NUR 256 Psych Exam 3 Questions and Answers–
Galen College of Nursing
In addition to PTSD symptoms the child may also experience... - ANSWER --
Dramatic mood swings
-Uncontrollable rage
-Negative symptoms like numbing and avoidance
Adult symptoms of PTSD - ANSWER --Persistent memories
-Recurrent dreams
-Flashbacks
-Psychological/physiological distress when exposed to cues or reminders
-Persistent avoidance of reminders associated with traumatic event
-Negative alterations in cognition and mood associated with the traumatic event
-Must be present after the event or worsening after the event
Treatment of PTSD - ANSWER --Cognitive behavioral therapy (CBT)
-Eye movt desensitization therapy (EMDR)
-No FDA approved meds for children
-SSRI's may improve social and school functioning and decrease avoidance
numbing and dissociations
-Adults: Antidepressants, antianxiety, clonidine
SSRI's for PTSD - ANSWER --Sertraline
-Paroxetine
Clonidine for PTSD - ANSWER -helps with hyperarousal and intrusive sx
Prazosin for PTSD - ANSWER -used for nightmares and sleep disturbances
Propranolol - ANSWER -used for hyperarousal and panic
Teaching for meds used for PTSD - ANSWER -MONITOR BP may cause
hypotension
, Acute stress disorder key concepts - ANSWER --Develops after exposure to
highly traumatic event
-Sx develop immediately after event and dx after 3-day minimum
-Dx must be made w/in a month of the trauma
-After a month sx will begin to resolve or become PTSD
Dissociative Amnesia key concepts - ANSWER --Inability to recall important
personal information often of a traumatic or stressful event
-Localized: pt may be unable to recall all events of a certain period
-Selective: pt can recall some but not all events in a certain period
Dissociative Fugue key concepts - ANSWER --Subtype of dissociative amnesia
-Sudden unexpected travel and an inability to recall one's identity and information
about some or all of the past
-Typically preceded by a traumatic event
Dissociative Identity Disorder key concepts - ANSWER --Presence of 2+ distinct
personality states that recurrently take control of behavior
-Each alt has its own pattern of perceiving, relating to, and thinking about the self
and the environment
-Believed that severe trauma predisposes the individual to development of DID
Assessment of the patient with DID - ANSWER --Hx of self harm
-Evaluate anxiety levels and signs of dissociation
-Identify support systems through a psychosocial assessment
-Refer pt to therapist
-Teach stress reduction, support effective coping and mindfulness techniques
-Goal to keep pt in present reality by learning to effectively cope w/ stress
Somatic symptom disorder key concepts - ANSWER --Frequent help seeking
behaviors w/ no relief of sx; overly concerned w/ sx
-Often includes chest pain, fatigue, dizziness, HA, swelling, back pain, SOB,
insomnia, abdominal pain, numbness
-Often identified as the difficult pt which can contribute to misdiagnosis
, Illness anxiety disorder key concepts - ANSWER --Pt is overly concerned with
the possibility to developing an illness
-Physical sx are not present or if an illness exists it is mild -> pt report is more
severe
-Either preoccupied with health checks OR has maladaptive avoidance
-Pt. typically avoids mental health tx when it is suggested
Conversion disorder key concepts - ANSWER --Neurologic sx in the absence of a
neurological dx
-Sx: deficits in voluntary motor or sensory functions (paralysis, blindness,
movement disorder, gait disorder, numbness, paresthesia), vision/hearing loss,
episodes resembling epilepsy
-Emotional conflicts or stressors are transferred into physical sx
-La belle indifference
-In some cases a condition may be present but exaggerated
Co-morbid conditions to conversion disorder - ANSWER --Depression
-Anxiety
-PTSD
-Other somatic disorders
-Personality disorders
Factitious disorder imposed on self - ANSWER --Consciously pretend to be ill
-Avoid allowing health care workers to speak with family
-If testing is negative new sx develop
-Unusually accurate knowledge of medical terms
-Risk sepsis
Factitious disorder imposed on another - ANSWER --Caregiver deliberately
falsifies illness in vulnerable dependent
-Frequently are health care workers or someone w/ extensive medical knowledge
Malingering - ANSWER --Conscious fabrication of illness or exaggerating
symptoms for secondary gain
Galen College of Nursing
In addition to PTSD symptoms the child may also experience... - ANSWER --
Dramatic mood swings
-Uncontrollable rage
-Negative symptoms like numbing and avoidance
Adult symptoms of PTSD - ANSWER --Persistent memories
-Recurrent dreams
-Flashbacks
-Psychological/physiological distress when exposed to cues or reminders
-Persistent avoidance of reminders associated with traumatic event
-Negative alterations in cognition and mood associated with the traumatic event
-Must be present after the event or worsening after the event
Treatment of PTSD - ANSWER --Cognitive behavioral therapy (CBT)
-Eye movt desensitization therapy (EMDR)
-No FDA approved meds for children
-SSRI's may improve social and school functioning and decrease avoidance
numbing and dissociations
-Adults: Antidepressants, antianxiety, clonidine
SSRI's for PTSD - ANSWER --Sertraline
-Paroxetine
Clonidine for PTSD - ANSWER -helps with hyperarousal and intrusive sx
Prazosin for PTSD - ANSWER -used for nightmares and sleep disturbances
Propranolol - ANSWER -used for hyperarousal and panic
Teaching for meds used for PTSD - ANSWER -MONITOR BP may cause
hypotension
, Acute stress disorder key concepts - ANSWER --Develops after exposure to
highly traumatic event
-Sx develop immediately after event and dx after 3-day minimum
-Dx must be made w/in a month of the trauma
-After a month sx will begin to resolve or become PTSD
Dissociative Amnesia key concepts - ANSWER --Inability to recall important
personal information often of a traumatic or stressful event
-Localized: pt may be unable to recall all events of a certain period
-Selective: pt can recall some but not all events in a certain period
Dissociative Fugue key concepts - ANSWER --Subtype of dissociative amnesia
-Sudden unexpected travel and an inability to recall one's identity and information
about some or all of the past
-Typically preceded by a traumatic event
Dissociative Identity Disorder key concepts - ANSWER --Presence of 2+ distinct
personality states that recurrently take control of behavior
-Each alt has its own pattern of perceiving, relating to, and thinking about the self
and the environment
-Believed that severe trauma predisposes the individual to development of DID
Assessment of the patient with DID - ANSWER --Hx of self harm
-Evaluate anxiety levels and signs of dissociation
-Identify support systems through a psychosocial assessment
-Refer pt to therapist
-Teach stress reduction, support effective coping and mindfulness techniques
-Goal to keep pt in present reality by learning to effectively cope w/ stress
Somatic symptom disorder key concepts - ANSWER --Frequent help seeking
behaviors w/ no relief of sx; overly concerned w/ sx
-Often includes chest pain, fatigue, dizziness, HA, swelling, back pain, SOB,
insomnia, abdominal pain, numbness
-Often identified as the difficult pt which can contribute to misdiagnosis
, Illness anxiety disorder key concepts - ANSWER --Pt is overly concerned with
the possibility to developing an illness
-Physical sx are not present or if an illness exists it is mild -> pt report is more
severe
-Either preoccupied with health checks OR has maladaptive avoidance
-Pt. typically avoids mental health tx when it is suggested
Conversion disorder key concepts - ANSWER --Neurologic sx in the absence of a
neurological dx
-Sx: deficits in voluntary motor or sensory functions (paralysis, blindness,
movement disorder, gait disorder, numbness, paresthesia), vision/hearing loss,
episodes resembling epilepsy
-Emotional conflicts or stressors are transferred into physical sx
-La belle indifference
-In some cases a condition may be present but exaggerated
Co-morbid conditions to conversion disorder - ANSWER --Depression
-Anxiety
-PTSD
-Other somatic disorders
-Personality disorders
Factitious disorder imposed on self - ANSWER --Consciously pretend to be ill
-Avoid allowing health care workers to speak with family
-If testing is negative new sx develop
-Unusually accurate knowledge of medical terms
-Risk sepsis
Factitious disorder imposed on another - ANSWER --Caregiver deliberately
falsifies illness in vulnerable dependent
-Frequently are health care workers or someone w/ extensive medical knowledge
Malingering - ANSWER --Conscious fabrication of illness or exaggerating
symptoms for secondary gain
