NURS 6550 Acute Care Study Guide for
Midterm
NURS 6550N Midterm Exam Study Guide
Correct and Verified Q & A
NURS 6550-Advanced Practice Care of
Adults in Acute Care Settings I
, NURS 6550 Acute Care Study Guide
for Midterm
Psychosocial WEEK 2
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2018). Current medical
diagnosis & treatment (57th ed.). New York, NY: McGraw Hill.
Chapter 25, “Psychiatric Disorders” (pp. 1059-1116)
Evaluate patients with psychosocial health conditions
Develop differential diagnoses for patients with psychosocial health conditions
Develop treatment plans for patients with psychosocial health conditions
Generalized anxiety disorder diagnosis criteria- Excessive
anxiety and worry
(apprehensive expectation), occurring more days than not for at
least 6 months, about a number of events or activities (such as
work or school performance).
B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of
the following six symptoms (with at least some symptoms present
for more days than not for the past 6 months). Note: Only one
item is required in children.
(1) restlessness or feeling keyed up or on edge
(2) being easily fatigued
(3) difficulty concentrating or mind going blank
(4) irritability
(5) muscle tension
(6) sleep disturbance (difficulty falling or staying asleep, or
restless unsatisfying sleep)
Primary neurotransmitter in PTSD- Due to the traumatic stress of PTSD victims,
the neurotransmitters that fuel the sympathetic versus parasympathetic system get
, out of balance. As a Yale University journal review states, “It has been suggested
that alterations in NE [norepinephrine], E [epinephrine], and 5-HT [5HTP] may have
relevance for symptoms commonly seen in survivors with PTSD
* PTSD diagnosis and treatment-assessing history of exposure to a perceived or actual
life threatening event, serious injury or sexual violence, symptoms lasting more than 1
month. Disturbance causes clinically significant distress or impairment in functioning
H) The disturbance is not attributable to the physiological effects of a substance or other
medical condition
DSM-5 recognizes a “with dissociative symptom” specifier when the PTSD symptoms
are accompanied by persistent or recurrent depersonalization or derealization.
The specifier “with delayed expression” should be included if the full criteria for PTSD
are not met for more than 6 months following the trauma.
The traumatic event is persistently re-experienced:
Nightmares
Intrusive thoughts of the traumatic event
Flashbacks
Marked emotional distress when exposed to traumatic reminders
Strong physiologic reaction when exposed to traumatic reminders
Treatment psychotherapy (cognitive processing, prolonged exposure therapy, eye-
movement desensitizing) . SSRIs (sertraline, paroxetine) clonidine 0.1mg at bed time,
prazosin 2-10mg for nightmare, antiseizure meds for anger management (carbamazepine
400-800mg daily), clonazepam 1-4mg daily for anxiety, Trazodone 25-100mg for sleep.
Treatment of acute panic attacks- What are the medications for initial/first line
therapy- SL 0.5-1 mg alprazolam, clonazepam 0.5-1mg, antidepressants, SSRIs (sertraline 25mg/day for
1 week, then 50mg)
Inpatient treatment of depression- ECT
o What are the therapies for patient’s that won’t eat, take meds, etc.
When is serotonin norepinephrine reuptake inhibitor indicated, when is it
contraindicated? For pain neuropathy/fibromyalgia
Venlafaxine dosing, when is follow up? What are you monitoring? - Blood pressure monitoring,
arrhythmias DOSE is 150-225 mg daily.Patients should be cautioned about the concomitant
use of Venlafaxine tabletsand NSAIDs, aspirin, warfarin, or other drugs that affect
coagulation since combined use of psychotropic drugs that interfere with serotonin
Midterm
NURS 6550N Midterm Exam Study Guide
Correct and Verified Q & A
NURS 6550-Advanced Practice Care of
Adults in Acute Care Settings I
, NURS 6550 Acute Care Study Guide
for Midterm
Psychosocial WEEK 2
Papadakis, M. A., McPhee, S. J., & Rabow, M. W. (2018). Current medical
diagnosis & treatment (57th ed.). New York, NY: McGraw Hill.
Chapter 25, “Psychiatric Disorders” (pp. 1059-1116)
Evaluate patients with psychosocial health conditions
Develop differential diagnoses for patients with psychosocial health conditions
Develop treatment plans for patients with psychosocial health conditions
Generalized anxiety disorder diagnosis criteria- Excessive
anxiety and worry
(apprehensive expectation), occurring more days than not for at
least 6 months, about a number of events or activities (such as
work or school performance).
B. The person finds it difficult to control the worry.
C. The anxiety and worry are associated with three (or more) of
the following six symptoms (with at least some symptoms present
for more days than not for the past 6 months). Note: Only one
item is required in children.
(1) restlessness or feeling keyed up or on edge
(2) being easily fatigued
(3) difficulty concentrating or mind going blank
(4) irritability
(5) muscle tension
(6) sleep disturbance (difficulty falling or staying asleep, or
restless unsatisfying sleep)
Primary neurotransmitter in PTSD- Due to the traumatic stress of PTSD victims,
the neurotransmitters that fuel the sympathetic versus parasympathetic system get
, out of balance. As a Yale University journal review states, “It has been suggested
that alterations in NE [norepinephrine], E [epinephrine], and 5-HT [5HTP] may have
relevance for symptoms commonly seen in survivors with PTSD
* PTSD diagnosis and treatment-assessing history of exposure to a perceived or actual
life threatening event, serious injury or sexual violence, symptoms lasting more than 1
month. Disturbance causes clinically significant distress or impairment in functioning
H) The disturbance is not attributable to the physiological effects of a substance or other
medical condition
DSM-5 recognizes a “with dissociative symptom” specifier when the PTSD symptoms
are accompanied by persistent or recurrent depersonalization or derealization.
The specifier “with delayed expression” should be included if the full criteria for PTSD
are not met for more than 6 months following the trauma.
The traumatic event is persistently re-experienced:
Nightmares
Intrusive thoughts of the traumatic event
Flashbacks
Marked emotional distress when exposed to traumatic reminders
Strong physiologic reaction when exposed to traumatic reminders
Treatment psychotherapy (cognitive processing, prolonged exposure therapy, eye-
movement desensitizing) . SSRIs (sertraline, paroxetine) clonidine 0.1mg at bed time,
prazosin 2-10mg for nightmare, antiseizure meds for anger management (carbamazepine
400-800mg daily), clonazepam 1-4mg daily for anxiety, Trazodone 25-100mg for sleep.
Treatment of acute panic attacks- What are the medications for initial/first line
therapy- SL 0.5-1 mg alprazolam, clonazepam 0.5-1mg, antidepressants, SSRIs (sertraline 25mg/day for
1 week, then 50mg)
Inpatient treatment of depression- ECT
o What are the therapies for patient’s that won’t eat, take meds, etc.
When is serotonin norepinephrine reuptake inhibitor indicated, when is it
contraindicated? For pain neuropathy/fibromyalgia
Venlafaxine dosing, when is follow up? What are you monitoring? - Blood pressure monitoring,
arrhythmias DOSE is 150-225 mg daily.Patients should be cautioned about the concomitant
use of Venlafaxine tabletsand NSAIDs, aspirin, warfarin, or other drugs that affect
coagulation since combined use of psychotropic drugs that interfere with serotonin
