NR 509 FINAL EXAM STUDY GUIDE / NR509 FINAL EXAM STUDY GUIDE:NEWEST-2022
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Course
NR 509 (NR509)
Institution
Chamberlain College Of Nursing
NR 509 FINAL EXAM STUDY GUIDE / NR509 FINAL EXAM STUDY GUIDE:NEWEST-2022NR 509 FINAL EXAM STUDY GUIDE / NR509 FINAL EXAM STUDY GUIDE:NEWEST-2022NR 509 FINAL EXAM STUDY GUIDE / NR509 FINAL EXAM STUDY GUIDE:NEWEST-2022
Chapter 5 Ashley (1-6)/ Catlin (7-9)
Behavior/Mental Health Assessment and Modification for Age
-Unexplained conditions lasting >6weeks should prompt screening for
depression, anxiety, or both
-PRIME-MD (Primary Care Evaluation of Mental Disorders). 26 questions
and take 10 minutes to complete. Used for the 5 most common=anxiety,
depression, alcohol, somatoform, and eating disorders.
-Patient indications for Mental Health Screening:
1.Medically unexplained physical symptoms-more than half have
depression and anxiety disorders
2. Multiple physical or somatic symptoms or high symptom count
3.High severity of the presenting somatic symptoms, chronic pain
4.Symptoms for more than 6 weeks
5. Physician rating as a “difficult encounter”
6. Recent stress
7.Low-self rating of overall health
8.Frequent use of health care services
9.Substance abuse.
-CAGE=substance-related and addictive disorders
Modification for Age
Elderly:
-Complain of memory problems but usually is due to benign forgetfulness
-Retrieve and process data more slowly and take longer to learn new
information
-Slower motor responses and their ability to perform complex task may
diminish
-Important to distinguish age-related changes from manifestations of mental
disorders
-More susceptible to delirium which can be the first sign of infection,
problems with medications, or impending dementia
Infant: Assess mental status of a newborn=observing newborn activities
, 1.Look at human faces and turn to parents voice
2.Ability to shout out repetitive stimuli
3. Bond with caregiver
4.Self-soothe
Normal VS. Abnormal Findings and Interpretation
-Mood disorders: compulsions, obsessions, phobias, and anxieties
-Lethargic: drowsy, but open their eyes and look at you, respond to questions,
and then fall asleep.
-Obtunded: open their eyes and look at you, but respond slowly and are
somewhat confused.
-Agitated depression: crying, pacing, and hand-wringing
-Depression: the hopeless slumped posture and slowed movements.
-Grooming and personal hygiene may deteriorate: Depression, schizophrenia,
and dementia
-Manic Episode: the agitated and expansive movement of a manic episode
-Obsessive-Compulsive Disorder: Excessive fastidiousness
-Lesion parietal cortex: one side neglect in the opposite parietal cortex,
usually in the nondominant side
-Parkinsonism: facial immobility
-Paranoia: anger, hostility, suspiciousness, or evasiveness
-Mania: Elation and euphoria
-Schizophrenia: flat affect and remoteness
-Apathy (dull affect with detachment and indifference): dementia, anxiety,
and depression
-Hallucination: schizophrenia, alcohol withdrawal, and systemic toxicity
-Amnestic Disorders: impaired memory or new learning ability and reduce
social or occupational functioning, but lack the global features of delirium and
or dementia. Anxiety and depression, and intellectual disability may also
cause recent memory impairment.
-Calculating ability: poor performance = dementia or aphasia
-Variations and abnormalities in thought processes:
1.Circumstantiality: The mildest thought disorder, consisting of speech with
unnecessary detail, indirections, and delay in reaching the point. Some topics
may have a meaningful connection
-Occurs in people with obsessions
2. Derailment: Tangential, speech with shifting from topics that are loosely
connected or unrelated. The patient is unaware of the lack of association
, -Schizophrenia, manic episodes, and other psychotic disorders
3.Flight of ideas, an almost continuous flow of accelerated speech with abrupt
changes from one topic to the next. Changes are based on understandable
associations, play on words, or distracting stimuli, but ideas are not well
connected.
-Manic episodes
4.Neologisms: invented or distorted words, or words with new and highly
idiosyncratic meanings
-Schizophrenia, psychotic disorders, and aphasia
5.Incoherence: Speech that is incomprehensible and illogical, with lack of
meaningful connections, abrupt changes in topic, or disordered grammar or
word use. Flight of ideas, when severe, may produce incoherence
-Schizophrenia
6.Blocking: Sudden interruption of speech in mid sentence or before the idea
is completed “losing the thought”
-Schizophrenia
7.Confabulation: Fabrication of facts or events, to fill in the gaps from
impaired memory
-Korsakoff syndrome from alcoholism
8.Perseveration: persistent repetition of words or ideas
-Schizophrenia or other psychotic disorders
9. Echolalia: Repetition of the words and phrases of others
-Manic episodes or Schizo
10.Clanging: Speech with choice of words based on sound, rather than
meaning, as in rhyming and punning. Example: “look at my eyes and nose,
wise eyes and rosy nose. To to one, the ayes have it!”
-Schizo and manic episodes
Abnormalities of Perception
1. Illusions: misinterpretations of real external stimuli, such as mistaking
rustling leaves for the sounds of voices
-Grief, delirium, PTSD, Schizo
2.Hallucinations: Perception-like experiences that seem real but, unlike
illusions, lack actual external stimulation. The person may or may not
recognize the experiences as false. May be auditory, visual, olfactory,
gustatory, tactile, or somatic.
-PTSD, Schizo, delirium, dementia, alcoholism
Abnormalities of Thought Content
1.Compulsions
-repetitive behaviors feel driven to perform in response to an obsession
(anxiety disorders)
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