NR606 FINAL EXAM QUESTIONS AND ANSWERS

What ADHD symptoms are lack of attention to detail, careless mistakes, not listening, losing things diverting attention, forgetfulness - ANS-Selective attention What ADHD symptoms are poor problem solving, trouble completing a task, disorganization, trouble sustaining mental effort - ANS-Lack of sustained attention What ADHD symptoms are excessive talking, blurting things out, not waiting ones turn, interrupting - ANS-Impulsivity What ADHD symptoms are fidgeting, leaving ones seat, running, climbing, trouble playing quietly - ANS-Hyperactivity What ADHD symptom is common in childhood - ANS-hyperactivity Effects of maturation ADHD- young kids may experience - ANS-DD, bx less mature than peers Effects of maturation ADHD- teens - ANS-poor academic performance, trouble driving, trouble in social situations, risky sexual bx, SUD Effects of maturation ADHD- Adult - ANS-Issues with EF, attention, working memory, that cause issues with day to day fnx and performance at work and in relationships Dx criteria for ADHD How many s/s How long How many settings - ANS-Pattern of 6 s/s that interfere with fnx/development, 6 months or longer Present in 2 or more settings How to combat anorexia with stimulant use - ANS-Take medication with breakfast to decrease anorexia or associated weight loss When patients with ADHD have co morbid MH issues, what do you tx first - ANS-ADHD (stimulants first line) Treating ADHD s/s first will give a clearer picture of the comorbidities Work up for starting stimulant - ANS-ECG- if personal/first relative fmly hx Check bp/wgt/hgt What co morbidity should the PMHNP assess for before starting a stimulant - ANS-BPD, CNS stimulant can cause psychotic or manic s/s in pt's with no prior hx or may exacerbate bx disturbances and thought d/o in pt's with pre-exisiting psychosis Stimulants can exacerbate what comorbid dx - ANS-anxiety and SUD Increased irritability or insomnia can be tx with what - ANS-low dose non stim Abrupt withdrawal from stimulants can cause what - ANS-irritability and rebound s/s What to do with tx for ADHD if the pt is argumentative or oppositional - ANS-Combo therapy with stim and non stim Recommendations for parent training in behavior management for ADHD as a first-line Intervention - What do the parents learn - ANS-Recommended for child under 6 - Parents learn positive communication and reinforcement, structure, and discipline - Teaches kids to better control their own bx = improved fnx at school, home, and relationships What setting is ODD most common - ANS-Home setting with peers or adults that the pt knows What is ODD proceeds - ANS-Conduct disorder and ADHD, more common in boys anxiety and depression. Increased risk of SI Dx criteria for ODD - ANS--4 or more symptoms have occurred during an interaction with one or more individuals not including siblings within the last 6 months -Kids under 5 bx occur on most days for at least 6 months ODD s/s - ANS-Angry/irritable mood: Loss of temper, easily annoyed, anger and resentment Argumentative/Defiant: Argues with authority figures, actively defiant or refusing to follow rules or requests from authority figure, deliberately annoys others, blames others for their mistakes/misbx Vindictiveness: spiteful or vindictive at least twice within the past 6 months. Hallmark of ODD - ANS-Persistent angry irritable mood and defiant bx with vindictiveness Conduct disorder exhibits lack of - ANS-empathy, aggression and impulsivity Severe behaviors violating society norms or rights of others and involved aggression towards others, animals, theft, destruction of property occurring in multiple settings - ANS-Conduct disorder