MARYVILLE NURS 623 EXAM 3 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS

MARYVILLE NURS 623 EXAM 3 QUESTIONS AND ANSWERS WITH COMPLETE What is the most common psychiatric disorder in the U.S? - Maryville NURS 623 Exam 3 Anxiety What are the DSM-5 symptom criteria for a diagnosis of general anxiety disorder? - Maryville NURS 623 Exam 3 excessive anxiety and worry of variety of things for at least 6 months What are the DSM-5 symptom criteria for a major depressive disorder? - Maryville NURS 623 Exam 3 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? - Maryville NURS 623 Exam 3 *Anxiety *PTSD *Substance Abuse What are the risk factors for major depression? - Maryville NURS 623 Exam 3 *Age *Gender *Personal Hx (migraines, PUD, chronic pain) * Fx Hx (depression, suicide, alcoholism, substance abuse) What are the common presenting symptoms of depression in the geriatric patient? - Maryville NURS 623 Exam 3 Somatic (general pain) Psychology (feeling of guilt/worry, suicidal, memory) Psychomotor (anxiety/agitation) Vegetative (poor appetite/sleep) What are the NON-pharmacologic treatments for management for major depressive disorder? - Maryville NURS 623 Exam 3 Interpersonal and cognitive behavior therapy What are the pharmacologic treatments for management for major depressive disorder? - Maryville NURS 623 Exam 3 SSRI, SNRI, TCA, MAO Names of common SSRIs - Maryville NURS 623 Exam 3 Fluoxetine (Prozac) Sertraline (Zoloft) Paroxetine (Paxil) Citalopram (celexa) Escitalopram (Lexapro) Names of common SNRIs - Maryville NURS 623 Exam 3 Duloxetine (Cymbalta) Venlafaxine (Effexor) Desvenlafaxine (Pristiq) What are concerns in elderly taking medication for major depression? - Maryville NURS 623 Exam 3 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? - Maryville NURS 623 Exam 3 non-pharmacological interventions of cognitive behavioral therapy has proven equal results to SSRI pharmacologic therapy DIGFAST for bipolar because your digging yourself into hole - Maryville NURS 623 Exam 3 Distractibility Indiscretion/Insomnia Grandiosity Flight of ideas Activities ↑ Sleep Deficit Talkativeness What is the symptom criteria for BD I? - Maryville NURS 623 Exam 3 identification of at least one-lifetime mania episode must have occurred What is the symptom criteria for BD II? - Maryville NURS 623 Exam 3 identification of at least one hypomania episode and one major depressive episode must have occurred What is the symptom criteria for diagnosing unipolar (depression) - Maryville NURS 623 Exam 3 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) - Maryville NURS 623 Exam 3 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? - Maryville NURS 623 Exam 3 *reluctant to speak in front of partner *gives evasive answers *Overly protective or controlling partner What are the stages of grieving? (DABDA) - Maryville NURS 623 Exam 3 Denial Anger Bargaining Depression Acceptance What are the phases of grief? (Aca) - Maryville NURS 623 Exam 3 Avoid Confront Accommodates Acknowledge the loss Reacting to the separation Recollecting and Re-experiencing the Relationship w/deceased How would you identify intimate partner violence? - Maryville NURS 623 Exam 3 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)? - Maryville NURS 623 Exam 3 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? - Maryville NURS 623 Exam 3 1 SYMPTOM of intrusive, avoidance, or hyper-arousal MUST HAVE PERSISTED FOR MORE THAN 1 MONTH What is the management for PTSD? - Maryville NURS 623 Exam 3 PHARMACOLOGY: SSRI's paroxetine (paxil) or sertraline (Zoloft), anxiolytic buspirone (BuSpar) NON-PHARMACOLOGICAL: cognitive behavioral therapies, brief eclectic psychotherapy, narrative exposure therapy Potential complications of over-prescription of opiate pain meds - Maryville NURS 623 Exam 3 Constipation Sedation Resp Depression Dizziness N/V