NR 546 Midterm Exam Questions and Answers Latest
Update 2024 Exam Advanced Pathophysiology (Latest
Update ) - CHAMBERLAIN COLLEGE OF
NURSING
What should the PMHNP consider when prescribing chemical restraints? - correct answers - -allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical restraint
-state regulations regarding chemical restrains must be reviewed
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse side effects to the drugs used for
chemical restraint? - correct answers - No.
The client has been court-ordered to take the prescribed medications and the standing order for chemical restraints is
approved. The PMHNP and other staff are not liable if the patient has an allergic reaction or adverse side effects.
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting medication for clients? -
correct answers - -Genetic testing can assist by providing more information on how clients may respond to certain
psychotropic medications
-provides information on how a client may break down and metabolize medications based on the cytochrome P450
system.
Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence of an inherited link for
schizophrenia and why one twin may develop schizophrenia when the other does not. When two people have 100%
identical DNA, why don't both persons develop the exact illnesses? Studies of identical Danish twins found that if one
twin had schizophrenia, the other twin had a 50% lifetime risk of developing schizophrenia (Lemvigh et al., 2020).
Why is there only half the risk? - correct answers - Both environmental and psychosocial stressors can impact mental
health. Although twins may have identical genes, their gene expression may be different.
There may be an environmental exposure that turned a gene "on" that should have been "off" for one twin to develop
schizophrenia and not the other.
,central sulcus - correct answers - separates the frontal lobe from the parietal lobe
brain tissue - correct answers - made up of grey matter and white matter
dorsal striatum - correct answers - involved in complex motor actions and linkage of cognition to motor actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
The field of epigenetics is rapidly growing and can help explain how gene expression is: - correct answers -
influenced by environmental factors and how epigenetics contributes to the manifestation of mental illness
How does epigenetics impact a person's mental health? - correct answers - internal or external factors activate
portions of the genome that result in the manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the genetic risk, results in the disease
, -genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of normal genes being "on" when
they should be "off."
Types of epigenetic changes: - correct answers - DNA Methylation
Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also be taken into account, including: -
correct answers - -informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent - correct answers - Clients have the right to receive enough information to make decisions about
treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly medicated if they are violent
toward themselves or others and when less restrictive methods have failed
Compliance - correct answers - A court order may be issued for a client to receive treatment against their wishes if
they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities or are incompetent to make
decisions
-PMHNPs are responsible for being knowledgeable about their state laws and abiding by them.
Off-Label Prescribing - correct answers - Some clients may benefit from the unapproved use of a drug for symptom
management.
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