Behavioral and Ethics

Question 1

A patient with dementia who develops delirium

Answer 1

Superimposed on dementia

Question 2

What components are needed for someone to have delirium?

Answer 2

1. Acute onset of mental status changes or a fluctuating course
2. Inattention
3. Disorganized thinking OR altered LOC

Question 3

How is depression diagnosed?

Answer 3

1. Depressed mood (feeling sad or low)
2. Loss of interest or pleasure in nearly all activities
   PLUS 4 additional s/s from the following:
   -Significant loss of appetite or weight loss or gain
   -Insomnia or hypersomnie
   -Psychomotor agitation or retardation
   -Fatigue or loss of energy
   -Feelings or worthlessness or guilt
   -Impaired thinking or concentration, indecisiveness
   -Suicidal thoughts/thoughts of death

Question 4

Adverse effects of tricyclic anti-depressents

Answer 4

Highly lethal in overdose (tachycardia, HoTN, fatal arrhythmias), vertigo, dry mouth, urinary retention, constipation, orthostatic hypotension, prolonged QT

Question 5

Common side effects of SSRIs

Answer 5

Headache, abdominal pain, nausea, diarrhea, sleep changes, jitteriness, or agitation.

Question 6

What medications can SSRIs inhibit metabolism?

Answer 6

Antiarrhythmics, benzo, warfarin, tricyclics, neuroleptics

Question 7

What is glucose and thiamine given during alcohol withdrawal?

Answer 7

To prevent Wernicke’s encephalopathy and Korsakoff syndrome

Question 8

Long-acting benzo often given for benzo withdrawal.

Answer 8

Chlordiazepoxide (Librium)

Question 9

What are the common signs of opiate withdrawal?

Answer 9

Insomnia, restlessness, yawning, lacrimation, rhinorrhea, diaphoresis

Question 10

The ability to synthesize and interpret multiple pieces of data, critical thinking.

Answer 10

Clinical judgement

Question 11

Works on behalf of others and able to identify and help resolve ethical issues.

Answer 11

Advocacy and moral reasoning

Question 12

Creates a compassionate, supportive, and therapeutic environment for patients/family, prevents unnecessary suffering.
-Anticipates needs

Answer 12

Caring practices

Question 13

Works with others in a manner that promotes/encourages each person’s contributions toward achieving optimal realistic goals.

Answer 13

Collaboration

Question 14

Manages environmental and system resources to meet patient/family needs, considers factors outside the unit, considered the hospital as a whole, the community

Answer 14

Systems Thinking

Question 15

Recognize, appreciate, and incorporate differences in the plan of care. Differences include age, gender, race, cultural differences, ethnicity, lifestyle, educational level, socioeconomic status, values, beliefs.

Answer 15

Response to diversity

Question 16

Promotes learning of patients, family, nursing staff, and members of healthcare team, both formally and informally.

Answer 16

Facilitation of learning

Question 17

Questions and evaluates practice, maintains familiarity with professional literature, shares best practices.

Answer 17

Clinical Inquiry

Question 18

The patient’s ability to “bounce back”

Answer 18

Resiliency

Question 19

Susceptibility to actual or potential stressors

Answer 19

Vulnerability

Question 20

Ability to maintain equilibrium (not only physiological)

Answer 20

Stability

Question 21

Family interaction, environment

Answer 21

Complexity

Question 22

The degree to which the outcome is expected, events expected.

Answer 22

Predictability