NURS 6670 / NURS 6670N FINAL EXAM. Question1.
Collette is a 23-year-old female who presented for
emergency care with her mother because her
... [Show More] behavior
has become increasingly erratic and caused her to lose
her job. Her mother reports that she had never done
anything like this in the past, but about 3 months ago,
her boyfriend of 3 years broke up with her, and
Collette began to express unrealistic beliefs that her
boyfriend wanted to drive her crazy and hurt her. A
gentleman trying to hail a taxi accidentally bumped
into her this morning, and she started screaming that
her ex-boyfriend had hired the man to throw her into
the street under a car.
Collette is on a 2-week suspension from her job as a
restaurant server because she was combative to a
customer— she accused him of colluding with her exboyfriend
to get her fired. After this morning's
incident, her mother was so worried she brought her to
the emergency room. Her appearance is disheveled, she
is clearly hyperalert and is crying that
her boyfriend must have converted her mother to work
against her. Head imaging, screening lab, and a
toxicology screen are negative. A leading differential
for Collette is:
Acute psychotic episode
Rationale:
Collette's differential diagnosis is an acute psychotic
episode, this disorder causes abnormal ideas and
perceptions. Two of the main symptoms are delusions
and hallucinations.
Delusions are false beliefs, such as that someone is
against them and hallucinations are false perceptions,
such as listening, or feeling something that does not
exist.
Question 2.
Jake and Laurie are a young married couple who have
been referred to mental health counseling because Jake
is having disturbing sleep events. Laurie reports that
on more than one occasion she has awakened to find
Jake having what appears to be a panic attack, but he
doesn't seem to realize it. When he finally wakes up,
he is confused and doesn't really understand what
happened, although he does have a sense of intense
fear. This has happened twice in the last 2 weeks, and
the last time Laurie heard him screaming. Jake is now a
bit afraid to go to sleep and as a result does not feel
well the next day. The PMHNP recognizes that sleep
terrors in adults:
Are often associated with trauma or psychiatric problems
Question 3.
Jack is a 27-year-old male who has a history of
paranoid schizophrenia that first became apparent
approximately 10 years ago. He developed paranoid
delusions and eventually decompensated to the point
that he required inpatient stabilization. At the time, he
was started on conventional antipsychotics, but due to
intolerable adverse effects he was switched to
haloperidol. It worked well, but whenever he stopped
taking it, symptoms would recur. After several
hospitalizations, he was stabilized. The
neurophysiologic theory of schizophrenia suggests
that Jack's symptoms were a result of:
Increased dopamine activity in the mesolimbic pathway
Question 4.
Johanne is a 22-year-old female who is being treated
for narcolepsy. She is attempting to implement a
regimen of forced daytime naps in an effort to manage
her condition without pharmacotherapy as she is
generally averse to taking medications. [Show Less]