NUR7350900 - Acute & Chronic Management of Child-Adolescent with Psychiatric Mental (2006 10)
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Free NUR7350900 - Acute & Chronic Management of Child-Adolescent with Psychiatric Mental (2006 10) Questions
The psychiatric mental health nurse practitioner is doing a medication evaluation follow-up appointment with a client with schizophrenia who takes antipsychotic medication. What laboratory tests should the PMHNP order?
- Complete blood count, complete metabolic profile
- Medication level
- Complete blood count, complete metabolic profile, lipid panel, hemoglobin A1C
Explanation
For clients on antipsychotic medications, it is important to monitor for side effects such as metabolic changes (e.g., weight gain, hyperglycemia, dyslipidemia) that can increase the risk of cardiovascular disease. The complete blood count (CBC) can identify potential blood disorders, the complete metabolic profile (CMP) assesses kidney and liver function, and the lipid panel and hemoglobin A1C are necessary to monitor for metabolic syndrome, which can be a side effect of antipsychotic medications, especially second-generation antipsychotics like risperidone. These tests help ensure the client’s overall health and detect potential complications early.
Correct Answer Is:
C. Complete blood count, complete metabolic profile, lipid panel, hemoglobin A1C
Freud's psychoanalytic theory consists of the preconscious, the ----------, and the unconscious. (Fill in the blank with the best answer.)
- Subconscious
- Conscious
- Psychic energy
Explanation
Freud’s psychoanalytic theory divides the mind into three levels: the conscious, the preconscious, and the unconscious. The conscious refers to thoughts and feelings that are immediately available to awareness, while the preconscious holds thoughts that are not currently in awareness but can be brought to consciousness. The unconscious contains repressed thoughts and desires. The subconscious (A) is a term that is not commonly used in Freud's theory, and psychic energy (C) refers to the energy associated with mental processes, not a level of consciousness.
Correct Answer Is:
B. Conscious
Trisomy 21 is a phenotype expressed in ______ syndrome.
- Rett's
- Down's
- Autosomal
Explanation
Trisomy 21 is the genetic condition that causes Down syndrome. It occurs when an individual has three copies of chromosome 21 instead of the usual two. Rett’s syndrome (A) is a separate genetic disorder that typically affects girls, and "autosomal" (C) refers to chromosomes that are not sex chromosomes, but does not specifically describe the condition associated with trisomy 21.
Correct Answer Is:
B. Down's
Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off the SSRIs. What is the initial dosage adjustment when tapering off antidepressants?
- Change dose to every other day dosing for a week.
- Reduce dose by 50% for three to four days.
- Reduce dose by 50% every other day.
- Escitalopram (Lexapro) can be stopped abruptly due to its long half-life.
Explanation
When tapering off SSRIs like escitalopram (Lexapro), it is important to gradually reduce the dose to minimize withdrawal symptoms and avoid the risk of relapse. A common method is to reduce the dose by changing it to every other day dosing for a week. This allows the body to adjust slowly, and the client can monitor any signs of withdrawal or return of symptoms. Stopping the medication abruptly or reducing it too quickly can lead to withdrawal symptoms such as dizziness, nausea, or irritability. Reducing by 50% every other day is too fast, and escitalopram should not be stopped abruptly even though it has a long half-life.
Correct Answer Is:
A. Change dose to every other day dosing for a week.
Oppositional defiant disorder is a pattern of ______ or ______ mood.
- Inattentive or unfocused
- Irritable or angry
- Elated or manic
Explanation
Oppositional Defiant Disorder (ODD) is characterized by a consistent pattern of angry, irritable mood, argumentative behavior, and defiant actions. Children with ODD often display frequent temper outbursts, irritability, and a tendency to argue with authority figures. This pattern can affect relationships at home, school, and in the community.
Correct Answer Is:
B. Irritable or angry
The mental status examination (MSE) is the -------- portion of the psychiatric assessment.
- Physical
- Subjective
- Objective
Explanation
The mental status examination (MSE) is considered the objective portion of the psychiatric assessment. It focuses on the observable aspects of the patient's mental state, including appearance, behavior, speech, mood, thought processes, and cognitive functions. The subjective portion typically involves the patient's self-reported symptoms, feelings, and experiences. The physical portion pertains to the assessment of physical health and bodily function.
Correct Answer Is:
C. Objective
Relieving stress behaviors include all of the following actions: crying, ---------------, and nail-biting.
- Pacing
- Laughing
- Sleeping
Explanation
Relieving stress behaviors are actions people engage in to manage or release tension. Pacing (A) is a common stress-relieving behavior, often used when someone is anxious or nervous. Laughing (B) and sleeping (C) can also be responses to stress but are not as commonly associated with active physical tension release like pacing is.
Correct Answer Is:
A. Pacing
What "onset of action" symptoms should be reviewed with patients who have been newly prescribed an SSRI?
- They will have insomnia for a week.
- They may feel a bit of nausea, but this will resolve in a week.
- They will have an "onset seizure" but this is considered normal.
- They will no longer dream.
Explanation
When starting an SSRI, common "onset of action" symptoms include mild gastrointestinal discomfort, such as nausea, which typically resolves within the first week of treatment. This side effect is temporary as the body adjusts to the medication. Insomnia (Option A) may occur, but it is not as universally expected as nausea. Seizures (Option C) are not normal and should be addressed immediately. SSRI use does not typically affect dreaming (Option D), so this is not a common symptom.
Correct Answer Is:
B. They may feel a bit of nausea, but this will resolve in a week.
According to trauma theory, which of the following best describes how early trauma can affect a child's development?
- A Trauma only affects physical development, not emotional functioning
- B Children quickly forget traumatic experiences, so long-term impact is rare
- C Trauma can disrupt brain development, emotional regulation, and attachment patterns
- D Trauma has no effect unless the child can clearly verbalize what happened
Explanation
Early trauma can have profound and lasting effects on a child’s development. Trauma may alter brain structure and function, impair emotional regulation, and negatively affect attachment with caregivers. These disruptions can increase the risk for behavioral, emotional, and mental health difficulties throughout childhood and into adulthood, even if the child cannot fully verbalize the traumatic experience.
Correct Answer Is:
C Trauma can disrupt brain development, emotional regulation, and attachment patterns
Which mental health disorder is most commonly diagnosed in early childhood?
- Attention-Deficit/Hyperactivity Disorder (ADHD)
- Schizophrenia
- Borderline Personality Disorder
- Generalized Anxiety Disorder
Explanation
Attention-Deficit/Hyperactivity Disorder (ADHD) is the most commonly diagnosed mental health disorder in early childhood. ADHD typically presents in children as early as age 3-4 and is characterized by symptoms of inattention, hyperactivity, and impulsivity. Early diagnosis and intervention can significantly improve outcomes, including academic success and social skills. Schizophrenia and borderline personality disorder typically have later onset, and generalized anxiety disorder can also occur, but ADHD is the most prevalent early childhood diagnosis.
Correct Answer Is:
A. Attention-Deficit/Hyperactivity Disorder (ADHD)
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