_NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+), Exams of Nursing

Download _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) and more Exams Nursing in PDF only on Docsity! _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) How to conduct Mini-Cog- • The Mini-Cog has been demonstrated to have comparable psychometric properties to the MMSE • The primary advantage of the Mini-Cog is that it is shorter than the MMSE and measures executive function. • It is composed of a three-item recall and the Clock Drawing Test (CDT) and takes about 3 minutes to administer • The Mini-Cog is a short dementia assessment that combines three-word recall with clock- drawing capability. • Patients are given a total score reflecting accuracy in clock drawing and recollection of the given three words. • A score of 0 to 2 is a positive screen for dementia Causes of delirium in elderly- • Causes of delirium are numerous and in elderly hospitalized patients there are often multiple etiologies, including metabolic, infection, cardiac, neurological, pulmonary, sensory impairments, medications, and toxins. • Regardless of cause, a consistent finding is significant reduction in regional cerebral perfusion during periods of delirium in comparison with blood flow patterns after recovery. • A possible neurological common pathway may involve acetylcholine and dopamine, and the disruption in the _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) sleep-wake cycle in delirium indicates melatonin as a possible factor. (Kennedy-Malone 59) Agnosia • Loss of ability to identify objects ADA criteria for diagnosing DM- • FPG ≥126 mg/dL (7.0 mmol/L). Fasting is defined as no caloric intake for at least 8 h.* • 2-h PG ≥200 mg/dL (11.1 mmol/L) during OGTT. The test should be performed as described by the WHO, using a glucose load containing the equivalent of 75-g anhydrous glucose dissolved in water.* • A1C ≥6.5% (48 mmol/mol). The test should be performed in a laboratory using a method that is NGSP certified and standardized to the DCCT assay.* • In a patient with classic symptoms of hyperglycemia or hyperglycemic crisis, a random plasma glucose ≥200 mg/dL (11.1 mmol/L). • Urinary incontinence- • Involuntary loss of urine from the bladder ▪ So common in women many consider it normal ▪ Common in older men w/ enlarged prostate o Can affect quality of life o Significance-One of the most common complains w/ older adults, Distress & embarrassment, Cost burden to pt & society as a whole, Not life-threatening, may effect _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) incontinence management; Decrease caregiver burden - 1st line management guidelines o AHRQ guidelines for management of UI in women ▪ Behavioral therapy ▪ Lifestyle modification ▪ Try for 3 months before pharm management o Weight loss, Smoking cessation(Tobacco is a bladder irritant),Less coughing o Dietary changes-Alcohol, soda, coffee with or without caffeine, acidic foods and spicy foods o Maintain adequate fluid balance to reduce constipation, provide adequate flow to kidneys - Behavioral strategies:Bladder training, Bladder control strategies,Timed voiding,Kegels, Pelvic floor training - 2nd line management - Medication o Antimuscarinic medication: 1st line for women ▪ Block the parasympathetic muscarinic receptors ▪ Inhibit involuntary detrusor contractions ▪ Side effects due to the effects on other muscarinic receptors o Outcomes unpredictable and side effects common o Common s/e: Dry mouth**, Blurred vision, Constipation,Nausea,Dizziness, Headache o AntimuscarinicsMechanism of action ● Blocks acetylcholine at muscarinic receptors, relaxes bladder smooth muscle, inhibits involuntary detrusor contractions (anticholinergic) ● CYP3A4 substrates _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) ▪ Indications: UI and OAB ▪ Contraindications: Untreated/uncontrolled narrow angle glaucoma,Gastric retention, Urinary retention ▪ Precautions:CNS depression,Caution in elderly ● Renal dosing o CrCl <30 o Beta 3 Adrenergic Agonist – Mirabegron (Myrbetriq) ▪ Also approved for UI and OAB ▪ Clinical trials – significant reduction in incontinence and micturations ● No anticholinergic s/e ▪ Mech of action ● Selectively stimulates beta-3 adrenergic receptors ● Relaxes smooth muscle – bladder ▪ Contraindications/caution: HTN- Do not use if SBP >180, DBP >100 ▪ Avoid severe renal/liver disease ▪ Dose – 25-50mg PO QD ▪ CrCl <30 – max 25mg - 2nd line of UI in Males – Alpha 1 blockers o Men, not women! _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) o Alpha 1 blockers antagonize peripheral alpha 1 adrenergic receptors o Used in men d/t high incidence of BPH in aging men o Alpha antagonists ▪ Alpha 1A – prostatic smooth muscle relaxation ▪ 1B – vascular smooth muscle contraction ▪ 1D – bladder muscle contraction and sacral spinal cord innervation o Meds ▪ Doxazosin SE: Dizziness, dyspnea, edema, fatigue, somnolence ▪ Terazosin SE: Asthenia, dizziness, postural hypotension ▪ Tamsulosin SE:Abnormal ejaculation, asthenia, back pain, dizziness, increased cough ▪ Alfuzosin- CrCl <30 use with caution, SE: Dizziness, URI ▪ Silodosin SE- Retrograde ejaculation Differentials as cause for erectile dysfunction- • Differential diagnosis: o Vascular, Endocrine, Neurological, Neurovascular, Substance abuse, End- organ disease, Psychogenic, Social causes (Kennedy-Malone 376) Elder abuse • Types- o Physical, Emotional, Sexual, Neglect, Exploitation, Abandonment, Self-Neglect • Risk Factors- o Age, Gender, Cognitive Impairment, Living Arrangement, Social Isolation _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) • Alpha 1B- Vascular smooth muscle contraction • Alpha 1D -Bladder muscle contraction and sacral spinal cord innervation UTIs in men and women UTI treatment guidelines BPH- • Progressive, benign hyperplasia of prostate gland tissue • Etiology/incidence- o Cause is uncertain, About 50% of men have it by 60, By age 85, 90% have it o Most common cause of bladder outlet obstruction in men over 50 • Symptoms are attributed to mechanical obstruction of the urethra by the enlarged prostate gland • Signs/Symptoms- o Gradual worsening of the following, Frequency, urgency, urge incontinence, Nocturia, dysuria, Weak urinary stream, dribbling, hesitancy, Sensation of full bladder even after voiding, Retention • Diff Dx- o Urethral stricture, Prostate or bladder cancer, Neurogenic bladder, Bladder calculus, Acute or chronic prostatitis, Bladder neck contractor, Medications that affect micturition • Physical findings- o Abdomen,May have distended bladder secondary to retention; _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) Prostate,Nontender w/ asymmetric or symmetrical enlargement, gross enlargement atypical, Consistency is smooth, rubbery (eraser), Nodules may be present • Differentiation from BPH and CA needs biopsy • Tests/Findings o UA-No hematuria or UTI, Urinary flow rate, Voided volume and peak urinary flow rate (uroflowmetry) may detect obstruction flow, Abdominal US – rules out upper tract patho, PSA, Consider PVR urine volume, Cr to assess renal function, elevated levels suggest urinary retention or underlying renal disease – refer this patient • Treatment/Management- o Refer men who have the following, ▪ Refractory urinary retention who have failed one attempt at cath removal, ▪ Recurrent infection, recurrent retention, refractory hematuria, bladder stone, large bladder, diverticula, or renal insufficiency related to BPH, ▪ Consider referral if complications exist or if patients have severe symptoms • Management- o Men who have no indications for surgery, ▪ Discuss risks/benefits of all options, Watchful waiting (observation), Behavioral techniques to reduce symptoms, Limit fluid after dinner, ▪ Avoid medications such as Antidepressants, Antiparkinson drugs, Antipsychotics, _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) Antispasmodics, Cold meds, Diuretics • Medication Treatments o Alpha adrenergic blocker – for smaller prostates o 5-alpha adrenergic blocker – larger prostates o Combo therapy is an alpha-adrenergic blocker and finasteride is used now for men w/ large prostates • Surgery has the best chance for relief of symptoms, but greater risks • Follow up: o Teach signs/symptoms of retention and obstruction, o If observing for now, recheck every 6-12 months, o In use of meds, recheck in 4-6 weeks, _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) o 3rd step: Opioid pain meds, sometimes around the clock for severe pain • Adjuvant meds: o Tricyclic antidepressants, Nortriptyline,Desipramine,Duloxetine,Gabapentinm, Pregabalin, Lidocaine 5% patch, Capsaicin cream, Corticosteroids, Calcitonin, Baclofen Pain management in elderly Delirium vs. dementia- • Delirium- o rapid onset (hours to days). o Poor memory, disorientation, speech disturbance, perceptual disturbance. o Typically fluctuates over course of day. _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) o History may reveal cause-medical condition, intoxication or withdrawal, use of med, toxin exposure or combination. (Kennedy 558). • Dementia- o Alz Disease most common. o An acquired persistent intellectual impairment with compromise in multiple spheres of mental activity. o Signal symptoms: confusion, impaired short term memory, cog dysfunction. o Progression is typically slow. o Could be reversible (secondary to treatable systemic disorder), or irreversible (primarily caused by progressive systemic or neuro disorder). o ***hallmark*** anosognosia- the patient is unaware of impairment and denies illness(kennedy, p.562) o Alz. ChEIs - cornerstone of pharm therapy as acetylcholine is important for brain cell function. Steps of the grieving process • Grief is the emotional response to loss, Mourning is the outward social expression of loss • Types of grief: o Anticipatory-experienced before death, can be experienced by everyone including the patient o Normal- encompasses the typical emotional, physical, cognitive, and spiritual reactions to a loss o Complicated-chronic, delayed, exaggerated, masked or disenfranchised _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) • Stages of Grief: o Notification and shock o Experiencing the loss emotionally and cognitively o Reintegration • Tasks of grieving: o Acknowledging the reality of death o Sharing in the process of working through the pain of grief o Reorganizing the family system, restructuring the relationship with the deceased, and reinvesting in other relationships and life pursuits • Kennedy p. 631 Alzheimer’s treatment • Signs and symptoms- o Preclinical ▪ can last 2-4+ years, impaired memory (excused or covered), poor judgement, decreased spontaneity, increased social anxiety, insidious instrumental ADL losses (bill paying, money handling), preserved basic ADLs o Mild/Moderate- ▪ lasts 2-10 years, obvious memory impairment, overt instrumental ADL impairment, basic ADL failing, behavioral difficulties, shortened attention span, language difficulty, variable social skills, supervision required _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) because of its associated risk for lactic acidosis and an excess cardiovascular mortality (see later discussion). • Dosing. The starting dose of metformin is 500 mg once daily with dinner. After 1 week, the dose is increased to twice daily, given with the two largest meals of the day (usually breakfast and dinner) to minimize gastrointestinal upset. The dose can be increased by 500 mg every 1 to 2 weeks until treatment goals are met or the maximum dose of 2,000 to 2,500 mg/d is reached. An extended-release formulation is also available, which can help to improve compliance. • Efficacy. When used as monotherapy in an obese person with moderate glucose intolerance, metformin’s efficacy in terms of glycemic control (i.e., lowering fasting glucose and glycosylated hemoglobin levels) is about the same as that of a second- generation sulfonylurea. Incidence of monotherapy treatment failure is less for metformin than for glyburide (21% vs. 34% at 5 years). A synergistic effect is achieved when combined with sulfonylurea therapy in patients who do not respond well to metformin alone. Unlike the sulfonylureas, metformin is effective even in severe fasting hyperglycemia (>300 mg/dL), indicative of poor beta-cell responsiveness. Plasma triglycerides and LDL cholesterol levels are decreased. In the UKPDS trial noted earlier, obese patients (>120% of ideal weight) with type 2 diabetes treated with metformin and attaining target glycemic control achieved clinically important, statistically significant, sustained long-term reductions in risks of microvascular disease and macrovascular complications (i.e., myocardial infarction, stroke, and cardiovascular death); all-cause mortality was also significantly reduced. These findings make metformin one of the few _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) antihyperglycemic drugs with demonstrated ability to reduce macrovascular risk, the holy grail of diabetes management. • Adverse Effects. The most common side effect of biguanide therapy is dose-related gastrointestinal upset (nausea, diarrhea, bloating, abdominal discomfort). The risk for serious prolonged hypoglycemia is minimal. Lactic acidosis represents the most potentially serious adverse effect. One of the original biguanides—phenformin —was taken off the market by the U.S. Food and Drug Administration (FDA) in 1977 because of its association with fatal episodes of lactic acidosis. The risk for lactic acidosis associated with metformin is greatest in the setting of hypoxemia, hypovolemia, and states with decreased tissue perfusion and in renal insufficiency (creatinine >1.5 mg/dL). Accumulation of the drug secondary to reduced excretion results in impaired hepatic metabolism of lactate. Other risk factors include binge drinking, use of intravenous radiologic contrast agents, hepatic failure (lactate is metabolized by the liver), and serious underlying illness, particularly heart failure.Long- term data on safety have yet to be accumulated. Because insulin secretion is not increased with metformin use, weight gain does not occur; some patients may even lose weight. Patients who are to undergo a radiologic procedure that requires intravenous iodinated contrast should have their metformin therapy held for a few days prior to the procedure and remain well hydrated. • Patient Selection. Based on the landmark results of the UKPDS, obese patients should be considered especially good candidates for metformin therapy. The drug helps to reverse their insulin resistance, peripheral responsiveness to insulin improves, and insulin needs decrease, so hyperinsulinism and its adverse effects, including weight _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) gain, are minimized. The typical candidate is a moderately obese person with type 2 diabetes _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) COPD via CXR findings- • Chest x-ray: for COPD o This exam can help support the diagnosis of COPD by producing images of the lungs to evaluate symptoms of shortness of breath or chronic cough. o While chest x-rays may not show COPD until it is severe, the images may show enlarged lungs, irregular air pockets ( bullae) or a flattened diaphragm. o A chest x-ray may also be used to determine if another condition may be causing symptoms similar to COPD. (Malone 207) – o chest X-ray in advanced COPD with emphysema May reveal hyperinflation bullae or blebs and a flat hemidiaphragm. OA HF stages- • ACCF/AHA STAGES: o A: At high risk for HF w/o structural heart Dz or Sx o B: Structural heart dz w/o s/sx of HF o C: Structural heart dz w/ prior or current sx of HF o D: Refractory HF requiring specialized interventions _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) • New York Heart Association classes- o I No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). o II Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). o III Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. o IV Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases. Causes for insomnia – • Anxiety, stress, and depression are some of the most common causes of chronic insomnia. • Having difficulty sleeping can also make anxiety, stress, and depression symptoms worse. • Other common emotional and psychological causes include anger, worry, grief, bipolar disorder, and trauma. Prescription for insomnia – • Avoid caffeine for 12 hours before bedtime, d/c alcohol and unnecessary sleep interrupting drugs, OTC melatonin • RX ramelteon can be tried, if ineffective initiate a short acting sedative-hypnotic such as zolpidem (Ambien) or zaleplon (Sonata) for 1 week or less • If a benzodiazepine is used, temazepam (Restoril) is relatively short acting • Approved pharmacological therapy includes temazepam for sleep onset insomnia, _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) eszopiclone (Lunesta) for sleep onset and sleep maintenance, zolpidem CR and zolpidem for sleep maintenance, and saleplon and ramelteon for sleep onset insomnia • Kennedy p 597-588 TABLE 232–4 Effective Drugs for Insomnia Agent (Brand Name) Onset Duratio n Dos e (mg ) Relati ve Cost (Bran d) Comme nts Benzodiazep ine receptor agonists May impair AM performance; ? anterograde amnesia; modest potential for abuse, withdrawal, dependence; drug–drug effects Zaleplon (Sonata)a Rapid Short 5–10 $ ($$$$) May be used for awakenings at night; possible interaction with inducers of CYP 3A4 Zolpidem (Ambien)a Rapid Short– intermedi 5–10 $ ($$$$) Potential interaction with inducers of CYP 3A4 _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) 0.25 Diazepam (Valium)a Rapid Long 2–5 $ ($$) Estazolam Rapid– Intermedi ate Intermedia te 1–2 $ Generic only Quazepam (Doral)a Intermediat e Long 15 $$ ($$$$) Flurazep am (Dalman e)a Intermediat e Long 15–30 $ ($$$) Lorazepam (Ativan)a Intermediat e Intermedia te 1 $ ($$$) Clonazep am Intermediat e Long 0.5– 1.0 $ ($$) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) (Klonopi n)a Oxazepam (Serax)a Intermedia te– slow Short– intermedi ate 10–15 $$ ($$$) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) Temazep am (Restoril) a Intermedia te– slow Intermedia te 15 $ ($$$) Melatonin Receptor Agonists No potential for abuse Ramelteon (Rozerem) Rapid Short 8 $$ Antidepressants Doxepin (Silenor) Rapid Long 3–6 $$$ Very-low-dose preparation may be helpful in elderly with chronic insomnia. GOLD criteria- Malone 207) • Gold standard = Spirometry for measuring airflow limitation. o GOLD Classification (post bronchodilator FEV1) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) • BMD measurement is expressed as the number of standard deviations from the mean for normal young adults of the same sex (T-score) and as the number of standard deviations from the mean for persons of the same sex and age (Z score). • The World Health Organization diagnostic criterion for osteoporosis is a T-score of less than -2.5. Osteopenia is defined as a T-score between -1.0 and -2.5. A Z score of less than -1.5 suggests a secondary cause of osteoporosis • Osteoporosis: -2.5 or lower • Osteopenia: -1 to -2.5 (lower than normal bone density w/o full osteoporosis) Anxiety treatment- • Treatment for anxiety should reduce symptoms and improve functioning. • Simply listening, being compassionate, and showing respect are important to improving outcomes. Treat comorbid depression and medical conditions that cause anxiety. • There are no large-scale studies of pharmacotherapy for late-life anxiety disorders to guide treatment decisions. • Start low and go slow with medication dosing to avoid risks from drug interactions, because older adults are more likely to take many medications and may have side effects from aging changes in absorption, metabolism, distribution, and excretion of medication. • Evaluate and manage side effects, because as many as 25% of patients stop taking medication in the first 6 months due to side effects. • First-line treatment is the selective serotonin reuptake inhibitors (SSRIs) o citalopram (Celexa), escitalopram (Lexapro), and sertraline (Zoloft). In older _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+) adults, they have the least risk of drug interactions, side effects, or worsening existing medical conditions. o Benzodiazepines, including lorazepam (Ativan), alprazolam (Xanax), and clonazepam (Klonopin), are effective according to research but are not the first choice due to the risk of falls and confusion. Research supports referral to psychotherapy for older adults, but this recommendation is limited to GAD and no other anxiety disorders (American Psychiatric Association, n.d.; Cassidy & Rector, 2008; Hollander & Simeon, 2008; Lenze et al., 2005; Lenze & Wetherell, 2009; Mohlman, 2005; National Institute of Mental Health, n.d.; Stanley et al., 2003; Wetherell, Lenze, & Stanley, 2005; Wetherell, Sorrell, Thorp, & Patterson, 2005). (Kennedy-Malone 553-554) _NR 601 FINAL EXAM FB BEST LATEST UPDATE 2021/2022 WELL ELABORATED ANSWERS (RATED A+)