Mental Healtjh Flashcards
Which of the following is part of the female athlete triad?
A.Lanugo
B.Premature osteoporosis
C.Self-absorbed behavior
D.Insulin resistance
Answer: B. Premature osteoporosis
The female athlete triad consists of amenorrhea, premature osteopenia/osteoporosis, and disordered eating. Lanugo and self-absorbed behavior, like the female athlete triad, are often seen with anorexia nervosa, but they are not part of the triad. Insulin resistance is part of metabolic syndrome.
A male patient’s history indicates that they are prescribed phenelzine (Nardil) for depression and anxiety. What information revealed during the patient interview would be the most urgent for the nurse practitioner to address with the patient?
A.Drinks one to two beers each week
B.Smokes three to four cigarettes daily
C.Has occasional difficulty sleeping
D.Reports poor appetite recently
Answer: A. Drinks one to two beers each week
Patients who are prescribed a monoamine oxidase inhibitor (MAOI) such as phenelzine (Nardil) should be advised to avoid alcohol because it contains tyramine. The consumption of tyramine while taking an MAOI can result in severely elevated blood pressure and increased risk for stroke. While the nurse practitioner should discuss smoking cessation, this is less urgent than explaining the dangerous food–drug interaction. Insomnia and anorexia are common side effects of selective serotonin reuptake inhibitors, but reports of occasional difficulty sleeping and recent poor appetite do not suggest any imminent risk for this patient.
A patient reports concern about the amount of alcohol they consume. Which screening tool should the nurse practitioner consider adminstering?
A.AUDIT
B.PCL-5
C.PHQ-2
D.GAD-7
Answer: A. AUDIT
The Alcohol Use Disorders Identification Test (AUDIT) is a highly accurate tool used to screen for potential alcohol use disorder. The PCL-5 (PTSD Checklist) is used to screen for posttraumatic stress disorder. PHQ-2 (Patient Health Questionnaire-2) is a screening tool for depression. GAD-7 is the Generalized Anxiety Disorder 7-Item Scale.
An older adult male with alcohol use disorder is scheduled for a physical exam and laboratory testing. The patient’s laboratory blood test results may show:
A.Increased serum creatinine levels and estimated glomerular filtration rate (eGFR)
B.Decreased number of platelets and increased mean corpuscular volume (MCV)
C.Increased serum potassium and increased triglycerides
D.Decreased aspartate transaminase (AST) and alanine transaminase (ALT) levels
Answer: B. Decreased number of platelets and increased mean corpuscular volume (MCV)
Chronic alcohol use affects the MCV because of reduction of folate levels from dietary deficiency and/or impaired absorption due to excessive use of alcohol. Alcohol also interferes with the production and function of white blood cells. Alcohol interferes with platelet production, with diminished fibrinolysis resulting in thrombocytopenia. Patients with alcoholism are at higher risk for bleeding. Alcoholism can increase AST and ALT because of liver inflammation. Alcohol affects lipid metabolism in the liver, resulting in hypertriglyceridemia.
The nurse practitioner is conducting the Mini-Mental State Exam (MMSE) on a patient. Which result indicates impairment?
A.Inability to copy an image of intersecting pentagons
B.Inability to recall today’s date
C.At least two positive findings
D.A score of 20
Answer: D. A score of 20
The MMSE is used to evaluate an individual for confusion and dementia. Using the exam as an outline, the nurse practitioner asks the patient to recall certain facts or perform certain tasks and then assigns a score based on the patient’s response. A maximum of 30 points are assigned, and any score <23 indicates impairment. Although the MMSE asks the patient to copy an image of intersecting pentagons and to recall the current date, the inability to do either is by itself insufficient to establish impairment.
Which of the following is a principle of motivational interviewing?
A.Providing the patient with reasons to change their behavior
B.Emphasizing the need to rely on a support network
C.Confronting the patient for their ambivalence
D.Rolling with the patient’s resistance
Answer: D. Rolling with the patient’s resistance
Motivational interviewing is a counseling technique used to help a patient find their internal motivation to make changes to improve their health. The five principles of motivational interviewing are expressing empathy, understanding the patient’s motivation, avoiding confrontation, rolling with resistance, and supporting self-efficacy. The nurse practitioner should help the patient identify their own motivation rather than prescribe reasons for changing behavior. Although a support network can be helpful, reliance on that network may run counter to the development of self-efficacy. The nurse practitioner should avoid argument or direct confrontation.
