NURS 4010 LATEST 2026 EVALUATION TEST QUESTIONS
AND SOLUTIONS GUARANTEE A+
✔✔considerations with atypical - ✔✔-black box warning: inc mortality in elderly pts with
dementia related psychosis
*hyperglycemia and diabetes- metabolic syndrome*
-baseline weight and BMI
-blood pressure
-baseline blood glucose levels
-fasting lipid profiles
*geodon*- can cause QT elevation (need baseline EKG)
*risperdal*- increase prolactin levels, gynecomastia
*abilify*- weight neutral
✔✔Clozaril (Clozapine) - ✔✔-atypical with special considerations and precautions
-indications for use: failed adequate course of standard antipsychotic therapy, reduce
risk of recurrent suicidal behavior
-last line bc of SE but excellent choice
-SE: weight gain, drooling, seizures, myocarditis, *agranulocytosis* (test for WBC count,
absolute neutrophil count)
-clozaril registry (not good for homeless pt, pharmacy has to keep copy of labs
*strict monitoring guidelines*
-baseline ANC and WBC
-weekly ANC and WBC (first 6 months)
-biweekly ANC and WBC (6-12 months)
-monthly ANC and WBC (as long as on med)
-*teaching*: immediately report signs of infection (weakness, sore throat, fever, mouth
sores)
✔✔compliance with medications - ✔✔-option for patients who do not stay on their meds
-long acting injections (Halodol Decanoate- a month, Invega Sustena, Risperdal Consta,
Prolixin Decanoate)
-extended release tablets (Invega, Seroquel)- stop taking a day- have hallucinations-
voices say don't take med- can be hard
-dissolving tablets (Zyprexa zydis, Risperdal)- can't cheek or hide it
-liquid forms (Haldol)
✔✔delusion interventions - ✔✔-never argue
-never say that's not true (fixed false beliefs)
-use same staff so they trust person
-avoid physical contact
-avoid laughing or whispering
✔✔interventions for hearing voices - ✔✔-observe for hallucinations
-ask what seeing and hearing
-what are voices saying
,-do not call voice he she or name
-say yes i do not hear the voice or see that- they don't know what is real and what is not
-distraction can help- music
-ask pt what will help
-involve in activity
-lowering stimuli
-low level of noises on unit- no day room for them
-discuss hallucination and what they are saying
-distingish hallucination from reality
-come up with ways to distract
✔✔nursing diagnoses for schizophrenia - ✔✔-disturbed thought process
-disturbed sensory perception
-risk for self-directed violence
-risk for violence
-social withdrawal
-self care deficit
-risk for violence: other directed
-disabled family coping
-impaired home maintenance
-ineffective health maintenance
✔✔predisopsing factors for substance abuse - ✔✔*genetics*- genetic link with alcohol
(children 4x more likely to be alcoholics if parents are
*biochemical*- a lot of substances increase dopamine and glutamate, alcoholic gene-
bodies change alcohol into morphine like substance
*cultural*- asians don't have the enzymes to break down alcohol (get very sick if they
even have one drink- like antabuse), NA- more prone to alcoholism bc poor
*psychological*- ppl self medicate a lot, delayed gratification, depression and others
*personality*- antisocial more likely to have addiction, passive/dependent more likely to
be addicted
*sociocultural*- learning- model life after parents
✔✔substance use disorder - ✔✔-a pathological use of a substance that leads to a
disorder of use, intoxication, and often, withdrawal if the substance is taken away
-addictions can be chemical or nonchemical (process addictions- addictions, gambling,
internet, shopping, sexual)
✔✔addiction - ✔✔-primary, chronic disease of brain reward, motivation, emory and
related circuitry
-dysregulation of the hedonic or reward pathway of the brain
-loss of behavioral control
-cravings and inability to abstain
-loss of emotional regulation- gets worse with addiction (feel worse in long run)
-loss of the ability to identify problematic behaviors and relationships
, ✔✔4 C's of addiction - ✔✔-complusive behavior
-cravings
-chronic relapsing brain disorder
-cognitive impairment
✔✔intoxication - ✔✔process of using a substance to excess, "under the influence"
✔✔tolerance - ✔✔-needing increasing amounts of a substance to receive the desired
effects or finding that using the same amount over time results in a diminished effect
-big issue for heroin- if they stop using and go back out and use same amount as they
used to- they could die ):
✔✔withdrawal - ✔✔-set of psychological symptoms that begin to occur as the
concentration of the chemical decreases in an individual's bloodstream
-*alcohol and benzos*- have life threatening withdrawal symptoms
✔✔signs of alcohol intoxication - ✔✔slurred speech, incoordination, impaired judgement
✔✔screening tools for alcohol - ✔✔AUDIT, CAGE
✔✔CAGE - ✔✔-have you ever felt the need to CUT down on your drinking?
-are people ANNOYED by your drinking?
-do you ever feel GUILTY about your drinking?
-do you ever have an EYE-OPENER in the morning?
✔✔alcohol use disorder - ✔✔-risk for injury
-need BAL- correlated with breathalyzer (0.08 would be BAL of 80)
-if pt is 325 and walking around and talking- means high tolerance- means ADDICTION
-abs- liver enzymes (AST and ALT) if elevated indicated chronic use, GTT- shows
recent use
-even if enzymes are okay doesn't mean they are
-quiet environment
-orienting
-VS
-assist w ambulation, falls precaution
-1:1 ratio of staff
-can have denial, rationalization
-addiction- affects level of functioning (social, occupational functioning)
-can be in denial
-interventions: assess where they are for how much they want to change, contemplating
or no, establish rapport, no power struggles, do inventory (pros and cons of drinking),
discourage focusing on why they drink (stay in here and now), refer to AA
-long term outcomes: attends AA, maintain abstinence
-short term: identify ways to deal, accept responsibility
-ineffective health promotion, denial, malnourishment
AND SOLUTIONS GUARANTEE A+
✔✔considerations with atypical - ✔✔-black box warning: inc mortality in elderly pts with
dementia related psychosis
*hyperglycemia and diabetes- metabolic syndrome*
-baseline weight and BMI
-blood pressure
-baseline blood glucose levels
-fasting lipid profiles
*geodon*- can cause QT elevation (need baseline EKG)
*risperdal*- increase prolactin levels, gynecomastia
*abilify*- weight neutral
✔✔Clozaril (Clozapine) - ✔✔-atypical with special considerations and precautions
-indications for use: failed adequate course of standard antipsychotic therapy, reduce
risk of recurrent suicidal behavior
-last line bc of SE but excellent choice
-SE: weight gain, drooling, seizures, myocarditis, *agranulocytosis* (test for WBC count,
absolute neutrophil count)
-clozaril registry (not good for homeless pt, pharmacy has to keep copy of labs
*strict monitoring guidelines*
-baseline ANC and WBC
-weekly ANC and WBC (first 6 months)
-biweekly ANC and WBC (6-12 months)
-monthly ANC and WBC (as long as on med)
-*teaching*: immediately report signs of infection (weakness, sore throat, fever, mouth
sores)
✔✔compliance with medications - ✔✔-option for patients who do not stay on their meds
-long acting injections (Halodol Decanoate- a month, Invega Sustena, Risperdal Consta,
Prolixin Decanoate)
-extended release tablets (Invega, Seroquel)- stop taking a day- have hallucinations-
voices say don't take med- can be hard
-dissolving tablets (Zyprexa zydis, Risperdal)- can't cheek or hide it
-liquid forms (Haldol)
✔✔delusion interventions - ✔✔-never argue
-never say that's not true (fixed false beliefs)
-use same staff so they trust person
-avoid physical contact
-avoid laughing or whispering
✔✔interventions for hearing voices - ✔✔-observe for hallucinations
-ask what seeing and hearing
-what are voices saying
,-do not call voice he she or name
-say yes i do not hear the voice or see that- they don't know what is real and what is not
-distraction can help- music
-ask pt what will help
-involve in activity
-lowering stimuli
-low level of noises on unit- no day room for them
-discuss hallucination and what they are saying
-distingish hallucination from reality
-come up with ways to distract
✔✔nursing diagnoses for schizophrenia - ✔✔-disturbed thought process
-disturbed sensory perception
-risk for self-directed violence
-risk for violence
-social withdrawal
-self care deficit
-risk for violence: other directed
-disabled family coping
-impaired home maintenance
-ineffective health maintenance
✔✔predisopsing factors for substance abuse - ✔✔*genetics*- genetic link with alcohol
(children 4x more likely to be alcoholics if parents are
*biochemical*- a lot of substances increase dopamine and glutamate, alcoholic gene-
bodies change alcohol into morphine like substance
*cultural*- asians don't have the enzymes to break down alcohol (get very sick if they
even have one drink- like antabuse), NA- more prone to alcoholism bc poor
*psychological*- ppl self medicate a lot, delayed gratification, depression and others
*personality*- antisocial more likely to have addiction, passive/dependent more likely to
be addicted
*sociocultural*- learning- model life after parents
✔✔substance use disorder - ✔✔-a pathological use of a substance that leads to a
disorder of use, intoxication, and often, withdrawal if the substance is taken away
-addictions can be chemical or nonchemical (process addictions- addictions, gambling,
internet, shopping, sexual)
✔✔addiction - ✔✔-primary, chronic disease of brain reward, motivation, emory and
related circuitry
-dysregulation of the hedonic or reward pathway of the brain
-loss of behavioral control
-cravings and inability to abstain
-loss of emotional regulation- gets worse with addiction (feel worse in long run)
-loss of the ability to identify problematic behaviors and relationships
, ✔✔4 C's of addiction - ✔✔-complusive behavior
-cravings
-chronic relapsing brain disorder
-cognitive impairment
✔✔intoxication - ✔✔process of using a substance to excess, "under the influence"
✔✔tolerance - ✔✔-needing increasing amounts of a substance to receive the desired
effects or finding that using the same amount over time results in a diminished effect
-big issue for heroin- if they stop using and go back out and use same amount as they
used to- they could die ):
✔✔withdrawal - ✔✔-set of psychological symptoms that begin to occur as the
concentration of the chemical decreases in an individual's bloodstream
-*alcohol and benzos*- have life threatening withdrawal symptoms
✔✔signs of alcohol intoxication - ✔✔slurred speech, incoordination, impaired judgement
✔✔screening tools for alcohol - ✔✔AUDIT, CAGE
✔✔CAGE - ✔✔-have you ever felt the need to CUT down on your drinking?
-are people ANNOYED by your drinking?
-do you ever feel GUILTY about your drinking?
-do you ever have an EYE-OPENER in the morning?
✔✔alcohol use disorder - ✔✔-risk for injury
-need BAL- correlated with breathalyzer (0.08 would be BAL of 80)
-if pt is 325 and walking around and talking- means high tolerance- means ADDICTION
-abs- liver enzymes (AST and ALT) if elevated indicated chronic use, GTT- shows
recent use
-even if enzymes are okay doesn't mean they are
-quiet environment
-orienting
-VS
-assist w ambulation, falls precaution
-1:1 ratio of staff
-can have denial, rationalization
-addiction- affects level of functioning (social, occupational functioning)
-can be in denial
-interventions: assess where they are for how much they want to change, contemplating
or no, establish rapport, no power struggles, do inventory (pros and cons of drinking),
discourage focusing on why they drink (stay in here and now), refer to AA
-long term outcomes: attends AA, maintain abstinence
-short term: identify ways to deal, accept responsibility
-ineffective health promotion, denial, malnourishment
