Exam (elaborations)
FNP Review Dunphy Chapter 18 Psychosocial Problems with Complete Solutions 100% Verified
- Course
- Institution
FNP Review Dunphy Chapter 18 Psychosocial Problems with Complete Solutions 100% Verified
[Show more]
Content preview
FNP Review Dunphy Chapter 18Psychosocial Problems with Complete
Solutions 100% Verified
What is the prevalence of GAD in the United States?
10.2% to 15.4%
1.3% to 4.4%
5.1% to 11.9%
13.2% to 18.7% - ✔✔C
Generalized anxiety disorder (GAD) is commonin both community and clinical settings. Epidemio- logical
studies of nationally representative samples in the United States have found a lifetime prev- alence of
GAD of 5.1% to 11.9%. A review of epidemiological studies in Europe found a 12-month prevalence of
1.7% to 3.4% and a lifetime preva- lence of 4.3% to 5.9%.
You have started Donald, age 44, on parox- etine hydrochloride (Paxil). You advise Donald to be aware of
which of the following side effects?
Flatulence
Nausea
Increased appetite
Changes in hearing - ✔✔B
Paxil (paroxetine hydrochloride) is a selective serotonin reuptake inhibitor (SSRI) antidepressant used to
treat depression, panic attacks, obsessive- compulsive disorder (OCD), anxiety disorders, post-traumatic
stress disorder, and a severe form of premenstrual syndrome (premenstrual dysphoric dis- order). Side
effects include headache, nervousness, restlessness, drowsiness, dizziness, nasal irritation, sleep
problems (insomnia), nausea, decreased sex drive, and potential impotence.
You are seeing Sonny, age 70, who has a history of anger issues. What medication requires cautious use
in a potentially aggressive client?
Mood stabilizers
Lithium
Antipsychotic medications
Benzodiazepines - ✔✔D
Paradoxical rage reactions due to benzodiazepines occur as a result of an altered level of consciousness,
,which generates automatic behaviors, anterograde amnesia, and uninhibited aggression. It is estimated
that anywhere between 1% to 20% of benzodiaze- pine users experience some form of increased anger
or express aggression. These aggressive incidents occurred at both low and high doses and by indi-
viduals with and without histories of this kind of behavior.
You are seeing Grace, age 45, who is severely depressed. She is seeing a psychiatrist but is here to see
you today for a cough. However, she answers all your questions slowly, and demonstrates psychomotor
retardation. She also is requesting medication to help her sleep. You fear she is sui- cidal. What is the
first thing you must do?
Call Grace's psychiatrist.
Ask Grace directly if she is thinking of killing herself, if she has a plan for when, where, and how she plans
to do this.
Call her family.
Spend time counseling her. - ✔✔B
Your immediate duty is to assess her suicidal ideation and/or lethal plan. You must carefully document
this assessment. You may need to call her psychiatrist and/or family, but it is not the first thing you must
do. You may also spend time counseling her, but this would only be after assessing the level of suicidality.
It must be directly but compassionately confronted.
Your client Johnny tells you he has had a car accident. You say, "Tell me about the accident." What type
of therapeutic communication is this response?
Offering self
Reflection
General lead
Making observations - ✔✔C
This statement is not making an observation, nor is it reflecting back to the client. An example of offer-
ing self is making oneself available to help. You are inviting further communication about the accident.
See Chapter 2 for additional therapeutic communi- cation techniques.
Life expectancy rates in the United States have declined for the first time for several years in a row. The
reasons for this are
little understood
increased suicide rates
more drug-resistant and/or nosocomial infections
the opioid crisis - ✔✔D
There has been an overall rise in suicide rates for several years, but these numbers are not significant
, enough to account for the decrease in life expectancy.
Deaths from opioid overdoses have continued to rise in dramatic numbers, and it is more accepted that
it is this rise that has accounted for an overall decrease in life expectancy. Some theorize that opioid
deaths may actually be suicides, but this can be difficult to tease out.
Medications may be needed in additions to screening, early intervention, counseling, and education to
treat alcohol use disorder (AUD), moderate to severe subtype. You are treating Jerry, age 60, who has
this diagnosis. He has been in detox numerous times. Jerry is desperate to stop drinking. He continues
his usual heavy usage of alcohol and is fearful of the consequences. You decide you must consider
pharmacological therapy for this client. What drug is your best choice?
Citalopram (Celexa)
Chlorpromazine (Thorazine)
Naltrexone (Revia)
Disulfiram (Antabuse) - ✔✔C
Naltrexone (Revia), an opioid antagonist thatis a synthetic congener of oxymorphone with no opioid
agonist properties, has been used effectively for treatment of AUD in combination with non-
pharmacological treatment. It can be started when a patient is still drinking alcohol. Naltrexone usein
randomized trials demonstrated lower relapse rates, fewer days drinking, and a decrease in crav- ing for
alcohol.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller TheeGrades. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
82871 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now