NR546 Midterm Exam With Questions and Correct Graded A+ Answers
What should the PMHNP consider when prescribing chemical restraints? - Answer--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? - Answer-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? - Answer--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? - Answer-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 - Answer-separates the frontal lobe from the parietal lobe
,frontal lobe - Answer-associated with movement, intelligence, abstract thinking
broca's area - Answer-speech production
temporal lobe - Answer-involves object identification and auditory signals
cerebellum - Answer-coordination
wernicke's area - Answer-speech comprehension
occipital lobe - Answer-primary visual area
parietal lobe - Answer-keeps us alert to what is going on around us
sensory cortex - Answer-pain, heat, and other sensations
motor cortex - Answer-movement
hippocampus - Answer-involved in both memory and anxiety
nucleus accumbens - Answer-involved in the reward process
thalamus - Answer-involved in sensory organ and motor command processing
striatum - Answer-involved in complex motor actions, also links cognition to motor actions
limbic system - Answer-includes circuits that are associated with pleasure and reward
,basal ganglia - Answer-group of structures involved in voluntary motor movements
amygdala - Answer-involved in emotional regulation and perception of odors
corpus callosum - Answer-controls the communication between the two brain hemispheres
white matter - Answer-contains nerve fibers that connect neurons from different regions
into functional circuits
grey matter - Answer-contains nerve cells and dendrites
brain tissue - Answer-made up of grey matter and white matter
dorsal striatum - Answer-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: -
Answer-influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
How does epigenetics impact a person's mental health? - Answer-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: - Answer-DNA Methylation
Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also be taken
into account, including: - Answer--informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent - Answer-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 - Answer-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 - Answer-Some clients may benefit from the unapproved use of a drug
for symptom management.
-Example: many SSRIs used to tx anxiety and OCD but are not FDA approved for use in this
disorder.
-potentially raises ethical and legal concerns
What should the PMHNP consider when prescribing chemical restraints? - Answer--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? - Answer-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? - Answer--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? - Answer-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 - Answer-separates the frontal lobe from the parietal lobe
,frontal lobe - Answer-associated with movement, intelligence, abstract thinking
broca's area - Answer-speech production
temporal lobe - Answer-involves object identification and auditory signals
cerebellum - Answer-coordination
wernicke's area - Answer-speech comprehension
occipital lobe - Answer-primary visual area
parietal lobe - Answer-keeps us alert to what is going on around us
sensory cortex - Answer-pain, heat, and other sensations
motor cortex - Answer-movement
hippocampus - Answer-involved in both memory and anxiety
nucleus accumbens - Answer-involved in the reward process
thalamus - Answer-involved in sensory organ and motor command processing
striatum - Answer-involved in complex motor actions, also links cognition to motor actions
limbic system - Answer-includes circuits that are associated with pleasure and reward
,basal ganglia - Answer-group of structures involved in voluntary motor movements
amygdala - Answer-involved in emotional regulation and perception of odors
corpus callosum - Answer-controls the communication between the two brain hemispheres
white matter - Answer-contains nerve fibers that connect neurons from different regions
into functional circuits
grey matter - Answer-contains nerve cells and dendrites
brain tissue - Answer-made up of grey matter and white matter
dorsal striatum - Answer-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: -
Answer-influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
How does epigenetics impact a person's mental health? - Answer-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: - Answer-DNA Methylation
Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also be taken
into account, including: - Answer--informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent - Answer-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 - Answer-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 - Answer-Some clients may benefit from the unapproved use of a drug
for symptom management.
-Example: many SSRIs used to tx anxiety and OCD but are not FDA approved for use in this
disorder.
-potentially raises ethical and legal concerns
