NR 607 final exam Question and Answer
(2026/2027) | Complete Revision Guide |
A+ Verified
• How long must symptoms persist for a diagnosis of Somatic Symptom Disorder? -✓✓
More than 6 months.
• What impact do the symptoms of Somatic Symptom Disorder have on an individual? -
✓✓ They cause major distress and/or disruption of daily life.
• ________ may occur when a client and provider agree that the client's symptoms
meet the criteria for inpatient hospitalization and that the client may benefit from
admission. This is the preferred way because it gives the patient a sense of control over
their life. The client will sign a consent form agreeing to a hospital stay in a locked unit.
Clients who voluntarily agree to admission may not require a psychiatric hold; however,
if the client requests discharge and the provider determines the client is not yet safe, the
provider may initiate an emergency involuntary hold -✓✓ A voluntary admission
• _______ occurs when a client does NOT agree to hospitalization. Still, an evaluation
by a mental health professional indicates that the client may be at high risk of harming
themselves or others. Other terms denoting an involuntary admission include
involuntary commitment, psychiatric hold, or civil admission. This means the patient is a
danger to themselves or others. -✓✓ Involuntary admission
Involuntary civil commitment is a legal intervention directed by a judge to order a person
with serious symptoms of continued danger to self or others, grave disability, or serious
deterioration to either remain in a psychiatric hospital or attend supervised outpatient
treatment for a period
• What is seclusion and when is this technique ok to be used? -✓✓ Different states have
different laws for seclusion so ensure to abide by state regulations.
Seclusion involves the involuntary confinement of an individual alone in a room or area
from which the individual is prevented from leaving. Seclusion or restraints should only
be used to ensure the IMMEDIATE physical safety of the client and others
• What are some exceptions to informed consent? -✓✓ 1.) incapacitation- find/ consult a
surrogate
2.) life threatening emergencies
3.) clients voluntarily waiving their informed consent
,• What is the primary reason for a patient to admitted to the hospital? -✓✓
STABILIZATION-Stabilization starts with the least restrictive interventions, including a
calm environment, de-escalation, and collaborative planning.
• Name some de-escalation techniques.
Do your AEIO risk assessment (agitation/arousal, environment, intent, objects) -✓✓
When acutely agitated patients present to the ED, the first priority is to address basic
physiological and safety needs by reducing environmental overstimulation and providing
food and drink, if desired. Patients should be included in the decision-making process
as much as possible.
give them space- assess needs, listen to them, watch for the doors, provide
nutrition/support, speak calm, do not agitate, clear limits, minimize light/noise
• What is the definition of a psychiatric emergency? name some examples -✓✓ This is
when a patient is a danger to self/ danger to others, unable to meet their own needs for
basic food, clothing, shelter due to psychological impairment.
Suicide, acute psychosis, agitation/aggression, mania, substance use concerns,
decompensation related to personality disorders, severe anxiety, medication related
emergencies.
• ____ occurs when medication that alter the way serotonin is produced/metabolized by
the body causes EXCESSIVE levels of serotonin to build up in the body. -✓✓
SEROTONIN SYNDROME
• What are some medications that can cause serotonin syndrome? -✓✓ SSRI's
MAOI's- severe cases
SNRI
Tricyclics
L-Trytophans
opioids, cocaine,
St. Johns Wart
antiemetics
Always remember there HAS TO be a 5 week washout when switching from an SSRI to
an MAOI or the other way around.
• What are some s/s of serotonin synrdome? -✓✓ AMS- delirium, agitation, insomnia,
hypervigilance
ANS dysregulation: Tachycardia, high temp, SHIVERING, sweating, diarrhea,
MYDRIASIS- DILATED PUPILS, HEADACHE, DYSRTHYMIAS, OCULAR CLONUS
HYPERREFLEXIA IN LOWER LIMBS, MYOCLONUS- MUSCLE TWITCHING,
TREMORS!!!!!
• how would you treat serotonin syndrome? -✓✓ 1.) D/C THE MEDICATION
, 2.) SUPPORTIVE TX IS DEPENDENT ON THE SEVERITY OF SYMPTOMS
3.) HOSPITALIZATION FOR STABILITY
• Is there any lab alterations that will help you to diagnose serotonin syndrome? -✓✓
NOOOO!!
This is solely dependent on looking at s/s!!!
• what is the onset of serotonin syndrome? -✓✓ It can develop over hours and it can
resolve within 24 hours!
• _____ is a LIFE THREATENING adverse effect caused by antipsychotics (d2
blockers/d2 antagonists=typical/atypical) which is caused by the disruption of dopamine
receptors in the anterior hypothalamus or due to direct toxicity to muscle cells. -✓✓
NEUROLEPTIC MALIGNANT SYNDROME- NMS
• What are some risk factors of developing neuroleptic malignant syndrome? -✓✓ depo
injections
changes in medications
anti emetic medications
antipsychotics
• What are the signs and symptoms of NMS? F.E.V.E.R -✓✓ F- Fever a temp of over 38
celcius
E- Encephalopathy- AMS
V- Vital signs/autonomic instability- Tachycardia, labile BP
E- enzymes- increased CK
R- muscle rigidity- lead pipe rigdity
HIGH FEVER, AMS, LABILE BP, INCREASED CK, LEAD PIPE RIGIDITY/CATATONIA
DROOLING, HYPOREFLEXIA, LEUKOCYTOSIS, LOW SERUM IRON
• What labs would indicate a possibility of NMS? -✓✓ Increased CK
leukocytosis
low serum iron
• How would you treat NMS? -✓✓ 1.) D/c the causative agent
2.) Supportive care- IV fluids, antipyretics, electrolyte replacement, cooling devices,
benzos can be used for agitation
3.) Do a two week washout. Close monitoring and a new med can be prescribed
• What is lithium toxicity? -✓✓ This is when excessive lithium intake is caused by
impaired excretion, sodium/volume depletion r/t vomiting, diarrhea, fever, low sodium
diet or lithium being re-absorbed into the kidneys.
(2026/2027) | Complete Revision Guide |
A+ Verified
• How long must symptoms persist for a diagnosis of Somatic Symptom Disorder? -✓✓
More than 6 months.
• What impact do the symptoms of Somatic Symptom Disorder have on an individual? -
✓✓ They cause major distress and/or disruption of daily life.
• ________ may occur when a client and provider agree that the client's symptoms
meet the criteria for inpatient hospitalization and that the client may benefit from
admission. This is the preferred way because it gives the patient a sense of control over
their life. The client will sign a consent form agreeing to a hospital stay in a locked unit.
Clients who voluntarily agree to admission may not require a psychiatric hold; however,
if the client requests discharge and the provider determines the client is not yet safe, the
provider may initiate an emergency involuntary hold -✓✓ A voluntary admission
• _______ occurs when a client does NOT agree to hospitalization. Still, an evaluation
by a mental health professional indicates that the client may be at high risk of harming
themselves or others. Other terms denoting an involuntary admission include
involuntary commitment, psychiatric hold, or civil admission. This means the patient is a
danger to themselves or others. -✓✓ Involuntary admission
Involuntary civil commitment is a legal intervention directed by a judge to order a person
with serious symptoms of continued danger to self or others, grave disability, or serious
deterioration to either remain in a psychiatric hospital or attend supervised outpatient
treatment for a period
• What is seclusion and when is this technique ok to be used? -✓✓ Different states have
different laws for seclusion so ensure to abide by state regulations.
Seclusion involves the involuntary confinement of an individual alone in a room or area
from which the individual is prevented from leaving. Seclusion or restraints should only
be used to ensure the IMMEDIATE physical safety of the client and others
• What are some exceptions to informed consent? -✓✓ 1.) incapacitation- find/ consult a
surrogate
2.) life threatening emergencies
3.) clients voluntarily waiving their informed consent
,• What is the primary reason for a patient to admitted to the hospital? -✓✓
STABILIZATION-Stabilization starts with the least restrictive interventions, including a
calm environment, de-escalation, and collaborative planning.
• Name some de-escalation techniques.
Do your AEIO risk assessment (agitation/arousal, environment, intent, objects) -✓✓
When acutely agitated patients present to the ED, the first priority is to address basic
physiological and safety needs by reducing environmental overstimulation and providing
food and drink, if desired. Patients should be included in the decision-making process
as much as possible.
give them space- assess needs, listen to them, watch for the doors, provide
nutrition/support, speak calm, do not agitate, clear limits, minimize light/noise
• What is the definition of a psychiatric emergency? name some examples -✓✓ This is
when a patient is a danger to self/ danger to others, unable to meet their own needs for
basic food, clothing, shelter due to psychological impairment.
Suicide, acute psychosis, agitation/aggression, mania, substance use concerns,
decompensation related to personality disorders, severe anxiety, medication related
emergencies.
• ____ occurs when medication that alter the way serotonin is produced/metabolized by
the body causes EXCESSIVE levels of serotonin to build up in the body. -✓✓
SEROTONIN SYNDROME
• What are some medications that can cause serotonin syndrome? -✓✓ SSRI's
MAOI's- severe cases
SNRI
Tricyclics
L-Trytophans
opioids, cocaine,
St. Johns Wart
antiemetics
Always remember there HAS TO be a 5 week washout when switching from an SSRI to
an MAOI or the other way around.
• What are some s/s of serotonin synrdome? -✓✓ AMS- delirium, agitation, insomnia,
hypervigilance
ANS dysregulation: Tachycardia, high temp, SHIVERING, sweating, diarrhea,
MYDRIASIS- DILATED PUPILS, HEADACHE, DYSRTHYMIAS, OCULAR CLONUS
HYPERREFLEXIA IN LOWER LIMBS, MYOCLONUS- MUSCLE TWITCHING,
TREMORS!!!!!
• how would you treat serotonin syndrome? -✓✓ 1.) D/C THE MEDICATION
, 2.) SUPPORTIVE TX IS DEPENDENT ON THE SEVERITY OF SYMPTOMS
3.) HOSPITALIZATION FOR STABILITY
• Is there any lab alterations that will help you to diagnose serotonin syndrome? -✓✓
NOOOO!!
This is solely dependent on looking at s/s!!!
• what is the onset of serotonin syndrome? -✓✓ It can develop over hours and it can
resolve within 24 hours!
• _____ is a LIFE THREATENING adverse effect caused by antipsychotics (d2
blockers/d2 antagonists=typical/atypical) which is caused by the disruption of dopamine
receptors in the anterior hypothalamus or due to direct toxicity to muscle cells. -✓✓
NEUROLEPTIC MALIGNANT SYNDROME- NMS
• What are some risk factors of developing neuroleptic malignant syndrome? -✓✓ depo
injections
changes in medications
anti emetic medications
antipsychotics
• What are the signs and symptoms of NMS? F.E.V.E.R -✓✓ F- Fever a temp of over 38
celcius
E- Encephalopathy- AMS
V- Vital signs/autonomic instability- Tachycardia, labile BP
E- enzymes- increased CK
R- muscle rigidity- lead pipe rigdity
HIGH FEVER, AMS, LABILE BP, INCREASED CK, LEAD PIPE RIGIDITY/CATATONIA
DROOLING, HYPOREFLEXIA, LEUKOCYTOSIS, LOW SERUM IRON
• What labs would indicate a possibility of NMS? -✓✓ Increased CK
leukocytosis
low serum iron
• How would you treat NMS? -✓✓ 1.) D/c the causative agent
2.) Supportive care- IV fluids, antipyretics, electrolyte replacement, cooling devices,
benzos can be used for agitation
3.) Do a two week washout. Close monitoring and a new med can be prescribed
• What is lithium toxicity? -✓✓ This is when excessive lithium intake is caused by
impaired excretion, sodium/volume depletion r/t vomiting, diarrhea, fever, low sodium
diet or lithium being re-absorbed into the kidneys.
