PMHNP FINAL EXAM 1 STUDY GUIDE WITH CORRECT SOLUTIONS

PMHNP FINAL EXAM 1 STUDY GUIDE WITH CORRECT SOLUTIONS _______ is produced in the locus ceruleus of the pons - CORRECT ANSWERNorepinephrine The hallmark symptom in _______ is a disturbance of consciousness accompanied by changes in cognitive function - CORRECT ANSWER-delirium Disturbance of consciousness develops over a short time, usually hours to days is seen in _______ - CORRECT ANSWER-delirium How are Sleep-rest cycle different in patients with delirium? - CORRECT ANSWERclients are awake at night andsleep during the day. Impaired _______ and ______ memory is seen in patients with delirium - CORRECT ANSWER-recent and intermediate Symptoms of delirium resolve within ? - CORRECT ANSWER-3 to 6 months Delirium Mnemonic - CORRECT ANSWER-D-Drugs E-electrolyte abnormality L-low oxygen saturation I-infection R-reduced sensory input I-intracranial U-urinary or renal retention M-myocardial What is the most common type of dementia? - CORRECT ANSWER-Alzheimer's __________ has a Gradual onset and progressive decline without focal neurological deficits - CORRECT ANSWER-Dementia of Alzheimer's type (DAT) What are the hallmark signs of Dementia of Alzheimer's type (DAT) - CORRECT ANSWER-amyloid deposits and neurofibrillary tangles senile plaques What changes in the brain are seen in DAT? - CORRECT ANSWER-Diffuse cerebral atrophy and enlarged ventricles Which neurotransmitters are decreased in DAT? - CORRECT ANSWER-acetylcholine (ACh) and norepinephrine ___________is Often induced by traumatic experiences such as physical/sexual abuse, or betrayal by a trusted individual - CORRECT ANSWER-Dissociative amnesia Clinical features of _____________ includes An inability to recall important personal information, usually of a traumatic/stressful nature, that is inconsistent with ordinary forgetting - CORRECT ANSWER-Dissociative amnesia localized amnesia is the disruption of - CORRECT ANSWER-an event or period of time selective amnesia is the disruption of - CORRECT ANSWER-Specific aspect of an event generalized amnesia is the disruption of - CORRECT ANSWER-Identity or life history purposeful travel or bewildered wandering that is associated with amnesia for identity or for other important autobiographical information - CORRECT ANSWER-dissociative fugue inability to learn new info - CORRECT ANSWER-Anterograde amnesia inability to recall previously remembered info - CORRECT ANSWER-Retrograde amnesia Which TCA is used in the treatment of OCD? - CORRECT ANSWER-Clomipramine Which substances may cause dementia? - CORRECT ANSWER-Alcohol · Heavy metals · Carbon monoxide ·Pseudodementia r/t meds ( anticholinergics) inhalants Which SSRIs have a sedative effect? - CORRECT ANSWER-Citalopram (Celexa) Escitalopram (Lexapro) Fluvoxamine (Luvox) Paroxetine (Paxil) Sertraline (Zoloft) Which TCAs have a sedative effect? - CORRECT ANSWER-Amitriptyline (Elavil) Doxepin (Sineqan) Which other antidepressants may cause sedation? - CORRECT ANSWER-Mirtazapine (Remeron) Nefazodone (Serzone) Trazodone What are side effects of trazadone? - CORRECT ANSWER-Sedation, nausea, headache, hypotension, priapism Wellbutrin (NDRI) can be used to treat which disorders? - CORRECT ANSWER-- Antidepressant (mood disorders, unipolar affective disorders and depressive disorders) -attention deficit hyperactive disorder -smoking cessation. Wellbutrin is contraindicated in clients with - CORRECT ANSWER-SZ disorder eating disorder What is Considered first-line agents for chronic anxiety disorders? - CORRECT ANSWER-Selective serotonin reuptake inhibitors (SSRIs) black box warning for SSRIs in children, adolescents, and young adults - CORRECT ANSWER-increased risk for suicide Which benzo have a short half life? - CORRECT ANSWER-Alprazolam (Xanax) Lorazepam (Ativan) Which benzo have a long half life? - CORRECT ANSWER-Clonazepam (Klonopin) Diazepam (Valium) Medications used to treat anxiety works on which system? - CORRECT ANSWERdirectly or indirectly on GABA Benzodiazepines with short/long half life have More severe withdrawal and more rebound anxiety - CORRECT ANSWER-short Which non- benzo anxiolytics can be used to treat anxiety - CORRECT ANSWERBuspirone (Buspar) Tiagabine (Gabitril) Gabapentin(Neurontin) Propranolol (Inderal) Males greater than ______ yrs old are have a risk factor associated with suicide - CORRECT ANSWER-45 yr. old females greater than ______ yrs old are have a risk factor associated with suicide - CORRECT ANSWER-55 yr.s old Which Benzodiazepines or hypnotics used for insomnia is long acting and should be avoided in older adults - CORRECT ANSWER-Flurazepam (Dalmane) Pharmacological Management for insomnia include: - CORRECT ANSWER-§Melatonin §Benzodiazepines or hypnotics Nonbenzodiazepine hypnotics §Antidepressants Classification? Zaleplon (Sonata) •Zolpidem (Ambien) •Eszopiclone (Lunesta) - CORRECT ANSWER-Nonbenzodiazepine hypnotics used for insomnia •Classification? Flurazepam (Dalmane) •Temazepam (Restoril) •Triazolam (Halcion) - CORRECT ANSWER-Benzodiazepines or hypnotics used for insomnia Which antidepressant use to treat insomnia should be avoided in older adults? - CORRECT ANSWER-Doxepin (Sinequan) Classification? •Amitriptyline (Elavil), Doxepin (Sinequan) •Mirtazapine (Remeron), Desyrel (Trazadone) - CORRECT ANSWER-Antidepressants used for insomnia Pharmacological Management for Hypersomnolence/Narcolepsy/OSA - CORRECT ANSWER-Armodafinil (Nuvigil) Modafinil (Provigil) Amphetamines Second-line treatment for Hypersomnolence/Narcolepsy/OSA - CORRECT ANSWERTraditional psychostimulants- Amphetamines Benzodiazepines should NEVER be used in which sleep disorder? - CORRECT ANSWER-OSA Pharmacological Management for nightmare disorder? - CORRECT ANSWER-Prazosin (Minipress) Pharmacological Management for Restless Leg Syndrome - CORRECT ANSWERDopaminergic agonists Levodopa Benzodiazepines Antiepileptics Which Dopaminergic agonists are used to treat RLS? - CORRECT ANSWERPramipexole (Mirapex) Ropinirole (Requip) Which Nonbenzodiazepine hypnotics has an Ultra-short half-life makes this drug particularly useful for initial or middle phase insomnia? - CORRECT ANSWER-Zaleplon (Sonata) Which Nonbenzodiazepine hypnotics is a Melatonin receptor agonist? - CORRECT ANSWER-Rozerem What is the classic sign of ETOH withdrawal? - CORRECT ANSWER-tremulousness Pharmacological management for Tremulousness/agitation r/t alcohol intoxication and withdrawal - CORRECT ANSWER-chlordiazepoxide (Librium) Pharmacological management for Withdrawal seizures/delirium tremens r/t alcohol intoxication and withdrawal - CORRECT ANSWER-diazepam/Valium; lorazepam/Ativan What is the aversion treatment for ETOH abuse? - CORRECT ANSWER-Disulfiram (Antabuse) Detox agents for ETOH withdrawal? - CORRECT ANSWER-Ativan, Librium, Valium, oxazepam/ Serax SSRIs used in ETOH withdrawal? - CORRECT ANSWER-citalopram/ Celexa Anti-seizure medication used in ETOH withdrawal? - CORRECT ANSWERcarbamazepine/ Tegretol Anti-craving medications used in ETOH withdrawal? - CORRECT ANSWER-naltrexone/ Revia; acamprosate/ Campral Which Adrenergic medications -to lower blood pressure and pulse rate associated with ETOH withdrawal - CORRECT ANSWER-catapres/ Clonidine Dysphoria, lethargy, fatigue, anxiety, headache, muscle/stomach cramps, anxiety, tremulousness, nightmares, bradycardia are associated with ____________ withdrawal? - CORRECT ANSWER-Amphetamine ________ is a atypical antipsychotic injectable give IM monthly (39-324mg) with S/E that include Orthostatic Hypotension, Hypoprolactinemia, GI upset, dizziness and headache - CORRECT ANSWER-Invega Sustenna ________ is a atypical antipsychotic injectable given IM every 2 weeks (25-50mg) with S/E that include Hypotension, Galactorrhea, nausea and insomnia. - CORRECT ANSWER-Risperdal Consta