All notes up to midterm Flashcards
schizotypal personality disorder
patterns of social isolation and detachment from the environment
homelessness with mental illness is often associated with:
decreased availability of community resources
A patient on a 24-hour emergency psychiatric hold is believed to need further treatment. In order to keep the patient in the facility, what legal action is required?
Filing of a probable cause statement
What legally qualifies a person to be placed in conservatorship?
if person is disabled due to mental illness
What are the criteria needed to plead guilty by reason of insanity?
- inability to understand charges filed against him.
- no mental capacity to advise an attorney
- no mental ability to understand legal process of the charges
Conservator
person who makes decision for the mentally disabled
rights of patients who are involuntarily admitted.
- right to participate in plan of care
- right to refuse any treatment
- right to receive explanation of their mental condition
The Tarasoff court case involves which nursing duty?
to protect others from harm
Which term describes the basic functional unit of the nervous system?
Neuron
Synapse
Receptor
Neurotransmitter
Neuron
Which brain structure is responsible for basic vital life functions?
Cerebrum
Brainstem
Cerebellum
Hippocampus
Brainstem
Which brain structure responds to stimuli, conducts electrical
impulses, and releases neurotransmitters?
Neuron
Synapse
Cerebellum
Receptor
Neuron
First-generation antipsychotics have which mechanism of action
and therapeutic effect?
Increase levels of dopamine to decrease positive symptoms in
schizophrenia
Decrease levels of dopamine to decrease positive symptoms in
schizophrenia
Increase levels of dopamine to increase positive symptoms in
schizophrenia
Decrease levels of dopamine to increase positive symptoms in
schizophrenia
Decrease levels of dopamine to decrease positive symptoms in
schizophrenia
Which neurotransmitter is selectively blocked by the
antidepressant effect of citalopram?
Gamma-aminobutyric acid (GABA)
Serotonin
Glutamate
Dopamine
Serotonin
Which imaging study would show the health care provider the
parts of the brain that are particularly active in a patient suspected
of having obsessive compulsive disorder?
Computed tomography (CT)
Positron emission tomography (PET)
Ventriculography
Electroencephalography (EEG)
Positron emission tomography (PET)
Which effect would a psychotropic drug that enhances gamma-
aminobutyric (GABA) receptor activity have on a patient?
Sedation
Pain relief
Stimulation of gastric secretion
Improvement of cognitive performance
Sedation
Which medication when administered calls for careful nursing
assessment of fluid and electrolyte balance?
Fluvoxamine
Clozapine
Lamotrigine
Lithium
Lithium
Which event would be responsible for a patient’s symptoms of
profound depression based on the current understanding of
neurotransmitters?
An increase in dopamine level
A decrease in serotonin level
An increase in norepinephrine level
A decrease in acetylcholine level
A decrease in serotonin level
Side effects that include dry mouth, constipation, and blurred
vision for a patient prescribed a psychotropic drug are most likely
caused by blocking of which receptors?
Alpha (a1)
Acetylcholine (ACh)
Serotonin (5-HT2)
Histamine (H1)
Acetylcholine
Which is a possible cause of depression?
Decreased norepinephrine & serotonin
Which priority teaching would the nurse include for a patient
who is beginning therapy with a monoamine oxidase inhibitor
(MAOI) medication? Select all that apply.
Take the medication at bedtime.
Monitor blood pressure.
Report double vision.
Reduce tyramine intake.
Do not take over-the-counter medication without provider approval.
Monitor blood pressure.
Reduce tyramine intake
Do not take over-the-counter medication without provider approval.
Which education would the nurse prioritize for a patient
beginning clozapine therapy?
Weekly liver function tests
Daily prothrombin time and international normalized ratio
Monthly creatinine levels
Regular absolute neutrophil count
Regular absolute neutrophil count
which antidepressant medication used for anxiety has low risk for sedation?
Buspirone
Which condition is likely the cause of fatigue in a nurse who is
otherwise healthy?
Secondary stress trauma
Acute stress disorder
Posttraumatic stress disorder
Traumatic brain injury
Secondary stress trauma
Which agency has overall responsibility to coordinate responses to
disasters in the United States?
World Health Organization (WHO)
Department of Homeland Security (DHS)
Federal Emergency Management Agency (FEMA)
National Incident Management System (NIMS)
Department of Homeland Security (DHS)
Which coping mechanism is commonly adopted during a crisis?
Engaging in other physical activity
Setting realistic goals
Avoiding talking with others
Avoiding eating
Engaging in other physical activity
developmental crisis
A developmental crisis occurs during significant life transitions or milestones, such as becoming a parent.
External crisis
External crisis refers to crises triggered by events outside the individual, such as financial hardship or loss.
Situational crisis
Situational crisis involves unexpected, often traumatic events, like losing a job or experiencing illness.
Adventitious crisis
Adventitious crisis includes crises resulting from rare, unplanned events like natural disasters or violence.
Which class of medications has been shown to be helpful in
treating somatic symptom disorders? Select all that apply.
Anxiolytics
Antipsychotics
Antidepressants
Mood stabilizers
Benzodiazepines
Anxiolytics
Antidepressants
Benzodiazepines
Which instruction would the nurse include on the diet chart for a
patient experiencing mania and is receiving lithium therapy?
Reduce sodium intake.
Take lithium with meals.
Take lithium on an empty stomach.
Avoid taking lithium before going to bed.
Take lithium with meals.
Provides notice of approaching emergencies worldwide
FEMA
Focuses on terrorist attacks
CCTA
Provides funds for mental health needs during disasters
NIMH
Provides food and shelter during disasters
American Red Cross
Steps of crisis intervention include the following:
1.Assess and gather data from a variety of sources.
2.Develop a list of problems focusing on immediate needs.
3.Plan interventions for immediate problems.
4.Implement interventions to alleviate anxiety and meet immediate needs.
5.Evaluate anxiety levels and effectiveness of immediate interventions.
6.Develop an individual plan of care for long-term needs.
Decreased amounts of serotonin have long been associated with…
depression, mood swings, suicidal thoughts/behaviors, and anxiety.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (SSRIs) increase the amount of serotonin in the brain, thus minimizing (or resolving) depression.
Serotonin synthesis during stress.
Serotonin is also associated with stress and an individual’s response to stress.
Serotonin synthesis is heightened during stress. In an individual experiencing depression, the brain’s ability to effectively use the serotonin to mitigate stress is reduced.
example of psychological stress?
Self-doubt and apprehension
What is the purpose of corticosteroid release during a stress response?
To increase muscle strength and stamina needed to withstand the stress symptoms
Decrease in GABA causes
anxiety
Decrease in norepinephrine causes
depression
Increase in dopamine causes
schizophrenia
Decrease in acetylcholine causes
alzheimer’s
Memory loss associated with CNS trauma is due to injury of which brain lobe?
Temporal lobe
Which medications may increase the risk of suicidal ideation and necessitate close monitoring of a patient?
Selective serotonin reuptake inhibitors and anticonvulsant medications
Which category of medication presents a significant risk for older adult patients with dementia?
Antipsychotics
Which category of medication presents a significant safety risk for children and adolescents?
Antidepressants
selective serotonin reuptake inhibitor (SSRI)
Paroxetine
Electroconvulsive therapy
is used for patients with major depressive disorder include psychosis and repeated threats to murder
Clang associations
communication of patient experiencing acute mania
Lithium and salt intake
patients on lithium need to have consistent salt intake. Sudden changes in sodium consumption can affect lithium levels in the blood, potentially leading to toxicity or reduced effectiveness of the medication
normal lithium level
0.6 - 1.8
Which medication would the nurse anticipate the health care
provider will prescribe for a patient diagnosed with bipolar
disorder and a history of alcohol use disorder?
Lithium
Lamotrigine
Valproic acid
Carbamazepine
Valproic acid
Which symptom is commonly seen in patients diagnosed with
bipolar II disorder and experiencing hypomania?
Hallucinations
Disturbed thoughts
Impaired social functioning
Hyperactivity and high energy
Hyperactivity and high energy
Which term describes the behavior of a patient admitted with
acute mania who tells staff and patients that they are on a secret
mission for the president to monitor citizens for terrorist activity?
Unpredictability
Rapid cycling
Grandiosity
Flight of ideas
Grandiosity
Which side effect of antipsychotic medication therapy is generally
not reversible?
Anticholinergic effects
Pseudoparkinsonism
Dystonic reaction
Tardive dyskinesia
Tardive dyskinesia.
Tardive dyskinesia may persist after discontinuation of antipsych meds and is characterized by involuntary, repetitive movements, typically affecting the face, mouth, and tongue. It can also involve the trunk and extremities
Grandiose Delusions
Individuals with grandiose delusions believe they possess exceptional talents, wealth, or importance
Somatic Delusions
These involve false beliefs about one’s body or health. People may believe they have a serious illness or that parts of their body are missing or malfunctioning
Erotomanic Delusions
This type involves the belief that someone, often of higher social status, is in love with the individua
Which population is most at risk for schizophrenia spectrum
disorders?
Middle-age adults
Older adults
Young adults
Toddlers
Young adults
psychosis
inability to recognize reality
Schizoaffective disorder
uninterrupted period of illness during which there is a major depressive, manic, or mixed episode, along with symptoms of schizophrenia
associative looseness
is nonlogical thinking
Trihexyphenidyl
drug administered with chlorpromazine to reduce extrapyramidal side effects.
Which nongenetic factor has been identified as a possible
contributing cause of schizophrenia?
Viral infection.
nutritional factors
birth injuries
Bipolar disorder
Bipolar disorder (hereditary), formerly known as manic-depression is characterized by shifts in mood, energy, and ability to function, and is the most expensive mental disorder to treat.
Manic Episode
A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased goal-directed activity or energy, lasting at least 1 week and present most of the day, nearly every day
Which are signs of suicidal ideation?
Increased risk-taking
Giving away belongings
Influx of substance abuse
Hallucinations
Sensations that are not really present
Delusions
Distorted beliefs
Manic phase lasts at least one week
Bipolar 1
Hypomanic episode lasts at least four days
Bipolar 2
Hypomania alternates with minor depressive episodes over at least 2-year period
Cyclothymic disorder
Three anticonvulsant drugs have been shown to be effective in treating mood disorders, including bipolar disorder.
valproate, carbamazepine, and lamotrigine.
Antianxiety Drugs
Clonazapam and lorazepam have been shown to be effective in patients experiencing acute mania
Atypical Antipsychotics
Olanzapine or risperdone have sedative effects during the early phase of treatment for bipolar, and tend to have mood-stabilizing properties
Electroconvulsive Therapy
Electroconvulsive therapy (ECT) is sometimes used to reduce severe manic behavior. It can be especially useful in decreasing severe depression, catatonia, paranoid-destructive symptoms, and treatment-resistant depression
fine hand tremors w/ Lithium use.
is normal.
A normal side effect of lithium carbonate is fine hand tremors.
s/sx of Lithium toxicity
diarrhea.
confusion.
blurred vision.
goals appropriate for bipolar disorder
Adherence to the medication regime.
Stable relationships with family, occupation, and social connections.
Improved mood.
Improved coping skills.
Reduced stress
Which tool is useful in assessing the patient diagnosed with bipolar disorder?
Mood Disorder Questionnaire
treatment of lithium toxicity
Gastric lavage.
Mannitol.
Urea.
Aminophylline.
a treatment that will act quickly to treat severe manic behavior
Electroconvulsive therapy (ECT) is sometimes used to reduce severe manic behavior. It can be especially useful in decreasing severe depression, catatonia, paranoid-destructive symptoms, and treatment-resistant depression.
What are the most common side effects of SSRIs?
Dry mouth and blurred near vision
SSRIs have anticholinergic properties that can result in dry mouth and blurred vision.
Which medical procedures may be used to treat patients with depressive orders?
Deep brain stimulation (DBS).
Electroconvulsive therapy (ECT).
Transcranial magnetic stimulation (TMS).
Which is a depression assessment tool?
Beck Depression Inventory
The Beck Depression Inventory is a depression assessment tool that helps determine behavioral changes over time.
tricyclic antidepressant (TCA)
The patient may experience constipation when taking a TCA due to its anticholinergic effects
what is the medication used for treatment-resistant schizophrenia?
Clozapine
teaching and instruction for patients taking antipsychotic medications:
Avoid immersion in hot water to avoid hypotensive effect
When outdoors, use sunscreen and wear protective clothing
To avoid heat stroke/exhaustion, keep hydrated
Avoid abrupt discontinuation of medication due to possible side effects
Report any unusual changes (sore throat, malaise, fever, or bleeding)
Which medications are more effective in treating the negative symptoms of schizophrenia?
Clozapine
Olanzapine
medication for somatic symptom disorder?
Anxiolytics
Displacement
putting anger on his or her diagnosis onto the spouse
type of anxiety associated with delusional thinking
Panic
