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Mental Health-FINAL EXAM Rasmussen QUESTIONS WITH ANSWERS What type of patients go to memory care? - correct answer--Dementia or Alzheimers What type of environment is a memory care unit? - correct answer--Locked unit, 24-7 supervision. What type of activities do you implement to interact with memory care patients? - correct answer--Activities that help them to recall their past-show old photos, ask questions like what was your first job? where did you grow up? what was your parents names? If a patient is not engaged in a group of people sharing photos what might they be feeling? - correct answer--Depressed, Isolated, Angry Can a social worker make a decision about placement for an elderly person if that person has living family members, a POA? - correct answer--No, they cannot make the decision. Nurses must educate family about decisions. What does agnosia mean? - correct answer--Inability to interpret sensations and hence to recognize things, typically as a result of brain damage. Example of something that could cause agnosia? - correct answer--TBI, vascular dementia. Characteristics of delirium. - correct answer--Rapid in onset, 24-72 hours, related to infection, NOT common with aging. What is an important intervention for patients with delirium? - correct answer--Reorient them. What are the primary characteristics of borderline personality disorder? - correct answer--splitting people (Pitting a group against each other). Self-defeating cycle of behavior. What do you give a patient who has overdosed on PCP? - correct answer-- Benzodiazepine Example of a benzodiazpine antidote? - correct answer--Flumazenil What type of personality disorder might a patient who still lives at home at 30 and depends on their mother for everything, have? - correct answer--dependent personality disorder Give an example of a positive statement made by a recovering alcohol that made signal that they are getting better? - correct answer--| will identify things that trigger my cravings Symptoms of patient with suspected opioid abuse/overdose? - correct answer-- Contracted pupils, increased HR, shallow Resp., increased temp (but not always). What do you give a opioid overdose patient? - correct answer--Narcan (Naloxone) S/S of acute alcohol withdrawal? - correct answer--Everything is increased! RR, BP, Temp, HR, delerium Characteristics of histrionic personality disorder? - correct answer--Mania, melodramatic, manipulative, emotional attention seeking behavior, often seductive and flirtatious. Interventions for histrionic personality disorder patient - correct answer--They are very manipulative. Set fine lines, do not offer relationship advice, avoid situations where they are the center of attention. Possible fatal complications of patient withdrawing from CNS stimulant - correct answer--Respiratory failure, suicide, and depression. What is a hypochondriac? - correct answer--Someone who thinks that everything is wrong with them. Ex. their acute headache is caused by a brain tumor. How does cocaine stimulate the body? What do cocaine users use to combat these effects? - correct answer--It is an upper. Alcohol-allows them to sleep. Characteristics of borderline personality disorder - correct answer--Split people apart and are very manipulative. Interventions for nurses dealing with borderline personality disorder patients - correct answer--Keep all the staff on the same page. Set limits and rules. What is a personality disorder in general? What type of issues do these patients have? - correct answer--When people rely on others to make decisions. They have difficulties in their social life, work, relationships, family problems. Place the blame on others. Many go undiagnosed. How long til we see complications with patients withdrawing from alcohol? - correct answer--24 to 48 hours. When giving narcan, what should you monitor closely? - correct answer--VS, at least every 15 min. Stay with patient! What would you give a patient with a heroin overdose? What would we expect to improve? - correct answer--Narcan. HR and Resp OD heroin patient receives narcan, 1 hr. later present with abd cramps, goose bumps. What is going on? - correct answer--Symptom of narcotic absence. "withdrawal" What should the nurse do for a sexual assault victim? - correct answer--Make sure counseling is available for them, set up an appointment Who is at the highest risk for physically abusing a nurse? - correct answer--A patient with dementia or a delusional patient What type of meds do ADHD patients receive? - correct answer--CNS stimulant Early signs of autism in kids? - correct answer--lsolation, not loving towards people, nonverbal, doesn't like to be touched, difficult relationship with parents Can restraints be PRN? - correct answer--NO!! Must clarify with doctor. What is lorazepam (Ativan) used for? - correct answer--Anxiety disorder or preop sedation. Side effects of lorazepam (Ativan) - correct answer--Drowsiness, respiratory depression, dizziness, lethargy, physical dependence Contraindications of lorazepam (Ativan) - correct answer--Angle closure glaucoma, hx of drug dependence, pre-existing CNS depression, severe hypotension, and sleep apnea Lithium therapeutic range - correct answer--0.5-1.5 Levels of maslow hierarchy of needs? - correct answer--Physiological needs, safety, love & belonging, self-esteem, self-actualization. Rights of voluntary and involuntary admission patients to mental health? - correct answer--Have the right to refuse meds, refuse treatments, and the right to informed consent. What vitamin isn't absorbed when taking an MAOI? - correct answer--Tyramine Characteristic of patient with body dysmorphic disorder? - correct answer--Preoccupied with an image of a defective body part resulting in obsessional thinking and compulsive behavior, such as mirror checking and camouflaging. Theraputic Communication Technique (TCT) Silence: - correct answer--using silence allows for meaningful relfection (TCT) accepting: - correct answer--conveys an attitude of reception and regard (TCT) Giving recognition: - correct answer--Acknowledging indicates awareness (TCT) Offering self: - correct answer--Making oneself available on an unconditional basis, increasing the clients feeling of self-worth (TCT) offering general leads: - correct answer--Allows the person to take direction in the discussion indicates that the nurse is interested in what comes next. ("go on", “and then?") (TCT) giving broad openings: - correct answer--clarifies that the lead is to be taken by the patient ("Where would you like to begin?") (TCT) Making observations: - correct answer--Calls attention to the person's behavior, encourages the person to notice behavior and to describe thoughts and feelings for mutual understanding. Helpful for mute or withdrawn people. (TCT) Encouraging description of perception: - correct answer--Increase the nurse's understanding of the patient's perceptions. Talking about feelings and difficulties can lessen the need to act them out inappropriately Non-therapeutic communication (NTC) Giving premature advice - correct answer-- Assumes the nurse knows best and the patient cannot think for self. (NTC) Minimizing feelings: - correct answer--Indicates the nurse is unable to understand or empathize with the patient. The patient's feelings or experiences are being belittled. What is beneficence? - correct answer--The duty to act as a benefit or to promote the good of others. What is autonomy? - correct answer--Respecting the rights of others to make their own decisions What is justice? - correct answer--The duty to distribute resource or care equally, regardless of personal attribtutes. Healthy defense mechanisms (4) - correct answer--Altruism, sublimation, suppression, and humor. What is altruism? - correct answer--Healthy defense mechanism. Emotional conflicts and stressors are addressed by meeting the needs of others. What is sublimination? - correct answer--Healthy defense mechanism. An unconscious process of substituting constructive and socially acceptable activity for strong impulses that are not acceptable in their original form. What is suppression? - correct answer--The constant denial of a disturbing situation or feeling. What are the intermediate defenses? (4) - correct answer--Repression, displacement, reaction formation, reationalization What is repression? - correct answer--Intermediate Defense. cornerstone of defense mechanisms and is the first life of defense against anxiety. Exclusion of unpleasant experiences, emotions, or ideas from conscious awareness. What is displacement? - correct answer--Intermediate defense. Transfer of emotions associated with a particular person, object, or situation to another person object or situation that is nonthreatening. What is reaction formation? - correct answer--Intermediate defense. Unacceptable feelings or behaviors are kept out of awareness by developing the opposite behavior or emotion. What is rationalization? - correct answer--Intermediate defense. Consists of justifying illogical or unreasonable ideas, actions, or feelings by developing acceptable explanations that satisfy the teller as well as the listener. What are the immature defenses? (4) - correct answer--Passive aggression, splitting, projection, denial. What is passive aggression? - correct answer--Indirectly and unassertively expressing aggression towards others. Expressed through procrastination, failure, inefficiency, and illness that affects others more than oneself. What is splitting? - correct answer--The inability to integrate the positive and negative qualities of oneself or others What is projection? - correct answer--A person unconsciously rejects emotionally unacceptable personal features and attributes them to other people objects or situations. What is denial? - correct answer--Escaping unpleasant realities by ignoring their existence. In regards to the MMSE? What does it focus on? - correct answer--Cognitive screening tool used to screen for dementia S/S of depression - correct answer--depressed mood, insomnia, excessive sleeping, indecisiveness, decreased ability to concentrate, suicidal ideation, increase or decrease in motor activity, increase or decrease in wt. and agnosia. Who influence peplau? - correct answer--Influenced by Sullivan's interpersonal relationship theory. What was peplau's theory? - correct answer--Interpersonal theory of nursing. Nurses therapeutic use of self during the nurse-patient interaction had a direct impact on the outcome of the patient's well-being. What is impulsive behavior? - correct answer--Common in borderline personality disorder. tendency to act w/o thinking about the consequences of your actions Characteristic of conversion disorder - correct answer--Marked by symptoms or deficits that affect voluntary motor or sensory functions. Symptoms of conversion disorder. - correct answer--Involuntary movements, seizures, paralysis, abnormal gait, anesthesia, blindness, and deafness. Symptoms cannot be Inked back to a certain cause. Foods high in tyramine - correct answer--aged cheese, cured meats, smoked or processed meats, pickled or fermented foods, sauces, soybeans, peas, dried or overripe fruits, alcoholic beverages. Difference between compassion and empathy? - correct answer--Compasson- sympathetic feeling towards other w/o attempt to know their feeling or understand suffering. Empathy-imagine another's problem coupled with strong feeling for that person. Preferred questionnaire for possible alcohol abuse? - correct answer--MAST (Michigan alcoholism screening testing) MAST-G for geriatrics What is dopamine? - correct answer--NT-involved in cognition, motivation, and movement. Controls emotional responses and the brain's reward and pleasure center. Stimulate the heart and increases blood flow to vital organs. With what diseases does dopamine increase? decrease? - correct answer--increase- schizophrenia decrease-Parkinson's disease and depression Contraindications for alprazolam (Xanax) - correct answer--Angle closure glaucoma, hx of drug dependence, pre-existing CNS depression, severe hypotension, and sleep apnea. What is amphetamine (Adderall) used for? SE? - correct answer--CNS stimulant used for ADHD. SE: insomnia, restlessness, wt. loss, dysrhythmias, and hypertension Names of common benzos - correct answer--Clonazepam, diazepam, alprazolam, lorazepam, chlordiazepoxide, flumazenil, clorazepate, and oxazepam Indications for benzos - correct answer--Anxiety, seizure disorders, insomnia, muscle spasm, alcohol withdrawal, anesthesia. SE of benzos - correct answer--CNS depressant-sedation, light headed, drowsiness, respiratory depression, dizziness, lethargy, and physical dependence What is buspirone (buspar) used for? - correct answer--Anxiety, OCD, panic disorders, and PTSD SE of buspirone (buspar) - correct answer--Dizziness, nausea, headaches, lightheadedness, and agitation What is chlorpromazine (Thorazine)? - correct answer--First gen antipsychotic used for positive symptoms of schizophrenia. SE of chlorpromazine (Thorazine) - correct answer--EPS symptoms, orthostatic hypotension, NUS What is codeine? - correct answer--Opioid used for mild pain and is sometime in cough meds What is disulfiram (Antabuse) used for? - correct answer--Treatment of alcohol abuse as an aversion therapy. What is lithium used for? SE of toxicity? - correct answer--Bipolar disorder; tremors, ataxia, confusion, convulsion, nausea, and vomitting Examples of MAOIs (3) - correct answer--Phenelzine (nardil), tranylcypromine (parnate), and isocarboxazid (Marplan) What should you watch for when administering narcan? - correct answer--Increased BP, tremors, hyperventilation, nausea, vomiting What is nortriptyline (pamelor)? - correct answer--Tricyclic antidepressant. Mental Health - Final Exam: Rasmussen Questions with AnswersMental Health - Final Exam: Rasmussen Questions with SE of nortriptyline? - correct answer--Sedation, orthostatic hypotension, decreased libido, dry mouth, urinary retention, and cardiac dysrhytmias Example of opioids? - correct answer--Codeine, hydrocodone, and oxycodone SE of opiods - correct answer--Respiratory depression, urinary retention, confusion, constipation, nausea, vomiting, orthostatic hypotension, drug dependence S/S of opioid overdose - correct answer--Resp depression, pin point pupils, coma What is rivastigmine (Exelon) used for? - correct answer--Combat symptoms of alzheimers disease. Slows progression of disease-not a cure Adverse reactions of rivastigmine (Exelon)? - correct answer--Nausea, diarrhea, and bradycardia” What is selegiline used for? Contraindications? - correct answer--Parkinsons disease. Not to be used with SSRIS or trycicylics-serotonin syndrome. SE of selegiline? - correct answer--Serotonin syndrome, confusion, dizziness, hallucinations, insomnia, sedation, nausea, dry mouth, and abd pain Examples of SSRIs (3) - correct answer--Fluoxetine, sertraline, and paroxitine SE of ssris - correct answer--fewer anticholinergic effects than tricylic agents and nausea and vomitting Examples of Tricyclic antidepressants (4) - correct answer--amitriptyline (Elavil), doxepin (Sinequan), notriptyline (pamelor), imipramine (tofranil What are tricyclic antidepressants used for? - correct answer--Depression, bipolar disorder, fibromyalgia, neuropathic pain, OCD, ADHD, and chronic insomnia. SE of tricyclic antidepressants? - correct answer--Sedation, orthostatic hypotension, decrease libido, dry mouth, urinary retention, and cardiac dystrhytmias. What is valproic acid (Depakote) used for? - correct answer--Seizure disorder also used for manic episodes with bipolar patients What effect does valproic acid have on neurotransmitters? - correct answer--Increases levels of GABA SE of valproic acid? - correct answer--Suicidal thoughts, agitation, dizziness, hepatotoxicity, pancreatitis, hypothermia, and tremors. Mental Health - Final Exam: Rasmussen Questions with AnswersMental Health - Final Exam: Rasmussen Questions with 
