NURS 6501 / NURS6501: Advanced Pathophysiology - Week 6 Knowledge Check (Latest 2021 / 2022) Walden University

Knowledge check Module 6  Question 1 Needs Grading A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes _of_ unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years _of_ high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 1 _of_ 4: Describe the positive symptoms _of_ schizophrenia and relate those symptoms to the case study patient. Selecte d Answer: Positive symptoms _of_ schizophrenia have to deal with symptoms that were not previously present or symptoms that were affected by an outside variable. These would be the psychotic symptoms such as delusions, hallucinations, disorganized speech, disorganized behaviors, and possible catatonia. He is experiencing auditory hallucinations that tell him he is not smart enough. He also has the delusion that he is not smart enough. The patient has negative behaviors such as unexpected rage and crying.  Question 2 Needs Grading A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes _of_ unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years _of_ high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. NURS 8501 EXAM WEEK 6 KNOWLEDGE CHECK Question 2 _of_ 4: Explain the genetics _of_ schizophrenia. Selected Answer: There is no definitive research showing how it is passed down through genetics. Studies that involves twins show the gene is carried but not all manifest the symptoms _of_ schizophrenia. There may be involvement _of_ different chromosomes and also protein interactions that may help to show the link in genetics.  Question 3 Needs Grading A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes _of_ unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years _of_ high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 3 _of_ 4: The APRN reviews recent literature and reads that neurotransmitters are involved in the development _of_ schizophrenia. What roles do neurotransmitters play in the development _of_ schizophrenia? Selected Answer: The neurotransmitters that may play a role in schizophrenia are GABA, glutamate, and dopamine. There is belief that reelin is reduced in adults with schizophrenia. Reelin is an interneuron that helps with migration _of_ neuronal activity. This reenin is found in abundance in GABA. Glutamate is believed to be involved because _of_ how the NMDA receptor does not activate with glutamate and therefore it causes schizophrenia. Dopamine is involved because the antipsychotic medications (dopamine antagonists) show decreased symptoms with schizophrenic patients leading to the theory that the D2 receptor is invovled. This also lends to the theory that other neurotransmitters are involved because if clozapine works (a blocker _of_ neurotransmitters like norepinephrine, serotonin, and GABA) then other neurotransmitters may be involved as well.  Question 4 Needs Grading A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes _of_ unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years _of_ high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 4 _of_ 4: The APRN reviews recent literature and reads that structural problems in the brain may be involved in the development _of_ schizophrenia. Explain what structural abnormalities are seen in people with schizophrenia. Selected Answer: The lateral and third ventricals _of_ the brain are enlarged and there is widening _of_ the frontocortical fissures and sulci. The thalamus and temporal lobe areas are small. Within the first year _of_ the syndrome the patients have a reduced hippocampus. Patients with schizophrenia also have an abnormal amygdala.  Question 5 Needs Grading A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints _of_ extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front _of_ the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line _of_ credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 1 _of_ 6: Discuss the role genetics plays in the development _of_ bipolar 2 disorders. Selected Answer: There is a high link between patients who have a family history _of_ mood disorders. Chromosomes 18 and 22 show a link with bipolar disorder.  Question 6 Needs Grading A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints _of_ extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front _of_ the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line _of_ credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 2 _of_ 6: Explain how the hypothalamic-pituitary-adrenal (HPA) system may be associated with bipolar type 2 disease. Selecte d Answer: The HPA allows for individuals to deal with stress. The patients with this disease show continued activation _of_ the HPA and elevation _of_ glucocorticoid secretions. The CRH triggers the ACTH then goes to adreanal glands to release cortisol. This cortisol then tells the hypothalamus to stop releasing CRH and then we experience a negative feedback mechanism that tells us to adjust our stress response.  Question 7 Needs Grading A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints _of_ extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front _of_ the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line _of_ credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorde