NURS663 2024 EXAM QUESTIONS WITH CORRECT ANSWERS || GRADED A+

NURS663 2024 EXAM QUESTIONS WITH CORRECT ANSWERS || GRADED A+ Examples of robust responses to psychotherapy - ANSWER Continue with skills learned in therapy. Such as using deep breathing or thought replacement techniques when anxiety symptoms appear Booster sections for symptoms recurrence Robust Response-- After a robust response to psychotherapy, patients and parents should be encouraged to continue to implement skills learned during therapy, particularly in response to reminders of the trauma, which can prompt symptom recurrence. Booster sessions may be helpful in patients who experience symptom recurrence. Be familiar with responses to psychotherapy - ANSWER Robust response: Continue with skills learned in therapy. Booster sections for symptoms recurrence. Changes in cortical and limbic areas of brain Inadequate response; Consider and solve the following factors: TREATMENT FIDELITY; (ie, the model is not provided as intended). Can be corrected by ensuring that therapists receive appropriate training and consultation in the selected model, receive ongoing, model-specific supervision, and monitor their treatment fidelity over time. TRAUMA REMINDERS; (ie exploration of potential trauma reminders or triggers) - Further development of different coping strategies for triggers -Helping the child to master the coping strategies identified. ONGOING TRAUMA ;( symptoms may persist when trauma occurs during treatment). This can be corrected by; Increasing the focus on child safety early in treatment. Helping children differentiate between real danger and trauma reminders. -Helping nonoffending parents collaborate with children to develop effective strategies for enhancing the child's safety. COMPLEX TRAUMA (response to early and prolonged interpersonal trauma occurring during crucial developmental periods). -Lengthier treatment with longer initial stabilization phase. Cyclothymic Disorder (Cyclothymia) - ANSWER for at least two years for adults and one year for children and adolescents there have been numerous periods with hypo manic symptoms that do not meet criteria for hypo manic episode in numerous periods of depressive symptoms that do not meet criteria for a major depressive episode during the above two year or one year. The hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than two months at a time. Criteria for major depression, mania, or hypo manic episode have never been met. The symptoms Are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum or other psychotic disorders. The symptoms are not attributed to physiological effects of a substance or another medical condition. Dysthymic disorder or persistent depressive disorder (dysthymia) - ANSWER Full criteria of major depressive episode have not been met. this disorder includes a depressed mood for most of the day, for more days than not, as indicated by either subjective account or observation by others, for at least two years. For children this may only last one year and mood may be irritable. Two or more of the following symptoms are present; poor appetite or over eating, insomnia or hypersomnia, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, feelings of hopelessness. During the period of time of the disturbance the individual has never been without symptoms for more than two months at a time. There has never been a manic episode or a hypo manic episode and the symptoms do not meet cyclothymic disorder. The symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Major depressive disorder - ANSWER in this disorder five or more of the following symptoms have been present during the same two week period and represent a change from previous functioning at least one of the symptoms is either a depressed mood or loss of interest or pleasure. The depressed mood is most of the day nearly every day. A marked diminished interest or pleasure in almost all activities nearly every day. Significant weight loss or gain insomnia or hypersomnia every day. Psycho mode agitation/retardation. Fatigue or loss of energy. Feeling of worth less Ness or excessive or inappropriate guilt. Diminished ability to think or concentrate or indecisiveness. Recurrent thoughts of death. This can cause significant clinical distress or impairment in social, occupational, or other important areas of functioning. Depression Screening SIG-E-CAPS - ANSWER S- Sleep changes (usually decreased) I- Loss of interest G- Guilty feelings/worthlessness E- Energy low C- Concentration A- Appetite changes (usually decreased) P- Psychomotor changes (Lethargic, fatigue, hyper ) S- Suicidal ideation Elderly and people with head injuries - ANSWER What population is most at risk for syndrome of inappropriate diuretic hormone? Carbamazepine (Tegretol) - ANSWER This medication may cause the syndrome of inappropriate secretion of antidiuretic hormone. Due to hypo natremia. SIADH - ANSWER excessive secretion of arginine vasopressin AVP also known as antidiuretic hormone results in increase retention of fluid in the body. This condition is called syndrome of inappropriate antidiuretic hormone. Water retention and SIADH causes hypo natremia. SIADH may develop in response to injury to the brain or from medication administration. The hyponatremia associated with this condition may cause delirium. SSRI withdrawal - ANSWER This stems from an abrupt withdrawal of this medication, especially one with a shorter half-life such as peroxy teen or fluvoxamine, has been associated with this. Symptoms may include dizziness, weakness, nausea, headache, rebound depression, anxiety, insomnia, poor concentration, upper respiratory symptoms, paresthesias, and migraine like symptoms. This usually does not occur for at least a six week period of treatment and usually resolves spontaneously in three weeks. People who experienced transient adverse effects in the first week of taking an SSRI are more likely to experience this. Fluoxetine/Prozac - ANSWER This is the SSRI lease likely to be associated with withdraw because the half-life of its metabolite is more than one week and it effectively tapers it self. It has been used in some cases to treat the discontinuation syndrome caused by the termination of other SSRIs. Medical causes for depression - ANSWER With symptoms of this clinicians should have depressed adolescence tested for mononucleosis and we should test patients who are marketally overweight or underweight for adrenal and thyroid dysfunction. We should has patient with appropriate risk factors for HIV and older patients for viral pneumonia among other conditions. Pharmacological agents that can cause depression - ANSWER Steroid oral contraceptives, reserpine methyl dopa, anti-cholinesterase insecticides, amphetamine or cocaine withdrawal, alcohol or sedative hypnotic withdrawal, Madeleine indomethacin, phenothiazine antipsychotic drugs, Valium, mercury, cycloserine, vincristine, vinblastine, interferon. Endocrine/metabolic disorders that mimic depression - ANSWER Hypo thyroidism, hyper thyroidism; mania, hypopituitarism, Addison disease, Cushing's syndrome, diabetes mellitus Infectious diseases that can mimic depression - ANSWER General paresis; tertiary syphilis, toxoplasmosis, influenza, viral pneumonia, viral hepatitis, infectious mononucleosis, acquired immune deficiency syndrome; aids Collagen disorders that can mimic depression - ANSWER Rheumatoid arthritis, lupus erythematosus Nutritional disorders that can mimic depression - ANSWER Pellagra, pernicious anemia Neurological conditions that can mimic depression - ANSWER Multiple sclerosis, Parkinson's disease, head trauma, complex partial seizures, sleep apnea, cerebral tumors, cerebrovascular infarction or disease Neoplastic conditions that can mimic depression - ANSWER Abdominal malignancies, disseminated carcinomatosis Modifiable Suicide Risk Factors - ANSWER this is a result of recurrent substance use, exposure to violent and abuse, self destructive behaviors, maltreatment, physical/sexual abuse, neglect. Non-modifiable suicide risk factors - ANSWER sexual orientation, genetic factors, monozygotic twins versus dizygotic twins. Carbamazepine (Tegretol) - ANSWER In pregnancy in this medication used during the first trimester may raise risk for neural tube defects example; spina bifida or other congenital anomalies. If drug is continued start on folate 1 mg per day early in pregnancy to reduce risk of neural tube defects. Atypical antipsychotics may be preferable to lithium or anticonvulsants such as this if treatment of bipolar disorder is required during pregnancy Carbamazepine (Tegretol) - ANSWER This drug is metabolized through da CYP 450 3A4 System it is metabolized in the liver and excreted renally. Due to how the drug is metabolized there are many drug interactions. Carbamazepine (Tegretol) - ANSWER Thos drug decreases serum concentrations of numerous drugs as a result of the prominent induction of hepatic CYP 3A4 system. Monitoring for a decrease in clinical affects is frequently indicated it can decrease blood concentration of Oral contraceptives which can result in breakthrough bleeding and uncertain prophylaxis against pregnancy. It should not be administered with MAOI's. Which must be stopped at least two weeks before initiating this treatment. With this drug and Depakote/valproate the dosage of this drug should be decreased because valproate displaces the strong binding onto proteins, the dosage of valproate may need to be increased. Carbamazepine (Tegretol) - ANSWER Side effects of this Medication that are noticeable include sedation, dizziness, confusion, unsteadiness, headache, nausea, vomiting, diarrhea, blurred vision, benign leukopenia and up to 10% of patients, rash, (Purpura, Steven Johnson syndrome), And syndrome of inappropriate antidiuretic hormone secretion with hypo natremia. Patient should be monitored carefully for signs of unusual bleeding or bruising, mouse or, infections, fever or sore throat as the wrist for a plastic anemia in agranulocytosis with this medication is 5 to 8 times greater than in the general population. Escitalopram (Lexapro) - ANSWER this is an SSRI that is not generally recommended for use during pregnancy, especially during the first trimester there may be more bleeding in the mother and transient irritability or sedation in the newborn.