N340 Exam 2
in state hospitals, some individuals may be admitted for forensic/court related care because they have committed a crime but are deemed as what? (read example) ******
not guilty by reason of insanity (NGRI) Example: Andrea Yates drowned her 5 young kids under the delusional belief she was saving them from their sinfulness. She was found not guilty by reason of insanity (NGRI) and was committed to a TX state psych facility
what Yalom Curative Factor is this an example of? ***** "I'm sorry that happened to you. I can help you"
altruism
what are 5 benefits of group therapy? (MLLPC) *****
tx multiple pts together learn from other's knowledge, insights, and life experiences learn new ways of relating to other people practice new communication skills feeling of cohesiveness
what HCP is involved in making home visits 1-3 times/week and have to be adept at assessing agitation, anxiety, and potential for violence, as well as evaluation, therapy, teaching in psych home care?
psych RN
a nurse in a community mental health center assists a patient in finding housing or obtaining entitlements. what type of service is this an example of?
psych case management
what are 6 examples of specialized psychiatric care providers that care for psych patients in the outpatient setting? (PPPSCO)
psychiatrists psychiatric-mental health APRN's psychologists social workers counselors other licenses therapists that have an educational background and experience in care of psychiatric problems and mental health
a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential (SAMSHA)
recovery
what is the court's opinion regarding mental illness and institutionalization? (3) ***
1. mental illness is a disability 2. institutionalization is a violation of the Americans with Disability Act 3. all people with disabilities have a right to live in the community
arrange the following from least to most restrictive: 1-emergency care 2-specialty care 3-community mental health centers 4-intensive outpatient programs 5-state hospital 6-crisis stabilization/observation units 7-psychiatric home care 8-primary care 9-patient-centered medical homes 10-assertive community treatment 11-general and private hospitals 12-partial hospitalization programs
8, 2, 9, 3, 7, 10, 4, 12, 1, 6, 11, 5
what Yalom Curative Factor is this an example of? ***** "is this the way that you speak to your wife at home?"
Corrective recapitulation of primary family group
what are four national patient safety goals in behavioral healthcare? (IUPI)
ID patients w/ 2 identifiers use medicines safely prevent infection ID patient safety risk
what are 6 disadvantages to group therapy? (CPDGCP) ******
Individuals may feel *cheated for participation time*, especially in a large group *Privacy* concerns A member of a group may become *disruptive* during an emotionally vulnerable point Group identity may *encourage descent* Cohesiveness may *bind members together and encourage unacceptable or illegal behaviors* People who are *acutely psychotic, acutely manic, or intoxicated* are not appropriate candidates for group therapy
what are two programs function as intermediate steps between inpatient and outpatient care? *****
Intensive Outpatient Programs (IOP) and Partial Hospitalization Programs (PHP)
An intense type of case management developed in 1970s in response to the hard-to-engage, community-living needs of those with serious, persistent psych symptoms For those with serious, persistent psychiatric symptoms that are often unable or unwilling to participate in traditional treatment. They have expensive repeat hospitalizations *******
assertive community therapy (ACT)
outpatient psych nurses require more flexibility and comfort in functioning more _______ compared to acute care nurses. they are adept at understanding both the ______ and _______ and _______ care.
autonomously system, resources coordinating
what Yalom Curative Factor is this an example of? ***** "this experience allowed me to get in touch with my sadness"
catharsis
what Yalom Curative Factor is this an example of? "This group has helped me to see that when I complain to my daughter about her father that I am triangulating her by trying to get her on my side. Now I see this is unfair to her." ****
cohesiveness
according to yalom, what is catharsis? ****
expression of deep emotions
medicare requires what 4 elements in psych home care to be met in order for these services to be reimbursed? (HPNP)
homebound status psychiatric diagnosis need skills of psychiatric RN POC under orders of physician or APRN
continuum of care example: patients discharged from the most acute levels of care (hospitalization) may need intensive services to maintain their initial gains. Failure to follow-up with outpatient treatment increases the likelihood of rehospitalization and other adverse outcomes. Patients may also reverse direction on the treatment continuum.
just read
example of outpatient psych nurse in criminal justice system (homeless population too) Provide care to those people as they are leaving the justice system and re-entering community Educate police and justice staff on how to work with individuals entering the criminal system
just read
according to yalom, what is universality? ****
knowing that others have similar problems
according to yalom, what is installation of hope? ****
leader shares optimism about success of group treatment; believes they will get better
according to yalom, what is corrective recapitulation of primary family group? *****
learning about one's own behavior in their family
according to yalom, what are socializing techniques in group therapy? *****
learning new social skills based on feedback
what are the two extremes of the continuum of care?
least restrictive care to most acute
what emergency care model uses stabilization in the field?
mobile crisis team
community mental health centers use what kind of team?
multidisciplinary team (RN: med admin, MH education; APRN: patient intakes, psychotherapy, med management)
why is unit design important to consider in the psych setting?
need to balance between aesthetically pleasing and safe (limit number of throwable objects)
Related to the shift from hospital to community care were the _______ breakthroughs in the mid-20th century that resulted in dramatic changes in the provision of psychiatric care. The introduction of ________, the 1st antipsychotic medication, in the early 1950s contributed to hospital discharges. Treatment provision expanded beyond specialists in psychiatry, as ______ ______ began to feel comfortable prescribing medication & managing symptoms ****
pharmacological chlorpromazine general practitioners
what are 3 types of primary care providers that can care for psych patients in the outpatient setting? (PAP)
physicians, advanced practice nurses, and physician assistants
what is the least restrictive care setting for mental health?
primary care
what HCP is involved with counseling + medical social services such as linking people with HC and services in psych home care?
social workers w/ master's
medicare allows what two health care professionals to specialize in psychiatric home care? (SR)
social workers with a master's degree psychiatric RN's
what is the most acute/restrictive care setting for mental health?
state hospital
what type of inpatient setting serve the most seriously ill and may have to give forensic/court related care? *****
state hospital
PHP/IOP's provide what three types of services? (STP) ****
structured activities therapy (group, individual, others) pharmalogical management
pediatric, geriatric, substance abuse, NAMI, and veterans psychiatric care are examples of ______________ of specialized psych care providers
subspecialties
a majority of inpatient psych patients are admitted through what 2 things? (EC)
the emergency department or crisis intervention service
what does it mean for a private psych hospital to be freestanding? *****
the entire building is dedicated to psych
what are 4 NDx regarding family? (CDII)
*Caregiver Role Strain* Dysfunctional family processes Ineffective role performance Impaired resilience
when caring for a schizoid PD patient, what 4 things should a nurse do? (ADAP)
Avoid being too "nice" or "friendly" *Do not try to increase socialization* Assess for symptoms the patient is reluctant to discuss Protect against group's ridicule
what vaccine can be given to prevent TB?
BCG vaccine
how is meningitis prevented?
Menactra vaccine
what are 3 examples of routinely collected data in epidemiology? (CVS)*******
Census data, vital records, surveillance data as carried out by CDC
what assessment tool is useful with borderline PD?
Minnesota Multiphasic Personality Inventory
a study that has one group with the disease/outcome of interest (cases) and the other has the same general characteristics as the cases group but does not have the disease/outcome of interest (control); compares past exposures of both groups******
case-control study
what kind of study involves participants that are KNOWN to have or not have the outcome of interest?*****
case-control study
the following is an example of what alteration in behavior? person stands in one position for hours, moving very little or not at all ****
catatonic behavior
estimate of the risk for death from a specific disease in a population****
cause specific mortality rate
why do antipsychotics carry the side effects of drooling and choking?***
causes impaired swallowing
what 5 medical conditions cause neurochemical abnormalities that can cause depression? (CPHAD)
cerebral infarction, Parkinson's, hypothyroidism, AIDS, drug use.
What is the goal of motivational interviewing?****
change client behavior
variations in the place aspect of descriptive epidemiology may be due to differences in the ______, _____, or ______ environment, differences in population _______ or _______, the _______, or mode of _______
chemical physical biological densities culture reservior transmission
twin studies point to genetics as a risk factor of depression because genetic markers related to depression were found when accompanied with early ______ maltreatment
childhood
hepatitis A may be silent in what age group?
children
what manipulative practice is one of the most widely used integrative therapies
chiropractic medicine
what medication can be given for a patient suffering from serotonin syndrome with hyperpyrexia/fever?***
chloropromazine
what six examples of bacteria can be transmitted by water? (CTDSVCE)
cholera, typhoid, dysentery, shigella, vibrio, campylobacter, e. coli
why do borderline PD patients have frequent ER visits?*****
chronic SI + self-harm
what is the difference between circumstantial and tangential speech?*****
circumstantial does eventually get to the point, while tangential does not
many details in speech but does get to the point
circumstantiality
what are 5 SSRIs used for treatment of depression? ****** (CEFPS)
citalopram escitalopram fluoxetine paroxetine sertraline
sound of a word rather than its meaning gives direction to the following words; compulsive rhyming; alliteration (same 1st consonant sound); stringing words together according to their sounds instead of meaning
clanging
what is the following alteration in speech an example of: on the track .... have a big mac click, clack, clutch, close
clanging
type of boundary that is adaptive & healthy, understood by all family member, sense of self, firm, yet flexible
clear
Participants are randomly assigned to groups in the study Neither the researcher or participants know who receives the actual treatment or placebos during the study*****
Double blind, randomized controlled trial (RCT)
match the expected outcome to the type of group it may involve (education/therapy) a. Patient identifies three significant side effects of prescribed medication b. Patient develops insight into the connection between drinking and negative consequences c. Patient will recognize med interactions d. Patient will ID time of day and dose for each medication
E T E E
what is an alternative somatic treatment for acute suicide risk?
ECT
since some FGA's and SGA's can prolong the QT interval, what should be tested before starting the medication?
EKG
FGA's block dopamine-2 receptors which causes _____ as a side effect***
EPS
what are 8 adverse effects of FGA's? (EOAPTSWA)
EPS orthostatic hypotension (teach about fall risk) anticholinergic effects (dry mouth, constipation, etc) photosensitivity tachycardia sedation weight gain (metabolic syndrome) agranulocytosis
what is the diathesis-stress model say?
Early life trauma cause brain changes and later on a person has exaggerated stress response in adulthood
T/F you should try to increase socialization with schizoid PD patients *****
FALSE
what are the main pathological traits of avoidant PD? (LSRDAAPA)******
Low self-esteem Shyness that increases with age (evident in infants & children) Inferiority Reluctance to engage with new people Depression, anxiety, and anger Preoccupied with rejection, humiliation, and failure Avoid new interpersonal relationships or activities due to fears of criticism or disapproval
how is measles and rubella prevented?
MMR live vaccine (attenuated)
what learning theory involves self-directed learners, past experiences are resources, learning relating to social roles, applying lessons/solving problems immediately, and internal motivation to learn? *****
adult learning theory (andragogy)
when are people dx with antisocial PD? when do symptoms start?
adults mid teens
external expression of a person's internal emotional state
affect
outward representation of a peron's internal state; objective finding by observing facial expression along with other nonverbal cues
affect
what are 7 areas to assess with depression? (ATMFCPV) *****
affect, thought processes, mood, feelings, cognitive changes, physical behavior, vegetative signs
feeling domain; involves changes in attitudes and values; professional and value domain
affective
hopelessness, dysphoria, and suicidality are all examples of ___________ symptoms******
affective
the following behavioral objective is an example of what learning domain?**** discuss possible solutions to family resistance to change
affective
which learning domain includes teaching content that includes purpose of flu vaccine for prevention, myths/beliefs about vaccine, CDC recommendations for vaccine and includes a lecture presentation and/or group discusion as a teaching method?
affective
reduced intensity of expression and response; do not change expressions in response to circumstances; voice lacks inflection; slow speech
affective blunting
what kind of symptoms involve experience and expression of emotions?
affective symptoms
cure rate can change by specifying _________ as a factor
age
rates that would have existed if the population under study had the same age distribution as the "standard" population
age-adjusted rates
animate or inanimate factor that must be present or lacking for a disease or condition to develop; biologic: bacteria, viruses; chemical: poison, alcohol, smoke; physical: trauma, radiation, fire; nutritional: lack, excess********
agent
bacteria, fungi, parasites, and viruses; what causes the disease
agent
match the part of the epidemicological triangle to its corrct description:***** 1. invader 2. condition 3. transporter 4. home
agent environment vector host
what are the 3 parts of the epidemiologic triangle that interact to influence disease onset?********
agent host environment
what is the common vehicle for Legionellosis and TB? what about Hep A? Hep B?*****
air droplets contaminated food/water contaminated blood
how is influenza transmitted? (AD)
airborne and droplets
how is TB transmitted?
airborne droplet by coughing, sneezing, talking
severe motor restlessness that causes pacing, repetitive movements, inability to stay still*****
akathiasia
what two substances are most commonly abused by patients with schizophrenia? (AM) *****
alcohol, marijuana
what is a homogenous group?
all members share central traits
reduction/poverty in speech
alogia
error in how one interprets perceptions or perceives reality
alterations in perception
what are the four types of positive symptoms? (ASPB) *******
alterations in reality testing, speech, perception, and behavior
unusual speech patterns due to information processing being disrupted by abnormal brain processes
alterations in speech
the following sign/symptom of schizophrenia relates to what nursing diagnosis? conversation is derailed by unnecessary and tedious details (circumstantiality)
altered thought processes
the following symptoms of mania relate to what nursing diagnosis? grandiosity, difficulty organizing and attending to information, poor concentration, agitation, hallucinations
altered thought processes
what non-NANDA NDx is mostly used for positive schizophrenia symptoms?
altered thought processes
type of care used instead of standard medical care ****
alternative
which area of the brain affected by bipolar disorder deals with memory, decision making, and emotion?*****
amygdala
type of epidemiology that focuses on determinants of outcomes****
analytic epidemiology
what type of epidemiology looks at determinants Iideology/origin/cause) of diseases and deals with distribution of health and disease patterns; looks at those factors, exposures, characteristics, behaviors, and contexts that determine or influence the patterns?******
analytic epidemiology
what type of epidemiology examines the how and why of observed patterns of health and disease?*****
analytic epidemiology (observational studies)
what are the two main approaches to developing learning theories? (AP)
andragogy, pedagogy
what are 3 physical behavior changes we assess in depressed patients? (ARA)****
anergia psychomotor retardation psychmotor agitation
the following may indicate what negative symptom? "i feel empty"
anhedonia (unable to experience pleasure)
what are four examples of vegetative signs of depression? (AISC) *****
anorexia, insomnia, self-care deficits, and constipation
Spore forming bacteria; found in soil; affects domestic and wild animals Not spread human-human; typically spread by handling products from infected animals or eating undercooked meat from infected animals; 3 types
anthrax
what are 4 agents of bioterrorism (ASPBS)
anthrax smallpox plague botulism selected hemorrhagic fevers
anthrax is treated with _______. success depends on _____ and _____ tx
antibiotics type immediate
what are 5 adverse effects of TCAs? (AWOTS) ****
anticholinergic effects weight gain orthostatic hypotension tachycardia sedation
how do we treat bipolar depression? (AM)
antidepressant with a mood stabilizer
what 4 med types can be given to reduce suicide? (ALAA)
antidepressants lithium antipsychotics antianxiety
ability to stimulate an immunological response
antigenicity
in which PD is a person commonly referred to as a sociopath?********
antisocial PD
which PD is the most researched personality disorder d/t its impact on society and in criminal activity in which a person has a pattern of disregard for & violation of the rights of others, is referred to as a sociopath, is very impulsive, and is diagnosed in adults
antisocial PD
what is the treatment for botulism? (AMV)
antitoxin (only shortens length), medical support, ventilation
pushing avoidant PD patients into social situations can cause severe ____
anxiety
what psychiatric problem is major depressive disorder most commonly combined with?
anxiety
cluster C personality disorders are described as what 2 things? (AF)****
anxious fearful
how does MRSA spread?
any contact with person or things they have touched
decreased interest in activities or beliefs that would otherwise be important
apathy
what drug may be called a 3rd generation antipsychotic?
aripiprazole
decreased desire for, or comfort during social interaction
asociality
what does the ACTS acronym stand for in education?****
assess main concern and learning needs collaborate with family + system train/teach audience survey if needs were accomplished
nurses are adept at what 3 things when it comes to family therapy? (IMS)
assisting family members to learn about the physical/mental illness of an afflicted family member understand medication help ID support groups and community resources
what is rapid cycling?*******
at least 4 mood episodes in a 12 month period; can also occur within the course of 1 month or even a 24 hour period
how many criterion A symptoms are required for a diagnosis of schizophrenia? for how long? at least 1 symptom must be what 3 symptoms? (DHD)*******
at least two 1 month (or less if tx) delusions, hallucinations, disorganized speech
when should TCAs be given and why?***
at night; sedation
Used in infectious disease; The proportion of persons exposed to an agent & develop the disease; 2 groups: developed + exposed*****
attack rate
the amount of subjects who dropped from the study
attrition
what is the most common type of hallucination?
auditory
effective health education programs involve what 6 elements? (MFEEPE)
clear *message* most appropriate learning *format* best possible *environment* positive and meaningful learning *experiences* engaging learners (*participation*) *evaluating* and giving objective feedback
symptom development is in the _____ stage and ______ prevention is used to detect disease
clinical secondary
what are the two types of experimental studies?******
clinical and community trials
test group and control group used in a double blind study; placebo groups are used in drug testing; objective is to test interventions; randomization to groups and masking/blinding of treatment********
clinical trials
what is the gold standard for experimental studies?******
clinical trials
what is botox derived from?
clostridium botulinum
what second generation antipsychotic causes agranulocytosis?
clozapine
what is premenstrual dysphoric disorder? ****
cluster of symptoms that occur in the last week before onset of a woman's period that interfere with ability to work/interact
past test ?: Study of pts with hx of addiction and recovery r/t monetary reward but only allowed to participate if had been thru 21 day program - problem is that only pts who had been thru program allowed to participate****
cofounding variable
variables that could affect the outcomes should be accounted for by either statistical methods or study measurements***
cofounding variables
the following behavioral objective is an example of what learning domain?**** describe the health benefits of a low fat diet
cognitive
thinking domain that includes memory, recognition, understanding, reasoning, application, and problem-solving****
cognitive
which learning domain includes teaching content that includes symptoms, methods for getting the flu, importance of reduced exposure, and use of hand-washing as prevention and includes a lecture or group discussion as a teaching method?
cognitive
how does helping the patient ID cognitive distortions that result in negative self-perception help people with depression?
cognitive distortions reinforce a negative inaccurate perception of self and world
assumes that thoughts precede moods and false self-beliefs lead to negative emotions; want to help pt recognize and reassess patterns of negative thoughts and replace them with positive thoughts****
cognitive learning theory
generalized slowing of thinking; difficulty in finishing thoughts
cognitive retardation
what are the three domains of learning?**** (CAP)
cognitive, affective, psychomotor
what 6 aspects of family life do family therapists explore in family therapy? (CCACCB)
cohesiveness cmcn appreciation commitment coping beliefs and values
what is the standard observational design of analytic epidemiology?****
cohort study
what kind of study deals with a group of people who share similar characteristics to calculate incidence rates and estimates of risk for disease?*****
cohort study
with respiratory anthrax, a patient experiences _____ and _____ symptoms that lead to ______, ____ discomfort, _____, and muscle ______. if untreated, there is a ____% mortality rate. if treated, there is a 45% mortality rate if caught less than ____ hours after symptom onset. symptoms often appear within ___ days of contact
cold flu cough chest SOB aches 100 48 7
what five symptoms may you see with meningococcal septicemia besides the typical meningitis symptoms? (CCPRD)
cold hands and feet, cold chills, severe pain in muscles/joint/abdomen, rapid breathing, and dark purple rash in later stages
what is symbyax?
combination of olanzapine (SGA) and fluoxetine (SSRI) for bipolar depression
the transportation of the infectious agent to a susceptible host via food, water, milk, blood, serum, saliva, or plasma*****
common vehicle
how does chest discomfort/cough differ between the flu and a cold?
common with flu, mild/moderate with cold
how does presence of headaches differ between the flu and a cold?
common with flu, rare with cold
Hep B infected persons are infectious many weeks before onset of their first symptoms and remain infected during the acute phase. what is this an example of?
communicable period
the flu is contagious 3-5 days after clinical symptoms onset. what is this an example of?
communicable period
the interval in which the host can transmit infection
communicable period
what theory provides a framework for thinking about human growth, development, and learning?****
developmental theory (erikson)
evidence-based therapy developed specifically for patients with borderline personality disorder. Combines cognitive and behavioral techniques Emphasizes being aware of thoughts & actively shaping them.
dialectical behavior therapy (DBT)
what type of therapy is crucial with borderline PD?****
dialectical behavior therapy (DBT) (form of psychotherapy)
what risk factor is the best explanation for the existence of schizophrenia? ***
diathesis-stress model
what medication can be given to relieve symptoms of anxiety/agitation in patients with paranoid PD?
diazepam
look at educator/learner barriers in notes
didn't want to include bc kinda self-explanatory
type of boundary that has unclear boundaries and lack of independence, everyone, thus no one, is in charge, and family members actually have problems defining who they are; individuals tend to become overly involved with one another
diffuse
what is the best response to a family member of a schizophrenic patient that asks what causes the patient to be schizophrenic? ****** (past test ?)
exact cause of schiz is unknown at this time
what are the 13 characteristics for histronic PD? (EDHCBFLASLEFA)*******
excitable dramatic/drama queen high-functioning center of attention bold behavior flamboyant limited ability to develop meaningful relationships attention-seeking self-centered low frustration excessive emotions flirtatious attempt suicide
what Yalom Curative Factor is this an example of? ***** "I understand that all of us struggle with the inevitable loss"
existential resolution
how can the mood of a person with a manic episode be described?*******
expansive mood >elevated & unrestrained emotional expressiveness; euphoric; overly joyous Unstable - can change quickly to irritation & anger
what are group norms?
expectations of members' behaviors; develop over time and provide structure
test an intervention; investigator initiates a treatment or intervention to influence the risk or course of disease*****
experimental study
Gained from non-research based published articles, professional guidelines, national guidelines, organizational opinions, panels of experts, nurses, clinical experience EB nursing: using clinical expertise as evidenced when used with your other types of evidence to make clinical decisions
expert opinions
what is the preclinical stage of disease?
exposure to causative agent, no symptoms present
what clubhouse model group is available in lafayette?
extra mile
how are Narcissistic PD patients with rejection and criticism?
extremely sensitive
what is the primary cause of schizophrenia relapse?****
failure to take prescribed medications
how does the presence of chills differ between the flu and a cold?
fairly common with flu, uncommon with cold
T/F all proportions deal with death
false
T/F lithium is addictive*****
false
true or false? US citizens are protected from giardia, even while traveling
false
true or false? antipsychotics are addictive medications****
false
true or false? for patients with associative looseness, you should pretend to understand what they are saying in order to build trust
false
true or false? it is uncommon for those dying by suicide to have alcohol or some other illicit substance in their blood at the time of death
false
true or false? screening and diagnosis are identical terms
false
true or false? screenings are used as diagnostic tests for diseases*****
false
true or false? those with delusional disorder have severe impairments of daily functioning
false
true or false? those with delusional disorder often experience hallucinations
false
true or false? with modern advancements, definitive tests have been developed to identify depression
false
T/F hospitalizations for borderline PD for self-destructive behaviors are considered a effective long term solution
false; are not
true or false? abstinence precautions when positive for ebola applies only to genital sex
false; also oral
true or false? major depressive disorder is a normal part of the aging process
false; although common, it is treatable
true or false? BSN level nurses cannot lead family groups for education or support without an advanced degree
false; as long as they aren't leading actual therapy
true or false? the list of reportable diseases varies by city
false; by state
true or false? informal conversation should not be used when intervening for family therapy
false; can be used as appropriate
true or false? botulism causes the release of neurotoxins that results in a reduces level of consciousness
false; causes paralysis without affecting consciousness
true or false? TCAs are very unlikely to be lethal with overdose
false; caution in OA
true or false? bipolar disorder is an acute condition
false; chronic
true or false? hanta virus is rarely fatal in humans
false; deadly
true or false? alcohol and drugs decrease the risk of suicide since they are stimulants and increase inhibitions, decrease aggressiveness, and improve judgment
false; depressants; decreases inhibitions, increases aggressiveness, and impairs judgment
true or false? it is possible to be re-infected after recovering from ebola
false; develops antibodies for at least 10 years
true or false? schizophrenia can also be known as split personality disorder*****
false; disconnected mind with lack of coherence in mental functioning
true or false? sodium intake should be decreased when taking lithium since the kidneys cannot differentiate between the two
false; do not need to increase/decrease, but keep consistent
true or false? early life trauma can cause diminished stress responses in adulthood
false; exaggerated due to brain changes
true or false? those with brief psychotic disorder are expected to have lifelong symptoms
false; expected to return to normal
true or false? cognitive deficits associated with mania are more severe than schizophrenia
false; milder
true or false? negative symptoms are usually relatively easy to treat
false; more difficult
true or false? major depressive disorder is among the least common psychiatric disorders
false; most common
true or false? SSRIs are chosen as the first line antidepressants because they can be stopped abruptly with no rebound effects ****
false; need to taper (educate)
true or false? you should focus on teaching the patient alone about early signs of schizophrenia relapse to maintain patient-centered care
false; need to teach family as well so they can recognize the signs
true or false? psychosis is a common manifestation of hypomania*****
false; never with hypomania, but may accompany the depressive side of the disorder
true or false? categories such as paranoid, disorganized, etc are used to specify diagnoses of schizophrenia
false; no longer used
T/F ebola is a vector-borne infection****
false; not transmitted by an insect
true or false? a positive PPD indicates current TB illness *******
false; only exposure, must obtain chest xray to see if active
true or false? when presenting a topic, all available information should be provided to learners
false; only the essential material you want them to know
true or false? previous, failed suicide attempts decreases risk for future attempts***
false; put person at high probability of completing suicide in future
true or false? EBR should focus on qualitative evidence
false; should implore all types of evidence, including qualitative (verbal) AND quantitative (data)
true or false? groups who will support an individual's health changes are always available to everyone
false; some people may not be able to access them due to social or emotional isolation
T/F a person with paranoid personality disorder would do well in group therapy*****
false; tend to reject treatment/threatening
true or false? those left behind after a suicide should avoid talking about the deceased person to avoid painful emotions
false; unhealthy to hold it in
true or false? the FDA has recently approved a vaccine for ebola (antiviral)
false; vaccine was developed in 2015 but has not been approved or fully tested, and is only for emergency outbreaks
how is hepatitis A transmitted?
fecal-oral route (contaminated food, feces, sex)
what is persistent depressive disorder?****
feelings of depression most of the day in majority of days for 2 years in adults and for 1 year in children/adolescents
what are 7 primary risk factors for major depressive disorder? (FASFNOC)
female adverse childhood experiences (ACE) stressful life events first-degree family members with major depressive disorder neuroticism - negative personality trait (anxiety, fear, moodiness, worry, envy, frustration, jealousy, loneliness) other disorders (substance abuse, anxiety, personality disorders) chronic/disabling medical conditions
are males or females more likely to be affected by major depressive disorder?
females
histronic PD is more common in males or females
females
what are 8 symptoms of ebola? (FHMWVDAE)
fever > 101.5 severe HA muscle pain weakness diarrhea vomiting abdominal pain unexplained hemorrhage
what are 5 symptoms of hepatitis A? (FMAAL)
fever, malaise, abdominal discomfort, anorexia, light-colored stool
how should you communicate with patients experiencing a manic episode? (FCSAR)
firm, calm, short/concise; act on legitimate complaints redirect energy into constructive channels
which have more side effects, first or second generation antipsychotics?
first
which is more likely to cause significant EPS, first or second generation antipsychotics?
first
what generation meds are used for schizophrenia according to the dopamine theory?****
first generation
what are the two categories of medications for schizophrenia?
first generation antipsychotics/typical second generation antipsychotics/atypical
the following describes what kind of affect? immobile or blank
flat
moving rapidly from 1 thought to the next; hard to follow convo
flight of ideas
how does the presence of fever differ between the flu and a cold?
flu usually has fever, rare with cold
what are 3 treatments for salmonella? (FAA)
fluid replacement antidiarrheals (emergency) antibiotics (sepsis)
seeks and accepts authority or direction of others***
follower
Epidemiology and the foundation of public health: 1. Involves application of scientific methods for describing the _____ and ______ of health-related states or events 2. Identifies _______ of health-related states or events & modes of transmission 3. Guides public health _______ and _______-_______ 4. Assists individuals/groups in making ______ health behavior changes
frequency & pattern causes planning & decision making informed
what are guidelines for nursing care with avoidant PD? (FRAA)*****
friendly + reassuring approach accept fears assertiveness training
controls outsiders' entrance into the group****
gatekeeper
members use global statements like "always" and "never" instead of dealing with specific problems
generalizing
the following is an example of what dysfunctional family communication? "harry is always angry"
generalizing
80% of risk for schizophrenia comes from what?
genetic factors (inherited)
what are 5 biological risk factors for depression?
genetics biochemical hormonal inflammation diathesis-stress model
what tool is used to provide information and define relationships across at least 3 generations of a family? *****
genogram
what 2 tools assess family function? what is an assessment that may be done by the nurse? (GES) *****
genogram eco-map self-assessment
Respiratory disease that is spread through inhalation or direct contact of infected droplets through respiratory secretions that is accompanied by symptoms of mild fever, large lymph nodes, fine pink rash; Pregnant women at risk
german measles/rubella
what does it mean for a screening to be valid?*****
get the correct result
what does it mean for a screening to be reliable?
get the same result each time
past test question: Manic pt comes to clinic and has lost 10 lb and is so anxious they can't even sit down to eat. what is the 1st intervention done by the nurse?************
give slices of cheese finger foods allow for "eating on the run"
the observable components of an emotion
glossary
with pedagogy, kids are motivated by _____. with andragogy, adults motivated by ____-______ *****
grades self-satisfaction
the following is an example of what kind of delusion? "i am possessed by my dead father"****
grandiose
the following is an example of what kind of delusion? claiming to have been abducted by aliens****
grandiose
the following is an example of what kind of delusion? claiming to know famous people, special powers, religious themes (some valid), science-fiction themes, supernatural themes *******
grandiose
the following is an example of what type of delusion? believing that one is very powerful or important; falsely believe have great wealth, talent, influence, power or beauty*****
grandiose
what are two common delusions with manic episodes? (GP)******
grandiose or persecutory
○ Community health on high alert when cases appear; this is a rare occurrence but very serious ○ Very dangerous; can be fatal (death can occur in as little as a few hours); non-fatal cases leave permanent disabilities (mostly limb amputations)
meningococcal septicemia (meningococcemia)
what are 5 examples of sources of botulism? (HFCFO)
home-canned foods fermented foods chili peppers foil wrapped potatoes oil infused with garlic
a cognitive change associated with depression in which a person has: negative expectations for future loss of control of future outcomes passive acceptance of futility of planning to achieve goals emotional negativism - despair, despondency, depression
hopelessness
what is the central emotional factor associated with suicide?****
hopelessness
transmission from person to person; Direct (STDs) or indirect (pinworm spread on toys, clothes, bedding), common vehicle, airborne, or vector-borne*****
horizontal transmission
what are the three main implementations during the acute phase of schizophrenia? (HME)
hospitalization (monitoring for suicide risk) medication psychoeducation (help pt recognize and manage symptoms)
what should be done for a patient with lithium plasma levels 2.0-2.5?
hospitalization, drug stopped, hastened excretion by bowel irrigation or some other method
what should be done for a patient with lithium plasma levels >2.5?
hospitalization, stop med, hasten excretion, and possible hemodialysis in severe cases
Living species (human or animal) capable of being infected or affected by an agent; Genetics, age, sex, race, previous diseases, immunological status, diet, exercise, religion, customs, occupation, marital status, family background******
host
human or animal that harbors the infectious agent
host
what 4 factors of the host affect the spread of disease? (RIHI)
host resistance, immunity, herd immunity, and infectiousness of the host
ebola survive on a dry surface (doorknob, counter) for several ______ and in body fluids (blood) for several _____ at room temp. it can be killed with hospital-grade _______
hours days disinfectants
what can you teach patients who are taking antipsychotics to minimize risk for metabolic syndrome?*****
how to minimize weight gain through proper nutrition and physical activity
how is the flu treated? (HRA)
hydration and rest antivirals
how can there be hormonal causes for depression?
hyperactivity of the HPA axis
what are the 16 symptoms of serotonin syndrome? (HTFHAIMHSMITADBA) ***
hyperactivity/restlessness tachycardia (CV shock) fever (hyperpyrexia) elevated BP altered mental states (delirium) irrationality mood swings hostility seizures (status epilepticus) myoclonus incoordination tonic rigidity abdominal pain diarrhea bloating apnea (death)
which is more closely associated with bipolar II disorder, a manic or hypomanic episode?******
hypomanic
what does polydipsia cause?****
hyponatremia
what are group themes?
ideas or feelings that recur and share a common thread
in what cases would we be unable to administer the live nasal spray for flu prevention? (PIU)
if pregnant or immunocompromised under 2
in what case would long-acting injectable antipsychotics be the preferred form of treatment for those with schizophrenia?
if they are unable to stay on top of oral meds
what two questions should you ask if your patient expresses that they are suicidal and have a plan? ******
if they have the means to carry out the plan and if there's anything that would prevent them from carrying out the plan
alteration in perception involving misinterpretation of real; ex: thinking coat on rack is a bear
illusion
what are three types of visual hallucinations?
illusions, depersonalization, derealization
what Yalom Curative Factor is this an example of? ***** "you took that criticism very well. You didn't appear to become upset. Maybe I can try to do that"
imitative behavior
how is hepatitis A treated?
immunoglobulin within two weeks of exposure
what are 3 treatments for chicken pox? (IAF) how do we prevent it? what disease can occur after exposure?
immunoglobulins (IG) acyclovir fever management vaccine shingles
difficulty in setting priorities, comparing options, placing in logical order, planning; may need help from someone else
impaired executive functioning
the following is an example of what alteration in behavior? consistently interrupting in group throwing unwanted food on floor
impaired impulse control
delayed responses; misperceptions, difficulty understanding others
impaired info processing
impacted ability to learn
impaired memory
the following symptoms of mania relate to what nursing diagnosis? dysfunctional interaction with others, pressured speech, flight of ideas, annoyance or taunting of others, loud and crass speech
impaired social interaction
the following sign/symptom of schizophrenia relates to what nursing diagnosis? loose association of ideas (associative looseness)
impaired verbal communication
the following sign/symptom of schizophrenia relates to what nursing diagnosis? (3) expresses feelings or rejection or loneliness
impaired verbal communication, impaired social interaction, risk for loneliness
if a patient is withdrawn and will not answer direct questions about suicide ideation, what should you do? *****
implement suicide preactions (q15, q5, LOS, 1:1)
how do SGAs help with schizoid PD?
improve emotional expressiveness
what are the 2 major aims of family therapy? (IS)
improve skills of the individual members strengthen functioning as a whole
past test ?: what is the main goal of a schizophrenic group therapy session?*****
improved social skills
what is the difference between the bumps seen in chicken pox and small pox?******
in small pox, the bumps do not burst/collapse like with chicken pox
the following describes what kind of affect? incongruent with actual emotional state or situation, such as laughing in response to a tragedy
inappropriate
how does bupropion help with schizoid PD?
inc pleasure in life
rate or risk of developing a condition; ex: Endemic for 7 new cases since spring*****
incidence
because new cases of diabetes are being diagnosed in a population, there may be an increase in ________. the _____ increases as well because diabetes is a chronic disease with no definitive cure and most patients live a long time with this diagnosis*******
incidence prevalence
with the flu, there may be a high ______ at a particular time, but the _____ rate is low because the flu runs a short course of illness and then the person returns to wellness*******
incidence prevalence
measures the risk of disease or the probability of developing disease during the specified period; "attack rate, probability of developing disease, cumulative incidence rate"*****
incidence proportion
proportion of that population at risk that actually experience the event over a specified time****
incidence proportion
the following is an example of what? how many of the women who have the breast cancer gene actually developed breast cancer in 1 year, 5 years, or 10 years after they found out, or at a specific age*****
incidence proportion
number of new cases of disease or injury during specific period OVER the time each person was observed, totaled for all persons*****
incidence rate
rate of development of new cases within a population at risk****
incidence rate
how do all antidepressants work?
increase availability of one or more NT's
how can exercise help treat depression? *****
increases availability of serotonin in the brain
why can't we treat bipolar depression with an antidepressant alone?
increases risk of manic episode
what is the goal of the behavioral learning theory?****
increasing engagement in positive/socially reinforcing activities
period from invasion to first signs and symptoms*****
incubation period
the age-specific death rates of the standard population applied to the study population's age distribution result in an index rate that is used with the crude rates of both the study and the standard populations to produce the final hypothetical adjusted rate; required when age-specific death rates for the study population are unknown or unstable (ex: based on small numbers)
indirect adjusted rate
an APRN can perform _____ and _____ therapy for depressed patients
individual group
what is a subgroup?
individual or small group isolated within a larger group; functions separately; may have greater loyalty, more similar goals, or more perceived similarities to one another than to the larger group
group participant role that relates to specific personalities, personal agendas, and desires for having personal needs met ****
individual role
what type of therapies are useful for avoidant PD patients to help them process anxiety by provoking symptoms & planning methods to approach anxiety-provoking situations
individual therapy group therapy
the following correlates with what nursing diagnosis? difficulty with simple tasks, inability to function at previous level, poor problem solving, poor cognitive function, verbalizations of inability to cope
ineffective coping
used as indicator of overall health and availability of HC service****
infant mortality rate
what is the best indicator of community health? *****
infant mortality rate
past test ?: HIV + is ______, but if you do not show signs you are not ______. If you are HIV + and show clinical signs of AIDS then you are both ______ and ______.*******
infected diseased infected and diseased
how is ebola transmitted? (IDBC)
infected animal (bats) direct contact (skin to skin, mucous mem, etc) blood or body fluids (resp. droplets, semen) contaminated needles
entry, development, and multiplication of the infectious agent in the susceptible host
infection
when is attack rate used?
infectious diseases
potential of the host to transmit; relative ease of transmission
infectiousness
ability to enter and multiply in the host
infectivity
what are the 6 characteristics of an infectious agent? (IPVTIA)
infectivity pathogenicity virulence toxicity invasiveness antigenicity
what is hepatitis?
inflammation of the liver
in order for a DSM-5 diagnosis of bipolar I, at least 3 of what 7 symptoms must be present during the episode? (I/GDPFDIPE)********
inflated self-esteem or grandiosity dec need for sleep more talkative than usual (pressured speech) flight of ideas or subjective experience that thoughts are racing distractibility inc in goal-directed activity (socially, work, school, sexually) or psychomotor agitation (purposeless, non-goal directed activity) excessive involvement in activities that have high potential for painful consequences (buying sprees, sexual indiscretions, foolish business investments)
health teaching and health promotion allow a depressed patient to make ______ choices and shows them that depression is an illness beyond ______ control and can be managed through _______ and ______ changes. nurses should promote self-_____ activities.*****
informed voluntary meds lifestyle care
before ECT is performed, an ______ _____ must be signed. an ECT workup must be performed which includes a ______, ______, ______, ______, other ______. make sure that patients have discontinued taking any __________ before ECT because they interfere with seizure induction.
informed consent CXR EKG UA CBC labs benzo
what are 3 ethical issues with group therapy? (ICW)
informed consent confidentiality when to ask a member to leave a group as a last resort
how do you contract salmonella? (RCEFV) *********
ingestion of food contaminants with fecal matter, such as raw meat, chicken, eggs, fruits, and veggies
how do TCA's work?
inhibit reuptake of norepinephrine and serotonin
what drug class is paliperidone palmitate in?
injectable antipsychotics
crisis stabilization/observation units, general hospitals, private hospitals, and state hospitals are all examples of ______________ settings ****
inpatient
what are the characteristics of borderline PD? (IIDUUESESSHAV)*****
instability in emotional control impulsive identity/self-image distortions unstable mood unstable relationships emotional liability splitting erratic/unpredictable behavior self-destructive behaviors (cutting, sex, SA) chronic SI + self-harm hostile anger violence
what Yalom Curative Factor is this an example of? ***** "you got better, maybe I can too"
installation of hope
type of care that uses non-mainstream medicine in conjunction with standard medical care in a coordinated way ***
integrative
Form of a systematic review that does not have the summary statistics (found in meta-analysis) due to limitations of studies Ex: smaller sample size
integrative review
in group therapy with schizoid PD, they practice _______ and ______ to increase ______
interactions feedback socialization
psychotherapy with schizoid PD tends to be _______ in which they explore emotions/feelings
introspective
ability to penetrate and spread throughout a tissue
invasiveness
what are 7 behavioral signs of a manic episode? (IEB/GGDHC)
involved in get-rich schemes excessive phone calls, emails busy all hours of day /night; grandiose plans & schemes may give away money, possessions, spend excessively distractability = a hallmark symptom of mania hyperactivity , push limits >> alienates others clothing - outlandish, bizarre, colorful, noticeably inappropriate; makeup gaudy & overdone
what three medications are used to treat latent TB? (IRR)
isoniazid (INH), rifampin (RIF), and rifapentine (RPT)
what four medications can be given for active TB? (IREP)
isoniazid (INH), rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA)
what is the hallmark symptoms of hepatitis B?
jaundice
who is considered the father of epidemiology and studied cholera and where water came from in houses?
john snow
why may first generation antipsychotics be preferred over second generation? (CM)
just as effective against positive symptoms and cheaper; appropriate choice if cost or metabolic syndrome a concern
outcomes associated with depression: Attends group meetings, interacts spontaneously with others, talks with nurse 1:1, demonstrates interest in engaging with family & others, identifies ineffective and effective coping Patient will report improved mood by_______. Patient will have adequate food & water intake >> Or % of meals? Will sleep ____ hours by_______. Balanced rest, sleep, activity? Or will sleep so many hours Attend groups as scheduled through discharge.
just read
outcomes/planning for suicide: o Patient remains free from injury o Expresses will to live o Disclose plan to staff if present o Identifies coping strategies o Identifies social support o Expresses willingness to call on other for help --> Create Safety Plan o Identifies 1 support system within community
just read
the person identified as "the problem" by the family may be the actual source of the problem, may divert from other hidden problems of the family, or may be a stabilizing mechanism to bring some cohesion to family in distress
just read
what is the purpose of scapegoating?***
keep focus off painful issues and problems of blamers
why is it important to keep sodium intake consistent when taking lithium?
kidneys cannot differentiate between sodium and lithium
outcomes expected in an education group focus on the demonstration of a certain ______ level. outcomes expected in a therapy group focus more on ______, ______ changes, and reduction in _______
knowledge insights, behavior, symptoms
the cognitive domain of learning includes what 6 things? (KCAASE)****
knowledge (recall) comprehension (recall + understanding) application (incorporate) analysis (reasoning) synthesis (problem solving) evaluation (judge value)
a person with a positive PPD and a negative CXR is active TB or latent TB?******
latent
■ Without the disease ■ Bacteria is inhaled, but no effective immune response ■ Treated to prevent it from becoming active ■ Cannot be spread
latent TB
guides and directs activity****
leader
process of gaining knowledge and skills that lead to behavioral changes; include measurable change in behavior that continues over time
learning
How quickly a person would die by that particular mode; how likely that the person would die this way****
leathality of plan
what should you tell families to do if they notice early signs of schizophrenia relapse?*****
let the treatment team know right away; provide a list of who to call, what to do, and where to go (crisis plan)
personality results in ongoing relationship problems or emotional distress
liability
what is stress?
life events that impact the vulnerabilities
if you are infected with measles, how long are you immune for? how is it spread?
lifetime droplets
what is the hallmark sign of hepatitis A?
light colored stool (due to bile obstruction from inflammation)
with paranoid PD, _____ _____ is essential in therapy when threatening behaviors are present*****
limit setting
what 3 types of meds are used to treat bipolar disorder? (LAS) *****
lithium anticonvulsants SGA
what are the two types of flu vaccines?
live nasal spray flu shots (ages 18-64)
when taking carbamazepine, it is important to check ____ enzymes every ___ weeks as well as a ______ because it can cause _______ or _______ _______
liver 8 CBC leukopenia aplastic anemia
since antipsychotics can cause liver impairment, what should be tested before and throughout treatment?
liver function studies
what two tests should be performed periodically for patients taking valproate/valproic acid? (LP)
liver function studies, platelet count
what is the following alteration in speech an example of: I need to get a coke. My friend was talking about AIDS. friends talk about french fries but how can you trust the French?
loose association
haphazard, illogical thinking, poor concentration, no apparent relationship between thoughts; disordered way person processing information; thought loosely connected in conversation
loose associations
What would you check for pre-op for ECT therapy? **** (past test ?)
low Na level
what is a hypomanic episode?*****
low level and less dramatic mania; no psychotic features; manifests with unusual gaiety, excitement, flamboyance, or irritability
what 2 SGA's are approved to treat bipolar depression? (LQ)
lurasidone and quetiapine
tics can transmit what 2 diseases? (LR)
lyme disease, rocky mountain spotted fever
belief that either your thoughts or actions affect others
magical thinking
what is the following alteration in speech an example of: wearing PJs inside to make it snow because I was mad at him, he fell down
magical thinking
what is the main outcome goal in the maintenance phase of schizophrenia?
maintaining and increasing symptom control and insight
the following describes which stage of schizophrenia? stabilized and a new baseline is established*****
maintenance
the following outcome criteria would likely be determined in what phase of schizophrenia? pt will report decrease in voices
maintenance
the following outcome criteria would likely be determined in what phase of schizophrenia? pt will take prescribed medications
maintenance (when problem is adherence)
ID tension of members and take steps to support them at high-stress times
maintenance behaviors
what type of group function includes helping members affirm, accept, and support each other, resolve conflicts, and create comfort****
maintenance function
what type of group norm is the following: create group pressures to affirm members and maintain comfort; schedule meetings at convenient times and in accessible and comfortable spaces*****
maintenance norms
group participant role in which the member keeps the group together, helps the person feel worthwhile and included, and creates a sense of group cohesiveness *****
maintenance role
provides physical and psychological support for members, which holds group together****
maintenance specialist
what is the leading cause of disability in the US?
major depressive disorder
if patient meets criteria A-C of MDD, this represents what? ****
major depressive episode
mosquitoes can transmit what four diseases? (MYWZ)
malaria, yellow fever, WNV, and zika
are males or females more often affected by schizoid PD?
males
schizotypical PD is more common in males or females
males
what are 5 family functions? (MBCES)
management boundary division communication emotional support socialization
which is more dramatic and risky, a manic or hypomanic episode?******
manic
instead of asking for directly what is wanted, family members manipulate others to get what they want; start fight to get attention, requests with strings attached so that it is difficult to refuse request
manipulating
the following is an example of what dysfunctional family communication? "if you clean my room for me, i won't tell daddy you are getting bad grades in school"
manipulating
the following is an example of what dysfunctional family communication? a child starts a fight with a sibling to get attention
manipulating
when intervening with antisocial PD, the nurse should help prevent/reduce effects of _______, set clear/realistic ______ with consequences in which all staff MUST follow, carefully document ______ and signs of _______, _____ to the patient and help ____ intense situations.*****
manipulation boundaries behaviors manipulation listen defuse
what characteristic of borderline PD includes acting quickly in response to emotions without considering consequences which results in damaged relationships & suicide attempts?******
marked impulsivity
why is it important to teach patients taking FGA's about fall risk?
may cause orthostatic hypotension
why do antipsychotics carry a fall risk? (OSG)
may cause orthostatic hypotension, sedation, and gait impairment [Question a/b risk for injury s/t sedation. What is first intervention for providing safety to pt - keep floor uncluttered (meds cause sedation]
how can the environment impact suicide risk?
may copy others who have committed suicide
how can milieu therapy help those experiencing a manic episode?******
may need less stimuli; redirect aggression as needed
why is nutrition a concern for those having a manic episode? ********* test question
may not be sitting long enough to have a meal, so need finger foods to eat "on the go"
how can meningococcal septicemia lead to permanent disabilities?
may require amputation of area with decreased perfusion
a respiratory disease caused by rubeola virus that occurs in adolescence/YA that is accompanied by symptoms of fever, runny nose, sneezing, cough, cuplike spots inside the cheeks, blotchy rash several days after and serious complications such as pneumonia, encephalitis, death
measles
Lyme's disease/Measles is highly infectious and airborne VS Lyme's disease/Measles cannot spread to other people and is done by a tick
measles lyme's disease
Measures the number of new cases of events in a population at risk during a specified time***
measures of incidence
what should be done for a patient with lithium plasma levels 1.5-2.0?
med withheld, measure blood levels, and reevaluate dose
what are the four approaches to implementation during the stabilization and maintenance phases of schizophrenia? (MARC)
medication treatment adherence relationship with trusted care providers and support people community-based therapeutic services
what are two treatments for disruptive mood dysregulation disorder? (MP) ****
medication for symptoms parent training to predict and reduce aggression by consistency
what is the difference between epidemiology and medicine?
medicine = dx + tx epidemiology = study of populations, evaluating where the disease is coming from, etc
what 3 things can specialized psych care providers do? (MPG)
meds psychotherapy group therapy
what is a closed group?
membership is restricted; no new members are added when others leave
are the following manifestations of bipolar disorder more closely associated with men or women? legal problems & commit acts of violence
men
obsessive-compulsive PD occurs more in men or women?
men
what is the cause of meningococcal septicemia?
meningitis bacteria has entered bloodstream
what is the most severe form of meningitis?
meningococcal septicemia (meningococcemia)
results of SEVERAL studies are quantified; specific method of statistical synthesis used in some systematic reviews when results from several studies are quantitatively combined and summarized *****
meta-analysis
what is desvenlafaxine?****
metabolite of venlafaxine (SNRI)
what is the first line medication for mild to moderate c diff?
metronidazole
what is an example of PH application of EBP?
model of PH nursing intervention wheel
what are 3 challenging behaviors met in group therapy? (MDS) ****
monopolizing demoralizing silent
a lithium blood draw may be every _____ in the beginning. after 6 months-1 year of stability, should drop to every ___ months. Draw blood in the AM/PM, ____-____ hours after last dose
month 3 AM 10-12
patient's subjective experience of sustained emotions or feelings ****
mood
what meds are used for borderline PD?
mood regulation
Medications involved in alieviating symptoms of irritability and aggression with antisocial PD include what?****
mood stabilizers
how can lithium help with Narcissistic PD ?
mood swings
premenstrual dysphoric disorder involves what 13 symptoms? (MIDAODLOI/HBABW) *****
mood swings irritability depression anxiety feeling overwhelmed difficulty concentrating lack of energy overeating hypersomnia/insomnia breast tenderness aching bloating weight gain
what are the 6 areas for assessment of those with bipolar disorders? (MBTSTC)
mood, behavior, thought processes/speech patterns, thought content, and cognitive function
related to disease or disability; frequency of a disease occurring in a population; includes comorbidities
morbidity
r/t death; only shows end outcome
mortality
a person is bitten by a mosquito and develops west nile. what is the vector?******
mosquito
what are two examples of vectors?***
mosquitos, tics
A tool designed to help clients verbalize their own motivations to change; Designed to help clients make their own choices; collaborative partnership****
motivational interviewing
how did epidemiology shift in the 20th century?
move from thinking diseases had a single cause to multifactorial in which some can be prevented/delayed
what are the 7 symptoms of NMS? (MCRHHTD)
muscular rigidity reduced consciousness reduced responsiveness hyperpyrexia (103) HTN tachy diaphoresis
what 3 behaviors with depression are considered psychomotor agitation? (NPF) *****
nail biting, pacing, finger-tapping, or other tension-relieving activity
PD that is described as a pattern of grandiosity, need for admiration, lack of empathy, beginning by early adulthood*****
narcissistic PD
Review done on published papers that support reviewer's point of view or opinion Usually does not include systematic review process
narrative review
the following is an example of what kind of immunity? possums rarely acquire rabies
natural
what kind of immunity is species specific and is the innate resistance to infectious agent?****
natural
what is the reason humans dont get cat anemia?*****
natural immunity
what are 3 useful educational principles? (NES)
nature of learning, the educational process, and the skills of effective educators
with GI anthrax, symptoms of _____, ______, _____ _____, and _____ occur (NABF). if treated, there is less than a 40% mortality rate
nausea anorexia bloody diarrhea fever
the psychomotor domain of learning requires what 3 conditions? (ASP)****
necessary ability to perform sensory image of how to carry out the skill opportunity to practice the skill
avolition, anergia, and alogia are examples of __________ symptoms****
negative
proportion of persons with a negative test who are actually disease free****
negative predictive value
what kind of room will a patient with TB be placed in?
negative pressure
resistant or oppositional behavior
negativism
what is the biggest cause of bacterial meningitis in the community setting?
neisseria meningitidis
using made-up words with the meaning known only to the person
neologisms
what is the following alteration in speech an example of: his mannerologies are poor
neologisms
what are two biochemical risk factors for depression?
neurochemical abnormalities from genetic/medical conditions dysregulation of the NT serotonin and norepinephrine
what is a very serious and life threatening complication of antipsychotic medications in which patients must be admitted to ICU?****
neuroleptic malignant syndrome (NMS)
negative personality trait (anxiety, fear, moodiness, worry, envy, frustration, jealousy, loneliness)
neuroticism
as a nurse caring for a Narcissistic PD patient, remain ______ and recognize source of narcissistic behavior such as _____ and ______, avoid ____ struggles or becoming _______, role model _____, and set _____ as necessary
neutral fear abandonment power defensive empathy boundaries
what is an open group?
new members are added as others leave
the following is an example of what type of delusion? believing that a major catastrophe will occur******
nihilistic
do those with paranoid PD lose contact with reality?****
no
what is the treatment for measles and rubella?
no tx, but MMR vaccine [fever reducers, antibiotics for secondary infection]
Cutting, burning, scraping/scratching skin, biting, hitting, skin picking, interfering with wound healing to allieviate psychic pain or to pierce the psychic numbness being experienced; peaks during 20-29 and declines after that
non-suicidal self-injury
Deliberate, direct attempts to inflict shallow, yet painful injuries to body without intending to end one's life
non-suicidal self-injury
Participants are not chosen by chance to a study group and are typically chosen by the researcher
nonrandomized clinical trial
levomilnacipran inhibits reuptake of ______________ more than ______________ (serotonin/norepinephrine)*****
norepinephrine, serotonin
rules about staring on time and no interrupting are examples of group _____
norms
what is the major cause of mania relapse?*******
not adhering to mood-stabilizing medications
how can serotonin syndrome be prevented regarding SSRIs? (NW) ***
not taken with another serotonin-enhancing drug like st john's wort if switching from certain drugs, allow a "washout" period, discontinuing all SSRIs for 2-5 weeks
why is it alarming when a suicidal patient suddenly shows a brightening of mood and more energy, especially after being prescribed an antidepressant?****
now have the energy to carry out their suicide plan
what is the numerator and denominator for crude mortality rate? *****
num: # deaths from any cause during time interval denom: estimated mid-year population
what is the numerator and denominator for case fatality rate (CFR)? *****
num: # deaths from specific disease denom: # persons diagnosed/cases
what is the numerator and denominator for proportionate mortality rate?
num: # deaths from specific disease denom: total # deaths in same period
what is the numerator and denominator for infant mortality rate?
num: # deaths of infants > 1 year of age in 1 year denom: total # live births in same year
what is the numerator and denominator for neonatal mortality rate?
num: # deaths under 28 days of age in 1 year denom: total # live births in same year
what is the numerator and denominator for incidence rate?*****
num: # new cases during specific period denom: time each person was observed, totaled for all persons
what is the numerator and denominator for incidence proportion? *****
num: # new cases during specific time denom: size of population at start of period
what is the numerator and denominator for prevalence?*****
num: all new + pre-existing cases during a given period denom: population during same period
in epidemiology, what does the numerator of a proportion indicate? what about the denominator?
numerator: number of cases (cause) denominator: number of people in population at risk (total)
Patient with hallucinations >> Box 12.3 p. 209 Patient with delusions >> Box 12.4 p.209
o Ask about the *content* of the hallucinations & how patient *reacting* to them. Assess for *command hallucinations* and if *causing fear or distress.* o Avoid referring to hallucinations as though they are real - not "What are the voices saying?" but rather ask *"What are you hearing?"* (real to them) o Do not negate their experience - but *offer own perceptions* - "I do not hear the voices, but that must be frightening to you." o *Use other sounds to compete* - headphones with music if allowed o ***Tell the voices to go away*** !!!!!!! o Tell yourself that the *voices are a symptom & not real* o Tell yourself that no matter what you hear - *you will be safe & you can ignore what you hear.* o *Never debate delusions* o *Validate the part of the delusion that is true* - "Yes, there was a man at the nurse's station, but I did not hear him talk about you." o Focus on reality-based topics. *Promote reality testing* by questioning - "I wonder if there might be another explanation for ____________."
what are the 3 cluster C PD? (ADO) do they worsen or lessen with age?*****
o Avoidant o Dependent o Obsessive-compulsive worsen
what are the 4 cluster B PD? (BNHA) do they worsen or lessen with age?*****
o Borderline o Narcissistic o Histrionic o Antisocial lessen
what are the 10 second generation antipsychotics used to treat schizophrenia? (CROQZPILAA)
o Clozapine o Risperidone o Olanzapine o Quetiapine o Ziprasidone o Paliperidone o Iloperidone o Lurasidone o Asenapine Aripiprazole
what are the 6 risk factors for personality disorders? (GEDTNP)
o Genetic - traits inherited o Environmental - childhood neglect or trauma o Diathesis-stress model : diathesis refers to the genetic/biological vulnerabilities; under conditions of stress, personality development becomes maladaptive for some > results in personality disorder o Temperament- tendency to respond to challenges in predictable ways such as "laid back" or "uptight" o Neurobiological o Psychological
what are the guidelines for nursing care for Obsessive-compulsive personality disorder? (GCSC)
o Guard against power struggles o Remember that the patient has difficulty dealing with unexpected changes o Structure - let enough time for habitual behavior o Identify ineffective coping >>develop effective coping
what are the 3 cluster A PD? (PSS) do they worsen or lessen with age?*****
o Paranoid o Schizoid o Schizotypal worsen
what are the characteristics of obsessive-compulsive PD? (RICESU)****
o Rigidity; inflexible standards for others and self o Constant rehearsal of social responses o Excessive goal-seeking that is self-defeating or relationship-defeating o Strict standards interfere with project completion o Unhealthy focus on perfection
what are 7 nursing roles with group education? (SCCKMAE)
o Supporting o Collaborating o Clarifying o Keeping group focused o Maintaining member self-esteem o Analyzing o Evaluating cmcn skills of educators box: Effective, solicits input, advocates, leads/participates, uses resources to convey info, effectively presents info Attitudes: listens unbiasedly, respects POV, promotes
what is the main difference between observational and experimental studies?*******
observational: researcher observes correlations but does not intervene experimental: tests effectiveness of an intervention
what is a common alteration in facial expressions for those with schizophrenia?
often grimaces or some other illogical expression
what two SGA's are most commonly used for acute mania? (OR)*******
olanzapine, risperidone
those with bipolar I have experienced at least _____________ manic episode(s)
one
what is a heterogenous group?
one with a range of differences between members
what is group conflict?
open disagreement among members; positive resolution necessary
what are overt statements?****
open; those plainly stated
what phase of group development involves introductions and creating a positive environment, encouraging members to talk to each other respectfully and maintain confidentiality? *****
orientation
The presence of personality disorder results in poorer ______ in treatment of other psychiatric disorders and may underlie treatment-______ cases Emotional dysregulation is amplified and is poorly modulated characterized by ______ _____
outcomes resistant mood swings
PCP's, ACT's, IOP's, PHP's, mobile mental health units, telephone crisis counseling, and telepsychiatry are all examples of mental health care in the ________________ setting
outpatient
many psych patients move to what level of care after discharge from a psychiatric hospital?
outpatient in order to continue care
how does a c diff infection work?
overgrows and destroys healthy bacteria in the intestine
Is this statement overt or covert? "I can't take it anymore"*****
overt
an epidemic on multiple continents; "worldwide outbreak"; Covid-19
pandemic
an epidemic that occurs worldwide and affects large populations****
pandemic
epidemic on multiple continents; presence of an event in epidemic proportions, involving many communities and countries in a relatively short period of time***
pandemic
match the disease to the correct disease spectrum (endemic, epidemic, pandemic)***** 1. covid-19 2. polio 3. HIV/AIDS 4. pertussis 5. SARS 6. Influenza A H1N1
pandemic epidemic pandemic endemic pandemic pandemic
irrational fear ranging from mild (wary, guarded) to profound (irrational fear that someone wants to kill you), resulting in some defensive actions
paranoia
pin worms, trichomoniasis, and toxoplasmosis are caused by what kind of organism?
parasite
why do relationships not last with histronic PD?
partner feels smothered
immunization through the transfer of a specific antibody from an immunized individual to a non-immunized individual; from mother to child or by infusion********
passive acquired immunity
transfer of antibodies from mother to infant or immunoglobulin/antiserum immunoglobulins for Hep A, rabies, tetanus are examples of what type of immunity?*******
passive acquired immunity
eating vitamin fortified foods and fluordination of water supplies are examples of what?
passive primary prevention
type of primary prevention that does not require behavior change
passive primary prevention
ability to produce a specific clinical reaction after infection occurs
pathogenicity
criteria used to evaluate the usefulness of evidence
patient-oriented evidence that matters (POEM)
why is Narcissistic PD difficult to treat?
patients not likely to seek help or confront shortcomings
what did aaron beck determine regarding cognitive aspects of depression?
patients with depression tend to have a certain combination of similar negative attitudes; people with depression process info in a negative way and ignore positive aspects of their lives
group leadership that has one person has final authority for group direction and involvement
patriarchal
attempts to reconcile conflict between group members or takes action in response to influences that disrupt the group process and threaten its existence****
peacemaker
teacher makes decisions about what will be learned and how and when it will be learned *****
pedagogy
match the tuckman step of the working phase of group development to its correct definition: 1. groups have establishing norms and rules and the focus is on achieving *goals* 2. *disagreements*, attempts at dominance, and personality clashes that must be addressed for the work to be done 3. personality clashes and disagreements are *resolved*, and a spirit of *cooperation* emerges ******
performing storming norming
the following is an example of what kind of delusion? FBI is spying on them; someone is harassing them - untrue
persecutary
the following is an example of what type of delusion? being singled out for harm; others are "out to get me;" thinking neighbors, family, etc. are planning harm, are spying, etc ******
persecutory
dysthymia is now known as what?
persistent depressive disorder
what aspect of descriptive epidemiology deals with race, sex, age, education, occupation, income, and marital status?*****
person
what is anosognosia?
person is unable to realize that they are ill, caused by the illness itself
Refers to proportion of persons who have a condition "existing disease" at or during a particular time period; usually for chronic diseases*****
prevalence
proportion of population with a condition****
prevalence
measure of existing disease in a population at a particular time***
prevalence proportion
the following is an example of what? prevalence of diabetes has increased over the last 10 years*****
prevalence proportion
how do MAOIs work?
prevent inactivation of amines like norepinephrine, serotonin, dopamine, and tyramine, resulting in an increase of mood-elevating NT's
nurse's role in epidemiology include: 1. looking at health and disease causation and how to _____ and _____ illness 2. using ______ to monitor disease trends which is reported to the _______ to ID patterns of disease in a group 3. caring for patients by _____ patients and giving ______
prevent,tx surveillance CDC educating vaccinations
what does latent TB treatment focus on?
preventing it from becoming active
education to daycare workers about hand hygiene, diapering, and food prep and storage; education of wearing seatbelts, immunizations are all examples of what level of prevention?
primary
for west nile, we use ______ prevention when using insect repellants, long sleeves, avoiding standing water, ensuring window/door screens in place, and using the AC when possible
primary
teaching coping strategies and giving psychosocial support is an example of ______________ prevention ****
primary
what level of prevention involves preventing incidence of diseases before they occur?******
primary
what type of prevention focuses on promoting and preventing the occurrence of disease, injury, or disability?
primary
what is the resolution stage of disease?
problem resolved, returned to health or chronic state or death
carbamazepine as a mood stabilizer seems to work better for patients in what 2 cases? (RP)
rapid cycling and severely paranoid angry patients experiencing mania rather than in euphoric, overactive/overfriendly patients experiencing mania
measure of frequency/how often; ratio; Deals with # of events over specific times; change over time and with additional specifics
rate
are rates ratios or proportions?
ratio
bipolar outcomes: o Demonstrates improved impulse control o Sleeps 4 - 6 hours per night o Completes __% of meals o Attending to hygiene; dresses in clean clothes o Demonstrates improved verbal interactions; avoids violating others' space o Patient is compliant with prescribed medication
read over
past test ?s: ****** ■ TB test - should be flush with arm ■ Nurse in close contact w/pt infected with TB - positive PPD if 8 mm (greater than 5 mm) ■ TB has s/s similar to flu
read over
scenario/example for EBP: Self-Management Education for Adults With Type 2 Diabetes A meta-analysis of the effect on glycemic control Susan L. Norris, MD, MPH1, Joseph Lau, MD2, S. Jay Smith, MIS, MSC3, Christopher H. Schmid, PHD4 and Michael M. Engelgau, MD, MSC1 + Author Affiliations OBJECTIVE—To evaluate the efficacy of self-management education on GHb in adults with type 2 diabetes. RESEARCH DESIGN AND METHODS—We searched for English language trials in Medline (1980-1999), Cinahl (1982-1999), and the Educational Resources Information Center database (ERIC) (1980-1999), and we manually searched review articles, journals with highest topic relevance, and reference lists of included articles. Studies were included if they were randomized controlled trials that were published in the English language, tested the effect of self-management education on adults with type 2 diabetes, and reported extractable data on the effect of treatment on GHb. A total of 31 studies of 463 initially identified articles met selection criteria. We computed net change in GHb, stratified by follow-up interval, tested for trial heterogeneity, and calculated pooled effects sizes using random effects models. We examined the effect of baseline GHb, follow-up interval, and intervention characteristics on GHb. RESULTS—On average, the intervention decreased GHb by 0.76% (95% CI 0.34-1.18) more than the control group at immediate follow-up; by 0.26% (0.21% increase - 0.73% decrease) at 1-3 months of follow-up; and by 0.26% (0.05-0.48) at ≥4 months of follow-up. GHb decreased more with additional contact time between participant and educator; a decrease of 1% was noted for every additional 23.6 h (13.3-105.4) of contact. CONCLUSIONS—Self-management education improves GHb levels at immediate follow-up, and increased contact time increases the effect. The benefit declines 1-3 months after the intervention ceases, however, suggesting that learned behaviors change over time. Further research is needed to develop interventions effective in maintaining long-term glycemic control.
read over and apply to concepts
3 past test quesitons: ****** with schizophrenic patients that are hearing voices, present _____ and tell them "I only hear your voice and my voice." the family should call the MD if ______ return to prevent relapse. should a patient journal what the voices are saying to cope with hearing voices?
reality hallucinations tell voices to go away; thoughts too disorganized to journal
what type of group norm is the following: members reinforce or challenge and correct their ideas of what is real; influence each member to see relevant situations in the same way other members see them Ex: examine life situations facing members and help them make sense of them Ex: DM group defines an uncontrolled diet as harmful --> members influence one another to maintain diet control --> nurse provide info and support******
reality norm
what can happen with abrupt discontinuation of SSRIs? ****
rebound symptoms and return of depression symptoms
what model believes that healing is possible and attainable, and focuses on strengths? ****
recovery model
what are 8 early signs of schizophrenia relapse? (RSWSTUHU) *******
reduced sleep, social withdrawal, worsening concentration, sleep disturbances, troubling thoughts, unsure of what is real, hearing voices, becoming more uncomfortable around others
what is the treatment for pseudoparkinsonian symptoms? (RD)
reducing the dosage of the antipsychotic or trying a different drug
case management with suicidal patients include aftercare ______ and ID ____ systems
referals support
the following is an example of what type of delusion? events or circumstances that have no connection to patient are somehow related to patient; believe newspaper articles, TV shows, songs are directed directly at them****
referential
an important nursing role in relation to group therapy is ______ to ____-based groups such as ______ groups like NAMI and ____-___ groups like AA/NA/OA *****
referral community support self-help
lamotrigine is used to treat ______ mania***
refractory
during evaluation of family therapy, evaluate the family's knowledge of therapeutic ______, help the family access outside _____, and look for improved family _______. during family consultations, nurses can help families by ______ the family, pointing them to family organizations such as _______, _____ the family, and _____ them to clinical services
regimen support coping mentor NAMI support refer
what could happen if a schizophrenic patient was nonadherent to medication regimen?
relapse
estimation of the risk of acquiring a problem for those exposed compared with those unexposed
relative risk
the precision of the measure and consistency/repeatability of the measurement
reliability
what are the two most important factors of a good screening?*****
reliable and valid
what 3 things can you do when there is monopolizer in a group? ***** (EPL)
remind about equal chance to contribute speak to them in private limit times to speak
what are commonly stereotyped behaviors for those with schizophrenia?*******
repetitive movements that do not serve a logical purpose, such as rocking back and forth for hours
ability for the host to withstand infection; Requires either natural or acquired immunity
resistance
treatment is in the _______ stage and _____ prevention is used
resolution tertiary
a PD marked by a pervasive pattern of detachment from social relationships; restricted range of emotions in interpersonal settings; begins by early childhood*******
schizoid personality disorder
cognitive deficits associated with mania are similar to _________________******
schizophrenia
family psychoeducation has been deemed especially successful in the treatment of ________
schizophrenia
to be diagnosed with SAD, a person must have symptoms of _______ along with ______, _______, and _______ ______ ****
schizophrenia MDD mania mixed episodes
what is the most expensive of all chronic illnesses? why?*****
schizophrenia; lifelong intervention needed and expensive inpatient treatment; strikes just as approaching earning years
what disorder has essential features of schizophrenia, but lasts less than 6 months?****
schizophreniform
what is the difference between Schizotypical PD and Schizophrenia? *********
schizotypical: psych symptoms are at a lesser degree and brief. they can be made aware of their suspiciousness, magical thinking, odd beliefs schizophrenia: far stronger delusions
light therapy is helpful for what type of depression? ***
seasonal affective disorder
event-related, time not measured from fixed dates, but time of exposure Ex: mardi gras 2020 and covid exposure
seasonal variation
what generation meds are used for schizophrenia for multiple neurochemical imbalances?******
second generation
DUI checkpoints, education on how to avoid exposures that flare up asthma, family history assessment, mammograms, pap smears, colonoscopy, glucose testing in pregnancy, oral rehydration therapy (ORT) are all examples of what level of prevention? *****
secondary
TB tests are examples of _____________ prevention
secondary
screening is an example of ____________ prevention*****
secondary
taking a health history to identify risk factors is an example of ____________ prevention*****
secondary
what kind of prevention has the goal to detect disease that may already exist in a person?***
secondary
what kind of prevention is aimed at reducing the prevalence with early identification of problems and screening intended to delay or avert progression? *****
secondary
what kind of prevention refers to interventions which increase the probability that a person with a disease will have the disease diagnosed early and treatment will cure it and occurs to reduce disease progress with the goal to detect disease?****
secondary
what level of prevention involves preventing the spread of diseases once it occurs by rapidly identifying poential contacts of reported cases?*****
secondary
long term patterns of morbidity and mortality, short term patterns, and outbursts of disease or conditions for a certain period of time
secular trends
what are 9 side effects of second generation antipsychotics? (SSSIAMAPL)******
sedation sexual dysfunction seizures inc mortality in elderly with dementia agranulocytosis (clozapine) metabolic syndrome anticholinergic toxicity prolonged QT interval (quetiapine, risperidone, ziprasidone) liver impairment
what is the main thing to teach patients about when taking lamotrigine?
seek medical attention for rash, since it may be a sign of stevens-johnson syndrome
what are three ways studies can be biased? (SMC)******
selection or the way subjects enter a study misclassification of subjects once they are in the study confounding variables not accounted for
what MAOI is available as a transdermal patch? what benefit does this provide?****
selegiline; does not require strict dietary restrictions
the following symptoms of mania relate to what nursing diagnosis? minimal calorie intake, poor hygiene, clothing unclean
self-care deficit
the following sign/symptom of schizophrenia relates to what nursing diagnosis? shows lack of motivation/avolition, unable to initiate tasks (ADLs)
self-care deficit (bathing, hygiene, dressing, grooming)
what type of interview is effective in borderline PD?
semi-structured
validity of a screening is measured by what 2 things? (SS)
sensitivity specificity
what is the hallmark sign of meningitis?
sensitivity to light
what is the role of outpatient psych nurses?
service provision in a variety of settings
past test ?: Bipolar manic gets up in middle of group and says "It's smoke time, I'm leaving". You should respond "please sit down smoke break if after group"*****
setting limits
what is the primary goal of family psychoeducation? *****
sharing of mental healthcare information
with depressed patients, nurses, prescribers, mental health technicians, social workers, etc. should all work together. safety must be kept at a priority with focus on care with ______, ______ prevention, and ______ risks
sharps, suicide prevention, strangulation risks
Passive immunity from immunoglobulins is almost immediate but is short/long lived*****
short
are point epidemics short or long term?
short term
what should water intake consist of when taking lithium? why?
should be consistent and 1500-3000mL/day; need to keep sodium/lithium vs water concentrations level to reduce AE's
what should be done if a screen tests positive?
should be referred for diagnostic evaluation to determine if they actually have the disease and need treatment
how did florence nightingale contribute to epidemiology? (M)
showed improved environmental conditions and added nursing care decreased mortality rates of soldiers
nurses can promote recovery by helping patients recognize _____ ____ and _____ of meds which helps patients self-_______ AND by practicing _______ ______ _____ which is respectful and responsive care that incorperates patient preferences, needs, and values ****
side effects interactions advocate patient-center care
what are symptoms of agranulocytosis?
signs of infection (fever, chills, sore throat)
what challenging behavior involves observing until the person feels that the group is safe, and they may feel incompetent? *****
silent
the following symptoms of mania relate to what nursing diagnosis? agitation, anxiety, confusion, perceptual disorders, restlessness,
sleep deprivation
what are 4 interventions for managing anorexia as a vegetative sign of depression? (SEWP)
small, high-calorie, high-protein snacks/fluids frequently encourage familial involvement weight pt weekly patient preference
Eradicated since 1979; Do not immunize anymore which makes it a leading candidate for bioterrorism; Susceptibility is 100% if not vaccinated; fatality rate is estimated at 20-40%, or higher if not vaccinated
smallpox
what is the confounding variable in the following situation? Found an association between gambling and lung cancer. The study may be confounded by _____. correlation does not/does equal causation *******
smoking does not equal
what are 9 characteristics of schizotypical PD as emphasized by DSM-5? (SIMOSIARP)******
social deficits interpersonal deficits magical thinking that influences behavior odd beliefs strange speech patterns inappropriate/constricted affect anxiety in all social situations (familiar or not) ramble in convo paranoia
the following correlates with what nursing diagnosis? dull/sad affect, no eye contact, preoccupation with own thought, seeks to be alone, uncommunicative, withdrawn, feels rejected and not good enough
social isolation
the following sign/symptom of schizophrenia relates to what nursing diagnosis? uncomminicative, withdrawn
social isolation
as a nurse caring for a schizotypical PD patient, respect the patient's need for ______ _____, be aware of and intervene appropriately with patient's ________, perform careful diagnostic ______ for symptoms that may need intervention (ex: suicidal thoughts), be aware that strange ______ may be part of a patient's life
social isolation suspiciousness assessment beliefs
what theory shows a perspective that states people learn within a social context and states that learning is facilitated through concepts such as modeling and observational learning?****
social learning theory
what type of theory is the critical learning theory?
social theory
using symbols instead of direct communication Example - demons are sticking needles in me - meaning feeling a sharp pain
symbolic speech
what drug is approved for bipolar depression since it contains a combination of olanzapine and fluoxetine?
symbyax
what is the main method of differentiating between the cold and the flu?
symptom onset; abrupt with flu, gradual with cold
what is the clinical stage of disease?
symptoms are present
what are affective symptoms?*****
symptoms involving emotions
what should be done for a patient with lithium plasma levels <1.5?
symptoms will often subside, but keep doses low and assess kidney/thyroid function before treatment and then on annual basis
use existing health data in real time to provide immediate analysis and feedback to those charged with investigation and follow-up of potential outbreaks
syndromic surveillance systems
identifying, appraising, and synthesizing research evidence in which research is relevant to ONE topic and aimed at evaluating and interpreting all available research to that topic; need computer accessibility (MEDLINE) ******
systematic review
what are 4 approaches used to search for the best evidence? (SMIN)****
systematic review meta-analysis integrative review narrative review
what are four tests for TB? (TPCA)
t-spot, PPD/mantoux (TST), chest xray, and AFB sputum culture
what is a drawback of antidepressants?*****
takes 1-3 weeks or longer for mood improvement
what can you do when there is a demoralizing person in your group? (P) ****
talk to them privately
wandering off topic & does not get to the point
tangentiality
persistent EPS side effect involving involuntary movements like lip smacking, neck twisting, facial grimacing, chewing that usually occur after prolonged treatment
tardive dyskinesia
what are the three types of group participant roles? (TMI) ****
task maintenance individual
what type of group function includes anything a member does that deliberately contributes to a group's purpose; Problem-solving skills, access to material resources, skills in directing ****
task function
what type of group norm is the following: commitment to return to the central goals of group; strength determines group adherence to work****
task norm
group participant role in which the member keeps the group focused on main role and help get the job done ****
task role
focuses or directs movement toward main work of group****
task specialist
best way to see if a patient learned from your education; immediate demo and teaching another
teach back
out of the following, which results in the most student retention of learning? reading lecture practice doing discussion demonstration teach others audiovisual
teach others
what 4 things are crucial for dealing with a borderline PD? (TBSC)
teamwork boundaries straightforward consistency
when does persistent depressive disorder usually onset? ****
teen years
during what phase of group development are feelings of loss and anger about group's termination discussed? *****
termination
what phase of group development summarizes personal accomplishments, shares new insights, reflects on progress, and identifies future goals, while providing feedback? ******
termination
fitness programs for heart attack patients are examples of _____________ prevention
tertiary
halfway houses for recovering alcoholics are an example of _____ prevention
tertiary
physical/occupational therapy for CVA victims is an example of ____________ prevention
tertiary
shelter homes for mentally disabled, fitness programs for MI patients, DOT with TB are all examples of _____ prevention *****
tertiary
shelter homes for the developmentally disabled are examples of _____________ prevention
tertiary
what kind of prevention involves interventions aimed at limiting disability from disease and enhancing rehabilitation; disease has already occured/exists?
tertiary
what kind of prevention involves treatment of disease with a focus on preventing progression of problems and aims at preserving or restoring functional ability? ****
tertiary
what level of prevention involves reducing complications of diseases through tx and rehab?******
tertiary
what is screening?*****
testing of groups of individuals who are at risk for a specific condition but do not have symptoms
the intervention wheel contains what 3 major levels of practice? (CSI)
the community, the systems, and the individual/family
what is research utilization?
the process of transforming research into practice
what is group process?
the way the group interacts with each other, such as being supportive, interruptive, judgmental, silent, etc; the art of doing group work; dynamics of interaction
what are 2 psychosocial interventions with suicide? (TS)
therapeutic alliance safety plan
interpersonal & social relationships & functioning are maladaptive, complicated, dysphoric; a state of being dissatisfied
unhealthy personality
what Yalom Curative Factor is this an example of? **** "you feel that way too? Wow, I am not alone"
universality
in 1999, the supreme court decreed that keeping people in psych hospitals was ______ _____
unjustified isolation
what are the 4 affective symptoms of schizophrenia? (ULID)
unstable/erratic labile incongruent depression
how long can hepatitis B live on counters?
up to one week
how does the presence of aches differ between the flu and a cold?
usual with flu, slight with cold
how does the presence of fatigue/weakness differ between the flu and a cold?
usual with flu, sometimes with cold
how is hepatitis A prevented? (VH)
vaccination and hand hygiene
what are two means of preventing hepatitis B? (VP)
vaccination and protection during sex
what can we do to prevent pertussis?
vaccine (Tdap)
how is the flu prevented? when does this method begin to be effective?
vaccine (live or flu shot) 10-14 days
what are the three types of auditory hallucinations? (VCC)
vague sounds, clear voices, or commands to take action (dangerous)
a false positive TB test is an indication of the abscence of ______ in a screening
validity
sensitivity and specificity; measures what it claims to measure and how accurate it is
validity
what drug has surpassed lithium in treating acute mania?
valproate/valproic acid
what is the gold standard mood stabilizer?
valproate/valproic acid
what 3 anticonvulsants are used for mood stabilization in bipolar patients? (VCL)*****
valproate/valproic acid carbamazepine lamotrigine
what medication is given for severe c diff?
vancomycin
what four antibiotics may be used for MRSA? (VRLS)
vancomycin, rifampin, linezolid, and sulfamethoxazole-trimethoprim
what are 3 sources of error with the reliability of a screening? (MOC)
variation inherit in the measured trait, observation variations, consistency in instrument
virus caused by varicella-zoster that is spread via respiratory (primary) or fluid from blister that is accompanied by sudden onset of slight fever and mild symptoms and rash present at onset. Vesicular lesions appear in 3-4 days then scab. Lesions abundant to trunk area and superficial lesions collapse by puncture
varicella (chicken pox)
Transmit the infectious agent by biting or depositing the infected material near the host****
vector
what SNRI is a popular next-step after trying SSRIs?****
venlafaxine
what are the 4 SNRIs used for the treatment of depression? **** (VDDL)
venlafaxine desvenlafaxine duloxetine levomilnacipran
transmission from parent to child via sperm, placenta, milk, vaginal contact***
vertical transmission
label the following preventable diseases as being viral or bacterial: **** 1. Measles 2. Rubella 3. Pertussis 4. Diphtheria 5. Influenza 6. Polio 7. Meningitis 8. Hepatitis B 9. Mumps 10. Varicella (chicken pox) 11. Streptococcus pneumonia
viral viral bacterial bacterial viral viral both both viral viral bacterial
ability to produce a severe pathological reaction
virulence
hepatitis A is caused by what type of organism?
virus
distortion of visual stimuli or formed and realistic; most common are seeing individuals or animals
visual hallucinations
what is diathesis?
vulnerabilities such as genetics, biochemical makeup, and personality structure
what is the aim of the cognitive learning theory?*****
want to help pt recognize and reassess patterns of negative thoughts and replace them with positive thoughts
how do we prevent most water-borne illnesses?
water purification through chlorine or boiling
in the first week of taking lithium, why do patients gain weight? how much do they gain?
water retention; up to 5lbs of water weight
diseases that contaminate by entering water supplies through fecal contamination***
waterborne diseases
what are 11 symptoms of severe c diff? (WCFBNDAWSKI)
watery diarrhea 10 to 15 times a day abdominal cramping and pain, which may be severe fever blood or pus in stool nausea dehydration anorexia weight loss swollen abdomen kidney failure inc WBC
what are two symptoms of moderate c diff? (WC)
watery diarrhea 3+/day for 2 or more days mild abdominal cramping and tenderness
when others can move the person's limbs, but the person will hold their limbs in that position for hours
waxy flexibility
what adverse effect is common with lithium?
weight gain
an emerging infectious disease relatively new to the US that stems from infected mosquitos or birds with the first outbreak in 2002 then again in 2012; 1st type is r/t animals in a particular area and does not harm or result in human illness; 2nd type has associations with clinical human encephalitis
west nile virus
with command hallucinations, it is important to assess ____ the patient is hearing, the ability to recognize the hallucination as "____ ____," and the patient's ability to _____ any commands****
what not real resist
when do patient seek care for antisocial PD?
when its court ordered
what is considered multidrug resistant TB?
when the organism is resistant to at least isoniazid and rifampin
what is bipolar II?*****
when they have experienced at least 1 hypomanic episode and at least 1 major depressive episode
in the surveillance of communicable disease, gather the _____, _____, _____, and _____ to use to answer the _______
who when where what why
analytic epidemiology is considered in terms of what two questions?****
why are some people affected more than others? how does it occur?
what can happen if a patient taking MAOIs eats tyramine-containing foods? *****
will not be broken down, resulting in hypertensive crisis
how is water purification different for protozoa than for other organisms?
will not respond to chlorine treatment, so need to boil water
should lithium be taken with or without meals?
with
when should premenstrual dysphoric disorder symptoms disappear? ****
with onset of period
how quickly can meningococcal septicemia cause death?
within a few hours
are the following manifestations of bipolar disorder more closely associated with men or women? abuse alcohol, commit suicide, develop thyroid disease
women
what phase of group development facilitates communication, flow of group processes, and group conduct, encouraging a focus on solving a problem consistent with the purpose of the group?
working
use of totally unrelated words; extreme loose associations
world salad
what is the following alteration in speech an example of: throat hoarse strength of policy highlighters on a boat reigning supreme
world salad
what are 5 feelings to be assessed for in depressed patients? (WGHHA) ****
worthlessness, guilt, helplessness, hopelessness, anger
would this be an appropriate goal for a manic patient: client will sleep at least 5 hours uninterrupted within 7 days of admission.*************
yes
if a person has Autism or other childhood diagnoses, can they be diagnosed with schizophrenia? *****
yes if criteria met
avian flu, ebola, flu virus jumping species, covid-19, and anthrax are all examples of what?
zoonosis
when an animal transmits a disease to a human; where 75% of recent diseases come from
zoonosis
what are the 9 first generation antipsychotics used for schizophrenia? (CTLPFHPTT)*******
§ Chlorpromazine § Thioridazine § Loxapine § Perphenazine § Fluphenazine § Haloperidol § Pimozide § Thiothixene § Trifluperazine
what are the 6 parts of the health belief model for motivation? (SSBBCS)*****
§ Perceived susceptibility § Perceived severity § Perceived benefits § Perceived barriers § Cue to action § Self-efficacy
what are 4 MAOIs? (PTIS) ******
§ Phenelzine § Tranylcypromine § Isocarboxazid § Selegiline
what are 7 types of learning formats that can be used to effectively develop health education programs? (PDSHNLB)
§ Presentation: large group, consistent message § Demo: how to do a task § Small informal group: learn from one another, share experiences § Health fair § Nonnative language sessions lecture bloom's taxonomy
what are 4 NDX associated with antisocial PD? (RDII)
§ Risk for other-directed violence § Defensive coping § Impaired social interaction § Ineffective health maintenance
what are 7 NDx associated with borderline PD? (SRRRIDI)
§ Self-mutilation*** § Risk for suicide § Risk for self- and/or other-directed violence § Impaired social interaction § Disturbed personal identity § Ineffective coping
in evaluating the usefulness of evidence using POEM, what 4 questions do we ask? (RIVA)
§ What are the results? § Are they important? § Are results valid? § How can results be applied to client care?
It is essential to evaluate the evidence and where is was procured. what 7 questions should you ask? (FWJBQEV)***
§ Who paid for the study? (how was it funded) § What website did you find it on? (who funds the website?) § What journal published it? (is it peer reviewed?) § Is there any bias? § What is the quality of the study? § Was an ethics board consulted prior to the study? (IRB Board) § Where all variables considered?
what are 3 elements to consider when evaluating lethality? (SLA)
· 1) Is there a specific plan? · 2)How lethal is the proposed method? · 3) Is there access to the planned method?
outcomes for antisocial PD are difficult to accomplish and involve what 6 things? (AACSHH)
· Abusive behavior self-restraint · Aggression self-restraint · Coping Social interaction · Health promotion knowledge · Health promoting behavior
what are 8 things to assess with an antisocial PD patient? (SCSVAAMS)***
· Current life stressors · Criminal history · Suicidal thoughts Violent/homicidal thoughts · Anxiety Aggression/anger levels · Motivation for maintaining control · Substance misuse
the affective domain includes what 6 things? (KCAASE) ******
· Knowledge - receiving information · Comprehension - responding · Application - value the info · Analysis - info makes sense · Synthesis - organizing info · Evaluation - adopting behaviors
learner motivation is influenced by what 3 factors? (VEA)
· The value component (Why am I learning this?) · The expectancy component (Can I do this?) · The affective component (How do I feel about this)
descriptive epidemiology is considered in terms of which 4 questions? *****
· What is disease? · Who is affected? · Where are they? · When do events occur?
what are 3 disinhibited behaviors associated with antisocial PD? (HDI)*****
· high risk taking · disregard for responsibility · impulsivity
are hepatitis B symptoms chronic or acute and include what 6 symptoms? (FJLNFJ)
■ Mild flu like ■ Jaundice ■ Extreme lethargy ■ Nausea ■ Fever ■ Joint pain
what symptoms does botulism cause? (DDFDDTNVAP)
● Difficulty swallowing or speaking ● Dry mouth ● Facial weakness on both sides ● Double vision ● Drooping eyelids ● Trouble breathing ● Nausea, vomiting, and abdominal cramps ● Paralysis
what are 2 ways to treat lyme's disease? (DA)
● Doxycycline ● Amoxicillin
what are 6 symptoms of lyme's disease? (FCFASB)
● Fever ● Chills ● Fatigue ● muscle/joint ache ● Swollen lymph nodes ● Bullseye rash
true or false? restraints, seclusion, and medication are of last resort with an aggressive patient
true
true or false? 1-2/1,000 people with measles will die from it, even with treatment
true
true or false? SSRIs have few to no anticholinergic effects ****
true
true or false? a court can mandate family therapy if criminal behavior is involved
true
true or false? all health care professionals are obligated to read, understand, and implement the latest research findings consistent with the area of practice
true
true or false? antipsychotics are unlikely to be lethal in overdose
true
true or false? bipolar I manic episodes may be preceded and followed by hypomanic or major depressive episodes
true
true or false? bipolar disorder is highly recurrent
true
true or false? delusions may progress to hallucinations as mania escalates******
true
true or false? depression rates are about equal prior to puberty and in older adults
true
true or false? even one night of unexplained sleep loss can be a sign of incoming mania
true
true or false? family therapists must have an advanced degree
true
true or false? for suicidal patients, it is best to ask directly whether they are having thoughts of killing themselves ****
true
true or false? for those grieving and suffering a major loss, a diagnosis of MDD can be given within the first two months according to clinical judgement *****
true
true or false? hepatitis B can live outside the body longer and is more infectious than HIV
true
true or false? hospitalization is rare with bipolar II****
true
true or false? immediate medical attention is crucial with hypertensive crisis *****
true
true or false? in a group, conflict should be seen as a positive opportunity for group development
true
true or false? magical thinking is usually nonpathological in children
true
true or false? medications used to treat bipolar disorder can increase risk for metabolic syndrome due to the side effect of weight gain
true
true or false? men and women have nearly equal rates of bipolar disorder
true
true or false? objectives of instruction should be provided before the learning session
true
true or false? once a person has recovered from ebola, they can no longer spread the virus
true
true or false? people with schizophreniform may not have impaired social/occupational functioning*****
true
true or false? people with scizophreniform may return to previous level of functioning*****
true
true or false? psychiatric disorders are present at the time of 90% of suicides
true
true or false? psychosis may or may not accompany major depressive disorder (hallucinations/delusions) ****
true
true or false? psychosocial events and stressors can cause brain changes
true
true or false? research study interventions should be described in detail and explicitly enough that another person could duplicate the study if desired
true
true or false? schizophrenia manifests at times of developmental and family stress*****
true
true or false? suicidal ideation is an emergency requiring immediate intervention ***
true
true or false? teens diagnosed with persistent depressive disorder may feel that they have "always felt this way" *****
true
true or false? those with command hallucinations can be dangerous and require careful monitoring
true
true or false? use of alcohol, drugs, caffeine, and OTC meds can cause relapse of bipolar disorder
true
true or false? you should encourage those with schizophrenia to participate in activities and groups to improve social skills ****
true
T/F: guilt is nearly a universal feeling in depressed patients ****
true (guilt: Ruminate or think over & over - present or past failings >>"I was never a good parent.")
true or false? a meta-analysis can provide stronger evidence than an RCT ******
true, if it includes all RCT's performed overtime in a particular topic
true or false? you can get the flu even if you were vaccinated
true; cannot get it from the vaccine, but since the flu changes so rapidly, you may get a different strain
true or false? in the first few weeks of taking an antidepressant, suicide risk is increased
true; energy is increased before mood improves, so they may have energy to carry out their plan
true or false? in research studies, the larger the sample size, the better
true; needs to be large enough to show an effect
true or false? patients should stop taking lithium if they experience excessive diarrhea, vomiting, or sweating
true; notify provider
true or false? c. diff can be carried in the intestines of healthy people
true; part of normal flora
true or false? the nurse can become triangulated into a patient's family system
true; patient may talk to other family member through you
what are 2 big things to avoid when taking an MAOI? ****
tyrosine foods OTC meds
how does epidemiology contribute to public health? (UDDEC)
understanding the factors that contribute to health & disease development of health promotion & disease-prevention measures detection and characterization of emerging infectious agents evaluation of health services & policies the practice of community nursing in community health
what is the hallmark sign of ebola?
unexplained hemorrhage
a patient taking lithium and experiencing convulsions, oliguria, or death would be expected to be at what plasma level?
>2.5 (severe toxicity)
proportion of persons diagnosed with a disorder (cases) who die within a certain period; yield survival rate****
case fatality rate
what kind of epidemiology is a picture of how things are or have been; deals with person, place, time?******
descriptive
what type of epidemiology deals with distribution of diseases?****
descriptive
what are the two types of epidemiology? (DA)*****
descriptive and analytic
the how and why; factors, exposures, characteristics, behaviors, and contexts that determine/influence the patterns***
determinants of health
look at box 25.4 on milieu therapy with suicide
!!!!!
read more about ECT on page 264!!!
!!!!!!
look at box 25.2
!!!!!!!!
what are 3 characteristics of schizotypical PD? (DDS)
*do not blend in with crowd* disturbed thought patterns with odd behavior, speech, appearance superstitious (ex: telepathy)
what are the 7 steps of the EBP process? ****
-cultivating a spirit of inquiry -asking questions -search for the best evidence -appraising the evidence -integrating the evidence -evaluating the outcomes of the practice decisions or decision changes -disseminating the EBP results
when doing a TB PPD skin test, what should the angle of insertion be?******
0 deg flush with arm
the mantoux test involves _____mL of PPD tuberculin
0.1
what is the maintenance range for lithium? levels should remain below _______ what levels will show early signs of mild-moderate toxicity? what levels will show advanced signs of moderate-severe toxicity? what levels will show severe, life-threatening toxicity?***********
0.6-1.2 mEq/L below 1.5 1.5-2.0 2.0-2.5 >2.5
which is more appropriately worded when speaking to a patient with associative looseness? 1-"i'm having trouble understanding what you're saying" 2-"you're not making sense"
1
all those diagnosed with schizophrenia have at least ______ of what 3 psychotic symptoms? (HDD)*****
1 hallucinations delusions disorganized speech/thought
for late adolescents with bipolar disorder, ____ in ____ with mania + depression will attempt suicide
1 in 5
delusional disorder lasts ______ or longer
1 month
which of the following apply to pedagogical learners? **** 1-motivated by external pressures, competition for grades, an the consequences of failure 2-concrete, repetitious, focusing on how materials are mastered 3- internal motivators like self-esteem, recognition, better QOL, self-confidence, self-actualization, etc 4-built on past experiences 5-offers learner choices
1, 2
which of the following apply to andragogical learners? ***** 1-offers learner choices 2- internal motivators like self-esteem, recognition, better QOL, self-confidence, self-actualization, etc 3-built on past experiences 4-concrete, repetitious, focusing on how materials are mastered 5-motivated by external pressures, competition for grades, an the consequences of failure
1, 2, 3
which of the following apply to andragogical learners? **** 1-learners want to perform a task, solve a problem, and live in a more satisfying way, so learning must be relevant to these tasks 2-students are told what they have to learn in order to advance to the next level of mastery 3-learning is organized around life/work situations rather than subject matter units
1, 3
which of the following apply to pedagogical learners? ***** 1-dependent upon the instructor for all learning 2-learner is responsible for their own learning 3-self-evaluation 4-learners come with little experience 5-the experience of the instructor is most influential
1, 4, 5
what are the 3 phases of symptoms of hypertensive crisis? (list symptoms) (HIAFS ARF FSCD)******
1- early symptoms of severe headache, irritability, anxiety, flushing, and sweating 2- becomes anxious, restless, and develops fever 3- fever becomes severe, seizures, and possible coma or death
in order for someone to be diagnosed with persistent depressive disorder, they must have at least _________ of what 6 symptoms? (A/O,I/H,LPDH) *****
2 dec appetite/overeating insomnia/hypersomnia low energy poor self-esteem difficulty thinking hopelessness
what are the two main symptoms of disruptive mood dysregulation disorder? (CT) *****
1. constant, severe irritability and anger in between ages 6 and 18 with onset before age 10 2. 3 or more temper tantrums a week in at least 2 of these settings: home, school, with peers
a patient taking lithium and experiencing GI upset, coarse hand tremor, confusion, hyperirritability of muscles, electroencephalographic changes, sedation, and incoordination would be expected to be at what plasma level?
1.5-2.0 (early signs of toxicity)
a TB test induration of at least _______mm is positive in those with certain medical conditions (alcoholism, diabetes, drug abuse), those who inject drugs, foreign-born persons from somewhere where TB is common, children under 4, and residents/staff of long-term care/jails/prisons******
10
what would the proportion be for the following: 10,000 deaths total, 1000 caused by CVD
1000/10,000 = 10% of deaths caused by CVD OR 1 in 10 deaths caused by CVD
when do symptoms of botulism begin?
12-36 hours after consumption
how quickly does c. botulinum onset? what is the duration?
12-36 hrs, sometimes days 1-7 days
how many negative ebola semen tests must a male have before it is safe to resume sex?
2 in a row during 3 month period
TB test induration of at least _______mm is positive in all persons more than 4 years of age with no risk factors for TB
15
how long after ingestion of tyramine-rich foods will hypertensive crisis occur in patients taking MAOIs?****
15-90 min
to be diagnosed with antisocial PD, a person must be at least _____ with evidence of conduct disorder that onset before age _____*****
18 15
match the level of prevention to each example: 1. client reminders and recalls via mail, phone, email to increase compliance with screening for colorectal and breast cancer 2. DM self-management education in community gathering places improves glycemic control 3. extended and extensive mass media campaigns to reduce youth initiation of tobacco use
2 3 1
match the stage of Lyme's Disease to the correct description: a. additional skin lesions, headache, neuro and cardiac abnormalities b. recurrent attacks of arthritis and joint pain, especially in knees. Can begin months after initial lesion c. characterized by bullseye lesion, beginning at site of tick bite and spreading outward. (70%); Lesion occurs 3-30 days after bite
2 3 1
which of the following apply to andragogical learners? ***** 1- teacher assumes all responsibility for what is taught and how it is learned 2-learner brings a greater volume of experience 3-the learner is self-directed 4-the teacher evaluates learning 5-adults are the richest resources for one another 6-different experiences assure diversity in groups 7-experience becomes the source of self-identity
2, 3, 5, 6, 7
symptoms of ebola may appear anywhere from ___-____ days after exposure to Ebola, but the average is about ____-____ days
2-21 8-10
what is the incubation period for staph food poisoning? what about HIV/AIDS stage 3?******
2-4 hours 10-15 years
how long do all antipsychotics take to achieve desired results?****
2-6 weeks
a patient taking lithium and experiencing ataxia, giddiness, serious EEG changes, blurred vision, clonic movements, large output of dilute urine, seizures, stupor, severe hypotension, coma, and potential death with pulmonary complications would be expected to be at what plasma level?
2.0-2.5 (advanced signs of toxicity)
what percentage of the population has either bipolar I or II?
4%
____% of those with schizophrenia attempt suicide****
20
match the level of prevention to its correct example:******** 1. treating a food-borne infection 2. giving vaccines and educating about them 3. educating about safe food handling 4. immediately ID source of food outbreak 5. reporting cases to prevent transmission 6. promoting vaccines in community 7. screening for TB, HIV, STDs 8. checking immunization records at daycares
3 1 1 2 2 1 2 1
match the level of prevention to its example: ***** 1. education in rehab centers or adult daycares to help those who have had a stroke maximize function 2. education at health fairs for immunizations 3. education at health fairs for earl dx and tx of DM, and HLD, with health screenings to shorten disease duration and severity
3 1 2
in order for a child to be diagnosed with disruptive mood dysregulation disorder, they must have ______ or more temper tantrums a week in at least 2 of these settings: __________, __________, and __________ *****
3 home, school, with peers
how long is ebola active in semen after they test negative?
3 months
arrange the following evidence sources from most to least important: 1-prospective cohort studies 2-case-control reports 3-the double-blind/RCT 4-nonrandomized control trials 5-expert opinions 6-quasi-experimental studies 7-qualitative studies
3, 4, 6, 1, 2, 7, 5
what is the incubation period of e coli?
3-4 days (but can be as short as 1 day and up to 10 days)
premature death due to physical illness is _____ times more likely in those with schizophrenia than the general population****
3.5
how quickly does staphylococcus aureus onset? what is the duration?
30 min-7 hrs 1-2 days
which of the following apply to pedagogical learners? **** 1-any change is likely to trigger a readiness to learn 2-the need to know in order to perform more effectively 3-able to assess gap between where one is now and where they want to be 4-learns by acquiring prescribed subject matter 5-content units are sequences according to the logic of the subject matter
4, 5
what is the incubation period of TB?
4-12 weeks
how long does it take for the full effect of TCA's to be reached? ****
4-8 weeks (educate)
after how long should a PPD test be read?
48-72 hours
a TB test induration of at least ______mm is positive in those who are immunosuppressed, HIV+, have a chest radiograph showing signs of previous TB, if in close contact with a person with TB, or if an organ transplant recipient
5
the percentage of those with schizophrenia that die by suicide is _____ times more than the general population*****
5
in order for a diagnosis of major depressive disorder, there must be at least _____ of what 9 symptoms present for the same 2 week period? (DAW/AI/HA/RFW/GD/IR) 1 of them must be either ___________ or ___________ *******
5 1- depressed mood (sad, empty, hopeless, tearful) 2- anhedonia; marked diminished interest or pleasure in all or almost all activities most of the day, nearly every day 3- weight changes/appetite changes; significant unintentional weight loss or gain or dec appetite 4- insomnia/hypersomnia nearly every day 5- psychomotor agitation/retardation nearly every day 6- fatigue/loss of energy nearly every day 7- feelings of worthlessness/excessive or inappropriate guilt nearly every day 8- diminished ability to think or concentrate or indecisiveness nearly every day 9- recurrent thoughts of death, suicide with or without plan, or an actual attempt depressed mood or anhedonia
example of CFR: 20 out of 100 diagnosed with skin cancer will die within 5 years. what is the case fatality rate? what is the survivlal rate? ******
5 year CFR = 20% 5 year survival rate = 80%
____-____% of those with schizophrenia die by suicide*****
5-10
e coli usually improves after how long? do symptoms begin suddenly or slowly?
5-7 days slowly
there is a ____% chance that if one twin has schizophrenia, the other will too
50
shizophreniform lasts for less than _______****
6 months
how long must symptoms occur before being diagnosed with schizophrenia? *****
6 months which include 1 month of symptoms in A
___% of those with schizophrenia use nicotine****
60
with lithium for bipolar, start at ____-_____ mg/day in 2-3 divided doses. May increase every few days by _____ mg/day. max dose _____ mg/day
600-1200 300 1800
manic episode = _____ long hypomanic episode = _____ long********
7 days 4 days
what is the proportion of the following example? in 2000, 2,404,624 deaths recorded with 709,894 caused by CVD because this deals with death, what can this also be called?****
709,894 divided by 2,404,624 = 0.295 (29.4%) proportionate mortality rate
___% of those with bipolar I and II have comorbid anxiety disorders
75
what six DSM-5 criteria are needed for a diagnosis of schizophrenia?***********
A- 2 or more symptoms present for significant portion of time during 1 month period (or less if successfully treated), with at least 1 must be delusions, hallucinations, disorganized speech (1-delusions, 2-hallucinations, 3-disorganized speech, 4-grossly disorganized or catatonic behavior, 5-negative symptoms) B- dysfunction in work, relations, self-care C- continuous for 6 months, including 1 month of symptoms that meet A D- not schizoaffective, depressive, or bipolar disorder with psychotic features E- substance/general medical condition ruled out F- relationship to developmental disorder
what are the 5 parts of the DSM-5 criteria for major depressive disorder? *****
A- 5 or more symptoms present during the same 2 week period, with 1 of them being either depressed mood or loss of interest of pleasure (anhedonia) B- symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning C- not attributed to substance abuse or medical condition D- not better explained by another psychiatric disorder E- never has been manic or hypomanic episode (bipolar)
what is the DSM-5 criteria for bipolar I? (4 sections)***********
A- distinct period of abnormally and persistently elevated, expansive, or irritable mood and increased goal-directed activity or energy, lasting 1 week and present most of the day, nearly every day (or any duration of hospitalized) B- during this period, 3 or more of seven specified symptoms (four if mood is only irritable) are present to significant degree and represents noticeable changes from usual behavior C- severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self/others or there are psychotic features D- not attributable to drug abuse, a medication, other treatment or condition
what is the DSM-5 criteria for antisocial PD?********
A-pervasive pattern of disregard for & violation of the rights of others, occurring since age 15 B-at least 18 years old C-evidence of conduct disorder with onset before age 15 D-occurrence of antisocial behavior is not exclusive during course of schizophrenia or bipolar
what is the acronym for education in action involved in teach back?****
ACTS
what are 2 interventions for managing self-care deficits as a vegetative sign of depression? (AI)
ADLs -->encourage use of toothbrush, washcloth, soap, makeup, and shaving supplies instructions --> when appropriate, give step-by-step instructions
what nursing association recognizes holistic nursing as an official specialty and the American Holistic Nurses Association that has standards of care
ANA
what are the 9 TCAs? (AADDIMNPT)****
Amitriptyline Amoxapine Desipramine Doxepin Imipramine Maprotiline Nortriptyline Protriptyline Trimipramine
match the correct description with either being chickenpox or smallpox: ********** 1. Sudden onset with high fever and mild symptoms 2. Sudden onset of fever, prostration, severe body aches, occasional abdominal pain and vomiting (flu-like) 3. Clear-cut prodromal illness; rash follows 2-4 days after fever begins decreasing 4. Rash is present at onset 5. Rash: macular --> popular --> vesicular --> pustular --> crusted scabs that fall off 6. Rash is maculopapular for a few hours, vesicular for 3-4 days, followed by granular scabs 7. Lesions abundant on face and extremities 8. Lesions are most abundant on trunk or areas of body covered by clothes 9. Lesions are in crops and can be at various stages in the same body area 10. Lesions all at same stage 11. Vesicles are superficial and collapse on puncture, mild scarring can occur 12. Vesicles are deep seated and do not collapse on puncture; pitting and scarring are common
C S S C S C S C C S C S
how do we treat MRSA? (CA)
C&S antibiotic
if a pt with Narcissistic PD seeks tx, what 4 things can be used? (CGLA)****
CBT group therapy lithium antidepressant
what are 4 mind-body approaches to care that are considered mainstream? (CRSE)
CBT relaxation techniques support groups exercise
states mandate requirements for disease reporting then the states report cases to the _____. ****mandatory reports by the state include what 4 diseases? (ADMS)
CDC Anthrax, Diphtheria, Meningeal Coccus disease, Syphilis
what are 8 CI to lithium? (CBRTMPBY)
CVD, brain damage, renal disease, thyroid disease, myasthenia gravis; pregnancy, breastfeeding, younger than age 12
what are 7 manipulative practices used in integrative care? (CMAMABP)
Chiropractic medicine Massage therapy Aromatherapy Music Art Bio electromagnetic (based on bright-light therapy) Prayer
what three FGA's can cause prolonged QT interval? (CHT)
Chlorpromazine haloperidol thioridazine
what 2 meds are used for obsessions, anxiety, and depression with obsessive compulsive PD? (CF)
Clomipramine or fluoxetine
what acronym is used for preparing and implementing change talk?
DARN-CAT
how do we treat c. diff? (DMVS)
DC abx metronidazole vancomycin surgery
emergence of multidrug resistance TB has prompted the use of ____ to ensure adherence. this is a form of _______ prevention.*******
DOT tertiary
what are 3 possible side effects of SSRIs? (GHS) ***
GI issues, headache, and sexual dysfunction
look at assessment guidelines for schizophrenia on pages 200-201
Hallucinations § When did they begin? Content? How the patient experiences them? § Are you hearing a voice telling you to do something? § Do you believe what you hear is real?
what are the 5 characteristics of dependent PD? (HSFLA)*****
High need to be taken care of Submissiveness Fears of separation and abandonment Lack confidence in own ability or judgment, leading to manipulating others to take responsibilities Intense anxiety when left alone even briefly
are cognitive deficits greater in bipolar I or II?*****
I
what are 5 interventions for managing constipation as a vegetative sign of depression? (IHEFL)
I&O High-fiber Exercise Fluids Laxatives/enemas
what are the 7 steps of developing a health education program? (ISCEDIE)
ID learning need select learning theory consider educational principles examine educational issues (cultural concerns, limited literacy, age, etc) design and implement the educational program evaluate the effects
what does it mean for a screening to be sensitive?******
ID those WITH condition; correctly classifies cases as true positives
what does it mean for a screening to be specific?*****
ID those WITHOUT condition; correctly classifies non-cases as true negatives
what is the treatment for acute dystonia (route, dose)? (BD) *******
IM/IV benztropine or diphenhydramine 25-50mg
what 2 community based therapeutic services can be recommended for schizophrenic patient post-discharge? (NC)
NAMI clubhouse models
what are 4 symptoms of meningitis? (NVLC)
NV light sensitivity confusion
obsessive thoughts & rituals; aware that these thoughts & actions are unreasonable
Obsessive-Compulsion Disorder
characterized more by the unhealthy focus on perfectionism - think their actions are right & feel comfortable with such self-imposed rules
Obsessive-compulsive personality disorder
what 2 antivirals are used to decreased the S&S of flu symptoms and are prescribed 24-48 hrs after symptoms begin? (OZ)
Oseltamivir (Tamiflu) Zanamivir (Relenza) - inhaled
a suicidal person may benefit from outpatient attendance in ______ or ______
PHP or IOP
what format is used to ask questions regarding EBP and what does it mean?*****
PICOT P- population of interest I- intervention or practice strategy in question C- comparison of populations or of intervention used O- outcome desired T- time frame
what are 8 ways as nurses to protect ourselves from ebola? (PHDWFDAP)
PPE hand hygiene double glove water-resistant gown facemask with shield dispose of PPE properly avoid contact w body fluids protect open cuts/skin tears
what are the hallmarks of obsessive-compulsive PD? (PPC)******
Preoccupation with orderliness, perfectionism, control
each subject has an equal chance of being selected from the population of interest; randomly assigned a control group or an intervention group; Most unbiased
Random selection
what are 4 interventions for managing insomnia as a vegetative sign of depression? (RSRD)
Rest after activities Stay out of bed during day Relax in evening Decaff coffee/soda
what are the first line antidepressants? why? ****
SSRIs low AE profile
how is hepatitis B transmitted? (SB)
STD or blood borne
what is the leading cause of death worldwide among infectious diseases?
TB
what is the natural history of disease?
The course of a disease from onset to resolution.
what is the most effective approach for treating depression?
a combination of therapy and psychopharmacology
the assumptions made by Aaron Beck on the cognitive aspect of depression lead to the development of the Cognitive Triad. what are the 3 parts? (NPN) ******
a negative, self-depreciating view of self (negative self-view) pessimistic worldview belief that negative reinforcement will continue into the future (self is not validated)
what 2 things should you educate a male on that is recovered from ebola? (AC)
abinstinence condoms
what scale is used to identify and track involuntary movements?
abnormal involuntary movement scale (AIMS)
what are negative symptoms of schizophrenia?*****
absence of something that should be present; absence of essential human qualities
family teaching assists members as they: 1. learn to ______ mental/physical illness of a family member 2. Learn to effectively _____ with an ill member's symptoms, such as hallucinations delusions, poor hygiene, physical limitations, disfigurement 3. Learn about _______ 4. Learn what community ______ are available & how to ______ 5. Regain a sense of ______ and _____ in family life *****
accept deal meds resources, assess control, balance
Resistance acquired by a host as a result of previous natural exposure to an infectious agent*****
acquired immunity
Having measles once will protect you against further infections is an example of what type of immunity?*****
acquired immunity (active)
when writing a behavioral objectives, it should begin with an _____ _____, state the ______ as learner outcome, have ____ outcome per objective, and the objective should be appropriate to _____ needs § Client will demonstrate proper hand-washing at the end of class § Clients will answer 70% correctly on post test
action objective one learner
■ TB infection with progression to disease ■ Can be spread to others ■ Typically forms in the lungs ■ Spread via respiratory droplets ■ Show up positive on chest Xray
active TB
immunization by administration of an antigen (infectious agent or vaccine) and is usually characterized by an antibody produced by the individual host (vaccination); vaccine or previous infection*******
active acquired immunity
PPE, vaccines, and needle exchange programs are all examples of what?
active primary prevention
type of primary prevention that requires behavior change on part of the subject
active primary prevention
does hepatitis A have an acute or gradual onset?
acute
in what phase of schizophrenia would the patient be hospitalized if a danger to self or others?
acute
the following describes which stage of schizophrenia? symptoms appear and may be mild to disabling, hospitalization may be needed*****
acute
the following outcome criteria would likely be determined in what phase of schizophrenia? pt. refrains from self-injury
acute
what are the three phases of depression treatment? how long are they for? (ACM) *****
acute - 6-12 weeks continuation - 4-9 months maintenance - 1 year or more
sudden, sustained contraction of 1 or more muscle groups, usually head and neck
acute dystonia
what four kinds of EPS may be present when taking FGA's? (AAPT)****
acute dystonia, akathisia, pseudoparkinsonian symptoms, and tardive dyskinesia
what 3 people are not good candidates for group therapy? (PMI) ***
acutely psychotic acutely manic intoxicated
what are the 4 guideline of nursing care of dependent PD? (ASAA)
address stressors set limits avoid countertransference assertive skills
what can you do when you have a silent person in your group? (AT) ****
address them and give them time to think about answers
with paranoid PD patients, nurses must do what 4 things? (ADSS)*******
adhere to schedule dont be overly friendly simple language setting limits
what are 3 ways to counteract mistrust in a paranoid PD patient? (SAN)
adhere to schedules avoid being overly friendly (suspicious) project a neutral yet kind affect
what are 9 criteria for assessing the quality of internet health information? (ACCCCDDIL)
authorship (credentials) caveats (function of the site) content (is info accurate?) credibility (source of info) currency (is info most current?) design (is it accessible?) disclosure (is profiling or data sharing done regarding the users?) interactive (does site provide feedback?) links
what is reality testing?*****
automatic process in which we determine what is real or not
loss of motivation/basic drive; cannot sustain work or self-care (not laziness)
avolition
the following may indicate what negative symptom? unable to sustain work or self-care
avolition
what three antimicrobials are used to treat pertussis but do not releave symptoms? (ACE)
azithromycin clarithromycin erythromycin
c. diff is caused by what type of organism?
bacteria
what kind of organism causes tuberculosis?
bacteria
what is the main difference in how we treat viral vs bacterial diseases?
bacterial we can use antibiotics, viral we cannot
when does disruptive mood dysregulation disorder onset? ****
before age 10
a structured approach that carefully measures what the person is doing and then seeks to increase chances for positive experience*****
behavioral learning theory
alteration in reality testing results in what symptom of schizophrenia?*****
belief that hallucinations/delusions are real
what is the treatment for akathisia? (BL) ******
benztropine or lorazepam
EBP is the integration of what four things? (BNPR)
best medicine, nursing expertise, values and preferences of the client/patient, and research utilization
when does schizophrenia usually present in males? females?*****
between ages 15-25 in males; 25-35 in females
in determining, casuality, a systematic error bc of the way the study is designed, how it was carried out, or some unplanned events that occured and affected the study****
bias
what is the most severe bipolar disorder?
bipolar I
the following describes what kind of affect? odd, illogical, inappropriate or unfounded, such as constant grimacing
bizarre
members blame others for failures, errors, or negative consequences of an action to deflect the focus from them
blaming
researcher should not know which participants are in the treatment group or control group
blinding
how do second generation antipychotics work for schizophrenia?****
block both serotonin and dopamine receptors to reduce symptoms
how do first generation antipsychotics work for schizophrenia?******
block dopamine-2-receptors, reducing hallucinations and delusions
how does hepatitis C spread?
blood or other body fluids
the following describes what kind of affect? reduced or minimal emotional response
blunted
how can botulism be prevented? (BDH)
boil home-canned foods for 10 min do not eat canned foods if top is bulging/food smells bad don't give honey to babies
which PD has severe impairments in functioning?****
borderline PD
what is the most well known and dramatic of the personality disorders?
borderline personality disorder
what are second generation antipsychotics used to treat?****
both positive and negative symptoms of schizophrenia
rare and fatal form of food poisoning causing release of neurotoxins that lead to paralysis and death (paralysis of all muscles, including those of heart and diaphragm) that is found in soil and require low-O2 levels to survive
botulism
what is another name for clostridium botulinum?
botulism
Distinctions among family members & between family & external individuals
boundaries
with borderline PD, provide clear and consistent _______. _____ -____ is very important and all staff need to be on the same page. use ______ cmcn. when behavioral problems arise, calmy review therapeutic ______. response matter of factly to superficial _____-_____ and have the patient write down sequence of _____ leading up to injury with ______ before staff discusses the event. ______ exercises encourage patient to think about behavior. we used meds for ______ ______.
boundaries limit setting straightforward goals self-injuries events consequences cognitive mood regulation
impaired ability to sense where one's body ends and another's begins; may stand too close; can't sense personal space of others
boundary impairment
what are the 2 treatment options for NMS? (BD) ******
bromocriptine dantrolene
fleas can transmit what disease? (B)
bubonic plague
why should patients stop taking lithium if they experience excessive diarrhea, vomiting, or sweating?
can lead to dehydration which will increase lithium to toxic levels; notify provider
how do we treat e coli? (RHA)
cannot cure, so only treat to relieve symptoms or prevent complications: rest, hydration, antidiarrheal for EMERGENCIES only
what workup should patients have done before taking TCAs and why?***
cardiac; can have severe cardiac AE's
what is a vector?
carrier that transmits an infectious agent
Compares patients who have a disease or outcome of interest such as cases with patients who do not have the disease or outcome which is our controls Looks back retrospectively to compare how frequently exposure is to a certain risk factor is present in each group to determine the relationship between the risk factor and the patient
case control study
what type of observational study involves an odds ratio?*****
case control study
in the working phase of group development, the leader should facilitate _______ and use _____-_____ skills. members should actively interact to help accomplish _______. _____ has developed so ______ and ______ can be expressed *******
communication problem-solving goals trust conflict disagreement
same type of people, but with different disease/exposure; in order to decide if the rate of disease is the result of a suspected risk factor, compare the exposed group with a group of comparable unexposed persons; same age and type of people, but do not have exposure to illness Ex: Similar in nature (same age) but missing exposure to flu
comparison group
non-mainstream medicine in conjunction with standard medical care; combo ****
complementary
what is the goal of antidepressant therapy? *****
complete remission of symptoms
the following sign/symptom of schizophrenia relates to what nursing diagnosis? (3) families and s/o become confused or overwhelmed, lack of knowledge about disorder or treatment, feel powerless in coping with patient
compromised family coping, caregiver role strain, deficient knowledge
what are covert statements?****
concealed; those that are not plainly stated
impaired ability to think abstractly; perceive things in literal manner
concrete thinking
bias that results from the relationship between both the outcome and study factor (exposure/characteristic) and some third factor not accounted for in analysis******
confounding factor
what is the confounding variable in the following situation? how can a bias occur?******** an investigation is done on the relationship between alcohol consumption and low birth weight. it is known maternal smoking during pregnancy and low-birth weight are related. it is also known that alcohol consumption and smoking are related.
confounding: smoking bias: not including smoking in analysis
syndrome that occurs in infants of mothers infected with rubella while pregnant that can cause deafness, cataracts, heart defects, mental retardation, liver and spleen damage
congenital rubella syndrome
with antisocial PD, they have a profound inability to _____ with others which impairs the usual process of developing therapeutic _______
connect relationships
similar findings amongst different studies, examining the same topic
consistency
the following describes what kind of affect? reduced in range or intensity, such as showing sadness or anger but no other moods
constricted
minutes of a meeting are considered group ____________ (content/process)
content
what sort of thought content is common with manic episodes?*****
content - sexually explicit, brilliant business ability, artistic talents delusions
match the focus of treatment to the appropriate phase of depression: (acute, continuation, maintenence) *** 1. relapse reduction 2. prevent further episodes of depression 3. symptom reduction
continuation maintenance acute
the following is an example of what type of delusion? believing that another person, group, or external force controls thoughts, feelings, impulses, or behavior; believing in aliens ****
control
participants are selected because they are easily available to the researcher; contain researcher/evaluator bias
convenience sampling
integrative care in the US involves _____ medicine which focuses on what is done TO the patient. integrative care is used as the _____ participates with provider to heal _____ and _____. Eastern/Western medicine defines health as absence of disease. Integrative health views health by how well the ______, ______, _____, ______, _____, and ______ components interrelate. (PEMESS)
conventional patient mind, body western physical, emotional, mental, environmental, spiritual, & social
what is group content?
conversation, interactions on the surface; all that is said; topics
A group of persons who are born about the same time, generally sharing some characteristic or interest; In the study this group is followed over time in a natural experiment****
corhort
what are 6 symptoms of active TB? (CFHCFW)
cough, fever, hemoptysis, chest pain, fatigue, weight loss
what could happen if a histronic PD patient went to group therapy?
could be distracting or disruptive to group
Narcissistic PD are more likely to be in _____ or ____ therapy than individual.
couples family
during family therapy at the BSN level, nursing interventions include: 1. ________ using _____-_____ approach 2. Effective _______ skills 3.View family members in _______ manner 4. Respond to cues that indicate amount of _____ family system experiencing 5. Using ______ conversation as appropriate 6. Look at how patient's medical _____ impact the family's function 7. Explain ______ in understandable manner 8. Elicit and listen to _____ of each family member
couseling, problem-solving listening nonjudgemental stress informal regimen treatment perspectives
Is this statement overt or covert? "How can I give my body to medical science?"****
covert
what are the two main symptoms of salmonella? (CD) when do they develop? how long do they last?
cramping and diarrhea 12-72 hours after infection 4-7 days
what are the 7 characteristics for antisocial PD as emphasized by DSM-5? (CDIIRCL)******
criminal activity deceitfulness impulsive irritable reckless consistent irresponsibility lack of remorse · Failure to conform to social normal with respect to lawful behaviors AEB repeated actions that are grounds for arrest · Deceitfulness - repeated lying, using of aliases, conning other for personal profit · Impulsivity - failure to plan ahead · Irritability - aggressiveness AEB repeated fights or assaults · Reckless disregard for safety of self or others · Consistent irresponsibility: repeated failure to sustain consistent work or honor financial obligations · Lack of remorse AEB being indifferent to rationalizing having hurt, mistreated or stolen from another
one that is oriented toward critiquing and changing society as a whole, in contrast to traditional theory oriented only to understanding or explaining it****
critial social theory
what type of observational study is also known as a prevalence study?*****
cross sectional
what kind of study takes a snap-shot of a population and collects info on current health status, personal characteristics, and potential risk factors or exposures all at once?******
cross-sectional study
risk for death of a person in a given population for that year****
crude mortality rate
Ex: 3:5 for a year for a particular disease given a specific remedy -may change if we specify age as a factor - rate for people 20-40 vs. rate for people 50-70; May then become 4:5 for ages 20 - 40 & 2:5 for ages 50 -70.
cure rate
what are the 3 types of anthrax? (CGR)
cutaneous GI respiratory
what are 3 self-destructive behaviors/harmful self-soothing that are seen with borderline PD?*****
cutting Promiscuous sexual behavior Numbing with substances
low-risk lethal sucide methods? (CNP)
cutting natural gas inhalation pills
seasonal fluctuations of disease is an example of _____ ____ in descriptive epidemiology time aspect
cyclic trends
what is the purpose of epidemiology? (DMIIE)
determine causes monitor population health identify determinants investigate and evaluate interventions to prevent disease and maintain health
what 2 medications can be given for a patient suffering from serotonin syndrome for muscle rigidity?**** (DD)
dantrolene diazepam
what symptom might you see in the later stages of meningococcal septicemia?
dark purple rash
pregnant women are especially at high risk with rubella because infection can cause intrauterine ____, spontaneous _____, or _____ ______ _____ in babies
death abortion congenital rubella syndrome
Rate of personality's change inc/dec over time but does NOT cease!! Opportunity to develop more ______ functioning!*** (encouraging)
dec adaptive
what are 3 antagonistic behaviors associated with antisocial PD? (DMH)****
deceitful manipulative hostile
make sure the EBP assists in the _____-_____ process, is presented in an ______ format, informs of _____ and ______, and is based on ______ views
decision-making understandable pros/cons client
what is CBT used for in Narcissistic PD?****
deconstruct faulty thinking/reframe thinking
what does anticholinergic toxicity cause? (DA)
delirium and altered mental status
false beliefs with lack of evidence to support****
delusions
brief psychotic disorder is the sudden onset of 1 of the following: ______, ______, _______ ______, or ______ or ______ behavior. (DHDDC) symptoms must last longer than ___ day but no longer than a ______ with the expectation of returning to _______
delusions, hallucinations, disorganized speech, disorganized or catatonic behavior 1 day 1 month normal
group leadership that is cooperative and promotes and supports member involvement in all aspects of decision making and planning
democratic
what kind of challenging group member behavior involves being self-centered, angry, or depressed, and may lack empathy, hope, or concern for others in the group? *****
demoralizing
routinely collected data provide numerators/denominators for various rates
denominators
feeling of being unreal or having lost identity; body parts do not belong to the body or have changed; ex: fingers missing
depersonalization
when assessing a patient with depression, what are 13 key findings? (DAASMCFDHHGAC) *****
depressed mood anhedonia anxiety slow thinking memory problems concentration probs focus on faults/failures (negatives) rather than strengths/successes (positives) delusions (punished for bad deeds) hoplessness helplessness guilt anger chronic pain
what psychiatric diagnosis is most closely associated with suicide?
depression
what affective symptom is most often present with schizophrenia?
depression (suicide risk, substance abuse, relapse)
what are 4 reasons borderline PD patients frequently seek repeat hospitalizations? (DASS)*****
depression, anxiety, suicidal/self-harm, substance use
DSM-5 no longer uses mood disorders. it separates into _______ disorders and _______ + related disorders
depressive bipolar
feeling that the environment has changed; ex: familiar is now strange
derealization
what is descriptive epidemiology?*****
describes a disease according to its person, place, or time
how did louis pasteur contribute to epidemiology? (GP)
developed the germ theory and pasteurization
type of adjusted rate that applies the age-specific death rates from the study population to the age distribution of the standard population; the result is the (hypothetical) death rate of the study population if it had the same age distribution as the standard population
direct adjusted rate
an example of a nurse delivering treatment to prevent the spread of communicable disease includes using ______ ______ ______ with a non-compliant TB patient*****
direct observational therapy
how can making observations help when a withdrawn patient is silent?
direct questions may raise anxiety and frustrate the nurse if they aren't ready to talk; will reinforce reality
what 7 should be done if a patient taking an SSRI experiences serotonin syndrome? ***** (DSCCDDA)
discontinue med give serotonin blocker cooling blankets chlorpromazine (hypothermia effect) dantrolene, diazepam (muscle rigidity) anticonvulsants
possible physiological or pathological outcome; physiological dysfunction or pathological reaction
disease
morbidity is related to _____________, while mortality is related to _______________
disease or disability death
what DSM diagnosis was introduced in 2013 in response to alarming numbers of children/adolescents diagnosed with bipolar disorder in which kids were put on meds that did not help and now has a label of SMI?
disruptive mood dysregulation disorder
during the implementation phase of the NP with depressed patients, the nurse should help with cognitive ______, not use _____ such as "things will get better," help ID _____ skills, and ID _____ such as support/spiritual groups******
distortions platitudes coping resources
what is a hallmark of mania?
distractability
the following is an example of what dysfunctional family communication? introducing irrelevant details into problematic issues
distracting
to avoid functional problem solving and resolving conflicts, family members introduce irrelevant details into problematic issues
distracting
nurses taking care of histronic PD patients must know that seductive behavior is a response to ______, keep interactions ______ and ignore ______, model _____ language, help patient _____ inner feelings, teach and role-model ______, and assess for ______ _____ or self-____ behavior*******
distress professional flirtations concrete clarify assertiveness SI self-harm
B: symptoms of MDD cause significant _____ or impairment in _____, _____, or other important areas of functioing C: MDD symptoms are not attributable to effects of ______ or ______ D: Symptoms of MDD are not better explained by another psychiatric disorder E: Never has been _____ or _____ episode. if they have, then should be diagnosed with _______ ******
distress social, occupational substance, illness manic/hypomanic bipolar
what are the characteristics of paranoid personality disorder? (DSBHHCDSDGDP)******
distrust suspicious believe others are out to get them w no evidence hypervigilant hostile counterattack defensive social anxiety in childhood difficult relationships (jealous/controlling) grudges do not lose contact with reality project feelings onto others
the following sign/symptom of schizophrenia relates to what nursing diagnosis? (2) delusions
disturbed belief system, altered thought processes
the following sign/symptom of schizophrenia relates to what nursing diagnosis? hears voices that others do not
disturbed sensory perception: auditory
what can abrupt discontinuation of antipsychotics cause? (DNTIEA)
dizziness, nausea, tremors, insomnia, electric-shock pains, anxiety (discontinuation syndrome)
before diagnosing a patient with a psychotic disorder, the physician must rule out what 7 other potential causative conditions? (DAMTDNO)****
drugs alcohol medication toxin exposure delirium neurological problem other disease processes
what SNRI can be used to treat depression, as well as pain associate with fibromyalgia and diabetic neuropathy? *****
duloxetine
Large and diverse group of bacteria in which most do not cause infection May be in water that contains contaminated human or animal feces
e. coli
positive symptoms of schizophrenia appear ______ and are ______*****
early dramatic
what is an example of a syndromic surveillance system for communicable diseases?
early aberration reporting system (EARS)
when does narcissistic PD develop? is it more common in males or females?
early adulthood males
when does schizoid PD begin?****
early childhood
an emerging infectious disease that has 5 types of viral strains in which 4/5 can be contracted by humans; first discovered in 1976; research believes that the virus is animal borne with bats being the most likely reservior
ebola
cluster A personality disorders are described as what 2 things? (EO)****
eccentric odd
parrot-like repetition of words or fragments of speech
echolia
what is the following alteration in speech an example of: nurse: mary come get your meds mary: come get your meds
echolia
mimicking of movements/behaviors of another
echopraxia
type of study that bridges both descriptive and analytic epidemiology; The analytic tries to determine if there is a relation of disease based on rate and risk variation.******
ecological studies
what kind of study looks at variations in the disease rates by person, place, or time, while also determining if there is a relation of disease rates to variations in rates for possible risk factors or characteristics?******
ecological studies
what is the highest level of evidence?***
randomized control trials
an activity undertaken or initiated by one or more agents that is designed to effect changes in the knowledge, skill, and attitudes of individuals, groups, or communities; establishing or arranging events to facilitate learning, including providing knowledge and skills
education
BSN nurses can only lead family group sessions for ______ or _____, not actual _____
education support therapy
what biological intervention can be used to treat depression that fails to respond to other modalities? ****
electroconvulsive therapy
remove disease from geographic area****
elimination
what is a primary feature of borderline PD in which one rapidly moves from 1 emotional extreme to the next?****
emotional lability
to have an effective health education program, remember that ______ can interfere with the learner hearing the message and speak in terms that the learner can understand at a ____TH GRADE READING LEVEL. Young learners like ______ learning. Most people have short/long attention spans. Provide _____ take home material. Allow for activity that increases learner _____***
emotions 10 interactive short written participation
constant presence of a disease within a geographic area or population***
endemic
normal occurrence of a condition; constant long-term presence of an event at about the frequency expected from the past history of the community****
endemic
normal/natural occurrence of a condition; ex: west nile in louisiana****
endemic
what are the 4 essential steps to motivational interviewing? (EEGE)****
engaging empathetic listening guiding evoking client's own motivation
behavior that occurs in diffuse boundaries in which individuals tend to become overly involved with one another
enmeshment
what are two examples of protozoa that can be transmitted by water? (EG)
entamoeba histolyticia (amoebic dysentery) giardia
what are the 11 characteristics for narcissistic PD? (EESAELACGWH)****
entitled exaggerated self-importance self-centered apathetic exploits others less functional impairment than other PD arrogant need constant admiration grandiosity weak self-esteem hypersensitive to criticism
everything internal or external to a given host or agent that is influenced and influences the host and or agent; Climate, plant/animal life, population distribution, socioeconomics, working conditions, temp, humidity, altitude, crowding, housing, neighborhood, water, milk, food, radiation, pollution, noise************
environment
facilitate the transmission of the disease (physical, biological, cultural, social factors external to host)
environment
use of mosquito nets to avoid bug bites, avoiding standing water that can breed mosquitos, installing sewage to prevent fecal contamination of water, and washing utensils after contact with raw meat are all examples that deal with the ________ of the epidemilogical triangle
environment
according to the social learning theory, people, especially children, learn from the ______ and seek acceptance from society by learning through influential _____ and by being ______ or _____ for these actions****
environment models rewarded punished
much greater than normal occurrence of a condition (outbreak is often used); short period of time; ex: 40 new cases this year of bacterial meningitis in Lafayette
epidemic
much greater than normal occurrence of a condition; outbreak****
epidemic
occurrence of a disease in a community or region in excess of normal expectancy*****
epidemic
Study of health events in populations; Multifaceted approach used to view how health patterns are distributed across populations over various geographical regions; Uses investigative techniques to identify the determinants or the factors that contribute to the health patterns
epidemiology
studying how the flu affects differrent populations around the world at different times is an example of _______
epidemiology
does avoidant PD occur more in men or women?
equal
terminate; irreversible termination of all transmission of an infection****
eradication (smallpox)
the following is an example of what type of delusion? believing another desires you romantically*****
erotomanic
cluster B personality disorders are described as what 3 things? (EED)*****
erratic emotional dramatic
what is hypomania?*******
euphoric and increased functioning accompanied by excessive activity and energy for at least 4 days; must have 3 of the behaviors listed under criterion B for bipolar I; never psychosis, but may accompany the depressive side of the disorder
how often are long-acting injectable antipsychotics administered?
every 2-4 weeks
how often are paliperidone palmitate injections given?
every 3 months
antisocial PD patients focus on their own _____ to an extreme. they have no capacity for _____ in relationships and will ____ others. they have a disturbing and profound lack of ________. they display ________ and can commit a crime and not feel bad. they have absence of _______ when they violate other's rights. they are also very good at ______ emotions of others*******
gratification intimacy exploit empathy callousness guilt manipulating
when assessing affect of a depressed person, the patient may have the following: 1. see world through ____-colored glasses 2. poor _____ 3. facial expression convey ______ 4. may frequently _____ or may state they feel _____ and are unable to 5. feel _______ 6. may not make _____ ____ 7. have a _____ affect (little-no facial expression) 8. just answer with ____ or ____ responses 9. frequent _______
gray posture sadness cry numb hopeless eye contact flat yes/no sighing
Vegetative signs of depression include decline in _____, _____, _____, _____ _____, changes in _____ habits, and changes in ______ _____ (cardinal sign!!!!) (GDHSBS) ****
grooming dressing hygiene sexual interest bowel (constipation) sleep pattern
Effective and powerful medium to initiate and implement changes for individuals, families, organizations, and the community.
group
what therapies work for obsessive compulsive PD? (GB)
group behavioral
_____ therapy is threatening to those with paranoid PD if they go. However, it can improve ____ skills. _____ can help give a reality check*****
group social feedback
attraction between members through values and common goals
group cohesion
standards that guide, control, and regulate individuals and communities; set standards for behavior, attitudes, perceptions****
group norms
what is the art of doing group work called?
group process
high-risk lethal sucide methods? (GJHPC)
gun jumping hanging poisoning car crash on purpose
what are the four organisms that can cause bacterial meningitis? (HSLN)
haemophilus influenza, streptococcus pneumoniae, listeria, and neisseria meningitidis
sensory experience for which there is no external stimulus; real to the person****
hallucinations
what is the most common alteration in perception?****
hallucinations
what are three screening tools for depression? (HBP) *****
hamilton depression scale, beck depression inventory, patient health questionnaire
how can we prevent e coli? (HCAKP)
hand washing, cook meats fully, separate cooked and raw meats, avoid raw food/wash well, prevent cross contamination
what model describes what motivates an individual? *****
health belief model
what do community trials typically deal with?******
health promotion and disease prevention
how can group therapy help a Narcissistic PD pt?******
help person in sharing and learning empathy with others
what is the focus of the behavioral learning theory?****
helping an individual understand how changing their behavior can lead to changes in how they are feeling
what are four things involved with family psychoeducation? (USSP) ****
helping them understand the illness, symptoms, and meds share feelings and coping strategies support from similar families parent management
inability to carry out even simple tasks
helplessness
what are 2 cognitive changes in depressed patients? (HH)****
helplessness hopelessness
what kind of virus can be transmitted by water?*****
hepatitis A
what is the most common blood-borne infection and is the leading cause of chronic liver disease, end stage liver disease, liver cancer, and liver transplants in the US?
hepatitis C
95% of kids in community have gotten an MMR vaccine. what is this an example of?*******
herd immunity
refers to the immunity of a group or community; high proportion of the population is immune Basis for increasing immunizations for vaccine preventable diseases****
herd immunity
borderline PD has a high/low genetic association. they have ______-______ factors as found by Margaret Mahler (psychologist) which is a disruption in the process of feeling safe to explore away from caregiver. This carries deep fear of _______ and _______ into adulthood.
high separation-individuation abandonment & anger
Persons, because of exposure, lifestyle, family history, or other factors, are at increased risk for disease than population at large
high-risk population
Higher immunization coverage leads to a higher/lower herd immunity because it blocks further spread of diseases****
higher
what are grandiose delusions?*****
highly inflated self-regard, exaggerated achievements
which area of the brain affected by bipolar disorder deals with memory?***
hippocampus
who was the first person to use ideas that are now part of epidemiology and used the descriptive approach, examining geography, climate, seasons of year, food, water, habits, and behaviors and how it affects health?
hippocrates
in which PD would a person be referred to as a "drama queen" or "drama major"****
histronic PD
schizophrenic patients have dysfunction in ______, ______ _____, or _____-___ (HIS) ******
home interpersonal relations self-care
individual's characteristic pattern of relatively permanent thoughts, feelings, behaviors that define his/her quality of experiences & relationships. From Latin- persona >> "mask" >> may refer to what people see compromises the sum of each person's unique bio-psychosocial characteristics that consistently influences inner experience and behavior across the lifespan
personality
schizotypical PD is both a _______ disorder and a ______ disorder
personality schizophrenia
"enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."
personality disorder
what is one of the most common psych disorders that is prevalent in about 6 % of the global population and in 50% of all psych patients?
personality disorders
also known as whooping cough; respiratory infection that progresses to irritating repeating cough where the cough can occur without intervening breaths
pertusis
the following is an example of what dysfunctional family communication? "don't yell at the children, dear. / put the shoes on the stairs."
placating
what aspect of descriptive epidemiology deals with geographic patterns?
place
what part of descriptive epidemiology is the following an example of: lyme disease is transmitted from animal reserviors to humans by a tick vector. disease is more likely to be found in areas where there are animals carrying this disease, a large tick population for human transmission, and contact between humans and the tick vectors. rocky mountain fever
place
what are "clubhouse models"?
place where anyone with mental illness diagnosis go for socialization, activities, etc; run by themselves
what phase of group development involves identifying the name, objectives, types of members, meeting schedule, physical setting, seating, leader/member responsibilities, and methods of evaluation? ******
planning
what are the four phases of group development? *****
planning orientation working termination
members pretend to be well meaning to keep peace in the family
platicating
a time and space related pattern that is important in infectious disease investigations and as an indicator for toxic exposures; peak shows short term patterns
point epidemics
what five abnormal thought processes might you find with depression? (PPIMD) *****
poor judgment, leading to indecisiveness poor memory/concentration intrusive negative thoughts mute with extreme depression delusional thoughts with severe depression
what is the main focus of both types of epidemiology?
populations
hallucinations, delusions, and unusual speech patterns are examples of ___________ symptoms *****
positive
according to the cognitive theory, if a person looks at life in positive way, that will lead to _______ emotions. if a person looks at life in negative way, that will lead to emotions such as ____, _____, and ______
positive sorrow, anger, hopelessness
what is the goal of evaluating outcomes of the practice decisions or decision changes?
positive change in quality of care and HC outcomes
proportion of persons with positive test who actually have the disease****
positive predictive value
what are first generation antipsychotics used to treat?****
positive symptoms of schizophrenia (hallucinations and delusions)
what are the four main categories of schizophrenia symptoms? (PNCA) ****
positive, negative, cognitive, and affective
with depressed patients what should nurses continuously assess for? what is the highest priority in planning?
potential for suicide safety
exposure to a disease is in the _______ stage and _____ prevention is used
preclinical primary
what are the three stages of disease?
preclinical, clinical, and resolution
which area of the brain affected by bipolar disorder deals with executive decision making, personality, and social behavior?****
prefrontal cortical region
for those with bipolar disorders, IMAGING will reveal dysfunction in what three areas? (PHA)*******
prefrontal cortical region (executive decision making, personality, social behavior) hippocampus (memory) amygdala (memory, decision making, emotion)
what does acronym DARN-CAT mean?***
preparing change talk: -desire (want) -ability (can) -reason (important) -need (should) implementing change talk: -commitment (will) -activation (ready/prepared/willing) -taking steps (action)
urgent or intense speech; resists allowing comments from others
pressured speech
what are 3 common speech patterns and 3 common thought processes in manic episodes? (PCT) (LFC)*****
pressured, circumstantial, or tangential speech, loose associations flight of ideas, and clang associations
the key element is establishing a therapeutic alliance to encourage the patient to engage in more realistic _____-______. a _______ ______ is a written 6 step plan that includes ID of warning signs, internal coping strategies, social settings, and people who provide distraction.
problem-solving safety plan
the following describes which stage of schizophrenia? symptoms appear 1 month to more than 1 year before first full-blown episode; speech + thought may be odd/eccentric ******
prodromal
what are the four phases of schizophrenia? (PASM) *******
prodromal acute stabilization maintenance
what is the dominant defense mechanism of paranoid PD?
projection of feelings onto others
what is this an example of: Accuse partner of being hypercritical when they themselves are fault finding
projection of feelings onto others in paranoid PD
what is motor retardation?
pronounced slowing of movement
what can result from hostility, anger, physical violence, destructive behaviors in borderline PD?****
property damage
type of ratio in which the denominator includes the numerator
proportion
the proportion of all deaths resulting from specific cause
proportionate mortality ration (PMR)
Follows over time a group of similar individuals who differ with respect to certain factors under study to determine how these factors affect rates of a certain outcome
prospective cohort study
what kind of study is classified on the basis of exposure, following participants over time to determine the occurrence of disease in each group, therefore estimating risk for acquiring disease for those who are exposed? uses current evidence *****
prospective/longitudinal study
what is group feedback?
providing members with awareness about how they affect one another
what 7 things does a nurse teach a suicidal patient? (DMRCSCS)
psychiatric diagnoses, medication, community resources, coping skills, stress management, communication skills; safety plan
for a MDD non-compliant suicidal patient, the best form of group therapy is _________ group to let her know how important _____ are for their condition***
psychoeducational meds
Showing clients then have them return demo how to bathe infants, dressing changes, injections, CBGs, BO, crutches, health promotion exercises are examples of what domain?
psychomotor
physical action domain; performance of skills that require neuromuscular coordination
psychomotor
the following behavioral objective is an example of what learning domain?**** rewrite the family favorite recipe using low fat ingredients
psychomotor
which learning domain includes teaching content that includes how to select and use OTC meds to provide comfort w/ flu, use of thermometer and recommendations on when to call PCP, use of hand gel to prevent transmission and includes a brainstorming activity to create a flu-list and demo/return demo of thermometer and hand gel use as teaching methods?
psychomotor
altered cognition, perception; impaired ability to determine what is or is not real; break with reality
psychosis
what is 1st line treatment for paranoid PD?****
psychotherapy
what is the treatment of choice for histronic PD
psychotherapy
with dependent PD, ______ is treatment of choice. _____-_____ therapy can help patients healthier thinking by examining & challenging automatic thoughts that result in fearful behavior
psychotherapy CBT
what are 2 treatments for histronic PD?
psychotherapy group therapy
what are 4 sources of treatment for schizoid PD? (PGBS)
psychotherapy group therapy bupropion SGAs
what are 2 treatments for schizotypical PD? (PA)*****
psychotherapy low-dose antipsychotics
to manage depression, a combo of ______ and ______ are more effective than either alone ****
psychotherapy meds
what is the main outcome goal in the stabilization phase of schizophrenia?
pt understanding, optimal med and psychosocial tx
what are 2 ways to disseminate EBP results? (PP)
publications presentations
5% of those with exposure to TB develop ______ TB. 95% become _____ TB
pulmonary latent
what are 4 suicide precaution measures that can be implemented? ******
q 15min checks (passive thoughts) q 5 minute checks LOS (line of sight) while awake/24 hrs 1:1 while awake/24 hrs
Used to understand people's beliefs, experiences, attitudes, behaviors, and interactions Generates non-numerical data
qualitative study
how well evidence was done, extent to which bias is minimized
quality
found evidence is given a "grade" based on what three things? (QQC)
quality quantity consistency
the number of studies on topic, magnitude of the effect, the sample size
quantity
No randomization of participants in the study
quasi experimental study
what three SGA's can cause prolonged QT interval? (QRZ)
quetiapine, risperidone, and ziprasidone
what are 4 examples of zoonotic/animal-borne diseases? (RHCA)
rabies, hanta virus, cat scratch fever, avian influenza
participants are randomly assigned a control group or intervention group; less biased than allowing participant to pick group they want to join
randomization
in the orientation phase of group development, the group leader must be active in structuring an atmosphere of _______, ______, and ______. members are encouraged to talk to each other in hopes to identify ______ with one another****
respect confidentiality trust universality
bacterial meningitis can spread by what two means? (RS)
respiratory secretions and saliva
what is the treatment for hepatitis B? (RAL)
rest avoid alcohol/drugs liver transplant
what kind of cohort study relies on existing records to define a cohort that is classified as exposed or unexposed and follows those records over time to determine whether the outcome occurred? historical cohort; uses past/existing records ***********
restrospective cohort study
type of boundary that demands adherence to rules & roles regardless of circumstances or outcomes; Boundaries can be so closed - members are disengaged & avoid one another; Communication is minimal and members lead separate lives; members have a hard time bonding with others when they leave; Opposite of diffuse
rigid
probability that an event will occur in specified time frame***
risk
the following symptoms of mania relate to what nursing diagnosis? alteration in cognitive functioning, compromised nutrition, alteration in affective orientation
risk for injury
the following symptoms of mania relate to what nursing diagnosis? alteration in cognitive functioning, impulsiveness, sexual advances, threatening violence, psychotic disorder
risk for other-directed violence
the following sign/symptom of schizophrenia relates to what nursing diagnosis? feels guilty because of "bad thoughts", extremely sensitive to real or perceived slights
risk for self-directed violence
the following correlates with what 2 nursing diagnoses? (SS) ***** previous suicidal attempts, putting affairs in order, giving away prized possessions, SI (plan and ability to carry out), overt/covert statements regarding killing self, feeling worthless/hopeless/helpless
risk for self-directed violence risk for suicide
the following sign/symptom of schizophrenia relates to what nursing diagnosis? hears voices telling him or her to hurt self or others
risk for self-directed/other-directed violence
what is the highest priority diagnosis out of the following?***** ineffective coping risk for suicide hopelessness chronic low self-esteem
risk for suicide
how is hanta virus transmitted?
rodent feces or urine
what are 3 sources of data in epidemiology? (RDE)***
routinely collected data data collected for other purposes epidemiological data
what is the difference between rubeola/red measles and rubella/german measles?
rubeola is redder
what is motor agitation?
running or pacing rapidly
what is the difference between being sad and being depressed? *****
sadness: a normal human response to appropriate situation depression: feels sad about everything with no specific trigger (life could be intact with a lot to be happy about)
what is the most important thing to assess for with depressed patients? ****
safety
what is the priority outcome with antisocial PD?
safety
the priority when planning for family therapy includes addressing the ______ needs of the family and determining if ______ services are needed
safety protective
what is the main outcome goal in the acute phase of schizophrenia?
safety and stabilization
how is rabies transmitted?
saliva of an infected animal
bacterial foodborne infection referred to as the "sneaky germ" in which foods are contaminated by fecal matter
salmonella
what are four examples of foodborne disease? (SCEL)
salmonella clostridium botulinum e coli listeria
what 9 factors should be taken into account when determining the quality of a research study? (SRSDOLACS)
sample selection (biased? random? convenient?) randomization (blinding) sample size description of the intervention outcomes length of follow-up attrition confounding variables statistical analysis (appropriate?)
what three factors affect statistical significance of a study? (SVC)
sample size variance of measure co-variables
a form of displacement in which a family member (usually the least powerful) is blamed for another family member's distress; blamers are usually family and the blamed is usually a child ****
scapegoating
what disorder is described by having symptoms of schizophrenia are concurrently present with MDD, mania, and mixed episodes (depression and bipolar)?******
schizoaffective disorder (SAD)
what is a thought and mood disorder WITH anxiety and depression? *****
schizoaffective disorder (SAD)
before being diagnosed with schizophrenia, what 3 disorders must first be ruled out? (SDB) what other conditions must be ruled out? (SG)*******
schizoaffective disorder (SAD) MDD w/ psychosis bipolar disorder w/ psychosis substance abuse general medical conditions
what are the characteristics of schizoid PD? (SFROLFDDD)
social withdrawal (lifelong) flat affect restricted range of emotions onset in childhood/adolescents loners occurs if family member has schizophrenia or schizotypical PD don't enjoy close relationships depersonalization detachment
those with schizoid PD usually succeed in at what type of jobs in which they can be alone and adjust to what they can tolerate? what is an example of such a job?******
solitary night security guard
the following is an example of what type of delusion? body is changing in unusual ways; body part is rotting*****
somatic
how does the presence of sneezing/stuffy nose/sore throat differ between the flu and a cold?
sometimes with flu, common with cold
with cutaneous anthrax, the first symptoms are ___ that develop into _____ with a _____ colored center that are non-painful. if treated, there is a 2% mortality rate.
sores ulcers black
how does providing information referrals for religious and spiritual support help people with depression?
spiritual and existential issues may be heightened during depressive episodes, and many people find strength, support, and comfort in spirituality or religion
what is a behavior of borderline PD that is described as an inability to view both positive and negative aspects of others as part of a whole; view person as wonderful or a horrible person?****
splitting
what is the following an example of? -at first may idealize new relationship/friend; if disappointed/frustrated - now quickly shifts & other person despised, devalued, etc. -"You're a great nurse" à "'I've never had a nurse so bad"
splitting
what herb is commonly used to treat depression and can lead to serotonin syndrome if combined with an SSRI? ****
st. john's wort
the following describes which stage of schizophrenia? symptoms diminishing and movement towards previous level of functioning; follow up care varies ******
stabilization
in what phases of schizophrenia is the focus on providing family education, support, and skills, shelter, educational and vocational strengths, and recognition of early signs of relapse?
stabilization and maintenance
what are four symptoms of e coli? (CDVF)
stomach cramps/pain, bloody diarrhea, vomiting, and low-grade fever (under 101)
what are tuckman's three steps of the working phase of group development? (SNP) ****
storming norming performing
how does the arrogance, need for constant admiration, and apathy with Narcissistic PD affect relationships over time?****
strains them
through family education, nurses reinforce _____, help ID _____, and strengthen ____ skills
strengths resources coping
what are 8 risk factors for schizophrenia? (DGDNBPPE)*****
stress-diathesis model genetic dopamine theory (overactivity) other neurochemical imbalances brain structure abnormalities prenatal infections psychsocial stressors environmental toxins
how did robert koch contribute to epidemiology? (TAC)
studied causes of TB, anthrax, and cholera
how did joseph lister contribute to epidemiology? (A)
studied use of antiseptics in surgery
how did edward jenner contribute to epidemiology? (V)
studied vaccinations (smallpox)
what 6 comorbidities are common with schizophrenia? (SADSIP)****
substance use, anxiety, depression, suicide, physical illness, and polydipsia
what are cognitive symptoms?*****
subtle/obvious impairments in memory, attention, or thoughts
histronic PD patients often attempt _____*****
sucide
what is brief psychotic disorder?
sudden onset of 1 type of psychosis lasting for longer than 1 day but not longer than one month with the expectation of returning to normal
does meningococcal septicemia onset suddenly or gradually?
suddenly
what is a major reason for hospitalization for patients with major depression?
suicidal thoughts
hopelessness in depressed patients is often correlated with ______
suicidality
what is the leading COD of schizophrenic patients?*****
suicide
what is the leading cause of early death in patients with schizophrenia?
suicide
borderline PD has a 10% _____ and _____ rate and 85% of borderline PD patients have/do not have another mental illness
suicide mortality have
what does SAFE-T stand for and what is it used for?
suicide assessment five-step evaluation and triage; suicide assessment
what assessment should be done on a depressed patient before being prescribed a TCA at home? ******
suicide assessment; lethal in OD
preoccupation with death, own funeral, dreams about death, thoughts about wanting to die, etc
suicide ideation
what are 3 types of magical thinking that influences behavior in schizotypical PD? (STC)****
superstitious telepathy clairvoyant
what are the 6 roles of the nurse in prevention or control of infectious disease? (SRESVD)
surveillance teams reporting to DPH/CDC educating screening vaccination delivering treatment (DOT)
how can avoiding platitudes such as "things will look up" or "everyone gets down once in a while" help with a severely withdrawn patient?
these minimize patient's feelings and can increase feelings of guilt and worthlessness, because the patient cannot "look up" or "snap out of it"
what are positive symptoms of schizophrenia?*****
those that are present, but shouldn't be
reduction or stoppage of thought; interruption of thought by hallucinations can cause this
thought blocking
believing thoughts are being removed from their head
thought deletion
believing someone has inserted thoughts into their brain; their thoughts are not their own but rather the thoughts of others that have become implanted in their heads***
thought insertion
how can depression have psychological/cognitive risk factors?
thoughts effect emotions in a negative or positive way
what aspect of descriptive epidemiology deals with secular trends, point epidemic, cyclical time patterns, and non-simultaneous, event-related clusters?
time
what is a big part of the diagnosis of delusional disorder?
time limits
what is the aim of therapeutic communication in those with schizophrenia?
to build trust and reduce anxiety
what is the goal of screening?*****
to determine the likelihood that individuals will develop a disease
what is the aim of the critical theory?****
to dig beneath the surface of social life and uncover the assumptions that keep us from a full and true understanding of how the world works
what is the purpose of the intervention wheel?
to identify public health nursing interventions; defines and explains each intervention and best practices
what is the first task of a family therapist?
to identify the presenting problem which often belongs to the identified patient that is regarded by the family as "the problem"
what is the main nursing goal during acute mania?
to stabilize patient while maintaining safety
what are short-acting injectable antipsychotics used for?
to treat agitation in behavioral emergencies
ability to produce a poisonous reaction
toxicity
a person should get a hep A vaccine if they are (TGDK)
traveling gay men drug user kids at least 1
what is the treatment for ebola?
treat S&S with IVF, IVE, maintain O2 status, maintain BP (dehydration), tx other infections
what are pseudoparkinsonian symptoms? (TRGRB)
tremors, reduced accessory movements, gait impairment, reduced facial expressiveness (mask facies), bradykinesia
1 member will not communicate directly wither another, but will communicate with a 3rd family member, forcing the 3rd member to be a part of the triangle and communication is routed through the 3rd person ****
triangulation
T/F Criminal misconduct & substance misuse is common with antisocial PD***
true
T/F MRSA & VRSA now commonly seen in places with shared dressing and bathing areas******
true
T/F Narcissistic PD has less functional impairment than other PD
true
T/F Personality is as essential to self-identity as physical appearance. Does not change easily or quickly.
true
T/F age is a predictor of overall mortality
true
T/F inflammation as a result of psychological injury can increase the risk of depression
true
T/F it is unlikely that there is a single cause for depression
true
T/F measles was declared eliminated in 2000 but we now have an influx of disease measles live in the nose and throat of people and can infect others for up to 2 hours after infected person leaves room
true
T/F paranoid PD may be apparent in childhood and manifested as social anxiety in which the child has few friends
true
T/F patients tend to seek help with obsessive compulsive PD and A + D
true
T/F schizotypical PD is very close to schizophrenia
true
T/F some substances, medications, and medical conditions can cause depression
true
T/F suicidal behavior is a result of interpersonal turmoil
true
T/F there is no specific meds to tx histronic PD
true
T/F with a schizotypical PD pt in psychotherapy, we must investigate for possible involvement with cults
true
T/F Risk of suicide is highest in the 1st year after a suicide attempt****
true
T/F: Lethal overdose is nearly impossible with newer antidepressants such as SSRIs
true
match the key characteristic of patient-centered medical homes to its correct definition (patient-centered, comprehensive care, coordination of care, improved access, systems approach) 1. patients are not limited to get the care they need. They have extended hours of service and provide email and phone support 2. all levels of mental and physical care are addressed. Physicians or APRNs lead teams 3. care is relationship-based with the patient and takes into account the unique needs of the whole person; patient is core member of team 4. evidence-based care is provided with a continuous feedback loop of evaluation and quality improvement 5. care is coordinated with the broader HC system such as hospitals, specialty care, and HH
improved access comprehensive care patient-centered systems approach coordination of care
according to yalom, what is imparting information? ****
instruction/lecture
what Yalom Curative Factor is this an example of? ***** "when you speak that way, I feel intimidated"
interpersonal learning
what are yalom's 11 curative factors? (ICIUIACSICE) *****
interpersonal learning catharsis installation of hope universality imparting information altruism corrective recapitulation of primary family group socializing techniques imitative behavior cohesiveness existential resolution
the number of people in state-managed psych hospitals began to decrease with the creation of what 2 things in the 1960s?
medicaid medicare
Of 12 million emergency department visits, nearly 13% are due to _____ ____ or _____ _____
mental health substance abuse
according to yalom, what is group cohesiveness? *****
when each member feels connected to others and can accept positive feedback and constructive criticism
according to yalom, what is existential resolution? *****
when members examine aspects of life like mortality and responsibility
match the intervention for the following nursing diagnoses: a. risk for self-directed violence b. risk for other-directed violence c. impaired mood regulation 1. mood management 2. suicide prevention 3. violence prevention
a. suicide prevention b. violence prevention c. mood management
what is the mainstay mental health care for those lacking funds? what type of care do they offer?
community mental health centers offers free or low-cost sliding scale care
what emergency care model is involved when an entire section of an ER is dedicated to psych and is often associated with a full-service ER in a hospital or medical center setting with dedicated clinical space and specialty staffing who use triage and stabilization?
comprehensive emergency service model
what are the 3 models of emergency care? (CHM)
comprehensive emergency service model hospital-based consultant model mobile crisis team
what kind of inpatient psych setting is overnight, but short term (1-3 days) and is for those who have symptoms that are expected to remit in 72 hours or less or have a stressor? ******
crisis stabilization/observation units
Movement along the continuum is fluid and patients may be moving in one/either direction. If symptoms do not improve, may be referred to a higher level of care to prevent _______ (deterioration of mental health) and ________
either decompensation hospitalization
community mental health centers can offer what 11 services? (EOMIPFDRVRP)
emergency outpatient medication individual therapy psychoeducational and therapy groups family therapy dual-diagnosis tx rehabilitation vocational services residential services psychiatric case management
what health care setting often serves as the bridge from the community to more intensive services such as inpatient care?
emergency department
tertiary prevention of MDD aims to avoid loss of ______, reduced _____ in families, and preventing _____. ****
employment disruption suicide
true or false? in inpatient psych facilities, patients are often forced to give up their rights as citizens
false
true or false? mental disorders do not have accompanying physical symptoms (backaches, headaches, digestive problems)
false
true or false? it is okay to fight back with a patient if they strike first
false; can only defend self, not fight back
patient-centered medical homes were developed in response to ______ care that resulted in some services _____ being done or ______
fragmented never duplicated
according to yalom, what is interpersonal learning? *****
gaining insight into oneself
medicaid paied for short term hospitalizations in _____ _____ and long term care in _____ ____. it did not cover care for most _____ hospitals. these incentives stimulated the development of _____ hospital _____ units and transfer of geriatric patients from _____ hospitals to ______-______ _____ ____. this caused an increase/decrease in state-managed psych hospitals
general hospitals nursing homes psych general hospital psych units state medicaid-reimbursed nursing homes decrease
according to yalom, what is imitative behavior? *****
group members may copy behavior from leader or peers and adopt healthier habits
what emergency care model is involved when the ER has on-call psych specialists with no dedicated clinical space or comprehensive separate staffing with on-call staffing who use triage and stabilization?
hospital-based consultant mdel
what Yalom Curative Factor is this an example of? ***** "I like the way you answered that question, maybe I can try that next time"
imitative behvaior
what Yalom Curative Factor is this an example of? **** "here is how to take you medicine"
imparting info
what is the main disadvantage of a freestanding psych hospital? ****
patient will need to be transferred if they need labs or have chest pain
what are the 5 key characteristics of patient-centered medical homes? (PCCIS)
patient-centered comprehensive care coordination of care improved access systems approach
how did the common setting of mental health care change in the 1960s?
patients diverted from state-funded hospitals to federally funded community mental health centers
what kind of prevention takes place before the problem manifests and is performed in order to reduce the incidence or rate of new cases? ****
primary
by the 1950s, what two options were available for those seeking mental healthcare?
private psychiatrist or mental hospital (asylum)
ACT teams work intensively with patients in their homes or agencies or wherever patient needs them. Creative _____ _____ and _______ are hallmarks of the mobile team. The ACT concept takes into account that people need support and resources after 5 p.m. therefore, teams are on-call ____ hours a day ACT teams are _______ and typically are composed of RNs, social workers, psychologists, APRNs, and psychiatrists. Often the RN serves as the _____ _____ and may have a caseload of patients who require visits ___-___ times per week.
problem solving and interventions 24 multidisciplinary case manager 3-5
what are 6 functions of the RN in inpatient psych facilities? (RTAMMS)
respecting patient rights teamwork + collaboration assessment milieu managing behavioral crises safety
what is the most important consideration for inpatient psych settings?
safety
what are 6 ways to determine which patient are most likely to attempt suicide in order to ID patient safety risk? (SDITMP)
suicide assessment tool assess during daily assessment inspect all belongings track patients (q15, LOS, 1:1) monitor visitation prohibit intimate relationships between patients
any group of people who meet together for personal development and psychotherapeutic growth
therapeutic group
forming a safe and secure structured environment (furniture, surroundings, etc) that facilitates the therapeutic interaction between clients and members of the professional team
therapeutic milieu
what are 2 disadvantages of mental healthcare by PCP's in the outpatient setting? (TP)
time constraints (15 min appt usually not adequate) PCPs have limited training in psychiatry and lack expertise
what is the main difference between PHP and IOP? explain. ****
time; IOP may visit every other day/half a day, while PHP may visit M-F/whole day
what is the primary goal of emergency mental health care? (2)
triage and stabilization [triage (determine severity and urgency) & stabilization (resolution of immediate crisis)]
T/F therapeutic milieu includes rules, activities, environment and even the placement of tables/chairs/furniture
true
true or false? emergency department admissions can be either voluntary or involuntary
true
true or false? in inpatient psych facilities, each health care discipline must perform their own individual assessment of the patient, even if questions become repetitive ***
true
according to yalom, what is altruism?****
what members gain by giving support to others
