NURS 138 Final Exam Questions With
Complete Marking Scheme
/.Psychosomatic symptoms in depression - Answer-✅headaches, GI discomfort, vague
body aches and pains
/.SSRIs - Answer-✅Citalopram
Escitalopram (Lexapro)
Fluoxetine
Paroxetine
Sertraline
/.Nursing considerations for SSRIs - Answer-✅- Take in the AM WITH FOOD to avoid
GI upset and insomnia
- If feeling sedated or tired, take in PM
- St. John's Wort & Ginkgo biloba may cause serotonin syndrome
- Instruct related to suicidal ideation and serotonin syndrome.
/.Seasonal Affective Disorder pharm therapy - Answer-✅Light therapy (phototherapy).
Bupropion (Wellbutrin) - more cost-effective than light therapy and just as effective.
/.Care for patient reveiving ECT - Answer-✅Performed under general anesthesia.
ensure pt is NPO for at least 4hrs prior to tx. Vital signs and brain activity are monitored
throughout the procedure.
Pt may experience confusion and memory loss. Lateral recumbent (side-lying) position
to facilitate drainage & prevent aspiration.
Support head.
Protect the airway.
NPO until fully awake.
/.ECT is useful for - Answer-✅for patients with severe depression who are resistant to
other treatments, those who are severely suicidal, and those with severe psychomotor
retardation (difficulty or slowness in speaking or in performing tasks).
MDD & Bipolar
/.Bipolar I - Answer-✅Consists of 1 or more manic\mixed episodes
Usually accompanied by major depressive disorder
,/.Bipolar II - Answer-✅Consists of 1 or more major depressive episodes accompanied
by at least 1 hypomanic episode
/.Interventions to address hallucinations - Answer-✅Present reality by spending time
with the patient.
Identify yourself, time & day, location, & other orienting info.
It is not therapeutic to argue or try to reason with patients who are experiencing
delusions or altered thought processes.
Arguing hardens the belief system and can impair the development of trust.
/.Typical onset for bipolar - Answer-✅15-30. Often misdiagnosed. Can be dx as ADHD
esp in children
/.Mania - Answer-✅M - Mood Swings
A - Active, Aggressive
N - Nothing is wrong (Denial)
I - Irritable, impulsive, intrusive behavior
C - Can't sit still
E - Euphoric Mood
P - Poor judgment; Provocative behavior
I - Increased sexual interest
S - Substance (stimulants, sleeping pills, alcohol) abuse
O - Omnipotent feelings
D - Decreased need for sleep
E - Endless energy
/.Hypomania - Answer-✅Less extreme form of mania
Not severe enough to markedly impair functioning or require hosp.
/.Toxicity symptoms with Lithium - Answer-✅begins appearing at blood levels above 1.5
mEq/L
Increased reflexes
Altered LOC
Tremors - may show when levels are normal
Diarrhea
Hypotension
Slurred speech
/.Sodium and Lithium - Answer-✅decreased sodium = increased lithium
increased sodium = decreased lithium
,/.Onset of action for Lithium - Answer-✅ranges from 1-3wks
/.Contraindications for Lithium - Answer-✅Pregnancy
Breastfeeding
Impaired renal function
CHF
Sodium-restricted diets
Organic brain disease
Impaired CNS functioning in these patients causes ⇧ risk for lithium toxicity
/.Physiological changes in cognition in older adults - Answer-✅modest shrinkage of
brain tissue and decreased blood flow to areas of the brain responsible for memory,
executive function, and cognitive flexibility.
slower reflexes, hearing changes, slowed response time, and word retrieval issue
/.strategies to improve cognitive processes associated with aging - Answer-✅making a
schedule, doing a puzzle, making lists, games
/.care and teaching for a new dementia dx - Answer-✅ensure pt isn't being
abused/exploited. educate on advance directives and legal protections. educate
caregivers and community members to understand cognitive disorders. determine ability
to self-admin meds.
/.How/why play is helpful for children with mental health disorders - Answer-✅children
learn more about the world by physically interacting with it. children use play to express
themselves or tell a story (especially to tell difficult/traumatic stories)
/.Risk factors for schizophrenia - Answer-✅GENETICS. 1st degreee relative = 50%
(parent or sibling). risk increases with advancing paternal age as a result of cumulative
mutations in sperm. advancing maternal age. social-environmental factors can
exacerbate issues.
/.Etiology - Answer-✅exact cause unknown. prenatal health issues, exposure to
adversity. men and women at equal risk.
/.Negative symptoms - Answer-✅take away from who you are; flat or blunted affect,
alogia, adhedonia, avolition, social withdrawal.
/.alogia - Answer-✅poverty of speech
/.anhedonia - Answer-✅inability to experience pleasure
/.avolition - Answer-✅lack of motivation
, /.Positive symptoms of sch - Answer-✅adds something; hallucinations, delusions,
problems with speech (mutism and echolalia)
/.echolalia - Answer-✅repeating another's words
/.Meds used to decrease auditory hallucinations - Answer-✅antipsychotics
typical (1st gen); phenothiazine (chlorpromazine). Nonphenothiazine (haloperidol).
atypical (2nd gen); treats +/- symptoms. Risperidone (Risperdal).
Dopamine system stabilizers (3rd gen); aripiprazole (abilify).
/.Suitable activities for ADHD - Answer-✅Following rputines, minimizing stimuli when
completing work, limit & monitor screen time, allow time for organizing
/.Psychosocial & developmental issues of adolescents with ADHD - Answer-✅often
missed dx, "just being a teen". academic difficulties regardless of cognitive abilities.
behaviors can be considered antisocial. inability to focus and stay organized
/.Predisposing factor - Answer-✅individual's risk of being a victim of a traumatic
experience or causing a traumatic experience for others. psychologic (aggressive
tendencies, uncontrolled anger, depression, etc). environmental, sociocultural,
behavioral.
/.Vulnerability factor - Answer-✅increase in an individual's risk of being a victim
(disability, abusive household).
/.Precipitating factor - Answer-✅factors that give rise to a specific incident (ex. bad day
at work, stuck in traffic, dinner wasn't ready etc.)
/.Protective factors - Answer-✅having support but doesnt guarantee anything, however,
may make it less likely to happen
/.cycle of violence - Answer-✅tension builds, abusive/threatening event, honeymoon
period
/.Trauma assessment - Answer-✅Airway maintenance with cervical spine protection
Breathing
Circulation
Disability and neuro assessment
Exposure and environmental control
Complete Marking Scheme
/.Psychosomatic symptoms in depression - Answer-✅headaches, GI discomfort, vague
body aches and pains
/.SSRIs - Answer-✅Citalopram
Escitalopram (Lexapro)
Fluoxetine
Paroxetine
Sertraline
/.Nursing considerations for SSRIs - Answer-✅- Take in the AM WITH FOOD to avoid
GI upset and insomnia
- If feeling sedated or tired, take in PM
- St. John's Wort & Ginkgo biloba may cause serotonin syndrome
- Instruct related to suicidal ideation and serotonin syndrome.
/.Seasonal Affective Disorder pharm therapy - Answer-✅Light therapy (phototherapy).
Bupropion (Wellbutrin) - more cost-effective than light therapy and just as effective.
/.Care for patient reveiving ECT - Answer-✅Performed under general anesthesia.
ensure pt is NPO for at least 4hrs prior to tx. Vital signs and brain activity are monitored
throughout the procedure.
Pt may experience confusion and memory loss. Lateral recumbent (side-lying) position
to facilitate drainage & prevent aspiration.
Support head.
Protect the airway.
NPO until fully awake.
/.ECT is useful for - Answer-✅for patients with severe depression who are resistant to
other treatments, those who are severely suicidal, and those with severe psychomotor
retardation (difficulty or slowness in speaking or in performing tasks).
MDD & Bipolar
/.Bipolar I - Answer-✅Consists of 1 or more manic\mixed episodes
Usually accompanied by major depressive disorder
,/.Bipolar II - Answer-✅Consists of 1 or more major depressive episodes accompanied
by at least 1 hypomanic episode
/.Interventions to address hallucinations - Answer-✅Present reality by spending time
with the patient.
Identify yourself, time & day, location, & other orienting info.
It is not therapeutic to argue or try to reason with patients who are experiencing
delusions or altered thought processes.
Arguing hardens the belief system and can impair the development of trust.
/.Typical onset for bipolar - Answer-✅15-30. Often misdiagnosed. Can be dx as ADHD
esp in children
/.Mania - Answer-✅M - Mood Swings
A - Active, Aggressive
N - Nothing is wrong (Denial)
I - Irritable, impulsive, intrusive behavior
C - Can't sit still
E - Euphoric Mood
P - Poor judgment; Provocative behavior
I - Increased sexual interest
S - Substance (stimulants, sleeping pills, alcohol) abuse
O - Omnipotent feelings
D - Decreased need for sleep
E - Endless energy
/.Hypomania - Answer-✅Less extreme form of mania
Not severe enough to markedly impair functioning or require hosp.
/.Toxicity symptoms with Lithium - Answer-✅begins appearing at blood levels above 1.5
mEq/L
Increased reflexes
Altered LOC
Tremors - may show when levels are normal
Diarrhea
Hypotension
Slurred speech
/.Sodium and Lithium - Answer-✅decreased sodium = increased lithium
increased sodium = decreased lithium
,/.Onset of action for Lithium - Answer-✅ranges from 1-3wks
/.Contraindications for Lithium - Answer-✅Pregnancy
Breastfeeding
Impaired renal function
CHF
Sodium-restricted diets
Organic brain disease
Impaired CNS functioning in these patients causes ⇧ risk for lithium toxicity
/.Physiological changes in cognition in older adults - Answer-✅modest shrinkage of
brain tissue and decreased blood flow to areas of the brain responsible for memory,
executive function, and cognitive flexibility.
slower reflexes, hearing changes, slowed response time, and word retrieval issue
/.strategies to improve cognitive processes associated with aging - Answer-✅making a
schedule, doing a puzzle, making lists, games
/.care and teaching for a new dementia dx - Answer-✅ensure pt isn't being
abused/exploited. educate on advance directives and legal protections. educate
caregivers and community members to understand cognitive disorders. determine ability
to self-admin meds.
/.How/why play is helpful for children with mental health disorders - Answer-✅children
learn more about the world by physically interacting with it. children use play to express
themselves or tell a story (especially to tell difficult/traumatic stories)
/.Risk factors for schizophrenia - Answer-✅GENETICS. 1st degreee relative = 50%
(parent or sibling). risk increases with advancing paternal age as a result of cumulative
mutations in sperm. advancing maternal age. social-environmental factors can
exacerbate issues.
/.Etiology - Answer-✅exact cause unknown. prenatal health issues, exposure to
adversity. men and women at equal risk.
/.Negative symptoms - Answer-✅take away from who you are; flat or blunted affect,
alogia, adhedonia, avolition, social withdrawal.
/.alogia - Answer-✅poverty of speech
/.anhedonia - Answer-✅inability to experience pleasure
/.avolition - Answer-✅lack of motivation
, /.Positive symptoms of sch - Answer-✅adds something; hallucinations, delusions,
problems with speech (mutism and echolalia)
/.echolalia - Answer-✅repeating another's words
/.Meds used to decrease auditory hallucinations - Answer-✅antipsychotics
typical (1st gen); phenothiazine (chlorpromazine). Nonphenothiazine (haloperidol).
atypical (2nd gen); treats +/- symptoms. Risperidone (Risperdal).
Dopamine system stabilizers (3rd gen); aripiprazole (abilify).
/.Suitable activities for ADHD - Answer-✅Following rputines, minimizing stimuli when
completing work, limit & monitor screen time, allow time for organizing
/.Psychosocial & developmental issues of adolescents with ADHD - Answer-✅often
missed dx, "just being a teen". academic difficulties regardless of cognitive abilities.
behaviors can be considered antisocial. inability to focus and stay organized
/.Predisposing factor - Answer-✅individual's risk of being a victim of a traumatic
experience or causing a traumatic experience for others. psychologic (aggressive
tendencies, uncontrolled anger, depression, etc). environmental, sociocultural,
behavioral.
/.Vulnerability factor - Answer-✅increase in an individual's risk of being a victim
(disability, abusive household).
/.Precipitating factor - Answer-✅factors that give rise to a specific incident (ex. bad day
at work, stuck in traffic, dinner wasn't ready etc.)
/.Protective factors - Answer-✅having support but doesnt guarantee anything, however,
may make it less likely to happen
/.cycle of violence - Answer-✅tension builds, abusive/threatening event, honeymoon
period
/.Trauma assessment - Answer-✅Airway maintenance with cervical spine protection
Breathing
Circulation
Disability and neuro assessment
Exposure and environmental control
