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We've found 12 Central Nervous System Depressants tests
Central Nervous System Depressants
Illicit Drug Use
Long Term Effect
Motor Vehicle Crashes
Health Exam Cards Ch. 10 – Flashcards 50 terms

Livia Baldwin
50 terms
Preview
Health Exam Cards Ch. 10 – Flashcards
question
The percentage of people in the United States who do NOT use illicit drugs is
answer
91.1%
question
About 75 percent of people aged 12 or older have used an illicit drug during their lifetime.
answer
false
question
A drug is any substance, natural or artificial, other than food, intended to affect the structure or function of the body through its chemical action.
answer
true
question
Drugs are called pharmaceutical drugs when they are developed
answer
medical use
question
Which of the following routes of drug administration is the fastest way for a drug to reach the brain?
answer
through the nose
question
If a person's biochemical state is already altered by another drug, the effect of a drug can be changed.
answer
true
question
Which type of drug has effects similar to the response evoked during the fight-or-flight reaction?
answer
stimulants
question
Which of the following is a demand reduction strategy in the war on drugs?
answer
treatment
question
People who abuse heroin are at higher risk for all of the following health conditions EXCEPT
answer
colon cancer
question
Ativan is an anti-anxiety drug.
answer
true
question
Compared to other routes of administration, ___________________ is the most complicated way for a drug to enter the bloodstream.
answer
oral consumption.
question
Which of the following statements about the effects of drugs on the brain is FALSE?
answer
Parts of the brain involved in rational thought are not affected.
question
Paco has come to depend on heroin to be able to function normally. A few weeks ago, he attempted to cut himself off, but he experienced severe diarrhea. Paco's case illustrates which of the following concepts?
answer
withdrawal syndrome.
question
One indicator of physiological dependence is the development of
answer
tolerance
question
Neuroscientists have found that many addictive drugs, such as cocaine, marijuana, opiates, alcohol, and nicotine, affect a pleasure and reward circuit lying deep inside the brain.
answer
true
question
Drug abuse rates are lower among college graduates than among those with a high school diploma.
answer
true
question
Sheena is engaging in drug misuse when she
answer
ingests her brothers ritalin
question
Psychoactive drugs are substances that are used only for recreational purposes.
answer
false
question
Most drugs are taken
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orally
question
The route of administration may have a profound effect on the speed and efficiency with which a drug acts.
answer
true
question
Probably the most popular psychoactive drug is
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caffeine
question
Amphetamines fall under which category of drugs?
answer
stimulants
question
The majority of federal funds directed toward fighting the war on drugs is spent on
answer
domestic law enforcement.
question
Most experts agree that drug treatment should be a one-time, short-term process without relapses.
answer
false
question
Dependence on barbiturates and hypnotics is common among middle-aged and older adults who use these sedatives as sleep aids.
answer
true
question
Smoking or orally consuming marijuana gives you the munchies.
answer
fact
question
Drinking alcohol does in fact kill brain cells in an adult.
answer
myth
question
Drinking alcohol does warm you up a little bit.
answer
myth
question
Which of the following statements is TRUE about cocaine?
answer
Cocaine's effects appear almost immediately after a single dose and disappear within a few minutes.
question
Which of the following combinations/associations is NOT correct
answer
methamphetamine/panic attacks.
question
Which of the following is a possible long-term effect of marijuana?
answer
development of chronic bronchitis
question
LSD does not produce compulsive drug-seeking behaviors, and physiological withdrawal symptoms do not occur when use is stopped.
answer
true
question
Users can develop a tolerance to stimulants and experience serious withdrawal effects without becoming physically dependent on them.
answer
true
question
Which of the following, by definition, is(are) a drug(s)?
answer
nicotine, aspirin, and caffeine.
question
Which of the following is a term used to refer to a substance that causes changes in brain chemistry and alters consciousness, perception, mood, and thought?
answer
psychoactive drug.
question
When choosing an over-the-counter medication, it is best to choose a medication with a single ingredient targeted at your symptoms rather than a combination of ingredients.
answer
true
question
It is not necessarily safe to consume food or beverages containing grapefruit juice with any medication; grapefruit juice contains an enzyme that can raise levels of some medications in the blood.
answer
true
question
The FDA does have the power to remove an herbal remedy from the market if it has proven harmful.
answer
true
question
Although close, which of the following geographic regions in the U.S. does the text's graph report as having the highest rate of recent illicit drug use?
answer
the West
question
Surprisingly, the data in the text reports that "completely rural counties" in the U.S. have a higher recent percentage of illicit drug use.
answer
false
question
Which of the following is NOT considered a harm reduction strategy?
answer
incarceration
question
The most effective approaches to drug abuse prevention on college campuses include all of the following strategies, EXCEPT
answer
engaging the media.
question
More than half of the people in jail have been incarcerated for drug offenses.
answer
true
question
While most of the funding has been for supply reduction efforts, most of the data suggest that treatment is a more effective and cost-effective approach for reducing drug use.
answer
true
question
Harm reduction strategies are based on the same set of assumptions as supply and demand reduction strategies in the war on drugs
answer
false
question
What is the most commonly used illicit drug among persons aged 12 and older?
answer
marijuana
question
The highest rates of illicit drug use occur among adults aged.
answer
18-20
question
Abuse of which of the following genres of prescription medications jumped by 343 percent from 1993-2005?
answer
pain relievers.
question
In the United States, drug use is most prevalent in _______, while the lowest occurs in
answer
large metropolitan areas; completely rural counties.
question
Which of the following drugs has seen a dramatic increase in abuse by college students?
answer
perscription drugs
Central Nervous System Depressants
Nursing
Pharmacology
Primary Health Care
Primary Health Care Provider
Chapter 36, 37 – Flashcards 20 terms

Suzette Hendon
20 terms
Preview
Chapter 36, 37 – Flashcards
question
Which antihistamine causes sedation an adverse drug effect?
answer
Diphenhydramine
question
Which condition is characterized by enlargement of air spaces caused by the destruction of the alveolar walls?
answer
Emphysema
question
The nurse observes that a patient has moon face, acne, an increase in fat pads, and swelling. After checking the patient history, the nurse finds that the patient is taking methylprednisolone for bronchospastic disorder. What will the nurse infer from the assessment?
answer
The patient has Cushing's syndrome.
question
The nurse is teaching a patient who has asthma about the frequency of inhalation of salmeterol. Which statement by the patient indicates effective learning?
answer
"I will inhale it twice a day approximately 12 hours apart."
question
A patient reports to the nurse that after taking guaifenesin for 1 week, the productive cough still persists. What advice should the nurse give to the patient?
answer
"Consult your primary health care provider."
question
What interaction can occur when an asthmatic patient consumes rifampin along with xanthine derivatives?
answer
Theophylline levels are decreased. Xanthine derivatives are used as bronchodilators in asthmatic patients. Administration of rifampin along with xanthine derivatives causes increased metabolism of theophylline, which results in decreased levels of theophylline. Additive cardiac and central nervous system stimulation is produced when caffeine is administered along with theophylline.
question
A patient is prescribed tiotropium for the treatment of chronic obstructive pulmonary disease (COPD). How can the absorption of tiotropium be improved?
answer
By waiting for 1 to 2 minutes before inhaling the second dose
question
The nurse is teaching a patient about the use of an expectorant. What is the most important instruction for the nurse to include in the patient teaching?
answer
"Increase your fluid intake to decrease viscosity of secretions."
question
A patient is prescribed diphenhydramine for the treatment of an allergic disorder. After reviewing the patient's history, the nurse finds that the patient drinks alcohol. Why should the nurse instruct the patient to stop alcohol consumption?
answer
Alcohol increases central nervous system depression.
question
A patient is prescribed inhaled corticosteroids. Why should the nurse ask the patient to rinse the mouth after each dose?
answer
To prevent the development of oral candidiasis It is recommended that patients rinse their mouth immediately after use of the inhaler or nebulizer dosage forms of corticosteroids. It helps to prevent overgrowth of oral fungi and subsequent development of oral candidiasis (thrush). Dry mouth, nasal congestion, and sore throat are not side effects of corticosteroid inhaler use
question
Which anticholinergic effect is seen in a patient who takes brompheniramine?
answer
Dry mouth
question
Which drug will the primary health care provider prescribe for a patient who has nighttime insomnia and motion sickness?
answer
Diphenhydramine
question
What are the adverse effects of ipratropium and tiotropium therapy? Select all that apply.
answer
Headache Dry mouth Nasal congestion
question
A patient is prescribed disulfiram for alcohol abuse. During the assessment, the nurse finds that the patient is also taking echinacea for wound healing. What should the nurse instruct the patient to do?
answer
"Stop using echinacea."
question
Which antiasthmatic drugs work by preventing the inflammation commonly provoked by the substances released from mast cells?
answer
Corticosteroids
question
A patient taking an oral theophylline drug is due for the next dose and has a blood pressure of 100/50 mm Hg and a heart rate of 110 beats/min. The patient is irritable. What is the nurse's best action?
answer
Hold the next dose of theophylline and assess the patient.
question
Which antiasthmatic, available only for oral use, is approved for use in children 2 years of age and older?
answer
Montelukast
question
A patient presenting with cough is prescribed diphenhydramine. The nurse instructs the patient to avoid consuming alcohol. Which consequence of drug interaction with alcohol would be prevented if the patient follows the nurse's instructions?
answer
Central nervous system (CNS) depression
question
A patient complains of worsening nasal congestion despite the use of oxymetazoline nasal spray every 2 hours. What is the nurse's most appropriate response?
answer
"Overuse of nasal decongestants results in rebound congestion."
question
The nurse is assessing a patient with asthma. Which symptoms should the nurse expect to find in the patient? Select all that apply.
answer
Wheezing Chest tightness Shortness of breath
Central Nervous System
Central Nervous System Depressants
Central Nervous System Stimulant
Grade Point Average
Illicit Drug Use
Poor Self Esteem
Personal Health Final #3 – Flashcards 120 terms

Daniel Thompson
120 terms
Preview
Personal Health Final #3 – Flashcards
question
Carl's biggest health risk from his current pattern of drug use is
answer
Respiratory depression
question
Which drug is mostly associated with flashbacks
answer
LSD
question
All of the following are signs that a persons life may be centered on drugs, EXCEPT
answer
increased social activity
question
Small doses of amphetamines result in all of the following, EXCEPT
answer
improved complex motor skills
question
Ice is an
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amphetamine
question
Which of the following statements is false regarding drugs and crime?
answer
people under the influence of drugs are less likely to commit violent crimes than people who do not use drugs
question
Consequences of heavy marijuana use may include all of the following, EXCEPT
answer
increased progesterone levels
question
All of the following are depressants, EXCEPT
answer
methedrine
question
Bill has just taken ephedrine. He can expect
answer
all of these choices
question
Caffeine use
answer
counters fatigue
question
The term used by the American psychiatric association to refer to what is commonly called addiction is
answer
substance dependence
question
According to the text, the best solution to drug abuse is
answer
prevention
question
The ___ is the physical and social environment surrounding an individuals drug use
answer
setting
question
The most widely used illegal drug in the United States is
answer
marijuana
question
For someone to be diagnosed as drug dependent according to the American psychiatric association criteria, how many clusters of symptoms must they demonstrate in a one year timeframe
answer
5
question
Carl is showing signs of
answer
alcohol tolerance
question
Which of the following is NOT a CNS stimulant
answer
alcohol
question
What is the estimated annual cost of illegal drug use in the united states
answer
500billion
question
Which of the following could marijuana possible be used to treat
answer
side effects of chemotherapy
question
Amphetamines can do all of the following, EXCEPT
answer
improve complex thinking
question
Sudden death from cocaine may result from of all of the following, EXCEPT
answer
depressed central nervous system
question
In terms of drug use, setting means the
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social environment
question
Which of the following would not be considered a psychoactive drug
answer
aspirin
question
The time action function Is the relationship between
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when a drug is taken and the intensity of its effect
question
Which of the following drugs is an opioid
answer
codeine
question
Which of the following best describes the phenomenon known as state dependence
answer
information learned in a drug induced state is difficult to recall when not under the influence of the drug
question
When tomas does not drink alcohol, he has tremors and shakes. He is experiencing
answer
withdrawal
question
Which characteristic of addictive behavior indicates that an individual needs more and more of a particular substance
answer
escalation
question
A psychological risk factor for drug dependence is
answer
difficulty controlling impulses
question
Which of the following is not a risk factor for experimenting with drugs
answer
being an independent thinker
question
One reason that females usually become intoxicated more quickly than males because
answer
the stomach enzyme that metabolizes alcohol is less active in women than in men
question
Among college students , frequent binge drinkers are ___ times more likely to engage in unplanned sexual activity, drive after drinking, or get injured than non binge drinkers
answer
3-7
question
Which of the following is an effect of environmental tobacco smoke
answer
all of these choiced
question
Even though Rodney has not successfully quit smoking in the past, he would like to quit before he and lisa get married. All of the following strategies might help him quit, EXCEPT
answer
substituting spit tobacco for cigarettes
question
Which of the following is associated with cirrhosis
answer
replacement of liver cells with scar tissue
question
Initial effects of low concentrations of alcohol include all of the following, EXCEPT
answer
sleepiness
question
What percentage of pregnant women are binge drinkers during their pregnancy
answer
10 percent
question
A component of tobacco smoke that seriously limits the body's ability to use oxygen is
answer
carbon monoxide
question
Which of the following is the most accurate description of the safe limit of alcohol consumption during pregnancy
answer
one drink per week during the first trimester
question
People who quit smoking suddenly may have all of the following symptoms. EXCEPT
answer
increased attentiveness
question
Which of the following statements is true concerning alcohol use
answer
Health benefits from alcohol are negated by heavy
question
The main site of alcohol metabolism is in the
answer
liver
question
Cardiovascular benefits from moderate alcohol consumption may be due
answer
increased levels of HDL cholesterol
question
Which of the following statements is FLASE
answer
nicotine is considered a powerful depressant
question
A 20 proof beverage is ___ percent alcohol
answer
40
question
On average, a regular user of tobacco can go how long between dosages of nicotine
answer
no more than 40 minutes
question
Which of the following statements is FALSE regarding coronary heart disease and smoking
answer
smokers have a death rate from CHD that is 25 percent higher than non smokers
question
Which of the following statements about alcohol related pancreatitis is TRUE
answer
Jaundice is an early sign of pancreatitis
question
Which of the following lingers in the bloodstream for 5 hours after exposure to environmental tobacco smoke
answer
carbon monoxide
question
At what blood alcohol concentration is pain perception significantly impaired
answer
0.15-0.30 percent
question
The effects of fetal alcohol syndrome are
answer
both physical and mental impairments
question
Lynette has quit smoking. She can expect all of the following changes to occur, EXCEPT
answer
a lack of improvement in circulation
question
Negative consequences associated with binge drinking include
answer
all of the above choices
question
A heart attack is also called
answer
a myocardial infarction
question
What would be the estimated blood alcohol concentration for a person who is experiencing emotional instability with exaggerated feelings and behavior
answer
0.05-0.10 percent
question
What role does ammonia play in cigarettes
answer
it boosts the amount of nicotine they deliver
question
Which of the following is not a major form of spit tobacco
answer
cloves
question
What are the estimated hours required to metabolize a BAC of .05 percent
answer
4-6 hours
question
Respiratory cilia
answer
keep air passages free of dust and soot
question
Which of the following would probably not be a sign of impending alcohol abuse
answer
drinking moderate amounts with most evening meals
question
Jonas is having severe chest pains with shortness of breath that has not subsided within the last ten minutes. He should
answer
have someone take him to the nearest emergency room
question
Western medicine traditionally relies on the use of ___ to treat and cure diseases
answer
pharmaceuticals
question
You should always consult with a doctor before taking an over the counter medication if you
answer
are pregnant
question
The most commonly used form of manual healing is
answer
chiropractic
question
Biofield therapies are based around energy fields thought to originate from the
answer
body of the patient
question
Which of the following types of health insurance requires a primary care physician
answer
health maintenance organization
question
Which of the following Is not a purpose or condition for which consumers are likely to turn to complementary and alternative medicine
answer
bone fractures
question
Which of the following is a guideline for sale self medication
answer
when buying a medication for the first time, buy the brand name version
question
Reiki is an example of which of the following domains of complementary and alternative medicine practice
answer
energy therapy
question
Which of the following describes the process of drug development
answer
it may take 12 years or more
question
Which of the following is true of managed care plans
answer
they restrict which physicians patients may use
question
What over the counter medication should you not give to children with flu like symptoms
answer
aspirin
question
Which of the following best describes symptoms you should check with a physician about
answer
recurrent
question
Which of the following is a product of Western medicines belief that illness is caused by outside factors
answer
the scientific method
question
A government health insurance program for americans over age 65 is
answer
medicare
question
Which of the following best describes generic drugs
answer
they generally cost much less brand name drugs
question
Why should consumers exercise caution when choosing a CAM therapy
answer
not all CAM practices have been scientifically evaluated for safety
question
In traditional Chinese medicine, the life force contained in all living things is called
answer
qi
question
Which of the following herbals may have severe interactions with nonsteroidal anti inflammatory drugs or anticoagulants
answer
ginkgo
question
Fatima has had a cough for several weeks. Which of the following is likely to be Fatima best option for addressing this symptom
answer
calling her physician
question
Western researchers might explain the effects of acupuncture as being the result of
answer
releasing hormone and neurotransmitters
question
Which of the following describes data based on evidence gathered by the senses and via systematic observations
answer
empirical
question
Which of the following best describes homeopathy
answer
its remedies have not been shown to have serious adverse effects
question
The purpose of bioelectromagnetic based therapies is to help patients
answer
manage pain
question
The CAM therapy that involves the use of highly diluted extracts is
answer
homeopathy
question
Marc has had a fever for two days. Which of the following is likely to be marcs best option for addressing this symptom
answer
treating the illness himself
question
If cara consults a physician based on her insurance plan she should contact
answer
the primary care physician assigned by her health maintenance organization
question
Which of the following is a sign that an online pharmacy may not be safe to purchase medication from
answer
it sells medications that have not been approved by the fda
question
Which of the following describes the state of health care in the united states
answer
as many as 50 million Americans to not have health insurance
question
Which of the following is listed first on an fda drug label
answer
active ingredients
question
The most common form of elder abuse is
answer
financial exploitation
question
Which of the following is a societal risk factor for interpersonal violence
answer
availability of firearms
question
Which of the following is a strategy for preventing fire injuries
answer
take short, shallow breaths, preferably through a wet cloth
question
Which of the following is a way to reduce the risk of motorcycle and motorized scooter injuries
answer
choose a helmet with a faceshield
question
Which of the following is not one of the four major classes of unintentional injuries
answer
private
question
The most common motivating bias in hate crimes is
answer
ethnicity
question
Which of the following is an effective way to avoid being stalked on the internet
answer
using a fake name in a chat room
question
Unintentional injuries are the leading cause of death of americans
answer
under age 45
question
Marias best friend was raped just hours ago. what advice should maria give her
answer
write down everything you remember and call the police
question
Which of the following statements best describes air bags
answer
They come standard on all new vehicles
question
What government entity deals with sexual harassment complaints
answer
equal employment opportunity commision
question
Which of the following is a safe cycling strategy
answer
using lights and reflectors, especially at night or in dark areas
question
Which of the following is not a recommendation for safe lifting
answer
bend at the waist
question
Which of the following is the best strategy for avoiding data range drugs
answer
getting a new drink after leaving the old one unattended
question
Firearms are used in ___ % of workplace homicides
answer
more than 80
question
The Heimlich maneuver helps to
answer
clear the airway
question
Women ages ___ have higher rates of nonfatal injuries than men in the same age range
answer
75-84
question
Which of the following is the only type of automobile crash in which front air bags provide substantial protection
answer
Head on collision
question
The use of electronic communications to repeatedly harass or threaten another person is known as
answer
cyberstalking
question
Salome thinks she is being sexually harassed at work. She should
answer
confront the harasser in person
question
Which of the following is not a factor that contributes to date rape
answer
androgynous view of sexually
question
Which of the following is the most likely explanation for the colleges low incidence of reported date rape
answer
most cases of date rape are not reported
question
Which of the following is a benefit of safety belt use
answer
prevention of being thrown from the car
question
Prevents who abuse their children tend to
answer
believe in physical forms of punishment
question
Which of the following is not a strategy for preventing motor vehicular injuries
answer
avoiding interstate highways
question
The recommended minimum age for front seat passengers in vehicles with air bags is
answer
13 years
question
What percentage of schools report no incidents of serious violence
answer
90%
question
Which of the following is the first step in providing emergency care
answer
Check to see if the situation is safe for you and the injured person
question
Which of the following workers is most likely to suffer a work related injury
answer
laborer
question
Which of the following substances has the least potential to impair driving
answer
vitamin supplements
Central Nervous System Depressants
Deep Breathing Exercises
Mental Health Nurse
Nursing
Psychology
Selective Serotonin Reuptake Inhibitors
PrepU Chapter 14, PrepU Chapter 14 combo – Flashcards 173 terms

August Dunbar
173 terms
Preview
PrepU Chapter 14, PrepU Chapter 14 combo – Flashcards
question
Increased blood pressure
answer
The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client? Vasodilation of peripheral blood vessels Increased blood pressure Decrease in blood glucose levels Pupil constriction
question
Providing the client with a comforting touch
answer
A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate? Providing the client with a comforting touch Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
question
Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
answer
A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply. Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback Using restraint when panic develops
question
assessing the client's ability to implement stress management techniques effectively
answer
Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client's ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
question
selective mutism is associated with social anxiety
answer
A school health nurse is meeting with the parents of a 6-year-old child who has been selectively mute. The nurse is offering the parents education regarding this problem. The nurse can tell the parents that what is true about selective mutism? selective mutism is associated with social anxiety parenting does not play a role in selective mutism selective mutism arises from child abuse children with selective mutism should be home-schooled.
question
Deep breathing
answer
A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what? Cognitive therapy Deep breathing Desensitization Problem-solving
question
"What kind of relationship do you have with your parents?"
answer
The client reports that the client feels anxious when interacting socially with others and "never seems to know what to say." Which question indicates the nurse has a sound understanding of interpersonal theory as it relates to anxiety? "What kind of relationship do you have with your parents?" "Do other members of your family have similar problems?" "How long have you experienced these problems?" "What have you tried to help manage your feelings and discomfort?"
question
Compulsion
answer
A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior? Compulsion Phobia Obsession Derealization
question
Client will adapt relaxation techniques to reduce stress.
answer
The nurse walks into the client's room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, "I am so scared. I have never known anyone who goes into a hospital and comes out alive." On this client's care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client? Client will adapt relaxation techniques to reduce stress. Client will be stress free. Client will avoid stressful situations. Client will start antianxiety agent.
question
"The client taps her fingers very rapidly when she is feeling anxious."
answer
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack? "The client taps her fingers very rapidly when she is feeling anxious." "I discourage her finger tapping since it serves to increase her anxiety level." "She knows that if she taps her fingers she will be able to lessen her anxiety." "I can tell that the more she taps, the less anxiety she is actually feeling."
question
6 months
answer
Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least ... 6 months 2 months 12 months 4 months
question
Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
answer
The nurse is caring for a client who is being treated in the emergency department for a panic attack. Which nursing intervention would be most appropriate? Demonstrate empathy for the client by trying to mimic the client's state of anxiety. Tell the client that the nurse must leave to go report the client's symptoms to the psychiatrist on duty. Tell the client this is an acute exacerbation with a positive prognosis and low morbidity. Stay with the client, emphasizing that the client is safe and that the nurse will remain with the client.
question
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
answer
The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve? The use of progressive tensing and relaxing of muscles to release tension in each muscle group Using a positive self-image to increase and intensify physical workouts in the gym, which decreases stress The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations The use of music and humor to create a calm and relaxed demeanor, which allows escape from stressful situations
question
The client would have an enhanced sense of security.
answer
A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer. The client would return to rational thought. The client would have an enhanced sense of security. The client would be able to demonstrate relaxation techniques. The client would be able to understand what the nurse is saying.
question
Staying with the client and speaking in short sentences
answer
Which would be an appropriate intervention of a client experiencing a panic attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music loudly
question
"Has something changed at work that is causing you to worry?"
answer
A client with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic? "It sounds to me like you're doing a good job." "Your worries are a feature of your anxiety disorder. Tell yourself that you have nothing to worry about." "Has something changed at work that is causing you to worry?" "Why do you think you'll be fired?"
question
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
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Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition? Reviewing the client's previous medication administration record and the client's current list of medications Questioning the client about the clinician who first diagnosed the medical problem Asking the client to provide a detailed explanation of his or her medical problem to determine if the presentation is typical of the problem Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
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Assisting the client with deep-breathing exercises
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A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest? Leaving the client's door open so the client can see into the hallway Assisting the client with deep-breathing exercises Offering the client a cup of tea Encouraging the client to take prescribed sedatives daily
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Adaptation
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What is the term for the change that takes place in response to a stressor? Rehabilitation Adaptation Positive movement Negative movement
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Specific phobia
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Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Specific phobia Posttraumatic stress disorder Obsessive-compulsive disorder Generalized anxiety disorder
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Concomitant use of alcohol
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Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
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Stay with the client while remaining calm.
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A client who has been diagnosed with panic disorder visits the clinic and experiences a panic attack. The client tells the nurse, "I'm so nervous. My hands are shaking, and I'm sweating. I feel as if I'm having a stroke right now." What would be the priority intervention at this time? Stay with the client while remaining calm. Move the client to a safe environment. Tell the client that the attack will soon pass. Teach the client deep breathing techniques to calm the client.
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The client is nervous and agitated.
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The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety? The client is focused in an activity. The client is nervous and agitated. The client has impaired cognitive skills. The client is unable to communicate verbally.
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depersonalization.
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A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as: depersonalization. derealization. decatastrophizing. demonstrating automatisms.
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"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."
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The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention? "Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life." "With the development of more life skills and a demonstration of continued success in life, your anxiety will shrink and eventually disappear." "Every time you feel anxious, try to focus on how much easier your life would be if you didn't experience anxiety so often." "If you address the causes of your anxiety head-on, you will find that you can recover from it without medications or therapy."
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Panic disorder
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The nurse has read in a client's admission record that the client has been taking propranolol for psychiatric, rather than medical, reasons. The nurse should recognize that the client likely has a history of which mental health condition? Obsessive-compulsive disorder (OCD) Panic disorder Acute stress disorder Nightmares
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"When I have a problem, I just deny it until it goes away."
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Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms? "I'm thankful that I have a way to manage my problems." "Defense mechanisms provide a sense of control over the uncontrollable." "I'm not sure when I'm actually using a defense mechanism." "When I have a problem, I just deny it until it goes away."
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Pacing and repeatedly asking staff what time the "doctor will be here."
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The nurse can document correctly that a client diagnosed with an anxiety disorder is experiencing moderate anxiety when the nurse observes the client doing what? Pacing and repeatedly asking staff what time the "doctor will be here." Reporting, "I just can't relax; I've got things to do." Telling another client that "there is nothing they can do for me; I just know it's really bad." Demonstrating difficulty actually verbalizing anxious feelings
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Tearfulness and sadness
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All except which are considered clinical symptoms of anxiety? Palpitations Extreme restlessness Motor excitement Tearfulness and sadness
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Selective serotonin reuptake inhibitors (SSRIs)
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Which medication classification has been used to treat social phobia? Selective serotonin reuptake inhibitors (SSRIs) Monoamine oxidase inhibitors (MAOIs) Tricyclic antidepressants (TCAs) Nonbenzodiazepines
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The nurse should speak in short and simple sentences.
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In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention? The nurse should speak in short and simple sentences. The nurse should remain with the client until the anxiety is reduced. The nurse should speak in a soft and calm voice. The nurse should take the client to a nonstimulating environment.
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Allow the client to pace
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A client is currently experiencing panic. Which acation would be most appropriate for the nurse to do? Allow the client to pace Ask the client repeated questions about feelings Employ the use of negative self-talk Urge the client to engage in vigorous exercise
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Determine the client's risk for self-harm or harm to others
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When assessing an elderly client who has newly been diagnosed with an anxiety disorder, the mental health nurse's priority is to carry out which task? Determine the client's risk for self-harm or harm to others Obtain a thorough history, focusing on the client's physiologic functioning Assess for physical conditions that may affect anxiety Determine the effects that culture has had on the client's anxiety issues
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Mild
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A client reports the client is beginning a new job and is feeling anxious about the client's performance. The nurse can explain which type of anxiety can actually improve functioning? Mild Moderate Severe All anxiety decreases functioning
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Anticipatory anxiety
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A client has sought treatment because of the overwhelming anxiety the client experiences regarding the safety of the client's young children. The client admits that the client will not normally let the client's children leave the client's sight for fear that they will be abducted, abused, or injured. The client is unable to function at work as a result of this anxiety. The nurse would recognize that this client experiences which condition? Signal anxiety Fear Derealization Anticipatory anxiety
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Mild
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During which type of anxiety does a person's perceptual field actually increase? Mild Moderate Severe Panic
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Establishing daily routines of meals and sleeping
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Nursing interventions for physical stress related illness should include what? Assessing the need for increased dose of benzodiazepines Attending group therapy Establishing daily routines of meals and sleeping Fostering use of a social support system
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40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months
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The nurse recognizes that who is the client most likely experiencing generalized anxiety disorder (GAD)? 40-year-old who has reported numerous absences from work, muscle aches, and difficulty falling asleep for the last 8 months 22-year-old soldier who served in the Middle East who "cannot sleep" and is facing criminal charges for hurting someone in a barroom brawl 70-year-old whose spouse died 1 year ago who has "no desire to leave my house" and reports severe fatigue 30-year-old business executive who reports being anxious about attending the meetings and social events that are the executive's job responsibilities
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Antidepressants
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Which medication classification has been found to be effective in reducing or eliminating panic attacks? Antidepressants Anticholinergics Antipsychotics Antimanics
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The client is often late to school and makes poor grades in most of the client's subjects.
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Which factor has the least influence on achieving mental health for the client who has anxiety disorder? The client's mother also suffered from an anxiety disorder. The client was raised in a household with high stress and frequent geographic moves. The client's mother often related to the client in ways that reflected the mother's high level of anxiety. The client is often late to school and makes poor grades in most of the client's subjects.
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Tearfulness
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A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what? Palpitations Extreme restlessness Motor excitement Tearfulness
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Women experience anxiety disorders more often than do men.
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A group of students is reviewing information about anxiety disorders in preparation for a class examination. The students demonstrate understanding of the material when they state what? Anxiety disorders rank second to depression in psychiatric illnesses being treated. Women experience anxiety disorders more often than do men. Most anxiety disorders tend to be short term with individuals achieving full recovery. Anxiety disorders are more common among children than among adolescents.
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Dry mouth Blurred vision Constipation
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A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply. Agitation Dry mouth Blurred vision Constipation Vomiting
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Moderate
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The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that the client is about to die. The nurse would classify this level of anxiety as what? Moderate Euphoria Mild Severe
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Coping mechanisms
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Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations? Coping mechanisms Ability to ignore symptoms Previous experience Communication skills
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Mild
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Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself? Mild Moderate Severe Panic
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Intense worry and stress about work or simple family life
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A group of students is reviewing information about the etiology of generalized anxiety disorder (GAD). The students demonstrate understanding of this information when they identify which as representing the bases for this disorder? Inaccurate environmental danger assessment Exposure to multiple stressful life events Kindling caused by overstimulation Intense worry and stress about work or simple family life
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The client is aware and alert
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A nurse assesses a client and determines that the client is experiencing mild anxiety based on what? The client is selectively inattentive The client is aware and alert The client has focused attention on a small area The client voices feelings of unreality
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In GAD, the person usually does not experience eruptions of acute anxiety.
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Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder? In panic disorder, the person suffers from a chronic state of elevated anxiety. Panic disorders are more easily treated than GAD. In GAD, the person usually does not experience eruptions of acute anxiety. GAD is characterized by occasional, unexpected panic attacks.
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Is conducive to concentration and problem solving
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An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what? Will interfere with her cognitive abilities Is conducive to concentration and problem solving May be transferred to her tutor and result in test anxiety Is pathologic and warrants postponing the test
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Going to a crowded, outdoor market independently
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A 21-year-old client has been recently diagnosed with agoraphobia. Which situation is most likely to cause the client anxiety? Having a blood sample drawn and experiencing mild pain Going to a crowded, outdoor market independently Having the client's work performance closely scrutinized by a supervisor Gaining 5 pounds and being unable to exercise vigorously
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Based in genetics with clinical symptoms being a result of chromosomal influence
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A biologic theory explains anxiety disorders in which way? Based in genetics with clinical symptoms being a result of chromosomal influence Rooted in episodes of physical or psychological abuse that occurred at times of developmental growth Originated from disappointments resulting from an exaggerated sense of self-worth Caused by substance abuse, particularly narcotics, resulting in damage to the brain's receptors
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Imipramine
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Which is considered a tricyclic antidepressant (TCA) used in the treatment of clients with panic disorder? Imipramine Fluoxetine Sertraline Lorazepam
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Sympathetic nervous system
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When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger? Parasympathetic nervous system Sympathetic nervous system Motherly response system Central nervous system
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Headache
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The nurse is assessing a client with anxiety. What symptom indicates that the the client has adopted a maladaptive behavior in response to stress? Tachycardia Dyspnea Headache Pedal edema
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Individuals may believe they are having a heart attack when a panic attack occurs.
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The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder? Individuals may believe they are having a heart attack when a panic attack occurs. People with panic attacks often have fewer attacks if they also have agoraphobia. Typically, individuals experience this disorder after the age of 30 years. Persons rarely have an underlying comorbid condition of depression.
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The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal."
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The nurse can be confident that the admitted client diagnosed with an anxiety disorder will respond well to treatment when the client which of the following conditions are present? The client states, "I understand what I need to do, and I'm ready to do it so I'm back to normal." The client has a family that is truly willing and capable of supporting him during the treatment The client readily agrees to immediately notify the mental health care team if symptoms reoccur after discharge The client has a no history of other psychiatric disorders
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an Asian American client
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Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse? a Native American client a African American client an Asian American client an Arab American client
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25%
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Nearly what percentage of adults are affected by anxiety disorders? 10% 25% 40% 55%
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Antidepressants
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Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what? Antidepressants Anticonvulsants Antipsychotics Central nervous system depressants
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"Do you have any problems going out alone to public places?"
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The nurse is assessing a client who recently experienced the client's first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask: "Do you have any problems going out alone to public places?" "What do you think is the origin of the panic you felt?" "Can you describe how you felt physically during the attack?" "Are you concerned there will be more panic attacks?"
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Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress
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When explaining the difference between anxiety and fear, the mental health nurse shares what? Select all that apply. Anxiety involves experiencing subjective, uncomfortable feelings resulting from unknown causes Fear results in objective, physical responses caused by real danger Anxiety is likely to result from an attempt to overcome stress People who experience anxiety tend to use maladaptive coping mechanisms Obsessive-compulsive behavior is often the result of abandonment
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Systematic desensitization
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A client who experiences panic anxiety around dogs is sitting in a room with a dog and the client's nurse therapist. The nurse therapist is using which behavioral intervention for this type of anxiety? Systematic desensitization Implosion therapy Relaxation exercise Biofeedback
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Safety
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Which is the primary concern for a client with panic-level anxiety? Safety Emotional needs Physiologic needs Social support
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Compulsion
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A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior? Compulsion Phobia Obsession Derealization
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"Anxiety is a sense of psychological distress."
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A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, "My partner tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which response would be most appropriate for the nurse to provide about the nature of anxiety? "Anxiety is an abnormal response to everyday stress." "Anxiety is a sense of psychological distress." "Anxiety is a physiologic response to stress." "Anxiety is a normal response to everyday stress."
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Concomitant use of alcohol
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Clients taking benzodiazepines need education about what? Avoiding cheeses and smoked meats Interactions with monoamine oxidase inhibitors (MAOIs) Avoiding spending too much time in the sun Concomitant use of alcohol
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A systematic way to replace a panic response with a relaxation response
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What does desensitization refer to? A systematic way to replace a panic response with a relaxation response A cognitive technique for replacing a worry with a positive statement Exposing the client to an anxiety-producing stimulus for 1 to 2 hours (flooding) Teaching the client to ignore or become immune to anxiety-producing situations
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Medications
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When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of what? Cognitive deficits Organic brain changes Medications Fluid and electrolyte imbalances
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Inform the client that the assessment can be postponed if the client is finding it overwhelming.
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During the admission assessment of a 27-year-old client who has been diagnosed with an anxiety disorder, the nurse observes that the client is becoming increasingly restless and agitated. How should the nurse respond to this development? Inform the client that the assessment can be postponed if the client is finding it overwhelming. Increase the speed of the assessment in order to ensure that it is completed sooner and inform the client that the nurse is doing so. Provide education regarding the level of anxiety that the client may be experiencing. Explain to the client that the client's current feelings of anxiety have the potential to foster better coping skills in the future.
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Adaptive coping strategies
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The most important factor in the person's stress response is what? Strength of the immune system Supportive friends Relaxation techniques Adaptive coping strategies
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To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
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The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client's mild anxiety during the session positively, because mild anxiety helps what? Select all that apply. To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity To calm restlessness
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There is evidence of a substantial familial predisposition to panic disorder
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A nurse is talking with a client who has experienced panic attacks. The client asks the nurse, "What causes these attacks?" Which information would the nurse most likely integrate into the response about the etiology of panic disorders? There is evidence of a substantial familial predisposition to panic disorder Neurologic abnormalities are a rare occurrence with panic disorder The link between panic disorders and neurotransmitters is lacking There is a strong evidence supporting a psychodynamic influence
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assess for depression
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Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety? assess for depression assess for panic attacks assess for elder abuse assess for dementia
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assessing the client's ability to implement stress management techniques effectively
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Which nursing intervention is focused on the primary goal of anxiety management and treatment? assessing the client's ability to implement stress management techniques effectively helping the client identify ways to eliminate all sources of stress in his or her daily life educating the client concerning the use of medications to manage anxiety disorders assessing the client for possible symptoms of panic disorder
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Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe.
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A nurse is seeing a client prior to discharge after being admitted to hospital for suicidal ideation. As the nurse begins the discharge process, the client closes the eyes and begins rapid, shallow breathing. The client also begins to shake and perspire profusely. Which actions should the nurse take? Select all that apply. Talk to the client in a comforting manner. Take the client to a quiet space. Reassure the client of being safe. Ask the client to spend some time alone. Assess the client for suicidal ideation.
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Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client
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A nursing role in providing client education regarding panic disorder includes which of the following? (Select all that apply.) Introduction of appropriate coping skills Identification of alternate treatment modalities Involving family and support persons when appropriate Providing feedback to support the client Adjustment of treatment plan when indicated
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Excessive worry or anxiety lasting more than 6 months
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Generalized anxiety disorder (GAD) is characterized by what criteria? Excessive worry or anxiety lasting more than 6 months Flashbacks and feelings of unreality Fear of going outdoors Behavioral changes in response to panic attacks
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The client has no adaptive coping mechanisms.
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A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client? The client is probably physically dependent on alcohol. Drinking alcohol is more socially acceptable than taking medications. The client has no adaptive coping mechanisms. A few glasses of wine each night is not necessarily a problem.
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Benzodiazepines
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Which medication classifications used in the treatment of panic disorder can cause physical dependence? Benzodiazepines Selective serotonin reuptake inhibitors (SSRIs) Tricyclic antidepressants (TCAs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
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The client has heightened awareness.
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The nurse understands that a certain level of anxiety is required in a client for effective learning. Which anxiety-related symptom indicates the client may be able to learn effectively? The client is trembling. The client is speaking in a high-pitch voice. The client has heightened awareness. The client has increased muscle tension.
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Resistance
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A client experiencing stress has tachycardia and tachypnea. On the basis of the physiological model of the general adaptation syndrome, in which stage is this client? Stress Alarm reaction Resistance Exhaustion
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Touching the client in an attempt to comfort the client
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After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention? Touching the client in an attempt to comfort the client Providing the client with a safe, quiet, and private place Encouraging the client to verbalize feelings and concerns Approaching the client in a calm, confident manner
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Social anxiety disorder
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A 30-year-old client who has been unemployed secondary to the client's anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what? Social anxiety disorder Agoraphobia Obsessive-compulsive disorder Panic disorder
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Heart racing Hypertension
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A nurse is assessing a client with anxiety. Which signs and symptoms would the nurse attribute to sympathetic nervous stimulation? Select all that apply. Pressure to urinate Fainting Heart racing Hypertension Bradycardia
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Administer the prescribed PRN anxiolytic medication.
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A client approaches the nurse on an inpatient psychiatric hospital unit crying, trembling, and feeling nauseous. The client states, "I've tried everything, I still feel so anxious." Which action by the nurse would be most appropriate? Direct the client to continue deep breathing. Take the client on a walk around the unit. Take the client to the dayroom as a distraction. Administer the prescribed PRN anxiolytic medication.
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flooding
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A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. This activity is repeated continuously until the client's fear subsides. Which strategy is being used to treat the client's specific phobia? systematic desensitization flooding decatastrophizing assertiveness training
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Staying with the client and speaking in short sentences
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Which would be an appropriate intervention for a client experiencing an anxiety attack? Staying with the client and speaking in short sentences Turning on the lights and opening the windows so that the client does not feel crowded Leaving the client alone Turning on stereo music
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Touching the client in an attempt to comfort the client
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Which would not be an initial intervention for the client with acute anxiety? Touching the client in an attempt to comfort the client Use of open-ended communication techniques Encouraging the client to verbalize feelings and concerns Maintaining a nonstimulating environment
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Phobic disorders
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Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger? Phobic disorders Posttraumatic stress disorder Obsessive-compulsive disorder Stress disorders
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Coping mechanism
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A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior? Defense mechanism Coping mechanism Caregiver burden Crisis
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interpersonal
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A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client's anxiety? interpersonal behavioral neurochemical genetic
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Heart attack
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While conducting a class on anxiety and stress reduction, a nurse describes the symptoms of anxiety (including panic), informing the class that the physical symptoms of a panic attack can mimic what? Stroke Gastrointestinal flu Heart attack Appendicitis
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Move the client to a quiet environment.
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When a client is experiencing panic, which is the priority intervention? Give the client medication immediately. Move the client to a quiet environment. Offer the client therapy to calm down. Physically restrain the client.
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The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now."
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A client is experiencing moderate anxiety. Which manifestation would the nurse most likely observe? Select all that apply. The client can sustain attention on a particular focus. The client verbally states, "For some reason, I am feeling anxious now." The client has flights of ideas and confusion. The client makes distorted inferences because of inadequacy of observed data. The client may pace, run, or fight violently if asked to perform a task the client does not want to perform.
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mild
answer
An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing? mild moderate severe panic
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Severe
answer
A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety? Mild Moderate Severe Panic
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somatic symptoms.
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A nurse is seeing a client in the emergency department who repeatedly presents with gastrointestinal discomfort. Despite exhaustive medical investigations, there are no significant medical findings to explain the discomfort. The nurse should suspect: endocrine dysfunction. chronic obstructive pulmonary disease. heart disease. somatic symptoms.
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"People with anxiety disorders generally find that the anxiety interferes with daily activities."
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A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best? "People with anxiety disorders experience a fight-or-flight response when threatened." "People with anxiety disorders generally find that the anxiety interferes with daily activities." "Normal anxiety does not result in feelings of dread or restlessness." "Normal anxiety occurs in response to everyday stressors."
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gastrointestinal upset.
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The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: gastrointestinal upset. sedation. vertigo. skin rash.
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Selective serotonin reuptake inhibitor (SSRI)
answer
A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer? Benzodiazepine Selective serotonin reuptake inhibitor (SSRI) Monoamine oxidase inhibitor (MAOI) Tricyclic antidepressant (TCA)
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Tachycardia
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Which is a cardiovascular response of the sympathetic nervous system? Tachycardia Bradypnea Hypotension Bradycardia
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Epinephrine
answer
A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release? Endorphins Dopamine Epinephrine Testosterone
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Lorazepam
answer
A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what? Lorazepam Duloxetine Escitalopram Fluvoxamine
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"How do you feel about everything that is happening in your life right now?"
answer
Which question in the assessment of a client with anxiety is most clinically appropriate? "What can I give you to make you feel less anxious right now?" "Does your anxiety make you feel less valuable and competent as a person?" "Do you think that you're justified in feeling anxious right now?" "How do you feel about everything that is happening in your life right now?"
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Coping mechanism
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A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor? Adaptation Homeostasis Coping mechanism Defense mechanism
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Deep breathing
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A client comes in for a therapy session and begins to have a panic attack. The therapist asks the client to relax in the chair and then gently asks the client to imagine the client in a very safe and calm place. This technique, often useful in anxiety disorders, is called what?
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Touching the client in an attempt to comfort the client
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Which would not be an initial intervention for the client with acute anxiety?
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Social phobia
answer
A 30-year-old client who has been unemployed secondary to anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?
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"Has something changed at work that is causing you to worry?"
answer
A client with generalized anxiety disorder states that the client is worried about the client's job. The client never feels like the client has control over the client's responsibilities, even though the client puts in extra hours. The client adds that the client is afraid the client will be fired. Which response by the nurse is most therapeutic?
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Reduction of autonomic arousal
answer
Relaxation techniques help clients with anxiety disorders because they can promote what?
question
Is conducive to concentration and problem solving
answer
An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. The nurse explains that this level of anxiety does what?
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Educate the client that this medication has a high risk for withdrawal symptoms, and the client should not discontinue without a doctor's supervision.
answer
In teaching a client who has been prescribed a benzodiazepine for panic disorder, the nurse must be certain to do what?
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"How do you feel about everything that is happening in your life right now?"
answer
Which question in the assessment of a client with anxiety is most clinically appropriate?
question
Establishing whether the client's anxiety preceded the medical problem or whether the medical problem appeared first
answer
Which assessment question is most likely to allow the nurse to differentiate between anxiety disorder due to a general medical condition and psychological factors affecting a medical condition?
question
Benzodiazepines
answer
Which medication classifications used in the treatment of panic disorder can cause physical dependence?
question
The mindful use of a word, phrase, or visual image, which allows oneself to be distracted and temporarily escape from stressful situations
answer
The nurse at the student health center is seeing a group of nursing students who are interested in reducing their stress level. The nurse identifies guided imagery as an appropriate intervention. What does guided imagery involve?
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Coping mechanism
answer
A young parent tells the nurse, "I can't stop smoking. That is what I do to make myself feel better." What is the term used to describe this behavior?
question
The nurse should speak in short and simple sentences.
answer
In speaking with a client with moderate anxiety, the client becomes tangential discussing unrelated topics. To help the client's attention from wandering, which is an effective intervention?
question
Staying with the client and speaking in short sentences
answer
Which would be an appropriate intervention of a client experiencing a panic attack?
question
Touching the client in an attempt to comfort the client
answer
After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?
question
Social anxiety disorder
answer
A 30-year-old client who has been unemployed secondary to the client's anxiety disorder states that the client would like to have a job where the client is alone and no one needs to evaluate the client's work. The nurse interprets these comments as an indicator of what?
question
Providing the client with a comforting touch
answer
A nursing instructor is describing the care of a client with acute anxiety to a class of nursing students. The instructor determines that more education is necessary when the students identify which intervention as appropriate?
question
Specific phobia
answer
Which condition involves a persistent, irrational fear attached to an object or situation that objectively does not pose a significant danger?
question
mild
answer
An adolescent who is seeing the school health nurse states, "I won't be able to hang out with my friends on Friday night because I have two essays due Monday." What level of anxiety is the adolescent experiencing?
question
flooding
answer
A client with a specific phobia of spiders is seeing a therapist for the first session of treatment. The therapist hands the client a clear container with a large house spider inside. Which strategy is being used to treat the client's specific phobia?
question
Compulsion
answer
A client spends hours stacking and unstacking towels. The client is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?
question
"People with anxiety disorders generally find that the anxiety interferes with daily activities."
answer
A nurse is giving a presentation on mental health promotion to college students. One student asks the nurse to explain the difference between normal anxiety and an anxiety disorder. Which response is best?
question
The client has no adaptive coping mechanisms.
answer
A client reports the client has been experiencing increased stress at work. The client has been managing the stress by drinking 2-3 glasses of wine per evening. Despite the nurse recommending that drinking alcohol is not an effective way to manage the stress, the client reports it is unlikely that the client will be able to stop. Which statement explains why this will be difficult for the client?
question
A woman who has been taking lorazepam for several months after witnessing a traumatic motor vehicle accident
answer
Which client is most likely to be at risk for drug dependence and difficulties with withdrawal?
question
"What did you experience just before and during the attack?"
answer
A client comes to the emergency department because the client thinks the client is having a heart attack. Further assessment determines that the client is not having a heart attack but is having a panic attack. When beginning to interview the client, which question would be most appropriate for the nurse to use?
question
Selective serotonin reuptake inhibitor (SSRI)
answer
A nurse is developing a plan of care for a client with panic disorder that will include pharmacologic therapy. Which would the nurse most likely expect to administer?
question
Increased blood pressure
answer
The nurse is assessing a client and finds two enlarged supraclavicular lymph nodes. The nurse asks the client how long these enlarged nodes have been there. The client states, "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that that body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in this client?
question
Epinephrine
answer
A client states that the client has just had an argument with the client's spouse over the phone. What can the nurse expect that the client's sympathetic nervous system has stimulated the client's adrenal gland to release?
question
Client will adapt relaxation techniques to reduce stress.
answer
The nurse walks into the client's room and finds the client sobbing uncontrollably. When the nurse asks what the problem is, the client responds, "I am so scared. I have never known anyone who goes into a hospital and comes out alive." On this client's care plan the nurse notes a nursing diagnosis of ineffective coping related to stress. What is the best outcome to be expected for this client?
question
Assisting the client with deep-breathing exercises
answer
A hospitalized client states that the client is having difficulty resting. Which intervention would help promote rest?
question
Sympathetic nervous system
answer
When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger?
question
Coping mechanism
answer
A client responds to bad news regarding test results by crying uncontrollably. What is the term for this response to a stressor?
question
Adaptive coping strategies
answer
The most important factor in the person's stress response is what?
question
Lorazepam
answer
A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?
question
Move the client to a quiet environment.
answer
When a client is experiencing panic, which is the priority intervention?
question
Using appropriate coping skill Identifying treatment modalities Involving family for support, if appropriate Providing supportive feedback
answer
A nurse is preparing a plan of care for a client with anxiety. Which would the nurse likely include? Select all that apply.
question
Antidepressants
answer
Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to what?
question
"When I have a problem, I just deny it until it goes away."
answer
Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?
question
interpersonal
answer
A nurse is seeing a client who is experiencing symptoms of moderate anxiety. She tells the nurse she and her parents disagree over her sexual orientation. Which theory would best explain the course of the client's anxiety?
question
depersonalization.
answer
A nurse is seeing a client who is having severe to panic level anxiety after a physical assault months previously. The client tells the nurse, "When the panic starts I feel like I am watching myself through a window." The nurse can most accurately describe this experience as:
question
In GAD, the person usually does not experience eruptions of acute anxiety.
answer
Which is one characteristic that differentiates generalized anxiety disorder (GAD) and panic disorder?
question
Based in genetics with clinical symptoms being a result of chromosomal influence
answer
A biologic theory explains anxiety disorders in which way?
question
Mild
answer
Which level of anxiety helps the client focus the client's attention to learn, problem solve, think, act, feel, and protect himself or herself?
question
Antidepressants
answer
Which medication classification has been found to be effective in reducing or eliminating panic attacks?
question
Tachycardia
answer
Which is a cardiovascular response of the sympathetic nervous system?
question
"Anxiety is a sense of psychological distress."
answer
A 25-year-old client tells the nurse that the client has been worried and tearful lately because of pressures at work. The client states, "My partner tells me that it's 'stress' and 'anxiety,' but doesn't everyone have that? What is anxiety anyway?" Which response gives the best information about the nature of anxiety?
question
Concomitant use of alcohol
answer
Clients taking benzodiazepines need education about what?
question
The client is often late to school and makes poor grades in most of the client's subjects.
answer
Which factor has the least influence on achieving mental health for the client who has anxiety disorder?
question
Buspirone
answer
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which medication has the lowest potential for abuse?
question
Individuals may believe they are having a heart attack when a panic attack occurs.
answer
The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which would the nurse include when describing panic disorder?
question
Coping mechanisms
answer
Humans are able to adapt to physiological and psychological threats. Which is key to a person's adaptation to these situations?
question
positive coping skills.
answer
The overall goals of care for individuals experiencing a stress response are to focus on interventions to develop ...
question
The client is nervous and agitated.
answer
The nurse is assessing a client with anxiety. Which behavior might indicate that the client has moderate anxiety?
question
The client would have an enhanced sense of security.
answer
A nurse is caring for a client who has panic attack. The nurse takes the client in a small, isolated room. How would this intervention benefit the client? Choose the best answer.
question
To focus attention to learn To feel and think To motivate to make a change To engage in goal-directed activity
answer
The nurse is teaching shoulder exercises to a client recovering from a mastectomy. The nurse might view the client's mild anxiety during the session positively, because mild anxiety helps what? Select all that apply.
question
Tearfulness
answer
A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify what?
question
assessing the client's ability to implement stress management techniques effectively
answer
Which nursing intervention is focused on the primary goal of anxiety management and treatment?
question
"The client taps her fingers very rapidly when she is feeling anxious."
answer
Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?
question
Self-preservation
answer
A nurse is assessing the vital signs of a client in the cardiac clinic. The nurse observes the client's blood pressure and heart rate are higher than what is normally expected for this client. The client tells the nurse, "It makes me nervous to come into the clinic." What is the most likely explanation for the unexpected change in the client's vital signs.
question
separation anxiety disorder.
answer
A school health nurse is seeing a 7-year-old child. The mother of the child describes the child holding on to her leg and crying loudly when she attempts to leave the child at school each morning. The nurse should explain that the child is experiencing:
question
A systematic way to replace a panic response with a relaxation response
answer
What does desensitization refer to?
question
Tearfulness and sadness
answer
All except which are considered clinical symptoms of anxiety?
question
"Anxiety is a feeling that is experienced by everyone at some point and it can never be completely removed from one's life."
answer
The nurse is providing care for a psychiatric-mental health client who has a diagnosis of anxiety. Which statement by the nurse is likely the most therapeutic intervention?
question
Neurobiologic vulnerabilities and perception of psychosocial stress
answer
The causes of anxiety disorders can be best explained by what?
question
Dry mouth Blurred vision Constipation
answer
A client diagnosed with anxiety disorder has been prescribed benzodiazepine drugs. The nurse is explaining the possible side effects of the medications. Which side effects of the drug explained by the nurse is correct? Select all that apply.
question
The client is aware and alert
answer
A nurse assesses a client and determines that the client is experiencing mild anxiety based on what?
question
25%
answer
Nearly what percentage of adults are affected by anxiety disorders?
Abnormal Psychology
Areas Of The Brain
Central Nervous System Depressants
Substance Use Disorders
Quiz 6 (Ch. 11-12) – Flashcards 10 terms

Stephen Sanchez
10 terms
Preview
Quiz 6 (Ch. 11-12) – Flashcards
question
Metabolic tolerance involves changes in _____________ while pharmacodynamic tolerance involves changes in _____________.
answer
enzymes / neurons
question
In recent years, the term addiction is being used to describe other kinds of impulsive behavior problems, including
answer
pathological gambling.
question
Tolerance and withdrawal are considered the __________ criteria included in the definition of alcohol use disorder.
answer
pharmacological
question
People suffering from gender dysphoria are likely to dress up in the clothing of the opposite sex because
answer
it helps them to adopt the role of the gender with which they identify.
question
One approach to the treatment of paraphilias involves drugs that
answer
reduce the levels of testosterone.
question
What point concerning sexual problems was highlighted by the case of Bill and Margaret described in your textbook?
answer
The thoughts people have about the meaning of sexual behavior are extremely important.
question
What is the rationale for sensate focus in sex therapy?
answer
Couples need to focus on erotic sensations rather than performance demands.
question
Why do psychologists consider sexual arousal to be a hypothetical construct?
answer
It cannot be measured directly.
question
What are the phases of the human sexual response cycle described by Masters and Johnson? Sexual sadism involves sexual arousal associated with
answer
excitement phase, orgasmic phase, resolution phase
question
Sexual sadism involves sexual arousal associated with
answer
being humiliated and feeling pain
Advanced Pathophysiology
Alcohol Withdrawal Symptoms
Central Nervous System Depressants
Pharmacology
Elsevier 321 Pharm Unit 2 – Flashcards 133 terms

Patricia Harrah
133 terms
Preview
Elsevier 321 Pharm Unit 2 – Flashcards
question
Which condition contraindicates barbiturates? 1 Drug allergy 2 Cardiac disease 3 Epileptic disease 4 Narrow-angle glaucoma
answer
Drug allergy
question
The nurse notes that a patient has taken an excessive dose of baclofen. Which action does the nurse implement immediately? 1 Comfort measures 2 Seizure precautions 3 Airway maintenance 4 Antidote preparation
answer
Airway maintenance
question
A patient is admitted to the emergency department after taking an overdose of a barbiturate 15 minutes before arrival. The nurse can anticipate that which drug will be prescribed? 1 Naloxone 2 Flumazenil 3 Ipecac syrup 4 Activated charcoal
answer
Activated charcoal
question
Which medication is beneficial for reducing presurgery anxiety and decreasing the patient's ability to remember an uncomfortable medical procedure? 1 Ramelteon 2 Midazolam 3 Alprazolam 4 Eszopiclone
answer
Midazolam
question
The nurse is teaching a group of nursing students about the stages of non-rapid eye movement (non-REM) sleep. Which is the third stage of sleep? 1 Dozing 2 Relaxation 3 Deep sleep 4 Sleepwalking
answer
Deep sleep
question
A patient is scheduled for a brief surgical procedure. Which drug does the nurse expect to be used during surgery? 1 Thiopental 2 Butabarbital 3 Pentobarbital 4 Phenobarbital
answer
Thiopental
question
Which drug is used as an antidote for overdose of oral benzodiazepine or excessive intravenous sedation? 1 Flumazenil 2 Olanzapine 3 Furosemide 4 Activated charcoal
answer
Flumazenil
question
While assessing a patient, the nurse finds that the patient is allergic to aspirin. Which medication in the prescription does the nurse question? 1 Baclofen 2 Zaleplon 3 Diazepam 4 Pentobarbital
answer
Zaleplon - If a patient is allergic to aspirin, there is a possibility that the patient is allergic to nonbenzodiazepines such as zaleplon, too.
question
A patient with epilepsy is prescribed barbiturates. On further assessment, the nurse finds that the patient has depression. What classes of antidepressants does the nurse expect the primary health care provider to avoid when prescribing to this patient? Select all that apply. 1 Tricyclic antidepressant 2 Monoamine oxidase inhibitor (MAOI) 3 Selective serotonin reuptake inhibitor (SSRI) 4 Reversible monoamine oxidase inhibitor (RMAOI) 5 Serotonin and noradrenaline reuptake inhibitor (SNRI)
answer
Tricyclic antidepressant Monoamine oxidase inhibitor (MAOI) Reversible monoamine oxidase inhibitor (RMAOI) - Tricyclic antidepressants, MAOIs, and RMAOIs interact with barbiturates. These drugs increase the activity of barbiturates and may lead to severe central nervous system depression.
question
A patient is brought to the trauma care unit for administration of activated charcoal via a nasogastric tube every 4 hours. What may be the reason for this? 1 The patient is experiencing a barbiturate overdose. 2 The patient is experiencing benzodiazepine toxicity. 3 The patient is experiencing a muscle relaxant overdose. 4 The patient was administered azole along with benzodiazepine.
answer
question
While teaching about a medication regimen, the nurse advises the patient to take the medication no later than midnight and at least 4 hours before the patient usually awakens. Which drug has been prescribed to the patient? 1 Zaleplon 2 Zolpidem 3 Diazepam 4 Midazolam
answer
Zaleplon
question
The nurse is assessing a child with attention deficit hyperactivity disorder (ADHD) who is prescribed amphetamine aspartate. The nurse instructs the parent to give medications 5 to 6 hours before bed. Why did the nurse give this instruction? 1 To prevent insomnia 2 To prevent gastric ulcer 3 To prevent hyperglycemia 4 To prevent nutrition deficiency
answer
To prevent insomnia
question
Which adverse effect does the nurse anticipate in a patient who uses analeptics at high doses? 1 Diarrhea 2 Reflex bradycardia 3 Decreased respiratory rate 4 Increased deep tendon reflexes
answer
Diarrhea
question
A patient is diagnosed with attention deficit hyperactivity disorder (ADHD). Which drug is suitable for treatment of this disorder? 1 Orlistat 2 Doxapram 3 Sumatriptan 4 Atomoxetine
answer
Atomoxetine
question
A 7-year-old child is highly impulsive and has not been attentive in school for the last 2 months. The child's parents are worried about the child's behavior. What will the nurse inform the child's parents? 1 "This is the normal behavior of a 7-year-old child." 2 "You should consult a child psychiatrist immediately." 3 "Your child has attention deficit hyperactivity disorder (ADHD)." 4 "You should continue to observe the child's behavior for 4 months."
answer
"You should continue to observe the child's behavior for 4 months."
question
The nurse prepares to collect the health history of a patient with narcolepsy. Which strategy should be used to complete this assessment? 1 Provide a structured form for the patient to complete in writing. 2 Seek information from significant others rather than the patient. 3 Use the patient's past medical records to locate important information. 4 Use short, focused interview sessions with active participation by the patient.
answer
Use short, focused interview sessions with active participation by the patient.
question
Which drug is used to treat attention deficit hyperactivity disorder (ADHD)? 1 Orlistat 2 Modafinil 3 Sumatriptan 4 Dextroamphetamine
answer
Dextroamphetamine
question
While caring for a patient, the nurse learns that the patient has dysfunctional rapid eye movement (REM) sleep. This finding is a symptom of which condition? 1 Diplopia 2 Glaucoma 3 Narcolepsy 4 Migraine headache
answer
Narcolepsy
question
A patient is diagnosed with narcolepsy. Which symptom does the nurse expect to find in the patient? 1 Hyperactivity 2 Pulsating headache 3 Skeletal muscle weakness 4 High body mass index (BMI)
answer
Skeletal muscle weakness
question
Which is an adverse effect of orlistat therapy? 1 Mania 2 Diarrhea 3 Fecal incontinence 4 Foul taste in the mouth
answer
Fecal incontinence - Orlistat is a drug used in the treatment of obesity. A common adverse effect of orlistat is gastrointestinal distress, which causes fecal incontinence and oily stools.
question
Which characteristic of amphetamines is the most likely reason that these drugs are abused? 1 They induce euphoria. 2 They increase energy. 3 They induce wakefulness. 4 They promote industriousness.
answer
They induce euphoria.
question
Which drug is most commonly used for the treatment of a spinal headache? 1 Caffeine 2 Modafinil 3 Sumatriptan 4 Atomoxetine
answer
Caffeine - Caffeine is a xanthine cerebral stimulant used to treat spinal headache. It acts by antagonizing the purine receptors.
question
The nurse is teaching a new nurse about medication administration for patients with attention deficit hyperactivity disorder (ADHD). Which statement by the new nurse indicates understanding of the teaching? 1 "I may dispense these medications to nursing staff if needed." 2 "I will give these drugs 30 to 45 minutes before meals to improve absorption." 3 "It is permissible to crush extended-release medications for patients who have difficulty swallowing pills." 4 "If I notice side effects of these medications, I should stop giving the drug immediately and notify the provider."
answer
"I will give these drugs 30 to 45 minutes before meals to improve absorption."
question
The nurse is assessing a patient who is obese. After reviewing the prescription the nurse instructs the patient to take the medication in the morning and avoid taking the medication before going to bed. Which drug is this patient taking? 1 Morphine 2 Diazepam 3 Phentermine 4 Phenobarbitone
answer
Phentermine
question
Which patients who have which conditions are contraindicated for anorexiant therapy? Select all that apply. 1 Patients who have glaucoma 2 Patients who have hypotension 3 Patients who have drug allergies 4 Patients who have hypothyroidism 5 Patients who have bulimia nervosa
answer
Patients who have glaucoma Patients who have drug allergies Patients who have bulimia nervosa
question
What is the dose regimen of methylphenidate (Ritalin) for a 6-year-old child with attention deficit hyperactivity disorder (ADHD)? 1 20 mg after lunch 2 120 mg at each meal 3 50 mg as a single dose 4 5 mg before breakfast and lunch
answer
5 mg before breakfast and lunch
question
Which is the primary action site for serotonin agonists? 1 Cerebral cortex 2 Medulla and brainstem 3 Cerebrovascular system 4 Hypothalamic and limbic regions
answer
Cerebrovascular system
question
The nurse explains to a patient using caffeine that which disease process/condition may be exacerbated by this drug? 1 Heart block 2 Constipation 3 Myelin degeneration 4 Cardiac dysrhythmias
answer
Cardiac dysrhythmias
question
Which drug should be used with caution with the herbal drug ginseng to prevent possible drug interactions? 1 Aspirin 2 Warfarin 3 Metformin 4 Disulfiram
answer
Metformin
question
Which class of drugs is prescribed for a patient who is obese to promote weight reduction? 1 Ergot alkaloids 2 Lipase inhibitors 3 Serotonin receptor agonists 4 Phosphodiesterase inhibitors
answer
Lipase inhibitors
question
The patient's serum phenytoin level is 31 mcg/mL. What is the appropriate nursing action? 1 Hold the medication. 2 Increase the medication dose. 3 Administer the medication intravenously. 4 Have the patient continue the current regimen.
answer
Hold the medication. - A therapeutic drug level for phenytoin is 10 to 20 mcg/mL. The nurse should hold the medication and then call the health care provider.
question
A patient receiving lamotrigine therapy has started using oral contraceptives. What is essential for the nurse to teach the patient? 1 "This combination may cause liver toxicity." 2 "With oral contraceptive use, you may need more lamotrigine." 3 "This medication may stop your oral contraceptive from working." 4 "This medication, together with oral contraceptives, may cause toxicity."
answer
"With oral contraceptive use, you may need more lamotrigine." - When given with oral contraceptives, lamotrigine [1] [2] may need an increased dose to be effective because the oral contraceptives also compete for the CYP450 enzyme pathway.
question
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug with a narrow therapeutic index? 1 Take the medication every other day. 2 Keep the medication with you at all times. 3 Make certain the drug is taken at the same time daily. 4 Crush the drug and put it in applesauce for better absorption.
answer
Make certain the drug is taken at the same time daily.
question
What is the appropriate way for the nurse to prepare a dosage of a suspension medication for a pediatric patient? 1 Pour it into a teaspoon 2 Draw it up in an oral syringe 3 Pour it into a medication cup 4 Pour the suspension without shaking
answer
Draw it up in an oral syringe
question
A patient is receiving carbamazepine to treat trigeminal neuralgia. What assessment indicates a therapeutic response to the medication? 1 The patient states no facial pain. 2 The patient states she is able to walk. 3 The patient has a reduction in foot pain. 4 The patient states they have no dizziness.
answer
The patient states no facial pain.
question
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What information should be included in the teaching plan for the patient? 1 Alter drug therapy based on normal meal times. 2 If there are side effects of therapy, stop the drug. 3 Take the medication at the same time each day. 4 If this medication is not effective, another drug will be added.
answer
Take the medication at the same time each day.
question
Which intervention will best maintain therapeutic levels of an antiepileptic drug? 1 Give the medication every 8 hours. 2 Administer the medication intravenously. 3 Administer the medication only during the day. 4 Establish a drug regimen based on the half-life of the medication.
answer
Establish a drug regimen based on the half-life of the medication.
question
Which patient should the nurse assess first? 1 The patient taking valproic acid with an increased appetite. 2 The patient taking carbamazepine who has bruises on his arms. 3 The patient taking carbamazepine who is not oriented to place or time. 4 The patient taking valproic acid who has lost 2 pounds since starting therapy.
answer
The patient taking carbamazepine who is not oriented to place or time. - Any patient who is not oriented has a potential risk to his safety. The patient who is not oriented and taking carbamazepine could be experiencing adverse effects of therapy. This is the patient the nurse should assess first.
question
Which patient is most likely to have toxic effects of antiepileptic therapy? 1 The patient with a primidone level of 10 mcg/mL 2 The patient with a phenobarbital level of 8 mcg/mL 3 The patient with a valproic acid level of 50 mcg/mL 4 The patient with a carbamazepine level of 15 mcg/mL
answer
The patient with a carbamazepine level of 15 mcg/mL - The only value listed that is above therapeutic plasma levels is the carbamazepine, which has a therapeutic range of 4 to 12 mcg/mL; this patient is most likely to have toxic effects of therapy.
question
A patient is receiving phenobarbital. What information is essential to include in the discharge teaching plan? Select all that apply. 1 "This medication may cause confusion." 2 "Checkups with a cardiologist are essential." 3 "Respiratory assessments should be performed daily." 4 "Good dental care is essential while on this medication." 5 "Don't drive until you determine how the medication affects you."
answer
"This medication may cause confusion." "Good dental care is essential while on this medication." "Don't drive until you determine how the medication affects you." - The most common adverse effects are lethargy and cognitive changes as well as gingival hyperplasia. Confusion can be a result of this therapy. Good dental care is essential because the medication can cause gingival hyperplasia. The patient should evaluate how the drug affects him before driving.
question
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action? 1 Continue to monitor the patient on this medication. 2 Assess liver function tests for clearance of the drug. 3 Call the health care provider for a decrease in the daily dose. 4 Call the health care provider for an increase in the daily dose.
answer
Continue to monitor the patient on this medication.
question
The nurse instructs a patient receiving phenytoin to visit the dentist regularly and perform frequent oral hygiene. What side effect will these interventions assist in preventing? 1 Oral candidiasis 2 Gingival hyperplasia 3 Increased risk of dental abscesses 4 Increased incidence of dental caries
answer
Gingival hyperplasia
question
What is the goal of antiepileptic therapy? 1 Reducing seizure occurrence to one per week. 2 Maximizing drug dosages to control seizure activity. 3 Maximally reducing seizure activity while minimizing side effects of medication therapy. 4 Eradicating all seizure activity and then weaning off medication once the patient is seizure-free for 3 months.
answer
Maximally reducing seizure activity while minimizing side effects of medication therapy.
question
The patient was started on an antiepileptic medication 6 weeks ago. The nurse notes that the patient's blood level of the medication is very low after 6 weeks of therapy. How will the nurse interpret this result? 1 The patient has received a toxic amount of the drug. 2 The patient should be placed on a different medication. 3 The patient may not be taking the medication as ordered. 4 The patient is experiencing an allergic reaction to the drug.
answer
The patient may not be taking the medication as ordered.
question
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement should the nurse include? 1 "You will only need to be on therapy for a few months." 2 "Your medication is chosen based on your type of seizure." 3 "You will be started on several drugs to control your seizures." 4 "Medication therapy is not essential to treat seizure disorders."
answer
"Your medication is chosen based on your type of seizure."
question
What is the reason for many potential drug interactions with antiepileptic drug therapy? 1 Altered urinary output 2 Altered electrolyte balances 3 Altered CYP450 enzyme metabolism 4 Alterations in blood urea nitrogen (BUN) and creatinine levels
answer
Altered CYP450 enzyme metabolism
question
What is important to teach the patient taking valproic acid for seizure management? 1 Do not take the medication with meals. 2 Take the medication every other day only. 3 Take the medication an hour before or after other medications. 4 Do not take the medication with milk or carbonated beverages.
answer
Do not take the medication with milk or carbonated beverages. - Oral forms of valproic acid are not to be given with milk, because this may cause the drug to dissolve early and irritate the mucosa. Carbonated beverages must also be avoided during the time of drug administration.
question
The health care provider has ordered once-daily phenytoin for an 8-year-old child who has a seizure disorder. The parents state the child cannot swallow pills. What intervention would the nurse recommend to the health care provider? 1 Suggest another medication be prescribed. 2 Suggest the phenytoin be administered intramuscularly. 3 Ask for a suspension form of the medication to be prescribed. 4 Ask for an intravenous form of the medication to be prescribed
answer
Ask for a suspension form of the medication to be prescribed.
question
The nurse is administering intravenous diazepam. When will the nurse expect the onset of action to occur? 1 Immediately 2 Within 1 hour 3 Within 5 minutes 4 Within 15 minutes
answer
Immediately
question
What intervention is appropriate to include in discharge teaching for a patient prescribed phenytoin therapy? 1 Perform good oral hygiene. 2 See a physical therapist for tremors. 3 Report headaches to your health care provider. 4 Report drowsiness to your health care provider.
answer
Perform good oral hygiene.
question
The nurse is assessing a patient who is receiving antiepileptic drug therapy with phenytoin. What assessment finding requires immediate action? 1 Nystagmus 2 Weight gain 3 Heart rate 60 beats/min 4 Blood pressure 130/80 mm Hg
answer
Nystagmus - The patient who has nystagmus may be presenting with adverse effects to phenytoin therapy and should be assessed for other signs of toxicity.
question
Which assessment is a priority for the patient starting on gabapentin therapy for a seizure disorder? 1 Cardiac assessment 2 Urologic assessment 3 Neurologic assessment 4 Respiratory assessment
answer
Neurologic assessment - Gabapentin requires a thorough neurologic assessment, including baseline energy levels, vision level, sensory and motor functioning, and any changes in speech.
question
The nurse is caring for a patient who has been taking phenytoin for the past week and has developed a rash. What is the first action the nurse should take? 1 Monitor the area. 2 Assess the patient. 3 Apply a topical steroid cream. 4 Notify the prescribing health care provider.
answer
Assess the patient.
question
A patient with a seizure disorder is taking oral phenytoin. He is nothing by mouth (NPO) for elective surgery. What is the appropriate nursing action? 1 Draw a serum phenytoin level after surgery. 2 Administer the medication immediately postoperatively. 3 Call the health care provider to clarify medication orders. 4 Administer the oral phenytoin before the patient goes to surgery.
answer
Call the health care provider to clarify medication orders.
question
What assessment indicates the patient is having a therapeutic response to valproic acid? 1 Nystagmus 2 Absence of seizures 3 Normal liver enzymes 4 Decrease in headaches
answer
Absence of seizures
question
A patient has been taking valproic acid and is being switched to another medication due to elevated liver function tests. What nursing action is appropriate? 1 Taper the valproic acid while starting the new medication. 2 Administer the new medication intravenously for fastest therapeutic action. 3 Stop the valproic acid and start the same dose of the new medication immediately. 4 Wait until the valproic acid is completely out of the patient's system before starting a new medication.
answer
Taper the valproic acid while starting the new medication.
question
A patient is admitted who has reportedly stopped taking her antiepileptic medication. What is the appropriate nursing action? 1 Assess for hypotension. 2 Assess for confusion and delirium. 3 Monitor for rebound seizure activity. 4 Monitor for acute withdrawal syndrome.
answer
Monitor for rebound seizure activity.
question
What intervention is essential before a patient starts therapy with lamotrigine? 1 Platelet count 2 Kidney function tests 3 Assessment of weight 4 Assessment of risk for Stevens-Johnson syndrome
answer
Assessment of risk for Stevens-Johnson syndrome
question
The nurse is administering intravenous phenytoin. When will the nurse expect the onset of the drug to occur? 1 Immediately 2 Within 5 minutes 3 Within 15 minutes 4 Within 1 to 2 hours
answer
Within 1 to 2 hours
question
What information should the nurse provide to a patient who will self-administer an antiepileptic agent for the first time at home? 1 "Do not take the medication if you have a fever." 2 "Lie in bed for at least an hour after taking your medication." 3 "Wait to see how you react to the medication before driving." 4 "Take the antiepileptic agent with milk or juice to prevent stomach upset."
answer
"Wait to see how you react to the medication before driving."
question
The nurse is administering morning medications. Which administration technique is in error? 1 The nurse administers intravenous phenytoin with a filter. 2 The nurse administers phenobarbital elixir with fruit juice. 3 The nurse administers carbamazepine with grapefruit juice. 4 The nurse administers gabapentin without checking when the patient ate.
answer
The nurse administers carbamazepine with grapefruit juice.
question
When administering phenytoin via intravenous (IV) push, which action will the nurse perform? 1 Monitor for hypertension. 2 Always use an infusion pump. 3 Administer through peripheral IV sites only. 4 Flush the line with normal saline before and after administration.
answer
Flush the line with normal saline before and after administration. - Phenytoin is very irritating to veins and incompatible with all fluids except normal saline.
question
A patient reports switching from brand-name antiepileptic drug therapy to generic drug products. What is an essential nursing intervention? 1 Call the insurance company. 2 Request a decrease in the patient's dose. 3 Request an increase in the patient's dose. 4 Monitor the patient's neurologic status closely.
answer
Monitor the patient's neurologic status closely. - Increased monitoring of the patient's neurologic status is necessary because there is concern that generic drugs may not be as effective as brand-name medications. When the patient switches preparations, the patient may have seizures if the blood level does not remain therapeutic.
question
The nurse is administering phenytoin intravenously. What interventions are essential? Select all that apply. 1 Administer using a filter. 2 Administer the medication through a large vein. 3 Administer the medication no faster than 50 mg/min. 4 Mix the medication in 5% dextrose with 0.9% saline. 5 Administer the medication through a 20-gauge or larger catheter.
answer
Administer using a filter. Administer the medication through a large vein. Administer the medication no faster than 50 mg/min. Administer the medication through a 20-gauge or larger catheter.
question
The patient asks the nurse why she is receiving a different drug than her usual phenytoin. The patient is NPO (nothing by mouth) and is receiving intravenous fosphenytoin. Which is the nurse's most accurate response? 1 "You cannot take phenytoin orally while you are NPO." 2 "You need to ask your health care provider this question." 3 "Your serum phenytoin levels were most likely not therapeutic." 4 "This is the same class of drug, but better tolerated intravenously."
answer
"This is the same class of drug, but better tolerated intravenously."
question
Which patient should receive her medication as ordered at 8 am? 1 The patient who is receiving phenobarbital and has a plasma level of 38 mcg/mL. 2 The patient who is scheduled to receive carbamazepine who was started on verapamil. 3 The patient who has been taking aspirin for a headache and is scheduled to receive valproic acid. 4 The patient who is scheduled to receive a barbiturate and was admitted after a night of drinking alcohol.
answer
The patient who is receiving phenobarbital and has a plasma level of 38 mcg/mL. - The patient who is scheduled to receive phenobarbital and has a plasma level of 38 mcg/mL is safe to receive the medication. The therapeutic range is 10 to 40 mcg/mL. Carbamazepine interacts with verapamil and can cause toxicity.
question
A patient receiving phenytoin complains of "blurred vision." What is the priority nursing action? 1 Monitor for seizure activity. 2 Assess the patient's pupils. 3 Hold the patient's medication. 4 Assess serum phenytoin levels.
answer
Assess serum phenytoin levels
question
What information should the nurse include in the care plan of a young woman who has been prescribed phenytoin? 1 "Take your blood pressure daily." 2 "Use birth control while on this medication." 3 "Do not take this medication with grapefruit juice." 4 "If your weight increases, call your health care provider."
answer
"Use birth control while on this medication." - The nurse should tell the young woman to use birth control while on the medication because an increased incidence of fetal defects occurred in those who took phenytoin while pregnant.
question
A patient receiving valproic acid should be monitored for which adverse effects? Select all that apply. 1 Dizziness 2 Pancreatitis 3 Weight gain 4 Hepatotoxicity 5 Hypoglycemia
answer
Dizziness Pancreatitis Weight gain Hepatotoxicity
question
The nurse is monitoring a patient with a phenytoin level of 8 mcg/mL. What is an appropriate nursing action? 1 Draw another drug level within the hour. 2 Hold the medication and call the health care provider. 3 Call the health care provider for an increase in dosage. 4 Document the value and continue to monitor the patient.
answer
Call the health care provider for an increase in dosage.
question
The parent of a child with a history of a seizure disorder calls into the clinic to report her child has a rash on his torso. What is the most appropriate assessment question for the nurse to ask? 1 "Has your child been outside today?" 2 "Does your child have seasonal allergies?" 3 "Has your child been around anyone who is ill?" 4 "Has your child started on any new medications lately?"
answer
"Has your child started on any new medications lately?"
question
A nurse is caring for a patient who has tonic-clonic seizures and is prescribed phenytoin therapy. What assessments should the nurse make to look for potential side effects? Select all that apply. 1 Eye exams for glaucoma 2 Changes in facial appearance 3 Assessment for increased body hair 4 Assessment for changes in the gums 5 Assessment for Stevens-Johnson syndrome
answer
Changes in facial appearance Assessment for increased body hair Assessment for changes in the gums
question
The nurse is assessing four patients who have seizures and are started on medication therapy. Which patient is receiving the correct assessment after starting medication therapy? 1 Patient starting barbiturate therapy being assessed for a rash. 2 Patient starting gabapentin therapy being assessed for anemia. 3 Patient starting iminostilbene therapy being assessed for neurologic symptoms. 4 Patient starting levetiracetam therapy being assessed for neuropsychiatric symptoms.
answer
Patient starting levetiracetam therapy being assessed for neuropsychiatric symptoms.
question
A patient was prescribed gabapentin for neuropathic pain. What information is essential to include in the patient's discharge teaching? 1 Take the medication before meals. 2 Do not drink alcohol while on this medication. 3 Take the medication with a full glass of water. 4 Stop the medication if you develop gastric upset.
answer
Do not drink alcohol while on this medication. - Gabapentin is effective as a single-drug therapy for new-onset epilepsy and is most commonly used for the treatment of neuropathic pain. It is essential to teach the patient that he should not drink alcohol while on the medication, as it contributes to neurologic depression and sleepiness.
question
A patient receiving phenytoin develops a measleslike rash. What is the appropriate nursing action? 1 Administer an antihistamine immediately. 2 Apply topical steroid cream for inflammation. 3 Instruct the patient to take oatmeal baths if it itches. 4 Stop the medication and notify the health care provider.
answer
Stop the medication and notify the health care provider. - The patient has a measleslike rash, which is an adverse effect of phenytoin. The nurse should stop administering the medication and notify the health care provider.
question
A patient is being seen at the clinic for follow-up regarding treatment for seizures. The nurse notes that the patient is diaphoretic and her hands are trembling. The patient is alert. What is the priority nursing action? 1 Document the finding and perform a neurologic assessment. 2 Question the patient regarding her state of mind during the visit. 3 Call for assistance from another health care professional in the clinic. 4 Stop the appointment and notify the health care provider of the findings.
answer
Document the finding and perform a neurologic assessment.
question
Which antiepileptic drug may cause gingival hyperplasia in patients? 1 Phenytoin 2 Gabapentin 3 Phenobarbital 4 Levetiracetam
answer
Phenytoin
question
Which action is the highest priority for a patient who is receiving antiepileptic drug therapy for the first time? 1 Weighing the patient weekly 2 Encouraging regular check-ups 3 Assessing for suicidal tendencies 4 Teaching the patient about potential side effects
answer
Assessing for suicidal tendencies
question
The patient taking carbamazepine should be instructed to avoid taking her dose with which beverage? 1 Grape juice 2 Apple juice 3 Orange juice 4 Grapefruit juice
answer
Grapefruit juice
question
A 25-year-old female patient is prescribed phenobarbital therapy for seizure control. What information is essential for the nurse to assess before discharge? 1 "Have you ever had headaches? 2 "What type of insurance do you have?" 3 "What form of birth control do you use?" 4 "How often have you been having seizures?"
answer
"What form of birth control do you use?"
question
A nurse is assessing a patient who has developed Stevens-Johnson syndrome as a result of medication therapy. What is the nurse's first intervention? 1 Hold all medications. 2 Assess for severity of rash. 3 Call the health care provider. 4 Increase the patient's fluid intake.
answer
Assess for severity of rash.
question
What is the most appropriate nursing action for a patient in status epilepticus? 1 Apply restraints. 2 Apply restraints, start and intravenous line and administer intravenous diazepam. 3 Start an intravenous line and administer intravenous diazepam. 4 Start an intravenous line and administer intravenous pain medications.
answer
Apply restraints, start and intravenous line and administer intravenous diazepam.
question
In administering barbiturate therapy for seizure disorders, what safety measures are essential for the nurse to perform? Select all that apply. 1 Assess the room for safety measures 2 A neurologic assessment before administration 3 Assess drug levels before each dose of medication 4 Assess vital signs before medication administration 5 Attach patient to electroencephalogram (EEG) monitoring before each dose of medication
answer
Assess the room for safety measures A neurologic assessment before administration Assess vital signs before medication administration
question
Which is the priority action when administering intravenous phenytoin therapy? 1 Monitor for side effects. 2 Monitor serum drug levels. 3 Flush the tubing after administration. 4 Administer by slow intravenous (IV) push.
answer
Administer by slow intravenous (IV) push. - The priority is to administer phenytoin slowly to prevent irritation to veins.
question
A patient is in status epilepticus. Which are essential nursing actions? Select all that apply. 1 Call a code. 2 Assess oxygenation. 3 Administer diazepam. 4 Sit the patient in high Fowler. 5 Turn the patient's head to the side.
answer
Assess oxygenation. Administer diazepam. Turn the patient's head to the side.
question
A patient who is postoperative neurosurgery is admitted to the intensive care unit and begins to have seizures. What is the nurse's priority action? 1 Reassure the patient. 2 Notify the family members. 3 Call the health care provider. 4 Assess for a patent intravenous line.
answer
Assess for a patent intravenous line.
question
Which phenomena does the nurse recognize as positive symptoms of schizophrenia? Select all that apply. 1 Catatonia 2 Delusions 3 Hallucinations 4 Poverty of speech 5 Social withdrawal 6 Conceptual disorganization
answer
Delusions Hallucinations Conceptual disorganization
question
Which activity should the patient be cautioned to avoid while taking a monoamine oxidase (MAO) inhibitor? 1 Eating aged cheese 2 Sunbathing at the pool 3 Participating in a bowling league 4 Smoking a low-nicotine cigarette
answer
Eating aged cheese - Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in patients taking MAO inhibitors.
question
Which patient is a poor candidate for therapy with diazepam to treat generalized anxiety disorder? 1 One with a history of alcoholism 2 One with type 2 diabetes mellitus 3 One who had convulsions as a child 4 One who has had a myocardial infarction
answer
One with a history of alcoholism - A patient with a history of alcoholism is a poor candidate for therapy with diazepam because of the potential for substance abuse and the adverse effects of therapy.
question
The nurse notes lithium on a patient's drug history upon admission. Which condition would the nurse suspect that this patient has been diagnosed with? 1 Bipolar disorder 2 Absence seizures 3 Paranoid schizophrenia 4 Obsessive-compulsive disorder
answer
Bipolar disorder
question
Which theory states that depression and mania are caused by alterations in the concentration of dopamine and norepinephrine and serotonin and histamine in the brain? 1 Dopamine hypothesis 2 Permissive hypothesis 3 Dysregulation hypothesis 4 Biogenic amine hypothesis
answer
Biogenic amine hypothesis
question
Which medication increases the rate of urinary elimination of tricyclic antidepressants (TCAs) in the event of an overdose? 1 Diazepam 2 Antidysrhythmic 3 Activated charcoal 4 Sodium bicarbonate
answer
Sodium bicarbonate
question
The nurse is assessing a patient with depression who has been prescribed nortriptyline. Following the assessment, the nurse finds that the patient has constipation and urinary retention due to interaction between the prescribed medications. Which class of medication found in the patient's prescription is responsible for these effects? 1 Diuretics 2 Anxiolytics 3 Anticholinergics 4 Antihypertensives
answer
Anticholinergics
question
Which are common symptoms of serotonin syndrome? Select all that apply. 1 Delirium 2 Myoclonus 3 Drowsiness 4 Coarse tremors 5 Suicidal thoughts
answer
Delirium Myoclonus Coarse tremors
question
The nurse is assessing a patient who has been prescribed alprazolam to treat panic disorder. Which adverse effects does the nurse monitor for in the patient? Select all that apply. 1 Ataxia 2 Dizziness 3 Confusion 4 Blurred vision 5 Paradoxical anxiety
answer
Ataxia Dizziness Confusion
question
Which adverse effects result from antipsychotic drugs' action on alpha-adrenergic receptors? Select all that apply. 1 Weight gain 2 Lightheadedness 3 Reflex tachycardia 4 Tardive dyskinesia 5 Postural hypotension
answer
Lightheadedness Reflex tachycardia Postural hypotension
question
What is another approved and indicated use for bupropion, a second-generation antidepressant? 1 Smoking cessation 2 Orthostatic hypotension 3 Nocturnal enuresis in children 4 Anorexia in patients undergoing chemotherapy
answer
Smoking cessation
question
Which mood-stabilizing drugs are used to treat bipolar disorder? Select all that apply. 1 Bupropion 2 Imipramine 3 Isocarboxazid 4 Oxcarbazepine 5 Lithium carbonate
answer
Oxcarbazepine Lithium carbonate
question
Which anxiolytic drug promotes antagonistic activity at both the serotonin and dopamine receptors? 1 Buspirone 2 Alprazolam 3 Lorazepam 4 Amitriptyline
answer
Buspirone
question
Which instruction does a nurse provide to a patient who is taking a selective serotonin reuptake inhibitor (SSRI)? 1 "Change positions frequently." 2 "Avoid foods or beverages rich in tyramine." 3 "Avoid hot baths, saunas, and hot climates." 4 "Increase the intake of dietary fiber supplements."
answer
"Increase the intake of dietary fiber supplements."
question
A patient is detoxifying from alcohol abuse. Which type of medication is indicated to help the patient manage withdrawal symptoms? 1 Phenothiazine 2 Dibenzazepine 3 Benzisoxazole 4 Benzodiazepine
answer
Benzodiazepine
question
The nurse notes that the patient has an increased blood glucose level, increased blood pressure (BP), and abnormal cholesterol levels. What does the nurse infer from these observations? 1 The patient has mania. 2 The patient has dystonia. 3 The patient has dyskinesia. 4 The patient has metabolic syndrome.
answer
The patient has metabolic syndrome.
question
What are the current indications for tricyclic antidepressants (TCAs)? Select all that apply. 1 Seizures 2 Insomnia 3 Depression 4 Childhood enuresis 5 Neuropathic pain syndrome
answer
Insomnia Childhood enuresis Neuropathic pain syndrome
question
Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism? 1 Increasing the placebo effect 2 Increasing alertness levels in the brain 3 Blocking the reuptake of neurotransmitters at nerve endings 4 Decreasing levels of epinephrine and serotonin at nerve endings
answer
Blocking the reuptake of neurotransmitters at nerve endings
question
What atypical antipsychotic medication would the nurse anticipate a health care provider prescribing for treatment of refractory schizophrenia? 1 Trazodone 2 Phenelzine 3 Amoxapine 4 Risperidone
answer
Risperidone
question
A patient with bipolar disorder has involuntary wavelike movements of the legs. Which drug is responsible for this adverse effect in the patient? 1 Diazepam 2 Buspirone 3 Alprazolam 4 Lithium citrate
answer
Lithium citrate
question
The nurse is caring for a patient who is experiencing respiratory depression due to long-term use of diazepam in high doses. The patient has been prescribed flumazenil by the primary health care provider. What does the nurse monitor while caring for the patient? 1 Presence of seizures 2 Presence of impaired vision 3 Presence of increased pulse rate 4 Presence of reduced blood glucose
answer
Presence of seizures
question
A patient who has depression is prescribed duloxetine. Which tests will the nurse suggest to the provider before the therapy is started? 1 Renal function test 2 Liver function test 3 Complete blood count 4 Complete urine examination
answer
Liver function test
question
A patient diagnosed with depression is started on a tricyclic antidepressant (TCA) after failure to improve symptoms on a selective serotonin reuptake inhibitor. The nurse should include which teaching point when educating the patient about the new medication? 1 There are no contraindications to this medication. 2 The medication is safe; it has been used longer than many others. 3 There is a risk of toxicity when this medication is taken with alcohol. 4 This class of medications has no other use and is only for depression.
answer
There is a risk of toxicity when this medication is taken with alcohol.
question
What is the main receptor in the central nervous system (CNS) that is blocked by conventional antipsychotic drugs? 1 Serotonin 2 Dopamine 3 Acetylcholine 4 Norepinephrine
answer
Dopamine
question
The nurse is caring for a patient with acute mania who has been prescribed lithium carbonate. The blood tests of the patient indicate the serum lithium level to be 1.2 mEq/L. What does the nurse interpret from this result? 1 The patient will have persistent manic symptoms. 2 The patient may have cardiac dysrhythmia and tremors. 3 The patient may have impaired liver and renal functioning. 4 The patient should have effective relief from the manic symptoms.
answer
The patient should have effective relief from the manic symptoms. - There is a narrow therapeutic window between the therapeutic and toxic serum levels of lithium. A serum lithium level of 1 to 1.5 mEq/L is optimum for the treatment of acute mania. Therefore a serum lithium level of 1.2 mEq/L indicates that the patient will have effective relief from the manic symptoms. If the serum lithium level is less than 1 mEq/L, then the patient may have persistent manic symptoms. The adverse effects of lithium toxicity include cardiac dysrhythmia and tremors. If the lithium serum level is more than 1.5 mEq/L, then the patient may have lithium toxicity, which is characterized by impaired liver and renal functioning.
question
A female patient who takes lorazepam for anxiety tells the nurse that she plans to become pregnant. What is the best instruction for the nurse to give the patient? 1 Eat a well-balanced diet that includes milk. 2 Stop taking the drug and form another plan to manage anxiety. 3 Discuss tapering the drug with the health care provider before conception. 4 Visit an obstetrician to determine the correct dose of lorazepam during pregnancy.
answer
Discuss tapering the drug with the health care provider before conception.
question
Clozapine, an atypical antipsychotic medication, is prescribed for a patient with a schizophreniform disorder. Which information would be most important to include in the teaching plan for this patient? 1 The importance of promptly reporting flulike symptoms 2 Strategies to manage breast enlargement and nipple discharge 3 Contraceptive measures and expected changes in menstruation 4 The meaning of various components of a white blood cell count
answer
The importance of promptly reporting flulike symptoms
question
A patient asks the nurse how long it will take for escitalopram to be completely effective. Which time frame should the nurse include in patient teaching? 1 1 week 2 2 or 3 days 3 2 or 3 months 4 Several weeks
answer
Several weeks
question
A patient is admitted to the emergency department after an overdose of oxazepam. Which antagonist may be used to treat this patient? 1 Naloxone 2 Naltrexone 3 Nalmefene 4 Flumazenil
answer
Flumazenil
question
A patient diagnosed with an anxiety disorder has been using lorazepam but finds the side effect of drowsiness to be interfering with life. Which anxiolytic medications might be a better option for this patient? 1 Buspirone 2 Alprazolam 3 Chlordiazepoxide 4 Hydroxyzine hydrochloride salt
answer
Buspirone
question
The primary health care provider reviews the medical history of a patient who is receiving buspirone. The health care provider instructs the nurse to continuously monitor the patient's blood pressure to prevent hypertension due to a drug interaction. Which other medication is the patient taking? 1 Iron supplement 2 Oral contraceptives 3 Nonsteroidal antiinflammatory drugs 4 Monoamine oxidase inhibitor (MAOI)
answer
Monoamine oxidase inhibitor (MAOI)
question
A patient with psychosis is experiencing adverse effects of conventional antipsychotic pharmacotherapy, including dystonia, akathisia, and abnormal limb movements. The nurse collaborates with the psychiatrist to enact a change in therapy. Which medication is best suited to this patient? 1 Molindone 2 Haloperidol 3 Risperidone 4 Chlorpromazine
answer
Risperidone
question
The nurse is caring for a patient who has bipolar disorder who has been administered lithium citrate. The primary health care provider asks the nurse to constantly monitor the patient's blood sodium levels. What is the reason for giving such an instruction? 1 To ensure proper nourishment in the patient 2 To prevent renal toxicity caused by the drug 3 To maintain therapeutic concentration of lithium 4 To maintain normal cholesterol levels in the body
answer
To maintain therapeutic concentration of lithium
question
The nurse prepares a patient who is taking sertraline for discharge. Which instruction should the nurse include in patient education? 1 Report any increase in mania. 2 Expect to feel better in 4 to 6 days. 3 Take sertraline at the same time each day. 4 Avoid overheating and direct sun exposure.
answer
Take sertraline at the same time each day.
question
The nurse is assessing a patient with depression who has been prescribed isocarboxazid. The nurse advises the patient to use steam inhalation for a cold rather than taking cetirizine. What is the reason for giving such advice to the patient? 1 To prevent the increased risk of bleeding 2 To prevent the increased risk of infection 3 To prevent impaired cardiovascular function 4 To prevent central nervous system depression
answer
To prevent central nervous system depression
question
The nurse is caring for a patient diagnosed with depression who has been prescribed isocarboxazid. Due to a slight increase in blood pressure and agitation, the primary health care provider prescribed buspirone for the patient. What does the nurse do to prevent adverse effects in the patient? 1 Administer buspirone at night and isocarboxazid after lunch. 2 Administer buspirone intravenously and isocarboxazid orally. 3 Administer buspirone and isocarboxazid by dissolving in water. 4 Administer buspirone 14 days after discontinuing isocarboxazid.
answer
Administer buspirone 14 days after discontinuing isocarboxazid. - Buspirone is prescribed for the treatment of agitation. It should not be coadministered with monoamine oxidase inhibitors such as isocarboxazid because the drugs interact and increase blood pressure. In order to prevent such adverse effects, the drug must be administered after a sufficient washout period. Therefore the nurse should administer buspirone 14 days after discontinuing isocarboxazid. On the other hand, continuing the administration of isocarboxazid by changing the administration time, by changing the dosage forms, or by diluting the drugs in water may not be helpful in preventing adverse effects. Therefore in order to prevent the drug interaction, the nurse should not simply administer isocarboxazid after lunch, dissolve the drug in water, or give it orally.
question
A patient taking risperidone has a necrotic foot ulcer that started as a minor scratch. Which patient data should the nurse check to help prevent complications of the pharmacotherapy? 1 Leukocyte count 2 Liver function studies 3 Fasting blood glucose 4 Kidney function studies
answer
Fasting blood glucose
question
A male patient tells the nurse that he wants to stop taking citalopram because of the sexual side effects. Which instruction should the nurse provide while educating the patient to help relieve the patient's sexual dysfunction? Select all that apply. 1 Avoid alcoholic beverages. 2 Discontinue the medication. 3 Decrease the regular dosage. 4 Take infrequent "drug holidays." 5 Report complaints to the psychiatrist. 6 Maintain the current pharmacotherapy.
answer
Avoid alcoholic beverages. Take infrequent "drug holidays." Report complaints to the psychiatrist. Maintain the current pharmacotherapy.
question
A patient currently prescribed duloxetine comes to the health clinic complaining of restlessness, agitation, diaphoresis, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which substance? 1 Gingko 2 Ibuprofen 3 St. John's wort 4 Glucosamine chondroitin
answer
St. John's wort
question
Which laboratory test should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine? 1 Renal panel 2 Liver function tests 3 Complete blood count 4 Immunoglobulin levels
answer
Complete blood count
question
A patient with schizophrenia presents to a clinic with a poorly healing leg ulcer and hyperglycemia. Which atypical antipsychotic agent is the best medication for this patient? 1 Olanzapine 2 Quetiapine 3 Ziprasidone 4 Risperidone
answer
Ziprasidone
question
Which food can be included in the diet of a patient who is taking monoamine oxidase inhibitors? 1 Red wine 2 Fava beans 3 Corned beef 4 Cottage cheese
answer
Cottage cheese
question
The nurse obtains a medication history from a patient diagnosed with primary hypertension. The nurse recognizes that teaching is needed when the patient states that he takes which over-the-counter medication and/or supplement? 1 Garlic 2 Ginseng 3 Valerian root 4 St. John's wort
answer
Ginseng
question
The nurse is assessing a patient diagnosed with bipolar disorder who has been prescribed lithium carbonate. On reviewing the laboratory reports of the patient, the nurse suspects that the drug has a risk of causing cardiac dysrhythmia. What is the reason for reaching such a conclusion? 1 The sodium level of the patient was 142 mEq/L. 2 The sodium level of the patient was 160 mEq/L. 3 The sodium level of the patient was 140 mEq/L. 4 The sodium level of the patient was 138 mEq/L.
answer
The sodium level of the patient was 160 mEq/L.
question
Which statement made by a patient demonstrates a lack of understanding of patient teaching regarding phenothiazine drug therapy? 1 "I need to change positions slowly to prevent dizziness." 2 "I will need to wear sunscreen and protective clothing when outdoors." 3 "It is okay to take this drug with a small glass of wine to help me relax." 4 "I should call my doctor if I notice any uncontrollable movements of my tongue."
answer
"It is okay to take this drug with a small glass of wine to help me relax."
question
Which piece of objective data contraindicates the use of clozapine? 1 Allergy to phenothiazines 2 Self-destructive behavior 3 Failed antipsychotic therapy 4 Acute lymphocytic leukemia
answer
Acute lymphocytic leukemia
question
The nurse finds that a patient who has been prescribed tricyclic antidepressant (TCA) therapy consumes alcohol regularly. What intervention will the nurse expect to perform to promote drug safety? 1 Refer the patient for regular hemodialysis. 2 Perform urine acidification until the pH is 5. 3 Administer hypotensive drugs as prescribed. 4 Administer multiple doses of activated charcoal.
answer
Administer multiple doses of activated charcoal.
Central Nervous System Depressants
Nursing
Three Times Per Day
Anxiety-NCLEX 3000 – Flashcards 68 terms

Owen Clarke
68 terms
Preview
Anxiety-NCLEX 3000 – Flashcards
question
A client who recently developed paralysis of the arms is diagnosed with conversion disorder after tests fail to uncover a physical cause for the paralysis. Which intervention should the nurse include in the plan of care?
answer
Exercising the client's arms regularly
question
(SELECT AL THAT APPLY) A 54-year-old client diagnosed with generalized anxiety disorder is admitted to the facility. Which therapeutic modalities are typically used to treat this disorder?
answer
1. Biofeedback 2. Buspirone 3. Relaxtion technique
question
During the client-teaching session, which instruction should the nurse give to a client receiving alprazolam (Xanax)?
answer
"Inform the physician if you become pregnant or intend to do so."
question
A client comes to the emergency department while experiencing a panic attack. The nurse should respond to a client having a panic attack by:
answer
staying with the client until the attack subsides
question
A client is admitted to the acute psychiatric care unit after 2 weeks of increasingly erratic behavior. The client has been sleeping poorly, has lost 8 lb (3.6 kg), is poorly groomed, exhibits hyperactivity, and loudly denies the need for hospitalization. Which nursing intervention takes priority for this client?
answer
Administering a sedative as prescribed
question
A client with obsessive-compulsive disorder tells the nurse that he must check the lock on his apartment door 25 times before leaving for an appointment. The nurse knows that this behavior represents the client's attempt to:
answer
reduce anxiety.
question
A 49-year-old painter who recently fractured his tibia worries about his finances because he can't work. To treat his anxiety, his physician prescribes buspirone (BuSpar), 5 mg by mouth three times per day. During buspirone therapy, the client should avoid which of the following drugs?
answer
Monoamine oxidase (MAO) inhibitors
question
A client is admitted to an inpatient psychiatric unit for treatment of obsessive-compulsive symptoms. Obsessive-compulsive disorder (OCD) is associated with:
answer
"repetitive thoughts and recurring, irresistible impulses.
question
While shopping at a mall, a woman experiences an episode of extreme terror accompanied by anxiety, tachycardia, trembling, and fear of going crazy. A friend drives her to the emergency department, where a physician rules out physiological causes and refers her to the psychiatric resident on call. To control the client's anxiety, the nurse caring for this client may expect the resident to prescribe:
answer
2. lorazepam (Ativan).
question
(SELECT ALL THAT APPLY) After receiving a referral from the occupational health nurse, a client comes to the mental health clinic with a suspected diagnosis of obsessive-compulsive disorder. The client explains that his compulsion to wash his hands is interfering with his job. Which interventions are appropriate when caring for a client with this disorder?
answer
2. Support the use of appropriate defense mechanisms. 4. Explore the patterns leading to the compulsive behavior. 6. Encourage activities, such as listening to music."
question
A client who has been diagnosed with a sexually transmitted disease (STD) asks that this information not be shared with her family members. Which of the following responses from the nurse would be appropriate?
answer
" ""Your health information is confidential, and I can't talk to anyone about it without your permission.""
question
Before eating a meal, a client with obsessive-compulsive disorder (OCD) must wash his hands for 18 minutes, comb his hair 444 strokes, and switch the bathroom light on and off 44 times. What is the most appropriate goal of care for this client?
answer
"Systematically decrease the number of repetitions of rituals and the amount of time spent performing them.
question
A client with a history of drug and alcohol abuse is concerned that the hospital will divulge her history to her employer without her knowledge. What response by the nurse would be appropriate?
answer
1. "Your personal health information can't be disclosed to your employer without your permission."
question
The nurse is caring for a Vietnam War veteran with a history of explosive anger, unemployment, and depression since being discharged from the service. The client reports feeling ashamed of being "weak" and of letting past experiences control thoughts and actions in the present. What is the nurse's best response?
answer
1. "Many people who have been in your situation experience similar emotions and behaviors."
question
Which nursing intervention would be most helpful for a client experiencing a panic attack?
answer
"3. Staying with the client and remaining calm, confident, and reassuring
question
A client is diagnosed with obsessive-compulsive disorder. Which intervention should the nurse include when assisting with development of the plan of care?
answer
2. Giving the client adequate time to perform rituals
question
While in the facility, a client with obsessive-compulsive disorder saves all used medicine cups and paper cups and arranges them in elaborate sculptures in the room. At home, the client saves mail and magazines and makes elaborate paper sculptures from them. Which outcome would indicate successful treatment for this client?
answer
1. The client throws away all disposable cups
question
A physician's order states to administer lorazepam (Ativan), 20 mg by mouth twice per day, to treat anxiety. How should the nurse proceed?
answer
2. Clarify the order with the prescribing physician because the amount prescribed exceeds the recommended dose.
question
A client is undergoing treatment for an anxiety disorder. Such a disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least:
answer
3. 6 months
question
A client admitted to the psychiatric unit for treatment of repeated panic attacks comes to the nurses' station in obvious distress. After observing that the client is short of breath, dizzy, trembling, and nauseated, the nurse should first:
answer
"3. escort the client to a quiet area and suggest using a relaxation exercise that he's been taught.
question
(SELECT ALL THAT APPLY) A physician prescribes clomipramine (Anafranil) for a client diagnosed with obsessive-compulsive disorder (OCD). What instructions should the nurse include when teaching the client about this medication?
answer
"1. Avoid hazardous activities that require alertness or good coordination until adverse central nervous system (CNS) effects are known. 2. Avoid alcohol and other depressants. 3. Use saliva substitutes or sugarless candy or gum to relieve dry mouth. "
question
During alprazolam (Xanax) therapy, the nurse should be alert for which dose-related adverse reaction?
answer
1. Ataxia
question
A client with obsessive-compulsive disorder may use reaction formation as a defense mechanism to cope with anxiety and stress. What typically occurs in reaction formation?
answer
1. The client assumes an attitude that is the opposite of an impulse that the client harbors.
question
The nurse notices that a client with obsessive-compulsive disorder dresses and undresses numerous times each day. Which comment by the nurse would be therapeutic?
answer
1. I saw you change clothes several times today. That must be very tiring.
question
A client enters the crisis unit complaining of increased stress from her studies as a medical student. She states that she has been increasingly anxious for the past month. Her physician prescribes alprazolam (Xanax), 25 mg by mouth three times per day, along with professional counseling. Before administering alprazolam, the nurse reviews the client's medication history. Which drug can produce additive effects when given concomitantly with alprazolam?
answer
3. Diphenhydramine (Benadryl)
question
A client with borderline personality disorder tells the nurse, "You're the only nurse who really understands me. The others are mean." The client then asks the nurse for an extra dose of antianxiety medication because of increased anxiety. How should the nurse respond?
answer
2. ""I'll have to discuss your request with the team. Can we talk about how you're feeling right now?""
question
After seeking help at an outpatient mental health clinic, a client who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, the client returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for this client?
answer
1. Exploring the meaning of the traumatic event with the client
question
Victims of sexual assault can experience posttraumatic stress reactions after the attack. Which of the following statements best describes symptoms associated with posttraumatic stress disorder (PTSD)?
answer
4. Flashbacks, recurring dreams, and numbness
question
(SELECT ALL THAT APPLY) After being examined by the forensic nurse in the emergency department, a rape victim is prepared for discharge. Due to the nature of the attack, this client is at risk for posttraumatic stress disorder (PTSD). Which symptoms are associated with PTSD?
answer
" 1. Recurrent, intrusive recollections or nightmares 3. Sleep disturbances 6. Difficulty concentrating "
question
The physician orders a new medication for a client with generalized anxiety disorder. During medication teaching, which statement or question by the nurse would be most appropriate?
answer
"Do you have any concerns about taking the medication?"
question
The nurse refers a client with severe anxiety to a psychiatrist for medication evaluation. The physician is most likely to prescribe which psychotropic drug regimen for this client?
answer
1. Buspirone (BuSpar), 5 mg orally three times per day "
question
Which of the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD)?
answer
"3. Fluvoxamine (Luvox) and clomipramine (Anafranil)
question
A client is admitted to the psychiatric unit with a diagnosis of conversion disorder. Since witnessing the beating of his wife at gunpoint, he has been unable to move his arms, complaining that they are paralyzed. When planning the client's care, the nurse should focus on:
answer
1. helping the client identify and verbalize feelings about the incident.
question
A client in a psychiatric facility is prescribed escitalopram (Lexapro) for anxiety. She tells the nurse that she has been having "weird dreams" and feelings of wanting to "end it all." What action should the nurse take?
answer
2. Consult a pharmacist to see if these symptoms are adverse effects of the drug.
question
During a panic attack, a client hyperventilates, becomes unable to speak, and reports symptoms that mimic those of a heart attack. Which nursing intervention would be best?
answer
4. Accompany the client to his room; remain there and provide instructions in short, simple statements.
question
A client arrives on the psychiatric unit exhibiting extreme excitement, disorientation, incoherent speech, agitation, frantic and aimless physical activity, and grandiose delusion. Which nursing diagnosis takes highest priority for the client at this time?
answer
"3. Risk for injury
question
A client who lost her home and dog in an earthquake tells the admitting nurse at the community health center that she finds it harder and harder to "feel anything." She says she can't concentrate on the simplest tasks, fears losing control, and thinks about the earthquake incessantly. She becomes extremely anxious whenever the earthquake is mentioned and must leave the room if people talk about it. The nurse suspects that she has:
answer
"3. posttraumatic stress disorder (PTSD).
question
(SELECT ALL THAT APPLY) A registered nurse caring for a client with generalized anxiety disorder identifies a nursing diagnosis of Anxiety. The short-term goal identified is: The client will identify his physical, emotional, and behavioral responses to anxiety. Which nursing interventions will help the client achieve this goal?
answer
4. Observe the client for overt signs of anxiety. 5. Help the client connect anxiety with uncomfortable physical, emotional, or behavioral responses. 6. Introduce the client to new strategies for coping with anxiety, such as relaxation techniques and exercise.
question
A nurse observes a medical student walk into a client's room and begin questioning her about her current health status. The client appears reluctant to respond. How should the nurse intervene?
answer
3. Explain to the client that she has the right to refuse to answer questions asked by the medical student.
question
Initial interventions for the client with acute anxiety include:
answer
2. encouraging the client to verbalize feelings and concerns.
question
During a shift report, the nurse learns that she will be providing care for a client who's vulnerable to panic attacks. Treatment for panic attacks includes behavioral therapy, supportive psychotherapy, and medication such as
answer
2. antianxiety drugs.
question
A client with agoraphobia has been symptom-free for 4 months. Classic signs and symptoms of phobias include:
answer
2. severe anxiety and fear.
question
While administering medications to a group of clients admitted with anxiety, a nurse hears someone call for help. The nurse should respond by:
answer
"4. locking the medication cart and responding to the call for help.
question
While being escorted to an operating room, a client is extremely anxious and says, "I really don't know what they're going to do to me today. The physician said I have a lump in my breast and that's all I know." Which action is appropriate for the nurse to take?
answer
"4. Notify the physician upon arrival at the operating room.
question
The nurse is formulating a short-term goal for a client suffering from a severe obsessive-compulsive disorder (OCD). An appropriately stated short-term goal is that after 1 week, the client will:
answer
"2. participate in a daily exercise group.
question
The nurse is caring for a client experiencing an anxiety attack. Appropriate nursing interventions include:
answer
3. staying with the client and speaking in short sentences.
question
Lorazepam (Ativan) is often given along with a neuroleptic agent, such as haloperidol (Haldol). What is the purpose of administering the drugs together?
answer
1. To reduce anxiety and potentiate the sedative action of the neuroleptic
question
During the admission data collection, a client with a panic disorder begins to hyperventilate and says, "I'm going to die if I don't get out of here right now!" What is the nurse's best response?
answer
4. ""You're having a panic attack. I'll stay here with you
question
A client with a conversion disorder reports blindness, and ophthalmologic examinations reveal that no physiologic disorder is causing progressive vision loss. The most likely source of this client's reported blindness is:
answer
2. having been forced to watch a loved one's torture.
question
"After months of coaxing by her husband, a client comes to the mental health clinic. She reports that she suffers from an overwhelming fear of leaving her house. This overwhelming fear has caused the client to lose her job and is beginning to take a toll on her marriage. The physician diagnoses the client with agoraphobia. Which treatment options are effective in treating this disorder?
answer
2. Desensitization 3. Alprazolam (Xanax) therapy 4. Paroxetine (Paxil) therapy
question
The nurse is caring for a client with panic disorder who has difficulty sleeping. Which nursing intervention would best help the client achieve healthy long-term sleeping habits?
answer
"2. Encouraging the use of relaxation exercises
question
The nurse in a psychiatric inpatient unit is caring for a client with obsessive-compulsive disorder. As part of the client's treatment, the psychiatrist orders lorazepam (Ativan), 1 mg by mouth three times per day. During lorazepam therapy, the nurse should remind the client to:
answer
"1. avoid caffeine.
question
While driving home from work, a nurse realizes that she failed to communicate to the oncoming nurse that a client asked for more information about advance directives. Which action would be appropriate for the nurse to take?
answer
4. Phone the nurse caring for the client and inform her of the client's request.
question
A nurse notices that a client who came to the clinic for treatment of anxiety disorder has a strong body odor. What can the nurse do or say to help this client?
answer
"2. Ask the client basic hygiene questions to determine how frequently he bathes.
question
A client admitted to the unit is visibly anxious. When collecting data on the client, the nurse would expect to see which cardiovascular effect produced by the sympathetic nervous system?
answer
3. Increased heart rate
question
A client with obsessive-compulsive disorder and ritualistic behavior must brush the hair back from his forehead 15 times before carrying out any activity. The nurse notices that the client's hair is thinning and the skin on the forehead is irritated — possible effects of this ritual. When planning the client's care, the nurse should assign highest priority to:
answer
3. setting consistent limits on the ritualistic behavior if it harms the client or others.
question
Because antianxiety agents such as lorazepam (Ativan) can potentiate the effects of other drugs, the nurse should incorporate which instruction in her teaching plan?
answer
1. Avoid mixing antianxiety agents with alcohol or other central nervous system (CNS) depressants
question
A woman, age 18, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the fall semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. The client asks the nurse, "Why has this happened to me?" What is the most appropriate response?
answer
3. "Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."
question
The nurse is collecting data on a client suffering from stress and anxiety. A common physiological response to stress and anxiety is:
answer
2. diarrhea
question
A nurse on the psychiatric unit realizes that she typically fails to administer medications according to schedule. What's the best way for the nurse to improve her medication administration practice?
answer
"2. Evaluate her current practice and devise an improvement plan.
question
A client, age 40, is admitted for a surgical biopsy of a suspicious lump in her left breast. When the nurse comes to take her to surgery, she is tearfully finishing a letter to her two children. She tells the nurse, "I want to leave this for my children in case anything goes wrong today." Which response by the nurse would be most therapeutic?
answer
"In case anything goes wrong? What are your thoughts and feelings right now?"
question
The nurse discovers that a client with obsessive-compulsive disorder (OCD) is attempting to resist the compulsion. Based on this finding, the nurse should look for signs of:
answer
4. increased anxiety.
question
A client tells the nurse that she has an overwhelming fear of having a heart attack. This client is most likely suffering from which disorder?
answer
2. Panic disorder
question
A 59-year-old client is scheduled for cardiac catheterization the next morning. His physician prescribed secobarbital sodium (Seconal), 100 mg by mouth at bedtime, for sedation. Before administering the drug, the nurse should know that:
answer
"4. sedatives reduce excitement; hypnotics induce sleep.
question
The nurse notices that a client with obsessive-compulsive disorder washes his hands for long periods each day. How should the nurse respond to this compulsive behavior?
answer
"1. By designating times during which the client can focus on the behavior
question
A nurse has been providing care to the same group of clients for 4 consecutive days. On day 5, she sees that her assignment has changed, and she is concerned about the continuity of care for these clients. What should the nurse do?
answer
2. Voice her concerns about continuity of care with the charge nurse.
question
During a panic attack, a client runs to the nurse and reports breathing difficulty, chest pain, and palpitations. The client is pale with his mouth wide open and eyebrows raised. What should the nurse do first?
answer
1. Assist the client to breathe deeply into a paper bag
question
A client diagnosed as having panic disorder with agoraphobia is admitted to the inpatient psychiatric unit. Until her admission, she had been a virtual prisoner in her home for 5 weeks, afraid to go outside even to buy food. When planning care for this client, what is the nurse's overall goal?
answer
2. To help the client function effectively in her environment
Central Nervous System Depressants
Emergency Medical Technology
Food Chemistry
Hydrogen Sulfide Gas
KIN 125//Exam 3 – Flashcards 66 terms

Mya Day
66 terms
Preview
KIN 125//Exam 3 – Flashcards
question
Poisons may enter the body in 4 ways...
answer
Ingestion, Inhalation, Injection, Absorption
question
First Aid Care: Ingested Poisons
answer
Ask many questions when taking a history 1. Maintain the airway and monitor the victim's ABCD's 2. If poison was a corrosive (acid) or caustic (alkali): -Immediately give one or two 8-ounce glasses of cold water or milk to dilute the poison as instructed by Poison Control (cold absorbs heat better) 3. Place the victim on his or her left side -Gravity will delay poison entering the small intestine, where most substances are absorbed into the bloodstream 4. Call Poison Control
question
Activated Charcoal
answer
-Odorless, tasteless powder or liquid -Used for Injested poisons -Absorbs poisons in stomach, preventing absorption by the body NEVER give if: - Victim is not fully conscious - Has swallowed acids or alkalies - Is unable to swallow Has taken Syrup of Ipecac
question
Pica
answer
The desire/action of eating inedible substances
question
First Aid Care: Inhaled Poisons
answer
1. Get the victim into fresh air as quickly as possible 2. Monitor the victim's ABCD's 3. If there are no contraindicating injuries and the victim is conscious, have the victim lie down with head elevated -Loosen all tight-fitting clothing, especially around neck and over the chest -If the victim is unresponsive, place the victim on his or her left side *CPR or Rescue Breathing as necessary *All victims of carbon monoxide poisoning must receive medical care
question
First Aid Care: Injected Poisons
answer
Activate EMS immediately, then: 1. Maintain the victim's airway 2. Be alert for vomiting -Keep sitting if possible to prevent vomit inhalation 3. In the case of an animal or insect bite or sting, protect yourself and the victim from repeated injection 4. Attempt to identify source and if possible send with victim to hospital 5. Assist with epi-pen, if applicable ANAPHYLACTIC SHOCK RISK
question
Urushiol
answer
The toxic element of poison ivy
question
First Aid Care: Absorbed
answer
1. Protecting your hands with gloves 2. Move victim from source of poison 3. Remove victim's contaminated clothing and jewelry 4. Brush any dry chemicals or solid poisons from the skin -Take extreme care not to scrape the skin 5. Irrigate the affected area with clean water for at least 20 minutes or until medical help arrives
question
First Aid Care: Absorbed (in contact with poisonous plant)
answer
1. If the victim has been in contact with a poisonous plant, clean the skin well with soap and water, and rinse well 2. To relieve the reaction from stinging nettle (Wash, rinse, apply cold wet compress) 3. If any reaction is severe, activate EMS or transport the victim to a medical facility
question
S/S of a Life Threatening Emergency
answer
1. Unconsciousness 2. Breathing difficulties 3. Fever 4. Abnormal or irregular pulse 5. Vomiting 6. Convulsions
question
Acute Intoxication
answer
- Drowsiness - Disordered speech and gait - Violence - May mimic insulin shock **Alchol is completely absorbed from stomach and intestine within 2 hours
question
4 General Stages of Alcohol Withdrawal Syndrome
answer
Stage 1: Occurs within about 8 hours of a cutback in alcohol (nausea, insomnia, sweating and tremors) Stage 2: Occurs within 8-72 hours Stage 3: Usually occurs within 48 hours, is characterized by major seizures Stage 4: Characterized by delirium tremens
question
Delirium Tremens
answer
Life threatening condition causing delirium that occurs within 5 days of an alcholic's last drink
question
General Guidelines for Managing a Drug/Alcohol Crisis
answer
1. Assure your own personal safety. 2. Provide a reality base. - Introduce yourself - Use victim's name, family/friends 3. Provide appropriate nonverbal support. 4. Encourage communication. 5. Foster confidence
question
Managing a Violent Drug/Alcohol Victim
answer
To prevent a victim from becoming violent, take these steps: 1. Do not invade the person's personal space (moving closer than 3 feet to the victim). Getting too close may seem threatening. 2. Use a calming voice and compassionate tone. 3. Do not place objects between the victim and the door or appear as if you are blocking his or her escape. 4. Move dangerous objects out of sight and reach of the victim.
question
If a victim is violent...
answer
1. Leave the scene and notify law enforcement authorities. 2. Do not attempt restraint unless you are trained and authorized to do so and you have sufficient people to do so effectively. 3. Leave the scene at any time weapons of any type are used or threatened.
question
What type of drug is heroin?
answer
Narcotic
question
Drugs of Concern
answer
- Hallucinogens: Changes moods, alters perception of space and time - Stimulant: Affects CNS, physical & mental activity - Depressants: Affects CNS, physical & mental - Club Drugs:
question
Care for Drug Misuse or Abuse
answer
- Recognize abnormalities in victim level of consciousness, breathing circulation skin color behavior -You do not need to know the specific substance to provide initial care -If overdose has occurred treat it as a form of poisoning
question
Without glucose, the body uses what as fuel What is insulin?
answer
Glucose does not get delivered to cells and they resort to fats and proteins as fuel Insulin- a hormone that takes sugar from blood stream to the cells
question
Type 1 Diabetes
answer
-"Juvenile-onset" Begins during childhood -Victim has little or no ability to produce insulin -Require daily insulin injections
question
Type 2 Diabetes
answer
-"Adult-onset diabetes," -Victim produces insulin but either not enough insulin or the cells do not respond to it
question
Gestational diabetes
answer
-Develops during pregnancy and occurs when hormone in placenta causes body to resist action of insulin -Usually not permanent, ends when baby born -Usually treated with diet, occasionally meds -Babies tend to be very large
question
For diabetics, when in doubt...
answer
give sugar
question
Hyperglycemia/Hypoglycemia
answer
Hyper- not enough of insulin and too much sugar (Happens gradually) Hypo- too much insulin and not enough sugar in the blood (Instant onset)
question
Without glucose, the body uses what as fuel
answer
resorts to fat and proteins as fuel
question
Upper right abdominal quadrant
answer
Right Upper Quadrant: Liver, Right kidney, colon, pancreas, gallbladder
question
First Aid Care: Abdominal Injuries
answer
1. Secure and maintain the airway; be alert for vomiting and possible aspiration 2. Position the victim as comfortably as possible, and take steps to prevent shock -If no S/S of shock are present they may prefer the fetal position. 3. Comfort and reassure the victim 4. Never give anything by mouth. Never give the victim medications of any kind, and do not let the victim take medications on his or her own 5. Record signs and symptoms, including the victim's description of the condition, and continue to monitor until emergency help arrives
question
Gastroenteritis
answer
Inflammation of the stomach and intestines
question
Kidney Stones
answer
A sharp, cramping pain in the back and side area of the kidney or in the lower abdomen.
question
Peptic Ulcers
answer
Deep ulcer in the stomach or duodenum
question
Labor
answer
The process that begins with the first uterine contraction and ends with delivery of the baby and placenta 3 stages: Dilation, delivery of baby delivery of the placenta, recovery
question
Stage 1: Dilation
answer
From the first contraction until the cervix is completely dilated longest stage!
question
Stage 2: Delivery of the baby
answer
Head becomes visible (crowning) The emergence of the baby's head at the vaginal opening
question
Stage 3: Delivery of the Placenta
answer
Occurs within 30 minutes after birth Placenta separates from uterine wall and exits through vagina
question
Stage 4: Recovery
answer
Recovery and stabilization of the mother Lasts approx 1 hour uterus contracts to control bleeding monitor vital signs
question
Care of a Newborn
answer
1. Immediately dry the infant, paying particular attention to the head, which has a large surface area. 2. Repeat suctioning with the bulb syringe, making sure the infant's nostrils and mouth are clear. 3. Assess the infant, evaluating the infant's color, pulse, grimace. 4. Stimulate the newborn if it is not breathing or the heart rate is less than 100 per minute.
question
Breech Birth
answer
1. When the buttocks or lower extremities are the first to present 2. Support the baby 3. If the baby has not delivered w/in 10 min place one hand in the vagina and form a V with your fingers around the babies nose 4. Get to the hospital -keep the mother in a gravity dependent position
question
Meconium
answer
Feces of a newborn -Indicates that the baby had a bowel movement in the uterus before delivery
question
What happens when the amniotic sac ruptures?
answer
Amniotic sac- A plastic-like sac of fluid in which the baby floats... time to push!
question
General Assessment procedure for a child
answer
Special Assessment Techniques -Difficult to pin point pain -Lack of body awareness -Lack of vocabulary to describe pain Does the child look sick? Is the child in shock? Is the child in extreme pain? How is the child breathing? Take vital signs- child: radial
question
Croup and Epiglottitis
answer
Croup- upper airway viral infection Epiglottitis- bacterial infection
question
5 ways the body loses heat
answer
1. radiation 2. convection 3. conduction 4. evaporation 5. respiration
question
Heat cramps
answer
Lest severe: Muscle spasm caused by electrolyte imbalance - usualy from excessive sweating - low calcium levels - too much water and not enough electrolytes - can be caused by supplementes or medications
question
First aid care: Heat cramps
answer
-Remove victim from hot environment immediately, rest in a cool place -Administer sips of salt water -Half a glass every 15 minutes -Dilute 1 tsp salt or 1 bouillon cube in 1 qt of water -Apply moist towels to victim's forehead and over cramping muscles -To relieve pain, try gently stretching the involved muscles -Ice resultant soreness afterward
question
Heat Exhaustion vs. Heat stroke
answer
Heat exhaustion- Caused by excessive loss of water and salt through sweating -Profuse Sweating -Pale, cool, ashen skin -weak, rapid pulse Heatstroke- most dangerous, body's temp regulation system shuts down -Body temperature of 105°or more -Hot, red skin -Initially rapid, strong pulse
question
Heatstroke (what needs to happen?)
answer
- remove from source of heat to cool the victim until mental status returns to normal
question
Heatstroke treatment
answer
1. Establish an airway 2. Remove victim from source of heat when possible 3. Remove as much of victim's clothing as possible, down to his or her underwear 4. Elevate victim's head and shoulders slightly 5. Use a combination of methods to cool the victim until mental status returns to normal 6. Never give the victim stimulants or hot drinks
question
first aid care: general hypothermia
answer
1. Check victim's vital signs -Measure for 1 full minute, vital signs are slowed in hypothermia -If there is no pulse, open airway and begin CPR -AED - deliver only one shock If no correction in rhythm, continue CPR, do not deliver additional shocks -Handle victim very gently -Don't let victim walk around or move much on own -Keep victim in a supine position -Prevent shock and increase blood flow to the brain.
question
Frostbite
answer
Damage to tissues resulting from prolonged exposure to extreme cold - ice crystals form between cells of skin
question
First aid care frostbite
answer
-Immediately remove victim from cold environment -Keep tissue frozen until you can initiate care -Never thaw tissue if there is any chance of it refreezing -Protect injured tissue from friction or pressure -Never poke or squeeze the tissue -Remove constricting clothing or jewelry that is not sticking to the skin -Thaw frostbitten tissue in water 100-110°F- Do not allow extremity to touch sides or bottom of container -Keep re-warming until skin color no longer improves -This may take as long as 40 minutes -Once skin is thawed, any solution that comes in contact with it must be sterile -Cover thawed parts with loose, dry, sterile dressings and elevate extremities -Place sterile gauze between fingers and toes to reduce the risk of increased injury -Monitor vital signs and keep the victim warm until EMS arrives -Do not let victim walk if feet are involved -Do not let the victim smoke
question
Severity of a snakebite
answer
-Location of bite - size of victim - weight of victim - whether disease causing organisms are in the venom - general health/physical activity right after
question
First aid care: snakebite
answer
never - cut the skin, use a tourniquet, apply ice Do the following: - clean with soap/water, cover with dressing, seek medical advice
question
Insect bites/stings: medical help is needed if..
answer
itching last longer than 2 days - signs of infection develop - signs of an allergic reaction develop - the insect is poisonous
question
Brown recluse spider bite symptoms
answer
A brown poisonous spider identified by a violin-shaped mark on its back Bites do not heal and require surgical grafting Serious medical condition Hone
question
what bee can only sting once?
answer
honeybees can only sting once, as they lose their stinger
question
Scorpion stings
answer
rarely fatal - severe paint, nausea, difficulty breathing/swallowing, irregular heart beat call 911, clean wound, apply ice
question
Removing a tick/care for a tick bite
answer
1. Using fine-tipped tweezers, grasp the tick as close as possible to the point where it is attached to the skin 2. Pull slowly, firmly, and steadily until the tick is dislodged 3. Wash the bite area thoroughly with soap and water and apply an antiseptic or antibiotic ointment to the area 4. Apply a cold pack or use Calamine lotion to relieve any pain and swelling 5. Encourage the victim to report the tick bite to a doctor
question
Siezures vs Epilepsy
answer
Seizures: Involuntary Sudden change in sensation, behavior, muscle activity, or level of consciousness Caused by irritation or over activity of brain cells Epilepsy:Chronic brain disorder characterized by recurrent seizures not caused by acute problems, with or without loss of consciousness
question
Types of Seizures
answer
Simple partial (Jacksonian) seizure- -Simple, partial seizure characterized by jerking in the fingers and toes Jerking may spread to involve the entire arm or leg, or even the entire body -Victim stays awake and aware Complex partial (psychomotor) seizure -Starts with a blank stare, then progresses into chewing and random activity -Victim seems dazed Myoclonic seizure -Sudden, brief, massive muscle jerks that involve part or all of the body Atonic seizure -"Drop attack," a seizure in which the legs of a child suddenly and temporarily collapse Absence (petit mal) seizure Characterized by a blank stare that lasts only a few seconds Most common in children Absence seizures do not involve convulsions
question
Generalized Tonic Clonic Seizures
answer
Grand Mal
question
First Aid care seizures
answer
1. Do not move the victim unless he or she is near a dangerous object that cannot be moved. Otherwise, move objects away from the victim. Place padding under the victim's head to prevent injury. 2. Maintain an open airway. 3. Stay calm; if the victim is responsive, reassure him or her; reassure others who are with the victim. 4. Stay with the victim until the seizure has passed; if you need to get help, send someone else. 5. Never try to force anything between the victim's teeth, and never give the victim anything by mouth. 6. Remove or loosen any tight clothing, especially around the neck; remove eyeglasses. 7. Turn the victim on his or her left side with the face pointed downward so secretions and vomitus can drain quickly out of the mouth and so the tongue will not fall back and block the airway. 8. If the victim stops breathing, open the airway, remove anything that might impair breathing, and provide artificial ventilation. 9. Do not try to restrain the victim unless he or she is in danger from objects that cannot be moved. 10. Cover the victim with a blanket to preserve warmth. 11. Keep the victim from becoming a spectacle; ask bystanders to leave. 12. Following the seizure, reassure and reorient the victim; speak slowly and calmly in a normal tone of voice. Allow the victim to rest; help the victim be as comfortable as possible. ***IF SEIZURE LASTS +5 MINUTES CALL EMS***
question
Central Vertigo
answer
Central Vertigo -Least common -Mimics transient ischemic attach or stroke -Victims do NOT experience nausea, vomiting, hearing loss or a whirling sensation Signs and Symptoms -Dysfunction of the eye muscles -Unequal pupil size -Facial droop
question
Labyrinthine Vertigo
answer
most common
question
Preventing Syncope
answer
If the victim has not yet fainted, prevent him or her from falling by having the victim sit down with head between the knees or have the victim lie on the floor with legs elevated 8 to 12 inches.
question
Seizure during pregnancy is indicative of
answer
Endocrine changes during pregnancy or menstruation
Central Nervous System Depressants
Driving Under The Influence
Inflammation Of The Stomach
Nursing
substance abuse disorders – Flashcards 60 terms

Pedro Huang
60 terms
Preview
substance abuse disorders – Flashcards
question
Which individual would have the lowest potential for alcohol dependency?
answer
A 20-year-old Asian woman.
question
The nurse is working with a 45-year-old client who has abused alcohol since age 20. Related to this client's stage of psychosocial development, what developmental data would the nurse expect to assess?
answer
The client may have trouble establishing intimate relationships.
question
Using the principles of biological theory, what contributing factor puts a client at risk for alcoholism?
answer
The client is a child of an alcoholic parent
question
Using the principles of social learing theory, what contributing factor puts a client at risk for alcoholism?.
answer
2. The client was raised in a home where substance use was the norm. 3. The client is from a family that culturally accepts the use of substances. 4. The client experiences pleasure when a substance is used and subsequently driven to repeat the use.
question
Which nursing statement focuses on the personality factors that are implicated in the predisposition to the abuse of substances?
answer
"A tendency toward addictive behaviors increases as low self-esteem, passivity, and an inability to relax or defer gratification increase."
question
. From a biochemical perspective, what factor is implicated in the predisposition to the abuse of substances?
answer
Animal tests show that injections of the morphine-like substance that is produced by alcohol results in addicted test animals.
question
. A client diagnosed with substance dependence states to the nurse, "My wife causes me to abuse methamphetamines. She uses and expects me to." This client is using which defense mechanism?
answer
Projection.
question
A client admitted for chest pain related to cocaine abuse states, "This is nothing but a little indigestion. What is all the fuss about?" This client is using which defense mechanism?
answer
Denial.
question
A client who has recently relapsed from alcohol abstinence is seen in the out-patient mental health clinic. The client states, "I don't know what all the fuss is about. Can't I have a few drinks now and then?" Which nursing diagnosis applies to this client?
answer
Ineffective denial.
question
Which assessment data should the nurse gather when confirming a diagnosis of substance dependence?
answer
A need for markedly increased amounts of the substance to achieve desired effect
question
While performing an intake interview, the nurse learns that the client drinks to avoid early morning "shakes." The nurse recognizes this behavior as characteristic of which assessment?
answer
Substance dependence.
question
The emergency medical service brings an intoxicated client to the emergency department, after the client has been hit by a car while walking on the side of the road. The client states, "How did I get here? Who brought me to the hospital?" Which is the client most likely experiencing?
answer
A blackout
question
What situation places an individual at highest risk for mood and behavioral changes related to alcohol consumption?
answer
A 180-lb college student drinking four beers in a 1-hour period
question
Which of the following are parts of the CAGE questionnaire screening tool? Select all that apply.
answer
1. Have you ever felt you should cut down on your drinking? 2. Have people annoyed you by criticizing your drinking? 3. Have you ever felt guilty about your drinking? 4. Have you ever had a drink in the morning to steady your nerves?
question
A client with a long history of alcoholism recently has been diagnosed with WernickeKorsakoff syndrome. Which symptom should the nurse expect to assess?
answer
Loss of short-term and long-term memory and the use of confabulation
question
A client with a long history of alcohol abuse is seen in the emergency department. The client complains of extreme muscle pain, swelling and weakness of extremities, and reddish-tinged urine. What lab value related to this client's symptoms would the nurse expect to assess?
answer
An elevated creatine phosphokinase
question
A client on an in-patient psychiatric unit is overheard stating, "I blew some snow yesterday while I was out on a pass with my family." What would the nurse expect to assess as a positive finding in this client's urine drug screen?
answer
Cocaine.
question
The following clients are waiting to be seen in the emergency department. Which client should the nurse assess first?
answer
A cocaine abuser with chest pain.
question
A client diagnosed with alcohol dependency states that his wife complains about his alcoholism, but continues to stock his bar with large quantities of bourbon. The nurse suspects codependency. Which characteristic would the nurse expect the wife to exhibit that would be indicative of this problem?
answer
The wife is a "people pleaser" and would do almost anything to gain approval.
question
Which of the following are effective ways to identify a substance-impaired nurse? Select all that apply
answer
1. The nurse may frequently administer medications to other nurses' clients. 2. High absenteeism if the substance source is outside of work area. 3. Denial of substance abuse problems. 4. A high incidence of incorrect narcotic counts. 5. Poor concentration and difficulty in meeting deadlines.
question
What percentage of a single dose of alcohol is absorbed immediately into the bloodstream from which organ of the body?
answer
1. 20% is absorbed through the stomach wall
question
Which statement is true regarding how the body processes alcohol?
answer
Rapidity of absorption is influenced by various factors, such as a full stomach.
question
Which behavior reflects the prealcoholic phase of drinking progression?
answer
Alcohol is used to relieve the stress of life situations, leading to the development of tolerance
question
The nurse is caring for a client on an in-patient substance abuse unit. Because of the client's alcohol abuse, the client has lost family, job, and driver's license. What phase of drinking pattern progression is this client experiencing?
answer
Crucial phase.
question
. A nursing student is reviewing a client's chart. It is noted that the client is exhibiting signs of a drinking pattern in the early alcoholic phase. Which behavior would the student expect to note?
answer
Amnesia that occurs during or immediately after a period of drinking
question
A client brought to the emergency department is observed to be sweating, has dilated pupils, and complains of muscle aches and abdominal cramping. A toxicology screen is ordered. The nurse would suspect these symptoms are indicative of withdrawal from which substance?
answer
Heroin.
question
Three days after surgery to correct a perforated bowel, a client begins to display signs and symptoms of tremors, increased blood pressure, and diaphoresis. What should the nurse suspect?
answer
Withdrawal from alcohol or other central nervous system depressants.
question
A newly admitted client with a long history of alcoholism complains of burning and tingling sensations of the feet. The nurse would recognize these symptoms as indicative of which condition?
answer
Peripheral neuropathy.
question
A client with a long history of alcoholism presents in the emergency department with a sudden onset of muscle pain, swelling, and weakness, and reddish-tinged urine. What lab value would the nurse evaluate as evidence of this client's disorder?
answer
Increase in CPK
question
A client has been diagnosed with Wernicke-Korsakoff syndrome. Which is an example of this client's use of confabulation?
answer
The client clearly discussed a field trip, when in reality no field trip occurred
question
A client with a long history of alcohol dependence comes to the emergency department with shortness of breath and an enlarged abdomen. Which complication of alcoholism is this client experiencing, and what is the probable cause?
answer
Ascites resulting from cirrhosis of the liver
question
. A client with a long history of alcohol dependence comes to the emergency department with frank hemoptysis. Which life-threatening complication of alcoholism is this client experiencing, and what is the probable cause?
answer
Hemorrhage of esophageal varices resulting from portal hypertension
question
A client with a history of alcoholism is seen in the emergency department 2 days after a binge of excessive alcohol consumption. The nurse suspects pancreatitis. Which symptoms would support the nurse's suspicion?
answer
Constant, severe epigastric pain; nausea and vomiting; and abdominal distention.
question
What substance stimulates the central nervous system?
answer
"Crack."
question
The nurse is educating a client about how to avoid sources of stimulation. What produces the least significant stimulation to the central nervous system?
answer
Tequila shooter.
question
All states had to conform to the __________ g/dL blood level standard of legal intoxication by 2004 or risk loss of federal highway funding.
answer
0.08
question
A client is admitted to the emergency department and is tested for blood alcohol level (BAL). The client has a BAL of 0.10 g/dL. What is an accurate assessment of this lab value?
answer
The client is assessed as legally intoxicated.
question
Which is the priority diagnosis for a client experiencing alcohol withdrawal?
answer
Risk for injury.
question
A client with a long history of alcoholism has been recently diagnosed with alcoholic cardiomyopathy. Which nursing diagnosis would take priority?
answer
Altered perfusion R / T effects of alcoholism AEB decreased oxygen saturations
question
Which is the priority diagnosis for a client experiencing cocaine withdrawal?
answer
Powerlessness.
question
. Which is the priority nursing diagnosis for a client experiencing cocaine intoxication?
answer
Risk for altered cardiac perfusion
question
Which is the priority diagnosis for a client experiencing alcohol intoxication?
answer
Risk for aspiration.
question
Which is true about the outcomes of nursing interventions for clients experiencing chemical dependence?
answer
Outcomes should be tailored to the individual's immediate needs and abilities
question
A client who is exhibiting signs and symptoms of alcohol withdrawal is admitted to the substance abuse unit for detox. One of the nursing diagnoses for this client is ineffective health maintenance. Which is a long-term outcome for this diagnosis?
answer
The client's medical tests will show a reduced incidence of medical complications related to substance abuse within 6 months
question
When the nurse is planning relapse prevention strategies for clients diagnosed with substance dependence, which should be the initial nursing approach?
answer
Keep the interventions simple
question
Family members bring a client to the emergency department after a serious motor vehicle accident caused by the client driving under the influence of cocaine. The client states, "This is my first time using crack." Which nursing intervention would the nurse implement next?
answer
Validate this information with family members
question
Which nursing intervention is appropriate for a client who has a nursing diagnosis of risk for injury R / T alcohol withdrawal?
answer
Provide the client with a quiet room free from environmental stimuli
question
Ineffective denial is the nursing diagnosis that is appropriate at this time for a client who has relapsed into alcoholism. What is the priority nursing intervention to address this problem?
answer
Help the client analyze the effects of substance abuse on life situations
question
A client is admitted for benzodiazepine dependence detox. This is the client's fourth detox, and the client's third detox was considered complicated. What would determine the nurse's priority intervention at this time?
answer
The nurse should monitor the client closely and initiate seizure precautions because the client will be at high risk for seizures.
question
Which intervention takes priority when dealing with a client experiencing WernickeKorsakoff syndrome?
answer
Monitor parenteral vitamin B1.
question
A client diagnosed with alcoholism is admitted to a substance abuse unit complaining of decreased exercise tolerance, lower extremity edema, arrhythmias, and dyspnea. Which nursing intervention would be appropriate for this client?
answer
Administering digoxin (Lanoxin) and furosemide (Lasix).
question
A client on the substance abuse unit states, "I used to be able to get a 'buzz on' with a few beers. Now it takes a six pack." How should the nurse, in the role of teacher, address this remark?
answer
. By explaining the effects of tolerance and telling the client that this is a sign of alcohol dependence
question
The nurse has given a client information on alcoholism recovery. Which client statement indicates that learning has occurred?
answer
"I realize that recovery is a lifelong process that comes about in steps."
question
Which of the following are reasons for the success of 12-step programs such as Alcoholics Anonymous (AA)? Select all that apply
answer
1. 12-step programs break down denial in an atmosphere of support. 2. 12-step programs give clients feelings of belonging to a community
question
What classification of drugs shares similar features with alcohol overdose and alcohol withdrawal?
answer
Anxiolytics.
question
A client with a long history of alcohol abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's alcohol recovery?
answer
Naltrexone (ReVia).
question
A client with a long history of heroin abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's recovery?
answer
Buprenorphine/naloxone (Suboxone)
question
A client receives lorazepam (Ativan) because of a high Clinical Institute Withdrawal Assessment (CIWA) score. What is the rationale for this pharmacologic intervention?
answer
Lorazepam (Ativan) is substitution therapy to decrease the intensity of withdrawal symptoms
question
The nurse is planning a teaching session for a client who has recently been prescribed disulfiram (Antabuse) as deterrent therapy for alcoholism. What statement indicates that the client has accurate knowledge of this subject matter?
answer
"I'll have to stop using my alcohol-based aftershave while I am taking the Antabuse."
question
A fasting blood glucose level value is to a sliding scale insulin dosage as a Clinical Institute Withdrawal Assessment (CIWA) score is to:
answer
A lorazepam (Ativan) dosage
Central Nervous System Depressants
Drug Delivery System
ATI- pain management – Flashcards 35 terms

Mary Moore
35 terms
Preview
ATI- pain management – Flashcards
question
acute pain (uh-kewt pane)
answer
transient discomfort or physical distress signaling actual or potential tissue damage and characterized by an identifiable cause, a short duration, resolution with healing, and few long-term emotional consequences
question
addiction (uh-dik-shun)
answer
referring to drug addiction: a dependence phenomenon characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving
question
adjuvant analgesia (aj-joo-vent an-uhl-jee-zee-uh)
answer
a drug primarily used to treat something other than pain but also enhances pain relief
question
alternatives therapies (all-tur-nuh-tiv ther-uh-peez)
answer
treatment approaches, used to replace conventional medical treatments, which are not currently considered part of conventional Western medicine
question
analgesia (an-uhl-jee-zee-uh)
answer
absence of sensitivity to pain
question
analgesic (an-uhl-jee-zik)
answer
substance used as a pain reliever; a drug that acts to reduce pain, including over-the-counter drugs such as aspirin as well as those available by prescription only
question
analgesic ceiling (an-uhl-jee-zik seel-ing)
answer
the dose of a particular drug beyond which additional amounts of the same drug do not increase the analgesic effect
question
breakthrough pain
answer
a flaring of moderate to severe pain despite therapeutic doses of analgesics
question
chronic pain
answer
a feeling of physical distress or discomfort that persists over a long period of time and does not always have an identifiable cause
question
complimentary therapies
answer
treatment approaches used to complement conventional medical treatments
question
dermatome (dur-muh-tome)
answer
area of skin supplied with afferent nerve fibers from a single posterior spinal root
question
efficacy (ef-ik-uh-see)
answer
the ability of a drug to achieve its desired effect
question
epidural anesthesia (ep-ih-dur-il an-es-thee-juh)
answer
medication injected via a catheter into the space between the dura mater and the lining of the spinal canal to create a regional nerve block; also called spinal anesthesia
question
nociceptor
answer
a peripheral sensory receptor for pain, stimulated by various types of tissue injury
question
narcotic
answer
an outdated umbrella term that has been used to refer to opioids, controlled substances, illicit drugs, central nervous system depressants, strong analgesics, and drugs capable of causing physical dependence; opioid is the preferred term for the family of potent pharmacologic analgesics commonly referred to as narcotics
question
neuropathic pain
answer
a type of pain usually felt as burning or tingling and resulting from direct stimulation of nerve tissue of the peripheral or central nervous system
question
non-steroidal anti-inflammatory drug (NSAID)
answer
any of a group of drugs that reduce pain, fever, and swelling (inflammation), including aspirin
question
opioid
answer
one of a group of analgesics that act on higher centers of the brain and spinal cord to modify perceptions of moderate to severe pain
question
pain scale
answer
assessment tool used to rate the severity of pain
question
pain treshold
answer
the point at which a person feels pain
question
pain tolerance
answer
the level of pain a person is willing to endure
question
paresthesia (par-ess-thee-zhuh)
answer
an abnormal burning, prickling, tingling, or numbing sensation or hypersensitivity most often felt in the extremities and typically associated with neuropathic pain
question
patient- controlled analgesia
answer
a drug delivery system that uses a computerized pump with a button the patient can press to deliver a dose of an analgesic through an intravenous catheter
question
physical dependence
answer
an adaptive state characterized by a drug class-specific withdrawal syndrome induced with abrupt cessation, rapid dose reduction, or administration of an antagonist
question
placebo
answer
a pharmacologically inert substance, such as a sugar pill or an injection of sterile water, given with the implication of effective treatment
question
progressive muscle relaxation
answer
a systematic, stepwise approach to releasing tension in major muscle groups
question
somatic pain
answer
generally well-localized pain that results from activation of peripheral pain receptors without injury to the peripheral nerve or central nervous system, such as musculoskeletal pain
question
spinal anesthesia (also called epidural anesthesia)
answer
medication injected via a catheter into the space between the dura mater and the lining of the spinal canal to create a regional nerve block; also called epidural anesthesia
question
titration
answer
the process of gradually adjusting the dose of a medication until the desired effect is achieved
question
tolerance
answer
an adaptive state characterized by a decreasing response to repeated constant doses of a drug or the need for increasing doses to maintain a constant response
question
transmission
answer
spreading of the pain "message" across the various nerve fibers linking the pain impulse to the brain
question
visceral pain
answer
pain that results from activating the pain receptors of organs in the thoracic, pelvic, or abdominal cavities and is felt as a generalized aching or cramping sensation sometimes referred to the surface of the body
question
visual analog scale
answer
a pain rating scale using a straight line; the left end of the line represents no pain, the right end represents the worst pain, and patients mark the place on the line that best represents the severity of their pain
question
WONG-BAKER FACES SCALE
answer
a pain assessment tool that asks patients (often children) to select one of several faces indicating expressions that convey a range from no pain through the worst pain
question
World Health Organization (WHO)
answer
the specialized agency of the United Nations that deals with health on an international level, functioning as a directing and coordinating authority on international health, and has developed a three-step pain "ladder" for cancer pain relief
AP Environmental Science
Central Nervous System Depressants
Criminal Law
Forensic Science
Photography
Spectroscopy
CSI chapter 7 and 8 164 terms

Patsy Brent
164 terms
Preview
CSI chapter 7 and 8
question
What is trace evidence?
answer
a generic term for small, often microscopic material. it is physical evidence of contact, and can become a significant part of an investigation.
question
this chapters discusses ways trace evidence is____
answer
collected, preserved, identified, and used
question
What is the Locard Exchange principle?
answer
a concept of transfer,when a person comes into contact with another person/environment, there are some small changes that take place. something is added or taken away. \"certain small and seemingly insignificant changes occur\"
question
what is the importance of transferred trace evidence?
answer
it links suspects to victims or locations
question
Who is the bad guy?
answer
suspect, perpetrator,
question
who is the good guy?
answer
victim
question
sources of trace evidence means
answer
places/hosts of where trace evidence can be found/is on.
question
types of source of trace evidence
answer
trace evidence can be found: on clothes (fibers/hairs on clothes), footwear, on the body, tools, weapons
question
how can trace evidence stick to clothes?
answer
static electricity or become caught in the fabric
question
things to know about clothes as a source of trace evidence:
answer
-collect clothes from the suspect and victim asap (bc evidence/fibers can be dislodged) -make the suspect undress on clean wrapping paper, so the paper will catch any trace evidence that might fall from the clothing -collect clothing, tag the clothing, marked and packaged in paper bags (NEVER PLASTIC BC THAT MAKES MOLD/MILDEW) -dont shake the clothes in the bag because it could dislodge the evidence -if the clothes are wet/bloodstained,they should first be allowed to air dry before packaging -keep suspects clothing away from any sources of trace evidence
question
clothes should be packaged in ___bags
answer
PAPER
question
If known samples from the scene have been collected as exemplars, they should never be packaged with the suspects clothing.
answer
because if he says he wasn't at the seen, then none of the samples should be found on his clothing right?
question
sentence that makes things clear
answer
officers at the scene collected samples of roofing, tar, wood, and plaster to be used as exemplars for any trace evidence that might be found on the suspect.
question
known samples=
answer
exemplars
question
what happens once the clothes have been put in a PAPER bag?
answer
submitted to the crime laboratory for careful examination
question
what if there is a hair/small fiber that could be dislodged on the shirt?
answer
carefuly packaged it in a test tube, pill box, paper fold, post-it note, or other appropriate container. Naturally, the location of this evidence should be noted and the items appropriately marked for identification.
question
how to solve improper evidence handling by emergency medical personnel when they are acting to save someone's life/an emergency?
answer
have police agencies attempt to educate them. crime laboratory personell should be advised to paramedics cut off pieces of clothing, etc.
question
how to collect clothes from deceased victims
answer
before the victim is undressed, the body should be carefully examined for trace evidence by the investigator. An alternate light source can be used in locating trace evidence. The clothing should be carefully removed and placed onto wrapping paper.-if wet from blood, let the clothes air-dry before placing into paper bags
question
Next type source for trace evidence: footwear
answer
shoes have dust, soil, debris, vegetation, or bloodstains on them -useful in shoe impression evidence comparison
question
how should shoes be packaged?
answer
INDIVIDUALLY PACKAGED TO AVOID CROSS CONTAMINATION
question
what happens if there is soil stuck to the shoe?
answer
particular care must be taken when packaging footwear evidence containing clumps of dried soil. make sure the soil does not become dislodged on its transmission to the laboratory
question
Next type source for trace evidence: evidence from the body
answer
Injuries-show signs of struggle -microscopic particles of gunshot residue are often present on the hands of a shooter -hair found on the victims body in rape cases -bloodstains on a victim or suspects body during an assault/murder -CLOSE examination of head, ears, fingernails scraping, and hands may yeild trace evidence so be on the lookout
question
other objects for sources of trace evidnece
answer
tools and weapons, and other objects
question
how to package tools?
answer
but in cardboard box and secure it with zip ties. If the tool/instrument has parts that could fall off-they should be removed and placed in appropriately labled containers.
question
Larger items can also be sources of trace evidence
answer
such as a car, search the car for trace evidence on the scene (if the lab doesnt have a car lot to bring to car to investigate)
question
microscopic evidence can be seen
answer
with high and low power light microscopes, scanning electron microscopes, various types of spectrigraphic tools-its not hard, it is common place to find trace evidnece! :) -it isn't a problem
question
A far greater problem than the SIZE is the QUANTITY of the material brought into the lab
answer
...
question
Collection and preservation of trace evidence
answer
there are legal and scientific aspects to collecting and preserving trace materials
question
what are some of the legal issues regarding trace evidence?
answer
chain of custody, search warrant, court orders are needed-investigators should contact the district attorney for guidance
question
commonly asked question: is it better to remove an item of trace material from a larger item or leave it alone?
answer
the answer is: it depends. If a hair, fiber, lose paint chip, or other very small easily lost item of evidence can reasonably be expected to become dislodged or lost from the item of origin, the smaller item should be removed. If the investigator thinks it will not be lost, then it should not be removed.IT IS PREFERABLE TO SEND THE TRACE EVIDENCE ATTACHED WITHOUT BEING REMOVED.
question
what is something is too large to transport/send to the lab?
answer
trace material should be carefully removed, packaged, and sent to the lab for examination
question
when possible
answer
send photographs of from where the trace evidence was taken from.
question
small items of evidence should always be ____ packaged
answer
double
question
what to mark on the containers?
answer
mark these things on BOTH of the containers: person doing the packaging, date/time, case number, brief description of the item
question
the known exemplars should never be packed with the
answer
questioned samples
question
examples of trace evidence:
answer
building materials, asbestos, safe insulation, paint, rust, metals, textiles/fibers, buttons, cordage and rope, cigarette/tobacco, matches, burned paper, ash, soil, chips and wood splinters, sawdust, wood meal, particles of finely powdered wood, plant material, glass, broken panes of glass, objects left at a crime scene (paper, articles of clothing, product markings), foodstuffs, hair, feathers, electrical wires, broken tools, tape, headlamps,
question
first example of trace evidence: building materials
answer
materials such as stucco, cement, brick, mortar, plaster, sheetrock, plasterboard, window glass, wood and paint constitute evidence generally considered as building materials.
question
where is building material trace evidence most likely to be found?
answer
on the clothes of burglars (in their cuffs, pockets, shoes), or the tools used to break into the location
question
additional building material as trace evidence info:
answer
-examine the point of entry, and take exemplars from it -If tool marks are present, samples of building material should NOT be taken from the area of the tool mark, but rather adjacent to the mark. don't cut through the tool mark -collect known specimens from each area of damage/ break in (bc the composition of the building may vary from spot to spot) -package each item of evidence separatly -TOOLS may be useful sources of building material trace evidence-chips of paint, bm, glass, may stick to them (if found on a tool, don't dislodge the evidence, send it into the lab attached to the tool) -search the interior of a suspects truck for building materials (vacuum sweepings), on shirts
question
building material evidence can only demonstrate_____ and cannot be shown to be unique to a specific source. It is valuable as_____ (this is true for most all trace evidence)
answer
class characteristics, circumstantial evidence
question
How can building material be identified?
answer
by physical, chemical, and microscopic means
question
Next type of trace evidence: Asbestos
answer
used to insulate older homes, can be identified microscopically
question
Next type of trace evidence: Safe insulation
answer
suspects clothes, shoes, and tools may yeild safe insulation
question
how can safe insulation be identiffied?
answer
microscopically and chemically
question
Next type of trace evidence: paint
answer
can show if paint came from a specific location if peices are large enough and can be fitted like a jigsaw puzzle back together with it's orginal place of location. (but most often only class characterisitcs can be demonstrated). easier to tell if came from once source if there are many layers of paint
question
how is paint identified?
answer
by physical and chemical properties
question
physical properities of paint
answer
color, layering, weathering, texture
question
chemical properties of paint
answer
solubility and composition
question
in cases where there was forced entry:
answer
take paint samples as close to the area of damage as possible to lessen the possibility that a further away spot had paint composed differently. BUT DONT COLLECT NEAR THE PRY AREA/TOOL MARK LEAVE THAT ALONE dont take a sample from here
question
In a hit and run investigation involving two vehicles, how many paint samples should be collected?
answer
four paint samples, separately packaged. collect a sample from sample A the point of impact that contains a paint transfer from vehicle b. Also collect a standard paint sample that shows no damage but is adjacent to the damaged area. do this with vehicle b as well
question
how to get a paint sample
answer
tap the side of the vehicle with a pocketknife and let it fall onto a pieve of paper. DO NOT PACKAGE A PAINT SAMPLE IN AN ENVELOPE OR PLASTIC BAG. package in folded paper or a small box with a good seal. Include the substrate
question
Rust
answer
rust may sometimes be confused with bloods stains but can be differentiated by a chemical test
question
Metals
answer
can be identified chemically or spectrographically. Metal filings (from doorknobs) can be found on teeth wrenches used in burgarly cases.
question
textiles and fibers
answer
torn fabric used to gag victims, left clothing at crime location, a portion of fabric may be physically fitted into another piece of fabric (individual characterists-came from one source location) as well as class characteristics. physical, chemical, and microscopic properties-thread count, dye, color, direction of yarn twist, etc. fiber evidence can be transfered from blankets, etc.
question
trace evidence that can have individual characteristics
answer
anything that can be jigsaw fitted into something else. Paint, textiles (clothing pieces/fabric BUT NOT FIBERS)
question
If textile evidence is found at the crime scene it should be:
answer
its location should be noted. Indicated on a crime scene diagram, and photographed. As with other trace evidence, it is preferable not to remove the textile from the object to which it is attached.
question
five types of textile fibers can be encountered as evidence:
answer
animal fibers (wool), vegetable fibers (cotton/hemp), synthetic fibers (polyester, nylon rayon), mineral fibers (glass wool), and blends of synthetic and nature fibers (such as cotton and polyester)
question
you should leave fibers intact to original object, but if not possible (fall off easily) you can
answer
remove by using forceps, cellophane tape, or vacuum sweeping. Of these three the tape method is probably the best (bc it only collects surface material, whereas a vacuum sweeping collects huge amounts and forceps may not capture the trace evidence). Fiber evidence can never come from one unique source (bc garments today are mass produced).
question
buttons
answer
can usually only be used as trace evidence if thread/piece of clothing was attached to the button.
question
cordage and rope
answer
If they were used to tie up a victim, don't untie the knots ( leave them alone). Cut the rope in another spot and tie it back together with string. The knots could provide to be useful evidence! In strangulation cases, skin cells may be attached
question
cigs and tobacco
answer
identify a brand from a butt (info about what brand a suspect uses could be useful).types of ashes left (smokes pipes?)-shows suspect habits.fingerprints may be found on cigs using the ninhydrin process. dna from the saliva left on the butt. cig box-determine location of sale from numbers on the box.
question
matches
answer
find the book of matches on the suspect. Paper/cardboard matches are most common. saliva found at the end of the match-dna could be on it.
question
burned paper
answer
if found in a metal file box, leave it there and send to lab. otherwise, put paper in rigid cardboard boxes. slide a flat peice of cardboard under charred paper to lift it up.- hand carry boxes to lab bc of their fragile nature. If a paper is burning at the scene-DO NOT PUT OUT THE FIRE. do not separate layers of paper, just turn it all into the lab
question
how to read burned documents?
answer
chemical treatement, photography, and examination under ultraviolet and infared light can make the writing legible.
question
how can ash be identified?
answer
microscopically, chemically, or by means of spectroscopy. the source of the ash may be difficult to determine.
question
what is the common type of ash in arson cases?
answer
residue of burned highway flares.
question
what does the ash contain a significant level of?
answer
strontium (responsible for the bright red color of the flare)
question
soil as trace evidence
answer
can be found on shoes, underside of a vehicle-impression evidence on soil-can tie a suspect/car to a place.
question
what is soil
answer
a mixture of decaying and weathered rock and decomposed organic material known as humus. minerals are in it such as quartz, feldspar, and mica, as well as decomposed leaves, pine needles, pollen grains, and other plant fragments. THUS IT IS EASY TO DIFFERENTIATE SOILS FROM VARIOUS LOCATIONS BY MICROSCOPIC EXAMINATION
question
how should soil be collected?
answer
it should be collected in various regions at the specific location in question, and several feet away from it, and at other locations (such as the subjects home or work) for elimination purposes.
question
Where should you place soil specimens?
answer
known samples can be placed in individual small glass jars, such as clean baby food jars. METAL CONTAINERS SHOULD BE AVOIDED.
question
how much of the soil should be taken?
answer
two or three tablespoons of TOPSOIL (DO NOT dig deeper than an inch bc the subsoil may have a different composition)
question
Wood
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can take the shape of many forms: sawdust, splinters, chips, large pieces used as assault weapons, etc. wood can have tool marks on it
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Wood trace evidence is ___ valuable
answer
most....it is possible to identify, compare and match sources of wood evidence.
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what are the two types of wood?
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hard woods and soft woods. It is possible to determine the type of wood and type of tree from pieces the size of sawdust particles (WHOA)
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how is the examination of wood done?
answer
microscopically.
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the ____rings of a tree are very characteristic
answer
annual
question
read the section on wood-it is confusing
answer
...
question
plant material
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wood, leaves, seeds, bark, twigs, and pollen-attached to clothing, found in a vehicle, etc. fragments of plant material are hard to identify, so botanists from a museum are likely to be sought out for help.
question
What type of plant material is useful to know if a suspect was in an area with flowered plants?
answer
pollen....vacuum sweeps of a suspects clothes may yeild microscopic pollen grains.
question
GLASS ASS ASS ASSS ASSSS
answer
broken glass may yield information about the direction and speed of a projectile, and, in the case of multiple projectiles, the sequence of events (this is importante!!)
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Broken panes of glass
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was it broken from the outside of inside/struck by a bullet or a rock?....how to find out:
question
What can determine from which direction the force came from that caused the glass to break?
answer
rib markings
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what are the two types of glass fractures?
answer
radial and concentric
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how to determine the direction of force?
answer
by examining the rib markings along the edges of radical and concentric fractures
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when examining rib marks of radial fractures
answer
look at the right angles..the side without the right angles is the side that the force was applied opposite side-concentric is the other way around
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how to send glass to a lab?
answer
the pieces should be individual wrapped in paper.the wrapped evidence may be placed together in a box for easier transportation.
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high velocity bullets leave:
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an almost circular hole in a pane of glass without noticable cracking or with cricks merely starting
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lower velocity bullets leave:
answer
an almost regular polygon with radial cracks running outward.
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a shot at very close range:
answer
more or less completely shatters the glass from the pressure of the muzzle gases-in such cases it is impossible to obtain a clear idea of the appearance of the shot hole. evidence of a shooting at close range-gun shot residue on the glass. sometimes you can metal around the ridges of glass that it when through (spectrographically).
question
difference between rock and bullet holes:
answer
the crater-like expansion of a hole caused by a small stone may not show the same uniform fracture in the glass as a bullet hole would. holes caused by small stones do not show the same geometric regularity in the radial and concentric cracks in the glass around the hole as that is shown by a bullet hold. Large stone can shatter a piece of glass if thrown at close range-thus you should search for the projectile that did the damage
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order of cracks? If multiple
answer
radical cracks produced by the first incident stop by themselves or run to the edges of the glass.the cracks on the subsequent incident stop when they meet the cracks already present from the earlier fracture
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cracked or burst panes of glass
answer
...
question
glass cracked by heat shows
answer
characteristic long wavy fractures. pieces fall out in the same direction as the source of heat.
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objects left at the crime scene
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paper, such as newspaper, wrapping paper, can be left behind-handwriting, latent fingerprints can be found. torn or cut peices, can find matching peices in the suspects home.stains may be used to show connection to another site
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articles of clothing
answer
clothing left at a scene can show the nationality of the wearer, and the size, laundry marks. Initials could be found inside the clothes. if dried blood is found on clothing, you can look for DNA.
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what is foodstuffs? cosmetics?
answer
foodstuffs in the form of stains or debris can be used to determine the type of work the suspect does. if starch is found in the vacuum sweep, the suspect could have been baking.
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Hair as trace evidence
answer
hair should use 2 things:microscopic hair evaluation should be couples wth DNA testing. mitochondrial DNA testing if the shaft is present, nuclear DNA testing if there is a root)
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what can hair tell us?
answer
species, location, growth place on the body, hair treatment, hair disease, if hair fell out naturally or pulled
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how to search for hair?
answer
flashlight and a pair of twezers.
question
how many hair should be collected from the head to use an exemplars?
answer
25
question
Chapter 8: Blood, Forensic biology, and DNA
answer
...
question
what can deoxyribonucleic acid (DNA do)?
answer
determine the identity of unknown human remains, tie a suspect or victim to a crime scene, establish paternity, and identity the unknown prepertrator to a cold case.
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safty procautions
answer
people working with wet or dried blood should use PPE personal protective equitment such as tyvek suits, lab coats, gloves, masks, and goggles/face shields. ppl should get hepitis vacinations. blood could have HIV, etc. so it is dangerous.
question
_____ should be worn when working with any biological products (blood, saliva, semen)
answer
surgical gloves
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______ gloves should be used when scraping an item for DNA evidence with a razor blade.
answer
cut resistant
question
how to dispose of biological evidence?
answer
use commerical disposal companies that specialize in biohazardous material waste.
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____is a big concern when handling biological evidence
answer
contamination. try to eliminate dna transfer. collected items of evidence should be packaged separatly. KNOWN AND QUESTIONED SAMPLES SHOULD NEVER BE PACKAGED TOGETHER.
question
What should tools be wiped down with to avoid cross contamination??
answer
10% bleach, followed by 70% ethanol.
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any individual in a crime scene should submit their dna in case their was contamination/transfer (used as elimination samples)--They will NOT be uploaded to CODIS
answer
...
question
what is the name of the national DNA database?
answer
CODIS COmbined DNA Indexing System
question
Blood pattern analysis-what ccan it do?
answer
the shape, grouping, and distribution of bloodstains can assist the investigator in reconstructing what took place at the crime scene. Determines the movement and direction of the person, the sequences of events, the area of origin, the number of impacts during an incident, and the object used to create the pattern.
question
what are the three basic classifications of bloodstains?
answer
passive, spatter, and altered
question
what are the two types of bloodstains?
answer
impact spatter (blood that travels through the air from an impact mechanism), and transfer stains (stains resulting from contact with a bloody surface)
question
a pointed of tail end of a bloodstain indicates direction of travel.
answer
...
question
equation for the angle of impact
answer
=arc sin(width of ellipse)/(length of ellipse)
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who is the BPA?
answer
The Scientific Working Group on Bloodstain Pattern Analysis
question
Presumptive tests for blood aka catalyic tests
answer
may be used to search for small amounts of blood, or note that its blood if they think it might be something else. They are chemical tests and can be used to see if a suspect cleaned up the crime scene.
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HOWEVER
answer
Presumptive tests are NOT confirmatory tests for blood.
question
names of the presumptive tests
answer
leucomalachite green, phenolphtalein, orthotolidine, tetramethylbenzidine, luminol
question
Presumptive tests are ____ tests that depend on the properties of ______
answer
color spot....hemoglobin (the oxygen carrying material found in blood). a positive result can result from human or animal blood, as well as some plant material so be careful
question
which two PTs are the most specific?
answer
phenolphthalein and leucomalachite green
question
which two PTs are the most sensitive?
answer
orthotolidine and tetramethylbenzidine
question
generally, the _____aka Kastle Mayer test is a good overall choice
answer
phenolphthalein
question
how is phenolphthalein conducted?
answer
on filter paper or on cotton-tipped swabs. PERFOMRING THE TEST DIRECTLY ON EVIDENCE SHOULD BE AVOIDED. then kastle mayer reagent is added, then a drop of 3% hydrogen peroxide....color will change from clear to pink if hemoglobin is present
question
____can be purchased at a drug store and was used to test for blood in urine
answer
Hemastix
question
what is the luminol test good for?
answer
very useful for searching for large areas of blood, specifically blood that has been cleaned up.
question
what are the drawbacks to the luminol test?
answer
room must be completely dark bc blood reacts with luminol by giving off light, a process called chemiluminescence. The reagent is sprayed with an aerpsol sprayer. the glow given off is faint. The test works best on older stains.-bleach can cause a false positive.
question
what is a better test than luminol and why?
answer
bluestar forensic latent bloodstain reagent-is nontoxic, total darkness is not required, has stronger luminescnce, longer lasting reactions, and higher sensitivity.
question
Postive presumtive test plus DNA test are both needed to indicate the presence of human blood. OR
answer
The Hexagon OBTI test allows the investigator to confirm the presence of human blood.
question
What color is a dry but relatively fresh bloodstain?
answer
reddish brown color and glossy. in a very thing layer the color may be grayish green. the gloss slowly dissapears.
question
color change on blood is ____ on metal surfaces and ____ on textiles
answer
quicker, slower
question
how to search for stains
answer
use lights, colored lights, red, green, white or infared lights.
question
how to record blood stains
answer
describe their form, size, color, position, direction of splash--
question
the best way to preserve the appearance of bloodstains if through____
answer
photography-overall, medium, and close up range shots (close up range should provide a scale)-also a sketch-(a drop of blood located 25 inches from the floor and 16 in east of the doorway om the north kitchen wall indicating a downward direction.
question
collection and preservation of bloodstains
answer
air dryed sample in a paper bag at room temperature. it does degrade over time in certain environmental conditions.
question
_____the specimans down slows down deteriroation
answer
drying.....DO NNOT place in air tight containers, or damp environments
question
why is it important to save evidence for awhile?
answer
some defendants need to use it in court and the evidence must be preserved. or else the case could be thrown out.
question
how to collect wet blood?
answer
place a cottown swaab into the still liquid pool of blood. or filter paper or cotton gauze. sterlyl cotton tip applicators...let air dry, then place in a coin enveleop
question
most blood found at crime scenes is ____
answer
dry.can collect with a cotton ball with distilled water on it. let it dry, place in an envelope, mark it
question
for very small stains, it is best to ____the blood on one area of the swab rather than spread it around the entire surface of the swab
answer
concentrate.
question
Bloodstained objects
answer
it is best to bring the entire blood stained object to the lab. If the blood apepars lose and flaky, then it should be collected and sent to the lab. packaged air dryed blood stained objects loosely in paper bags.
question
semen stained objects
answer
sexual assault cases.
question
how to identify semen stains?
answer
an alternate light source can be used due to semens flourescent properties under certain wavelengths of light. once a stain is located, a presumptive test is done to determine if the stain is indeed semen.
question
what are the presumptive tests for semen?
answer
looking for acid phosphate (AP)-color spot test that changes from clear to reddish-purple. after the PT another test must be done-either look microscopically for sqimming spirm, or detect Prostate specific antigen (PSA) or p30.
question
Forensic DNA typing
answer
...
question
how to collect DNA
answer
buccal swipes are taken (inside of a cheek)-an excellent alternative to collecting blood samples.
question
DNA typing is based on our_____
answer
genetic makeup
question
differences has a root in
answer
genetics, mid 19th century, gregor Mendel
question
DNA is the biochemical key to differentiating uniqueness amoung individuals.
answer
twisted ladder, double helix, the steps within the ladder consist of four chemical subunites or bases
question
what are the names of the bases
answer
guanine (G) Adenine (A) Thymine (T) and Cytosine (C)
question
the bases always pair in this way
answer
AT, CG
question
DNA is folded into microscopic bundles called
answer
chromosomes
question
chromosomes exist in the celll
answer
nuclei
question
____ blood cells contain DNA
answer
white
question
what has DNA?
answer
blood, semen, bone marrow, tissues, hair roots, dandruff, saliva, tooth pulp
question
How to examine DNA?
answer
using a Polymerse chain reaction procedure (PCR) or is known as STR analysis
question
PCR is
answer
a technology that copies short segments of DNA millions of times in a process that resembles the way in which DNA naturally duplicates itself in the body. It is a powerful method bc it can applied to any body sample no matter how small.
question
how PCR works
answer
extracts DNA from the cells, separates the DNA double helix into two strands by HEATING the sample. A PCR mixutre is then added. has DNA primers (Short segments to indicate the target segment of DNA to be copied), DNA polymerse (an enzyme), and the four nucleotide bases ACTG.
question
what type of instrument is a PCR performed in??
answer
thermocycler, repeated for 28 cycles.
question
after DNA is separated, then it goes through a process called
answer
capillary electrophoresis.---eventually data is converted to electronic data into an exlectropherogram
question
high sensitivity DNA testing/touch DNA
answer
used to detect and recover small amounts of DNA--increased cycle number for PCR and interpretation methods. example items to be used:car swabs, handles of weapons, keys, pens, air bags.
question
mitochondrial DNA
answer
mitochondira are found in the cytoplasm of most cells.they are the engery for the cell.
question
how does mtDNA differ from DNA
answer
-mtDNA is much smaller molecule (circular shaped) -it is only inherited maternally -is present within a cell in multiple copies bc there are many mito in the cell
Central Nervous System Depressants
Nursing-LPN
Psychology
Theories And Techniques Of Counseling
Zoology
Addiction Counseling Study Guide/ NAADAC 69 terms

Kevin Stewart
69 terms
Preview
Addiction Counseling Study Guide/ NAADAC
question
Principles of the Behavioral Modification theory
answer
There are three principles, Causes, Maintenance and change of behavior. Classical conditioning, Operant conditioning, Modeling is the most effective.
question
Principle of CT/RT. Control Theory/ Reality Therapy
answer
is based on the principle that four elements guide human functions: Doing, Thinking, Feeling, and Physiology. People choose negative reactions to events, Is responsible for one's own life. Cant change how the body feels or functions but can control how he reacts and thinks.
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Principles of person centered therapy.
answer
Centered around the idea that it is the patient's responsibility to find ways to deal with reality. Three principles/ Positive regard, Empathy, Congruence, demonstrate being real and genuine.
question
Principles of Freudian or Psychonalytical
answer
Human being are influenced by powerful inner and unconscious drives. id, ego, superego. People go through 5 stages of life. oral, anal, phallic, latency, and genital.
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How substance abuse and domestic violence programs may be in conflict.
answer
Terms such as denial, codependency, and powerlessness are seen as stigmatizing and self defeating in helping people who are in violence abuse situations.
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Rational Emotive Behavioral Theory.
answer
It is not the actual event that disturbs a person but how he sees the event. Negative life events, negative beliefs, and negative consequences. ABC model.
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Deductive reasoning
answer
The ability to solve problems by working from a given situation to a conclusion.
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Inductive reasoning
answer
The ability to solve problems by working from a specific experience to a conclusion.
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Adolescent egocentrism
answer
Self -centeredness based on the concern about what others think
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Identity formation
answer
Process that a person goes through in becoming a distinctive individual.
question
Identity achievement
answer
Occurs when a person sets a goal based on his values.
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Pharmacotherapies in treatment of substance abuse
answer
Means using prescription drugs along with some form of therapy to treat substance abuse. Benzodiazepines and anti-seizure medicines are aids for this, and methadone for treatment of heroin.
question
Family Systems and addiction counseling
answer
When a person uses drugs the whole family is affected.
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Solution focused therapy
answer
Focused on things that work rather than the problem. The successes of a patient should be dealt with rather than his disabilities or deficits.
question
Gestalt Therapy
answer
Based on the idea that people must accept responsibility for what happens to them and find their own way in life. Help the patient be what he wants to be rather than try to be something that he is not.
question
Adlerian Individual Therapy
answer
Believed that social urges were what influenced people. Based on people are always striving to do better. Therapist try to see the world from the viewpoint of the patient.
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id, ego, and Super Ego
answer
The unconscious drives, The internalized outside world and, Takes the forces of conflict results in creating a defense mechanisms such as denial.
question
Characteristics of physical, mental and personality, Social development of young adulthood and late adulthood
answer
Physical health issues, Mental health issues, personality and social disorders.
question
Motivational Enhancement Therapy - (MET)
answer
It is Motivational Psychology. Belief that the patient has the capability as well as the responsibility to change. 5 Stages of change.
question
pharmacotherapies is based on.
answer
Prescription drugs can be used to detox, stabilize and maintain people with substance abuse addictions.
question
Behavior Modification Theory
answer
The idea that all behavior is learned, and what is learned can be unlearned.
question
Classical conditioning
answer
Substituting a stimulus which brings about the same result
question
Operant Conditioning
answer
Increase or decrease of certain behaviors through the use of reinforcement. Negative reinforcement can decrease a behavior.
question
NAADAC regarding the addiction of alcohol to the National Drug Control Strategy
answer
Alcohol is a drug even though it is legal. Alcoholisim is the primary chronic disease among many groups of U.S. Citizens.
question
Difference between medical malpractice and negligence.
answer
a patient filing a law suit for compensation, and a breach of duty.
question
Safety Sensitive
answer
refers to an employee's job description.
question
Reasonable cause
answer
is conducted when a supervisor suspects that an employee is engaging in alcohol or drug misuse.
question
DOT Drug testing policy
answer
Marijuana, cocaine, opiates, narcotics, amphetamines, PCP and Alcohol are required to be apart of a drug screen.
question
Professional issues and Self Referral Process
answer
When a professional is using substances, use the process to get help for their behavior.
question
NAADAC Peer assistance committee
answer
Help other professional that have relapsed or are using illicit drugs or are impaired and cannot perform their counseling duties.
question
Professional Ethical decision making
answer
Is it based off of what I believe, or professional codes of conduct? Which principle of ethical conduct is involved. Is the conflict based on intellect, emotion, or needs?
question
Client Relationship Principle of Ethical standards
answer
Make sure the client has access to effective treatment, and that the integrity of the treatment relationship is safeguarded. Do not use the Client/Counselor relationship for personal gain or sexual behavior etc.
question
Competence principle of ethical standards
answer
The counselor need to continue their education so that they can provide the very best professional competency. Counselor should be able to treat several types of disorders.
question
Non-Discrimination, responsibility, Competence, legal and moral standards for alcohol and drug abuse counselors
answer
Not to discriminate against clients or members of the profession because of race, religion, age, gender, disability, ancestry, sexual orientation, or economic condition. Protect the rights of the client.
question
Transportation services provided by DOT.
answer
Known as SAP services SAP is to provide a drug free work place. Professional services for substance abuse is set up by DOT.
question
Ethical principles of interpersonal relationships, remuneration, and societal obligations.
answer
Members should be treated with courtesy, respect, fairness and good faith. Never counsel someone who already has a counselor. Co-operation with other professionals ethics committees is require unless confidentiality will be broken.
question
Publication Credit -Ethical Principles
answer
Give every one credit who contributes to published material
question
Client walfare-Ethical Principles
answer
Inform all client of the code of ethics, professional loyalties, and responsibilities
question
Confidentiality -Ethical Principles
answer
Keep client confidentiality the first obligation.
question
Client Relationship-Ethical Principles
answer
Must be safe guarded so that the moral soundness of the counseling relationship is preserved.
question
HIV infection and AIDs for chemically dependent individuals
answer
Many people have fear of HIV and AIDS: Therefore counselors must learn ways to deal with this fear.
question
Laws and regulations regarding reports and record keeping
answer
Accurate reports and record keeping is the responsibility of counselors. Federal, State and licensing require that appropriate records are kept by healthcare professionals
question
Quality Assurance (Q.A.)
answer
A means of evaluating the quality of treatment services by a facility. A written plan and documentation that problems are addressed after they are identified.
question
Referral, consultation and client welfare
answer
Knowing the responsibility of counseling as well as client, Competence, legal and moral standards, client welfare, confidentiality, consult with other professionals.
question
Federal Controlled Substance Act
answer
Record keeping for Programs. Documentation monitoring, All mandatory information on forms, Dosage. Maintain records for two years and kept confidential.
question
Alcohol health disorders
answer
Gastrointestinal disorder, Cardiovascular disorder,Skin disorder, Neurologic and psychiatric disorders
question
Confidentiality laws and regulations
answer
Signed Consent forms must be completed before any information can be shared.
question
Confidentiality exceptions by Law.
answer
imminent harm or danger, Legal attorney consultations.
question
Drug testing
answer
Is a means of getting help for someone and not a form of punishment.
question
Chemicals found in PSYCHOTROPIC DRUGS, ANTIDEPRESSANTS
answer
Dibenzoxazepine, Selective Serotonin, Prozac, Zoloft, Luvox, Selective Norepinephine, Effexor, Tetracyclic and Trazodone.
question
Psychotropic,Mood Stabilizer and Antipsychotic family
answer
Chlorpromazine, Triflupromazine Resperidone, resperadol, Clozapine,
question
Narcotics
answer
Opiates, codine, oxycodone, morphine, perocet, percodan, vicodin,
question
Benzodiazepine depressants
answer
Xanax, Clonazepam, Diazepam, Short term effects include anti-anxiety and sedative effects.
question
Barbiturate Depressant -taken oral, Intravenous, or smoke.
answer
Phentobarbital, short term effects are induced sleep, relax muscles,and calm anxiety. Long term, vomiting, constipation, high blood pressure, insomnia, confusion.
question
Naltrexone
answer
An opiate blocker, has been found to be effective in treatment of heroin addicts.
question
Withdrawal from Stimulants
answer
depression, increased appetite, irritability, weakness and energy loss. Increased need for sleep and loss of concertration
question
Pharmacotherapies available for alcohol use disorder are
answer
Disuliram and Naltrexone. Also groups for coping skills, relapse prevention, and the use of other support groups.
question
Central Nervous System Depressants
answer
Alcohol, Barbiturates, Benzodiazepines, Klonopin,
question
Cross Dependence
answer
Similar drugs substituting for each other within the body and preventing withdrawal or two drugs preserving the state of physical dependence.
question
Major class of psychoactive chemicals
answer
CNS Depressants,CNS Stimulants, Narcotics, Hallucinogens, Cannabis, Solvents/Inhalants,Steroids, Psychotropics.
question
Central Nervous System is made up of three parts.
answer
Brain & Spinal Cord, pheripheral nervous system, and The Autonomic nervous system.
question
Dependent delusional system is a way a person protects the inner person from the realization of his dependency on drugs.
answer
Memory and recall are one part, Denial is the second part of the system.
question
Stages of withdrawals from CNS depressants
answer
The Shakes, Hallucinations, Seizures, Delirium Tremens [DT]
question
Controlled substance
answer
Any drug that has an abuse liability and is placed on restricted use by the DEA.
question
Poly-chemical abuse
answer
When more than one psychoactive chemical is used at a time.
question
Anabolic-Androgenic Steroids
answer
Are drugs related to male hormones.
question
Methamphetamines
answer
Are chemically made stimulants/ Speed, Chalk , Ice, crystal, glass.
question
Inhalants
answer
Vapors that are inhaled in order to produce mind altering effects.
question
Cannabis long term effects
answer
Lung damage just as cigarettes, slow mental process