Mental Health Medications, Personality Disorders, and Nursing Considerations, Exams of Health psychology

Download Mental Health Medications, Personality Disorders, and Nursing Considerations and more Exams Health psychology in PDF only on Docsity! Neebs Mental Health FINAL Dochorecker Questions And Answers Who has been called the founder of nursing? The mortality rate went from 42.7% to 2.2% - correct answer Who is Florence Nightingale? Who was a school teacher, not a nurse? Her primary focus was on the care of prisoners and the mentally ill? - correct answer Who is Dorothea Dix? Who opened the Boston City Hospital Training School for Nurses? It was opened to specialize care for the mentally ill. - correct answer Linda Richards. What organizations helped develop schools and programs to teach nurses how to properly care for the mentally ill? - correct answer American Nurses Association (ANA) National League for Nursing (NLN) Who initiated the first psychiatric program of study for nurses? - correct answer Effie Jane Taylor Dr. Peplau believed nurses should provide type of services? Neebs Mental Health FINAL Dochorecker Questions And Answers - correct answer She believed that nurses should take every opportunity to educate the public and be role models. 1. Resource person, provides information 2.Counselor, helps patients to explore their thoughts and feelings 3. Surrogate, role-playing or other means to help the pt explore and identify feelings from the past 4. Technical support, coordinates professional services. How did Dr. Peplau see the nurse as? - correct answer A resource person, provides info A counselor, helps patients to explore their feelings Surrogate, role-play scenarios Technical support, coordinate professional services What are the 4 stages of a therapeutic relationship, between a nurse and patient. (Peplau,, 1952) - correct answer 1. Orientation, Pt feels a need and a will to seek out help Neebs Mental Health FINAL Dochorecker Questions And Answers What is active and purposeful listening "listening between the lines" used for? - correct answer Successful therapeutic communication What is ethics? - correct answer They are one's own values What is proxemics? - correct answer It concerns space, time, and waiting. US-northern states tend to be more rushed, vs southern states life is a bit slower-paced What is HIPAA? - correct answer Health Insurance Portability and Accountability Act This allows communication between medical information between patients, providers, employers and insurers. It allows more control of the part of the patient as to what part his/her information is disclosed. - correct answer HIPAA What is the leading national accrediting body of health- care organizations? - correct answer Joint Commission Neebs Mental Health FINAL Dochorecker Questions And Answers What are the goals of the Joint Commission? - correct answer -Have a commitment of quality on a daily basis within the entire facility. -Reducing the risk of undesirable patient outcomes -encouraging continuous improvement What is the average length of an involuntary commitment? - correct answer 48-72 hours What is patient advocacy? - correct answer Being a voice for your patient to ensure they get the best fair treatment What is ethnicity defined as? - correct answer It identifies a person with his or her shared heritage, such as their language, skin color What type of parent sets up strict rules, while the child has little or no voice in family decisions? - correct answer Authoritarian parent What type of parent has firm, consistent rules and limits, while allowing for discussion and occasional flexibility of Neebs Mental Health FINAL Dochorecker Questions And Answers those rules? - correct answer Authoritative parent What are some common reasons of homelessness? - correct answer Economic setbacks Major health expenses Mental health What does the mental health exam include? - correct answer 1.Level of awareness and orientation 2.Appearance and behavior 3.Speech and communication 4.Mood and affect 5.Memory 6.Thinking/cognition 7.Peception 8.Judgement How would you check a person's orientation? - correct answer You may ask them things like "Where are you know?" "Tell me what day it is" "Who is the current president?" Neebs Mental Health FINAL Dochorecker Questions And Answers A person who always sounds as he/she is making excuses is displaying? - correct answer rationalization The use of defense mechanisms is related to what part of Freud's personality theory? - correct answer Id, ego and superego What is the ability to think rationally and to process those thought? - correct answer cognitive ability What are the types of antipsychotics? - correct answer Neuroleptics/Major tranquilizers Typical and Atypical What agent works on the CNS, main action is to block dopamine receptors? - correct answer Typical antipsychotics *If this is overproduced in the body it can cause someone to exhibit psychotic behavior What agent block both serotonin and dopamine? - correct answer Atypical antipsychotics Neebs Mental Health FINAL Dochorecker Questions And Answers What are antipsychotics used for? - correct answer To treat psychotic behaviors, e.g schizophrenia What does typical antipsychotic agents treat? - correct answer The positive symptoms of schizo, e.g hallucinations, delusions and suspiciousness. What treats positive symptoms of schizophrenia? - correct answer Typical antipsychotics What does Atypical antipsychotics treat? - correct answer They reduce negative symptoms of schizo, e.g flat affect, social withdrawal and difficulty with abstract thinking. What reduces negative symptoms of schizophrenia? - correct answer Atypical antipsychotics What are the side effects of antipsychotics? - correct answer -photosensitivity -darkening of skin -anticholinergic effects, dry mouth and a group of effects call EPS Neebs Mental Health FINAL Dochorecker Questions And Answers What antipsychotic disorder has less of a risk for EPS? - correct answer atypical antipsychotics What are extrapyramidal symptoms? - correct answer 1. Drug induced parkinsonism 2.Akathisia 3.Dystonia 4.Tardive dyskinesia When does symptoms appear for drug-induced parkinsonism? - correct answer 1-8 weeks What are the major symptoms of drug induced parkinsonism? - correct answer Akinesia (muscle weakness) shuffling gait drooling fatigue mask like facial expression tremors Neebs Mental Health FINAL Dochorecker Questions And Answers What are Antiparkinson agents? - correct answer They are anticholinergics they inhibit the action of acetylcholine. Acetylcholine increases as dopamine decreases. There is then a better balance between the 2 neurochemicals, and the symptoms of parkinson decrease. What are the side effects of antiparkinson agents? - correct answer Blurred vision dry mouth dizziness drowsiness confusion tachycardia-changes in bp urinary retention constipation When beginning treatment with a parkinson agent what should you monitor? - correct answer Monitor blood pressure every 4 hours What may you encourage someone to do that is taking an anticholinergic agent? Neebs Mental Health FINAL Dochorecker Questions And Answers - correct answer Suck on sugarless candy to combat dry mouth What are some common antiparkinson agents? - correct answer Benadryl (diphenhydramine) Mirapex (pramipexole) What are antianxiety agents? - correct answer Anxiolytics and minor tranquilizers They depress activities of the cerebral cortex What are the side effects of antianxiety agents? - correct answer Physical and psychological dependance drowsiness lethargy fainting postural hypotension What must you do if a patient is taking an antianxiety medication and starts feel nausea and has hypotension? - correct answer Discontinue immediately, this can happen 12 hrs-2 weeks after the drug is stopped Neebs Mental Health FINAL Dochorecker Questions And Answers What are some nursing considerations while taking antianxiety medications?/ - correct answer monitor BP before and after giving med pt should rise slowly should be given at bedtime dont drive or drink What medication when taken with an antianxiety medication up the risk of orthostatic hypotension? - correct answer tricyclic antidepressant What is alprazolam? - correct answer It is xanax an antianxiety med What is BuSpar? - correct answer buspirone, an anxiolytic, not an SSRI What is Serax? - correct answer oxazepam, anxiolytic What is Valium? - correct answer diazepam, anxiolytic Neebs Mental Health FINAL Dochorecker Questions And Answers What is fluoxetine? - correct answer SSRI Prozac What is Escitalopram? - correct answer SSRI Lexapro What is Paroxetine? - correct answer SSRI Paxil What are tricyclic antidepressants? - correct answer Antidepressants which work to correct chemical imbalance of neurotransmitter concentrations in the synaptic cleft of the CNS by inhibiting the reuptake of neurotransmitters back into the cells. If someone is experiencing; sleep disturbances sexual function disturbances changes in appetite cognitive changes Neebs Mental Health FINAL Dochorecker Questions And Answers what may they be prescribed? - correct answer tricyclic antidepressant What can increase the effects of tricyclic antidepressants? - correct answer alcohol antihistamines sodium bicarbonate benzodiazepines What decreases the effects of tricyclic antidepressants? - correct answer nicotine barbiturates If you combine tricyclic antidepressant with St. John's wort what may happen?/ - correct answer Serotonin syndrome may occur What is amitriptyline? - correct answer tricyclic antidepressant Elavil What is imipramine? - correct answer tricyclic antidepressant Neebs Mental Health FINAL Dochorecker Questions And Answers Tofranil What drugs increased the availability of serotonin and norepinephrine, patients with decreases in the brain of depressed individuals? - correct answer SNRIs What are MAOIs? - correct answer monoamine oxidase inhibitors The prevent the metabolism of neurotransmitters, but to much MAOIs can lead to destructive psychotic behaviors What do you need to avoid when taking an MAOI? - correct answer food containing tyramine -aged cheese -avocados -livers of chicken and beef -Smoked meats -bananas, raisins, figs What is phenelzine? - correct answer MAO inhibitor Nardil Neebs Mental Health FINAL Dochorecker Questions And Answers What are the goals of psychotherapy? - correct answer 1.Decrease emotional discomfort 2.INcrease patients social functioning 3.Increase patients ability to behave appropriately to a situation What is catharsis? - correct answer Emotional release What are the phases of a crisis? - correct answer 1.Precrisis-person denies stress 2.Impact- feeling the anxiety, but may down play it 3.Crisis-withdraws and may rationalize behaviors 4.Adaptive- crisis perceived positively, anxiety decreases 5.Postcrisis-may be positive or negative, may use food or alcohol to cope What are the goals of a crisis intervention? - correct answer 1. Ensure safety: assess the situation, you shouldn't leave unless you are in danger. 2. Diffuse the situation: Verbally if possible. 3.Determine the problem: Attempt to figure out issue from patients viewpoint remain calm. Neebs Mental Health FINAL Dochorecker Questions And Answers 4.Decrease anxiety level:Reassure patient he/she is safe, try and reassure help in any way. 5.Return the patient to pre-crisis level of functioning: What is Wellbutrin? - correct answer An atypical antidepressant that has none of the negative sexual side effects associated with other antidepressants, is generally stimulating, curbs nicotine cravings, and can treat ADHD What is biofeedback? - correct answer A person uses his/her own thoughts to control body responses. What is biofeedback used for? - correct answer insomnia some seizures functional nausea tinnitus phantom limb pain What is Rolfing? - correct answer series of 10 treatments to the fascia to balance the body Neebs Mental Health FINAL Dochorecker Questions And Answers What types of aromatics might be used for mental illness and depression? - correct answer lavender thyme gardenia `What is St. John's wort good for? What should you watch for? - correct answer Antidepressant No MAOIs, antidepressants, digoxin What is kava kava? - correct answer Used to treat depression and anxiety, also used as a sleep aid. Dont use with alcohol, used with alprazolam may cause coma. Levadop can increase parkinson like symptoms. What is Reiki? - correct answer Japanese technique for stress reduction and relaxation What is neurolinguistic programming? - correct answer A form of communication that is a way of Neebs Mental Health FINAL Dochorecker Questions And Answers nausea diarrhea chills polyuria insomnia difficulty swallowing What is diagnosed when excessive worry is related to two or more things and lasts 6 months or longer? - correct answer generalized anxiety disorder (GAD) GAD symptoms - correct answer restlessness easily fatigued difficulty concentrating irritability muscle tension sleep disturbances What is a recurrent condition that is a state of extreme fear that cannot be controlled? - correct answer What is panic disorder, aka panic attack Neebs Mental Health FINAL Dochorecker Questions And Answers Panic disorder traits can include - correct answer fear dissociation nausea diaphoresis chest pain increased pulse shaking unsteadiness feeling suffocated What is defined as an irrational fear? - correct answer What is a phobia What is acrophobia? - correct answer fear of heights What is ailurophobia? - correct answer fear of cats What is nyctophobia? - correct answer fear of darkness Neebs Mental Health FINAL Dochorecker Questions And Answers what is scoleciphobia? - correct answer fear of worms What is thanatophobia? - correct answer fear of death What is agoraphobia? - correct answer fear of public places What is social phobias? - correct answer fear of speaking in public and fear of public facilities, toilets What is specific phobias? - correct answer claustrophobia hematophobia What causes reoccurring thoughts, ideas, and actions that interfere with a person's daily ability to function? - correct answer OCD What are the 2 components of OCD? - correct answer obsessions and compulsions Neebs Mental Health FINAL Dochorecker Questions And Answers What is lorazepam used for? - correct answer Anxiety, status epileptics, and preoperative sedation Ativan What is clonazepam used for? - correct answer panic attacks, anxiety What are some common nursing diagnoses for people with anxiety and anxiety-related disorders? - correct answer Anxiety, coping ineffective Yoga acupuncture Kava Symptoms such as muscle aches, shakes, palpitations, dry mouth, nausea, chills, vomiting, hot flashes, polyuria, difficult swallowing feeling of dread can be linked to what disorder? - correct answer GAD Fear dissociation nausea, diaphoresis, chest pain, increased pulse, shaking, unsteadiness and paralysis can Neebs Mental Health FINAL Dochorecker Questions And Answers be symptoms of what? - correct answer Panic disorder Irrational fear of a particular object or situation is known as what? - correct answer Phobia flashbacks, social withdrawal, low self-esteem, relationships that may change or be difficult to form, irritability, anger, seemingly for no reason, depression, chemical dependency can be symptoms of what? - correct answer PTSD What is characterized by somatic symptoms that are either very distressing or result in significant disruption of functioning, as well excessive and disproportionate thoughts, feelings and behaviors regarding those symptoms - correct answer SSD somatoform disorders What is amitriptyline used for? - correct answer elavil can be used for somatic disorders Neebs Mental Health FINAL Dochorecker Questions And Answers What can Bupropion be used for? - correct answer somatic disorders wellbutrin What can trazadone be used for? - correct answer somatic disorder Oleptro What is Sertraline used for? - correct answer Zoloft somatic disorder Medication of choice for OCD include? - correct answer Paxil-paroxetine Prozac-fluoxetine Luvox-fluvoxamine What is a painful and debilitating illness that affects all areas of ones life? - correct answer depression What is characterized by a combination of symptoms that severely interfere with a person's ability to work, sleep, Neebs Mental Health FINAL Dochorecker Questions And Answers What is a useful treatment for depression with seasonal pattern> - correct answer Light therapy What drug may cause a hypertensive crisis? - correct answer MAOIs What is amitriptyline? - correct answer tricyclic antidepressant You patient states that their sertraline isn't working, after taking it for 3 days what may you tell them? - correct answer These medications usually take a few weeks to bring about an improvement to your symptoms Euphoria would be indicative of what? - correct answer Bipolar depression What is characterized by marked shifts in mood, energy, and ability to function, often with profound depressions to periods of hyperactivity or mania, with normalcy periods. - correct answer Bipolar disorder What are the common forms of bipolar disorder? - correct answer Bipolar I Neebs Mental Health FINAL Dochorecker Questions And Answers Bipolar II Cyclothymia What is a chronic disorder marked by multiple episodes of hypomania (less severe hyperactivity) and depression? - correct answer Cyclothymic disorder What are characterized by a distinct period of abnormality and persistently elevated, expansive, or irritable mood. - correct answer Mania episodes What are some clues that a person has bipolar disorder? - correct answer family history of bipolar disorder recurrent depressions repeated loss of efficacy of antidepressants hyperactivity during depressive episodes How long does the manic phase last? - correct answer it may last days to months. causes marked disruption of occupational and social functioning. Neebs Mental Health FINAL Dochorecker Questions And Answers Signs of manic phase - correct answer Easily distracted little need for sleep poor temper control, easily agitated reckless behavior -drinking, drug use, binge eating -poor judgement -sex with many partners -spending sprees very elevated mood -increased energy -talking a lot -very high self-esteem What has a full syndrome of manic symptoms and most likely depression episodes? - correct answer bipolar 1 What has at least one bout of major depression with episodic occurrence of hypomania, may never experience a full episode of mania. - correct answer Bipolar 2 Neebs Mental Health FINAL Dochorecker Questions And Answers - correct answer True, they experience dry mouth as a side effect Which of the following is not a mood stabilizer? -Carbamazepine -Olanzapine -Valproic Acid -Gabapentin - correct answer Olanzapine, antipsychotic A newly admitted patient is in acute manic state, is at risk for injury related to hyperactivity. What is an appropriate nursing intervention? - correct answer Administer antipsychotic med as ordered prn by the physician True or false: Patients with bipolar II have major depression with hypomanic symptoms? - correct answer True What is the 10th leading cause of death in the US? - correct answer suicide Neebs Mental Health FINAL Dochorecker Questions And Answers Who is the largest group of suicides? - correct answer White males Decreased levels of serotonin are associated with: - correct answer found in people with depression, impulsive disorders, suicide victims What are some risk factors for suicide? - correct answer Mood disorder- depression, bipolar Beginning of treatment with antidepressants Alcohol Family history of mental disorder, sexual abuse Grief from recent loss Poor support system What has been linked to suicidal ideation? - correct answer Overwhelming sense of hopelessness shame guilt humiliation Neebs Mental Health FINAL Dochorecker Questions And Answers When do personality disorders occur? - correct answer when personality traits become inflexible and personality functioning becomes individually and interpersonally impaired. What are cluster A personality disorders? - correct answer Behaviors described as odd -paranoid personality disorder -schizoid personality disorder -schizotypal disorder What are cluster b personality disorders? - correct answer Behaviors described as dramatic -Antisocial personality disorder -Borderline personality disorder -Histrionic personality disorder -Narcissistic personality disorder What are cluster c personality disorders? - correct answer Behaviors described as anxious or fearful -avoidant personality disorder -dependent personality disorder -Obsessive-compulsive personality disorder Neebs Mental Health FINAL Dochorecker Questions And Answers - correct answer childhood bullying and cruelty, animal abuse and manipulative behaviors. May have been diagnosed with conduct disorder before age 15 What is conduct disorder? - correct answer A disregard for the rights of others leading to aggression towards people and animals, destruction of property, deceitfulness, theft, or serious violation of rules What is the most frequent personality disorders? They exhibit both clinging and distancing behavior, known for intense chaotic relationships, self-destructive, impulsive and dramatic coping. - correct answer Borderline personality disorder Chronic sense of emptiness, poor self image, and excessive self-criticism, may also utilize self-mutilating behaviors. Origins may be from an abusive childhood, poor relationships with parental figures where one faces abandonment. - correct answer Borderline personality disorder Neebs Mental Health FINAL Dochorecker Questions And Answers Who has splitting as a defense mechanism? - correct answer Borderline personality disorder e.g a nurse is caring during one shift may become the patient idealizes as the perfect nurse, and then the next nurse that comes in may be called "mean" What is histrionic personality disorder? - correct answer -Theatrical -Center of attention -Extreme emotionality -Approval seeking -Low frustration tolerance -Unable to delay gratification What is narcissistic personality disorder? - correct answer -Grandiosity -Attention seeking -Lack of empathy -Egomaniac with inferiority complex These individuals are extremely sensitive and may avoid social situations to protect themselves from possible rejection. But have a strong need to be accepted. Neebs Mental Health FINAL Dochorecker Questions And Answers Labeled as shy, they can be awkward in social situations. Low self-esteem avoidance of close relationships anxiety anhedonia - correct answer Avoidant personality disorder Pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation. They want other people to make decisions for them. - correct answer Dependant personality disorder Disciplined and rigid to an extreme, meticulous and demand accuracy and discipline in others. They are occupied with details, rules, and order. May appear polite and formal but can become critical with others. Demonstrate persistence at tasks longer after the behavior has ceased to be functional - correct answer obsessive-compulsive personality disorder Neebs Mental Health FINAL Dochorecker Questions And Answers -catatonia, echolalia, echopraxia What are the positive symptoms of schizophrenia? - correct answer They are symptoms that are found among people with schizophrenia. e.g delusions, thought disorders, hallucinations magical thinking, neologisms, echopraxia, echolalia. types of hallucinations - correct answer Auditory, visual, tactile, olfactory and gustatory. common types of delusions - correct answer Grandeur- "i am Napolean" Paranoia- "The FBI are following me" Reference- "The people on the radio are talking to me" Physical sensations- "I have no blood in me" Thought insertion- "The devil made me say that" What might be prescribed to someone with schizophrenia? - correct answer Antipsychotic medications Neebs Mental Health FINAL Dochorecker Questions And Answers What are long acting injectable antipsychotics? - correct answer Haloperidol fluphenazine risperidone Typical antipsychotic drugs - correct answer Thorazine Fluphenazine(Prolixin) Haloperidol (Haldol) atypical antipsychotic drugs - correct answer * clozapine (Clozaril®) Prototype • olanzapine (Zyprexa®) • quetiapine (Seroquel®) - Risperidone (Risperdal) Typical antipsychotics are more prone to what type of side effects? - correct answer EPS, extrapyramidal symptoms as well and anticholinergic effects. How are extrapyramidal symptoms treated? - correct answer With anticholinergic drugs e.g benztropine Neebs Mental Health FINAL Dochorecker Questions And Answers biperiden trihexyphenidyl dopaminergic agonist (amantadine, diphenhydramine) What are some serious side effects of atypical antipsychotics? - correct answer reduced seizure threshold blood dyscrasias cardiac arrhythmias agranulocytosis from clozapine When taking clozapine what must you do? - correct answer Keep a close monitor on WBC count, because of agranulocytosis. agranulocytosis is a severe and dangerous leukopenia most common in neutrophils How long does it take buspirone to take effect? - correct answer It take 7-10 days to start to work 2-4 weeks for the full effect do not take with grapefruit juice because it can increase the level of the medication in the system. Neebs Mental Health FINAL Dochorecker Questions And Answers What is the gradual loss of pervious levels of cognitive functioning, which can include memory, language, executive functions, (like organizing) and attention? It is a slow progressive condition that eventually impacts all aspects of mental and social functioning. - correct answer dementia What are the different types of dementia? - correct answer primary dementias-alzheimer's secondary dementias- HIV-related, and vascular What is a common disorder in the elderly and can be mistaken for dementia? - correct answer Depression it includes -forgetfulness -little effort to complete responsible -limited communication but the difference being, they can oriented to time, place unlike dementia patients What accounts for 60-80% of the dementias? - correct answer alzheimer's Neebs Mental Health FINAL Dochorecker Questions And Answers What is usually the cause of death from alzheimer's? - correct answer it is often, aspiration pneumonia, infection and complications from falls, swallowing disorder and malnutrition(later stages) How is the diagnosis of alzheimer's made? - correct answer With an MRI or PET scan which can detect the presence of plaque and tangles. -plague, chemical deposits made of degenerating nerve cells tangles-malformed nerve cells the enzyme acetylcholine is also reduced. What are some symptoms of alzheimers? - correct answer agnosia-loss of ability to recognize objects agraphia-difficulty writing and drawing apraxia-inability to carry our motor activities despite intact motor function -withdrawal -memory loss that disrupts daily life -confusion with time or place -misplacing things and losing the ability to retrace steps Neebs Mental Health FINAL Dochorecker Questions And Answers What is a medication to treat early onset alzheimer's? - correct answer cholinesterase inhibitors -act by inhibiting acetylcholinesterase which increase the concentration of acetylcholine. What are cholinesterase inhibitors? - correct answer Donepezil Rivastigmine Galantamine Tacrine What is vascular dementia? - correct answer dementia assoc w/ hx of stroke and cerebrovascular disease is the second most common type of dementia. When does substance abuse become a problem? - correct answer interferes with normal functioning continues despite negative consequences hurts others