PN 3003 VARIATIONS (MENTAL HEALTH) EXAM QUESTIONS WITH COMPLETE SOLUTIONS

PN 3003 VARIATIONS (MENTAL HEALTH) EXAM QUESTIONS WITH COMPLETE SOLUTIONS “definition of mental health vs mental illness - CORRECT ANSWER mental health: -state of wellbeing in one's own abilities & normal stresses of life -only in a complete state of wellbeing when physical, mental, and social well-being is intact mental illness: -disturbance in a person's cognition, emotions, or behaviors" "describe bargaining stage of grief - CORRECT ANSWER -an attempt to postpone acceptance of reality -frequent labile moods -continued anger & unwillingness to accept loss" "describe depression stage of grief - CORRECT ANSWER -deep sense of loss as reality of what happened or anticipated settles -may withdraw from social interaction -predominant affect is feelings or emptiness or loss -sadness & grief can be intertwined w/ good days of positive emotions -sometimes this period can be overwhelming & recovery from depth of sorrow unlikely w/o professional help" "describe acceptance stage of grief - CORRECT ANSWER -person begins to experience peace & serenity -time for letting go & allowing life to provide new experiences & relationships" "describe psychotherapy - CORRECT ANSWER use of psychological methods, particularly when based on regular personal interaction, to help a person change behavior, increase happiness, and overcome problems" "describe cognitive behavioral therapy (CBT) - CORRECT ANSWER based on cognitive model that focuses on identifying & correcting distorted thinking patterns that can lead to emotional stress & problem behaviors -it is believed that clients respond in stressful situations based on subjective perception of an event -once misperception identified, clients can change their behaviors by changing their maladaptive thinking about themselves & experiences" "describe orientation phase - CORRECT ANSWER pt & nurse getting to know each other -involves explaining purpose of nurse-pt interaction for building trust, establishing roles, & identifying problems & expectations" "describe working stage - CORRECT ANSWER where outcomes & interventions toward behavior change are planned & goals are developed to improve client's well being" "describe termination phase - CORRECT ANSWER allows client to depend on themselves while developing improved adaptive skills (end of nurse-pt relationship) -important to discuss termination w/ client & respond to any feelings/concerns" "what components are included in mental status examination? - CORRECT ANSWER appearance: grooming, eye contact, posture attitude: cooperative or uncooperative, friendly, hostile speech pattern: speed, volume, slurring mood & affect LOC/LOO memory: recent or short-term perceptions: hallucinations, illusions, etc. judgement: problem-solving, decision-making abilities thought processes: speed, content, logical or illogical" "differentiate each characteristic empathy genuineness acceptance self awareness - CORRECT ANSWER empathy -seeing, understanding, & sharing others viewpoints w/o judgement genuineness -attribute of realness & concerns that fosters an honest & caring foundation for trust acceptance -ability to see the client as a person w/ worthy & dignity who isn't judged or labeled by the standards of another self-awareness -consciousness of one's own individuality & personality w/ an attitude of openness to make positive changes" "what are the types of anxiety disorders? - CORRECT ANSWER -generalized anxiety disorder -panic disorder -specific phobia -social anxiety disorder (social phobia) -PTSD -OCD" "define agoraphobia - CORRECT ANSWER avoidance of specific places, situations tending to trigger panic attacks" "what are different types of specific phobias? - CORRECT ANSWER PTSD, social, agoraphobia, claustrophobia, acrophobia (fear of heights)" "specific phobia - CORRECT ANSWER fear of objects or specific situations or events" "most common types of specific phobia? - CORRECT ANSWER animals, height, water, storms, blood or needles, flying, elevators, or enclosed space" "signs & symptoms of specific phobia - CORRECT ANSWER -irrational & persistent fear of object or situation -immediate anxiety on contact w/ feared object or situation -loss of control, fainting, panic response -avoidance of activities w/ feared stimulus -worry w/ anticipatory anxiety -possible impaired social or work functioning" "incidence & etiology of specific phobia - CORRECT ANSWER -affects over 6m adult Americans -twice as common in females as males -common but not severe enough to be diagnosed -symptoms usually have an onset during childhood or adolescence & persists throughout adult life" "describe social anxiety disorder (social phobia) - CORRECT ANSWER excessive fear of any social situation which embarrassment is possible" "s+s of social anxiety disorder - CORRECT ANSWER -hyperventilation -palpitations -trembling hands or voice -inability to speak correctly -blushing -sweating -GI symptoms -urinary urgency -muscle tension -anticipatory anxiety -fear of embarrassment or ridicule" "incidence & etiology of social anxiety disorder - CORRECT ANSWER -equally common in men & women -onset usually occurs in childhood or early adolescence -onset can be abrupt after an event occurs or it can be slow -runs in families" "post traumatic stress disorder - CORRECT ANSWER an anxiety disorder has been subjected to a traumatic event" "s+s of PTSD - CORRECT ANSWER -intense feeling or fear and dread following a traumatic event -mental reruns of the event -emotional numbness following the event -avoidance of people, places, or things associated w/ event -insomnia -↑ vigilance or watchfulness -startles easily -irritability and aggressiveness -depression -impaired social or work functioning -difficulty in interpersonal relationships" "incidence & etiology of PTSD - CORRECT ANSWER -more common in females & can be seen in any age group -also more common if there is a family hx of the disorder" "obsessive compulsive disorder - CORRECT ANSWER An anxiety disorder characterized by unwanted repetitive thoughts (obsession) and/ or actions (compulsions) for more than 1hr daily" "define mood - CORRECT ANSWER an emotion that is prolonged to the point it color one's entire psychological thinking" "define affect - CORRECT ANSWER facial expression displayed in association with mood" "euphoria - CORRECT ANSWER excessive feeling of happiness which has the possibility of escalating to mania" "define mania - CORRECT ANSWER frenzied, unstable mood, may be out of touch w/ reality" "what is the DSM-V? - CORRECT ANSWER diagnostic and statistical manual of mental disorders -list of criteria that one must meet in order to be diagnosed with psychological disorder -allows for precision and consistency in diagnosis research based -includes depressive, bipolar & related disorders" "what are the types of mood disorders? - CORRECT ANSWER -major depressive disorder -persistent depressive disorder (dysthymia) -bipolar -cyclothymic" "depression - CORRECT ANSWER A prolonged feeling of helplessness, hopelessness, and sadness for a duration of over 2 weeks or longer" "s+s of major depressive disorders - CORRECT ANSWER -hopelessness, worthlessness -guilt & self blame -crying episodes -sleep disturbances -weight & appetite changes -↓ sex drive -poor concentration & memory lapse -irritability -anxiety -↑ somatic complaints -difficulty making decisions -anhedonia & anergia -thoughts of death & suicide" "incidence & etiology of major depressive disorders - CORRECT ANSWER -more common in females & who have familial hx -people aged 14-16 & 65+ have a higher incidence" "Persistent Depressive Disorder (Dysthymia) - CORRECT ANSWER Moderate depression that persists for two years or more" "s+s of persistent depressive disorder - CORRECT ANSWER -chronic depression syndrome -feelings of inadequacy, failure, emptiness -hopelessness -negativism (learned sense of helplessness) -inappropriate sexual behaviors -maladaptive coping skills (substance use, spending sprees) -sleep difficulties -↑ or ↓ appetite -fatigue -low self esteem -difficulty concentrating -↓ decision making ability" "incidence & etiology of persistent depressive disorder - CORRECT ANSWER -2x-3x more common in women than men -likely to occur in 1st degree biologic relatives w/ depressive disorders -early onset beginning anytime from childhood through early adulthood -can eventually develop bipolar disorder" "bipolar disorder - CORRECT ANSWER mood disorder in one experiences both manic and depressed episodes" "What is rapid cycling? - CORRECT ANSWER occurrence of >4 mood episodes/year" "what are tx options for mood disorders? - CORRECT ANSWER -antidepressants (fluoxetine, citalopram, sertaline, wellbuttine) -mood-stabilizing drugs: lithium -psychotherapy (same as anxiety disorders) -ECT" "differentiate following delusions: depression delusion somatic delusion delusion of grandeur delusion of persecution - CORRECT ANSWER depression delusion: -type of major depression accompanied by psychotic symptoms somatic delusion: individual believes something is wrong w/ part or all of their body delusion of grandeur: when one believes they have more power, wealth, smarts, or other grand traits than what is true delusion of persecution: -when one is convinced that someone is mistreating, conspiring against, or planning to harm them or their loved one" "fluoxetine - CORRECT ANSWER brand: Prozac class: SSRIs (inhibits reuptake of 5TN in the CNS) uses: major depression, OCD, bulimia, panic -monitor for serotonin syndrome" "citalopram - CORRECT ANSWER brand: Celexa class: antidepressant/SSRI (inhibits reuptake of serotonin in the CNS) uses: depression -monitor for serotonin syndrome, suicidal thoughts, neuroleptic malignant syndrome" "bupropion - CORRECT ANSWER brand: Wellbutrin class: antidepressant/aminoketones (decreases reuptake of dopamine in CNS) uses: depression w/ psychotherapy, seasonal depression, smoking cessation -monitor any suicidal thoughts/behavior, seizures" "lithium - CORRECT ANSWER brand: Lithobid class: mood stabilizer (alters cation transport in nerve & muscle) uses: tx of acute manic & mixed episodes associated w/ bipolar 1 disorder -monitor for toxicity with specific timeframes for bw -metallic taste in mouth is normal -↑ risk for dehydration; encourage fluids - tinnitus indicates a type of kidney malfunction Life threatening effects: arrythmias, bradycardia, renal toxicity, epileptiform seizures, coma" "Illusions vs Hallucinations vs Delusions - CORRECT ANSWER illusions -misperceptions of real external stimuli (ex: a black box is seen as a snake) hallucinations -false perception of objects or events involving sight, smell, touch & taste (ex: hearing voices no one else hears) delusions -belief that is clearly false (ex: thinking one is being stalked)" "define psychosis & its 3 types - CORRECT ANSWER loss of contact with reality -have hallucinations & delusions -perceptual disturbances -disorganized thinking -behavior alterations" "describe residual stage of schizophrenia - CORRECT ANSWER -looks like prodromal phase -obvious psychosis has subsided, but pt may exhibit negative symptoms like social withdrawal, lack of emotions, anhedonia" "negative symptoms seen in a schizophrenic patient - CORRECT ANSWER -blunt or flat affect -lack of motivation -lack of emotion -substance use -violence -depression & suicidal acts -social withdrawal -violent behavior -anhedonia -anergia -avolition (the decrease in the ability to initiate and persist in self-directed purposeful activities)" "what are the various themes of delusions a schizophrenic patient can have? - CORRECT ANSWER depressive (have committed terrible deeds) somatic (their body is disintegrating into another substance or infested w/ insects) persecution (others are out to get them)" "what should a nurse include in pt education regarding antipsychotic drugs? - CORRECT ANSWER -take meds as directed -S+S of tardive dyskinesia, EPS -take meds w/ food or milk to decrease stomach irritation -avoid taking meds within 1hr of taking antacids or antidiarrheals (can decrease effectiveness of antipsychotic drugs) -can take several days to weeks for full effects of meds -drowsiness can occur -avoid direct sunlight & use sunscreen -avoid vigorous exercise & overheating -phenothiazines can turn urine pinkish red, red, brownish red -avoid alcoholic drinks (will increase CNS action) -avoid standing up too fast (orthostatic hypotension)" "clozapine - CORRECT ANSWER brand: Clozaril class: antipsychotic (binds to dopamine receptors in CNS) uses: schizophrenia -considered a neuroleptic drug" "haloperidol - CORRECT ANSWER brand: Haldol class: antipsychotic/butyrophenones (alters effects of dopamine in CNS) uses: schizophrenia, mania, drug induced psychoses, behavioral problems -considered a neuroleptic drug" "describe cluster A personality disorders - CORRECT ANSWER paranoid, schizoid, shizotypal -people w/ these disorders tend to demonstrate odd or eccentric behaviors" "paranoid personality disorder - CORRECT ANSWER persistent pattern of suspicion & mistrust in actions or motives of others" "incidence & etiology of schizotypal disorder - CORRECT ANSWER -typically apparent during childhood & adolescence -more common in men -higher risk if 1st degree bio relative has schizophrenia" "incidence & etiology of histrionic personality disorder - CORRECT ANSWER -occurs more in women & usually seen by early adulthood -speculated to stem from childhood experiences -considered a disorder when traits become maladaptive & impair functioning" "which personality types fall in cluster C personality disorders? - CORRECT ANSWER avoidant, dependent, obsessive compulsive -exhibit anxious & fearful behaviors" "avoidant personality disorder - CORRECT ANSWER shy, sensitive, social inadequacy & low self esteem behaviors" "s+s avoidant personality disorder - CORRECT ANSWER -shy, sensitive to negative comments of others -avoid interactions w/ others -extreme fear of ridicule or disapproval -social inadequacy, intense anxiety in a group -perceives rejection even if nonexistent -self doubt, low self esteem" "incidence & etiology of avoidant personality disorder - CORRECT ANSWER -seen frequently in women & men -shyness & fear of situations during childhood increases chance of development -evidence shows decrease in age" "dependent personality disorder - CORRECT ANSWER inability to make decisions, extreme fear of being alone, abusive relationships common" "s+s dependent personality disorder - CORRECT ANSWER -consistent, extreme dependence on others -self perceived helpless & incompetent -insecurity, self doubt, self care decision avoidance -independent activities not an option" "incidence & etiology of dependent personality disorder - CORRECT ANSWER -more dx in women than men -one of the most frequently reported personality disorder -children & adolescencs who experience" "obsessive compulsive personality disorder - CORRECT ANSWER conscientious, highly organized, & preoccupied w/ order & perfection" "s+s obsessive compulsive personality disorder - CORRECT ANSWER -rigid, controlling -highly critical of self & others -difficult to feel accomplishment satisfaction -rigid morals & ethics -relationships serious & shallow" "incidence & etiology of obsessive compulsive personality disorder - CORRECT ANSWER -twice as often in men than women" "Types of Somatoform disorders - CORRECT ANSWER -somatic symptom disorder -illness anxiety disorder (formerly hypochondriasis) -conversion disorder (functional neuroleptic symptom disorder) -factitious disorder" "soma vs somatization - CORRECT ANSWER soma: refers to the body somatization: physical expression of stress and emotions d/t significant psychological stress" "somatic symptom disorder - CORRECT ANSWER one or more somatic symptoms that suggests physical illness/injury but are unexplained by medical findings" "s+s of somatic symptom disorder - CORRECT ANSWER -recurring somatic complaints usually continue for several years (may include pain) -excessive worry or anxiety over physical health symptoms that are disruptive to the person's life -exaggerated belief in the severity of their symptoms & health -excessive time is devoted to investigating their health symptoms -anxiety & depression" "incidence & etiology of somatic symptom disorder - CORRECT ANSWER -seen more in women than men -coexistence of PTSD, excessive anxiety or depression is common & imposed disability -tends to run in families" "illness anxiety disorder (formerly hypochondriasis) - CORRECT ANSWER may or may not have a medical condition, but have unwarranted fear & anxiety over the possibility of an existing undiagnosed illness" "s+s of illness anxiety disorder (formerly hypochondriasis) - CORRECT ANSWER -repeated health care visits seeking verification of fears -excessive amt of anxiety -symptoms reported in specific detail but don't follow those types of pathologic condition -perceived illness focal point of existence -physician shopping -perception of incompetent medical care -impaired social family relationships" "conversion disorder - CORRECT ANSWER sensory or neurologic impairment that isn't supported by results of diagnostic testing" "s+s of conversion disorder - CORRECT ANSWER -lack of conscious control over symptoms -loss of balance or paralysis of a limb -loss of swallowing, speaking, seeing, or hearing -loss of pain or touch sensation -impaired functioning in social or work related areas caused by symptoms -a la belle indifference (little anxiety/concern over symptoms) -seizures or convulsion type behavior inconsistent w/ usual symptom pattern -lack of physical change or disability -functional ability & symptoms inconsistent w/ usual neuropathic disorders" "factitious disorder (previously called Munchausen syndrome) - CORRECT ANSWER has 2 types: disorder imposed on oneself & disorder imposed on another -deliberate falsification of physical or mental symptoms primarily to assume the sick role" "dissociation vs dissociative disorder - CORRECT ANSWER dissociation: mechanism which allows the mind to separate specific memories from conscious awareness dissociative disorder: disturbance in conscious awareness, memory, identity & view of oneself in relation to the environment" "what is switching in dissociative identity disorder? - CORRECT ANSWER process of shifting from one identity state to another" "depersonalization/derealization disorder & s+s - CORRECT ANSWER depersonalization persistent, repetitious experience of feeling detached from oneself -person doesn't recognize themselves, almost like an out of body experience derealization -perceives external environment as unreal, feels detached from external environment -sees others as mechanical but recognizes the illogical nature of feelings -anxiety, panic, depression, obsessive & somatic complaints" "tx for dissociative disorders - CORRECT ANSWER many people recover completely w/o tx (less severe like depersonalization, DID is more difficult to tx) therapies -meds: antianxiety & antidepressants -psychotherapy: cognitive, hypnosis, creative" "what are the phases of substance dependency? - CORRECT ANSWER phase one: first use -user experiences "high" & regulates amt of substance & opportunities for use phase two: hangover effects -begins to feel guilty for behaviors during use phase three: dependent lifestyle begins -user no longer predict outcome; engages in compromising behaviors & loses insight phase four: dependency/addiction -periods of blackout, paranoia, helplessness" "what are the substance classes recognized by the DSM-5? - CORRECT ANSWER -alcohol -caffeine -stimulants (amphetamines, cocaine) -hallucinogens (includes PCP/PHENCYCLIDINE) -inhalants, opioids -sedatives, hypnotics, anxiolytics -other (or unknown) substance intoxication" "what can lead to substance abuse? - CORRECT ANSWER -genetics, family influences -peer pressure -environmental stress factors -personality characteristics -chronic physiologic disease -codependency -enabling" "how does codependence & substance use/abuse affect family dynamics? - CORRECT ANSWER tend to feel a responsibility for drug user's problem & internalize guilt for behaviors of that person -due to that, they will do anything to sustain the relationship and enable the drug user -will be defensive towards their behaviors -family can become dysfunctional" "what is the cycle of addiction? - CORRECT ANSWER precontemplation -addict hasn't yet considered stopping behavior or use of substances contemplation -addict is starting to consider making a change in behavior preparation -addict is mentally & possibly physically making a change action -addict has taken an action, like tx, self-help groups or counseling. tx has been provided & addict has stopped using maintenance -addict is maintaining their new lifestyle & behavior, following a recovery program" "which disorders are classified as substance induced disorders? - CORRECT ANSWER -substance intoxication -substance withdrawal" "substance intoxication & s+s - CORRECT ANSWER maladaptive behavioral & psychological changes R/T effects of substances on CNS signs & symptoms -disturbances in areas of perception, sleep-wake cycle -attention, concentration, thinking & judgement -flushed appearance, blood shot eyes -increased RR & BP" "substance withdrawal & s+s - CORRECT ANSWER symptom-specific maladaptive changes in behavior -occurs when blood or tissue concentrations of drug declines signs & symptoms -develops several hours to a few days after cessation -unpleasant symptoms occur so pt most likely to seek relief by re-ingesting drug" "what is CIWA? - CORRECT ANSWER Clinical Institute Withdrawal Assessment -most common method to tx alcohol withdrawal symptoms -benzos are the meds used -helps prevent DTs from occurring" "substance-specific use disorders & its types - CORRECT ANSWER patterns of cognitive, behavioral & physiological symptoms resulting from continued substance abuse symptoms range from: -mild: 2-3 symptoms -moderate: 4-5 symptoms -severe: over 6 symptoms types: alcohol use disorder, cannabis, inhalant, opioid, stimulant, caffeine, nicotine, sedative/anxiolytic, substance abuse by HCPs" "what is Wernicke-Korsakoff syndrome & the s+s? - CORRECT ANSWER type of alcohol use disorder encephalopathy & psychosis; nutritional disease of nervous system in alcoholics -primarily caused by thiamine & niacin deficiency, chronic use of alcohol -significant cerebral deterioration & actual cell death occurs w/ chronic & permanent impairment signs & symptoms -progressive memory loss -disorientation w/ emotional lability & apathy -weakness & fatigue" "what is Delirium tremens? - CORRECT ANSWER type of alcohol use disorder state of profound confusion & delusion w/ withdrawal symptoms seen within short period of cessation signs & symptoms: -anxiety, tremors, seizures & hallucinations -lasts 72-80hrs -fatality rate 5-15% (pg. 241 mental health textbook. slide says 20%)" "cannabis related disorder & s+s - CORRECT ANSWER high feelings followed by mental & physical effects -often used w/ other substances -chronic use comorbidities high dosage can result in: -poss anxiety, dysphoria, social withdrawal, irritability, psychoactive effects" "hallucinogen related disorder & s+s - CORRECT ANSWER PCP/Phencyclidine most common drug abused -taken orally or injected -users demonstrate dangerous behaviors, lack judgement & insight -mood swings, fearfulness -anxiety, feelings of going insane, dying -toxic episodes, flashbacks, psychological effects -medical comorbidities" "inhalant related disorders & s+s - CORRECT ANSWER nitrous oxide; psychoactive effects -behavioral/psychological changes -euphoria, psychomotor disturbances -breath smells of pain/solvent "glue sniffer's rash" -permanent CNS, PNS damage possible -medical comorbidities -"sudden sniffing death"" "what is glue sniffer's rash? - CORRECT ANSWER a rash around the mouth that extends to the middle of the face--adverse effect from chemicals" "what dangers occur from inhalation abuse? - CORRECT ANSWER acute resp failure -prevents sufficient amt of O2 from reaching rest of body as a result of ongoing substance abuse heart rhythm disturbances -exposure to chemicals in glue can lead to an arrhythmia which then can lead to fatal heart failure sudden sniffing death -inhalants force heart to beat rapidly & erratically until user goes to cardiac /resp arrest" "opioid related disorders & S+S - CORRECT ANSWER heroin most abused drug -rx meds like oxycodone, hydrocodone -dependence: compulsive, prolonged self admin for no legit medical reason -effects: initial high, then apathy, depressed mood, motor functioning problems, impaired judgement -drug related crime" "stimulant use disorder & S+S - CORRECT ANSWER crack most common form of cocaine -easily vaporized, inhaled = potent euphoric effect -methamphetamines changes any function in neuron containing dopamine signs & symptoms -mood changes, weight loss, malnutrition -chronic use = mental & physical complications -psychosis resembling schizophrenia: violent, erratic behavior" "caffeine related disorder & S+S - CORRECT ANSWER caffeine is found in coffee, soda, tea, OTC pain relievers, cold remedies, chocolates, anti-drowsiness & weight loss agents, etc. no link between intake & criteria for substance abuse or dependence -caffeine intoxication & withdrawal may be clinically significant -heavy use is 4-6 caffeinated beverages a day signs & symptoms -mild sensory alterations -anxiety, agitation, restlessness, sweating & diarrhea" "nicotine related disorder & S+S - CORRECT ANSWER not considered a maladaptive drug, but included in DSM-5 for abuse & dependence -primarily found in all forms of tobacco signs & symptoms -rapid dependence: tobacco odor, cough, excessive wrinkles, chronic pulmonary disease -↑ risk: lung, oral, & other cancers, cardiovascular & cerebrovascular disease" "sedative, hypnotic or anxiolytic use disorder & S+S - CORRECT ANSWER includes: benzos, carbamates, barbiturates, rx sleep & antianxiety drugs -brain depressants: particularly lethal when mixed w/ alcohol signs & symptoms -maladaptive behavioral & psychological changes -accidental overdoses/resp arrests" "what is detoxification? - CORRECT ANSWER first phase of dependency tx -immediate withdrawal from the drug: 3-5 days -physical & psychological effects -unsupervised withdrawal from drug dependence can result in death -meds available to ease detoxification" "what are the types of eating disorders? - CORRECT ANSWER -anorexia nervosa -binge eating disorder -bulimia nervosa" "what is the CAGE questionnaire? - CORRECT ANSWER used to screen for alcohol dependency and see if there's any concerns for withdrawal to start CIWA 1. "Have you ever felt you should Cut down on your drinking?" 2. "Have people Annoyed you by criticizing your drinking?" 3. "Have you ever felt Guilty about your drinking?" 4. "Have you ever had a drink first thing in the morning (Eye-opener) to steady your nerves or get rid of a hangover?" a positive answer to 2+ questions indicates the pt abuses alcohol" "anorexia nervosa & S+S - CORRECT ANSWER a person who restricts calories to maintain least essential normal body disorder, has an intense fear of weight gain & significant self-image disturbance -maintenance of subnormal weight levels for age/height (below 85% or BMI <17.5kg) signs & symptoms -weight loss achieved via dieting, starvation, excessive exercise -binge eating: eating more food than usual in a discrete time span -purging: emptying digestive tract via self induced vomiting; use of laxatives & diuretics -malnutrition, anemia -amenorrhea, dehydration -lanugo" "why is lanugo seen in pts w/ anorexia? - CORRECT ANSWER baby hairs developed for body to sustain warmth -usually occurs from amenorrhea --> body shows they can't house a baby --> results in lanugo" "bulimia nervosa & S+S - CORRECT ANSWER binge eating w/ repeated attacks, self induced destructive methods to prevent weight gain -two sub groups: purging & non-purging signs & symptoms -seeming lack of control or inability to stop eating during a binge episode -ashamed of disorder, attempt to hide symptoms -events trigger binge behavior -repeated use of risky, inappropriate methods to prevent weight gain" "binge eating disorder & S+S - CORRECT ANSWER similar to bulimia, but w/ slightly different pattern. vomiting, laxative/diuretic use & excessive exercise aren't seen in this condition signs & symptoms -overweight, obese -binging doesn't stop -hx of other psychological issues" "paraphilic disorder & its types - CORRECT ANSWER a sexual disorder any extreme & persistent sexual interests other than typically normal sexual interests exhibitionist: exposure of genitals to a stranger fetishistic: use of inanimate objects in sexual activity sexual masochism: recurrent strong sexual urges, behaviors, or fantasies of being beaten, bound, humiliated or otherwise made to suffer voyeuristic: act of window peeping of a stranger undressing, naked, engaging in sexual activity w/o victim's knowledge frotterurism: activity that involves touching or rubbing contact w/ a nonconsenting person" "what is pica? - CORRECT ANSWER persistent eating of nonfood materials -not dx in children under 2yo -not associated w/ cultural tradition" "circumstatiality - CORRECT ANSWER can't be selective when speaking & describes in length, great detail" "echolalia - CORRECT ANSWER involuntary parrot-like repetition of words spoken by others; twitching seen" "flight of ideas - CORRECT ANSWER rapid shift between topics that are unrelated to each other" "loose association - CORRECT ANSWER a thought that has little or no logical connection to the next one" "primary gain vs secondary gain - CORRECT ANSWER primary: anxiety is diverted to the physical problem (ex: stressing over final, deciding to skip it = no more anxiety) secondary: receiving attention from another (ex: attention from teacher, classmates, etc)" "repression vs regression - CORRECT ANSWER repression -suppressing a thought or desire so it remains unconscious ex: child gets bitten by a dog & develops intense phobia of dogs later in adulthood & doesn't remember experience as a child regression -defense mechanism where person reverts back to an earlier stage of development ex: in periods of stress, person may revert to bedwetting or thumb sucking" "define displacement - CORRECT ANSWER defense mechanism where it involves an individual transferring negative feeling from one person or thing to another ex: a person who is angry at their boss and may take out their anger on a family member" "define rationalization - CORRECT ANSWER Making excuses for actions or feelings ex: person is rejected by crush & rationalizes situation by saying they were not attracted to other person anyway" "define intellectualization - CORRECT ANSWER defense mechanism where person avoid uncomfortable emotions by focusing on facts & logic ex: if person A is rude to person B, person B may think about possible reasons for person A's behavior" "what are the stages of grief? - CORRECT ANSWER denial, anger, bargaining, depression, acceptance" "describe denial stage of grief - CORRECT ANSWER -avoiding reality & may act like nothing happened -allows an adjustment period to gather coping strategies for grieving" "describe anger stage of grief - CORRECT ANSWER -occurs once reality is real -expressed in many ways, like crying, expressions of self-blame and guilt -sometimes anger can turn inwards, which results in physical illness and/or psychological dysfunction" "describe electroconvulsive therapy - CORRECT ANSWER biomedical tx using low voltage electric shock waves passed through the brain for several seconds to induce short periods of seizures -causes changes in brain chemistry that can immediately reverse symptoms of certain mental illnesses -can be used in depression, psychosis, bipolar, catatonia, severe agitation & aggression in dementia pts -done 2-3x a week, lasting about 6-12 txs -confusion clears within hours while memory loss becomes more persistent" "what meds are used when performing ECT? - CORRECT ANSWER administered along w/ general anesthesia & muscle relaxants to minimize any seizures impacting entire body & severe muscle contractions that can fracture or dislocate bones" "when is ECT performed? - CORRECT ANSWER recommended when people who have symptoms aren't responding to meds or psychosocial txs" "what is contraindicated for ECT? - CORRECT ANSWER -lithium → contributes to cognitive side effects (delirium & cognitive problems) -BP meds -benzos" "what is important to do after ECT completed? - CORRECT ANSWER reorient patient (name, date, location)" "what is psychopharmacotherapy - CORRECT ANSWER use of medications to treat psychological problems" "what are the most common symptoms of psychiatric disorders as described by DSM-5? - CORRECT ANSWER -mood alterations -irritability & anxiety -altered thought processes -misperceptions of environment -impaired & illogical communication or interaction patterns -disorientation & confusion" "what are the phases of a therapeutic relationship? - CORRECT ANSWER Orientation, working, termination" "describe generalized anxiety disorder (GAD) - CORRECT ANSWER excessive worrying and anxiety experienced daily for longer than 6 months -can coexist w/ depression" "S+S of generalized anxiety disorder - CORRECT ANSWER excessive worry & anxiety plus (at least) 3 of the following: -restlessness -irritability -muscle tension -difficulty falling/staying asleep -fatigue poss somatic (relating to the body) symptoms: -chest pain -hyperventilation, headaches -tremors, ↑ urinary frequencies -GI disturbances" "etiology & incidence of generalized anxiety disorder - CORRECT ANSWER -onset usually occurs in childhood/early adolescence -tends to run in families & more common in females -female to male ratio is 3:2" "define panic disorder vs panic attack - CORRECT ANSWER panic disorder: recurrent, unexpected panic attacks panic attack: intense feeling of fear/terror occurring suddenly & intermittently w/o warning" "how often do attacks occur? - CORRECT ANSWER can occur daily, weekly, monthly -can last few mins or longer" "S+S of panic disorders - CORRECT ANSWER -heartbeat rapid & pounding -↑ perspiration -chilling or flushing -tingling or numbness of hands, shaking -nausea -chest pain, SOB -fear of being out of control -agoraphobia -depression" "incidence & etiology of panic disorders - CORRECT ANSWER -onset usually occurs between late adolescence & mid 30's -first gen bio relatives are more likely to develop panic disorders -more common in females than males" "s+s of OCD - CORRECT ANSWER -recurrent unwanted thoughts referencing contamination, sexuality, aggression, need for perfection -attempts to reduce unwanted thoughts -repetitive acts, impulses, or rituals -lack of concentration and task completion -impaired social or work functioning" "what are the common types of obsessive thoughts diagnosed OCD pts may have? - CORRECT ANSWER contamination: thoughts of being polluted w/ germs repeated doubts: questioning thoughts as to whether one did or didn't do something (ex: turning oven off) orderliness: thinking that one has to have everything in a particular order (ex: placing things in alphabetical order) impulses that are aggressive or horrific: recurring thoughts about doing actions that could bring distress to others (ex: hurting an innocent person) sexual imagery: thoughts about sexually revealing images or porn" "incidence & etiology of OCD - CORRECT ANSWER -equally common in men & women, but occurs earlier in men -onset in childhood or adolescence" "what are the treatments for anxiety disorders? - CORRECT ANSWER -sertraline -buspirone (short-term, non-drowsy) -bromazepam (short-term) -Xanax (long-term) -psychotherapy" "describe sertraline (brand, uses, side effects, etc) - CORRECT ANSWER brand: Zoloft class: SSRIs (helps restore balance of serotonin in the brain) uses: tx depression, panic attacks, OCD, PTSD, SAD, & severe premenstrual syndrome -monitor for serotonin syndrome/toxicity" "buspirone - CORRECT ANSWER brand: Buspar class: anxiolytic (affects neurotransmitters in the brain) uses: anxiety, short-term -avoid eating/drinking grapefruit" "bromazepam - CORRECT ANSWER class: antianxiety uses: anxiety, short-term (binds 5TN & dopamine receptors in the brain) -avoid grapefruit" "alprazolam - CORRECT ANSWER brand: Xanax class: benzodiazepine (acts in CNS to produce anxiolytic effect) uses: GAD, panic disorder, anxiety w/ depression -avoid grapefruit juice" "psychotherapy for anxiety tx - CORRECT ANSWER -most effective: cognitive behavioral therapy -helps individuals replace negative thoughts & behaviors w/ more positive, productive thoughts" "labile - CORRECT ANSWER Changing rapidly and often -high manic (euphoria, high energy) to low depressive periods" "s+s of bipolar disorder - CORRECT ANSWER hypomania/mania -hypo: more than 4 days -hyper: up to 1wk -delusions of grandeur or persecution (mania) -auditory & visual hallucinations (mania) -inflated self esteem -flight of ideas -↓ need for sleep -easily distracted -extreme irritability & moodiness -reckless & impulsive behaviors -lack of judgement -poor hygiene" "incidence & etiology of bipolar disorder - CORRECT ANSWER -environmental factors, changes in neurotransmitters, familial pattern, substance abuse & stressful events are potential causes -women are at greater risk at developing -average onset is early 20s, but can start as early as adolescence or late as age 50" "list nursing interventions for a pt experiencing hypomania or a manic episode - CORRECT ANSWER -create a safe environment -decrease environmental stimuli -assess risk for accidents to self or others -monitor own anxiety level & convey messages w/ soothing tone of voice -refrain from becoming angry w/ clients who are hostile or behaving in an appropriate in an inappropriate manner -avoid arguing w/ or being charmed by clients -educate pt about meds & give pt food w/ meds to reduce upper GI discomfort & nausea -provide nutritional finger food when pt unable to sit long enough -monitor I&O to prevent dehydration; give juices and waters in containers -set & maintain limits like unit rules & policies -spend time w/ client so they can talk, walk etc -provide positive feedback when needed" "cyclothymic disorder - CORRECT ANSWER chronic mood disturbance w/ fluctuating periods of hypomanic symptoms & periods of depression" "s+s of cyclothymic disorder - CORRECT ANSWER -recurrent episodes of hypomania & dysthymia (usually <2 months) -states not as severe as in bipolar -no psychotic symptoms -functioning not severely impaired" "incidence & etiology of cyclothymic disorder - CORRECT ANSWER -common in both men & women -begins in adolescence or early adulthood -usually chronic w/ an insidious onset" "describe perceptual disturbances - CORRECT ANSWER includes hallucinations which are false sensory experiences, such as seeing something in the absence of an external visual stimulus" "describe disorganized thinking - CORRECT ANSWER includes delusions which are fixed, false ideas/beliefs w/o appropriate external stimuli which are inconsistent w/ reality & can't be changed by reasoning" "describe behavior alterations - CORRECT ANSWER -agitated, aggressive, silly & childlike -inappropriate, unpredictable, frenzied motor activity -unkempt appearance, sexually inappropriate -catatonic behaviors -waxy flexibility" "Schizophrenia - CORRECT ANSWER A psychotic disorder involving distortions in thoughts, perceptions, and/or emotions -has 3 stages: prodromal, acute, residual" "describe prodromal stage of schizophrenia - CORRECT ANSWER -↑ anxiety w/ inability to concentrate -distraction -loss of connections (destroys ability to think, learn) -paranoia -delusional thinking -deteriorating relationships" "describe acute stage of schizophrenia - CORRECT ANSWER -contains positive symptoms -evidenced early in disease" "positive symptoms seen in a schizophrenic patient - CORRECT ANSWER -delusions -perceptual alterations -behavior patterns -word salad -clang associations -thought insertion -loose associations -neologism -hallucinations -illusions -depersonalization -catatonia" "incidence & etiology of schizophrenic pt - CORRECT ANSWER onset typically occurs between late adolescence & mid 30's -there are times where onset starts in childhood, and also late onset after 45 -late onset is more common in women than men -higher risk in those who have 1st degree bio relative w/ the disorder" "subtypes of schizophrenia? - CORRECT ANSWER paranoid, disorganized, catatonic, undifferentiated, residual" "describe paranoid schizophrenia - CORRECT ANSWER experience hallucinations & delusions -often auditory & delusions of being persecuted or followed -delusions are very organized & focus on the theme" "Describe disorganized schizophrenia - CORRECT ANSWER exhibits disorganized & unintelligible speech, bizarre behavior, and a flat affect -delusions don't have a theme but are fragmented & varied in focus -unusual mannerisms and posturing are seen -demonstrates inappropriate laughter" "describe catatonic schizophrenia - CORRECT ANSWER severe decrease in motor activity and responsiveness to an environment -may be mute & suddenly started repeating words at an earlier time -no movement for hours & hours" "Describe undifferentiated schizophrenia - CORRECT ANSWER exhibits a # of classic symptoms like delusions, hallucinations, disorganized speech, strange behavior, and blunted affect" "Describe Residual Schizophrenia - CORRECT ANSWER has experienced prominent psychotic symptoms w/ a previous dx of schizophrenia but no longer has them" "describe schizoaffective disorder - CORRECT ANSWER mood episode & active symptoms occur together preceded by at least 2 weeks of delusions & hallucinations" "what are tx options for psychotic disorders? - CORRECT ANSWER -psychotherapy -hospitalization -clozapine -haldol" "what is EPS? - CORRECT ANSWER extrapyramidal side effects -long term use side effects caused by antipsychotic & other drugs -caused by blocking dopamine which irritates pyramidal tracts of the CNS that coordinates involuntary movements -these side effects include: akathisia, dystonia, tardive dyskinesia, drug-induced parkinsonism, neuroleptic malignant syndrome" "what is akathisia? - CORRECT ANSWER Motor restlessness -first symptom to appear -reversible" "what is dystonia? - CORRECT ANSWER rigidity in muscles controlling posture, gait, or eye movement -2nd symptom to appear -reversible" "what is tardive dyskinesia - CORRECT ANSWER late appearing, irreversible movements of mouth & face -if akathisia & dystonia first noticed, tardive can be avoided" "drug induced parkinsonism - CORRECT ANSWER tremors, rigidity, akinesia, absence of movement w/ diminished mental state" "neuroleptic malignant syndrome - CORRECT ANSWER potentially fatal reaction, onset from 3-9 days after tx" "what are the types of personality disorders? - CORRECT ANSWER Cluster A Cluster B Cluster C" "s+s of paranoid personality disorder - CORRECT ANSWER -suspicious nature, angry or hostile outbursts -rigid, inflexible nature, often quite efficient -inability to achieve closeness in interpersonal relationships -unable to take constructive criticism yet critical of others" "incidence & etiology of paranoid disorder - CORRECT ANSWER -more prevalent in men -seen in early adulthood -possible genetic link" "schizoid personality disorder - CORRECT ANSWER a personality disorder characterized by persistent avoidance of social relationships and little expression of emotion -self absorbed, loners" "s+s of schizoid personality disorder - CORRECT ANSWER -bland affect, unresponsive to happy emotions in others -derive less pleasure from soothing, sensual activities -characteristics seen in most aspects of life by adult years -oblivious to perception of behaviors by others" "incidence & etiology of schizoid personality disorder - CORRECT ANSWER -more common in men than women -↑ risk for people w/ familial hx -characteristics are seen in early adolescence or adult years" "schizotypal personality disorder - CORRECT ANSWER exhibits strange & unusual patterns of thinking & communicating -considered a mild form of schizophrenia but w/o thought alterations" "s+s of schizotypal personality disorder - CORRECT ANSWER -social secluded, withdrawn -magical thinking -rigid & inflexible emotions, little ability to respond to feelings of others -psychotic behavior may occur in brief episodes" "which personality disorders are considered cluster B? - CORRECT ANSWER antisocial, borderline, narcissistic, histrionic -characteristics are dramatic, emotional, or erratic" "antisocial personality disorder - CORRECT ANSWER pattern of disregard & infringement on the rights of others in a society" "s+s antisocial personality disorder - CORRECT ANSWER -sociopath w/o a conscience -chronic disorder, difficult to tx -impulsive, victimize others for self-gain -continual involvement w/ police" "incidence & etiology of antisocial personality disorder - CORRECT ANSWER -onset before 15y -child abuse, unstable parenting, inconsistent parental discipline ↑ risk -more common in men -higher incidence in people w/ low socioeconomic class, crowded living situations, prison, hx of substance abuse -has familial pattern w/ 1st gen -tends to be chronic but becomes less evident as pt ages" "borderline personality disorder - CORRECT ANSWER unstable interpersonal relationships, insecure self-image, and mood swings" "s+s of borderline personality disorder - CORRECT ANSWER -unstable relationships -insecure self-image -mood swings -dissociation -impulsive outbursts of anger -chronic sense of abandonment -splitting (brief episodes of paranoia & hallucinations)" "narcissistic personality disorder - CORRECT ANSWER grandiose sense of self importance & unrealistic sense of thinking" "s+s narcissistic personality disorder - CORRECT ANSWER -arrogance, entitlement -underlying feelings of inferiority, envy of others -over exaggerated & personal achievement -little regard for others' feelings -w/o insight into behaviors, unrealistic thinking" "what are the types of dissociative disorders? - CORRECT ANSWER -dissociative amnesia -dissociative amnesia w/ dissociative fugue -dissociative identity disorder -depersonalization/derealization" "dissociative amnesia & its 4 types - CORRECT ANSWER inability to remember important personal information, usually traumatic or stressful nature 4 types: -localized: amnesia occurs within few hours of traumatic event -selective: retains a memory of a portion of the event only -generalized: unable to recall any aspect of life -continuous: amnesia encompasses period up to/including present" "dissociative amnesia w/ dissociative fugue & the S+S - CORRECT ANSWER inability to recall some/all of one's past/identity, accompanied by sudden, unexpected travel away from home or place of work signs & symptoms -often remember things unrelated to identity -malingered fugue -unable to remember a time of altered identity upon recovery -brief; most w/ full recovery" "what is dissociative fugue? - CORRECT ANSWER sudden and unexpected travel, inability to remember past, might not be able to recall personal identity & assume a new one -can remember skills like driving a car, how to use a phone etc. -don't remember personality traits but don't realize what's happened" "what is malingered fugue? - CORRECT ANSWER occurs in ppl trying to avoid legal, financial, or unwanted personal situation" "dissociative identity disorder (formerly multiple personality disorder) - CORRECT ANSWER two or more distinct identities or personalities are present in the same person -each personality character may appear w/ distinct: personal hx, self-concept, identity, name, memories, behaviors, social relationships -one personality manifests at a time; the switching process -memory gaps -has 2 forms: possession & nonpossession" "describe possession & nonpossession form of dissociative identity disorder - CORRECT ANSWER possession form: -multiple identities are apparent to family members & others -acts like the person is taken over by another -are overt & noticeable d/t tone, voice, body language nonpossession form: -different identities aren't as apparent -clients aware what's happening but feel detached from themselves -sudden shift & not overt -food preferences, interests, hobbies etc. can change"