106 Questions
What is the most common type of neurocognitive disorder?
Alzheimer's disease
What is the primary difference between cognitive disorder and mental health disorder?
Reversibility
What is a risk factor for delirium?
Metabolic imbalance
What is a characteristic manifestation of delirium?
Disorientation and confusion, often worse at night
What is a risk factor for Alzheimer's disease?
Advanced age
What is the primary difference between mild neurocognitive disorder and major neurocognitive disorder?
Impact on daily functioning
What is a characteristic of Alzheimer's disease?
Gradual impairment of cognitive function
What is a type of neurocognitive disorder caused by Parkinson's or Huntington's?
Neurocognitive disorder due to another medical condition
What is a characteristic of Delirium?
Restlessness, anxiety, motor agitation, and fluctuating moods
Which of the following is NOT a subtype of Neurocognitive Disorder?
Hypothyroidism
What is a defense mechanism used by clients with Neurocognitive Disorder?
Denial
What is the primary risk factor for Neurocognitive Disorder?
Advanced age
What is the purpose of the Confusion Assessment Method (CAM)?
To assess for delirium
What is an important aspect of nursing care for clients with Delirium?
Minimizing risk factors and promoting early detection
What is an outcome of Delirium?
Reversible if diagnosis and treatment of underlying cause are prompt
What is a common manifestation of Delirium?
Restlessness, anxiety, motor agitation, and fluctuating moods
What is NOT a cause of Delirium?
Advanced age
What is the purpose of the Mini-Mental State Examination (MMSE)?
To assess cognitive function in clients with Neurocognitive Disorder
What is a characteristic of delirium?
The person is extremely distracted
What is a predisposing factor for delirium?
Systemic infections
What is a type of neurocognitive disorder?
Mild cognitive impairment
What is a symptom of a neurocognitive disorder?
Disregard for conventional rules of social conduct
What is a characteristic of Alzheimer's disease?
Gradual decline in cognitive functions
What is a symptom of stage 4 Alzheimer's disease?
Forgetting major events in personal history
What is a characteristic of primary neurocognitive disorder?
Not directly related to any other organic illness
What is a type of delirium?
Substance intoxication delirium
What is the primary goal of cognitive support in managing neurocognitive disorders?
To provide compensatory memory aids
What is a characteristic of neurocognitive disorder?
Impairment in cognitive functions is dependent on the underlying etiology
Why is it important to monitor vital signs in individuals with neurocognitive disorders?
To detect signs of delirium
What is a symptom of stage 6 Alzheimer's disease?
Disorientation of surroundings and time
What is the role of cholinesterase inhibitor medications in managing neurocognitive disorders?
To slow down the progression of Alzheimer's disease
What is a common adverse effect of cholinesterase inhibitor medications?
All of the above
Why is it important to use caution when administering medications PRN for agitation or anxiety in individuals with neurocognitive disorders?
Because medications can exacerbate delirium
What is the primary goal of memantine medication in managing neurocognitive disorders?
To block the entry of calcium into nerve cells
What is a common characteristic of delirium?
Acute disturbance of cognition
What is the primary role of the nurse in managing neurocognitive disorders?
To provide cognitive support
Why is it important to cover or remove mirrors in individuals with neurocognitive disorders?
To decrease far and agitation
What is the primary difference between delirium and neurocognitive disorders?
Delirium is an acute condition, while neurocognitive disorders are chronic
What is a common feature of neurocognitive disorder due to Alzheimer's disease?
Slow and insidious onset
What is the focus of primary consideration in neurocognitive disorder?
Etiology identification
What is a characteristic of neurocognitive disorder due to frontotemporal disease?
Shrinking of the frontal and temporal anterior lobes of the brain
What is a common neurobehavioral symptom of neurocognitive disorder due to traumatic brain injury?
Amnesia
What is a medication used to treat cognitive impairment in neurocognitive disorder?
Physostigmine
What is a characteristic of neurocognitive disorder due to Lewy Body disease?
Progressive and irreversible
What is a goal of outcome criteria in neurocognitive disorder?
Slowing down the process
What is a type of medication used to treat depression in neurocognitive disorder?
SSRI
What is an important aspect of care for clients with neurocognitive disorder?
Providing a quiet and low-stimuli environment
What is a laboratory test used to aid in the diagnosis of neurocognitive disorder?
All of the above
What is the primary difference between Major Depressive Disorder and Persistent Depressive Disorder?
Duration of symptoms
Which of the following is NOT a risk factor for Depression?
Diet
What is the primary feature of Premenstrual Dysphoric Disorder?
All of the above
Which of the following is a biological theory of Depression?
All of the above
What is the term for a loss that is internalized and becomes directed against the ego?
Melancholia
What is the primary difference between Dysthymic Disorder and Major Depressive Disorder?
Duration of symptoms
What is the term for a depressed mood that is expressed by feelings of sadness, despair, and pessimism?
Mood
Which of the following pharmaceutical agents is used to treat anxiety?
Chlordiazepoxide
What is the term for a depressive disorder that is caused by the physiological effects of a substance?
Substance-induced depressive disorder
Which of the following is a risk factor for Depression?
Older age
What is the primary goal of the continuation phase in treating MDD?
Relapse prevention through education and medication
Which type of antidepressant medication can cause orthostatic hypotension?
Tricyclic Antidepressant
According to the learned helplessness theory, what leads to depression?
A feeling of lack of control over one's life situation
What is the leading cause of death among suicide victims?
Gunshot wounds
According to Durkheim, what type of suicide occurs when an individual feels disconnected from society?
Anomic suicide
What is the primary disturbance in depression according to the cognitive theory?
Cognitive
Which of the following is a characteristic of severe depression?
Feelings of total despair and worthlessness
What is the primary goal of electroconvulsive therapy?
To increase the levels of biogenic amines
What is the purpose of the IS PATH WARM acronym?
To assess suicidal ideation in clients
What is a common symptom of depression in children under the age of 3?
Feeding problems
What is a common characteristic of clients with depression?
All of the above
What is the primary difference between mild depression and moderate depression?
The severity of symptoms
What is a key difference between depression in adolescents and normal stormy adolescent behavior?
Duration of symptoms
What is the primary goal of group therapy?
To teach coping skills and strategies
Which of the following is a risk factor for suicide?
Being single
What is a risk factor for depression in the elderly?
All of the above
What is a characteristic of complicated grieving?
A disorder that occurs after the death of a significant other
What is the primary goal of the acute phase in treating MDD?
Treatment of severe clinical findings of depression
What is a common symptom of postpartum depression?
Loss of appetite
What is the focus of therapy for depressed children?
Both A and B
What is powerlessness?
A lack of control over a situation
What is the purpose of monitoring for serotonin syndrome when prescribing SSRIs?
To prevent serotonin syndrome
What is a potential consequence of learned helplessness?
Depression
What is the primary goal of family therapy?
To teach coping skills and strategies to family members
What is a common side effect of St. John's Wort, an alternative therapy for depression?
Photosensitivity
What is a common treatment for depression in the elderly?
All of the above
What is a characteristic of a homogeneous group?
All members share the same goal
What is the primary goal of concept care mapping?
To provide individualized care to clients
What is a characteristic of object loss theory?
Feelings of helplessness and despair
What is a characteristic of transcranial magnetic stimulation?
It is a non-invasive therapy that uses magnetic pulsations
Which of the following is a psychosocial risk factor for suicide?
Sense of hopelessness
What is the primary difference between bipolar I disorder and bipolar II disorder?
History of full manic episodes
Which of the following is a biological predisposing factor for bipolar disorder?
Genetics
What is a characteristic of mania in bipolar disorder?
Lability of mood, panic anxiety
What is the term for an emotional reaction associated with an experience?
Affect
What is a key aspect of planning for a client with bipolar disorder?
Setting limits on manipulative behaviors
Which of the following is a symptom of stage II acute mania?
All of the above
What is a type of therapy used to treat bipolar disorder?
All of the above
What is the primary difference between cyclothymic disorder and bipolar II disorder?
History of full manic episodes
What is a medication used to treat mania in bipolar disorder?
Lithium
Which of the following is a cultural risk factor for suicide?
American Indian or Alaskan native heritage
What is a side effect of Lithium?
All of the above
What is the term for a mood swing from profound depression to extreme euphoria?
Bipolar disorder
Which of the following is a protective factor against suicide?
Feelings of responsibility toward partner and children
What is important to do when taking Lithium?
Maintain a regular diet with high sodium
What is the primary goal of medication treatment for bipolar disorder?
To stabilize mood
What is a precaution when taking Antipsychotics?
Use sunblock when going outside
Why is it important to take medications regularly in bipolar disorder?
To prevent symptoms from recurring
Study Notes
Cognitive Disorders: Alzheimer's, Dementia, and Delirium
- Delirium:
- Acute confusional state characterized by altered consciousness, disorientation, and fluctuating levels of cognitive impairment
- Can be caused by medical conditions, infections, surgery, or substance abuse/withdrawal
- Symptoms: disorientation, memory impairment, agitation, restlessness, and fluctuating levels of consciousness
- Reversible with prompt treatment of underlying cause
- Dementia:
- Chronic, irreversible cognitive impairment characterized by decline in memory, judgment, and cognitive function
- Most common type: Alzheimer's disease
- Other types: vascular dementia, frontotemporal dementia, Lewy body dementia, and traumatic brain injury
- Symptoms: memory loss, aphasia, apraxia, agnosia, and decline in cognitive function
Alzheimer's Disease
- Most common type of dementia
- Progressive, irreversible cognitive decline
- Caused by neurodegenerative changes in the brain
- Symptoms:
- Forgetfulness, memory loss
- Decline in cognitive function
- Impaired judgment, decision-making, and problem-solving
- Memory loss, aphasia, apraxia, and agnosia
- Stages:
- Stage 1: No apparent symptoms
- Stage 2: Forgetfulness
- Stage 3: Mild cognitive decline
- Stage 4: Moderate cognitive decline
- Stage 5: Moderate to severe cognitive decline
- Stage 6: Severe cognitive decline
- Stage 7: Very severe cognitive decline
Neurocognitive Disorders
- Impairment in cognitive function, memory, learning, and speaking
- Classified as mild or major
- Reversible or irreversible
- Causes:
- Alzheimer's disease
- Vascular dementia
- Lewy body dementia
- Frontotemporal dementia
- Traumatic brain injury
- Symptoms:
- Cognitive impairment
- Memory loss
- Decline in cognitive function
- Impaired judgment, decision-making, and problem-solving
- Aphasia, apraxia, and agnosia
Diagnosis and Assessment
- No specific lab test for diagnosis
- Diagnosis based on:
- Medical history
- Physical examination
- Laboratory tests (e.g., EEG, CT/MRI scans)
- Cognitive and neuropsychological tests (e.g., MMSE, CAM)
- Assessment tools:
- Confusion Assessment Method (CAM)
- Neelon-Champagne (Neecham) Confusion Scale
- Functional Dementia Scale
- Brief Interview for Mental Status (BIMS)
- Mini-Mental State Examination (MMSE)
Management and Treatment
- Non-pharmacological interventions:
- Cognitive training and rehabilitation
- Environmental modifications (e.g., simplification, routine)
- Behavioral management (e.g., redirection, distraction)
- Pharmacological interventions:
- Cholinesterase inhibitors (e.g., donepezil, galantamine)
- Memantine
- Antipsychotics (e.g., risperidone, quetiapine)
- Antidepressants (e.g., selective serotonin reuptake inhibitors)
Depressive Disorders
- Epidemiology:
- Affective disorder characterized by sadness, despair, and pessimism
- Leading cause of disability in the US
- Types:
- Major Depressive Disorder
- Persistent Depressive Disorder (dysthymia)
- Premenstrual Dysphoric Disorder
- Substance/Medication-Induced Depressive Disorder
- Risk factors:
- Age
- Gender (females more common)
- Social class
- Race and culture
- Marital status
- Seasonality
- Symptoms:
- Depressed mood
- Loss of interest or pleasure in activities
- Changes in appetite, sleep, and energy
- Difficulty concentrating or making decisions
- Recurring thoughts of death or suicide
Treatment of Depressive Disorders
- Pharmacological interventions:
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
- Atypical antidepressants (e.g., bupropion, venlafaxine)
- Non-pharmacological interventions:
- Cognitive-behavioral therapy (CBT)
- Interpersonal therapy (IPT)
- Psychodynamic therapy
- Light therapy### Learning Theories
- Learned Helplessness: individuals who experience numerous failures learn to give up trying, leading to feelings of depression and a lack of control over their life situation (Seligman's theory)
- Object Loss: experiencing loss of a significant other during the first 6 months of life can lead to feelings of helplessness and despair, predisposing individuals to lifelong periods of depression in response to loss
-
Cognitive Theory: views primary disturbance in depression as cognitive rather than affective, with three cognitive distortions:
- Negative expectations of the environment
- Negative expectations of self
- Negative expectation of the future
- Transactional Model: no single theory or hypothesis exists to explain depressive disorder, instead, it is the combined effects of genetic, biochemical, and psychosocial influences on an individual's susceptibility to depression
Developmental Implications
-
Childhood Depression: symptoms vary by age, including:
- Feeding problems, tantrums, and lack of playfulness (under 3)
- Accident proneness, phobias, and excessive self-reproach (3-5)
- Physical complaints, aggressive behavior, and clinging behavior (6-8)
- Morbid thoughts and excessive worrying (9-12)
- Adolescence: symptoms include anger, aggressiveness, running away, delinquency, social withdrawal, and substance abuse
- Senescence: high percentage of suicides among the elderly, with symptoms of depression often confused with symptoms of neurocognitive disorder
Nursing Process/Assessment
- Four Spheres of Human Functioning: affective, behavioral, cognitive, and physiological
- Depression Continuum: severe, moderate, mild, and transient depression, with varying symptoms and severity
Treatment
- Therapy: individual, group, family, and cognitive therapy
- Pharmacological Interventions: antidepressants, electroconvulsive therapy, and psychosocial therapies
- Concept Care Mapping: client-centered care focused on individual needs and goals
Group and Family Therapy
- Group Process: verbal and nonverbal communication, interaction, and group dynamics
- Group Norms: rules and behaviors established by the group
- Phases of Group Development: orientation, working, and termination phases
- Types of Groups: homogeneous, heterogeneous, open, and closed groups
Brain Stimulation Therapies
- Electroconvulsive Therapy: enhances neurotransmitters, used for severe depression
- Transcranial Magnetic Stimulation: noninvasive, stimulates cerebral cortex
- Vagus Nerve Stimulation: implanted device, increases neurotransmitters and enhances antidepressant medication
Depressive Disorders
- Major Depressive Disorder: acute, continuation, and maintenance phases
- Risk Factors: family history, age, neurotransmitter deficiencies, medical illness, and stressful life events
- Expected Findings: anergia, anhedonia, anxiety, sluggishness, and fatigue
- Medications: SSRIs, tricyclic antidepressants, monoamine oxidase inhibitors, and atypical antidepressants
Suicide and Risk of Self-Harm
- Suicide: act of taking one's own life, often associated with mental disorders
- Risk Factors: single, never-married, divorced, widowed, old age, religion, socioeconomic status, occupation, and ethnicity
- Symptoms: IS PATH WARM (ideation, substance abuse, purposelessness, anxiety, trapped feeling, hopelessness, withdrawal, anger, recklessness, mood change)
- Protective Factors: feelings of responsibility, religious and cultural beliefs, access to medical care, and positive social support
Bipolar Disorder
- Mood: pervasive and sustained emotion, influenced by biological, psychological, and environmental factors
- Affect: emotional reaction associated with an experience
- Mania: elevated, expansive, or irritable mood, with increased energy and activity
- Bipolar Disorder: characterized by mood swings from depression to mania, with intervening periods of normalcy
- Types of Bipolar Disorder: bipolar I, bipolar II, cyclothymic disorder, substance-induced, and associated with another medical condition
- Predisposing Factors: biological, physiological, and environmental factors
- Symptoms: categorized by degree of severity, including hypomania, acute mania, and delirious mania
- Treatment: individual, group, and family therapy, cognitive therapy, and psychopharmacology (mood stabilizers, antipsychotics, and antidepressants)
This quiz covers cognitive disorders, Alzheimer's disease, dementia, delirium, and neurocognitive disorders, based on ATI Chapter 17 and FA Davis Chapter 22. It's designed for mental health students preparing for Exam 2, Modules 4, 5, 6, and 7.
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