MH Exam

Question 1

Paranoid personality disorder

Answer 1

They are suspicious of all others with whom they come in contact

Question 2

Schizoid personality disorder

Answer 2

Has s lifelong pattern of social withdrawal

Question 3

Schizotypal personality disorder

Answer 3

Believes he has a sixth sense and can know what others are thinking

Question 4

Antisocial personality disorder

Answer 4

Shows no remorse for exploitation and manipulation of others

Question 5

Borderline personality disorder

Answer 5

Swallows a bottle of pills after therapist leaves on vacation

Question 6

Histrionic personality disorder

Answer 6

Demonstrates highly emotional and overly dramatic behaviors

Question 7

Narcissistic personality disorder

Answer 7

Believes she is entitled to special privileges others do not deserve

Question 8

Avoidant personality disorder

Answer 8

Refused to enter into a relationship due to fear of rejection

Question 9

Dependent personality disorder

Answer 9

Allows others to make all her important decisions for her

Question 10

Obsessive compulsive personality disorder

Answer 10

Believes everyone must follow the rules and that the rules can be bent for no one ever

Question 11

Common characteristics of clusters

Answer 11

Inflexible
Maladaptive
Pervasive across life activities (same s/s everywhere they go)
Functional impairment or subjective distress (according to them always under distress)
Chronic- early origin (by adolescence)

Question 12

Cluster A

Answer 12

Odd or eccentric
Paranoid, schizoid, schizotypal
Med: antipsychotics

Question 13

Cluster B

Answer 13

Dramatic, Emotional, Erratic
Antisocial, borderline, histrionic, narcissistic
Med: mood stabilizers, possibly antidepressants

Question 14

Cluster C

Answer 14

Anxious or Fearful
Avoidant, dependent, obsessive compulsive
Med: antidepressants, maybe SSRI

Question 15

Antisocial PD

Answer 15

A pattern of socially irresponsible, exploitative, and guiltless behavior that reflects a general disregard for the rights of others. Exploit and manipulate others for personal gain and are unconcerned with obeying the law. They have difficulty sustaining consistent employment and in developing stable relationships.

Question 16

Borderline personality disorder

Answer 16

Characterized by a pattern of intense and chaotic relationships, with affective instability and fluctuating attitudes toward other people. These individuals are impulsive, are directly and indirectly self destructive, and lack clear sense of identity.

Question 17

Histrionic personality disorder

Answer 17

Characterized by colorful, dramatic, and extroverted behavior in excitable, emotional people. They have difficulty maintaining long lasting relationships, although they require constant affirmation of approval and acceptance from others.

Question 18

Narcissistic PD

Answer 18

An exaggerated sense of self worth. Lack empathy, and are hypersensitive to the evaluation of others. They believe that they have the right to receive special consideration and that their desire is sufficient justification for possessing whatever they seek.

Question 19

Resolution of grief process

Answer 19

When a bereaved individual is able to remember comfortably and realistically both the pleasure and disappointments of that which is lost

Question 20

Difference between normal and maladaptive grieving

Answer 20

The loss of self esteem does not occur in uncomplicated bereavement. The loss of self esteem ultimately precipitates depression

Question 21

4 ads of geriatric MH assessment

Answer 21

Depression
Dementia
Delirium
Delusions

Question 22

Loss of intellectual abilities

Answer 22

Interferes with usual social or occupational activities

Question 23

Impairment of memory

Answer 23

Judgement and abstract thought

Question 24

Onset of dementia usually gradual

Answer 24

Without clouding of awareness seen with delirium

Question 25

Behaviors of dementia

Answer 25

``` Loss of intellectual abilities Impairment of memory Onset is gradual Personality change Aphasia, apraxia, agnosia, amnesia, disturbed sleep pattern, impulsive sexual advances, confabulation, deterioration in social skills, labile affective behavior ```

Question 26

Aphasia

Answer 26

Difficulty finding the right word

Question 27

Apraxia

Answer 27

Inability to perform familiar skilled activities

Question 28

Agnosia

Answer 28

Difficulty in recognizing well known objects, including people

Question 29

Amnesia

Answer 29

Significant memory impairment in absence of clouded consciousness or other cognitive symptoms

Question 30

Confabulation

Answer 30

Confused person's tendency to make up answers when unable to remember

Question 31

Delirium

Answer 31

A sudden fluctuating and usually reversible disturbance of mental function. Characterized by an inability to pay attention, disorientation, an inability to think clearly, and fluctuations in the level of alertness. Abnormal mental state, temporary. Has acute onset that may be from physical illness, medications, sensory deprivation

Question 32

Delirium behaviors

Answer 32

Disorientation, thought process disorganized, poor judgement, little decision making ability, stimuli may be misinterpreted- illusions/distortions of reality, labor affect, loss of usual social behavior, act on impulse

Question 33

Depression in elderly

Answer 33

Dx missed 85% of the time- assumed to be a normal part of aging. Decreased interest in activities, no energy. Increased sense of helplessness & dependence on others. Conversation focuses on past- lost sense of present, no future. To psychotropic meds or ECT

Question 34

Dementia

Answer 34

Involves structural & neurochemical brain changes from trauma, infection, cerebrovascular disruptions, substance use, or unknown cause. Changes in memory and personality. AD most common

Question 35

Dementia stage 1: mild 2-4yr

Answer 35

Repeats word or actions, has trouble remembering names and common objects, gets lost easily, loses things, beginning problems in ADLs, subtle personality changes, shows lack of interest in usual activities

Question 36

Dementia stage 2: moderate 2-10yr

Answer 36

Obvious memory problems, gets confused about recent events, decreased ability to perform ADLs, argues easily, seems anxious and depressed, paces, noticeable behavior difficulties, close supervision needed

Question 37

Stage 3: severe 1-3yr

Answer 37

Fragmented memory, not recognition of familiar people, no recognition of self in mirror, used word improperly, depend on others for basic ADLs, reduced mobility

Question 38

Dementia interventions

Answer 38

Highest priority is to help pt maintain optimism level of function Adjust routines to focus in pt not task Adjust communication to ensure pt receives message No cure Cholinesterase inhibitors may improve cognitive symptoms or temporarily decrease cognitive decline

Question 39

Sunrise syndrome

Answer 39

Early morning confusion | Wake up confused

Question 40

Sundowning syndrome

Answer 40

Increased disorientation or confusion at night resulting from loss of visual accommodation and other factors Turn on lot lights, have more structure Need interventions to prevent falls

Question 41

Nursing dx

Answer 41

Risk for injury, disturbed thought process, disturbed sensory perception, low self esteem, self care deficit, fear r/t nursing home placement, impaired mobility, complicated grieving, disturbed body image, social isolation, imbalanced nutrition, risk for trauma