Maryville NURS 623 Exam 3 With Complete Solution What is the most common psychiatric disorder in the U.S? Correct Answer- Anxiety
What are the DSM-5 symptom criteria for a diagnosis of general anxiety disorder? Correct
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Maryville NURS 623 Exam 3 With Complete Solution What is the most common psychiatric disorder in the U.S? Correct Answer- Anxiety
What are the DSM-5 symptom criteria for a diagnosis of general anxiety disorder? Correct Answer- excessive anxiety and worry of variety of things for at least 6 months
What are the DSM-5 symptom criteria for a major depressive disorder? Correct Answer- Five or more symptoms including at least one depressed mood or loss of interest present in the same two weeks and present nearly every day
differential diagnoses that would mimic the symptoms of depression? Correct Answer- *Anxiety
*PTSD
*Substance Abuse
What are the risk factors for major depression? Correct Answer- *Age
*Gender
*Personal Hx (migrains, PUD, chronic pain)
*Fx Hx (depression, suicide, alcholism, substance abuse)
What are the common presenting symptoms of depression in the geriatric patient? Correct Answer- Somatic (general pain)
Psychology (feeling of guilt/worry, suicidal, memory)
Psychomotor (anxiety/agitation)
Vegetative (poor appitite/sleep)
What are the NON-pharmacologic treatments for management for major depressive disorder? Correct Answer- Interpersonal and cognitive behavior therapy
What are the pharmacologic treatments for management for major depressive disorder? Correct Answer- SSRI, SNRI, TCA, MAO
Names of common SSRIs Correct Answer- Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine (paxil)
Citalopram (celexa)
Escitalopram (Lexapro)
Names of common SNRIs Correct Answer- Duloxetine (Cymbalta)
Venlafaxine (Effexor)
Desvenlafaxine (Pristiq)
What are concerns in elderly taking medication for major depression? Correct Answer- a slower metabolism requires lower dosing; greater risk of falls, osteoporosis, fractures
What are the pharmacologic versus nonpharmacologic treatment for management for general anxiety disorder? Correct Answer- non-pharmacological interventions of cognitive behavioral therapy has proven equal results to SSRI pharmacologic therapy
DIGFAST for bipolar because your digging yourself into hole Correct Answer- Distractibility
Indiscretion/Insomnia
Grandiosity
Flight of ideas
Activities ↑
Sleep Deficit
Talkativeness
What is the symptom criteria for BD I ? Correct Answer- identification of at least one-lifetime mania episode must have occurred
What is the symptom criteria for BD II ? Correct Answer- identification of at least one hypomania episode and one major depressive episode must have occurred
What is the symptom criteria for diagnosing unipolar (depression) Correct Answer- persistently depressed mood or loss of interest in activities, causing significant impairment in daily life (no mania/hypomania)
How do you assess suicide risk (consider mnemonic SAD PERSONS) Correct Answer- S-ex
A-ge
D-epression
P-revious attempt
E-thanol abuse
R-ational thinking loss
S-ocial support loss
O-rganized plan
N-o spouse
S-ickness
How would you identify intimate partner violence? Correct Answer- *reluctant to speak in front of partner
*gives evasive answers
*Overly protective or controlling partner
What are the stages of grieving? (DABDA) Correct Answer- Denial
Anger
Bargaining
Depression
Acceptance
What are the phases of grief? (Aca) Correct Answer- Avoid
Confront
Accomadate
Acknowledge the loss
Reacting to the separation
Recollecting and Re-experiencing the Relationship w/deceased
How would you identify intimate partner violence? Correct Answer- 1) a patient who is reluctant to speak in front of her partner and gives evasive answers
2) Overly protective or controlling partner
What is the clinical presentation of post-traumatic stress disorder (PTSD)? Correct Answer- A: INTRUSIVE thoughts, nightmares or flashbacks
B: AVOIDANCE any situation of activity that brings memories
C: HYPERAROUSAL: Hypersensitive or on edge, unprovoked anger, jumpiness, and on guard
What are the DSM-5 criteria for a diagnosis of PTSD? Correct Answer- 1 SYMPTOM of intrusive, avoidance, or hyper-arousal MUST HAVE PERSISTED FOR MORE THAN 1 MONTH
What is the management for PTSD? Correct Answer- PHARMACOLOGY: SSRI's paroxetine (paxil) or sertaline (Zoloft), anxiolytic buspirone (BuSpar)
NON-PHARMACOLOGICAL: cognitive behavioral therapies, brief eclectic psychotherapy, narrative exposure therapy
potential complications of over-prescription of opiate pain meds Correct Answer- Constipation
Sedation
Resp Depression
Dizziness
N/V
Medications that can cause Constipation? Correct Answer- Antacids, anticholinergics, Anti convulsive, Antidepressants (TCAs), Antihypertensives, NSAIDs, Opioids
What are the warning signs that the patient has Anorexia? Correct Answer- Substantial weight loss
S/S of depression or mood swings
cardio problems
preoccupation with weight, calories, and food,
wear baggy clothes
history of excessive exercise
What do labs look like in anorexia? Correct Answer- leukopenia elevated BUN
anemic
hypomagnesmia
elevated TSH
sinus bradycardia.
What are the warning signs that the patient has Bulemia? Co
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