NUR 371 Exam 2

Which of the following are unique parts of the psychiatric evaluation for children and adolescents compared to adults? -academic achievement -effect of the problem on family and siblings' lives -types of play -pregnancy, birth, neonatal data -thought processes and content -characteristics of play

-effect of the problem on family and siblings' lives -types of play -characteristics of play

Which of the following are part of the I MURDER? mnemonic? -ego-dystonic -irrational -malicious -distressing -rewarding -unwanted

-ego-dystonic -distressing -unwanted

The primary risk factors for major depressive disorder (MDD) include: -history of using tobacco products -first-degree family member(s) with MDD -regular consumption of 1-2 alcoholic drinks/day -family member with any diagnosed mental health condition -female gender -chronic or disabling health conditions

-first-degree family member(s) with MDD -female gender -chronic or disabling health conditions

Indicators of seasonal affective disorder (SAD) include: -feeling worthless or hopeless -hypersomnia -weight gain -suicidal ideation -carbohydrate cravings -loss of interest in most, if not all, activities

-hypersomnia -weight gain -carbohydrate cravings

Side effects of clonidine (Kapvay/Catapres) include: -insomnia -fatigue -nausea -diarrhea -nightmares -hypersalivation

-insomnia -fatigue -nightmares

Which of the following also increase when the number of adverse childhood experiences (ACEs) increase? -legal trouble -borderline personality disorder -schizoaffective disorder -intimate partner violence -financial distress -major depressive disorder

-intimate partner violence -financial distress -major depressive disorder

Symptoms and treatments of persistent depressive disorder (PDD), also known as dysthymia, include: -low-level depression and related symptoms for most days for at least 2 years in adults -atypical antipsychotics -irritability -suicidality -decreased/increased appetite -insomnia/hypersomnia

-low-level depression and related symptoms for most days for at least 2 years in adults -decreased or increased appetitie -insomnia or hypersomnia

Place the sequence of the operational definition of anxiety in correct order from beginning (1) to end (4): -anxiety -stress -effective mediation OR ineffective mediation -relief behavior

1. stress 2. anxiety 3. relief behavior 4. effective mediation OR ineffective mediation

Reduction in speech and sometimes known as poverty of speech, is referred to as ________

alogia

an ______ affect is odd, illogical, inappropriate, or unfounded

bizarre

An affect characterized by reduced or minimal emotional response is said to be ________

blunted

Standing too close to others or drinking/eating another person's food because that drink/food is nearby, therefore making it the patient's, are examples of ________

boundary impairment

The only medication FDA approved for postpartum depression is ________ (Zulresso), and can only be given by IV infusion

brexanolone

_______ occurs when there is a pronounced decrease or increase in the rate or amount of movement and excessive movement is purposeless

catatonia

Traditionally known as stuttering, _______ disorder is noted for hesitation or repetition of speech

child onset fluency

Per the US Department of Health & Human Services Centers for Medicare and Medicaid Services, __________ is "any manual method, physical or mechanical device, material, or equipment that immobilizes or reduce the ability of a patient to move [their] arms legs, body, or head freely."

restraint

The DIG FAST mnemonic for mania includes: -Sleep -Impulsivity -Distractibility -Troublemaking -Fast talking -Generosity

sleep impulsivity distractibility (distractibility, impulsivity, grandiosity, flight of ideas, activity increase, sleep deficit, talkativeness)

-major depressive disorder -Parkinson disease -treatment-resistant obsessive compulsive disorder

deep brain stimulation (DBS)

Distorted (and generally false) thoughts are called _______

delusions

False beliefs that exist even though there is little/no evidence to support them are known as _______

delusions

_________ occurs when a person feels unreal or that they have lost a part of their person or identity

depersonalization

-anxiety -obesity -pain -treatment-resistant depression

vagus nerve stimulation (VNS)

The external expression of a person's emotional state is known as the person's _______

affect

_______ occurs when the affect is reduced or constricted

affective blunting

An action or behavior that ends in an attack (physical or verbal) is defined as ________

aggression

The automatic and unconscious process by which we determine what is real and what is not is called ________

reality testing

Per Zoloski and Bullock, qualities of resilient children include: -an ability to form nurturing relationships with other adults should parents be unavailable -social intelligence -dependence on parents for nurturing relationships -ability to see a long-term future -a fixed view of the world -ability to become part of the emotional chaos

-an ability to form nurturing relationships with other adults should parents be unavailable -social intelligence -ability to see a long-term future

Which of the following are true regarding pain management in older adults? -Opioids are less effective in older adults. -Analgesics (pain relievers) have a longer duration of action in older adults, so initial dosing should be 1/4 to 1/2 of normal. -Older adults often receive better pain management than younger adults. -Constipation is a frequent side effect of opioids. -Acetaminophen (Tylenol) is effective at reducing inflammation. -Older adults often get pain medication less often than younger adults.

-Analgesics (pain relievers) have a longer duration of action in older adults, so initial dosing should be 1/4 to 1/2 of normal. -Constipation is a frequent side effect of opioids. -Older adults often get pain medication less often than younger adults.

Which of the following are important de-escalation techniques? -Keep yourself and the patient calm -Don't allow the patient to interrupt you -Use a loud, commanding tone of voice -Assess the patient and situation -Preserve patient self-esteem and dignity -Tell the patient what they want to hear

-Keep yourself and the patient calm -Assess the patient and situation -Preserve patient self-esteem and dignity

Which of the following are true regarding depression in childhood/adolescence and older adults? -Depression is a normal result of aging. -Older adults with depression are more likely to die by suicide than younger adults. -Infants can display depressive symptoms. -Depression and declining health are not related. -Less than 5% of U.S. adolescents have had a least one major depressive episode. -Adolescents have higher rates of depression than adults.

-Older adults with depression are more likely to die by suicide than younger adults -Infants can display depressive symptoms -Adolescents have higher rates of depression than adults

Which of the following are included in the HE RILED UP mnemonic for ADHD? -Excitable -Running around -Loss of attention -Unseated -Distractable -Interrupts

-Running around -Unseated -Interrupts

Important strategies for performing assessment of older adults include -Avoid providing treatment options; just select the best one for the patient to avoid confusion. -Stand when in the room with the patient to help them understand your authority. -Sit at the same level as the patient to establish rapport and put the patient at ease -Use touch (with permission) -Be formal with the patient to show respect -Ensure adequate lighting and noise reduction to help people who may have auditory and/or visual impairments

-Sit at the same level as the patient to establish rapport and put the patient at ease -Use touch (with permission) -Ensure adequate lighting and noise reduction to help people who may have auditory and/or visual impairments

The guidelines for assessing depression include: -always evaluate for risk of harm to self or others -assess which previous treatments worked and which did not work -assess which second- and third-degree relatives had depression -assess for family history of cancer -always use a standardized screening tool -evaluate if depression is primary or secondary to other disorders

-always evaluate for risk of harm to self or others -assess which previous treatments worked and which did not work -evaluate if depression is primary or secondary to other disorders

Which of the following should be avoided when taking monoamine oxidase inhibitors (MAOIs)? -yogurt -all wines (except Chianti wines) -all berries -cured meats -avocados -medications containing ephedrine

-cured meats -avocados -medications containing ephedrine

Important patient education related to selective serotonin reuptake inhibitors (SSRIs) includes: -hypercoagulability is a rare, but severe side-effect -may cause anorgasmia and/or lack of libido -common side effects include fatigue, nausea, diarrhea, dry mouth, dizziness, and tremor -medication can be stopped at any time with no significant side effects -liver and renal function tests should be performed and and blood counts checked periodically -any products containing alcohol should be avoided

-may cause anorgasmia and/or lack of libido -common side effects include fatigue, nausea, diarrhea, dry mouth, dizziness, and tremor -liver and renal function tests should be performed and and blood counts checked periodically

Which of the following are toxic effects of monoamine oxidase inhibitors (MAOIs)? -nausea and vomiting -hypotensive crisis -severe headache -bowel blockage -hypertensive crisis -hypoglycemia

-nausea and vomiting -severe headache

Per Halter, important areas to asses for autism spectrum disorder include: -parent-child relationship for evidence of bonding, anxiety, tension, and fit of temperaments -financial ability of families to pay for ASD treatments -performance of screening for intellectual disability -developmental delays, uneven development, or loss of acquired abilities -developmental performance that is accelerated compared to children of a similar age -performance of screening for anxiety disorders

-parent-child relationship for evidence of bonding, anxiety, tension, and fit of temperaments -performance of screening for intellectual disability -developmental delays, uneven development, or loss of acquired abilities

Which of the following are part of the DSM-5 criteria for diagnosing autism spectrum disorder (ASD)? -restricted, repetitive patterns of activities, behavior, or interests as demonstrated by at least two areas -symptoms are explained by intellectual disability or global developmental delay -persistent social communication and social interaction deficits across multiple areas -symptoms do not noticeably affect everyday functioning -symptoms are present from the early developmental period -symptoms are present in adulthood, not in childhood or adolescence

-restricted, repetitive patterns of activities, behavior, or interests as demonstrated by at least two areas -persistent social communication and social interaction deficits across multiple areas -symptoms are present from the early developmental period

Which nursing diagnoses would be fitting for a person who has a lack of responsiveness or interest in others, empathy, or sharing? -risk for impaired parenting -risk for social isolation -impaired child development -risk for injury -self-destructive behavior -impaired socialization

-risk for impaired parenting -risk for social isolation -impaired socialization

Which nursing diagnoses would be appropriate for a person experiencing depression, inability to concentrate, difficulty in functioning, feeling down, and change in vegetative symptoms? -risk for suicide -risk for injury -risk for impaired caregiver child attachment -hopelessness -impaired coping -spiritual distress

-risk for suicide -hopelessness -spiritual distress

Which of the following are the major causes for depression and depression-like symptoms? -social environment -cultural beliefs and practices -neurobiological factors -resident of a rural area -regular use of social media -pharmaceutical company greed

-social environment -cultural beliefs and practices -neurobiological factors

Causes and risk factors for delirium in older adults include: -use of a multivitamin -family history of Alzheimer's disease -thyroid dysfunction -stroke -recent antibiotic treatment -electrolyte imbalance

-thyroid dysfunction -stroke -electrolyte imbalance

Which of the following are components of the SURP-rise! mnemonic? -Repetitive -Unexpected -Short -Panic disorder -Sudden -Recurrent

-unexpected -sudden -recurrent

-mild treatment-resistant depression

repetitive transcranial magnetic stimluation (rTMS)

Telling a patients to avoid aged or cured foods, go to the emergency department if a severe headache develops, and telling the patient to following dietary and drug restrictions for 14 days after discontinuing treatment are all education related to taking ________

MAOI

A person with ___________ feels that everything they experience has profound significance. This makes it difficult for people with schizophrenia to determine what information is relevant

aberrant salience

_______ is the inability or reduced ability to experience pleasure

anhedonia

________ arises when a person cannot realize that they are ill

anosognosia

________ is defined as a feeling of apprehension, uneasiness, uncertainty, or dread arising from a real or perceived threat

anxiety

_______ is seen when a person has decreased interest in activities or beliefs that would normally be of interest to them

apathy

_________ is the decreased desire for social interaction or discomfort associated with social situations

asociality

________ is the result of thinking that is haphazard and illogical where concentration is poor and thoughts are connected loosely

associative looseness

_______ is reduced motivation or goal-directed behavior

avolition

The letters that can be a helpful clue as to whether a medication is a benzodiazepine are _______

aze

When a person includes unnecessary and often tedious details in conversation but eventually reaches the point, the pathological speech pattern they are demonstrating is _________

circumstantiality

Choosing words because of the way they sound instead of what they mean, often involving words that rhyme or have similar starting sounds, is referred to as ____________

clang association

A generalized slowing of thinking represented by delays in responding to questions or difficulty finishing thoughts is known as _________

cognitive retardation

A person is directed to take action by ________ hallucinations

command

Around 6% of children have some variety of _________ disorder that affects communication, language, and speech

communication

When a person has _______ patterns, they cannot think abstractly and interpret/perceive things in a literal manner

concrete thinking

An affect characterized by being reduced in range or intensity is said to be ________

constricted

The most extreme form of associative looseness, where what is said is merely a mess of words that have no meaning to the listener, is called _________

derailment

Feeling that one's environment has changed (e.g., that surroundings are now strange or unfamiliar) is known as _______

derealization

The pathological repetition of another person's words is called _________

echolalia

________ is seen when a person mimics the movements of another

echopraxia

-bipolar disorder -major depressive disorder -mania -schizoaffective disorder -schizophrenia

electroconvulsive therapy (ECT)

a _______ affect is seen in someone with an immobile or blank facial expression

flat

_______ occurs when a person rapidly moves from one thought to another, making it difficult for other people to follow along

flight of ideas

________ is seen when thoughts flow in a rapid, continuous manner and change from topic to topic

flight of ideas

with ________ delusions, a person shows a highly-inflated self-regard

grandiose

A relationship ordered by a court that gives a person the ability to act on behalf of another person (the ward) is known as ___________

guardianship

By thinking of the "flu" part of fluoxetine (Prozac), we are reminded that this SSRI has a longer _______ than other SSRIs

half life

When a person misperceives sensory experiences that have no external source, those sensory experiences are known as ________

hallucinations

A low-level and less dramatic version of mania generally seen in people with bipolar II disorder is known as _______

hypomania

The misinterpretation of a real experience is known as a(n) ________

illusions

Interrupting others or throwing unwanted food on the floor are examples of ________

impaired impulse control

an _________ affect does not match the actual emotional state or situation

inappropriate

The belief that someone has placed thoughts into the patient's brain is known as thought _________

insertion

Representing the disordered way that a person processes information, people with ________ have thoughts that are only loosely connect to one another

loose associations

A person who believes that reality can be changed merely by using thoughts or unrelated actions is using _______

magical thinking

The period that often precedes schizophrenia during which milder symptoms appear is known as the ________ phase

prodromal

________ is seen when a person exhibits excited behavior such as running or rapidly pacing in response to external or internal stimuli

motor agitation

A pronounced slowing of movement is defined as ________

motor retardation

______ symptoms include blunted affect, anhedonia, alogia, and avolition

negative

Which of these are components of the HD BS Network mnemonic for schizophrenia? -Negative symptoms -Dopamine elevated -Hallucinations -Second-generation treatment -Basal ganglia -Delusions

negative symptoms hallucinations delusions

A tendency to resist or oppose the requests or wishes of others is known as _______

negativism

_______ are words that the patient finds meaningful, but have different or no meaning to other people

neologisms

For duloxetine (Cymbalta), the mnemonics "dull"-oxetine and "dual"-oxetine remind us that this medication affects the neurotransmitters _______ and _________; while also reducing the ________ related to fibromyalgia, diabetic neuropathy, and premenstrual symptoms

norepinephrine, serotonin, pain

_________ is irrational fear that ranges from mild to profound

paranoia

A person with _______ delusions believe that someone, godly or mundane, is seeking to harm them in some way (emotionally, financially, physically, etc.)

persecutory

_______ symptoms include bizarre behavior, delusions, disorganized speech, and hallucinations

positive

________ or ________ occur when a person assumes unusual or illogical expressions, postures, or positions

posturing, gesturing

A person with thinking that is so severely slowed that responses are delayed or absent is said to have ________ of thought

poverty

Speech that is urgent or intense in nature or that shows a reluctance to allow comments from other people is called _______ speech

pressured

When a person uses words based on what they represent instead of what they mean, they are using ________

symbolic speech

The 2-for-6-ophrenia mnemonic reminds us that to diagnose schizophrenia, a person must have 2 or more of the DSM-5 ________ for at least 6 _______

symptoms, months

_________ happens when a person wanders off topic or goes on tangents without ever getting to the point

tangentiality

_______ is a reduction or stoppage of thought that may be caused by cognitive disorganization or interruptions of thought by hallucinations

thought blocking

The belief that thoughts have been taken or are missing is known as _______

thought deletion

The second most common type of hallucinations in schizophrenia are ___________ hallucinations

visual