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Practice of Nursing IV > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

What are the four domains of personality?

A

Cognition, affectivity, interpersonal behavior, impulse control

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2
Q

When do personality disorders usually manifest?

A

Adolescence and adulthood

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3
Q

What three personality disorders are women at risk for?

A

Paranoid, avoidant, dependent personality disorders.

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4
Q

Men are at higher risk for what type of personality disorder?

A

Antisocial

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5
Q

When threatened, people with personality disorders do what instead of trying to change their behavior?

A

They attempt to manipulate their environment

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6
Q

Which theory of personality places importance on nurturing from caregivers in order to foster positive personality traits ?

A

Psychoanalytic theory

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7
Q

Which theory of personality places importance on genes as well as environmental factors in the development of personality?

A

Biological theory of personality

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8
Q

Which theory of personality believes that personality develops thru thought and interaction with the environment?

A

Social learning and cognitive perspective

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9
Q

According to DSM criteria, symptoms must manifest in how many of the four areas of personality?

A

In two or more

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10
Q

Cluster A disorders are described as what?

A

“Odd or eccentric”

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11
Q

What three personality disorders fall into Cluster A?

A

Paranoid, schizoid, and schizotypal

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12
Q

Cluster B disorders are described as what?

A

Dramatic, emotional or erratic

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13
Q

What four personality disorders fall into Cluster B?

A

Histrionic, borderline, antisocial and narcissistic

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14
Q

Cluster C personality disorders are described as what?

A

Anxious or fearful

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15
Q

What three personality disorders are included in Cluster C?

A

Avoidant, dependent and obsessive-compulsive

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16
Q

Which personality disorder involves a suspiciousness and distrust of others’ motives?

A

Paranoid personality disorder

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17
Q

Schizoid personalities are characterized primarily by what?

A

An inability to form close personal relationships

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18
Q

Thought patterns are disturbed in schizoid or schizotypal personality disorder?

A

In schizotypal personality disorder

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19
Q

Which is more serious, schizoid or schizotypal personality disorder?

A

Schizotypal personality disorder

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20
Q

Can a schizotypal personality exhibit psychotic breaks?

A

Yes, when under stress

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21
Q

What personality disorder is irresponsible and aggressive, yet superficially charming?

A

Antisocial

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22
Q

Which personality disorders shows a disregard for the rights of others as one of its main traits?

A

Antisocial

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23
Q

Ppl with antisocial PD usually have what kind of temperament as a child?

A

Aggressive

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24
Q

What might the parents of someone with antisocial PD be like?

A

May not discipline or otherwise influence their child, and may be sociopaths or alcoholics

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25
Q

Which personality disorder is characterized by intense and chaotic relationships, as well as extreme attitudes regarding others?

A

Borderline personality

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26
Q

What is the most common personality disorder?

A

Borderline personality disorder

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27
Q

How long do episodes of emotional instability usually last in borderline PD?

A

A few hours to a full day

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28
Q

Which PD always seems to be in a state of crisis?

A

Borderline

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29
Q

Which PD is characterized by attention-seeking, dependent on approval of others, and easily influenced?

A

Histrionic PD

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30
Q

Which PD is grandiose and self-absorbed, yet has a fragile self esteem?

A

Narcissistic PD

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31
Q

In narcissistic PD, criticism may result in what?

A

Rage and humiliation

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32
Q

What is the general mood of someone with narcissistic PD?

A

Optimistic and carefree

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33
Q

Which PD is characterized by being shy, withdrawn, and afraid to form relationships for fear or being rejected?

A

Avoidant personality disorder

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34
Q

What is the difference between social phobia and avoidant PD?

A

Avoidant PD involves avoiding all social situations, while social phobia involves avoiding just select situations

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35
Q

Which personality disorder is characterized by having an intense need to be cared for, and staying in abusive relationships?

A

Dependent PD

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36
Q

Which PD has a persistent negative attitude and reacts poorly to the normal demands of social and occupational functioning?

A

Passive-aggressive PD

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37
Q

What are two nursing interventions for Cluster A PD?

A

Solve the immediate crisis and provide social skills training

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38
Q

For what cluster of PDs is it especially important to try and prevent suicide and self-harm?

A

Cluster B

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39
Q

What are three nursing interventions for Cluster C PDs?

A

Enhance social functioning, cognitive restructuring, and assertiveness training

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40
Q

What happens to blood clotting when someone is anxious?

A

It increases

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41
Q

When is an anxiety disorder diagnosed?

A

When someone experiences persistent anxiety that cannot be dismissed, and when anxiety interferes with ADLs.

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42
Q

What is the difference between anxiety and fear?

A

Anxiety is an emotional process, and fear is a cognitive process

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43
Q

At what level does anxiety begin to dull perceptions?

A

Moderate

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44
Q

At what level of anxiety is one unable to differentiate real from imagined stimuli?

A

Panic

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45
Q

What is the most common type of psychiatric disorder?

A

Anxiety disorders

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46
Q

The body’s inability to regulate what two neurotransmitters is likely to lead to anxiety disorders?

A

Serotonin and GABA

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47
Q

How long can a panic attack last?

A

5-20 mins (in some cases up to one hour)

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48
Q

What is generalized anxiety disorder characterized by?

A

Chronic, unrealistic worry for at least 6 months

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49
Q

What is diagnosed when phobias accompany panic attacks?

A

Panic disorder

50
Q

In obsessive-compulsive disorder, the pt spends how much time per day on their compulsions?

A

At least one hour

51
Q

Acute stress disorder occurs in what time frame after exposure to a trauma?

A

In the first month

52
Q

Acute stress disorder resolves in how many days?

A

2-28 days

53
Q

How long must symptoms continue for PTSD to be diagnosed?

A

Greater than one month

54
Q

After how long is PTSD considered chronic?

A

After 3 months

55
Q

What should be kept in mind when using benzodiazepines to treat anxiety disorders?

A

They should not be discontinued abruptly

56
Q

Binge eating disorder is diagnosed when compulsive overeating occurs how often and for how long?

A

Twice a week or more for longer than 6 months

57
Q

OCD, bulimia and anorexia are associated with excessive levels of which hormone?

A

Vasopressin

58
Q

In anorexia, the pt will weigh at least what % less than their expected ideal body weight?

A

15%

59
Q

In anorexia/bulimia, the pt should maintain at least what % of their expected body weight as a goal?

A

At least 80%

60
Q

When being treated for anorexia/bulimia, it is very important that the pt feel what?

A

That they are in control of their treatment

61
Q

Morbid obesity is a BMI of above what?

A

Above 40

62
Q

Overweight is considered a BMI of what?

A

25-30

63
Q

What differentiates substance abuse from substance dependence?

A

Substance dependence occurs when there is tolerance to the drug and withdrawal when someone stops using

64
Q

A healthy liver can metabolize how much alcohol per hour?

A

About 1 oz

65
Q

A BAL of what will result in death?

A

0.5

66
Q

A BAL of what will result in coma?

A

0.4

67
Q

Which condition, related to alcohol dependence, is marked by an inability to learn new info, unsteady gait, and muscle weakness?

A

Wernicke’s encephalopathy

68
Q

Which condition, related to alcohol dependence, is marked by gait disturbance, confabulation, disorientation?

A

Korsakoff’s psychosis

69
Q

Wernicke’s encephalopathy and Korsakoff’s psychosis are both related to deficiencies of what?

A

Thyamine

70
Q

When do early signs of alcohol withdrawal begin?

A

A few hours after decreasing consumption

71
Q

How soon after stopping alcohol consumption do withdrawal symptoms peak?

A

Within 24 to 48 hours

72
Q

How serious is alcohol withdrawal delirium?

A

Very serious – it is a medical emergency that can result in death

73
Q

How long after stopping alcohol consumption does withdrawal delirium start and how long does it last for?

A

Peaks 2-3 days after stopping and lasts for 2-3 days

74
Q

A pt who has stopped drinking alcohol 2 days ago exhibits tachycardia, diaphoresis, hallucinations and a fever of 103F. The nurse suspects what?

A

Alcohol withdrawal delirium

75
Q

A pt exhibits dry mouth/nose, darting pupils and hyperactivity. The nurse suspects what?

A

Central nervous system stimulant use (crack, cocaine, or amphetamines)

76
Q

How long does a crack high last?

A

5-7 mins

77
Q

What two main effects on the body does crack/cocaine have?

A

Anesthetic and stimulant

78
Q

Rave drugs such as MDMA may lead to failure of what two organs?

A

Kidneys and heart

79
Q

What kind of amnesia do date rape drugs produce?

A

Anterograde amnesia

80
Q

Date rape drugs produce relaxation of what type of muscles?

A

Voluntary muscles

81
Q

What should you do if a nursing coworker is under the influence of drugs on the job?

A

Document and report to the nursing manager

82
Q

How does naltrexone work for alcohol abuse?

A

It works by blocking opiate receptors, which reduces alcohol cravings

83
Q

How does disulfiram work for alcohol abuse?

A

It causes unpleasant side effects when combined with alcohol

84
Q

What is the only med approved to treat pregnant addicts?

A

Methadone

85
Q

Before 1950, what were the two main classes of drugs used to treat pysch problems?

A

Sedatives and amphetamines

86
Q

In general, how do antidepressants work?

A

By blocking the reuptake of neurotransmitters

87
Q

How do antipsychotics work, in general?

A

Block dopamine and other receptors

88
Q

In general, how do benzodiazepines work?

A

By facilitating the transmission of GABA

89
Q

How long do antidepressants take to work?

A

Initial relief may be felt in 7 days, but complete relief could take up to several weeks

90
Q

Antidepressants cause increased risk of suicide in what age groups?

A

Children and adolescents

91
Q

How do SNRIs work?

A

By inhibiting reuptake of seritonin and norepinephrine

92
Q

What should be verified before starting a pt on an NDRI?

A

Verify if there is a history of seizure disorder

93
Q

SSRIs should not be used with what other type of antidepressant?

A

MAOIs

94
Q

A client on SSRIs presents with tachycardia, hyperthermia, and N/V. The nurse suspects what?

A

Serotonin syndrome

95
Q

What general kind of side effects do tricyclics have?

A

Anticholinergic (dry mouth, blurred vision, urinary retention)

96
Q

Tricyclics and SSRIs differ in what important way?

A

Tricyclics have more serious side effects and a higher lethal potential

97
Q

Besides anticholinergic effects, what is another common effect of tricyclics?

A

Sedation

98
Q

Why can tricyclics not be given to suicidal pts?

A

Because they can be fatal when used to overdose

99
Q

How do MAOIs work?

A

By inhibiting MAO, which is an enzyme that breaks down serotonin and norepinephrine

100
Q

MAOIs mixed with what may cause hypertensive crisis?

A

Tyramine-rich foods

101
Q

MAOIs should never be combined with what other type of med?

A

SSRIs

102
Q

Foods such as cheese, chocolate, figs, and beer should be avoided with what type of antidepressant?

A

MAOIs

103
Q

A pt on MAOIs presents with tachycardia, lightheadedness, and vomiting. The nurse suspects what?

A

Hypertensive crisis

104
Q

What is the therapeutic blood level for lithium?

A

0.8 to 1.5 meq/L

105
Q

Thirst, urinary frequency, and hand tremor are side effects of what?

A

Lithium

106
Q

Lithium blood levels above what are life-threatening?

A

Above 2.5 meq/L

107
Q

If a dose of lithium is missed, the pt should NOT do what with the next dose?

A

Double it

108
Q

What is the relationship between salt intake and lithium absorption?

A

Higher salt intake=lower lithium absorption

109
Q

What kind of beverages should be avoided with lithium?

A

Caffeinated beverages

110
Q

Should anticonvulsants be given with or without food?

A

With food

111
Q

Which anticonvulsant may cause a severe, life-threatening skin rash? What should be done if such a rash develops?

A

Lamotrigine. If rash develops, discontinue immediately

112
Q

Benzodiazepines are contraindicated in which type of pt?

A

Those with renal or hepatic impairment, and those who are suicidal

113
Q

Which medication-related movement disorder causes slow movement and rigidity?

A

Pseudoparkinsonism

114
Q

Which medication-related movement disorder causes involuntary muscle spasms?

A

Dystonia

115
Q

Which medication-related movement disorder causes an inability to sit still?

A

Akathisia

116
Q

How is akathisia treated?

A

With beta blockers

117
Q

How is dystonia and psuedoparkinsonism treated?

A

Anticholinergic meds

118
Q

What occurs in tardive dyskinesia?

A

Irregular, repetitive movements such as lip smacking and tongue protrusion

119
Q

How can tardive dyskinesia be prevented?

A

By using atypical antipsychotics

120
Q

What is the most common reason for noncompliance with psych meds?

A

Side effects

Practice of Nursing IV (3 decks)

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