Nursing 117 Final Exam – Medical-Surgical Nursing Comprehensive Review and
Study Guide
Major Depressive Disorder - correct answer ✔✔Tricyclic antidepressants-Amitriptyline (Elavil)
Paranoid Personality Disorder - correct answer ✔✔a mental disorder characterized by paranoia
and a pervasive, long-standing suspiciousness and generalized mistrust of other
Obsessive Compulsive Disorder - correct answer ✔✔Antidepressants--Alprazolam (Xanax)
Clonazepam (Klonopin)
Diazepam (Valium)
Lorazepam (Ativan)
Buspirone (BuSpar)
Helping the client maintain anxiety at a manageable level without having to resort to use of
ritualistic behavior.
Developing more adaptive methods of coping with anxiety.
Obsessions: Recurrent thoughts, impulses, or images experienced as intrusive and stressful, and
unable to be expunged by logic or reasoning.
Compulsions: Repetitive ritualistic behavior or thoughts, the purpose of which is to prevent or
reduce distress or to prevent some dreaded event or situation
Restraints - correct answer ✔✔free of restraints unless absolutely necessary;
prevent a client from harming self or others;
-must be ordered by the primary care provider in writing
-order must specify the duration of treatment
-provider must rewrite the order depending on the type of restraint every 24 hours or the
frequency of time specified by facility policy
*Nursing responsibilities must be identified
,-how often the client should be assessed; safety, physical needs, client behavior is documented
-offered food, fluid and toileting
-monitored for vital signs
Complete documentation includes description of the following:
-Precipitating events and behavior of the client prior to seclusion/ restraint
-Alternative actions attempted to avoid seclusion or restraint
-Time treatment began
-Medications administration
-Client's current behavior, food and fluids offered, vital signs and ADL needs
PTSD - correct answer ✔✔reaction to extreme trauma, natural or man-made disasters, combat,
serious accidents, witnessing the violent death of others, being the victim of torture, terrorism,
rape, or other crimes
Characteristic symptoms: Re-experiencing the traumatic event, high level of anxiety or arousal,
general numbing of responsiveness, recollections or nightmares, Amnesia to certain aspects of
the trauma, Depression, survivor's guilt, Substance abuse, Anger and aggression, Relationship
problems
**increasing numbers of problems with veterans,
Chronic negative emotions, diminished interest or participation in significant activities
Aggressive, reckless, or self-destructive behavior
Hypervigilance and exaggerated startle response
Angry outbursts, problems with concentration, and sleep disturbances
Bipolar Disorder - correct answer ✔✔mood swings from profound depression to extreme
euphoria (mania), with intervening periods of normalcy.
Delusions or hallucinations may or may not be part of clinical picture
Onset of symptoms may reflect seasonal pattern
, A somewhat milder form of mania is called hypomania, More common in single than in married
persons, Occurs more often in the higher socioeconomic classes, Sixth leading cause of disability
in the middle age group
Lithium - correct answer ✔✔May modulate the effects of certain neurotransmitters,
norepinephrine, serotonin, dopamine, glutamate, and GABA, thereby stabilizing symptoms
associated with bipolar disorder.
Side effects: Drowsiness, dizziness, headache; Dry mouth; thirst; GI upset; nausea/vomiting;
Fine hand tremors; Hypotension; arrhythmias, pulse irregularities; Polyuria; dehydration;
Weight gain; Potential for lithium toxicity: Blurred vision, ataxia, tinnitus, persistent nausea and
vomiting, and severe diarrhea
Take regularly
Do not skimp on dietary sodium, Consume a diet adequate in sodium,
Drink 2,500 to 3,000 ml of fluid per day
Notify physician if vomiting or diarrhea occur
Have serum lithium level checked every 1 to 2 months, or as advised by physician
Lithium is a salt and competes in the body with sodium. If sodium is lost, the body will retain
lithium with resulting toxicity.
SSRI - correct answer ✔✔Toxic, sometimes fatal, reactions have occurred with concomitant use
of MAOIs,
Increased effects of SSRIs with cimetidine, L-tryptophan, and lithium
Concomitant use of SSRIs may increase effects of hydantoin, tricyclic antidepressants,
benzodiazepine, beta-blockers, carbamazepine, clozapine, haloperidol, phenothiazine, St. John's
wort, sumatriptan, sympathomimetics, tacrine, theophylline, and warfarin
Concomitant use of SSRIs may decrease effects of buspirone and digoxin
Serotonin syndrome can occur with concurrent use of other drugs that increase serotonin Side
effects:
May occur with all chemical classes
Dry mouth, sedation, nausea
Study Guide
Major Depressive Disorder - correct answer ✔✔Tricyclic antidepressants-Amitriptyline (Elavil)
Paranoid Personality Disorder - correct answer ✔✔a mental disorder characterized by paranoia
and a pervasive, long-standing suspiciousness and generalized mistrust of other
Obsessive Compulsive Disorder - correct answer ✔✔Antidepressants--Alprazolam (Xanax)
Clonazepam (Klonopin)
Diazepam (Valium)
Lorazepam (Ativan)
Buspirone (BuSpar)
Helping the client maintain anxiety at a manageable level without having to resort to use of
ritualistic behavior.
Developing more adaptive methods of coping with anxiety.
Obsessions: Recurrent thoughts, impulses, or images experienced as intrusive and stressful, and
unable to be expunged by logic or reasoning.
Compulsions: Repetitive ritualistic behavior or thoughts, the purpose of which is to prevent or
reduce distress or to prevent some dreaded event or situation
Restraints - correct answer ✔✔free of restraints unless absolutely necessary;
prevent a client from harming self or others;
-must be ordered by the primary care provider in writing
-order must specify the duration of treatment
-provider must rewrite the order depending on the type of restraint every 24 hours or the
frequency of time specified by facility policy
*Nursing responsibilities must be identified
,-how often the client should be assessed; safety, physical needs, client behavior is documented
-offered food, fluid and toileting
-monitored for vital signs
Complete documentation includes description of the following:
-Precipitating events and behavior of the client prior to seclusion/ restraint
-Alternative actions attempted to avoid seclusion or restraint
-Time treatment began
-Medications administration
-Client's current behavior, food and fluids offered, vital signs and ADL needs
PTSD - correct answer ✔✔reaction to extreme trauma, natural or man-made disasters, combat,
serious accidents, witnessing the violent death of others, being the victim of torture, terrorism,
rape, or other crimes
Characteristic symptoms: Re-experiencing the traumatic event, high level of anxiety or arousal,
general numbing of responsiveness, recollections or nightmares, Amnesia to certain aspects of
the trauma, Depression, survivor's guilt, Substance abuse, Anger and aggression, Relationship
problems
**increasing numbers of problems with veterans,
Chronic negative emotions, diminished interest or participation in significant activities
Aggressive, reckless, or self-destructive behavior
Hypervigilance and exaggerated startle response
Angry outbursts, problems with concentration, and sleep disturbances
Bipolar Disorder - correct answer ✔✔mood swings from profound depression to extreme
euphoria (mania), with intervening periods of normalcy.
Delusions or hallucinations may or may not be part of clinical picture
Onset of symptoms may reflect seasonal pattern
, A somewhat milder form of mania is called hypomania, More common in single than in married
persons, Occurs more often in the higher socioeconomic classes, Sixth leading cause of disability
in the middle age group
Lithium - correct answer ✔✔May modulate the effects of certain neurotransmitters,
norepinephrine, serotonin, dopamine, glutamate, and GABA, thereby stabilizing symptoms
associated with bipolar disorder.
Side effects: Drowsiness, dizziness, headache; Dry mouth; thirst; GI upset; nausea/vomiting;
Fine hand tremors; Hypotension; arrhythmias, pulse irregularities; Polyuria; dehydration;
Weight gain; Potential for lithium toxicity: Blurred vision, ataxia, tinnitus, persistent nausea and
vomiting, and severe diarrhea
Take regularly
Do not skimp on dietary sodium, Consume a diet adequate in sodium,
Drink 2,500 to 3,000 ml of fluid per day
Notify physician if vomiting or diarrhea occur
Have serum lithium level checked every 1 to 2 months, or as advised by physician
Lithium is a salt and competes in the body with sodium. If sodium is lost, the body will retain
lithium with resulting toxicity.
SSRI - correct answer ✔✔Toxic, sometimes fatal, reactions have occurred with concomitant use
of MAOIs,
Increased effects of SSRIs with cimetidine, L-tryptophan, and lithium
Concomitant use of SSRIs may increase effects of hydantoin, tricyclic antidepressants,
benzodiazepine, beta-blockers, carbamazepine, clozapine, haloperidol, phenothiazine, St. John's
wort, sumatriptan, sympathomimetics, tacrine, theophylline, and warfarin
Concomitant use of SSRIs may decrease effects of buspirone and digoxin
Serotonin syndrome can occur with concurrent use of other drugs that increase serotonin Side
effects:
May occur with all chemical classes
Dry mouth, sedation, nausea
