NUR 326 Exam 1 with Accurate
Solutions
The way a person feels - ANSWER-Mood
The observable response a person has to his or her own feelings - ANSWER-Affect
Lack of feelings, emotions, interests, or concern. - ANSWER-Apathy
Any observable, recordable, and measurable act, movement, or response. - ANSWER-
Behavior
Great happiness and exhiliration - ANSWER-Elation
Four signs of affective instability (mood disturbance) - ANSWER-1. Agitation
2. Sadness
3. Elation (Great happiness)
4. Blunting (Showing little to no emotion, monotone voice, unusually brief responses)
Showing little to no emotion, monotone voice, unusually brief responses - ANSWER-
Blunting
The complex process during the period of grief and mourning. During this time, people
often experience fluctuating thoughts that occur in intense waves. We know from our
own experience that significant losses are never forgotten. As time goes on, the painful
feelings become less intense and more manageable. - ANSWER-Bereavement
Who is the greatest expert on a patient's mood? - ANSWER-The patient
In this stage, grieving people are unable or unwilling to accept that the loss has taken
(or will shortly take) place. It can feel as though they are experiencing a bad dream, that
the loss is unreal, and they are waiting to "wake up" as though from a dream, expecting
that things will be normal. - ANSWER-Denial
In this stage, people beg their "higher power" to undo the loss, saying things along the
lines of, "I'll change if you bring her (or him) back to me". This phase usually involves
promises of better behavior or significant life changes which will be made in exchange
for the reversal of the loss. - ANSWER-Bargaining
Subjective feeling and affect that follows a loss - ANSWER-Grief
,The process by which grief is resolved - ANSWER-Mourning
Survivors repeatedly want to reunite with the person who died in some way, and may
even want to die themselves in order to be with their loved one. Normal expression of
grief. - ANSWER-Yearnings
Examples of disturbed vegetative functioning. (3) - ANSWER-1. eating
2. sleeping
3. menstruation
Which neurotransmitters of the brain are disturbed with a mood disorder? (3) -
ANSWER-1. Dopamine
2. Norepinephrine
3. Serotonin
Which two populations are at greatest risk for a mood disorder? - ANSWER-1. Females
2. Individuals in the second and sixth decades of life
List 6 risk factors for developing a mood disorder. - ANSWER-1. Stress
2. Early trauma
3. Neglect
4. Abuse
5. Family history
6. Substance dependence
What are some manifestations of grief? - ANSWER-1. Troubling breathing
2. Trouble sleeping
3. Loss of appetite
4. Trembling, shakiness, dry mouth, nausea, muscle weakness.
What are some symptoms of complicated grief? - ANSWER-1. Grief lasting more than
2-6 months
2. Persistent feeling of hopelessness
3. Maladaptive behaviors
What is the #1 disabling illness in the world? - ANSWER-Depression
One or more episodes of major depression with one or more episodes of mania
Prevalence is 0.4%-1.6% - ANSWER-Bipolar I disorder
One or more episodes of major depression with periods of hypomania
Prevalence is 0.5% - ANSWER-Bipolar II disorder
Normal, healthy fluctuations of mood - ANSWER-Euthymia
,Mood is a ____ experience of feelings, whereas affect is an _____ reflection of feelings.
- ANSWER-Subjective. Objective.
The *undiagnosed* mood state characterized by sadness, despair, and loss of
functional status - ANSWER-Melancholy
Diagnosed overwhelming sadness and despair that one feels drained of energy. They
may feel so sad and empty that he or she becomes incapacitated by a loss of the will to
live, and suicidal thoughts may prevail. - ANSWER-Depression
What is the difference between mania and hypomania? - ANSWER-Mania involves
perceptual disturbances and is more severe than hypomania. With hypomania, there is
less impairment.
Characteristics of mania. - ANSWER-Perceptual disturbances, such as racing thoughts,
grandiose delusions, difficulty concentrating, impulsivity, and lack of insight. Also,
impaired functional status.
What is the most common mood stabilizer? - ANSWER-Lithium
Some symptoms of this condition include dilated pupils, myoclonus and hyperthermia
(>106) - ANSWER-Serotonin toxicity
Intermittent tremor or twitching - ANSWER-Myoclonus
What is the narrow therapeutic index for lithium? - ANSWER-0.8-1.4 mEq/L, toxic range
starts at 1.5
Five EARLY signs of lithium toxicity. - ANSWER-1. Diarrhea
2. Vomiting
3. Drowsiness
4. Muscular weakness
5. Lack of coordination
Three SEVERE symptoms of lithium toxicity. - ANSWER-1. Ataxia
2. Tinnitus
3. Blurred vision
Severe depressive mood symptoms that interfere with functional status, employment,
and/or relationships that last for at least a two week period of time. - ANSWER-Major
depressive disorder
Characterized by extreme mood swings--both lowering of mood and exaggerated
elevation of mood. - ANSWER-Bipolar I disorder
, Characterized by mood swings but is less severe. There is a less exaggerated elevation
of mood or "lesser mania". It does not lead to life-threatening consequences, nor does
psychosis occur. - ANSWER-Bipolar II disorder
A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI)
antidepressant. After taking the new medication, the patient states, "This medication
isn't working. I don't feel any different." What is the best response by the nurse?
a. "I will call your care provider. Perhaps you need a different medication."
b. "Don't worry. We can try taking it at a different time of day to help it work better."
c. "It usually takes a few weeks for you to notice improvement from this medication."
d. "Your life is much better now. You will feel better soon." - ANSWER-C (Seeing a
response to antidepressants takes 3 to 6 weeks. No change in medication is indicated
at this point of treatment, because there is no report of adverse effects from the
medication. If nausea is present, taking the medication with food may help, but this is
not reported by the patient, so a change in administration time is not needed. Telling a
depressed patient that his or her life is better does not acknowledge the patient's
feelings.)
A patient coming to the health clinic for a blood pressure check reports to the nurse that
she just does not have the energy to go out much in winter but looks forward to
gardening in summer. The nurse realizes that this patient is describing a major
symptom of what condition?
a. Anxiety
b. Seasonal affective disorder
c. Medication side effects
d. Antisocial personality - ANSWER-B (Decreased exposure to sunlight in winter
months can reduce the production of serotonin in the brain, leading to a type of
depression termed seasonal affective disorder; this tends to resolve with the longer
days and increased exposure to sun of spring and summer. There are not enough data
to identify anxiety or signs linked to medication, which also tend to not resolve with
seasons. Antisocial traits include isolation but also include behaviors of manipulation
and lack of remorse in interpersonal relationships.)
A family member of a patient diagnosed with bipolar disorder asks what behaviors
would indicate the beginnings of a manic phase. What is the best response by the
nurse?
a. "The person may sleep more, have trouble completing hygiene needs, and have a
poor appetite."
b. "The person may have sudden spikes in blood pressure and crave foods that are
sweet or salty."
c. "The person may have excess energy, talk a lot, feel restless, and spend too much
money."
d. "The person may experience decreased energy and interest in activities beginning in
the winter months." - ANSWER-C (Signs that a person is cycling into a manic phase
Solutions
The way a person feels - ANSWER-Mood
The observable response a person has to his or her own feelings - ANSWER-Affect
Lack of feelings, emotions, interests, or concern. - ANSWER-Apathy
Any observable, recordable, and measurable act, movement, or response. - ANSWER-
Behavior
Great happiness and exhiliration - ANSWER-Elation
Four signs of affective instability (mood disturbance) - ANSWER-1. Agitation
2. Sadness
3. Elation (Great happiness)
4. Blunting (Showing little to no emotion, monotone voice, unusually brief responses)
Showing little to no emotion, monotone voice, unusually brief responses - ANSWER-
Blunting
The complex process during the period of grief and mourning. During this time, people
often experience fluctuating thoughts that occur in intense waves. We know from our
own experience that significant losses are never forgotten. As time goes on, the painful
feelings become less intense and more manageable. - ANSWER-Bereavement
Who is the greatest expert on a patient's mood? - ANSWER-The patient
In this stage, grieving people are unable or unwilling to accept that the loss has taken
(or will shortly take) place. It can feel as though they are experiencing a bad dream, that
the loss is unreal, and they are waiting to "wake up" as though from a dream, expecting
that things will be normal. - ANSWER-Denial
In this stage, people beg their "higher power" to undo the loss, saying things along the
lines of, "I'll change if you bring her (or him) back to me". This phase usually involves
promises of better behavior or significant life changes which will be made in exchange
for the reversal of the loss. - ANSWER-Bargaining
Subjective feeling and affect that follows a loss - ANSWER-Grief
,The process by which grief is resolved - ANSWER-Mourning
Survivors repeatedly want to reunite with the person who died in some way, and may
even want to die themselves in order to be with their loved one. Normal expression of
grief. - ANSWER-Yearnings
Examples of disturbed vegetative functioning. (3) - ANSWER-1. eating
2. sleeping
3. menstruation
Which neurotransmitters of the brain are disturbed with a mood disorder? (3) -
ANSWER-1. Dopamine
2. Norepinephrine
3. Serotonin
Which two populations are at greatest risk for a mood disorder? - ANSWER-1. Females
2. Individuals in the second and sixth decades of life
List 6 risk factors for developing a mood disorder. - ANSWER-1. Stress
2. Early trauma
3. Neglect
4. Abuse
5. Family history
6. Substance dependence
What are some manifestations of grief? - ANSWER-1. Troubling breathing
2. Trouble sleeping
3. Loss of appetite
4. Trembling, shakiness, dry mouth, nausea, muscle weakness.
What are some symptoms of complicated grief? - ANSWER-1. Grief lasting more than
2-6 months
2. Persistent feeling of hopelessness
3. Maladaptive behaviors
What is the #1 disabling illness in the world? - ANSWER-Depression
One or more episodes of major depression with one or more episodes of mania
Prevalence is 0.4%-1.6% - ANSWER-Bipolar I disorder
One or more episodes of major depression with periods of hypomania
Prevalence is 0.5% - ANSWER-Bipolar II disorder
Normal, healthy fluctuations of mood - ANSWER-Euthymia
,Mood is a ____ experience of feelings, whereas affect is an _____ reflection of feelings.
- ANSWER-Subjective. Objective.
The *undiagnosed* mood state characterized by sadness, despair, and loss of
functional status - ANSWER-Melancholy
Diagnosed overwhelming sadness and despair that one feels drained of energy. They
may feel so sad and empty that he or she becomes incapacitated by a loss of the will to
live, and suicidal thoughts may prevail. - ANSWER-Depression
What is the difference between mania and hypomania? - ANSWER-Mania involves
perceptual disturbances and is more severe than hypomania. With hypomania, there is
less impairment.
Characteristics of mania. - ANSWER-Perceptual disturbances, such as racing thoughts,
grandiose delusions, difficulty concentrating, impulsivity, and lack of insight. Also,
impaired functional status.
What is the most common mood stabilizer? - ANSWER-Lithium
Some symptoms of this condition include dilated pupils, myoclonus and hyperthermia
(>106) - ANSWER-Serotonin toxicity
Intermittent tremor or twitching - ANSWER-Myoclonus
What is the narrow therapeutic index for lithium? - ANSWER-0.8-1.4 mEq/L, toxic range
starts at 1.5
Five EARLY signs of lithium toxicity. - ANSWER-1. Diarrhea
2. Vomiting
3. Drowsiness
4. Muscular weakness
5. Lack of coordination
Three SEVERE symptoms of lithium toxicity. - ANSWER-1. Ataxia
2. Tinnitus
3. Blurred vision
Severe depressive mood symptoms that interfere with functional status, employment,
and/or relationships that last for at least a two week period of time. - ANSWER-Major
depressive disorder
Characterized by extreme mood swings--both lowering of mood and exaggerated
elevation of mood. - ANSWER-Bipolar I disorder
, Characterized by mood swings but is less severe. There is a less exaggerated elevation
of mood or "lesser mania". It does not lead to life-threatening consequences, nor does
psychosis occur. - ANSWER-Bipolar II disorder
A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI)
antidepressant. After taking the new medication, the patient states, "This medication
isn't working. I don't feel any different." What is the best response by the nurse?
a. "I will call your care provider. Perhaps you need a different medication."
b. "Don't worry. We can try taking it at a different time of day to help it work better."
c. "It usually takes a few weeks for you to notice improvement from this medication."
d. "Your life is much better now. You will feel better soon." - ANSWER-C (Seeing a
response to antidepressants takes 3 to 6 weeks. No change in medication is indicated
at this point of treatment, because there is no report of adverse effects from the
medication. If nausea is present, taking the medication with food may help, but this is
not reported by the patient, so a change in administration time is not needed. Telling a
depressed patient that his or her life is better does not acknowledge the patient's
feelings.)
A patient coming to the health clinic for a blood pressure check reports to the nurse that
she just does not have the energy to go out much in winter but looks forward to
gardening in summer. The nurse realizes that this patient is describing a major
symptom of what condition?
a. Anxiety
b. Seasonal affective disorder
c. Medication side effects
d. Antisocial personality - ANSWER-B (Decreased exposure to sunlight in winter
months can reduce the production of serotonin in the brain, leading to a type of
depression termed seasonal affective disorder; this tends to resolve with the longer
days and increased exposure to sun of spring and summer. There are not enough data
to identify anxiety or signs linked to medication, which also tend to not resolve with
seasons. Antisocial traits include isolation but also include behaviors of manipulation
and lack of remorse in interpersonal relationships.)
A family member of a patient diagnosed with bipolar disorder asks what behaviors
would indicate the beginnings of a manic phase. What is the best response by the
nurse?
a. "The person may sleep more, have trouble completing hygiene needs, and have a
poor appetite."
b. "The person may have sudden spikes in blood pressure and crave foods that are
sweet or salty."
c. "The person may have excess energy, talk a lot, feel restless, and spend too much
money."
d. "The person may experience decreased energy and interest in activities beginning in
the winter months." - ANSWER-C (Signs that a person is cycling into a manic phase
