NURS 661 Exam 3 Questions and Answers (100 out of 100) Score.

NURS 661 Exam 3 Questions and Answers (100 out of 100) Score. Who is at highest risk of suicide? - correct answer White, elderly men Schizophrenia Single, never married, divorced, recently widowed Previous attempts Adolescents with depression, bullied, or family hx of suicide Who is most likely to succeed at committing suicide? - correct answer Older while males What are some protective factors for suicide? - correct answer Having children Religion Stronger alliances with medical providers and therapists What is lethality? - correct answer the probability that a person will successfully complete suicide What is intent? - correct answer Effective expectations for desire of active death What is a suicide attempt? - correct answer Includes all willful, self-inflicted lifethreatening attempts that have not led to death What is suicidal ideation? - correct answer thinking about suicide, usually with some serious emotional and intellectual or cognitive overtones Where in the brain do we theorize violence and aggression originate? - correct answer Prefrontal cortex How to assess for homicidal ideation? - correct answer Do you have homicidal ideation? Who do you want to kill? How do you plan to do this? Do you have access to the means necessary? Do you intend to commit the act? What legal follow up is needed for homicidal ideation? - correct answer Duty to warn Based on state laws Obsession - correct answer 1. Recurrent and persistent thoughts, urges, or images that are experienced, at some time during the disturbance, as intrusive and unwanted, and that in most individuals cause marked anxiety or distress 2. The individual attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (i.e. by performing a compulsion) Compulsion - correct answer 1. Repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to rules that must be applied rigidly 2. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation, however, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent, or are clearly excessive Obsessive-Compulsive Disorder (OCD) - correct answer A. Presence of obsessions, compulsions, or both B. The obsessions or compulsions are time-consuming (e.g. take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance or another medical condition D. The disturbance is not better explained by the symptoms of another mental disorder PANDAS - correct answer Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections OCD common co-morbid conditions - correct answer MDD (Major depressive disorder) Skin Picking Hair Pulling Most Common Compulsions - correct answer Checking Ordering Arranging Washing/cleaning Hand-washing Flipping lights Counting Differentiation between OCD and eating disorders - correct answer Those with eating disorders will be counting calories, focused on weight loss or maintaining a specific weight Treatment for OCD - correct answer Cognitive Behavioral Therapy Pharmacological Treatment for OCD - correct answer First line treatment-SSRI (Luvox, fluoxetine) Second-line treatment TCA with serotonergic properties (clomipramine) SNRI or MAOI Augmentation with benzos, lithium, or Buspar DSM-5 Body Dysmorphic Disorder - correct answer Preoccupation with perceived flaw on body taht is not observed by others Repetitive behaviors such as mirror checking, excessive grooming, skin picking, reassurance seeking, clothes changing Clinical significance Differentiation from eating disorder BDD common preoccupations - correct answer Facial flaws genitalia Differentiation between BDD and eating disorders - correct answer BDD is more obsessed with one specific body flow, not the entire body Differentiation between BDD and OCD - correct answer OCD may have food rituals but not obsession on a specific body flaw Treatment for BDD - correct answer Cognitive Behavioral Therapy Pharmacological treatment of BDD - correct answer Clomipramine and fluoxetine reduce symptoms in about 50% of patients DSM-5 Hoarding Disorder - correct answer A. Persistent difficulty discarding or parting with possessions, regardless of their actual value B. This difficulty is due to a perceived need to save the items and to distress associated with discarding them C. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning E. The behavior is not attributable to another medical condition F. The hoarding is not better explained by the symptoms of another mental disorder Hoarding Treatment - correct answer Cognitive Behavioral Therapy Hoarding Pharmacological Treatment - correct answer SSRI (difficult to treat with medication) Hoarding Safety Issues - correct answer Falls Fires Stuff falling on them Infections Health hazards Cleaning hazards DSM-5 Trichotillomania - correct answer A. Recurrent pulling out on one's hair, resulting in hair loss B. Repeated attempts to decrease or stop hair pulling C. The hair pulling causes clinically significant distress or impairment in social, occupational, or other important areas of functioning D. The hair pulling or hair loss is not attributable to another medical condition E. The hair pulling is not better explained by the symptoms of another mental disorder Automatic Trichotillomania - correct answer Automatic response, the patient doesn't even know they are doing it Forced Trichotillomania - correct answer Conscious response, patient knows they are doing it to relieve tension Who's most at risk for trichotilomania? - correct answer Only or oldest child More common in females Trichotillomania Treatment - correct answer Cognitive Behavioral Therapy Limited pharmacology- may use naltrexone if they get pleasure from it B12 injections if the patient has a B12 deficiency DSM-5 Criteria for Insomnia - correct answer A. A predominant complaint of dissatisfaction with sleep quantity or quality, associated with one (or more) of the following symptoms: 1. Difficulty initiating sleep 2. Difficulty maintaining sleep, characterized by frequent awakenings or problems returning to sleep after awakenings 3. Early-morning awakening with inability to return to sleep B. The sleep disturbance causes clinically significant distress or impairment in social, occupational, educational, academic, behavioral, or other important areas of functioning C. The sleep difficulty occurs at least 3 nights per week D. The sleep difficulty is present for at least 3 months.