MARYVILLE NURS 663 EXAM 2 QUESTIONS AND ANSWERS |
NURS 663 EXAM 2 STUDY GUIDE & PRACTICE TEST 2026/2027
Lithium labs - ANS ✔✔level, NA, Ca, P, EKG, Creatinine, Urinalysis, CBC, TSH
bipolar meds: depression - ANS ✔✔lurasidone (13+), olanzapine + fluoxetine (10+)(Symbian)
bipolar acute and mixed mania - ANS ✔✔aripiprazole, risperidone, olanzapine (13+), quetiapine (acute
only), Asena pine (10+)
classic mood stabilizers - ANS ✔✔Lamotrigine (excellent medication to use), lithium, Depakote (avoid in
females if possible due to PCOS and Pregnancy), Tegretol, Trileptal (no evidence for true Bipolar disorder)
anti-depressants - ANS ✔✔class not used w/bipolar disorder
lithium - ANS ✔✔Anti-manic, antidepressant, anti-suicidal
Lithium side effects - ANS ✔✔Frequent urination, increased thirst, weight gain, sedation
lithium toxicity - ANS ✔✔sudden onset tremors, N/V/D, muscle weakness, slurred speech, confusion,
seizures (slowing down, feel really out of it)
Persistent Motor or Vocal Tic Disorder - ANS ✔✔pt in front of you only has one or the other but not both
—they usually don't even know it is a tic, it is only meaningful if it's affecting their quality of life
Tourette's d/o - ANS ✔✔Multiple motor and at least one vocal tic (some tics come and go, they don't
have them all at the same time to receive the diagnosis)
HRT - ANS ✔✔habit reversal training can be used to manage tics
Tics tx - ANS ✔✔Alpha agonists (clonidine, guanfacine); Haldol is not the first-line txt
Developmental Coordination Disorder - ANS ✔✔a motor disorder characterized by marked impairment
in the development of motor coordination; movement isn't consistent w/age
Stereotypic Movement Disorder - ANS ✔✔a motor disorder characterized by repetitive, seemingly
driven, and apparently purposeless motor behavior, such as hand waving or head banging, but not
include ASD sx
Specific Learning Disorders - ANS ✔✔difficulties in the acquisition and use of listening, speaking,
reading, writing, reasoning, or mathematical abilities; dx by other professionals w/specialized training;
NP tx comorbid d/o
Anorexia nervosa - ANS ✔✔an eating disorder in which an irrational fear of weight gain leads people to
starve themselves; restrictive or binge/purge/exercise
, Bulimia nervosa - ANS ✔✔an eating disorder characterized by episodes of overeating, usually of high-
calorie foods, followed by vomiting, laxative use, fasting, or excessive exercise
Binge-eating disorder - ANS ✔✔significant binge-eating episodes, followed by distress, disgust, or guilt,
but without the compensatory purging, fasting, or excessive exercise
Avoidant/restrictive eating disorder - ANS ✔✔avoiding or restricting foods in childhood. significantly low
BMI; no distortion of body image or fear of gaining wt. r/o delusions around food
Pica - ANS ✔✔an abnormal craving or appetite for nonfood substances, such as dirt, paint, or clay that
lasts for at least 1 month; decrs incidence with incr age
Feeding and Eating Disorders tx - ANS ✔✔Talk therapy (counseling is needed for the distress) (intensive
outpatient, partial inpatient or actual inpatient admission may be needed); most have associated
depression and/or anxiety
Feeding and Eating Disorders meds - ANS ✔✔fluoxetine help but not direct tx
Vyvanse approved for binge eating but not because of stimulant effects
Encopresis - ANS ✔✔a childhood disorder characterized by repeated defecating in inappropriate places,
such as one's clothing
Enuresis - ANS ✔✔involuntary urination
Encopresis Treatment - ANS ✔✔Behavior management: toilet refusal behavior, scheduled toileting time,
incentives.
Prevention of constipation
Counseling
Enuresis treatment - ANS ✔✔1. First line is behavioral interventions: bed alarms, toileting at bedtime
and during the night, bladder training
2. reassurance, resolves spontan, normal 4-5 yo
Enuresis meds - ANS ✔✔Desmopressin nasal spray;
Major Depressive Disorder Dx - ANS ✔✔5+ for at least a 2-week period; either #1 or 2 req
1. Depressed mood most of the day, nearly every day (can be irritability in children & adolescents)
2. Diminished interest or pleasure in all, or almost all, activities
3. Change appetite/weight; kids not wt goals
Insomnia or hypersomnia nearly every day
4. Up or down Psychomotor
5. Fatigue or loss of energy
6. Worthlessness/excessive or inappropriate guilt
7. Diminished ability to think or concentrate, or indecisiveness (don't confuse with ADHD, address mood
first)
8. Recurrent thoughts of death, thoughts of suicide, or suicidal plan/intent: if hosp then 2 wk not req.
NURS 663 EXAM 2 STUDY GUIDE & PRACTICE TEST 2026/2027
Lithium labs - ANS ✔✔level, NA, Ca, P, EKG, Creatinine, Urinalysis, CBC, TSH
bipolar meds: depression - ANS ✔✔lurasidone (13+), olanzapine + fluoxetine (10+)(Symbian)
bipolar acute and mixed mania - ANS ✔✔aripiprazole, risperidone, olanzapine (13+), quetiapine (acute
only), Asena pine (10+)
classic mood stabilizers - ANS ✔✔Lamotrigine (excellent medication to use), lithium, Depakote (avoid in
females if possible due to PCOS and Pregnancy), Tegretol, Trileptal (no evidence for true Bipolar disorder)
anti-depressants - ANS ✔✔class not used w/bipolar disorder
lithium - ANS ✔✔Anti-manic, antidepressant, anti-suicidal
Lithium side effects - ANS ✔✔Frequent urination, increased thirst, weight gain, sedation
lithium toxicity - ANS ✔✔sudden onset tremors, N/V/D, muscle weakness, slurred speech, confusion,
seizures (slowing down, feel really out of it)
Persistent Motor or Vocal Tic Disorder - ANS ✔✔pt in front of you only has one or the other but not both
—they usually don't even know it is a tic, it is only meaningful if it's affecting their quality of life
Tourette's d/o - ANS ✔✔Multiple motor and at least one vocal tic (some tics come and go, they don't
have them all at the same time to receive the diagnosis)
HRT - ANS ✔✔habit reversal training can be used to manage tics
Tics tx - ANS ✔✔Alpha agonists (clonidine, guanfacine); Haldol is not the first-line txt
Developmental Coordination Disorder - ANS ✔✔a motor disorder characterized by marked impairment
in the development of motor coordination; movement isn't consistent w/age
Stereotypic Movement Disorder - ANS ✔✔a motor disorder characterized by repetitive, seemingly
driven, and apparently purposeless motor behavior, such as hand waving or head banging, but not
include ASD sx
Specific Learning Disorders - ANS ✔✔difficulties in the acquisition and use of listening, speaking,
reading, writing, reasoning, or mathematical abilities; dx by other professionals w/specialized training;
NP tx comorbid d/o
Anorexia nervosa - ANS ✔✔an eating disorder in which an irrational fear of weight gain leads people to
starve themselves; restrictive or binge/purge/exercise
, Bulimia nervosa - ANS ✔✔an eating disorder characterized by episodes of overeating, usually of high-
calorie foods, followed by vomiting, laxative use, fasting, or excessive exercise
Binge-eating disorder - ANS ✔✔significant binge-eating episodes, followed by distress, disgust, or guilt,
but without the compensatory purging, fasting, or excessive exercise
Avoidant/restrictive eating disorder - ANS ✔✔avoiding or restricting foods in childhood. significantly low
BMI; no distortion of body image or fear of gaining wt. r/o delusions around food
Pica - ANS ✔✔an abnormal craving or appetite for nonfood substances, such as dirt, paint, or clay that
lasts for at least 1 month; decrs incidence with incr age
Feeding and Eating Disorders tx - ANS ✔✔Talk therapy (counseling is needed for the distress) (intensive
outpatient, partial inpatient or actual inpatient admission may be needed); most have associated
depression and/or anxiety
Feeding and Eating Disorders meds - ANS ✔✔fluoxetine help but not direct tx
Vyvanse approved for binge eating but not because of stimulant effects
Encopresis - ANS ✔✔a childhood disorder characterized by repeated defecating in inappropriate places,
such as one's clothing
Enuresis - ANS ✔✔involuntary urination
Encopresis Treatment - ANS ✔✔Behavior management: toilet refusal behavior, scheduled toileting time,
incentives.
Prevention of constipation
Counseling
Enuresis treatment - ANS ✔✔1. First line is behavioral interventions: bed alarms, toileting at bedtime
and during the night, bladder training
2. reassurance, resolves spontan, normal 4-5 yo
Enuresis meds - ANS ✔✔Desmopressin nasal spray;
Major Depressive Disorder Dx - ANS ✔✔5+ for at least a 2-week period; either #1 or 2 req
1. Depressed mood most of the day, nearly every day (can be irritability in children & adolescents)
2. Diminished interest or pleasure in all, or almost all, activities
3. Change appetite/weight; kids not wt goals
Insomnia or hypersomnia nearly every day
4. Up or down Psychomotor
5. Fatigue or loss of energy
6. Worthlessness/excessive or inappropriate guilt
7. Diminished ability to think or concentrate, or indecisiveness (don't confuse with ADHD, address mood
first)
8. Recurrent thoughts of death, thoughts of suicide, or suicidal plan/intent: if hosp then 2 wk not req.
