PREBOARDS 1_NP5 Flashcards by Justine Mae Palomata

Annie, a 30-year-old female, has been scheduled for initial assessment after showing signs of suspected Schizophrenia for almost 3 years. According to the family, they did not have enough funds for her medical and psychiatric check-up during the past years as a reason for the late admission. You are the assigned nurse to Annie.

Annie is also a mother of two, a 15-year-old boy and a 12-year-old girl. The children reported that they usually do not understand what their mother is saying when they are talking with each other in the living room. Unusual speech patterns are common manifestations of Schizophrenia. Which speech pattern is NOT paired with the correct definition.

*
1 point
a. Clang associations pertains to ideas that are put together based on sound or rhyming.
b. Echolalia is the stereotyped repetition of words or phrases that may or may not have meaning to the listener.
c. Word salad is a mix of jumbled words and phrases that are incoherent.
d. Neologisms are words invented by the client.

b. Echolalia is the stereotyped repetition of words or phrases that may or may not have meaning to the listener. - this more of VERBIGERATION

Echolalia - pt imitation or repetition of what the other person says

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Throughout the assessment, Annie also shows signs of auditory hallucinations such as mumbling and arguing to self as if talking to another person. As a psychiatric nurse, which action done by Annie needs further improvement?

*
1 point
a. Be sincere and honest when communicating with Annie
b. Recognize the client’s delusions as the client’s perception of the environment.
c. Agree that you can also hear these hallucinations to avoid distressing Annie and to gain her trust.
d. Encourage Annie to share her thoughts with you, but do not pry for information.

c. Agree that you can also hear these hallucinations to avoid distressing Annie and to gain her trust.

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The brother of Annie shared that they always keep her water source full since she complains of being thirsty most of the time. She can consume 3,500 mL in a few hours. As a nurse who is knowledgeable and skillful in psychiatric nursing, you anticipate which of the following complication/s?

*
1 point
a. Seizure
b. Diabetes mellitus
c. Insomnia
d. All of the above

a. Seizure > Water intoxication due to diluted sodium levels

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Fortunately, the family were able to contact a non-profit organization that could help with the medical fees of Annie. She completed the required assessment and tests and was confirmed to have Schizophrenia. What daily medication do you expect Annie to be prescribed with?

*
1 point
a. Citalopram SSRI
b. Lithium Mood Stabilizer
c. Risperidone
d. Paroxetine SSRI

c. Risperidone

SSRI - antidepressant
Mood Stabilizer - Bipolar

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Based on your answer above, what is the usual daily dosage prescribed for treating Schizophrenia?

*
1 point
a. 150 – 500 mg
b. 40 – 160 mg
c. 2 – 20 mg
d. 2 – 8 mg

d. 2 – 8 mg

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Situation:
Sheena is 16-year-old
female who came to the hospital with her mother. She says that she wears an oversized
sweater because it’s her boyfriend’s clothes. She likes to talk about her food
preferences and fads that she has been trying to lose weight. Upon assessment,
her BMI falls to the underweight category.

Sheena has been diagnosed with anorexia nervosa. Which of the following physical manifestations is NOT expected in anorexia nervosa?

*
1 point
a. Hair loss
b. Dental caries
c. Tachycardia
d. Pedal edema

c. Tachycardia

It should be bradycardia or arrythmia

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Which is the correct diagnostic criteria for anorexia nervosa?
*
1 point
a. A commonly used threshold is body mass index (BMI) of less than 18.0 kg/m2 in adults
b. Total body weight rapid loss of 20% or more within 6 months with other positive diagnostic requirements.
c. Threshold for children and adolescents is BMI-for-age under 10th percentile.
d. Rapid weight loss of more than 10% of total body weight within 6 months may replace the low body weight guideline as long as other diagnostic requirements are met

b. Total body weight rapid loss of 20% or more within 6 months with other positive diagnostic requirements.

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The mother is asking more about anorexia nervosa so that she can help her daughter during the treatment. The nurse was tasked to render health teaching to the mother. Which of the following statements would indicate that she misunderstood your teachings?

*
1 point
a. They usually lose their appetites
b. For clients with anorexia, about 30% to 50% achieve full recovery, while 10% to 20% remain chronically ill.
c. Binge eating and purging is seen in patients with anorexia nervosa.
d. They like grocery shopping, collecting food books and recipes, and cooking family meals.

a. They usually lose their appetites

R: They still have appetite but they just don’t want to eat

Anorexia could also have binge eating and purging

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Which medication is unlikely to be prescribed to the patient with anorexia nervosa?

*
1 point
a. Elavil (Amitryptaline)
b. Parlodel
c. Prozac
d. Zyprexa (Olanzapine)

b. Parlodel (Bromocriptine) > for Parkinson’s Disease

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The mother asks the reason behind her daughter’s behavior. You, as a nurse, explains that anorexia nervosa that the specific cause of this illness is still unknown. Which of the following risk factors is commonly not related to anorexia nervosa?

*
1 point
a. Obesity, dieting at an early age
b. Cultural ideal of being thin; media focus on beauty, thinness, fitness
c. Issues of developing autonomy and having control over self
d. Chaotic family with loose boundaries

d. Chaotic family with loose boundaries - seen in bulimia nervosa

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Situation
Kian, a software
developer, has been employed for 5 months in a small start-up company. His
manager was one of his close friends during college. His work hours are
flexible and would only need tasks to be finished, regardless of the time of
the day. Kian has been working from home, however, their team has been ordered
to return onsite. He was brought for assessment due to complaints of not having
several panic attacks.

You were told that the physician suspects General Anxiety Disorder (GAD). As a competent nurse, which of the following are not included in the criteria for diagnosing GAD?

*
1 point
a. Excessive anxiety and worry about several events or activities for more than 6 months.
b. Anxiety causes significant distress or impaired ability to work or to maintain relationships.
c. There may or may not be underlying medical cause.
d. They may or may not have physical symptoms.

c. There may or may not be underlying medical cause.

No underlying cause - criteria in diagnosing GAD

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Unexpected panic attacks may also happen for cases of GAD. Which of the following accurately depicts these panic episodes? Select all that apply.

I. Moderate to severe levels of anxiety (depending on the trigger), resulting to disturbed behavior

II. Produces a sudden onset of feelings of intense apprehension and dread
III. Cause/s can usually be identified

IV. Recurrent, intermittent anxiety attacks lasting 30 to 60 minutes occur

*
1 point
a. I, II, III, IV
b. I, II, IV
c. II, IV only
d. II only

II. Produces a sudden onset of feelings of intense apprehension and dread

Occurs for 5-30 mins only

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After further assessment with the physician, it has been found out that Kian does not have GAD but specific phobias. He is afraid of being in open spaces and in situations in which he might be embarrassed or criticized or making a fool of oneself. Which option pertains to these specific phobias?

*
1 point
a. Acrophobia and Situational phobia
b. Xenophobia and Situational phobia
c. Agoraphobia and Social phobia
d. Acrophobia and Social phobia

c. Agoraphobia and Social phobia

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Which of the following is/are true about social phobias?

I. Irrational fear of an object, activity, or situation that persists and that leads to avoidance

II. Associated with panic-level anxiety or fear if the object, situation, or activity that can be avoided by the client

III. Defense mechanisms commonly used include repression and displacement.

*
1 point
a. I only
b. I, II, III
c. I, II
d. I, III

d. I, III

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During one of the treatment sessions of Kian, he suddenly felt dread, terror, and sense of impending doom. You think he is having a panic attack episode. What other sign or symptoms do you expect to observe?

*
1 point
a. Disorganization, difficulty perceiving reality, and ability to concentrate if the client tries
b. Loss of rational thoughts with distorted perception occur
c. The individual is unable to communicate or function effectively unless the nurse talks to the client
d. A significant narrowing in the perceptual field occurs

b. Loss of rational thoughts with distorted perception occur

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Situation:
As a nurse, we encounter
various cases of losses along the continuum of health and illness. Depending on
the type of loss, the nurse should have a basic understanding on how to deal
with discomfort of loss.

This theory describes the five stages that explains what people experience as they grieve and mourn. Who developed this theory?

*
1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz

b. Kübler-Ross (5 stages of grief)

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This theory proposes that humans instinctively attain and retain affectionate bonds with significant others through attachment behaviors which are crucial to the development of a sense of security and survival.

*
1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz

a. John Bowlby

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The five stages of grief are the following: (1) Shock and disbelief, (2) developing awareness, (3) restitution, (4) resolution of loss, and (5) recovery. To whom is this theory attributed to?

*
1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz

c. George Engel

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A single mother of a deceased pediatric patient has been coming to your ward even after a week of the death. She would bring fruits to the staff and ask about the nurse-in-charge or physician-in-charge of her child. She would often talk to them about her child with them. Her child was confined for two years after being born in the hospital. As the past nurse of the patient when she was still alive, you would like to help the mother. Which among the following is not correct about the tasks of grieving?

*
1 point
a. Recognize: Experiencing the loss
b. Reinvest: Beginning to return to daily life; loss feels less acute and overwhelming
c. Recognize: Understanding that it is real, and that it has happened
d. Reinvest: Accepting changes that have occurred; reentering the world

b. Reinvest: Beginning to return to daily life; loss feels less acute and overwhelming

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The mother (from #19) ended up crying as the two of you are talking. She said, “I don’t feel like being in this world without my child anymore.” What will be your response as the nurse?

*
1 point
a. You shouldn’t say that, Ma’am. How would your child feel if she hears you?
b. I don’t believe you should do that, Ma’am.
c. Do you have intentions of hurting yourself, Ma’am?
d. Use silence as therapeutic response

c. Do you have intentions of hurting yourself, Ma’am? - direct confrontation

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Situation:
One of the mothers, Mari, knows another
mother, Tes, who had a son diagnosed with autism. Mari tells you that she is
worried that her 6-month-old may have a similar illness since her uncle and
brother had the same. She brings her 6-month-old daughter to the clinic for
assessment.
21. The mother is wanted to consult about the nature of autism. She asked a beginner nurse about this, which of the following statements needs intervention when heard?

*
1 point
a. Autism spectrum disorder (ASD) is almost five times more prevalent in boys than in girls.
b. The behaviors, limitations, and degree of affectation varies along the continuum from mild to severe.
c. Signs and symptoms usually start as early as 6 months and no later than 2 years old.
d. Autism have a genetic link, many children with autism have a relative with autism or autistic traits.

c. Signs and symptoms usually start as early as 6 months and no later than 2 years old.

Identifiable at 18 months and no later than 3 years old

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The nurse explains that there are common behaviors shown by children diagnosed with ASD. The following signs are usually seen in autism spectrum disorder. Select all that apply.

I. Doesn’t show interest by pointing to objects or people by 14 months of age

II. Avoids eye contact

III. Prefers to be with mother or father

IV. Delayed speech and language skills

VI. Upset by major changes in routine and does not mind minor changes.

VII. Flaps hands, or rocks or spins in a circle

*
1 point
A. I, II, III, IV, VII
B. I, II, III, VI, VII
C. I, II, IV, VII
D. All of the above

C. I, II, IV, VII

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Aside from teaching communication and language skills, pharmacologic treatment may also treat specific target symptoms such as temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors. Which medications are used for these symptoms of ASD?

*
1 point
a. Aripiprazole
b. Lithium
c. Donepezil
d. Fluvoxamine

a. Aripiprazole

Lithium = bipolar
Donepexil = alzheimer’s
Fluvoxamine = depression or anxiety

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. When dealing with children with ASD, which of the following interventions precedes the others?

*
1 point
a. Managing the environment of the child
b. Giving structured daily routine and schedule
c. Stopping unsafe behaviors
d. Listening to the parent’s feelings and frustrations.

c. Stopping unsafe behaviors

R: SAFETY AMONG ALL

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Related disorders to ASD may also be observed in various cases and may start manifesting in different ages. Learning, motor skills, communication, and elimination disorders are a few of the disorders that are usually present in children with ASD. Toddlers and preschool-aged children commonly manifest elimination disorders. Which of the following are not accurate in describing this disorder? * 1 point a. Encopresis is the repeated passage of feces into appropriate places such as diapers or the toilet by a child who is at least 4 years of age (either chronologically or developmentally). b. Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child c. Impairment associated with elimination disorders depends on the limitations on the child’s social activities, effects on self-esteem, and degree of social ostracism by peers d. Enuresis can be treated effectively with imipramine (Tofranil), an antidepressant with a side effect of urinary retention

a. Encopresis is the repeated passage of feces into appropriate places such as diapers or the toilet by a child who is at least 4 years of age (either chronologically or developmentally).

Situation: In a psychiatric ward, it not uncommon to have episodes of sudden anxiety, anger, and aggression among the patients. You are the nurse who is assigned in the day shift of the psychiatric ward 1. 26. During your rounds, you found Brian crouched on the floor with hands covering his ears. He was observed to be hyperventilating, crying, sweating, and having tremors. What is your priority action? * 1 point a. Remove the hands from the ears and convince him to lie on the bed. Leave the patient alone for him to collect his thoughts. b. Stay with the client and ask the client to identify how he feels c. Provide the patient a calm environment, decrease stimuli, and stay with the client d. Monitor vital signs

c. Provide the patient a calm environment, decrease stimuli, and stay with the client

The next day, you encountered Lian in the hallway with his fingers overlapped with each other and palms together. He’s visibly sweating and is experiencing mild tremors. What is your priority action? * 1 point a. Provide the patient a calm environment, decrease stimuli, and stay with the client b. Encourage the client to verbalize his current thoughts, feelings, or concerns c. Return after 15 minutes to check if the client’s condition improved d. Go to the patient but stay silent and wait for him to tell you what happened.

b. Encourage the client to verbalize his current thoughts, feelings, or concerns

Jin, one of the patients with bipolar syndrome, was hospitalized last week for being a threat to other’s safety. He was showing improvements in handling his mood recently. What action would you do to prevent an episode of anger outburst? * 1 point a. Administer depressant drugs to slow down the brain activity b. Avoid competitive games for the client c. Stay with the client d. Set limits with the patient about his requests

b. Avoid competitive games for the client R: PREVENT NOT MANAGE

Although a single cause has not been established, it has been found that neurotransmitters play a role in anger and aggression in humans. Which of the following is true about the relationship of aggressive or violent behaviors and neurotransmitters? * 1 point a. Low serotonin levels, decreased activity of dopamine, increased activity of norepinephrine b. Low serotonin levels, increased activity of dopamine and norepinephrine c. High serotonin levels, increased activity of dopamine, decreased activity of norepinephrine d. Low serotonin levels, decreased activity of dopamine, increased activity of norepinephrine

b. Low serotonin levels (inc aggression), increased activity of dopamine and norepinephrine (inc violence secondary to impulse)

During one of your night shifts, someone screamed from the common room of the patients. Once you arrived, you saw Mark holding another patient by the neck with a makeshift weapon in hand. The patient was able to break free from Mark, but he still holds the weapon. What is your priority action? * 1 point a. Attempt to remove the weapon from Mark to prevent further injuries to the patients and other staff b. Decrease stimulation by turning the television off or lowering the volume, lowering the lights, or asking others to leave the area c. Ask the other patients to leave the common room and call for help d. Remain calm and talk down to patient, ordering him to drop the weapon

c. Ask the other patients to leave the common room and call for help R: Safety is the priority

Understanding a patient’s developmental stage will help to comprehend their condition. According to Erik Erikson’s Stages of Psychosocial Development, which stage requires learning to manage conflict and anxiety as a task to be accomplished? * 1 point a. Autonomy vs. Shame and Doubt b. Initiative vs. Guilt c. Industry vs. Inferiority d. Identity vs. Role diffusion

b. Initiative vs. Guilt

According to Erikson’s Stages of Psychosocial Development, which of the following includes the adult development tasks for Angela, a 35-year-old female. I. Create a comfortable home II. Cherish old friends and make new ones III. Establish a career or vocation. IV. Become an involved citizen V. Adjust to health changes. * 1 point a. I, II, III, IV, V b. II, III, IV c. I, III, IV d. III, IV

d. III, IV

Sometimes, Angela encounters troubles and difficulties in her work as an assistant manager in a famous company in BGC. She has been a consistent team leader awardee and most of her co-workers look up to her as a role model. In one of her interviews, she was asked how she handles the stress in her workplace. She answered, “I usually take action when I encounter problems because I want to believe that my behavior will make a difference”. Angela is showing which individual factor? * 1 point a. Self-resistance b. Self-actualization c. Self-determination d. Self-efficacy

d. Self-efficacy - personal ability has an effect to other person’s life

Mika, who is a manager, became curious that how does Angela does not usually get sick while she easily affected by fatigue and flu under stress. Angela has low occurrences of illness despite a high stress-inducing job and company. What specific individual factor has been found to have buffering effect on people under stress? * 1 point a. Good healthiness b. Hardiness c. Self-awareness d. Resilience

b. Hardiness

Angela shared that she practices self-care activities, makes daily journal to monitor her thoughts and feelings about stressful situations in the office, and performs health-seeking behaviors. What specific individual factor refers to the use of problem-solving abilities and belief that she can cope with adverse situations? * 1 point a. Resourcefulness b. Self-awareness c. Spirituality d. Good healthiness

a. Resourcefulness

Situation: Coco is 27-year-old male who started drinking alcohol during his teenager years. It has become a habit to drink alcohol whenever he was elated, sad, disappointed, regretful, and in a celebratory mood. He drinks alone or with friends, as long as he had money to spare. 36. Coco is 27-year-old male who started drinking alcohol during his teenager years. It has become a habit to drink alcohol whenever he was elated, sad, disappointed, regretful, and in a celebratory mood. He drinks alone or with friends, as long as he had money to spare. * 1 point a. 1 to 6 hours b. 2 to 8 hours c. 3 to 10 hours d. 4 to 12 hours

d. 4 to 12 hours

For severe withdrawal cases who cannot abstain during detoxification, a short admission (3-5 days) is recommended for safe withdrawal. Which of the following are used for safe withdrawal of alcohol intake? * 1 point a. Ativan b. Prozac c. Olanzapine d. None of the above

a. Ativan - benzodiazepine (lorazepam)

What are the following signs and symptoms that you should monitor for alcohol withdrawal in Coco? * 1 point a. Sleepiness, low blood pressure, anxiety, nausea, and vomiting b. Hand tremors, elevated blood pressure, nausea, and vomiting c. Insomnia, low blood pressure, anxiety, nausea, and vomiting d. Sleepiness, elevated blood pressure, anxiety, nausea, and vomiting

b. Hand tremors, elevated blood pressure, nausea, and vomiting

A protocol used in identifying alcohol withdrawal in patients is an assessment tool called Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-AR). The patient was asked about the presence and/or severity of auditory disturbances. He scored a 5 in this category. What does this mean? * 1 point A. Extremely severe hallucinations B. Continuous hallucinations C. Severe hallucinations D. Moderately severe hallucinations

C. Severe hallucinations

Coco has been a chronic alcohol drinker, which of the following complications is related to a brain condition characterized by confusion, loss of mental activity, ataxia, vision changes, and is considered a medical emergency? * 1 point a. Alcohol cerebral damage syndrome b. Wernicke encephalopathy c. Korkiff alcohol syndrome d. Wernicke alcohol syndrome

b. Wernicke encephalopathy

Situation: As a psychiatric nurse, one must be knowledgeable in medications to ensure patient safety and correct medication administration. 41. Josh has been diagnosed with major depression disorder, which of the following medication is has a fatal side effect of arrythmias. * 1 point a. Zolof (SSRI) b. Tranylcypromine (MAOI) c. Paxil ( d. Anafranil

d. Anafranil (TCA)

John has been ordered to avoid certain type of food as it may cause hypertensive crisis if combined with the medication prescribed. Which is the most likely medication prescribed to him? * 1 point A. Parnate B. Paxil C. St John’s Wort D. Fluphenazine

A. Parnate

Mila was complaining of auditory hallucinations and was observed to have disturbed perceptions. She was diagnosed with Schizophrenia. Which of the following primarily decreases the levels of dopamine and is considered typical antipsychotics? * 1 point A. Thioridazine B. Clozapine C. Aripiprazole D. Haloperidol Decanoate

A. Thioridazine (typical -zine ending) Clozapine - Atypical Aripiprazole - 3rd gen Decanoate - Long term

A patient is experiencing high fever, high blood pressure, and irregular breathing. You observed hyperreflexia and clonus in the lower extremities, as well as muscle spasms. Which of the following will you expect that the physician will prescribe as muscle relaxant in this condition? * 1 point A. Amantadine B. Baclofen C. Bromocriptine D. Cogentin

B. Baclofen Amantadine - Pseudo Parkinsonism Bromocriotine - CNS toxicity Cogentin - EPS

You were assigned to a patient with substance abuse characterized by weight loss, rotting and stained teeth, dilation of pupils, and in state of euphoria. Which drug would you expect the physician would prescribe to reduce the craving for the substance abuse mentioned? * 1 point A. Amantadine B. Baclofen C. Bromocriptine D. Cogentin

C. Bromocriptine - decrease craving for methamphetamine abuse

Situation: Nurses are bound to interact with clients and families who respond to grief in different ways. It is important that nurses understand the phenomena that comes with grief in order to support clients and families through the process. Patient Beetle, 19, female, had just lost her boyfriend to rabies one month ago. Patient Beetle appears quiet and withdrawn. At one point, she said “I miss his tan skin, his sweet smile; so good to me, so right”. Based on Rando’s Six Tasks of Grieving, what task refers to the acceptance of a new phase as a result of the loss? * 1 point a. Relinquish b. Readjust c. Recognize d. Reframe

a. Relinquish (Acceptance of new phase) Rando’s Six R’s of Grieving

The following are dimensions and symptoms of a grieving patient, except: * 1 point a. Sense of independence and confidence as the person evolves b. Preservation of the person’s assumptions and beliefs surrounding the loss c. “Auto-pilot” activities d. Seeking and doing activities during the phase of reorganization

b. Preservation of the person’s assumptions and beliefs surrounding the loss (disrupt instead of preserve)

According to the crisis theory, all but one of the following are crucial factors that the nurse needs to consider in working with a grieving client: * 1 point a. Adequate perception of the individual b. Adequate acceptance of the individual c. Adequate support from others d. Adequate coping of the individual

b. Adequate acceptance of the individual

Situation: You are working as a registered nurse in a psychiatric facility. As a stellar nurse, you understand the key differences in psychiatric conditions and your responsibilities in administering medications in order to develop a quality nursing care plan that promotes patient safety and desired outcomes. 49. Patient Oli, 25 years old, is diagnosed with bipolar type I. She is receiving Tegretol as part of her medication regimen. Upon assessment, you noticed that the patient has red blotches on the skin. What is the priority nursing intervention that you should do? * 1 point a. Assess the patient and administer an oral antihistamine, as ordered. b. Assess the patient and order a stat drug serum level. c. Assess the patient and administer the prescribed dose of Tegretol. d. Assess the patient and report to the physician immediately.

d. Assess the patient and report to the physician immediately. Rashes from the tegretol possibly steven johnson’s syndrome

You know that the priority nursing diagnosis for Patient Kate who is new yet compliant to her antidepressant medications during her first week of admission is: * 1 point a. Deficient knowledge related to unfamiliarity with antidepressant medication regimen b. Self-care deficit related to inability to carry out self-care routine due to depressive episodes c. Risk for injury related to increased suicidal ideations and attempts d. Readiness for enhanced self health self-management related to increased desire to actively participate in therapy

c. Risk for injury related to increased suicidal ideations and attempts

Sofia, a patient with alcohol addiction, is taking Acamprosate (Campral) to suppress her alcohol cravings. She receives 666 mg of the drug, three times daily. Which of the following nursing considerations should you note when administering this drug? * 1 point a. Take blood pressure before each dose and withhold if hypotensive. b. Inform the patient that urine may turn dark yellow in color. c. Instruct the patient to avoid products that contain alcohol. d. Monitor for diarrhea, vomiting, flatulence, and pruritus.

d. Monitor for diarrhea, vomiting, flatulence, and pruritus. A = Clonidine B = Folic Acid C = Disulfiram

Neuroleptics work to treat the symptoms of psychosis such as delusions and hallucinations seen in schizophrenia, schizoaffective disorder, and the manic phase of bipolar disorder. The major mechanism of action of all antipsychotics is by: * 1 point a. Stabilizing dopamine output by preserving dopaminergic transmission when it is too low or reducing it when it is too high in order to prevent adverse effects. b. Inhibiting the reuptake of serotonin in order to increase their effectiveness in treating depressive symptoms of schizophrenia. c. Blocking the receptors for dopamine transmission which helps reduce extrapyramidal side effects. d. Allowing the medication to be slowly absorbed over time through an extended-release form.

c. Blocking the receptors for dopamine transmission which helps reduce extrapyramidal side effects.

Patient Theresa, 70 years old, female, is admitted to the psychiatric facility with a diagnosis of schizophrenia. One week ago, she was rushed to the ER because of myocardial infarction secondary to stress from paranoid delusions and audiovisual hallucinations from a traumatic event. As her nurse, which of the following antipsychotic medications listed in her therapeutic sheet should you question? * 1 point A. Aripiprazole (Abilify) B. Risperidone (Risperdal) C. Molindone (Moban) D. Ziprasidone (Geodon)

D. Ziprasidone (Geodon) - contraindicated to QT prolongation, MI, Uncompensated HF

Antidepressants help regulate mood, arousal, attention, sensory processing, and appetite for patients with major depressive illness, anxiety disorders, and psychotic depression. What neurotransmitters are particularly involved in the mechanism of action provided by antidepressants? * 1 point a. Norepinephrine and serotonin b. Serotonin and noradrenaline c. Serotonin and GABA d. Dopamine and serotonin

a. Norepinephrine and serotonin

Situation: Somatoform disorders have long existed in various patients throughout history. It was common before as it is today. However, the stigma that somatization is a way for patients to get their needs met through “faking” symptoms, has also long existed. Hence, nurses should be well-informed and unbiased towards such cases. 55. Malingering and factitious disorder are body-related disorders which are different from somatoform disorders. Which of the following statements is true? Both factitious disorder and malingering are characterized by intentional production of false or exaggerated physical or psychological symptoms; but: * 1 point a. Only factitious disorder is driven by the individual’s want for an external incentive. b. Malingering is the same as Munchausen syndrome, where the individual feigns symptoms to avoid work, obtain drugs, avoid criminal prosecution, or gain financial compensation. c. Individuals with factitious disorder inflict injury on themselves or other people to gain attention. d. Malingering can manifest as the feeling of “alienation from a part of their body”, thus patients with this condition have a strong desire for amputation.

c. Individuals with factitious disorder inflict injury on themselves or other people to gain attention.

Hysteria is defined as multiple physical complaints with no organic basis. Such complaints are usually described dramatically. Which of the following prominent figures in psychiatric studies identified hysteria as a disorder of the nervous system? * 1 point a. Sigmund Freud b. Paul Briquet c. William Glasser d. Viktor Frankl Q

b. Paul Briquet

Patient Zea, female, 19 years old, has untreated attention deficit hyperactivity disorder (ADHD). She is prescribed Pemoline (Cylert) 37.5 mg/day in the morning. Which of the following laboratory results will you report to the physician? * 1 point a. K+: 2.0 mEq/L; Na: 140 mEq/L b. Creatinine: 0.7 mg/dL c. FBS: 65 mg/dL d. ALT: 45 U/mL; AST: 55 U/L

a. K+: 2.0 mEq/L; Na: 140 mEq/L d. ALT: 45 U/mL; AST: 55 U/L - main answer since the med is hepatotoxic ALT: 9-35 AST: 15-30

Nurse Angelica is working at Sunnyside Daycare Center. She understands that the goals of treatment of children with autism are the following, except: * 1 point a. Effectively treat and stop behavioral symptoms such as stereotyped motor behaviors. b. Promote learning and development, particularly the acquisition of language skills. c. Target symptoms such as temper tantrums using antipsychotics such as haloperidol. d. Diminish self-injurious and obsessive behaviors.

Bonus

Jo March, 15 years old, female, comes into the clinic accompanied by her mother, Marmee. According to Marmee, Jo recently dropped out of school because of a number of conduct problems, particularly vandalism and theft. Jo blurts out, saying “I do not care what they say about me! This is annoying! Can we leave now?!” As a nurse, what is the initial therapeutic action to do? * 1 point a. Give in to the patient’s request by politely accompanying them to the exit. b. Ask the client what triggered her to feel annoyed and why she feels that way. c. Role-model appropriate conversation and social skills for the client. d. Encourage the client to talk about her thoughts and feelings.

d. Encourage the client to talk about her thoughts and feelings.

Amy Dunne is diagnosed with dementia. Her husband, Nick, reports that Amy can no longer perform complex tasks. Confusion is apparent and so is her memory loss. She can only recognize both of her parents. She no longer remembers important details such as her address and phone number. Nurse Andie recognizes that Amy is in what stage of dementia? * 1 point a. Early b. Mild c. Moderate d. Severe

c. Moderate Mild: Forgetfullness = hallmark Severe: Personality and emotional changes occur

George is taking Donepezil (Aricept) 8 mg P.O. daily for dementia. Nurse Charlotte knows that she should monitor which of the following assessment parameters? * 1 point a. Monitor for vomiting, constipation, hypertension, pain, and fatigue. b. Test stools periodically for GI bleeding. c. Watch out for infection and monitor absolute neutrophil count (ANC). d. Monitor serum electrolytes.

b. Test stools periodically for GI bleeding.

Daphne, 56 years old, has been using cocaine intermittently for the past year. She also heavily consumes alcohol. She was rushed to the emergency room when she attempted to jump from their balcony after showing symptoms of hallucinations. The physician diagnosed her with delirium. Daphne says to Nurse Eloise, “The angels are telling me I have wings so I can fly with them from the window. I need to walk to the window now”. What is Nurse Eloise’s initial response? * 1 point a. Immediately restrain the client and administer an intramuscular dose of haloperidol, as ordered. b. Call security and tell them to lock all windows and doors in the floor where Daphne’s room is. c. In a non-judgmental tone, tell Daphne that angels do not exist and that what she’s hearing are only symptoms of her illness. d. In a matter-of-fact manner, tell the patient, “I do not hear anyone else in this room”.

d. In a matter-of-fact manner, tell the patient, “I do not hear anyone else in this room”.

Alcohol-induced amnestic disorder results from chronic deficiency of what vitamin? * 1 point a. Vitamin A b. Vitamin B c. Vitamin C d. Vitamin D

b. Vitamin B = korsakoff syndrome

Abigail, 32 years old, is diagnosed with manic disorder. She has a history of substance abuse and assaultive behavior. Last week, she spat on and punched a nurse in the face when the nurse did not give in to her requests. This morning, Abigail requested for an additional phone call to her husband, but got denied her request. Nurse Vanessa notices that Patient Abigail is restless, pacing around the hallway, and talking to herself in an irritated and loud voice. Which of the following actions should Nurse Vanessa take? I. Encourage the patient to express her concerns. II. Administer PRN medications right away to de-escalate the situation. III. Offer the patient to walk with the nurse. IV. Obtain assistance from other staff members and exhibit a “show of force”. V. Obtain a doctor’s order for restraining the patient. * 1 point a. I, III b. II, IV c. II, V d. I, IV

a. I, III

. Nurse Angelica hears a patient yelling at staff members while pacing around the ward. The patient shouts, “I will hurt anyone who goes near me.” The patient appears pale and is clenching his fists from time to time. Which of the following principles should guide Nurse Angelica’s next action(s)? * 1 point a. Call for the assistance of other staff members to restrain the client since his behavior is a threat to others. b. Approach the patient and direct him to a time-out in a quiet area. c. In a direct and calm manner, give the patient feedback for regaining control and set expectations in a non-aggressive manner. d. All of the above.

b. Approach the patient and direct him to a time-out in a quiet area.

Situation: Autism spectrum disorder (ASD) requires comprehensive and individualized treatment in order to garner for more favorable outcomes. Nurse Paella Marie, a newly-hired psychiatric nurse, hopes to develop some insights in caring for clients with ASD. 66. Autism spectrum disorder (ASD) requires comprehensive and individualized treatment in order to garner for more favorable outcomes. Nurse Paella Marie, a newly-hired psychiatric nurse, hopes to develop some insights in caring for clients with ASD. * 1 point A. Childhood aberrant syndrome B. Dissocial behavior C. Digressive disorder of early childhood D. Pervasive developmental disorder

D. Pervasive developmental disorder

According to DSM-V, the core diagnostic criteria of autism spectrum disorder (ASD) encompass the following, excluding: * 1 point A. Deficits in social communication B. Restricted patterns of behavior C. Repetitive patterns of behavior D. Aberrant language development and usage

D. Aberrant language development and usage

Which is accurate about the prevalence of autism spectrum disorder (ASD) in terms of gender? * 1 point A. Significantly prevalent in females than in males B. Significantly prevalent in males than in females C. Has slight preponderance of males D. Has an almost equal sex ratio

B. Significantly prevalent in males than in females

This pertains to the modality used in persons with autism-spectrum disorder (ASD) which can influence symptoms of ADHD, anxiety, and increased social interaction by providing computer games or other games which reinforce the desired behavior. At the same time, the child wears electrodes that monitor electrical activity in the brain. * 1 point a. Neuromuscular training b. Electroencephalographic therapy c. Neurofeedback d. Neuronal reinforcement modality

c. Neurofeedback

Projection, denial, and distortion are part of which classification of defense mechanism? * 1 point a. Narcissistic-Psychotic Defenses b. Immature Defenses c. Neurotic Defenses d. Mature Defenses

a. Narcissistic-Psychotic Defenses

Situation: Nurse Buchukoy, a tenured nurse at NCMH, decides to reinforce the proficiency of his junior colleagues with regards to the different psychiatric disturbances. 71. According to CDC, this is the most common method of completed suicide across all age span. * 1 point a. Suffocation b. Firearms c. Poisoning d. Jumping from height

b. Firearms = 50% of suicide cases

With alcohol consumption, disulfiram (Antabuse) produces a wide array of unpleasant symptoms through sustained accumulation of what specific chemical in the blood? * 1 point a. Acetaldehyde b. Toluene c. Hexamine d. Naphthalene

a. Acetaldehyde Disulfiram is acetaldehyde inhibitor

Transitive inferences specifically syllogisms such as “all insects are animals; all butterflies are insects; therefore, all butterflies are animals” are typically developed in what particular age group? * 1 point a. 5-6 years of age b. 7-11 years of age c. 11-14 years of age d. 15-19 years of age

b. 7-11 years of age = concrete operational thinking

Among the drugs indicated for ADHD, which is used infrequently because of the potential of liver problems? * 1 point a. Pemoline b. Atomoxetine c. Methylphenidate d. Dextroamphetamine

a. Pemoline Ast and alt is monitored

Lithium is contraindicated for use during pregnancy since administration of such is associated with what condition? * 1 point a. Neural tube defects b. Ebstein anomaly c. Oral clefts d. Omphalocele

b. Ebstein anomaly A - carbamazepine and valproic acid C - Lamotrigine D - Advanced maternal age

Situation: Nurse Amanda has been a nurse in the psychiatric 76. The specific cause of eating disorders is unknown, however there are different risk factors that could lead to them. The following are developmental risk factors, except: * 1 point a. Self perceptions of being overweight b. Dieting at a young age c. Developing a unique identity d. Having a dissatisfaction with body image

b. Dieting at a young age

Psychopharmacology drugs have been of help in treating eating disorders. Several classes of drugs have been studied and few of them have been considered successful, one of which has been used because of its effectivity on bizarre body image distortions but has been associated with weight gain, what is this medication called: * 1 point a. Haloperidol (Haldol) b. Fluoxetine (Prozac) c. Olanzapine (Zyprexa) d. Cyproheptadine (Periactin)

c. Olanzapine (Zyprexa)

Studies have shown that anorexia nervosa and bulimia nervosa have been a product of familial tendencies. It is said that the disruptions of the nuclei of the hypothalamus may produce the variety of symptoms seen in eating disorders. Deficit in this part of the hypothalamus leads to decreased eating and decreased responses to sensory stimuli that are important to eating. * 1 point a. Ventral Hypothalamus b. Dorsal Hypothalamus c. Lateral Hypothalamus d. All of the above

c. Lateral Hypothalamus

The Eating Attitudes Test is often used in studies of anorexia and bulimia. This test can also be used at the end of treatment to evaluate outcomes because it is sensitive to clinical changes. A total score of _ indicates significant concerns with eating behavior. * 1 point a. 20-30 b. 30-40 c. 40-50 d. 50-60

b. 30-40

The National Eating Disorders Association (2018) provides the following suggestions to promote positive body image, except: * 1 point a. Learn everything you can about anorexia nervosa, bulimia nervosa, binge eating disorder, and other types of eating disorders. b. Don’t read or listen to others’ negative comments. Surround yourself with positive, supportive, real people. c. Avoid becoming a critical viewer of the media and its messages about self-esteem and body image. Don’t accept that the images that you see are the ideals you should try to attain. d. Avoid categorizing foods as “good/safe” versus “bad/dangerous.” Remember that we all need to eat a balanced variety of foods.

c. Avoid becoming a critical viewer of the media and its messages about self-esteem and body image. Don’t accept that the images that you see are the ideals you should try to attain.

Situation: The nurse, through careful assessment, elicits the necessary information that can assist in diagnosis of an ophthalmic condition. 81. This diagnostic examination uses light to evaluate retinal and macular diseases as well as anterior segment conditions. This method is noninvasive and involves no physical contact with the eye. * 1 point a. Fundus Photography b. Optic Coherence Tomography c. Laser Scanning d. Slit Lamp Test

c. Laser Scanning

This diagnostic test is used to measure nerve fiber layer thickness and is an important indicator of glaucoma progression. * 1 point a. Fundus Photography b. Optic Coherence Tomography c. Laser Scanning d. Slit Lamp Test

c. Laser Scanning

This diagnostic test is used to detect and document retinal lesions, the results are viewed stereoscopically so that elevations such as macular edema can be identified. * 1 point a. Fundus Photography b. Optic Coherence Tomography c. Laser Scanning d. Slit Lamp Test

a. Fundus Photography

Indocyanine green angiography is used to evaluate abnormalities in the choroidal vasculature, which often are seen in macular degeneration. Which among the choices is true regarding the aforementioned procedure. * 1 point a. It is an invasive procedure in which fluorescein dye is injected, usually into an antecubital vein b. Within 10 to 15 seconds, this dye can be seen coursing through the retinal vessels. c. Multiple images are captured using digital video angiography over a period of 30 seconds to 20 minutes. d. Over a 10-minute period, serial black-and-white photographs are taken of the retinal vasculature.

c. Multiple images are captured using digital video angiography over a period of 30 seconds to 20 minutes.

. In relation to question number 4, what are the nursing interventions needed prior to angiography, Select all that applies: I. A patient's blood urea nitrogen and creatinine should be checked II. The patient should be well hydrated, and clear liquids are usually permitted until two (2) hours prior to the test. III. The patient is instructed to remain immobile during the angiogram process IV. The patient is told to expect a brief feeling of warmth in the face, behind the eyes, or in the jaw, teeth, tongue, and lips V. It is normal for a metallic taste when the contrast agent is injected * 1 point a. I, II, III b. I, III, IV c. I, II, III, V d. I, III, IV, V e. I, II, III, IV, V

d. I, III, IV, V

Situation: Disorders of balance are common and dizziness may increase the risk of falls. Mrs. Gonzales has been suffering from vertigo every time she shifts her position, it became unbearable that she decided to seek the help of a healthcare professional. 86. All of the following are TRUE regarding BPP, except: * 1 point a. The vertigo is usually accompanied by nausea and vomiting; however, hearing impairment does not generally occur. b. The debris is formed from small crystals of calcium carbonate from the auricle c. A repositioning technique that involves quick movements is performed to rearrange the debris in the canal d. Patients with acute vertigo may be treated with meclizine for 1 to 2 weeks.

b. The debris is formed from small crystals of calcium carbonate from the auricle

The canalith repositioning is done to patients with BPP to rearrange the debris inside the inner ear structure. This maneuver is also known as ________: * 1 point a. Pollette Maneuver b. Hansson Maneuver c. Epley Maneuver d. Brattmo Maneuver

c. Epley Maneuver

Ménière disease is an abnormality in inner ear fluid balance caused by a malabsorption in the endolymphatic sac or a blockage in the endolymphatic duct. The following are dietary guidelines for patients with Meniere Disease, select all that applies: I. Limit foods high in salt or sugar. II. Drink plenty of fluids daily. III. Provide monosodium glutamate as alternative to salt IV. Pay attention to the intake of foods containing potassium V. Avoid aspirin and aspirin-containing medications. * 1 point a. I, II b. I, III c. I, II, IV, V d. I, III, IV, V

d. I, III, IV, V

Most patients with Ménière disease can be successfully treated with diet and medication. Many patients can control their symptoms by adhering to a low-sodium of: * 1 point a. 250-500 mg/day b. 500-1000 mg/day c. 1,000 to 1,500 mg/day d. 1,500 to 2000 mg/day

c. 1,000 to 1,500 mg/day

Surgery such as a resection of the vestibular nerve or total removal of the labyrinth ( labyrinthectomy) may be performed when medical therapy is ineffective and the functional level of the client with meniere’s disease has decreased significantly. As a nurse, which of the following postoperative interventions is the most correct for the client. * 1 point a. Assist with ambulation immediately after surgery for 20 minutes b. Administer antivertiginous and antiemetic medications as per necessary c. Perform neurological assessment q 12 hours d. Encourage the client to use a bedside commode rather than ambulating to the bathroom.

d. Encourage the client to use a bedside commode rather than ambulating to the bathroom.

Situation: Nurses, in many practice settings, encounter patients with altered neurologic function. Knowledge of anatomy and physiology and skills in the assessment of neurologic function is vital to implement appropriate interventions. 91. The cranial nerves are a set of 12 paired nerves that arise directly from the brain. Which of the following about the origin of cranial nerves is incorrect? * 1 point a. Cranial nerves III through VI originate in the midbrain b. Cranial nerves IX through XII originate in the medulla c. Cranial nerves I and II originate in the cerebrum d. None of the above

a. Cranial nerves III through VI originate in the midbrain CN III and IV - Midbrain CN V and VI - Pons

The voluntary motor system consists of upper motor neurons and lower motor neurons. As a knowledgeable nurse, you identified the differences between the two. The following statements are not correct, except? * 1 point a. Loss of voluntary control is present with upper and lower motor neuron lesions b. Atrophy of the affected muscles is a principal sign of upper motor neuron disease c. The sensory pathways from the brain to the spinal cord are formed by lower motor neurons d. Hyperactive deep tendon reflex is a sign of lower motor neuron disease

a. Loss of voluntary control is present with upper and lower motor neuron lesions

Leo, a middle-aged man, is transported to the emergency department unconscious and accompanied by a nurse from the medical floor. The nurse states that Leo was in line in front of her in the hospital cafeteria when he suddenly fell to the floor and exhibited stiff and jerky movements. The physician prescribed a drug that increases levels of GABA by inhibiting succinic semialdehyde dehydrogenase. What anticonvulsant drug is being described? * 1 point a. Phenytoin b. Lamotrigine c. Valproate d. Ethosuximide

c. Valproate Phenytoin: inhibition of voltage gated sodium and calcium channels Lamotrigine: inhibits voltage fated sodium channel Ethosiximide: inhibition of low threshold voltage gated calcium channels

Selene, a patient diagnosed with multiple sclerosis, is admitted to the unit due to acute exacerbation of symptoms. The physician prescribed mitoxantrone. The nurse must monitor which side effect when taking this medication? * 1 point a. Nephrotoxicity b. Hepatotoxicity c. Cardiotoxicity d. Ototoxicity

c. Cardiotoxicity

The pathogenesis of Alzheimer’s disease includes specific neuropathologic and biochemical changes that interfere with neurotransmission. What refers to the molecule that is synthesized and secreted by astrocytes and macrophages and is thought to be important for mobilizing lipids during normal development of the nervous system and during regeneration of peripheral nerves after injury? * 1 point a. Amyloid β-Peptide b. Apolipoprotein E c. Presenilins d. β -amyloid precursor protein

b. Apolipoprotein E

Situation: Glaucoma is often called the “silent thief of sight” because it slowly damages the eyes and can cause irreparable harm before there is any vision loss. Glo, a 42-year-old woman, is diagnosed with open-angle glaucoma. 96. Glaucoma is characterized by elevated IOP. Which of the following factors determines IOP? * 1 point a. Rate of aqueous production b. Resistance encountered by the aqueous humor c. Venous pressure of the episcleral veins d. All of the above

d. All of the above

Nurse Gia is preparing to instill eye drops as prescribed by the physician to Glo. Which among the following is incorrect when administering eye medications? Select all that apply. i. Ensure that blurred vision, stinging, and burning sensation after instillation are temporary ii. Medication must be recapped immediately after use iii. Apply gentle pressure on the eyelids for 1 to 2 minutes immediately after instilling eyedrops iv. Do not refrigerate eye medications to ensure maximal efficacy v. Hold the upper lid up without pressing the eyeball vi. Allow a 2-minute interval between successive administrations to retain the drug * 1 point A. i, iii, v, vi B. iii, iv, v, vi C. i, ii, iv D. iv, v, vi

B. iii, iv, v, vi

Prior to discharge, Nurse Gia reinforces that glaucoma has a genetic predisposition. She teaches Glo’s family members to undergo eye examinations at least how often? * 1 point a. At least once a year b. At least twice a year c. At least once every 2 years d. At least once every 5 years

c. At least once every 2 years

Te anatomic organization of the visual system is useful for localizing neurologic disease. What type of defect is caused by lesions that compress the central portion of the chiasm, such as pituitary tumors? * 1 point A. Bitemporal hemianopia B. Homonymous hemianopia C. Superior quadrantanopia D. Inferior quadrantanopia

A. Bitemporal hemianopia

Iya is being assessed by the nurse as part of her annual physical examination. She told the nurse that she will be attending a concert, which will be at a volume of 90 dB. What should be the nurse’s response about the possible consequence of this sound level? * 1 point a. “Hearing will not be affected this level is safe for ears” b. “Sounds in this level may cause hearing loss” c. “Conductive hearing loss may occur with a decibel level in this range” d. “This level is perceived to be distressing to the ear but hearing is intact”

b. “Sounds in this level may cause hearing loss”

PREBOARDS 1_NP5 Flashcards

(100 cards)