Maryville NURS 623 Exam 3 With Complete Solution. Graded A+

Maryville NURS 623 Exam 3 With Complete Solution. Graded A+ Document Content and Description Below Maryville NURS 623 Exam 3 With Complete Solution What is the most common psychiatric disorder in the U.S? Correct Answer- Anxiety What are the DSM-5 symptom criteria for a diagnosis of general anxie ty disorder? Correct Answerexcessive anxiety and worry of variety of things for at least 6 months What are the DSM-5 symptom criteria for a major depressive disorder? Correct Answer- Five or more symptoms including at least one depressed mood or loss of interest present in the same two weeks and present nearly every day differential diagnoses that would mimic the symptoms of depression? Correct Answer- *Anxiety *PTSD *Substance Abuse What are the risk factors for major depression? Correct Answer- *Age *Gender *Personal Hx (migrains, PUD, chronic pain) *Fx Hx (depression, suicide, alcholism, substance abuse) What are the common presenting symptoms of depression in the geriatric patient? Correct AnswerSomatic (general pain) Psychology (feeling of guilt/worry, suicidal, memory) Psychomotor (anxiety/agitation) Vegetative (poor appitite/sleep) What are the NON-pharmacologic treatments for management for major depressive disorder? Correct Answer- Interpersonal and cognitive behavior therapy What are the pharmacologic treatments for management for major depressive disorder? Correct Answer- SSRI, SNRI, TCA, MAONames of common SSRIs Correct Answer- Fluoxetine (Prozac) Sertraline (Zoloft) Paroxetine (paxil) Citalopram (celexa) Escitalopram (Lexapro) Names of common SNRIs Correct Answer- Duloxetine (Cymbalta) Venlafaxine (Effexor) Desvenlafaxine (Pristiq) What are concerns in elderly taking medication for major depression? Correct Answer- a slower metabolism requires lower dosing; greater risk of falls, osteoporosis, fractures What are the pharmacologic versus nonpharmacologic treatment for management for general anxiety disorder? Correct Answer- non-pharmacological interventions of cognitive behavioral therapy has proven equal results to SSRI pharmacologic therapy DIGFAST for bipolar because your digging yourself into hole Correct Answer- Distractibility Indiscretion/Insomnia Grandiosity Flight of ideas Activities ↑ Sleep Deficit Talkativeness What is the symptom criteria for BD I ? Correct Answer- identification of at least one-lifetime mania episode must have occurredWhat is the symptom criteria for BD II ? Correct Answer- identification of at least one hypomania episode and one major depressive episode must have occurred What is the symptom criteria for diagnosing unipolar (depression) Correct Answer- persistently depressed mood or loss of interest in activities, causing significant impairment in daily life (no mania/hypomania) How do you assess suicide risk (consider mnemonic SAD PERSONS) Correct Answer- S-ex A-ge D-epression P-revious attempt E-thanol abuse R-ational thinking loss S-ocial support loss O-rganized plan N-o spouse S-ickness How would you identify intimate partner violence? Correct Answer- *reluctant to speak in front of partner *gives evasive answers *Overly protective or controlling partner What are the stages of grieving? (DABDA) Correct Answer- Denial Anger Bargaining Depression Acceptance What are the phases of grief? (Aca) Correct Answer- AvoidConfront Accomadate Acknowledge the loss Reacting to the separation Recollecting and Re-experiencing the Relationship w/deceased How would you identify intimate partner violence? Correct Answer- 1) a patient who is reluctant to speak in front of her partner and gives evasive answers 2) Overly protective or controlling partner What is the clinical presentation of post-traumatic stress disorder (PTSD)? Correct Answer- A: INTRUSIVE thoughts, nightmares or flashbacks B: AVOIDANCE any situation of activity that brings memories C: HYPERAROUSAL: Hypersensitive or on edge, unprovoked anger, jumpiness, and on guard What are the DSM-5 criteria for a diagnosis of PTSD? Correct Answer- 1 SYMPTOM of intrusive, avoidance, or hyper-arousal MUST HAVE PERSISTED FOR MORE THAN 1 MONTH What is the management for PTSD? Correct Answer- PHARMACOLOGY: SSRI's paroxetine (paxil) or sertaline (Zoloft), anxiolytic buspirone (BuSpar) NON-PHARMACOLOGICAL: cognitive behavioral therapies, brief eclectic psychotherapy, narrative exposure therapy potential complications of over-prescription of opiate pain meds Correct Answer- Constipation Sedation Resp Depression Dizziness N/VMedications that can cause Constipation? Correct Answer- Antacids, anticholinergics, Anti convulsive, Antidepressants (TCAs), Antihypertensives, NSAIDs, Opioids What are the warning signs that the patient has Anorexia? Correct Answer- Substantial weight loss S/S of depression or mood swings cardio problems preoccupation with weight, calories, and food, wear baggy clothes history of excessive exercise What do labs look like in anorexia? Correct Answer- leukopenia elevated BUN anemic hypomagnesmia elevated TSH sinus bradycardia. What are the warning signs that the patient has Bulemia? Correct Answer- Significant weight gain tooth erosion calluses on back of hands esophageal erosion negative body image eats rapidly until uncomfortably full swollen salivary (parotid) glands irregular menses eat large amounts of food in isolation signs or symptoms of depression What do labs look like in bulemia? Correct Answer- Hyponatremia, hypochloremia, elevated amylaseDiscuss sleep hygiene strategies for a patient complaining of insomnia Correct Answer- Maintain a regular sleep and wake schedule Eat regular meals every day Develop a relaxing bedtime routine Limit amount of liquid consumed in evening Limit amount of caffeine consumed later in day Avoid tobacco and alcohol later in the day Avoid daytime naps Exercise regularly Limit exposure to bright lights or television in evening Bed should be used for sleeping and sex only Turn any clocks facing the bed away If not asleep after 20 mins get out of bed and engage in quiet activity before reattempting to fall asleep. What is the The most common long term effect of sexual assault Correct Answer- PTSD In an attempt to promote behavioral changes in a patient, what is the best approach to take as the provider? Correct Answer- Educate the patient on all of the options available to them and allow them to choose their plan what are the risk factors for substance abuse disorder Correct Answer- *Underlying mental health/emotional problems *low socioeconomic status *access to medications and substances patterns commonly seen in domestic violence among victims? Correct Answer- -Feels afraid of their partner -Avoids certain topics out of fear of angering partner -Feels they deserve to be hurt or mistreated -Feels emotionally numb or helplesspatterns commonly seen in domestic violence among perpetrator? Correct Answer- - Humiliates/Criticizes partner -Blames the victim for their abusive behavior -Acts jealous and possessive -Limits partners access to money, phone, car What are different types of abuse? Correct Answer- *Physical *verbal *psychological *sexual populations that domestic violence typically affects? Correct Answer- -Can occur in ANY population higher prevalence in ethnic minorities & women Risk factors of suicide in the elderly? Correct Answer- *male gender *being single, divorced, or separated and without children *personal or family history of a suicide attempt *drug or alcohol abuse *severe anxiety or stress *physical illness *a specific suicide plan with access to firearms In a femal