Says Who?
Which age group holds the third leading cause of death by Suicide?
a. 2 - 3-year-olds
b. 6 - 10-year-olds
c. 11 - 14 year olds
d. 15 - 24 year olds
d. 15 - 24 year olds
One of the easiest ways to assess a child's developmental stage is to observe what?
a. their intellectual ability
b. their hand-eye coordination
c. their play
d. their drawing ability
Play is the easiest way to measure a child's developmental stage. For example: are they doing parallel play (playing side by side with other kids, but not interacting with them - around age 2 - 4) when they should be playing with others?
There are many theories.
Inadequate levels of what neurotransmitter/s are related to depression and suicide?
a. norepinephrine and serotonin
b. dopamine and serotoninc
c. GABA
d. adrenalin/epinephrine
a. a lack of norepinephrine and serotonin are linked to depression and suicide
Which of the following is a negative symptom of schizophrenia?
a. hallucinations
b. delusions
c. apathy
d. cognitive decline
c. apathy is a negative symptom of schizophrenia
The nurse knows that a patient living in Alaska is more likely to experience SAD (seasonal affective disorder) and will include which medication on her care plan?
a. escitalopram (Lexapro)
b. paroxetine (Paxil)
c. buproprion (Wellbutrin)
d. sertraline (Zoloft)
c. bupropion
Bupropion is used to treat major depressive disorder (MDD) and to prevent seasonal affective disorder (SAD)
The first onset of mental health symptoms is most likely to occur in early childhood or adolescence. The most prevalent co-morbid conditions to be seen are what? Select all that apply.
a. anxiety
b. depression
c. paranoia
d. hallucinations
a, b
anxiety and depression are the most prevalent co-morbidities in young children and adolescents.
A child with ADHD will begin medication therapy. The nurse should prepare a teaching plan to include which class of medications?
a. MAOIs
b. CNS Stimulants
c. antipsychotics
d. anxiolytics
b. CNS stimulants such as methylphenidate (Ritalin), amphetamine salts (Adderall), or lisdexamfetamine (Vyvanse). These help children with ADHD to improve their attention and focus as well as reduce hyperactive behaviors.
In the inattentive type of ADHD, which neurotransmitter is involved?
a. the norepinephrine transporter gene
b. the adrenalin transporter gene
c. both a and b
When children and adults have the inattentive type of ADHD, the norepinephrine transporter gene is affected. p. 421
What two primary neurotransmitters are related to depression?
a. epinephrine and dopamine
b. serotonin and norepinephrine
c. serotonin and choline
d. GABA and serotonin
b. serotonin and norepinephrine
While the classical theories of the neurobiology of depression mainly focused on serotonin and norepinephrine, there is increasing interest in the role of dopamine 50. Remember, our test is from the book, not updated evidence.
A client with schizophrenia, repeated hospitalizations, and a history of homelessness is ready for discharge. Given the client's history, the nurse should recommend which plan?
a. Program of Assertive Community Treatment
b. Monthly follow-up visits at the mental health clinic
c. social skills training
d. family therapy
a. PACT - utilize a transdisciplinary approach to deliver comprehensive care and promote independent, integrated living for individuals with serious mental illness.
To build resiliency in a child, when Sarah falls and scrapes her knee, mom says what?
a. Alright, get up, let's go!
b. Oh No!
c. Are you ok?
d. Come here honey, does it hurt?
a. Alright, get up, let's go.
Resiliency is developed through a successful transition through a previous crisis, often with guidance and support. A trait that can be learned.
Adverse events in a child's life that lead to a higher probability that mental and physical issues will arise include the following? Select all that apply.
a. being slapped across the face for bedwetting
b. Daddy punching mommy when he's drunk
c. no one is home after school and no dinner is made 4 - 5 times a week
d. substance abuse in the home
e. divorce or separation of parents
f. incarceration of a parent
g. mental illness in the home
All of the answers are correct.
Abuse and neglect of any kind increase a child's risk of developing psychological conditions. Emotional abuse leads to a higher risk! The brain is modable during childhood, with neuronal chains being rapidly connected. These connections are based on environmental input telling the child that the world is good and safe or scary and unpredictable. Without intervention to form positive pathways, these early connections can guide thoughts and behaviors for the rest of a person's life. The events are called ACE (adverse childhood events) p. 421
Patients with a predominantly hyperactive-impulse type of ADHD have a variation in what?
a. dopamine transporter gene
b. norepinephrine transporter gene
c. both a and b
Hyperactive, impulse type of ADHD patients have a dopamine transporter issue. p. 421
A client comes into the ED and is slow to answer questions, exhibits slow concentration, and decreased memory according to his spouse. What is the most accurate assessment by the nurse?
a. the client has depression
b. the client has dementia
c. the client does not trust the nurse
d. the client only speaks French
a. the client has depression
Which medications are considered SSRIs? SATA
a. doxepin (Silenor)
b. escitalopram (Lexapro)
c. sertraline (Zoloft)
d. mirtazapine (Remeron)
e. paroxetine (Paxil)
b, c, e are all SSRIs
doxepin is a tricyclic antidepressant
mirtazapine is an atypical antidepressant - same class as Buproprion (Wellbutrin and Zyban for smoking)
Children and youth with high resilience often have certain things in common. Select all that apply.
a. Vulnerability to stress
b. Less vulnerable to stress
c. more available resources
d. good parenting or mentoring
b, c, d
Children with high resilience are less vulnerable to stress and it's impact. They can handle stress better by processing the information and "bouncing back".
This is a combination of personality traits made of nine different areas: activity level, biological rhythms, sensitivity, intensity of reaction, adaptability, approach/withdrawal, persistence, distractibility, and mood. I make up a child's what?
a. mood
b. temperament
c. resilience
d. vulnerability
b. temperament, p. 421
Temperament is thought to be both genetically influenced and learned through relationships.
We watch our parents and caregivers. If they have a short temper and we are exposed to this as a child, chances are the child will have a short temper.
In the combined type, attention deficit and hyperactive ADHD type, the transporter gene impacted is what?
a. choline transporter gene
b. dopamine transporter gene
c. norepinephrine transporter gene
In combined ADHD, the choline transporter gene is impacted.
With all of that said: this explains why certain medications help certain types of ADHD.
For example: Stimulants affect dopamine, and non-stimulants (atomoxetine or Strattera) affect norepinephrine.
Which SSRIs carry the disadvantage of the potential for seizures?
a. duloxetine (Cymbalta)
b. alprazolam (Xanax)
c. desvenlafaxine (Pristiq)
d. levomilnacipran (Fetzima)
a. duloxetine (Cymbalta)
Seizures are listed as a rare but serious side effect of Cymbalta.
The nurse admitted a client diagnosed with substance abuse intoxication to the unit. What will one of the first assessments be?
a. genetic factors
b. drug use
c. family history of drug use
b. client's perception of the admitting problem
b. drug use
The nurse must determine the type of drugs the client has been using
When assessing a child, the most important finding is to determine what?
a. the child's mental awareness
b. the child's developmental level
c. the child's support system
d. the child's grade level
The nurse must determine the child's developmental level first. For example, if you see a child in the grocery store, age 2, throwing a temper tantrum you know this is normal. What if this child is 12 years old? You know this is not normal. What developmental stage, according to Erikson, is this child in? infancy, toddlerhood, preschooler, school age? Then proceed with your assessment according to the theory.
The husband of the patient diagnosed with depersonalization disorder says to the nurse "did I cause my wife's illness? We haven't had any trauma in our marriage." The nurse knows the patient's diagnosis was likely caused by which of the following?
a. somatization
b. childhood emotional abuse
c. genetic predisposition
d. biological predisposition
c. childhood emotional abuse is most likely the cause of depersonalization.
Serotonin levels play a factor in impulse control and aggression.
True
False
True. Low serotonin activity may correlate with increased impulsive-aggressive behavior.
a. I am next in line to be the pope
b. I am so hungry, I could eat two meals
c. I couldn't sleep last night , but I'm still wide awake
d. I just ordered 6 new pairs of shoes
a, c, d
a. the client is suppressing his true feelings about the disorder
b. the client displays a "la belle indifference"
c. the client's needs have been met by this hospitalization
d. the client has decided not to disclose authentic fears
b. la belle indifference
It's a symptom of conversion disorder, also known as functional neurologic symptom disorder (FNSD) or hysteria, that describes a patient's apparent lack of concern about their symptoms, despite a serious medical illness or health condition. It's often described as a paradoxical absence of psychological distress.