MENTAL HEALTH FINAL EXAM ACTUAL EXAM TEST
BANK 300 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |
AGRADE
what are the MOST COMMON side effects of ANTIPSYCHOTIC? - ANSWER: -
anticholinergic effects
- sedation
- orthostatic hypotension
- weight gain
- reduction in seizure threshold especially with CLOZAPINE
- photosensitivity
- hyperglycemia and diabetes
- hormonal effects (gynecomastia, amenorrhea, low libido, retrograde ejaculation)
- EKG changes
- AGRANULOCYTOSIS especially with CLOZAPINE
- EXTRAPYRAMIDAL
- NEUROLEPTIC MALIGNANT SYNDROME
- increased risk of mortality in elderly patients with NCD-related psychosis
what is AGRANULOCYTOSIS side effect associated with CLOZAPINE? - ANSWER: - sore
throat
- fever
- malaise
what is NEUROLEPTIC MALIGNANT SYNDROME side effect of antipsychotic ? -
ANSWER: - fever
- muscle rigidity
- diaphoresis
- tachycardia
HOLD THE MEDICATION IF ANY OF THESE SIGNS ARE PRESENTED
HALOPERIDOL - ANSWER: - typical antipsychotic
- high risk for EPS
what are extrapyramidal side effects of antipsychotic ? - ANSWER: -
pseudoparkinsonism such as tremors, shuffling gait, drooling, rigidity; symptoms
appears 1 to 5 days occur in women, elderly and dehydrated patients
- akinesia; muscular weakness
- akathisia; continuous restlessness and fidgeting; more in women
- dystonia is involuntary muscular movements spasms of face, arms, legs, and neck;
more in men and younger than 25 year of age
- oculogyric crisis; uncontrolled rolling back of the eye; it can be mistaken for seizure
act; this side effect may appear as part of the syndrome described as dystonia
,DISTONIA AND OCULOGYRIC CRISIS SHOULD BE TREATED AS AN EMERGENCY
SITUATION because laryngospasm follows these symptoms and can be fatal
- tardive dyskinesia, bizarre facial and tongue movements, stiff neck, and difficulty
swallowing; it is permanent and irreversible
Extrapyramidal symptoms are treated with - ANSWER: Benztropine (cogentin)
Tardive dyskinesia symptoms are treated with - ANSWER: DISCONTINUE THE
MEDICATION
bipolar disorder pharmacology treatment - ANSWER: - lithium
- anticonvulsants such as valproic acid
lithium patient teaching - ANSWER: - take medication on a regular basis even when
feeling well; discontinuation can result in return of symptoms
- not drive or operate dangerous machinery until lithium levels are stabilized;
drowsiness and dizziness can occur
- consume enough SODIUM and WATER intake and avoid excessive use of beverages
containing caffein because it can promote increase urine output
- notify the physician if vomiting or diarrhea occurs; these symptoms; these
symptoms can result in sodium loss and an increased risk of lithium toxicity
- carry a card or other identification noting that he or she is taking lithium
- be aware of appropriate diet should weight gain become a problem; include
adequate sodium and other nutrients while decreasing number of calories
- HAVE SERUM LITHIUM LEVEL CHECKED EVERY 1 TO 2 MONTHS FOR MAINTENANCE
OR AS ADVISED BY PHYSICIAN
what are lithium toxicity symptoms? - ANSWER: - persistent nausea and vomiting
- severe diarrhea
- ataxia
- blurred vision
- tinnitus
- excessive output of urine
- increasing tremors or mental confusion
NOTIFY THE PHYSICIAN IF THESE OCCUR
anticonvulsant (VALPROIC ACID) patient teaching - ANSWER: - contraindicated in
patient with LIVER PROBLEMS
- Rare pancreatitis* (** most serious)
- Hyperamnonemia
- Associated with urea cycle disorders
- Teratogenicity - Neural tube defect (Spina bifida)
- Somnolence in the elderly
- Thrombocytopenia (MONITOR FOR BLEEDING)
- VALPROIC ACID IS USED FOR ACUTE MANIA OR BIPOLAR DISORDER
characters ADHD? - ANSWER: - inattention
, - hyperactivity
- impulsivity
ADHD - ANSWER: - Is difficult to diagnose before 4 years of age; BC CHILDREN ARE
HYPER AND ITS HARD TO TELL
- More common in boys
- Affects about 9.5% of school-age children
- Motor activity excessive, movements random/impulsive
- Children - highly distractible and unable to contain stimuli
- 60-70% - ADHD persists into young adulthood
- 25% will meet criteria for Antisocial Personality D/O as adult
assessment of ADHD - ANSWER: - difficulty in performing age-appropriate tasks
- highly distractible; THEY OFTEN SHIFT FROM ONE UNCOMPLETED ACTIVITY TO
ANOTHER
- extremely limited attentions span
- impulsive
- difficulty forming satisfactory interpersonal relationships
- demonstrates behaviors that inhibit acceptable social interaction
- disruptive and intrusive in group endeavors; THEY HAVE DIFFICULTY COMPLYING
WITH SOCIAL NORMS
- excessive levels of activity, restlessness, and fidgeting; DESCRIBED AS PERPETUAL
MOTION MACHINE; CONTINUOUSLY RUNNING, JUMPING, WIGGLING, OR
SQUIRMING
- accident prone; THEY EXPERIENCE A GREATER THAN AVERAGE NUMBER OF
ACCIDENTS THAY MAY LEAD TO PHYSICAL INJURY OR DESTRUCTION OF PROPERTY
- low frustration tolerance and temper outbursts
nursing diagnosis for ADHD - ANSWER: - risk for injury related to impulse accident
prone behavior and the inability to perceive self-harm
- impaired social interaction related to intrusive and immature behavior
- low self-esteem related to dysfunctional family system and negative feedback
- noncompliance with task expectations related to low frustration tolerance and
short attention span
care plan for ADHD
risk for injury related to impulsive and accident prone behavior and the inability to
perceive self-harm - ANSWER: - ensure patient has a safe environment/remove from
immediate area objects on which patient could injure self as a result of random,
hyperactive movements
- identify deliberate behaviors that put the child at risk for injury/ institute
consequences for repetition of this behavior/ behavior can be modified with aversive
reinforcement
- if there is a risk for injury associated with specific therapeutic activities, provide
adequate supervision and assistance, or limit patient's participation if adequate
supervision is not possible
BANK 300 QUESTIONS AND CORRECT DETAILED
ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |
AGRADE
what are the MOST COMMON side effects of ANTIPSYCHOTIC? - ANSWER: -
anticholinergic effects
- sedation
- orthostatic hypotension
- weight gain
- reduction in seizure threshold especially with CLOZAPINE
- photosensitivity
- hyperglycemia and diabetes
- hormonal effects (gynecomastia, amenorrhea, low libido, retrograde ejaculation)
- EKG changes
- AGRANULOCYTOSIS especially with CLOZAPINE
- EXTRAPYRAMIDAL
- NEUROLEPTIC MALIGNANT SYNDROME
- increased risk of mortality in elderly patients with NCD-related psychosis
what is AGRANULOCYTOSIS side effect associated with CLOZAPINE? - ANSWER: - sore
throat
- fever
- malaise
what is NEUROLEPTIC MALIGNANT SYNDROME side effect of antipsychotic ? -
ANSWER: - fever
- muscle rigidity
- diaphoresis
- tachycardia
HOLD THE MEDICATION IF ANY OF THESE SIGNS ARE PRESENTED
HALOPERIDOL - ANSWER: - typical antipsychotic
- high risk for EPS
what are extrapyramidal side effects of antipsychotic ? - ANSWER: -
pseudoparkinsonism such as tremors, shuffling gait, drooling, rigidity; symptoms
appears 1 to 5 days occur in women, elderly and dehydrated patients
- akinesia; muscular weakness
- akathisia; continuous restlessness and fidgeting; more in women
- dystonia is involuntary muscular movements spasms of face, arms, legs, and neck;
more in men and younger than 25 year of age
- oculogyric crisis; uncontrolled rolling back of the eye; it can be mistaken for seizure
act; this side effect may appear as part of the syndrome described as dystonia
,DISTONIA AND OCULOGYRIC CRISIS SHOULD BE TREATED AS AN EMERGENCY
SITUATION because laryngospasm follows these symptoms and can be fatal
- tardive dyskinesia, bizarre facial and tongue movements, stiff neck, and difficulty
swallowing; it is permanent and irreversible
Extrapyramidal symptoms are treated with - ANSWER: Benztropine (cogentin)
Tardive dyskinesia symptoms are treated with - ANSWER: DISCONTINUE THE
MEDICATION
bipolar disorder pharmacology treatment - ANSWER: - lithium
- anticonvulsants such as valproic acid
lithium patient teaching - ANSWER: - take medication on a regular basis even when
feeling well; discontinuation can result in return of symptoms
- not drive or operate dangerous machinery until lithium levels are stabilized;
drowsiness and dizziness can occur
- consume enough SODIUM and WATER intake and avoid excessive use of beverages
containing caffein because it can promote increase urine output
- notify the physician if vomiting or diarrhea occurs; these symptoms; these
symptoms can result in sodium loss and an increased risk of lithium toxicity
- carry a card or other identification noting that he or she is taking lithium
- be aware of appropriate diet should weight gain become a problem; include
adequate sodium and other nutrients while decreasing number of calories
- HAVE SERUM LITHIUM LEVEL CHECKED EVERY 1 TO 2 MONTHS FOR MAINTENANCE
OR AS ADVISED BY PHYSICIAN
what are lithium toxicity symptoms? - ANSWER: - persistent nausea and vomiting
- severe diarrhea
- ataxia
- blurred vision
- tinnitus
- excessive output of urine
- increasing tremors or mental confusion
NOTIFY THE PHYSICIAN IF THESE OCCUR
anticonvulsant (VALPROIC ACID) patient teaching - ANSWER: - contraindicated in
patient with LIVER PROBLEMS
- Rare pancreatitis* (** most serious)
- Hyperamnonemia
- Associated with urea cycle disorders
- Teratogenicity - Neural tube defect (Spina bifida)
- Somnolence in the elderly
- Thrombocytopenia (MONITOR FOR BLEEDING)
- VALPROIC ACID IS USED FOR ACUTE MANIA OR BIPOLAR DISORDER
characters ADHD? - ANSWER: - inattention
, - hyperactivity
- impulsivity
ADHD - ANSWER: - Is difficult to diagnose before 4 years of age; BC CHILDREN ARE
HYPER AND ITS HARD TO TELL
- More common in boys
- Affects about 9.5% of school-age children
- Motor activity excessive, movements random/impulsive
- Children - highly distractible and unable to contain stimuli
- 60-70% - ADHD persists into young adulthood
- 25% will meet criteria for Antisocial Personality D/O as adult
assessment of ADHD - ANSWER: - difficulty in performing age-appropriate tasks
- highly distractible; THEY OFTEN SHIFT FROM ONE UNCOMPLETED ACTIVITY TO
ANOTHER
- extremely limited attentions span
- impulsive
- difficulty forming satisfactory interpersonal relationships
- demonstrates behaviors that inhibit acceptable social interaction
- disruptive and intrusive in group endeavors; THEY HAVE DIFFICULTY COMPLYING
WITH SOCIAL NORMS
- excessive levels of activity, restlessness, and fidgeting; DESCRIBED AS PERPETUAL
MOTION MACHINE; CONTINUOUSLY RUNNING, JUMPING, WIGGLING, OR
SQUIRMING
- accident prone; THEY EXPERIENCE A GREATER THAN AVERAGE NUMBER OF
ACCIDENTS THAY MAY LEAD TO PHYSICAL INJURY OR DESTRUCTION OF PROPERTY
- low frustration tolerance and temper outbursts
nursing diagnosis for ADHD - ANSWER: - risk for injury related to impulse accident
prone behavior and the inability to perceive self-harm
- impaired social interaction related to intrusive and immature behavior
- low self-esteem related to dysfunctional family system and negative feedback
- noncompliance with task expectations related to low frustration tolerance and
short attention span
care plan for ADHD
risk for injury related to impulsive and accident prone behavior and the inability to
perceive self-harm - ANSWER: - ensure patient has a safe environment/remove from
immediate area objects on which patient could injure self as a result of random,
hyperactive movements
- identify deliberate behaviors that put the child at risk for injury/ institute
consequences for repetition of this behavior/ behavior can be modified with aversive
reinforcement
- if there is a risk for injury associated with specific therapeutic activities, provide
adequate supervision and assistance, or limit patient's participation if adequate
supervision is not possible
