Mental Status Examination & Mood Disorders Review
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Questions and Answers

Which aspect of the Mental Status Examination is primarily concerned with a patient's physical demeanor during the assessment?

  • Thought Processes
  • Sensorium
  • Affect/Mood
  • General Observations (correct)
  • What is a key characteristic of mania commonly associated with bipolar disorder?

  • Decreased energy levels
  • Increased need for sleep
  • Intense feelings of hopelessness
  • Racing thoughts (correct)
  • Which nursing intervention is considered the least restrictive when managing a patient in a manic state?

  • Isolate the patient
  • Use physical restraints
  • Prevent physical harm (correct)
  • Medicate with sedatives
  • In the context of mood disorders, what question is NOT typically asked in assessing suicidal ideation?

    <p>How many friends does the client have? (A)</p> Signup and view all the answers

    What should be evaluated in the Insight and Judgment section of the Mental Status Examination?

    <p>The patient's chemical dependence (B)</p> Signup and view all the answers

    Which of the following mood stabilizers is commonly used for treating bipolar disorder?

    <p>Lithium (B)</p> Signup and view all the answers

    When conducting a Mental Status Examination, which cognitive function is assessed in the Sensorium section?

    <p>Calculation (B)</p> Signup and view all the answers

    What is the primary focus during the Assessment stage of the Nursing Process?

    <p>Conducting a Mental Status Examination (A)</p> Signup and view all the answers

    Which of the following statements about mood disorders is inaccurate?

    <p>Depression can manifest with increased energy. (A)</p> Signup and view all the answers

    What is the main role of mood stabilizers in treating mood disorders?

    <p>To stabilize mood fluctuations (A)</p> Signup and view all the answers

    Which class of medications requires avoidance of tyramine-containing foods to prevent a hypertensive crisis?

    <p>MAOIs (D)</p> Signup and view all the answers

    What is a primary side effect associated with typical antipsychotic medications?

    <p>Dystonia (A)</p> Signup and view all the answers

    Which of the following is NOT a benzodiazepine?

    <p>Buspirone (D)</p> Signup and view all the answers

    Which medication is primarily used as a mood stabilizer?

    <p>Lithium (D)</p> Signup and view all the answers

    A patient's treatment plan includes using depot medication for better compliance. Which medication can be administered in depot form?

    <p>Risperidone (A)</p> Signup and view all the answers

    What effect do atypical antipsychotics generally have compared to typical antipsychotics?

    <p>Lower incidence of extrapyramidal symptoms (A)</p> Signup and view all the answers

    Which medication is classified as an SNRI?

    <p>Duloxetine (D)</p> Signup and view all the answers

    Which type of medication is buspirone primarily classified as?

    <p>Antianxiety agent (C)</p> Signup and view all the answers

    What is the primary use of carbidopa/levodopa in treatment?

    <p>Parkinson's disease (D)</p> Signup and view all the answers

    Which of the following is a common side effect of antidepressant medications?

    <p>Gastrointestinal disturbances (D)</p> Signup and view all the answers

    What is a key requirement for patients with substance use disorder to move towards abstinence?

    <p>They need to acknowledge the consequences of their substance use. (D)</p> Signup and view all the answers

    Which of the following describes a common withdrawal symptom associated with cocaine use?

    <p>Depression (B)</p> Signup and view all the answers

    What is a physical symptom characteristic of anorexia?

    <p>Dehydration (B)</p> Signup and view all the answers

    Which emotional symptom is commonly experienced by individuals with bulimia?

    <p>Depression (C)</p> Signup and view all the answers

    In the context of eating disorders, what does the term 'amenorrhea' refer to?

    <p>Loss of menstrual periods (B)</p> Signup and view all the answers

    What behavioral change can indicate impaired professionals in the healthcare field?

    <p>Increased use of the bathroom (A)</p> Signup and view all the answers

    What is an essential outcome for a patient receiving treatment for bulimia?

    <p>They will become binge and purge free. (D)</p> Signup and view all the answers

    Which intervention is appropriate for patients suffering from anorexia?

    <p>Educating that perfection is unattainable (A)</p> Signup and view all the answers

    What characterizes patients with bulimia compared to those with anorexia?

    <p>They usually exhibit normal or overweight status. (A)</p> Signup and view all the answers

    Which of the following is NOT a sign of substance use disorder?

    <p>Consistent exercise routine (C)</p> Signup and view all the answers

    Flashcards

    Mania characteristics

    Abnormally upbeat, jumpy, or wired; increased activity, energy or agitation; exaggerated self-confidence; decreased sleep need; unusual talkativeness; racing thoughts; distractibility

    Mania interventions

    Prevent harm; manage care with distractibility; redirect; support self-control

    Suicide assessment questions

    Thoughts/ideas of suicide? Plan? Means? Intent? Lethality?

    Mental Status Exam (MSE) sections

    General observations (appearance, grooming, motor behavior). Sensorium (memory, orientation, intellectual function); Affect/mood (affect, mood, congruency); Thought processes (content, form); Insight and judgment

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    MSE stage in Nursing Process

    Assessment

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    Mood disorder: Depression

    A mood disorder characterized by persistent feelings of sadness, loss of interest, and other symptoms.

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    Mood disorder: Bipolar Disorder

    A mood disorder characterized by extreme mood swings between mania and depression.

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    Mood stabilizers

    Medications that help regulate mood swings, typically used in bipolar disorder.

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    Anticonvulsants

    Medications typically used for seizures, and some are used in managing bipolar treatment.

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    Nursing Process stages

    Assessment, diagnosis, planning, implementation, evaluation

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    Substance Use Disorder (Alcohol)

    Patients with this disorder must acknowledge negative consequences of their use and recognize the need for abstinence from alcohol.

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    Substance Use Disorder (Cocaine) Withdrawal

    Symptoms include depression, drowsiness, cravings, and urges.

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    Impaired Professionals

    Professionals experiencing substance use issues might demonstrate increased bathroom use, consistent pain complaints, excessive working hours (especially night shifts), frequent call-outs, and volunteering for extensive nursing duties.

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    Anorexia Physical Symptoms

    Low body weight, amenorrhea, muscle weakness, yellow skin, dehydration, and nutritional deficiencies are potential signs.

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    Anorexia Emotional Symptoms

    Depression, anxiety, perfectionism, obsessiveness, and fear of weight gain are common.

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    Bulimia Physical Symptoms

    Bulimic patients often have normal or slightly above-normal weight, experiencing fluctuations and irregular bowel function.

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    Bulimia Emotional Symptoms

    Depression, anxiety, and low self-esteem are common.

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    Anorexia Outcome Intervention

    Educate the patient about unattainable standards & guide them to healthy weight gain.

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    Bulimia Outcome Intervention

    Strategies address elimination of binge/purge cycle and consistent healthy weight management.

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    Pharmacology Importance

    Accurate knowledge of medication classes is essential for proper treatment.

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    Benzodiazepine Side Effect

    Benzodiazepines can cause sedation and drowsiness.

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    Benzodiazepine Patient Teaching

    Patients taking benzodiazepines should avoid driving or operating heavy machinery.

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    Avoid Tyramine with MAOIs

    Patients taking MAOIs should avoid foods containing tyramine, like aged cheese and cured meats, as this can cause a dangerous hypertensive crisis.

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    Typical Antipsychotic Side Effect

    Typical antipsychotics can cause dystonia, characterized by involuntary muscle contractions, stiff neck, and thickened speech.

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    Atypical Antipsychotic Advantage

    Atypical antipsychotics have fewer extrapyramidal side effects (EPS) and are often preferred for newly diagnosed patients.

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    Depot Medication Form

    Depot medications are long-acting, providing medication for weeks to months, making them suitable for patients with compliance issues.

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    What is Carbidopa/Levodopa used for?

    Carbidopa/levodopa is a dopaminergic agent used to treat Parkinson's disease.

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    What is Pramipexole?

    Pramipexole is a dopamine agonist used to treat Parkinson's disease.

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    What is Benztropine used for?

    Benztropine is an anticholinergic medication used to treat Parkinson's disease.

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    What is Diphenhydramine used for?

    Diphenhydramine, an antihistamine, can be used to treat Parkinson's disease.

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    Study Notes

    Mental Status Examination (MSE) Review

    • Sections of MSE: Review each section and associated terminology (review MSE form)
    • General Observations: Appearance, grooming, dress
    • Motor Behavior/Activity: Physical condition, rapport/reaction
    • Sensorium: Memory, orientation, concentration, abstraction, calculation
    • Affect/Mood: Affect, mood, congruency, thought processes, thought content, thought form, insight and judgment
    • Nursing Process (ADPIE): Assessment - MSE is part of this stage, diagnosis, planning, implementation, evaluation

    Mood Disorders

    • Depression
    • Bipolar Disorder
      • Mania: Abnormally upbeat, jumpy, or wired; increased activity, energy, or agitation; exaggerated sense of well-being and self-confidence; decreased need for sleep; unusual talkativeness; racing thoughts; distractibility
      • Mania Interventions (least restrictive): Prevent physical harm, redirect patient, support patient in maintaining self-control
      • Medications: Mood stabilizers and anticonvulsants (detailed medication information is in the pharmacology section)

    Suicide

    • Questions to Ask: Thoughts of suicide, presence of a plan, means to act on the plan, expression of intent to act, lethality of the plan
    • Safety is paramount

    Substance Use Disorders

    • Alcohol: Patients need to acknowledge consequences and recognize the need for abstinence
    • Cocaine: Withdrawal symptoms (depression, drowsiness, sedation, cravings, urges); impaired professionals (increased bathroom use, always in pain, working nights, extra shifts, volunteering)

    Eating Disorders

    • Anorexia: Physical symptoms (low body weight, amenorrhea, muscle weakness, yellow skin, dehydration, nutritional deficiencies); emotional/cognitive symptoms (lack of hunger, depression, anxiety, perfectionism, obsessiveness, fear of gaining weight)
      • Interventions: Education that perfection is unachievable, patient will gain weight
    • Bulimia: Physical symptoms (normal/overweight, fluctuating, irregular bowel function); emotional/cognitive symptoms (depression, anxiety, low self-esteem)
      • Interventions: Binge and purge free; maintain weight (bulimic patients do not need to lose weight, they are usually normal weight or overweight)

    Pharmacology

    • Antianxiety Medications: Benzodiazepines (diazepam, alprazolam, lorazepam, side effects - sedation, drowsiness); Non-Benzodiazepines (buspirone); Patient teaching - avoid driving or operating heavy machinery while taking medications
    • Antidepressant Medications: TCAs (amitriptyline, imipramine, nortriptyline); SSRIs (fluoxetine, paroxetine, citalopram, escitalopram, sertraline); SNRIs (venlafaxine, duloxetine); MAOIs (tranylcypromine, phenelzine: avoid tyramine-containing foods to prevent hypertensive crisis); Atypical Antidepressants (bupropion, trazodone)
    • Antimanic Medications/Mood Stabilizers: Lithium; Anticonvulsants (valproic acid, carbamazepine, gabapentin, lamotrigine)
    • Antipsychotic Medications: Typical (chlorpromazine, haloperidol, fluphenazine, thioridazine, thiothixene); Atypical (risperidone, olanzapine, clozapine, quetiapine)
    • Antiparkinson Medications: Dopaminergic agent (carbidopa/levodopa), dopamine agonist (pramipexole), anticholinergic (benztropine), antihistamine (diphenhydramine) - Additional notes for patients who have difficulty with compliance, this provides a great alternative (e.g., risperidone depot IM)

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    Description

    This quiz provides a comprehensive review of the Mental Status Examination (MSE) and explores key aspects of mood disorders such as depression and bipolar disorder. Participants will assess understanding of MSE components and consider important interventions and medications related to mood disorders.

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