Podcast
Questions and Answers
Which lobe of the brain is primarily responsible for processing auditory information?
Which lobe of the brain is primarily responsible for processing auditory information?
Which of the following is NOT a function typically associated with the frontal lobe?
Which of the following is NOT a function typically associated with the frontal lobe?
Difficulties with reading and writing are most likely associated with damage to which area of the brain?
Difficulties with reading and writing are most likely associated with damage to which area of the brain?
Which of the following is a primary function of the occipital lobe?
Which of the following is a primary function of the occipital lobe?
Signup and view all the answers
A patient experiences visual hallucinations after a head injury. Which lobe is most likely affected?
A patient experiences visual hallucinations after a head injury. Which lobe is most likely affected?
Signup and view all the answers
The Clock Drawing Test (CDT) is primarily used to assess which of the following?
The Clock Drawing Test (CDT) is primarily used to assess which of the following?
Signup and view all the answers
Which of the following functions is most closely associated with Broca's area?
Which of the following functions is most closely associated with Broca's area?
Signup and view all the answers
What does the acronym CRAFFT stand for in the context of adolescent risk screening?
What does the acronym CRAFFT stand for in the context of adolescent risk screening?
Signup and view all the answers
According to the provided information, what score on the 'cut down, annoyed, guilty, eye opener' questions indicates a high likelihood of alcohol or drug use?
According to the provided information, what score on the 'cut down, annoyed, guilty, eye opener' questions indicates a high likelihood of alcohol or drug use?
Signup and view all the answers
A person shows changes in personality after a brain injury. Which lobe would most likely be affected?
A person shows changes in personality after a brain injury. Which lobe would most likely be affected?
Signup and view all the answers
What is the primary purpose of the CRAFFT tool?
What is the primary purpose of the CRAFFT tool?
Signup and view all the answers
According to the CRAFFT screening, which of the following is NOT a focus of the questions asked?
According to the CRAFFT screening, which of the following is NOT a focus of the questions asked?
Signup and view all the answers
What does a clinically significant score of 2 or greater on 'cut down, annoyed, guilty, eye opener test' suggest?
What does a clinically significant score of 2 or greater on 'cut down, annoyed, guilty, eye opener test' suggest?
Signup and view all the answers
Which of the following best describes the concept of 'insight' in a mental health assessment?
Which of the following best describes the concept of 'insight' in a mental health assessment?
Signup and view all the answers
When assessing a patient's 'judgment', a clinician would likely explore their ability to:
When assessing a patient's 'judgment', a clinician would likely explore their ability to:
Signup and view all the answers
What is the primary purpose of the Mini Mental Status Examination (MMSE)?
What is the primary purpose of the Mini Mental Status Examination (MMSE)?
Signup and view all the answers
Which of these tasks is used to assess concentration/attention/calculation in the MMSE?
Which of these tasks is used to assess concentration/attention/calculation in the MMSE?
Signup and view all the answers
During an MMSE, if a clinician asks, What is the year? Season? Date? Day? and Month?, they are assessing:
During an MMSE, if a clinician asks, What is the year? Season? Date? Day? and Month?, they are assessing:
Signup and view all the answers
Which question would be used to assess a patient's 'registration/ability to learn new material' during an MMSE?
Which question would be used to assess a patient's 'registration/ability to learn new material' during an MMSE?
Signup and view all the answers
A patient who demonstrates 'poor insight' might display which behavior?
A patient who demonstrates 'poor insight' might display which behavior?
Signup and view all the answers
If a patient is asked 'What would you do if you found a wallet on the street?', what type of assessment is being performed?
If a patient is asked 'What would you do if you found a wallet on the street?', what type of assessment is being performed?
Signup and view all the answers
Which of the following is NOT a characteristic of subcortical dementia?
Which of the following is NOT a characteristic of subcortical dementia?
Signup and view all the answers
Which type of dementia is characterized by a step-like decline, often linked to cardiovascular issues?
Which type of dementia is characterized by a step-like decline, often linked to cardiovascular issues?
Signup and view all the answers
What is a common early clinical sign of dementia due to HIV disease?
What is a common early clinical sign of dementia due to HIV disease?
Signup and view all the answers
Which of the following is a key feature of frontotemporal dementia (Pick's disease) in its early stages?
Which of the following is a key feature of frontotemporal dementia (Pick's disease) in its early stages?
Signup and view all the answers
Which neurotransmitter decrease is associated with Dementia of Alzheimer's type (DAT)?
Which neurotransmitter decrease is associated with Dementia of Alzheimer's type (DAT)?
Signup and view all the answers
Which of the following is a characteristic of Lewy body disease?
Which of the following is a characteristic of Lewy body disease?
Signup and view all the answers
In late-stage HIV related dementia, which cluster of symptoms is likely to be observed?
In late-stage HIV related dementia, which cluster of symptoms is likely to be observed?
Signup and view all the answers
Which of the following statements is true regarding the use of medications in treating psychosis or agitation related to dementia?
Which of the following statements is true regarding the use of medications in treating psychosis or agitation related to dementia?
Signup and view all the answers
Which of the following is considered a key factor in the development of vascular dementia?
Which of the following is considered a key factor in the development of vascular dementia?
Signup and view all the answers
Which type of dementia has a higher incidence of depression and psychosis?
Which type of dementia has a higher incidence of depression and psychosis?
Signup and view all the answers
Which laboratory test is crucial to perform before initiating lithium therapy due to the potential for lithium to cause hypothyroidism?
Which laboratory test is crucial to perform before initiating lithium therapy due to the potential for lithium to cause hypothyroidism?
Signup and view all the answers
A client with bipolar disorder is being started on lithium therapy. Which baseline lab result would be of most concern to the nurse?
A client with bipolar disorder is being started on lithium therapy. Which baseline lab result would be of most concern to the nurse?
Signup and view all the answers
Why is an electrocardiogram (ECG) recommended before lithium initiation for clients over age 50?
Why is an electrocardiogram (ECG) recommended before lithium initiation for clients over age 50?
Signup and view all the answers
A client on lithium presents with a maculopapular rash and pruritis. Which body system is most likely affected?
A client on lithium presents with a maculopapular rash and pruritis. Which body system is most likely affected?
Signup and view all the answers
What effect can NSAIDs have on lithium levels?
What effect can NSAIDs have on lithium levels?
Signup and view all the answers
A client taking lithium is experiencing severe nausea, vomiting, diarrhea, and confusion. What is the priority action by the nurse?
A client taking lithium is experiencing severe nausea, vomiting, diarrhea, and confusion. What is the priority action by the nurse?
Signup and view all the answers
A client on lithium has developed polyuria. This can potentially lead to what other side effect?
A client on lithium has developed polyuria. This can potentially lead to what other side effect?
Signup and view all the answers
What is the primary reason why a pregnancy test is done before starting a female client on lithium?
What is the primary reason why a pregnancy test is done before starting a female client on lithium?
Signup and view all the answers
Which of the following is NOT a common side effect of lithium therapy?
Which of the following is NOT a common side effect of lithium therapy?
Signup and view all the answers
A client is prescribed an MAOI. Which of the following should the client be educated to avoid while taking this medication to prevent a hypertensive crisis?
A client is prescribed an MAOI. Which of the following should the client be educated to avoid while taking this medication to prevent a hypertensive crisis?
Signup and view all the answers
Which of the following medications when taken with an MAOI can cause a hypertensive crisis?
Which of the following medications when taken with an MAOI can cause a hypertensive crisis?
Signup and view all the answers
A client prescribed lithium is also taking an ACE inhibitor for hypertension. What is the priority nursing action related to lithium levels?
A client prescribed lithium is also taking an ACE inhibitor for hypertension. What is the priority nursing action related to lithium levels?
Signup and view all the answers
Which finding indicates lithium toxicity rather than a common side effect of lithium?
Which finding indicates lithium toxicity rather than a common side effect of lithium?
Signup and view all the answers
Which of the following best describes the neuroprotective effect of lithium in bipolar disorder?
Which of the following best describes the neuroprotective effect of lithium in bipolar disorder?
Signup and view all the answers
A client on lithium has developed leukocytosis. What would this be categorized as?
A client on lithium has developed leukocytosis. What would this be categorized as?
Signup and view all the answers
Which of the following best describes the primary goal of using affirmations in motivational interviewing?
Which of the following best describes the primary goal of using affirmations in motivational interviewing?
Signup and view all the answers
A client states, 'I've tried to cut back before, but it never lasts.' Which response exemplifies a simple reflection?
A client states, 'I've tried to cut back before, but it never lasts.' Which response exemplifies a simple reflection?
Signup and view all the answers
Why is it important to use reflections in motivational interviewing?
Why is it important to use reflections in motivational interviewing?
Signup and view all the answers
What is the primary purpose of using summaries during a motivational interviewing session?
What is the primary purpose of using summaries during a motivational interviewing session?
Signup and view all the answers
Which response best illustrates a complex reflection to the statement, 'I know I should exercise, but I just can't seem to get motivated'?
Which response best illustrates a complex reflection to the statement, 'I know I should exercise, but I just can't seem to get motivated'?
Signup and view all the answers
If a therapist says, 'you've described some real challenges you've faced and yet you are still hoping to make changes,' this is an example of:
If a therapist says, 'you've described some real challenges you've faced and yet you are still hoping to make changes,' this is an example of:
Signup and view all the answers
What is the benefit of reflecting back the client's words during a motivational interview?
What is the benefit of reflecting back the client's words during a motivational interview?
Signup and view all the answers
At the end of a session, the therapist reviews key topics, discussing both reasons for and doubts about changing. Which motivational interviewing technique is this best described as?
At the end of a session, the therapist reviews key topics, discussing both reasons for and doubts about changing. Which motivational interviewing technique is this best described as?
Signup and view all the answers
Study Notes
Test Taking Strategies
- Carefully read the entire question, focusing on keywords
- Avoid assumptions or adding extra info
- Narrow down answer options, look for opposites, or similar wording
- Prioritize patient needs using Maslow's hierarchy (physiological, safety)
- Patient safety is paramount, prioritize it before assessment
- Culture is important in nursing care
- Critical thinking and rationale are essential
- Collaboration with other healthcare professionals is encouraged
Lithium
- Toxicity occurs with levels of 1.5 mEq/L or higher, normal 0.6-1.2 mEq/L
- Gold standard for treating manic episodes
- Evidence for anti-suicidal effects
- Neuroprotective for bipolar disorder
- Baseline labs are crucial for lithium initiation
- Lithium can cause hypothyroidism
- Hyperthyroidism symptoms can mimic mania
- Serum creatinine: 0.6-1.2 mg/dL
Side Effects of Lithium
- Clinical Findings: weight gain, impaired thyroid function, fine hand tremors, fatigue, mental cloudiness, etc.
- Endocrine, Central nervous system, Dermatological, Gastrointestinal, Renal, Cardiac, Hematological
- Kidney disease and drugs that reduce renal clearance can increase Lithium serum concentration.
- Signs of Lithium toxicity: severe nausea, vomiting, diarrhea, confusion, convulsions, drowsiness, blurred vision, slurred speech, muscle weakness, heart palpitations, coarse hand tremors, ataxia
Hypertensive Crisis
- Occurs when MAOIs are taken with foods that contain tyramine
- Symptoms include: blood pressure >180/120 mmHg, sudden headache in occipital region, elevated blood pressure, facial flushing, palpitations, urinary dilation, etc
- Treatment includes discontinuing MAOI, giving phentolamine, stabilizing fever, and reevaluating medication guidelines
Teratogenic Risks
- Benzodiazepines: Floppy baby syndrome, cleft palate
- Buspar, SSRIs: safer in pregnancy
- Carbamazepine: Neural tube defects
- Lithium: Epstein anomaly
- Lamotrigine: safer in pregnancy
- Divalproex: Neural tube defects, spina bifida, atrial septal defect, cleft palate, and potential long-term developmental defects
Stevens Johnson Syndrome (SJS)
- Rare, potentially life-threatening immune reaction
- Common with anticonvulsant use
- Symptoms include fever, facial swelling, tongue swelling, macules, papules, skin sloughing, prodromal headache, malaise, arthralgia, painful mucous membranes
Clozaril and Carbamazepine
- Risk of neutropenia is monitored by ANC (absolute neutrophil count) instead of total WBC count
- Normal ANC is between 2,500-6,000
- Monitoring for Clozaril: during the first 6 months, weekly; during the second 6 months, every two weeks; then monthly if ANC is normal
- Discontinue Clozaril/Carbamazepine when ANC is less than 1000 mm3 or WBC is 2000-3000
- Monitor for signs of infection (sudden fever, chills, sore throat, weakness)
Bulimia and Anorexia Nervosa
- Individuals may be within normal weight range
- Symptoms of Bulimia: erosion of dental enamel, Russel’s sign, hypertrophy of salivary glands, rectal prolapse
- Symptoms of Anorexia: Low BMI, amenorrhea, emaciation, bradycardia, hypotension, ECG changes, inversion of T-waves, ST-segment depression, prolonged QT interval, hypothermia, yellow skin
Pharmacological Management
- Medication management as adjunctive therapy for anorexia nervosa, and Bulimia nervosa
- Fluoxetine is FDA-approved for Bulimia
- SSRIs and TCAs are effective in reducing binging and purging
Psychotherapeutic Interventions
- Individual psychotherapy
- Behavioral therapy
- CBT
- Family therapy
- Group therapy
Inducers and Inhibitors
- Enzyme Inducers*: decrease the serum level of other drugs
- Examples*: tobacco, carbamazepine, hypericum (St. John's Wort), phenytoin, phenobarbital, tobacco.
- Enzyme Inhibitors*: increase the serum level of other drugs
- Examples*: bupropion, clomipramine, cimetidine, clarithromycin, fluoroquinolones, grapefruit juice, ketoconazole, nefazodone
Neurotransmitters
- Norepinephrine (Noradrenaline): attention, mood, sleep, and memory. Imbalances can contribute to anxiety and depression
- Serotonin: mood, appetite, sleep, memory, and learning. Imbalances linked with disorders like depression, anxiety, and OCD
- Dopamine: reward, pleasure, motivation, movement. Imbalances linked with psychosis, addiction, and depression
- Acetylcholine: memory, learning, and muscles. Deficits linked to Alzheimer's disease and dementia
Lobes of the Brain
- Frontal Lobe (Thinking, planning, problem-solving, emotions, behavioral control, decision-making)
- Temporal Lobe (Memory, language, facial recognition, hearing)
- Parietal Lobe (Perception, sensory information, language comprehension, vision and touch)
- Occipital Lobe (Vision, visual processing, color identification)
- Cerebellum (Motor skills, hand-eye coordination)
- Brainstem (Temperature regulation, heart rate, swallowing)
- Cerebrum (Largest part of the brain, divided into two hemispheres, responsible for most functions)
Clock Drawing Test
- Used to assess executive function and cognitive dysfunction, often as an indicator for dementia or Alzheimer's Disease
Hypothalamus and Thalamus
- Hypothalamus: regulates satiety, appetite, thirst, water balance, circadian rhythm, body temperature, libido, and hormonal regulation
- Thalamus: sensory relay station, modulates flow of sensory information, regulations emotions, memory, and affective behaviours
Neuroleptic Malignant Syndrome (NMS)
- Rare, potentially life-threatening
- Caused by typical and atypical antipsychotics
- Symptoms include: mutism, hypotension, extreme muscle rigidity, hyperthermia, tachycardia, diaphoresis, coma
Dementia types
- Alzheimer's disease
- Frontotemporal dementia
- Primary progressive aphasia
- Parkinson's disease dementia
- Huntington's disease
- Vascular dementia
- Dementia type due to HIV disease
Suicide Assessment
- Risk factors: Ages ≥ 45/55, divorced/separated, living alone, white, psychiatric disorder, physical illness, substance abuse, previous suicide attempt, recent loss, male gender
Therapeutic Relationship
- Genuineness, acceptance, nonjudgment, empathy, authenticity, respect, professional boundaries, open-ended questions
Screening Brief Intervention Referral to Treatment (SBIRT)
- Brief intervention for alcohol
- FRAMES*: Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy
CAGE-AID
- Screening tool for alcohol or substance abuse
- A positive response to at least one question warrants further assessment
CRAFFT (Car)
- Screening tool to detect teens/young adults misuse.
- Questions to use to determine if adolescents require interventions.
Motivational Interviewing
- Focused, goal-directive therapy that builds on the Transtheoretical Model of Change
- Non-confrontational, empathetic, client-centered, and empowering strategies such as ask open-ended questions, reflections, summarizing and affirmations.
Action Steps
- Provide information
- Offer feedback
- Do not give prescriptive advice
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on the functions of various brain lobes with this engaging quiz. Discover how different areas of the brain relate to behaviors, cognitive functions, and assessments like the CRAFFT tool. This quiz is perfect for students studying neuroscience or psychology.
