Final

Question 1

Autonomy

Answer 1

respecting the rights of others to make their own decisions.

Question 2

Justice

Answer 2

the duty to distribute resources of care equally regardless of personal attributes

Question 3

Fidelity (non-maleficence)

Answer 3

Maintaining loyalty and commitment to the pt and doing no wrong to the pt

Question 4

Intentional torts are

Answer 4

Battery, assault and false imprisonment

Question 5

What happens in the orientation phase of the nurse patient relationship?

Answer 5

First time nurse meets pt
Establish rapport
Mutual agreement on goals is part of contract
Contract contains place, time and date of meetings
Pt needs to know what information will be shared
Termination begins in orientation

Question 6

What happens in the working phase of the nurse patient relationship?

Answer 6

Gather further data
Promote pt problem solving skills, self esteem
Facilitate behavioral changes
Overcome resistance behaviors
Evaluate problems, goals, and redefine them as necessary

Question 7

Antisocial personality disorder

Answer 7

Characterized by deceit, manipulation, revenge, and harm to others with an absence of remorse for hurting others. Have sense of entitlement, no restraint on behavior, lack regard for the law, May have a hx of violence, partner abuse anger in response to minor slights

Question 8

Borderline personality disorder

Answer 8

Characterized with instability of affect marked by unstable and frequent mood changes. Feelings of dysphonia, anxiety, and irritability. Chronic depression is common. Feelings of deadness, panic, fury, self mutilation, and suicide are responses to threats of separation or rejection. Desperately seek relationships to avoid feelings of abandonment. Excessive demands and impulsive behavior. Splitting is a common defense mechanism

Question 9

Side effects of Nardil (phenelzine)

MAOI

Answer 9

Seizures, dizziness, drowsiness, fatigue, HA, tremor, hyperreflexia, euphoria, weakness, blurred vision, hypertensive crisis, dry mouth, abdominal pain, N/V, insomnia

Question 10

Delusions

Answer 10

Believing ideas with no basis in fact

Question 11

Hallucinations

Answer 11

Sensory perceptions that are not based in reality

Question 12

S/S of schizophrenia

Answer 12

• Positive sx (hallucinations, delusions, disorganized speech, bizarre behavior)
• Negative sx (anhedonia, blunted affect, alogia, avolition)
• Cognitive sx (inattention, easily distracted, impaired memory, poor problem solving, illogical thinking,impaired judgement)

Question 13

Neologisms

Answer 13

Made up words that have special meaning for the person

Question 14

Echolalia

Answer 14

Pathological repeating of another’s words by imitation and often seen in people with catatonia

Question 15

Clang association

Answer 15

Meaningless rhyming of words, often in a forceful manner

Question 16

Word salad

Answer 16

Jumble of words that is meaningless to the listener and perhaps to the speaker as well

Question 17

Auditory hallucinations

Answer 17

Hearing voices or sounds that do not exist in the environment but are projections of inner thoughts or feelings. Voices may be familiar, or strange, single or multiple. Command hallucinations are voices that command the person to hurt self or others. May signal a psychiatric emergency

Question 18

Evidence of possible auditory hallucination

Answer 18

Turning or tilting of head, frequent blinking of eyes and grimacing

Question 19

Zyprexa (olanzapine)

Answer 19

Used to treat schizophrenia and agitation

Question 20

S/e of zyprexa

Answer 20

Weight gain, high lipid abnormalities, increased risk for diabetes, drowsiness, hyperprolactinemia, agitation and restlessness, insomnia, hypotension, seizures at initiation of therapy, possibly akathisia pr parkinsonism

Question 21

Difference b/w 1st and 2nd generation antipsychotics

Answer 21

First generation target the positive sx, and 2nd are thought to diminish some of the negative sx. Second generation have fewer side effects and thus are better tolerated, and newer agents also help with sx of anxiety and depression, decrease suicidal behavior and are thought to increase neurocognitive functioning. SGA’s have a higher risk for metabolic syndrome. First generation can cause NMS.

Question 22

Delirium

Answer 22

Person is in a state of confusion that develops quickly and fluctuates in intensity. Reduced awareness and responsiveness to environment and person is often disoriented and incoherent and has severe memory disturbance. Usually secondary to another condition.

Question 23

Interventions for delirium

Answer 23

Safety, assess potential for injury 
Maintain face to face contact
Interact with pt when awake 
Place clocks and calendars to orient to time 
Monitor V/S
Use simple, short sentences
Keep room well lit
Clarify reality when hallucinations are present 
Ignore insults

Question 24

When can you start seeing alcohol withdrawal sx

Answer 24

Early signs may develop within a few hours after cessation. They peak after 24-48 hrs and then rapidly disappear. Early sx appear 7-48 hrs and continue for 5-7 days

Question 25

Sx of alcohol withdrawal

Answer 25

Intense tremors
Cramps
Vomiting
Increased HR, BP, and temp 
Seizures may occur

Question 26

Naltrexone (revia)

Answer 26

reduces alcohol craving, blocks endorphins released related to alcohol intake

Question 27

Acomprosare (Camprol)

Answer 27

Helps by reducing some of the unpleasant sx of abstinence such as anxiety, tension and dysphoria

Question 28

Topiramate (Topomax)

Answer 28

works to decrease alcohol cravings

Question 29

Disulfiram (Antabuse)

Answer 29

Used after an individual has been sober for a number of months and is used as a motivational aid for people who want to stay sober.

Question 30

Indicators of opioid toxicity (triad sx)

Answer 30

Pinpoint pupils
Decreased respirations
Coma

Question 31

Treatment of opioid toxicity

Answer 31

Usually naloxone (Narcan), short acting. Nalmefene (Revex) longer half life. Detoxification is the first step in treatment

Question 32

Long term management of opiod users

Answer 32

• Methadone (reduces withdrawal effects)
• Buprennorphine (Subutex) used for the same purpose as methadone, weaker opioid effects
• Naltrexone is used for maintenance after the pt has undergone detoxification, blocks euphoric effects of the drug

Question 33

Adventitious crisis

Answer 33

Crisis of disaster, its unplanned and accidental. May result from natural disaster, national disaster or a crime of violence

Question 34

Interventions for sexual assault

Answer 34

Do not leave pt alone
Approach in nonjudgmental manner
Confidentiality
Listen, do not press pt to talk
Do not use “alleged, refused, or intercourse”
Assess S/S of physical trauma
Explain and get permission to take photos and specimens
Make a body map to identify size, color, and location of injuries
Explain procedures before doing them
Explain the specimens you plan to collect and why
Offer prophylaxis to pregnancy

Question 35

What psychological-emotional factors present when people become suicidal?

Answer 35

Hopelessness
Worthlessness
Helplessness