Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Mental Health > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Two most common mental health disorders in the United States

A

Depression and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is an isolated panic attack and what percentage of the population does it affect?

A

1 time event panic attack and affects 22.7 % of population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors for Anxiety disorders include (3)

A

Family history, substance use disorders, and severe stressors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

True or false- Anxiety does have a familial predisposition and is estimated to be 48% hereditary

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Levels of Anxiety

A

Mild, moderate, severe, panic.
Mild is normal and beneficial while moderate becomes negatively impactful- selective attention, can refocus if directed by another person
Severe- Unable to be redirected
Panic- Focus is on scattered details and distorted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Panic Attack have an ICD code?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a panic attack

A

Discrete period of fear/discomfort. Symptoms develop abruptly and peak within 10 minutes of onset and generally last 30 minutes. 4 of the following are present
- sweating, trembling, chest pain, feeling of choking, palpitations, nausea, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is derealization?

A

Mental state where you feel detached from surroundings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Depersonalization definition

A

Detached from ones body or mental processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Panic Attack Nursing Care- Body systems affected, symptoms similar to, and Labs run

A

Systems affected (GI, Cardiac, Respiratory)
Conduct EKG, check troponin levels
Panic attack S/S appear as MI or ACS so you need to rule out medical before focus on mental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Panic Disorder

A

Recurrent Panic attacks
At least one of the attacks have been followed by 1 month or more of the following
- Persistent concern about having a panic attack
- Worry about implication of the attack and its consequences
- Significant change in behavior related to the attacks (withdrawal, isolation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Agoraphobia

A

Client exhibits extreme fear of certain places (a bridge or the outdoors) where client feels vulnerable or unsafe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sometimes companion is utilized for those with agoraphobia- true or false

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neurotransmitters involved with those who have anxiety

A

Serotonin, GABA, and norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Acrophobia

A

Fear of heights

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Ailurophobia

A

The fear of cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Algophobia

A

Fear of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Arachnophobia

A

Fear of spiders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Brontophobia

A

Fear of thunder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Cynophobia

A

the fear of dogs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Microphobia

A

the fear of germs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Nyctophobia

A

the fear of night or dark places

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ophidiophobia

A

the fear of snakes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Xenophobia

A

the fear of strangers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Social phobia

A

Client reports difficulty performing or speaking in front of others or participating in social situations due to an excessive fear of embarrassment or poor performance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Generalized anxiety disorder defined as

A

The client exhibits excessive worry that is uncontrollable for the majority of days over at least 6 months time- Can affect sleep, cause depression, difficult to concentrate, common to feel hopeless

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Separation anxiety

A

Fearful and anxious about separation from attachment figures that is developmentally inappropriate. Common in children and pets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Selective mutism

A

Consistent failure to speak in social situations where there is an expectation to speak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Substance/medical induced anxiety

A

Anxiety due to excessive substance use, substance withdrawal and medication use (bronchodilators, amphetamines, steroids, caffeine, cocaine, stimulants)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Dr. Patricia Benner- theory for patients

A

Build treatment for patient around their own natural routine and sleep schedule in order to reinforce compliance in the client. Don’t put them on the hospital schedule if they are used to something else.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is first line treatment for anxiety disorders

A

Cognitive Behavioral Therapy. Uses cognitive reframing to help the client identify negative thoughts that produce anxiety, examine the cause, and develop supportive ideas that replace negative self-talk.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Psychosocial Intervention for Anxiety

A

Distractive behavior to aid and distract during the trigger of anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Exposure Therapy for anxiety

A

Prolonged exposure to stimulus and aids in cognitive processing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Best treatment for Interventions of anxiety include ______ and ______.

A

Therapy and psychopharmacology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

SSRIs and SNRI’s take to work for anxiety and depression

A

Typically 2-6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Benzodiazepines utilized for

A

Fast acting, prescribed in conjunction with SSRIs for acute anxiety. They can help with alcohol withdrawal, very addictive, enhance effects of GABA, used an adjunct medication to help alleviate the worsening of symptoms on medications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Most common SNRI prescribed for anxiety

A

Venlafaxine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What will happen if you stop taking benzodiazepines abruptly

A

Rebound anxiety and panic, taper off over 2-4 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

3 Drugs for long-term Benzo treatment

A

Xanax, Alprazolam, and Clonazepam (Klonopin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons?
A. Narcissistic behavior
B. Fear of rejection from staff
C. Attempt to reduce anxiety
D. Adverse effect of antidepressant medication

A

C.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

A nurse is caring for a client who experiencing a panic attack. Which of the following actions should the nurse take?
A. Discuss new relaxation techniques
B. Show the client how to change the behavior
C. Distract the client with a television show
D. Stay with the client and remain quiet

A

D. Quietly remain with client to promote safety and reassurance. TV could increase anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q 
A nurse is assessing a client who has GAD, which of the following findings should the nurse expect- select all that apply
A. Excessive worry for 6 months
B. Impulsive decision making
C. Delayed reflexes
D. Restlessness
E. Sleep disturbance
A

A, D, E

Muscle tension and procrastination are not symptoms for this individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Nurse is planning care for a client who has body dysmorphic disorder. Which of the following actions should the nurse plan to take first?
A. Assess the clients risk for self harm
B. Instill hope for positive outcomes
C. Encourage client to participate in group therapy sessions
D. Assist the client to participate in treatment decisions

A

A. Safety is key, biggest priority for this patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

A nurse is caring for a client who has GAD and is experiencing severe anxiety. Which of the following statements actions should the nurse make?
A. Tell me about how you are feeling right now
B. You should focus on the positive things in your life to decrease your anxiety
C. Why do you believe you are experiencing this anxiety
D. Lets discuss the medications your provider is prescribing to decrease your anxiety

A

A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Peak illness onset for OCD

A

Early adolescence to early adulthood (13-early 20s)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Adult women who have OCD are more likely to experience OCD related to ___ and mens are more likely to have ______ obsessions

A

Contamination, Blasphemous (sexual, religion, some violent)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Are there genetic and biological factors to OCD?

A

Yes genetic with link to first degree relatives and no neurotransmitter is identified.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Comorbidity with OCD

A

Anxiety disorders, mood disorders, eating, substance use, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

OCD is what

A

Recurrent obsessions or compulsions - not simply obsessive worries about real life problems, individual is aware of how crazy they may appear to others, person attempts to ignore or neutralize them with other thoughts or actions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Difference between adults and children with OCD

A

Adults are aware of how excessive the obsessions or compulsions are while children are not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What percentage of patients will have OCD paired with eating disorder

A

10-17%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Big nursing diagnosis for OCD patients

A

Risk for impaired skin integrity, excessive hand washing or cleaning rituals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Interventions for OCD individuals

A

Maintenance of skin integrity- tepid hand-washing, moisturizing soaps, hand creams, time scheduled hand-washing.
and relaxation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

SSRIs and Tricyclics used for patients with OCD?

A

Yes, SSRIS before Tricyclics as less side effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

SSRIs used for OCD

A

Fluoxetine, Fluvoxamine, Sertraline, Paroxetine (10-12 weeks before desirable effects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

TCA used for OCD

A

Clomipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

OCD scale used

A

Yale-Brown OCD scale, self rating scale, used before and after treatment to gauge the relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Interventions for Therapy (3) in OCD individuals

A

Exposure and Response Prevention- Expose then develop healthier response
Cognitive Restructuring- Reduce anxiety by restructuring rituals
Acceptance and commitment- Accept obsessions at present, try not to perform rituals- stop them

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Trichotillomania

A

Pulling out hair, onset prior to 5 years of age, 1-2% of population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is ACT

A

Acceptance and Commitment Therapy, Commit to alternate relief techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Body Dysmorphic disorder

A

Client is preoccupied with certain defects or flaws in appearance. Practices obsessive mirror checking or covering up of the flaw in order to gain control over the anxiety felt. Generally the flaw is minor and unnoticed by others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Does Body Dysmorphic disorder occur in women just as much in men

A

Yes 2.4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Hoarding disorder Intervention

A

Cognitive Behavioral Therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

True or false, risk for depression and suicidal ideation in individuals with Body dysmorphic disorder is high

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Onset to remission for women compared to men in traumatic stress disorders

A

4 years for women compared to 1 year in men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Risk factors for PTSD

A

Prior diagnosis of Acute stress disorder, number and frequency of adverse childhood events. environmental factors (natural disasters and man-made)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Acute Stress Disorder diagnosed

A

Must have symptoms for at least 3 days and up to 1 month after the exposure, experienced directly or indirectly, witnessed or confronted with an event involving actual or threatened death or serious injury or threat to the physical integrity of self or others
Doest not include exposure through e-media, television, movies or pictures unless work realted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

True or false, Acute stress disorder left unhandled can lead to PTSD

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Avoidance in PTSD is indicated by 3 or more of the following

A
  • Avoids thoughts, feelings, or convos associated with the trauma
  • Anhedonia
  • Feelings of detachment
  • Persistent negative emotional state
  • Inability to experience positive emotions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

PTSD Reactivity examples

A
  • Difficulty falling asleep
  • Anger outbursts
  • Hyper vigilance
  • reckless or self-destructive behavior
  • difficulty concentrating
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Most common SSRIs prescribed for PTSD

A

Sertraline (Zoloft) and paroxetine (Paxil)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

A nurse working on an acute mental health unit is caring for a client who has PTSD, which of the following findings should the nurse expect- select all that apply
A. Difficulty concentrating on tasks
B. Obsessive need to talk about the event
C. Negative self image
D. Recurring nightmares
E. Diminished reflexes

A

A, C, D,

Client doesn’t want to talk about disorder and is easily startled because of hyper vigilance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

A nurse is involved in a serious and prolonged mass causality incident in the ER. Which of the following strategies should the nurse use to help prevent developing a trauma related disorder? Select all that apply
A. Avoid thinking about the incident when it is over
B. Take breaks during the incident for food and water
C. Debrief with others following the incident
D. Avoid displays of emotion in the days following the incident
E. Take advantage of offered counseling

A

B, C, E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

A nurse is collecting an admission history for a client who has acute stress disorder. Which of the following client behaviors should the nurse expect
A. The client remembers many details about the traumatic incident
B. the client expresses heightened elation about what is happening
C. The client remembers first noticing manifestations of the disorder 6 weeks after the traumatic incident occurred
D. The client expresses a sense of unreality about the traumatic incident

A

D- Dissociative manifestations regarding the event, which includes a sense of unreality is common in those with ASD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

A nurse is caring for a client who has a derealization disorder. Which of the following findings should the nurse identify as an indication of derealization?
A. The client describes a feeling of floating above ground
B. The client has suspicions of being targeted in order to be killed and robbed
C. The client states that the furniture in the room seems small and far away
D. The client cannot recall anything that happened during the past 2 weeks

A

C This is an example of derealization in relation to surroundings. Feeling body floating is example of depersonalization. Cant remember past 2 weeks is amnesia, being targeted for robbery is a paranoid delusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

A nurse in an acute mental health facility is planning care for a client who has dissociative fugue. Which of the following interventions should the nurse add to the plan of care?
A. Teach the client to recognize how stress brings on a personality change in the client
B. Repeatedly present the client with information about past events
C. Make decisions for the client regarding routine daily activities
D. Work with the client on grounding techniques

A

D.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is codependence

A

Peer pressure of abusing with another person.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Is there a genetic component linked to substance use abuse

A

Yes, relation to 1st degree relative but no special gene identified

79
Q

Neurotransmitter related to substance use abuse

A

Dopamine

80
Q

Substance use abuse, related to what part of brain

A

Pleasure center- limbic system

81
Q

What is the lethal dose of alcohol

A

.4%

82
Q

Substance use definition

A

Over-indulgence/becoming dependent on addictive substance

83
Q

Tolerance definition

A

Gradual decrease in the action of a substance at a given amount in the blood. Tolerance increases as you take more

84
Q

Dependence definition

A

Psych and physically dependent on substance

85
Q

Detoxification

A

Safely and effectively getting someone off drug, normally under medical supervision

86
Q

Withdrawal definition

A

adverse S/S when off drug or using less of, both psychological and physical

87
Q

Overdose definition

A

Too much taken either intentionally or accidentally

88
Q

Codependence definiiton

A

Relationship, inadvertently need partner to abuse with them

89
Q

Enabling definition

A

Protecting another person from experiencing full affects of their behavior

90
Q

What is chronic use- wernicke korsakoff Syndrome

A

chronic memory disorder caused by a severe deficiency of thiamine (Vitamin B-12), can cause psychosis and other long term health problems

91
Q

Alcohol use disorder has criteria in the DSM-5 (true or false)

A

True

92
Q

What is the purpose of gastric lavage

A

Induce vomiting in order to prevent unabsorbed alcohol from being absorbed into blood stream

93
Q

What percentage of patients admitted to med surge are at risk for alcohol withdrawal

A

40%

94
Q

How long does it take for alcohol withdrawal symptoms to appear in a patient? (hours)

A

6-72 hours after the sudden cessation or decrease in alcohol , depends on the severity of addiction

95
Q

How many hours does it take for delirium tremors, seizures and convulsions to occur in patient undergoing withdrawal

A

Usually within 48 hours

96
Q

Symptom peak of withdrawal and how long it takes to fully withdrawal, when symptoms of withdrawal start

A

Feel withdrawal 6-72 hours after stopping alcohol, symptoms peak in day 2. May take 3-5 days to withdraw, yet can take up to 1-2 weeks

97
Q

Is withdrawal life threatening

A

Yes can be life threatening if not properly managed by healthcare professionals

98
Q

Medication treatment for alcohol withdrawals

A
  • Benzodiazepines (suppress withdrawal symptoms) 1st line option for symptom management- fixed dosing round the clock or titrated based on the CIWA-Ar score
  • Banana Bag, thiamine, folic acid, magnesium and multivitamin in 1 liter of NS or dextrose in water solution
  • Antiemetic medication
  • Blood glucose monitoring due to malnutrition
99
Q

Medication Disulfiram (Antabuse), Patient teaching

A

deters drinking, causes severe reaction (flushing, N/V, headache) if alcohol is consumed.
Be sure to educate patient to read all labels of products to see if they contain any alcohol

100
Q

How long will patient feel affects of antabuse in their system?

A

Even after discontinuation, could take up to 2 weeks to clear system so could still have reaction to any alcohol products

101
Q

Purpose of Naltrexone (ReVia)

A

Reduces cravings, usually take daily for 3 months

Also an opioid antagonist, so can use to deter cravings of opioids

102
Q

Acamprosate (Campral)

A

Reduces cravings, take 2 tabs, 3 times a day. Side effects are diarrhea, N/V and pruritus, should not be taken if person has renal problems

103
Q

What scale do we utilize assessing the risk of someone having withdrawal

A

CAGE an AUDIT-C
Audit C has 10 items while cage is the 4 token questions to assess abuse level
CAGE- 2 yes answers for male will be at risk for withdrawal while 1 for female will indicate withdrawal

104
Q

Purpose of CIWA-Ar

A

Determine the severity of withdrawal

105
Q

Barbiturates

A

Group of drugs called sedative hypnotics. Lethal in overdose, can cause respiratory arrest, cardiac arrest, come and death

106
Q

How to treat patient with severe alcohol intoxication

A

Assess ABCs, assess for injury, assess blood glucose, stabilize VS, HOB elevated to prevent aspiration, left side recovery position, allow the person to “sleep it off” yet monitor closely

107
Q

Can you overdose on benzodiazepines?

A

valium and Xanax are most frequently abused drug in this class, rarely fatal in overdose! Patient can become very lethargic and confused

108
Q

How to treat person who took two many Benzodiazepines

A

Gastric lavage and activated charcoal

109
Q

Chlorpromazine (Thorazine)

A

1st Generation, treats positive symptoms of psychosis

110
Q

Cocaine use can lead to what condition

A

Acute coronary syndrome/ MI

111
Q

What is considered the gateway drug to heroine

A

hydrocodone

112
Q

What is COIN

A

Committee on Impaired Nurses

113
Q

What is the focus on Comprehensive treatment for drug abuse

A

Treat root of addiction, Medications, Coping mechanisms

Treat basically all aspects

114
Q

Opioid Withdrawal peaks in _____ days and subsides in _____ days or longer

A

2-3 days, and subsides in 5-7 days

115
Q

What is COWS

A

Clinical Opioid WIthdrawal Scale, typically done every 4 hours

116
Q

Methadone use

A

Used as a replacement for opioids (synthetic heroin) coming off heroin can take months or years, this medication replaces heroin and then you wean off this

117
Q

Levomethadyl (Orlaam)

A

helps with addiction to pain killers when other treatment options fail. Be careful with this drug as arrhythmias can occur, 12 lead EK recommended

118
Q

Symptoms of Opioid Overdose and treatment

A

Drowsy, slurred speech, slow respirations, pinpoint pupils (morphine)
Treat with Naloxone (Narcan) give until symptoms improve
May require ventilator support

119
Q

Medications for Hallucination intoxication?

A

No medication interventions- treat the S/S, treatment is supportive (protect airway, decrease BP, Seizure precautions)
*Could see elevated VS, hyperreflexia, dilated pupils, paranoia, depression, etc.

120
Q

Examples of Hallucinogens

A

LSD, Ecstasy, Peyote, Mushrooms, K2/Spice

121
Q

Long term effects of inhalants

A

Neuropathy and memory loss

122
Q

Bodily systems affected by Inhalants

A

heart, lungs, kidneys, and brain

123
Q

Symptoms of inhalant intoxication

A

Similar to a drunk person, blurred vision, lack of coordination, dizziness, nystagmus, confusion, etc.

124
Q

Treatment for Inhalant Intoxication

A

No antidote, supportive care (protect the airway, stabilize VS)

125
Q

Marijuana onset peak duration

A

less than a minute of inhalation, peaks in 20 minutes, duration of 2-3 hours

126
Q

3 of the 5 states with highest opioid use disorder?

A

West Virginia, Delaware, Maryland

127
Q

What is the most common substance addiction in the world

A

Tobacco

128
Q

Nicotine gum directions on educating patient on how to use

A

Chew gum slowly and intermittently for 30 minutes, ensure patient hasn’t eaten or drank anything 15 minutes prior, this is a short term therapy that shouldn’t be used for over 6 months

129
Q

Nicotine Lozenge teaching

A

Will dissolve in mouth over 20-30 minutes, 5 total in 6 hours and no more than 20 in 1 day. do not eat or drink 15 minutes prior

130
Q

Nicotine Patches Education

A

Apply patch to clean dry skin, dont use for over 16 hours, remove the patch for an MRI, dont double up and have a patch on and consume nicotine at the same time

131
Q

What is the priority for individuals suffering from substance use in the medical realm

A

Detoxification

132
Q

Areas where personality traits can affect personal life to point of personality disorder diagnosis

A

Enough traits and affects functional life in

  • Social
  • Occupational
  • Interpersonally (w/ others)
  • Intrapersonally (Inside self)
133
Q

What is most common comorbidity diagnosis

A

Depression and anxiety (PTSD, generalized, panic)

134
Q

DSM-5 generally not diagnosed before age 18? True or false

A

True, can be with a complete history that describes longitudinal impact of traits, the exception is antisocial personality disorder

135
Q

Cluster A Personality Disorders

A

(Odd Eccentric) Paranoid, Schizoid, Schizotypal

136
Q

Cluster B

A

(Dramatic, emotional, erratic behavior) Antisocial, Borderline, Histrionic

137
Q

Cluster C (anxious, fearful)

A

Avoidant, dependent, obsessive compulsive

138
Q

Paranoid personality disorder

A

Cluster A, pervasive pattern of distrust and suspiciousness of others (4 or more)
suspicion without basis, reluctance to confide in others, persistent grudges, suspicions of infidelity

139
Q

Schizoid Personality disorder

A

Cluster A
Pervasive pattern of social detachment and restricted range of affect (4 or more)
lacks desire or enjoyment of close relationships
participates in solitary activities
lacks close friends
little pleasure in activities
emotional coldness (flat affect or detachment)

140
Q

Schizotypal Personality Disorder

A 
Cluster A 
Social and interpersonal deficits, significant discomfort with close relationships, cognitive and perceptual distortions and odd behavior (five or more)
- Ideas of reference
- odd thinking and speech
- odd beliefs
- magical thinking
- bodily illusions
141
Q

What cluster is the most common type of personality disorders

A

Cluster B

142
Q

Antisocial Personality Disorder

A

Cluster B
Pattern of disregard or violation of the rights of others (three or more)
- Failure to conform to social norms and lawful behavior
- Impulsivity, failure to plan ahead
- lack of remorse, indifferent, rationalizes behavior
- irritable and aggressive, repeated fighting
- deceitfulness, exploitation of others for profit

143
Q

Psychopaths generally have what type of personality disorder

A

Antisocial

144
Q

In order to be diagnosed with antisocial personality disorder you must be __ years of age, unless

A

18, unless there is evidence of a conduct disorder prior to age 15

145
Q

Most common type of personality disorder

A

Borderline personality disorder

146
Q

Borderline personality disorder

A

Cluster B
Pattern of instability of interpersonal relationships, self image, affect, and marked impulsivity (5 or more)
- frantic efforts to avoid real life or imagined abandonment
- patterns of unstable and intense interpersonal relationships marked by extremes of idealization and devaluation
- Identity disturbance, persistent, and marked unstable self image

147
Q

What is common with Borderline personality disorder

A

Recurrent suicidal and/or self harm behaviors- provides emotional release
Generally impulsive in two areas that are self damaging (spending, sex, substance abuse, reckless driving, binge eating).

148
Q

Histrionic Personality Disorder

A

Cluster B
Pattern of Excessive emotionality and attention seeking (5 or more)
- Uncomfortable not being center of attention
- Inappropriate sexually seductive or provocative behavior
- rapidly shifting and shallow expression of emotion
- Uses physical appearance to draw attention to self
- Believe relationships are more intimate than they really are

149
Q

Narcissistic Personality Disorder

A

Cluster B
Pattern of grandiosity, needs admiration, and lacks empathy (5 or more)
- Grandiose sense of self importance
- Preoccupation with fantasies of unlimited success, power, brilliance
- Belief that he/she is special or unique, believes can only be understood by those who are also special or of higher status
- strong sense of entitlement
- envious of others or believes others are envious of him or her, haughty behaviors, aloof

150
Q

Avoidant Personality Disorder

A

Cluster C
Pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative feedback (4 or more)
- Focuses on criticism or rejection in social situations
- Feelings of inadequacy are inhibiting in new interpersonal situations
- Views self as socially inept, inferior to others
- Unwilling to get involved with others unless certain of being liked
- Avoids new activities for fear of embarrassment

151
Q

Dependent Personality Disorder

A

Cluster C
Excessive need to be taken care of that leads to submissiveness, clinging behavior, and fears of separation (5 or more)
-Difficulty making everyday decisions without reassurance or advice from others
- Go to excessive lengths to get nurturance from others
- Seeks care and support, strong need to jump into close relationships
- Lack of self confidence in projects and task
- Don’t express disagreement for fear of loss of support or approval

152
Q

Dependent Personality Disorder is common for what patients

A

Patients who are victims of domestic abuse

153
Q

OCD Personality disorder

A

Cluster C
Pattern of orderliness, perfectionism, and metal and interpersonal control at the expense of flexibility, openness, and efficiency (4 or more)
- Rigid and stubborn
- Miserly spending, money is hoarded for future catastrophies
- unable to discard worn-out worthless objects
- excessively devoted to work and productivity
- Preoccupation with rules, details, lists, order, organization, and schedules, etc.

154
Q

What is dialectal behavior therapy

A

Is a type of cognitive behavioral therapy but it is focused on talking therapy. The goal is to help you understand and accept your difficult feelings while learning skills to manage them

155
Q

Psychopharmacology in Personality disorders

A

No specific meds for personality disorders, medications may be used to treat symptoms associated with personality disorders

  • Antidepressant meds
  • mood stabilizing meds for aggression
  • anti anxiety meds
  • anti-psychotic meds
156
Q

A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching?
A. I can promote my clients sense of control by establishing a schedule
B. I should encourage clients who have a schizoid personality disorder to increase socialization
C. I should practice limit-setting to help prevent client manipulation
D. I should implement assertiveness training with clients who have antisocial personality disorder

A

C

157
Q

A nurse is caring for a client who had avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder?
A. Im scared you’re going to leave me
B. Ill go to group therapy if you let me smoke
C. I need to feel that everyone admires me
D. I sometimes feel better if I cut myself

A

A. Avoidant personality often have fear of abandonment
The manipulation in B would be expected from someone who has antisocial personality disorder, C relates to narcissistic personality disorder, Risk for self injury is related to someone who has borderline personality disorder

158
Q 
A nurse is caring for a client who has borderline personality disorder. The client says, "The nurse on the evening shift is always nice, you are the meanest nurse ever!" The nurse should recognize the clients statement as example of which of the following defense mechanisms?
A. Regression
B. Splitting
C. Undoing
D. Identification
A

B. A patient cannot see both good and bad qualities of an individual. The patient will either see them as good or bad

159
Q

A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? Select all that apply
A. Demonstrates extreme anxiety when placed in a social situation
B. Often engages in magical thinking
C. Attempts to convince other clients to relinquish their belongings
D. Becomes agitated if personal area is not neat and orderly
E. Blames others for personal past and current problems

A

C and E

Exploitation, manipulation, and failure to accept responsibility for these individuals

160
Q

A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching? Select all that apply
A. Difficulty in getting along with other members of the group
B. Belief in the ability to become invisible during times of stress
C. Display of defense mechanisms when routines are changed
D. Claiming to be more important than other persons
E. Difficulty understanding why it is inappropriate to have a personal relationship with staff.

A

A, C, E

161
Q

A nurse is planning a staff education program on substance use in older adults. Which of the following info should the nurse include in the presentation
A. Older adults require higher doses of a substance to achieve a desired effect
B. Older adults commonly use rationalization to cope with a substance use disorder
C. Older adults are at an increased risk for substance use following retirement
D. Older adults develop substance use to mask manifestations of dementia

A

C

162
Q 
A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? (select all that apply)
A. Bradycardia
B. Fine tremors of both hands
C. Hypotension
D. Vomiting 
E. Restlessness
A

B, D, E

163
Q

A nurse is planning care for a client experiencing benzo withdrawal, which of the following interventions should the nurse identify as the priority?
A. Orient the client frequently to time, place, person
B. Offer fluids and nourishing diet as tolerated
C. Implement seizure precautions
D. Encourage participation in group therapy sessions

A

C

164
Q 
A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol. 
A. Chlordiazepoxide
B. Bupropion
C. Disulfiram
D. Carbamazepine
A

C
A- acute alcohol withdrawal rather than to maintain abstinence from alcohol
B- Nicotine withdrawal
D- acute alcohol withdrawal

165
Q

A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates an understanding of the teaching? Select all that apply
A. We need to understand that our sibling is responsible for their disorder
B. Eliminating codependent behavior will promote recovery
C. Our sibling should participate in al-anon group to assist with recover
D. The primary goal of treatment is abstinence from substance abuse
E. Our siblings need to discuss personal feelings about substance use to help with recovery

A

B, D, E

Patients are not responsible for disease only responsible for recovery

166
Q

Typical age to begin dieting

A

8 years old

167
Q

What percentage of teens exercise in order to improve their shape or lose weight?

A

%50

168
Q

Anorexia

A

Without appetite

169
Q

Bulimia

A

Derived from cow- eating then regurgitation

170
Q

3 types of eating disorders in DSM 5

A

Anorexia, Bulimia, and binge eating disorder

171
Q

Anorexia Nervosa has a comorbidity often with

A

OCD

172
Q

Body weight of anorexia nervosa patient

A

less than 85% of that expected for height, gender, age etc

173
Q

Psychological problems with someone who has anorexia nervosa

A

intense fear of gaining weight or becoming fat
disturbance in which the way body weight or shape is viewed
Denial of low body weight and consequences

174
Q

Two types of behaviors of anorexia nervosa

A

restricting and binge eating/purging

175
Q

Binge eating/purging anorexia patient problems

A

Don’t understand negative health consequences
Increased impulsivity
More likely to abuse drugs, alcohol, and nicotine

176
Q

Onset of anorexia often associated with

A

life stressor (puberty, going off to college)

177
Q

Bulimia definition

A

Recurrent episodes of binge eating, lack of control to stop eating, self induced vomiting, misuse of laxatives, diuretics etc

178
Q

Two types of Bulimia

A

Purging and non-purging

179
Q

Purging occurence

A

1x a week for 3 month occurrence is common

180
Q

True or false patients with anorexia deny any abnormal eating behavior, turn away food in order to cope and are preoccupied with losing more weight

A

true

181
Q

True or false, bulimia patient recognize abnormal eating behavior and use food in order to cope, Preoccupied with attaining an ideal but often unrealistic weight

A

True

182
Q

Binge eating disorder severity is rated by what

A

The number of binges per week that patient is experiencing

183
Q

Health problems associated with binge eating

A

Weight gain increase risk for DM, HTN, Cardiovascular conditions

184
Q

Bulimia patients typical BMI

A

18.5-30%, generally normal or slightly higher

185
Q

Lanugo

A

Anorexia associated fine, soft hair on face and back that compensate for the loss of fat

186
Q

Russel Sign

A

Lacerations and calluses on knuckles via the contact of fingers with teeth during self induced vomiting episodes

187
Q

What meds can be used for patients with eating disorders

A

SSRI’s can help patients with eating disorders, 1-3 weeks for initial response and up to 2 months for maximal response
Anti psych meds- second generation can increase appetite

188
Q

Lab abnormalities and health irregularities for purging patients

A

GI problems, MSK problems, Anemia, Abnormal glucose levels, hypokalemia, hyponatremia, hypochloremia, abnormal thyroid tests
Can also cause period irregularities
Always rule out physical problems before addressing mental issues

189
Q

A nurse is obtaining a nursing history from a client who has a new diagnosis of anorexia nervosa. Which of the following questions should the nurse include in the assessment? Select all that apply
A. What is your relationship like with your family
B. Why do you want to lose weight
C. How would you describe your current eating habits
D. At what weight do you believe you will look better
E. Can you discuss your feelings about your appearance

A

A, C, E

190
Q

A nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90 lbs. Which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing?

A

A- the clients perception of their appearance or situation is much worse than their current condition

191
Q 
A nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. Which of the following is an expected finding- select all that apply
A. Amenorrhea
B. Hypokalemia
C. yellowing of the skin
D. Slightly elevated body weight
E. Presence of lanugo on the face
A

B and D

192
Q

A nurse is planning care for a client who has anorexia nervosa with binge eating and purging behavior. Which of the following actions should the nurse include in the plan of care?
A. Allow the client to select preferred meal times
B. Establish consequences for purging behavior
C. Provide the client with a high-fat diet at the start of treatment
D. Implement one-to-one observation during meal times

A

D

193
Q

A nurse is caring for a client who has bulimia nervosa and has stopped purging behavior. The client tells the nurse about fears of gaining weight. Which of the following responses should the nurse make?
A. Many clients are concerned about their weight. However, the dietitian will ensure that you don’t get too many calories in your diet
B. Instead of worrying about your weight, try to focus on other problems at this time
C. I understand that you have concerns about your weight but first lets talk about your recent accomplishments
D. You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you.

A

C. Promote positive self image

Mental Health (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions