Insomnia Treatment Periods and Mental Health Mechanisms: NRNP

NRNP 6635 QUESTIONS WITH ANSWERS ALL CORRECT 1- Select the maximum time period recommended for treatment of insomnia with hypnotic drugs. A. 1 week B. 2 weeks some have this as answer. C. 1 month SOME HAVE THIS ONE I FOUND 2-4 WEEKS D. 6 months another one has this as answer 2- Select the symptom that is least associated with manic and hypomanic episodes. A. Suicidal ideation B. Inflated self-esteem C. Distractibility D. Pressured speech 3- All the following are classes of coping mechanisms in the Model of Mental Health as Resilience where humans overcome stressful situations EXCEPT: A. Adaptive involuntary coping mechanisms (defense mechanisms) B. Generativity versus Stagnation C. Conscious Cognitive Strategies D. Consciously Seeking Social Support 4- Select the primary cause of reactive attachment disorder in children. A. Death of mother B. Bullying by peers C. Negligent parenting D. Fetal alcohol syndrome Reactive attachment disorder and disinhibited social engagement disorder are clinical disorders characterized by aberrant social behaviors in a young child that reflect grossly negligent parenting and maltreatment that disrupted the development of normal attachment behavior 5- Select the type of amnesia in which patients are aware of their memory loss with repeated questioning. A. Substance related B. Posttraumatic C. Transient global D. Dissociative

6- Select the serum substance that should be measured to aid the diagnosis of restless leg syndrome. A. Potassium B. Ferritin X5 C. Magnesium D. Albumin Uncontrollable movement of the legs is not a symptom of restless leg syndrome (RLS). RLS (also known as Ekbom syndrome) is an uncomfortable, subjective sensation of the limbs, usually the legs, sometimes described as a “creepy crawly” feeling or as the sensation of ants walking on the skin. It tends to be worse at night and is relieved by walking or moving about. It appears as a cause of sleep initiation insomnia because the patient may find it difficult to lie still in bed, needing to get up to relieve the discomfort. The ultimate cause is unknown, but it appears often in pregnancy, iron or vitamin B12 deficiency anemia, and renal disease. The first step in treatment is looking for anemia and treating it, if found. Benzodiazepines are relatively ineffective. The off-label use of l-dopa and carbidopa (Sinemet), bromocriptine (Parlodel), and pergolide (Permax) is often helpful. In rare patients who are severely affected, the off-label use of narcotic analgesics can help when other treatments have been tried and have failed. Ropinirole (Requip), a dopamine agonist already available for treatment of patients with Parkinson’s disease, is now the first drug approved by the U.S. Food and Drug Administration for treatment of moderate to severe RLS 7- Select two imaging methods used to study anxiety disorders. A. CT B. TMS C. MRI D. EKG 8- Select the activity in which children are most likely to suffer selective mutism. A. Religious B. Family C. Playmates D. School Selective mutism is defined as a consistent failure to speak in specific social situations (e.g., school) where speaking is expected despite speaking in other situations. For the diagnosis to be made, the lack of speech must interfere with achievement or communication, must last at least 1 month, and must not be attributable to a lack of knowledge or comfort with the language required.

9- Select the anxiety disorder that is most associated with selective mutism in children, A. Social B. Generalized C. Separation D. Phobic 10- Select the most exclusive feature rapid eye movement (REM) sleep. A. Bradycardia B. Relaxation of skeletal muscles C. Dreaming D. Tachypnea Probably the most distinctive feature of REM sleep is dreaming. 11- Select the drug with the most rapid onset of action to treat acute mania. A. Lithium is either or book page 373 B. Clonazepam C. Lamotrigine D. Valproate 12- Select two types of theories that have contributed to causes of anxiety. A. Psychoanalytic theory B. Behavioral theory C. Family D. Group 13- Select the disorder that is most similar to cyclothymia. A. Major depression B. Bipolar II

C. Schizophrenia D. Bipolar I either bipolar I or Bipolar II, not sure Cyclothymia is characterized by at least 2 years of numerous periods with hypomanic symptoms and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. This disorder apparently occurs at the same rate in both men and women, but women seek treatment more often than men. The lifetime prevalence rate of cyclothymic disorder is 0.4 to 1 percent 14- Select the exposure to violence that is excluded as a DSM-5 diagnostic criterion for PTSD in children and adolescents. A. Electronic media B. Directly witnessed C. Report of family member D. Repeated natural disaster 15- Select the alternate name for persistent depressive disorder. A. Cyclothymia B. Bipolar I C. Bipolar II D. Dysthymia An individual suspected to have persistent depressive disorder needs to experience symptoms for at least 2 years before a diagnosis can be made. The essential feature is a chronically depressed mood (or possibly an irritable mood in children and adolescents) for most of the day, more days than not, for at least 2 years (1 year for children and adolescents). Clients with a diagnosis of MDD show impaired social and occupational functioning that has existed for at least 2 weeks. 16- Select the antidepressant drug that is most likely to cause death when taken in an overdose. A. Fluoxetine B. Mirtazapine C. Imipramine D. Trazodone

17- Select two events that are causes of dissociative trance disorder. A. Natural disaster I think is this one B. Substance abuse C. Experienced violence I think is this one D. Appropriate drug therapy Dissociative trance disorder is manifested by a temporary, marked alteration in the state of consciousness or by loss of the customary sense of personal identity without the replacement by an alternate sense of identity. There is often a narrowing of awareness of the immediate surroundings or a selective focus on stimuli within the environment and the manifestation of stereotypical behaviors or movements that the individual experiences as beyond his or her control 18- Select the two criteria used to differentiate between diagnosing Bipolar I from Bipolar II Disorder. NEED ANSWER A. A distinct period of abnormally and persistent elevated, expansive, or irritable mood and increased activity or energy SAME B. The episode is associated with an unequivocal change in functioning that is uncharacteristic of the individual when not symptomatic.SAME C. The disturbance in mood and change in functioning are observable by others D. The episode is not severe enough to cause marked impairment in social or occupational functioning or to necessitate hospitalization X1 Recurrent bouts of depression and episodic occurrences of hypomanic symptoms are diagnostic criteria for bipolar II disorder. Experiencing a full manic episode would indicate a diagnosis of bipolar I disorder and rule out a diagnosis of bipolar II disorder. Bipolar I disorder, which includes manic and depressive symptoms. The client in the question is exhibiting manic symptoms. Manic episodes are distinct periods of abnormal extreme euphoria, expansive mood, or irritable mood, lasting at least a week. 19- Select the percentage occurrence of anxiety disorders in children and adolescents. A. 2-5 B. 5-10 C. 10- 20 D. 20-30