Exam 1

Question 1

NT for Alzeimers

Answer 1

ACH

Question 2

NT for Parkinsons

Answer 2

Dopamine

Question 3

PRIMARY NT for Depression

Answer 3

Serotonin

Question 4

NTs for Anixety

Answer 4

Serotonin
Gaba
NorEpi

Question 5

NTs for Schizophrenia

Answer 5

too much dopamine and glutmate

Question 6

What can happen if you have too little dopamine for antipsychotic drugs?

Answer 6

meds result in loss of dopamine everywhere, tardive dyskinesia

Question 7

Drugs for psychotic disorders work on what NT?

Answer 7

D2 (dopamine)

Question 8

IM olanzapine should NOT be used with ______ together and need to be given at least 1 hour apart owing to FDA black box warning, from multiple case reports of cardiopulmonary arrest.

Answer 8

lorazepam

Question 9

3 meds for emergencies

Answer 9

Haloperidol (Haldol)
Ziprasidone (Geodon)
Olanzapine (Zyprexa)

Question 10

1st vs 2nd gen antipsychotics- movement disorder?

Answer 10

1st = higher rate EPS/ Tardive (d2)
2nd = Lower Rate of EPS (serotonin +d2)

Question 11

What special testing/evaluation for we do related to movement for antipsychotic drugs?

Answer 11

AIMS testing

Question 12

2nd generation antipsychotic has what kind of side effects?

Answer 12

metabolic side effects

Educate/monitor: BMI, Diabetes, weight gain, diet, exercise

Question 13

Clozapine associated with risk for _______

and requires management within a lab monitoring program

Answer 13

agranulocytosis

Question 14

What drugs causes neuroleptic malignant syndrome?

Answer 14

All antipsychotic drugs can cause NMS.

*more common in older meds

Question 15

What can cause neuroleptic malignant syndrome? (aka we need to avoid these things to prevent it from happening)

Answer 15

Take a high doses of medication
Quickly increased doses
IM medications
Switch antipsychotic medications

Question 16

s/s ofNeuroleptic Malignant Syndrome

Answer 16

High fever(102 to 104 F)
Increased respirations
Muscle stiffness
Sweating
Anxiety/changes in mental state
Tachycardia
Arrhythmia 
Alterations on blood pressure 

- Serious symptoms:
Kidney failure
Heartand lung failure
Hypoxia 
Aspiration Pneumonia
Acidosis

Question 17

3 NT for depression

Answer 17

Serotonin
Dopamine
Nor Epi

Question 18

SSRI vs SNRI common side effects

Answer 18

SSRI: 
Nausea 
Insomnia
Anxiety
Tremors
Sexual dysfunction

SNRI:
Nausea
Tired
Fatigue
Dry mouth

Question 19

What causes serotonin syndrome?

Answer 19

too much serotonin

Question 20

s/s of serotonin syndrome?

Answer 20

Mental status changes, autonomic hyperactivity, neuromuscular abnormalities (tremors, rigidity), hypothermia , dry mouth

Question 21

how do we treat serotonin syndrome?

Answer 21

Stop the medication, provide supportive therapy, treat symptoms

Question 22

therapeutic lithium levels ? toxicity?

Answer 22

therapeutic: 0.6-1.2
toxic: >1.5

Question 23

Benzo’s vs antihistmine for treating depression- side effects?

Answer 23

Benzodiazepines (with caution) —> cognitive disinhibition, sedation, overdose can lead to CNS depression

Antihistamines (e.g. hydroxyzine) - sedation, not CNS depressant though

Question 24

how does one stop taking benzos for anxiety?

Answer 24

taper, SSRI, NOT cold turkey! –> withdrawal

Question 25

ADHD NT

Answer 25

Dopamine and NorEPi

Question 26

2 main Side effects of ADHD meds?

Answer 26

**Anorexia -**Restriction of affect (“zombie-look”)

Question 27

Are ADHD meds controlled substance?

Answer 27

schedule II

Question 28

ways to show we are engaged in active listening?

Answer 28

posture- lean forward, listen intently, don't cross arms, face patient square on

Question 29

______ interviewing identifies a motivation that helps someone get to and end goal

Answer 29

motivational

Question 30

resiliency means we facilitate not

Answer 30

do everything for the person

Question 31

Can a nurse do CBT with apatient?

Answer 31

NO! must have training nurses can use therapeutic elements of CBT but not engage in therapy with patient

Question 32

best model for mental health care?

Answer 32

integrated

Question 33

primary vs secondary vs tertiary intervention

Answer 33

◦ Primary intervention, education, prevention ◦ secondary intervention, screening, have some concerns ◦ tertiary intervention, ongoing management

Question 34

criteria for involuntarily committing someone?

Answer 34

◦ cant take care of yourself or risk to yourself or others **dependent on state and hospital policies

Question 35

what happens to patient rights when they are IVCed?

Answer 35

do not lose rights! still need to get consent, possibly through the court system

Question 36

What kind of environment are nurses trying to create for patients?

Answer 36

safe, recovery oriented

Question 37

what is focus on during a processing group?

Answer 37

acceptance, recovery environment, empathy, concern Example: ◦ be careful not to laugh at front desk someone could be very sad or be on edge about this - make sure everyone has time to talk -do not engage in trauma experiences

Question 38

what do we do when someone is having a delusion? what are we assessing for?

Answer 38

◦ don't confront delusion but assess for safety - is voice telling you to hurt yourself or others? ‣ might have need for distraction or active listening

Question 39

best way to prevent drama and trauma for patients?

Answer 39

relaxation

Question 40

therapy vs therapeutic relationship?

Answer 40

therapeutic relationship= nurse can use respect and think of of person as a whole to build therapeutic relationship. Therapy is a structured occurrence

Question 41

considerations for restraints?

Answer 41

skin, food, hydration, toileting reassess!

Question 42

a tool to help maintain boundaries

Answer 42

put the focus back on patient- "lets talk about you and your needs."

Question 43

how do we provide culturally competent care?

Answer 43

◦ being knowledgeable, give patient choices/options, check with person to meet them where they are at

Question 44

stigma is a ____ to mental health

Answer 44

barrier