NR 326 Final Exam With Correct Answered
Questions Latest Update,.
Mild anxiety- Correct answer-heightened perception
-increased awareness
-increased alertness
-learning is enhanced
-restlessness
-irritability
-may remain superficial with others
-rarely experiences as distressful
-motivation is increased
Moderate Anxiety- Correct answer-reduced perceptual field
-reduces alertness to environmental events
-decreased ability to learn
-decreased attention span
-decreased ability to concentrate
-increased restlessness
-increased HR and RR
-gastric discomfort
-increased muscular tension
-increase in speech rate, volume, and pitch
-a feeling of discontent, can have impairment in personal relationships (begins to focus
on self)
Severe Anxiety- Correct answer-greatly diminished; only single detail focused
-inability to focus elsewhere when pointed out
-extremely poor ability to learn
-HA, dizziness, nausea, trembling, insomnia, palpitations, tachycardia, hyperventilation,
urinary frequency, diarrhea
-feelings of dread, horror
-total focus on self and intense desire to relieve the anxiety
Panic- Correct answer-unable to focus on even one detail in environment
-misperceptions of environment
-no ability to learn
-dilated pupils, labored breathing, severe trembling, incoherence, sleeplessness,
palpitations, diaphoresis and pallor, muscular incoordination, immobility or purposeless
hyperactivity
-feelings of terror/doom
,-bizarre behavior - shouting, screaming, running wildly around, hallucinations,
delusions, and extreme withdrawal into self
Generalized Anxiety Disorder- Correct answer-uncontrollable excessive worry
> 6 months without known cause
-SX: muscle tension, avoidance of stressful events, difficulty making decisions,
restlessness (hand wringing), and constant seeking reassurance with significant
impairment in functioning
-tx: group and individual therapy, meds for anxiety/depression
-NI: CBT, use a non-judgmental approach, relaxation techniques, modeling, reframing,
use Hamilton A tool for assessment
Panic Disorder- Correct answer-recurrent panic attacks accompanied by
worry about future attacks
-onset is sudden, trigger is often unidentifiable
-sx: include desire to escape, chest pain, chills, hot flashes, choking sensation,
depersonalization, dizziness, nausea, palpitations, SOB, sweating, trembling, fear of
loss of control, decreased peripheral vision
-tx: benzodiazepines for acute sx, SSRIs which can treat both anxiety and depression
-NI: remain calm, spend time with client, offer reassurance, use clear, concise, direct
approach, and reduce environmental stimuli
-can develop into agoraphobia
social anxiety disorder- Correct answer-clients experience excessive fear of
social or performance situations
-clients report difficulty performing or speaking with excessive fear of embarrassment
when having to speak in front of others
-physical manifestations can be actual or reported (factitiously) in an attempt to avoid
the situation of having to speak in front of others
-tx: propanolol a beta blocker
-NI: assist the client to discuss fears and teach use of relaxation training and behavioral
therapy techniques such as reciprocal inhibition
PTSD- Correct answer-caused by a psychologically traumatic event
-sx may persist for more than 1 month and cause a significant amount of impairment
and distress
-avoidance of stimuli associated with trauma
-hypervigilence, emotional numbing, flashbacks
-tx: group and individual therapy, medication for insomnia (prasozin for nightmares),
anxiety, and/or depression
-NI: supportive, non-judgmental approach, encourage expression of feelings, and
encourage healthy coping mechanisms
, Major Depressive Disorder- Correct answer-sx: sadness, hopelessness,
powerlessness, helplessness, difficulty concentrating, irritability, SI, impacts sleep,
appetite, and energy levels
-tx: SSRIs, NSRIs, TCAs, MAOIs, CBT, 1:1 psychotherapy, ECT, support groups
-NI: close monitoring for safety, suicide precautions, removal of unsafe items,
medication education including black box warnings (suicide risk after 1 week), education
on serotonin syndrome, discontinuation syndrome, food and drug interactions,
promotion of group therapy sessions (CBT), ensuring client has developed a crisis
management plan and has outside support contacts and phone numbers prior to
discharge
Bipolar Disorder- Correct answer-Bipolar I Disorder: episodes of depression
and mania
-Bipolar II Disorder: depression and hypomania over time
-sx: elevated, expansive or irritable mood, inflated self-esteem and grandiosity, racing
thoughts, rapid pressured speech typical of mania
-may have a depressive episode or cycle between both with mixed bipolar sx
-tx: antipsychotics, lithium, anticonvulsants
-NI: teach med indications for use and lab draws for levels, multiple areas to teach for
lithium safety with potential for toxicity, monitor kidney and thyroid function and
electrolytes, avoid diuretics and NSAIDS, assess labs for therapeutic levels
Lithium Therapeutic Blood Level- Correct answer0.4-1.4
Lithium Maintenance Blood Level- Correct answer0.6 - 1.2
Lithium Normal side effects- Correct answer-less than 1.5
-fine hand tremors, N/V, diarrhea, polyuria, thirst, fatigue
Toxic Blood Level- Correct answer-at or above 1.5
-HOLD lithium
Should a patient take their lithium dose before a lab draw? - Correct
answerno, hold dose until after lab is drawn
Lithium Level 1.5 and greater: Toxicity- Correct answerblurred vision, ataxia,
tinnitus, N/V
Lithium Level 2.0: Toxicity- Correct answerexcessive output of dilute urine,
tremors, and muscular irritability
Questions Latest Update,.
Mild anxiety- Correct answer-heightened perception
-increased awareness
-increased alertness
-learning is enhanced
-restlessness
-irritability
-may remain superficial with others
-rarely experiences as distressful
-motivation is increased
Moderate Anxiety- Correct answer-reduced perceptual field
-reduces alertness to environmental events
-decreased ability to learn
-decreased attention span
-decreased ability to concentrate
-increased restlessness
-increased HR and RR
-gastric discomfort
-increased muscular tension
-increase in speech rate, volume, and pitch
-a feeling of discontent, can have impairment in personal relationships (begins to focus
on self)
Severe Anxiety- Correct answer-greatly diminished; only single detail focused
-inability to focus elsewhere when pointed out
-extremely poor ability to learn
-HA, dizziness, nausea, trembling, insomnia, palpitations, tachycardia, hyperventilation,
urinary frequency, diarrhea
-feelings of dread, horror
-total focus on self and intense desire to relieve the anxiety
Panic- Correct answer-unable to focus on even one detail in environment
-misperceptions of environment
-no ability to learn
-dilated pupils, labored breathing, severe trembling, incoherence, sleeplessness,
palpitations, diaphoresis and pallor, muscular incoordination, immobility or purposeless
hyperactivity
-feelings of terror/doom
,-bizarre behavior - shouting, screaming, running wildly around, hallucinations,
delusions, and extreme withdrawal into self
Generalized Anxiety Disorder- Correct answer-uncontrollable excessive worry
> 6 months without known cause
-SX: muscle tension, avoidance of stressful events, difficulty making decisions,
restlessness (hand wringing), and constant seeking reassurance with significant
impairment in functioning
-tx: group and individual therapy, meds for anxiety/depression
-NI: CBT, use a non-judgmental approach, relaxation techniques, modeling, reframing,
use Hamilton A tool for assessment
Panic Disorder- Correct answer-recurrent panic attacks accompanied by
worry about future attacks
-onset is sudden, trigger is often unidentifiable
-sx: include desire to escape, chest pain, chills, hot flashes, choking sensation,
depersonalization, dizziness, nausea, palpitations, SOB, sweating, trembling, fear of
loss of control, decreased peripheral vision
-tx: benzodiazepines for acute sx, SSRIs which can treat both anxiety and depression
-NI: remain calm, spend time with client, offer reassurance, use clear, concise, direct
approach, and reduce environmental stimuli
-can develop into agoraphobia
social anxiety disorder- Correct answer-clients experience excessive fear of
social or performance situations
-clients report difficulty performing or speaking with excessive fear of embarrassment
when having to speak in front of others
-physical manifestations can be actual or reported (factitiously) in an attempt to avoid
the situation of having to speak in front of others
-tx: propanolol a beta blocker
-NI: assist the client to discuss fears and teach use of relaxation training and behavioral
therapy techniques such as reciprocal inhibition
PTSD- Correct answer-caused by a psychologically traumatic event
-sx may persist for more than 1 month and cause a significant amount of impairment
and distress
-avoidance of stimuli associated with trauma
-hypervigilence, emotional numbing, flashbacks
-tx: group and individual therapy, medication for insomnia (prasozin for nightmares),
anxiety, and/or depression
-NI: supportive, non-judgmental approach, encourage expression of feelings, and
encourage healthy coping mechanisms
, Major Depressive Disorder- Correct answer-sx: sadness, hopelessness,
powerlessness, helplessness, difficulty concentrating, irritability, SI, impacts sleep,
appetite, and energy levels
-tx: SSRIs, NSRIs, TCAs, MAOIs, CBT, 1:1 psychotherapy, ECT, support groups
-NI: close monitoring for safety, suicide precautions, removal of unsafe items,
medication education including black box warnings (suicide risk after 1 week), education
on serotonin syndrome, discontinuation syndrome, food and drug interactions,
promotion of group therapy sessions (CBT), ensuring client has developed a crisis
management plan and has outside support contacts and phone numbers prior to
discharge
Bipolar Disorder- Correct answer-Bipolar I Disorder: episodes of depression
and mania
-Bipolar II Disorder: depression and hypomania over time
-sx: elevated, expansive or irritable mood, inflated self-esteem and grandiosity, racing
thoughts, rapid pressured speech typical of mania
-may have a depressive episode or cycle between both with mixed bipolar sx
-tx: antipsychotics, lithium, anticonvulsants
-NI: teach med indications for use and lab draws for levels, multiple areas to teach for
lithium safety with potential for toxicity, monitor kidney and thyroid function and
electrolytes, avoid diuretics and NSAIDS, assess labs for therapeutic levels
Lithium Therapeutic Blood Level- Correct answer0.4-1.4
Lithium Maintenance Blood Level- Correct answer0.6 - 1.2
Lithium Normal side effects- Correct answer-less than 1.5
-fine hand tremors, N/V, diarrhea, polyuria, thirst, fatigue
Toxic Blood Level- Correct answer-at or above 1.5
-HOLD lithium
Should a patient take their lithium dose before a lab draw? - Correct
answerno, hold dose until after lab is drawn
Lithium Level 1.5 and greater: Toxicity- Correct answerblurred vision, ataxia,
tinnitus, N/V
Lithium Level 2.0: Toxicity- Correct answerexcessive output of dilute urine,
tremors, and muscular irritability
