PREBOARDS 1_NP5 Flashcards
Annie, a 30-year-old female, has been scheduled for initial assessment after showing signs of suspected Schizophrenia for almost 3 years. According to the family, they did not have enough funds for her medical and psychiatric check-up during the past years as a reason for the late admission. You are the assigned nurse to Annie.
- Annie is also a mother of two, a 15-year-old boy and a 12-year-old girl. The children reported that they usually do not understand what their mother is saying when they are talking with each other in the living room. Unusual speech patterns are common manifestations of Schizophrenia. Which speech pattern is NOT paired with the correct definition.
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1 point
a. Clang associations pertains to ideas that are put together based on sound or rhyming.
b. Echolalia is the stereotyped repetition of words or phrases that may or may not have meaning to the listener.
c. Word salad is a mix of jumbled words and phrases that are incoherent.
d. Neologisms are words invented by the client.
b. Echolalia is the stereotyped repetition of words or phrases that may or may not have meaning to the listener. - this more of VERBIGERATION
Echolalia - pt imitation or repetition of what the other person says
Throughout the assessment, Annie also shows signs of auditory hallucinations such as mumbling and arguing to self as if talking to another person. As a psychiatric nurse, which action done by Annie needs further improvement?
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1 point
a. Be sincere and honest when communicating with Annie
b. Recognize the client’s delusions as the client’s perception of the environment.
c. Agree that you can also hear these hallucinations to avoid distressing Annie and to gain her trust.
d. Encourage Annie to share her thoughts with you, but do not pry for information.
c. Agree that you can also hear these hallucinations to avoid distressing Annie and to gain her trust.
The brother of Annie shared that they always keep her water source full since she complains of being thirsty most of the time. She can consume 3,500 mL in a few hours. As a nurse who is knowledgeable and skillful in psychiatric nursing, you anticipate which of the following complication/s?
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1 point
a. Seizure
b. Diabetes mellitus
c. Insomnia
d. All of the above
a. Seizure > Water intoxication due to diluted sodium levels
Fortunately, the family were able to contact a non-profit organization that could help with the medical fees of Annie. She completed the required assessment and tests and was confirmed to have Schizophrenia. What daily medication do you expect Annie to be prescribed with?
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1 point
a. Citalopram SSRI
b. Lithium Mood Stabilizer
c. Risperidone
d. Paroxetine SSRI
c. Risperidone
SSRI - antidepressant
Mood Stabilizer - Bipolar
Based on your answer above, what is the usual daily dosage prescribed for treating Schizophrenia?
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1 point
a. 150 – 500 mg
b. 40 – 160 mg
c. 2 – 20 mg
d. 2 – 8 mg
d. 2 – 8 mg
Situation:
Sheena is 16-year-old
female who came to the hospital with her mother. She says that she wears an oversized
sweater because it’s her boyfriend’s clothes. She likes to talk about her food
preferences and fads that she has been trying to lose weight. Upon assessment,
her BMI falls to the underweight category.
- Sheena has been diagnosed with anorexia nervosa. Which of the following physical manifestations is NOT expected in anorexia nervosa?
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1 point
a. Hair loss
b. Dental caries
c. Tachycardia
d. Pedal edema
c. Tachycardia
It should be bradycardia or arrythmia
Which is the correct diagnostic criteria for anorexia nervosa?
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1 point
a. A commonly used threshold is body mass index (BMI) of less than 18.0 kg/m2 in adults
b. Total body weight rapid loss of 20% or more within 6 months with other positive diagnostic requirements.
c. Threshold for children and adolescents is BMI-for-age under 10th percentile.
d. Rapid weight loss of more than 10% of total body weight within 6 months may replace the low body weight guideline as long as other diagnostic requirements are met
b. Total body weight rapid loss of 20% or more within 6 months with other positive diagnostic requirements.
The mother is asking more about anorexia nervosa so that she can help her daughter during the treatment. The nurse was tasked to render health teaching to the mother. Which of the following statements would indicate that she misunderstood your teachings?
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1 point
a. They usually lose their appetites
b. For clients with anorexia, about 30% to 50% achieve full recovery, while 10% to 20% remain chronically ill.
c. Binge eating and purging is seen in patients with anorexia nervosa.
d. They like grocery shopping, collecting food books and recipes, and cooking family meals.
a. They usually lose their appetites
R: They still have appetite but they just don’t want to eat
Anorexia could also have binge eating and purging
Which medication is unlikely to be prescribed to the patient with anorexia nervosa?
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1 point
a. Elavil (Amitryptaline)
b. Parlodel
c. Prozac
d. Zyprexa (Olanzapine)
b. Parlodel (Bromocriptine) > for Parkinson’s Disease
The mother asks the reason behind her daughter’s behavior. You, as a nurse, explains that anorexia nervosa that the specific cause of this illness is still unknown. Which of the following risk factors is commonly not related to anorexia nervosa?
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1 point
a. Obesity, dieting at an early age
b. Cultural ideal of being thin; media focus on beauty, thinness, fitness
c. Issues of developing autonomy and having control over self
d. Chaotic family with loose boundaries
d. Chaotic family with loose boundaries - seen in bulimia nervosa
Situation
Kian, a software
developer, has been employed for 5 months in a small start-up company. His
manager was one of his close friends during college. His work hours are
flexible and would only need tasks to be finished, regardless of the time of
the day. Kian has been working from home, however, their team has been ordered
to return onsite. He was brought for assessment due to complaints of not having
several panic attacks.
- You were told that the physician suspects General Anxiety Disorder (GAD). As a competent nurse, which of the following are not included in the criteria for diagnosing GAD?
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1 point
a. Excessive anxiety and worry about several events or activities for more than 6 months.
b. Anxiety causes significant distress or impaired ability to work or to maintain relationships.
c. There may or may not be underlying medical cause.
d. They may or may not have physical symptoms.
c. There may or may not be underlying medical cause.
No underlying cause - criteria in diagnosing GAD
Unexpected panic attacks may also happen for cases of GAD. Which of the following accurately depicts these panic episodes? Select all that apply.
I. Moderate to severe levels of anxiety (depending on the trigger), resulting to disturbed behavior
II. Produces a sudden onset of feelings of intense apprehension and dread
III. Cause/s can usually be identified
IV. Recurrent, intermittent anxiety attacks lasting 30 to 60 minutes occur
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1 point
a. I, II, III, IV
b. I, II, IV
c. II, IV only
d. II only
II. Produces a sudden onset of feelings of intense apprehension and dread
Occurs for 5-30 mins only
After further assessment with the physician, it has been found out that Kian does not have GAD but specific phobias. He is afraid of being in open spaces and in situations in which he might be embarrassed or criticized or making a fool of oneself. Which option pertains to these specific phobias?
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1 point
a. Acrophobia and Situational phobia
b. Xenophobia and Situational phobia
c. Agoraphobia and Social phobia
d. Acrophobia and Social phobia
c. Agoraphobia and Social phobia
Which of the following is/are true about social phobias?
I. Irrational fear of an object, activity, or situation that persists and that leads to avoidance
II. Associated with panic-level anxiety or fear if the object, situation, or activity that can be avoided by the client
III. Defense mechanisms commonly used include repression and displacement.
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1 point
a. I only
b. I, II, III
c. I, II
d. I, III
d. I, III
During one of the treatment sessions of Kian, he suddenly felt dread, terror, and sense of impending doom. You think he is having a panic attack episode. What other sign or symptoms do you expect to observe?
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1 point
a. Disorganization, difficulty perceiving reality, and ability to concentrate if the client tries
b. Loss of rational thoughts with distorted perception occur
c. The individual is unable to communicate or function effectively unless the nurse talks to the client
d. A significant narrowing in the perceptual field occurs
b. Loss of rational thoughts with distorted perception occur
Situation:
As a nurse, we encounter
various cases of losses along the continuum of health and illness. Depending on
the type of loss, the nurse should have a basic understanding on how to deal
with discomfort of loss.
- This theory describes the five stages that explains what people experience as they grieve and mourn. Who developed this theory?
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1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz
b. Kübler-Ross (5 stages of grief)
This theory proposes that humans instinctively attain and retain affectionate bonds with significant others through attachment behaviors which are crucial to the development of a sense of security and survival.
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1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz
a. John Bowlby
The five stages of grief are the following: (1) Shock and disbelief, (2) developing awareness, (3) restitution, (4) resolution of loss, and (5) recovery. To whom is this theory attributed to?
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1 point
a. John Bowlby
b. Kübler-Ross
c. George Engel
d. Mardi Horowitz
c. George Engel
A single mother of a deceased pediatric patient has been coming to your ward even after a week of the death. She would bring fruits to the staff and ask about the nurse-in-charge or physician-in-charge of her child. She would often talk to them about her child with them. Her child was confined for two years after being born in the hospital. As the past nurse of the patient when she was still alive, you would like to help the mother. Which among the following is not correct about the tasks of grieving?
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1 point
a. Recognize: Experiencing the loss
b. Reinvest: Beginning to return to daily life; loss feels less acute and overwhelming
c. Recognize: Understanding that it is real, and that it has happened
d. Reinvest: Accepting changes that have occurred; reentering the world
b. Reinvest: Beginning to return to daily life; loss feels less acute and overwhelming
The mother (from #19) ended up crying as the two of you are talking. She said, “I don’t feel like being in this world without my child anymore.” What will be your response as the nurse?
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1 point
a. You shouldn’t say that, Ma’am. How would your child feel if she hears you?
b. I don’t believe you should do that, Ma’am.
c. Do you have intentions of hurting yourself, Ma’am?
d. Use silence as therapeutic response
c. Do you have intentions of hurting yourself, Ma’am? - direct confrontation
Situation:
One of the mothers, Mari, knows another
mother, Tes, who had a son diagnosed with autism. Mari tells you that she is
worried that her 6-month-old may have a similar illness since her uncle and
brother had the same. She brings her 6-month-old daughter to the clinic for
assessment.
21. The mother is wanted to consult about the nature of autism. She asked a beginner nurse about this, which of the following statements needs intervention when heard?
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1 point
a. Autism spectrum disorder (ASD) is almost five times more prevalent in boys than in girls.
b. The behaviors, limitations, and degree of affectation varies along the continuum from mild to severe.
c. Signs and symptoms usually start as early as 6 months and no later than 2 years old.
d. Autism have a genetic link, many children with autism have a relative with autism or autistic traits.
c. Signs and symptoms usually start as early as 6 months and no later than 2 years old.
Identifiable at 18 months and no later than 3 years old
The nurse explains that there are common behaviors shown by children diagnosed with ASD. The following signs are usually seen in autism spectrum disorder. Select all that apply.
I. Doesn’t show interest by pointing to objects or people by 14 months of age
II. Avoids eye contact
III. Prefers to be with mother or father
IV. Delayed speech and language skills
VI. Upset by major changes in routine and does not mind minor changes.
VII. Flaps hands, or rocks or spins in a circle
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1 point
A. I, II, III, IV, VII
B. I, II, III, VI, VII
C. I, II, IV, VII
D. All of the above
C. I, II, IV, VII
Aside from teaching communication and language skills, pharmacologic treatment may also treat specific target symptoms such as temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors. Which medications are used for these symptoms of ASD?
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1 point
a. Aripiprazole
b. Lithium
c. Donepezil
d. Fluvoxamine
a. Aripiprazole
Lithium = bipolar
Donepexil = alzheimer’s
Fluvoxamine = depression or anxiety
. When dealing with children with ASD, which of the following interventions precedes the others?
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1 point
a. Managing the environment of the child
b. Giving structured daily routine and schedule
c. Stopping unsafe behaviors
d. Listening to the parent’s feelings and frustrations.
c. Stopping unsafe behaviors
R: SAFETY AMONG ALL
Related disorders to ASD may also be observed in various cases and may start manifesting in different ages. Learning, motor skills, communication, and elimination disorders are a few of the disorders that are usually present in children with ASD. Toddlers and preschool-aged children commonly manifest elimination disorders. Which of the following are not accurate in describing this disorder?
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1 point
a. Encopresis is the repeated passage of feces into appropriate places such as diapers or the toilet by a child who is at least 4 years of age (either chronologically or developmentally).
b. Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child
c. Impairment associated with elimination disorders depends on the limitations on the child’s social activities, effects on self-esteem, and degree of social ostracism by peers
d. Enuresis can be treated effectively with imipramine (Tofranil), an antidepressant with a side effect of urinary retention
a. Encopresis is the repeated passage of feces into appropriate places such as diapers or the toilet by a child who is at least 4 years of age (either chronologically or developmentally).
Situation:
In
a psychiatric ward, it not uncommon to have episodes of sudden anxiety, anger,
and aggression among the patients. You are the nurse who is assigned in the day
shift of the psychiatric ward 1.
26. During your rounds, you found Brian crouched on the floor with hands covering his ears. He was observed to be hyperventilating, crying, sweating, and having tremors. What is your priority action?
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1 point
a. Remove the hands from the ears and convince him to lie on the bed. Leave the patient alone for him to collect his thoughts.
b. Stay with the client and ask the client to identify how he feels
c. Provide the patient a calm environment, decrease stimuli, and stay with the client
d. Monitor vital signs
c. Provide the patient a calm environment, decrease stimuli, and stay with the client
The next day, you encountered Lian in the hallway with his fingers overlapped with each other and palms together. He’s visibly sweating and is experiencing mild tremors. What is your priority action?
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1 point
a. Provide the patient a calm environment, decrease stimuli, and stay with the client
b. Encourage the client to verbalize his current thoughts, feelings, or concerns
c. Return after 15 minutes to check if the client’s condition improved
d. Go to the patient but stay silent and wait for him to tell you what happened.
b. Encourage the client to verbalize his current thoughts, feelings, or concerns
Jin, one of the patients with bipolar syndrome, was hospitalized last week for being a threat to other’s safety. He was showing improvements in handling his mood recently. What action would you do to prevent an episode of anger outburst?
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1 point
a. Administer depressant drugs to slow down the brain activity
b. Avoid competitive games for the client
c. Stay with the client
d. Set limits with the patient about his requests
b. Avoid competitive games for the client
R: PREVENT NOT MANAGE
Although a single cause has not been established, it has been found that neurotransmitters play a role in anger and aggression in humans. Which of the following is true about the relationship of aggressive or violent behaviors and neurotransmitters?
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1 point
a. Low serotonin levels, decreased activity of dopamine, increased activity of norepinephrine
b. Low serotonin levels, increased activity of dopamine and norepinephrine
c. High serotonin levels, increased activity of dopamine, decreased activity of norepinephrine
d. Low serotonin levels, decreased activity of dopamine, increased activity of norepinephrine
b. Low serotonin levels (inc aggression), increased activity of dopamine and norepinephrine (inc violence secondary to impulse)
During one of your night shifts, someone screamed from the common room of the patients. Once you arrived, you saw Mark holding another patient by the neck with a makeshift weapon in hand. The patient was able to break free from Mark, but he still holds the weapon. What is your priority action?
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1 point
a. Attempt to remove the weapon from Mark to prevent further injuries to the patients and other staff
b. Decrease stimulation by turning the television off or lowering the volume, lowering the lights, or asking others to leave the area
c. Ask the other patients to leave the common room and call for help
d. Remain calm and talk down to patient, ordering him to drop the weapon
c. Ask the other patients to leave the common room and call for help
R: Safety is the priority
Understanding a patient’s developmental stage will help to comprehend their condition. According to Erik Erikson’s Stages of Psychosocial Development, which stage requires learning to manage conflict and anxiety as a task to be accomplished?
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1 point
a. Autonomy vs. Shame and Doubt
b. Initiative vs. Guilt
c. Industry vs. Inferiority
d. Identity vs. Role diffusion
b. Initiative vs. Guilt
According to Erikson’s Stages of Psychosocial Development, which of the following includes the adult development tasks for Angela, a 35-year-old female.
I. Create a comfortable home II. Cherish old friends and make new ones III. Establish a career or vocation. IV. Become an involved citizen V. Adjust to health changes.
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1 point
a. I, II, III, IV, V
b. II, III, IV
c. I, III, IV
d. III, IV
d. III, IV
Sometimes, Angela encounters troubles and difficulties in her work as an assistant manager in a famous company in BGC. She has been a consistent team leader awardee and most of her co-workers look up to her as a role model. In one of her interviews, she was asked how she handles the stress in her workplace. She answered, “I usually take action when I encounter problems because I want to believe that my behavior will make a difference”. Angela is showing which individual factor?
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1 point
a. Self-resistance
b. Self-actualization
c. Self-determination
d. Self-efficacy
d. Self-efficacy - personal ability has an effect to other person’s life
Mika, who is a manager, became curious that how does Angela does not usually get sick while she easily affected by fatigue and flu under stress. Angela has low occurrences of illness despite a high stress-inducing job and company. What specific individual factor has been found to have buffering effect on people under stress?
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1 point
a. Good healthiness
b. Hardiness
c. Self-awareness
d. Resilience
b. Hardiness
Angela shared that she practices self-care activities, makes daily journal to monitor her thoughts and feelings about stressful situations in the office, and performs health-seeking behaviors. What specific individual factor refers to the use of problem-solving abilities and belief that she can cope with adverse situations?
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1 point
a. Resourcefulness
b. Self-awareness
c. Spirituality
d. Good healthiness
a. Resourcefulness
Situation:
Coco
is 27-year-old male who started drinking alcohol during his teenager years. It
has become a habit to drink alcohol whenever he was elated, sad, disappointed,
regretful, and in a celebratory mood. He drinks alone or with friends, as long
as he had money to spare.
36. Coco is 27-year-old male who started drinking alcohol during his teenager years. It has become a habit to drink alcohol whenever he was elated, sad, disappointed, regretful, and in a celebratory mood. He drinks alone or with friends, as long as he had money to spare.
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1 point
a. 1 to 6 hours
b. 2 to 8 hours
c. 3 to 10 hours
d. 4 to 12 hours
d. 4 to 12 hours
For severe withdrawal cases who cannot abstain during detoxification, a short admission (3-5 days) is recommended for safe withdrawal. Which of the following are used for safe withdrawal of alcohol intake?
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1 point
a. Ativan
b. Prozac
c. Olanzapine
d. None of the above
a. Ativan - benzodiazepine (lorazepam)
What are the following signs and symptoms that you should monitor for alcohol withdrawal in Coco?
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1 point
a. Sleepiness, low blood pressure, anxiety, nausea, and vomiting
b. Hand tremors, elevated blood pressure, nausea, and vomiting
c. Insomnia, low blood pressure, anxiety, nausea, and vomiting
d. Sleepiness, elevated blood pressure, anxiety, nausea, and vomiting
b. Hand tremors, elevated blood pressure, nausea, and vomiting
A protocol used in identifying alcohol withdrawal in patients is an assessment tool called Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-AR). The patient was asked about the presence and/or severity of auditory disturbances. He scored a 5 in this category. What does this mean?
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1 point
A. Extremely severe hallucinations
B. Continuous hallucinations
C. Severe hallucinations
D. Moderately severe hallucinations
C. Severe hallucinations
Coco has been a chronic alcohol drinker, which of the following complications is related to a brain condition characterized by confusion, loss of mental activity, ataxia, vision changes, and is considered a medical emergency?
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1 point
a. Alcohol cerebral damage syndrome
b. Wernicke encephalopathy
c. Korkiff alcohol syndrome
d. Wernicke alcohol syndrome
b. Wernicke encephalopathy