Answer 21

Adjustment Disorder

-pattern of LIFE LONG difficulty accepting change

Question 22

4 types of dissociative disorders

Answer 22

• depersonalization/derealiziation disorder
• dissociative amnesia
• dissociative fugue
• dissociative identity disorder

Question 23

disorder characterized by temporary change in awareness displaying depersonalization, derealization, or both in response to stress.

Answer 23

-depersonalization/derealiziation disorder

Question 24

feeling that a person is observing one’s own personality or body from a distance

Answer 24

depersonalization

Question 25

feeling that an outside event is unreal or part of a dream or that objects apprear larger or smaller than they should

Answer 25

derealization

Question 26

inability to recall personal information related to traumatic or stressful events. amnesia can be events of certain period of time or just certain details

Answer 26

dissociative amnesia

Question 27

tyoe of dissociative amnesia in which client travels to a new area and is unable to remembers ones own identity and at least some of ones past. Can last weeks to months, usually follows traumatic event

Answer 27

dissociative fugue

Question 28

client displays more than one distinct personality, with a stressful event precipitating the change from one personality to another

Answer 28

dissociative identity disorder

Question 29

when should military and first responders receive treatment related to trauma?

Answer 29

before severe trauma reactions occur (ie preventative)

Question 30

PTSD prevention after a traumatic incident

Answer 30

- need for breaks, rest, water, nutrition - emotional support - staff supporting each other - debrief following incident - expression of feelings - offer counseling resources

Question 31

PTSD puts client at risk for what other mental health disorders?

Answer 31

anxiety, depression, substance abuse, dissociative

Question 32

ASD and PTSD expected findings

Answer 32

- intrusive memories or flashbacks - dissociative flashbacks where client feels event is occuring again in present - avoidance ofthings associated with event - avoiding thinking about event - anxiety, depression - anger, irritability - decreased interest and inability to feel happiness - guilt - hypervigiliance - inability to focus - suicidal or homicidal thoughts

Question 33

adjustment disorder expected findings

Answer 33

depression anxiety changes in behavior( erratic, arguing)

Question 34

signs of dissociative identity disorder

Answer 34

client displays 2 or more seperate personalities

Question 35

nursing intervention for dissociative disorders

Answer 35

- grounding techniques - facilitate decisions that lower stress - when ready, encourage client to make deicision independntly - avoid giving too much info about past events to prevent increased stress

Question 36

meds for ASD and PTSD?

Answer 36

antidepressants prazosin (decrease hypervigilance and insomnia) propranolol

Question 37

meds for adjustment and dissociaitve disorders?

Answer 37

online if shoing signs of anxiety and depression

Question 38

EMDR for PTSD is contraindicated in which patient populations?

Answer 38

-active suicidal ideation, psychosis, severe dissociaitiv, disorders, eyes disorders, unstable substance abuse eye movement desensitization and reprocessing

Question 39

a single or recurrent episode of unipolar depression (not associated with mood swings from major depression to mania) resulting in a significant change in a pts ability to function normally.

Answer 39

major depressive disorder mdd

Question 40

In order to have MDD, 5 or more of the following symptoms must be present for at least 2 weeks

Answer 40

depressed mood difficulty sleeping, increased sleepiness indecisiveness, decreased ability to concentrate suicidal ideation psychomotor agitation, or psychomotor retardation increase/decrease in weight

Question 41

Psychotic Features of MDD vs postpartum features of MDD

Answer 41

visual or auditory hallucinations or the presence of delusions a depressive episode that begins within 4 weeks of childbirth

Question 42

PMDD (prementstrual dysphoric disorder) is associated with whih phase of the menstrual cycle?

Answer 42

luteal

Question 43

phases of MDD threatment

Answer 43

1. acute: severe clinical findings , 6-12 week treatment : safety, reduction of major symptoms 2. continuation: improved function, 4-9 mo duration: medication, relapse prevention 3. maintenance: remission - goal = prevent future depressive episodes

Question 44

risk factors for MDD

Answer 44

- family history - females - >65 yrs - neurotransmitter deficiences (decrease serotonin) *depression can be a primary disorder or a response to another physical or mental health disorder

Question 45

top 3 SSRI for depression, pateint education

Answer 45

``` citalopram fluoxetine sertraline -no st john wort -sexual dysfunction common -HA/N, insomnia, anxiety, agitation ```

Question 46

Tricyclic antidepressant for depression + education

Answer 46

amitriptyline -orthostatic hypotension anticholingergic remediation: - chew sugarless gum - high fiber - increase fluid

Question 47

MAOI for depression + education

Answer 47

phenelzine - no tyramine - high drug drug interaction- talk to provider before new meds

Question 48

a typical antidepressant + patient education

Answer 48

buproprion - HA, dry mouth, constipation, Nausea insomnia, increase HR - appetite suppression- monitor weiht - not cool with seizure disorders

Question 49

SNRI for depression + education

Answer 49

venlafaxine duloxetine - nausea, insomina, weifght gain, sweating, sexual dysfunction - caution with HTN

Question 50

SSRI + St John wort =

Answer 50

serotonin syndrome

Question 51

milder depression that lasts at least 2 years for adults, 1 year for children and 3 clinical findings of depression

Answer 51

persistent depressive disorder

Question 52

distrust/suscipision based on unfound beliefs others want to harm/exploit deceive that person

Answer 52

paranoid personality disorder

Question 53

emotional detachment from relationships , indifference to praise/criticism, uncooperative

Answer 53

schizoid personality disorder

Question 54

odd beliefs leading to interpersonal difficulties, magical thinking, perceptual distortions that are not clear delusions or hallucinations

Answer 54

schizotypal personality disorder

Question 55

instability of affect/identity/relationships, manipulation, fear of abandonment, self injurious, nonadherence to traditional morals/values, verbally charming and engaging, extreme mood lability, SAFETY PLANS, stigma towards this diagnosis, may have element of attention seeking behavior

Answer 55

borderline personality disorder

Question 56

lack of empathy, disregarding of people around them, bring people in to get what they need and then discard them, grandiose/arrogance, sensitive to criticism, risk for suicide and depression when not getting praise from people

Answer 56

narcissistic personality disorder

Question 57

need for secondary gain, report inability to function when they can, want family to take care of them, physical complaints frequent, level of validation that allows them to move beyond

Answer 57

◦ fictitious/Munchausen

Question 58

characterized by emotional attention-seeking behavior, in which the person needs to be the center of attention; often seductive and flirtatious

Answer 58

Histrionic personality disorder

Question 59

characterized by disregard for others w/ exploitation, lack of empathy, repeated unlawful actions, deceit, and failure to accept personal responsibility; sense of entitlement, manipulative, impulsive, and seductive; nonadherence to traditional morals and values; verbally charming and engaging

Answer 59

antisocial personality disorder

Question 60

characterized by social inhibition and avoidance of all situations that require interpersonal contact, despite wanting to close relationships, due to extreme fear of rejection; often very anxious in social situations

Answer 60

avoidant personality disorder

Question 61

characterized by extreme dependency in a close relationship w/ an urgent search to find a replacement when one relationship ends

Answer 61

Dependent personality disorder

Question 62

characterized by perfectionism w/ focus on orderliness and control to the extent that the individual might not be able to accomplish a given task

Answer 62

Obsessive-compulsive personality disorder