Exam (elaborations)
FITZGERALD PMHNP PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER FINAL EXAM QUESTIONS AND ANSWERS
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FITZGERALD PMHNP PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER FINAL EXAM QUESTIONS AND ANSWERS
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FITZGERALD PMHNP PSYCHIATRIC-MENTALHEALTH NURSE PRACTITIONER FINAL
EXAM
Potentially modifiable - risk factors for delirium in older adults - ANSWERS-
sensory impairment
immobilization
substance abuse
acute severe illness
malnutrition
Non-modifiable - risk factors for delirium in older adults - ANSWERS-age > 65
male sex
cognitive impairment
history of delirium
history of depression
comorbidity
surgery
terminal illness
,Mild Cognitive Impairment (MCI) - ANSWERS-- a slight but noticeable and
measurable decline in cognitive abilities, including memory and thinking skills
- no change in ADL's
Alzheimer's disease (AD) prevalence - ANSWERS-- AD= 50-70% of all cases of
dementia
Vascular Dementia (VaD) - ANSWERS-A form of dementia characterized by
sporadic, and progressive, loss of intellectual functioning caused by repeated
infarcts, or temporary obstructions of blood vessels, which prevent sufficient
blood from reaching the brain. (Also called multi-infarct dementia.)
- 3rd most common dementia
Dementia w/ Lewy Bodies (DLB) - ANSWERS-2/3 needed: Fluctuating cognition,
recurrent visual hallucinations, spontaneous motor feature of Parkinsons
Lewy Neurites (alpha synuclein accumulations)
Frontotemporal Dementia - ANSWERS-aka Pick's disease. Is associated with
pronounced atrophy of the frontal lobe. It manifests initially with changes in
personality, social behavior, and language that progress over time to a more
global dementia with obvious neurocongnititve deficits.
mild cognitive impairment first symptoms - ANSWERS-memory loss
Alzheimer's disease first symptoms - ANSWERS-memory loss
,vascular dementia first symptoms - ANSWERS-- cognitive decline after
cardiovascular event
- apathy, falls, focal weakness
demential w/lewy body first sypmtoms - ANSWERS-- fluctuating levels of
cognition, aertness, attention
- recurrent well-formed visual hallucinations
- severe neuroleptic snesitivity
Frontotemporal Dementia first symtpoms - ANSWERS-- insidious onset and
gradual progression
- social cognition/personality changes cause more problems than cognitive
problems
Pharmacologic treatment: mild cognitive impairment - ANSWERS-acetyl-
cholinesterase inhibitors can delay BUT not prevent progression
Pharmacologic treatment: Alzheimer's disease - ANSWERS-acetyl-cholinesterase =
mild/moderate
NMDA receptor antgonists = moderate/severe
Pharmacologic treatment: vascular dementia - ANSWERS-cholinesterase inhibitors
may help
, Pharmacologic treatment: demential w/Lewy Body - ANSWERS-- antipsychotic use
can result in NMS sensitivity and EPS
- SGA less problematic (Quetiapine=least adverse effects)
Pharmacologic treatment: frontotemporal dementias - ANSWERS-symptomatic
psychiatric treatment
Suspected/Diagnosed Dementia Labs - ANSWERS-cbs, tsh, b12, folate, renal,
hepatic function, electrolytes, glucose, albumin and protein, hiv, vdrl, UA
Neuropsychiatric symptoms (NPS) - pharmacologic treatment - ANSWERS--
cholinesterase inhibitors
- N-methyl-D-aspartate (NMDA)
- Antidepressants
DICE mnemonic for treatment of NPS - ANSWERS-Describe
Investigate
Create
Evaluate
DICE mnemonic - ANSWERS-Describe - obtian accurate description of behavior
from patient and caregivers
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