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2024 NR546 WEEK 3 TEST YOUR KNOWLEDGE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 NR546 WEEK 3 TEST YOUR KNOWLEDGE EXAM QUESTIONS WITH CORRECT ANSWERS
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2024 NR546 WEEK 3 TEST YOURKNOWLEDGE EXAM QUESTIONS
WITH CORRECT ANSWERS
antipsychotic meds - CORRECT-ANSWERSprimarily used for schizophrenia &
psychotic disorders
-also used as adjunctive meds for management of tx-resistant depression &
other conditions
-not curative
-decrease/control symptoms/improve quality of life
Schizophrenia - CORRECT-ANSWERSa disturbance that must last for 6
months or longer, including at least one month of positive symptoms or
negative symptoms
-neurodevelopmental, brain disorder
-psychological condition involving chronic or repeated episodes of psychosis
cause: combination of genetics and environmental factors
DX: based on clinical interview
Schizophrenia increases the risk of: - CORRECT-ANSWERSsuicide
homeless
jail/prison
Which of the following statements is inaccurate regarding the management
of Terence's agitation? - CORRECT-ANSWERSAggressive pharmacological
intervention should be done early to fully sedate this client so that a full
evaluation can occur.
Rationale: Aggressive pharmacological intervention (such as full sedation)
interferes with the ability to perform a full evaluation, including history and
physical examination. Terence requires medication that will support the
completion of an evaluation and differential diagnosis without putting the
patient or staff at risk. Early aggressive pharmacological treatment can
result in masking underlying conditions.
Terence continues to be uncooperative. He has become violent and is
threatening to leave. He reports hearing voices and states that he will kill
everybody in the room. As staff attempt to apply restraints, Terence swings
his fists and almost injures a nurse. Which of the following medications is the
,most appropriate to administer to Terence? - CORRECT-ANSWERSOlanzapine
(Zyprexa) 10mg IM
Rationale: Terence is uncooperative and is threatening harm and requires
immediate support. Oral medication will likely be rejected or refused. A more
desirable medication would have a short onset to support the safety of all
involved. Administering intranasal Versed may put the staff and the patient
at risk. Further, midazolam and other benzodiazepines administered by
themselves promote sedation; they do not treat the underlying disease,
which is causing agitation or psychosis. Administering medication via
intramuscular injection is the best option. Of the choices, olanzapine is the
most appropriate medication because it has a rapid onset of action and
potent antihistamine actions. Although ziprasidone is an option, the dose
listed is excessive.
Terence is now calm, and his workup has been completed. Physical
differential diagnoses have been ruled out, and a diagnosis of new-onset
schizophrenia is suspected based on history gained from the family and the
physical examination. Terence is admitted for initial stabilization. Which of
the following will you prescribe for his initial treatment? - CORRECT-
ANSWERSAripiprazole (Abilify)
Rationale: Aripiprazole (Abilify) is the best choice of initial treatment for
Terence. Second-generation antipsychotics (SGAs) are prescribed initially
due to the effect on both D2 and 5HT2A. When initiating medication, it is
important to consider metabolic risk, especially in a young patient such as
Terence. Aripiprazole has low metabolic risks and low weight gain.
Olanzapine has a high metabolic risk. Haloperidol is an FGA. Clozapine is not
an appropriate choice for first-line treatment. Clozapine treatment has a
serious risk of severe neutropenia and low absolute neutrophil count.
Because of the risk of agranulocytosis, this medication is available only
through a restricted program (REMS) and is prescribed for treatment-
resistant schizophrenia.
all forms of psychosis are linked to the neurotransmitter systems: -
CORRECT-ANSWERSdopamine, serotonin, and glutamate
Dopamine Theory - CORRECT-ANSWERSHyperactive dopamine at D2
receptors in the mesolimbic pathway
Glutamate theory - CORRECT-ANSWERSNMDA receptor hypofunction
Serotonin theory - CORRECT-ANSWERS5HT2A receptor hyperfunction in the
cortex
Alogia - CORRECT-ANSWERSdysfunction of communication
, -poverty of speech
asociality - CORRECT-ANSWERSlack of interest in social interactions
anhedonia - CORRECT-ANSWERSa diminished ability to experience pleasure
avolition - CORRECT-ANSWERS-lack of motivation
-reduced ability to complete everyday tasks
Key negative schizophrenia symptoms identified solely on observation -
CORRECT-ANSWERS-reduced speech
-poor grooming
-limited eye contact
match each symptom to hypothetically malfunctioning brain circuits: positive
symptoms - CORRECT-ANSWERSmesolimbic
match each symptom to hypothetically malfunctioning brain circuits:
negative symptoms - CORRECT-ANSWERSmesocortical/prefrontal cortex
nucleus accumbens reward circuit
match each symptom to hypothetically malfunctioning brain circuits:
cognitive symptoms - CORRECT-ANSWERSdorsolateral prefrontal cortex
match each symptom to hypothetically malfunctioning brain circuits:
aggressive symptoms - CORRECT-ANSWERSorbitofrontal cortex
amygdala
match each symptom to hypothetically malfunctioning brain circuits:
affective symptoms - CORRECT-ANSWERSventromedial prefrontal cortex
polygenic risk score - CORRECT-ANSWERSadd up all the abnormal genes an
individual has amongst the known few hundred risk genes, suggesting how
much risk there might be for developing schizophrenia.
Barnes Akathisia Rating Scale (BARS) - CORRECT-ANSWERS
Abnormal Involuntary Movement Scale ( AIMS) - CORRECT-ANSWERSthis tool
is used to monitor involuntary movements and tardive dyskinesia in clients
who take antipsychotic medication
-best practice/recommendation to document the AIMS at minimum every 6
months for patients taking an antipsychotic agent/dopamine blocker
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