NR547 FINAL EXAM COMPLETE TEST QUESTIONS WITH ANSWERS A+ GRADED
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Course
NR 547
Institution
NR 547
NR547 FINAL EXAM
COMPLETE TEST QUESTIONS WITH
ANSWERS
A+ GRADED
Use to protect against suicide - ANSWER lithium
MDD and BPD genetics - ANSWER genetic factors contribute 31-42% of the
disease risk in MDD and 59-85% in BPD
Bipolar disorder symptoms - ANSWER Depressive Symp...
NR547 FINAL EXAM
COMPLETE TEST QUESTIONS WITH
ANSWERS
A+ GRADED
Use to protect against suicide - ANSWER ✔ lithium
MDD and BPD genetics - ANSWER ✔ genetic factors contribute 31-42% of the
disease risk in MDD and 59-85% in BPD
Bipolar disorder symptoms - ANSWER ✔ Depressive Symptoms
-similar to MDD
Manic Symptoms
-elevated, expansive, or irritable mood
Hypomanic Symptoms
-milder form of mania
Mixed Symptoms
-presence of symptoms of depression and mania simultaneously
dx manic - ANSWER ✔ -elevated, expansive, or irritable mood for at least one
week, mood present most of the day and nearly every day
-severe enough to cause significant impairment in social or occupational
functioning, to req hospitalization to prevent harm to the client or others, or
symptoms include psychotic features
-three or more of the following symptoms (APA, 2022) must be present and
represent a significant change from usual behavior:
• inflated self-esteem or grandiosity
• decreased need for sleep
• increased talkativeness
• racing thoughts
• distracted easily
• increase in goal-directed activity or psychomotor agitation
,• engaging in activities that hold the potential for painful consequences, e.g.,
unrestrained buying sprees
dx hypomania - ANSWER ✔ must experience symptoms for at least four
consecutive days with symptoms present most of the day and nearly every day.
-energy level is higher than normal but not as high as with mania
-episodes can lead to challenges but do not tend to lead to major issues with daily
functioning
-episodes do not involve psychotic symptoms and are less likely to lead to hospital
visits.
Bipolar disorder triggers - ANSWER ✔ Environmental factors can trigger
-Selective Serotonin Reuptake Inhibitors (SSRIs) can trigger manic episode
-Stimulant drugs can be legal or illegal
-Changes in circadian rhythm (could be due to shift work or change in time zones)
-Life stressors
Clinical presentation: Bipolar Tyle I - ANSWER ✔ at least one episode of mania
for at least one week (or any hospitalization)
-Hypomanic episodes may also occur
-MDD episodes are common in bipolar I (not req for diagnosis)
Clinical presentation: Bipolar Tyle II - ANSWER ✔ at least one major depressive
episode and at least one current or past hypomanic episode, but no full mixed or
manic episode
-symptoms last for at least four days, but fewer than seven and include the same
symptoms as mania without causing severe impairment or requiring hospitalization
-Psychotic features are not present with bipolar II disorder, although irritability and
anger are common.
Carlo is a 24-year-old married auto mechanic who works full-time. His wife
reports that he began several home repair projects about three weeks ago "out of
the blue." He is painting the exterior of the home, remodeling a bathroom, and
digging a new garden. He used to sleep 6-7 hours per night, but he is now sleeping
about 3 ½ hours per night. Although Carlo has no history of bipolar disorder, his
wife is concerned that this may be a manic episode. Her father was diagnosed with
bipolar I disorde - ANSWER ✔ unable to determine
,Rationale: Carlo meets category A criteria (abnormal and persistent increased
activity lasting at least one week) and two diagnostic criteria in category B for
bipolar I disorder (decreased need for sleep and increase in goal-directed activity).
However, three symptoms are required for diagnosis; more information is needed
to determine if Carlo is experiencing additional symptoms or if his behaviors are
significantly impacting his occupational or social interactions. In addition, the
PMHNP should inquire about the use of medications and/or legal and illegal
stimulants to determine if they may be impacting Carlo's behavior.
Rapid cycling - ANSWER ✔ four or more episodes of depression and mania
occur within one year
Cyclothymia - ANSWER ✔ numerous episodes of hypomanic symptoms that do
not meet the criteria for a hypomanic episode and numerous periods of depressive
symptoms that do not meet the criteria for a major depressive episode
-at least two consecutive years during which clients are symptomatic at least half
the time and not symptom-free for more than two consecutive months
Tariq is a 22-year-old who presents with symptoms of racing thoughts and an
inability to pay attention in his college classes. He is currently failing most of his
courses. He feels like he needs to talk constantly. He calls friends at all hours and
tries to engage strangers in conversation. He also reports feeling restless and tense.
He has experienced these symptoms continuously for the past two weeks. His
toxicology screen is negative, and he takes no medications.
What is the appropriate ICD-1 - ANSWER ✔ F31.89
Rationale: The ICD-10 code is F31.89 bipolar 1 disorder with anxious distress.
Tariq meets diagnostic criteria for Bipolar I, with symptoms including racing
thoughts, difficulty paying attention, and constant talking. He is experiencing
consequences from his behavior as he is failing classes. He has experienced the
symptoms for two weeks. Because he also has symptoms of restlessness and
increased tension, he also meets the qualifying diagnostic criteria for anxious
distress.
Savannah is a 32-year-old who presents with her husband. Her husband states that
Savannah has spent thousands of dollars on new clothing and shoes in the past
month. The clothing she has purchased is much more revealing than her typical
wardrobe. She is sleeping for just a few hours per night. She is spending hours on
Twitter and is constantly boasting about how many retweets she receives and how
, many followers she has. Two days ago, Savannah reported that the drummer of her
favorite band began - ANSWER ✔ F31.2
Rationale: The ICD-10 code is F31.2 bipolar 1 disorder with mood-congruent
psychotic features. Savannah meets diagnostic criteria for bipolar I, with symptoms
of grandiosity, decreased sleep, and excessive shopping. She is experiencing
impairment in social and occupational functioning. She has experienced these
symptoms for a month. Because Savannah is also experiencing delusional thinking
consistent with her mood, she also meets the criteria for mood-congruent psychotic
features.
Vladimir is a 25-year-old who presents with feelings of racing thoughts. His
thoughts are centered on feelings of worthlessness. He reports feeling very fatigued
and continually paces around the room. He has been irritable and easily distracted
for the last two weeks. He endorses an increase in sexual behavior, including
several recent episodes of unprotected sex with multiple partners. He admits to
having suicidal ideations.
What is the appropriate ICD-10 code for Vladimir? - ANSWER ✔ F31.12
Rationale: The ICD-10 code is F31.12 bipolar 1 disorder manic episode with
mixed features. Vladimir meets diagnostic criteria for bipolar I disorder, with
symptoms including racing thoughts, psychomotor agitation, distraction, risky
behaviors, and irritability for the past two weeks. Because he also endorses fatigue,
feelings of worthlessness, and suicidal ideation, he meets the criteria for a manic
episode with mixed features.
Screening tools for bipolar disorders: - ANSWER ✔ Mood disorder questionnaire
-a non-diagnostic, self-rated instrument that provides information to clients who
may need additional assessment.
Bipolar spectrum diagnostic scale
-a self-rated instrument presented in story format that is sensitive to subtle
symptoms of bipolar disorder
Medical Diagnoses that Mimic Bipolar Disorder - ANSWER ✔ -hyperthyroidism
-hyperaldosteronism
-brain tumor
-neurocognitive disorder
-delirium
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