A.T MARYVILLE NURS 663 EXAM #2
QUESTIONS WITH CORRECT ANSWERS
Lithium labs - answer-level, na, ca, p, ekg, creatinine, urinalysis, cbc, tsh
Bipolar meds: depression - answer-lurasidone (13+), olanzapine + fluoxetine (10+)
(symbyax)
Bipolar acute and mixed mania - answer-aripiprazole, risperidone, olanzapine (13+),
quetiapine (acute only), asenapine (10+)
Classic mood stabilizers - answer-lamotrigine (excellent medication to use), lithium,
depakote (avoid in females if possible due to pcos and pregnancy), tegretol, trileptal (no
evidence for true bipolar disorder)
Anti-depressants - answer-class not used w/bipolar disorder
Lithium - answer-anti-manic, antidepressant, anti-suicidal
Lithium side effects - answer-frequent urination, increased thirst, weight gain, sedation
Lithium toxicity - answer-sudden onset tremors, n/v/d, muscle weakness, slurred
speech, confusion, seizures (slowing down, feel really out of it)
Persistent motor or vocal tic disorder - answer-pt in front of you only has one or the
other but not both—they usually don't even know it is a tic, it is only meaningful if it's
affecting their quality of life
Tourette's d/o - answer-multiple motor and at least one vocal tic (some tics come and
go, they don't have them all at the same time to receive the diagnosis)
Hrt - answer-habit reversal training can be used to manage tics
Tics tx - answer-alpha agonists (clonidine, guanfacine); haldol is not the first-line txt
Developmental coordination disorder - answer-a motor disorder characterized by
marked impairment in the development of motor coordination; movement isn't consistent
w/age
Stereotypic movement disorder - answer-a motor disorder characterized by repetitive,
seemingly driven, and apparently purposeless motor behavior, such as hand waving or
head banging, but not include asd sx
, Specific learning disorders - answer-difficulties in the acquisition and use of listening,
speaking, reading, writing, reasoning, or mathematical abilities; dx by other
professionals w/specialized training; np tx comorbid d/o
Anorexia nervosa - answer-an eating disorder in which an irrational fear of weight gain
leads people to starve themselves; restrictive or binge/purge/exercise
Bulimia nervosa - answer-an eating disorder characterized by episodes of overeating,
usually of high-calorie foods, followed by vomiting, laxative use, fasting, or excessive
exercise
Binge-eating disorder - answer-significant binge-eating episodes, followed by distress,
disgust, or guilt, but without the compensatory purging, fasting, or excessive exercise
Avoidant/restrictive eating disorder - answer-avoiding or restricting foods in childhood.
Significantly low bmi; no distortion of body image or fear of gaining wt. R/o delusions
around food
Pica - answer-an abnormal craving or appetite for nonfood substances, such as dirt,
paint, or clay that lasts for at least 1 month; decrs incidence with incr age
Feeding and eating disorders tx - answer-talk therapy (counseling is needed for the
distress) (intensive outpatient, partial inpatient or actual inpatient admission may be
needed); most have associated depression and/or anxiety
Feeding and eating disorders meds - answer-fluoxetine help but not direct tx
Vyvanse approved for binge eating but not because of stimulant effects
Encopresis - answer-a childhood disorder characterized by repeated defecating in
inappropriate places, such as one's clothing
Enuresis - answer-involuntary urination
Encopresis treatment - answer-behavior management: toilet refusal behavior,
scheduled toileting time, incentives.
Prevention of constipation
Counseling
Enuresis treatment - answer-1. First line is behavioral interventions: bed alarms,
toileting at bedtime and during the night, bladder training
2. Reassurance, resolves spontan, normal 4-5 yo
Enuresis meds - answer-desmopressin nasal spray;
Major depressive disorder dx - answer-5+ for at least a 2-week period; either #1 or 2 req