Download NU665 EXAM 2-SUD, integrated care, paraphilic metabolic syndrome and more Exams Nursing in PDF only on Docsity!
NU665 |! EXAM |! 2-SUD, |! integrated |! care, |!
paraphilic |! d/o, |! metabolic |! syndrome
DSM5 |!
Mild |! SUD MODERATE SEVERE early |! remission sustained |! remission |! - |! Correct |! answer |! ✔2-3 |! sx 4-5 |! SX 6 |! or |! more |! sx |! no |! criteria |! except |! cravings |! for |! at |! least |! 3 |! mos. |! and |! < no |! criteria |! except |! craving |! for |! >12 |! mos pulsatile |! release |! pattern |! - |! Correct |! answer |! ✔release |! of |! extended |! release |! drugs |! I.e. |! stimulants |! false |! sense |! of |! security-still |! able |! to |! be |! misused |! I.e. |! stimulants how |! do |! you |! resensitize |! drug |! receptors |! for |! pleasurable |! effects? |! - |! Correct |! answer |! ✔substance |! needs |! to |! be |! withdrawn-leads |! to |! cravings
when |! are |! nicotinic |! receptors |! desensitized |! - |! Correct |! answer |! ✔time |! that |! one |! cigarette |! is |! finished resensitized |! in |! ~45 |! mins most |! commonly |! abused |! substances |! (in |! order) most |! commonly |! USED |! substance |! - |! Correct |! answer |! ✔alcohol-tobacco-MJ |! (in |! that |! order) caffeine onset |! of |! caffeine |! w/d |! sx |! peak resolution |! - |! Correct |! answer |! ✔12-24 |! hrs |! peak |! 24-48 |! hrs |! resolution |! 1 |! week nicotine |! w/d |! sx |! onset peak duration |! - |! Correct |! answer |! ✔onset |! 2 |! hrs |! peak |! 24-48 |! hrs |! last |! weeks-months ETOH |! w/d |!
what |! percent |! of |! people |! with |! OUD |! will |! attempt |! suicide |! at |! least |! once? |! - |! Correct |! answer |! ✔15% fatal |! withdrawals |! - |! Correct |! answer |! ✔ETOH BZDs heroine |! w/d |! onset |! and |! peak methadone |! w/d |! onset |! and |! peak |! - |! Correct |! answer |! ✔1. |! 6-8 |! hrs, |! 2-3 |! days, |! resolves |! 7-10 |! days
- |! 1-3 |! days, |! lasts |! 10-14 |! days non-BZD |! sedative |! hypnotics |! - |! Correct |! answer |! ✔zolpidem |! (ambien) eszopiclone |! (Lunesta) BZDs |! OD |! antidote |! - |! Correct |! answer |! ✔flumazenil |! (romazicon) how |! to |! taper |! BZD |! - |! Correct |! answer |! ✔decrease |! by |! no |! more |! than |! 10% |! total |! dose |! each |! week stimulant |! w/d |! onset |! peak |! and |! duration |! - |! Correct |! answer |! ✔peak |! 2-4 |! days |! last |! about |! a |! week |! onset |! hrs |! after |! last |! use
hallucinogen |! intoxication |! sx |! - |! Correct |! answer |! ✔synesthesia |! (see |! sounds, |! taste |! words |! etc) |! hallucinations illusions hallucinogen |! persisting |! perception |! disorder |! - |! Correct |! answer |! ✔"flashbacks" |! that |! occur |! in |! 15-80% |! of |! users |! DSM- solvents volatile |! substances |! - |! Correct |! answer |! ✔other |! names |! for |! inhalants MAT |! options |! - |! Correct |! answer |! ✔naltrexone |! (opioid |! antagonist) methadone |! (opioid |! agonist) Suboxone |! (partial |! agonist) |! subutex |! (bup |! only) goals |! of |! MAT |! - |! Correct |! answer |! ✔1. |! reduce |! adverse |! effects |! of |! OUD |! (relapse, |! crime, |! death)
- |! stabilize |! brain
- |! reduce |! opioid |! cravings who |! is |! naltrexone |! best |! for? |! - |! Correct |! answer |! ✔highly |! motivated |! clients |! 2/ |! blocks |! opioid |! effects
the |! brains |! pleasure |! center |! - |! Correct |! answer |! ✔nucleus |! accumbens-dopamine |! powerhouse Counteradaptation |! - |! Correct |! answer |! ✔initial |! positive |! reward |! feelings |! are |! followed |! by |! development |! of |! tolerance-greater |! amounts |! of |! substance |! are |! needed |! to |! achieve |! diminishing |! levels |! of |! positive |! rewards SBIRT |! - |! Correct |! answer |! ✔Screening, |! Brief |! Intervention, |! and |! Referral |! to |! Treatment SAMHSA PRINCIPLES |! OF |! MOTIVATIONAL |! INTERVIEWING |! - |! Correct |! answer |! ✔Change |! talk |! roll |! with |! resistance-avoid |! challenging |! person's |! resistance |! and |! accept |! ambivalence contingency |! management |! in |! SUD |! treatment |! - |! Correct |! answer |! ✔behavioral |! reinforcement |! based |! approach |! w/in |! CBT |! model accountable |! care |! organizations |! - |! Correct |! answer |! ✔groups |! of |! doctors, |! hospitals, |! and |! other |! health |! care |! providers, |! who |! come |! together |! voluntarily |! to |! give |! coordinated |! high |! quality |! care |! to |! their |! Medicare |! patients medicare |! pts |! get |! right |! care |! at |! right |! time |! and |! she |! in |! the |! cost |! savings
what |! is |! the |! mainstay |! of |! integrated |! care |! settings? |! - |! Correct |! answer |! ✔screenings |! (medical |! and |! mental |! health) what |! are |! 2 |! new |! services |! in |! collaborative |! integrative |! care |! model |! - |! Correct |! answer |! ✔1. |! BH |! care |! manager |!
- |! consulting |! psychiatrist/mental |! health |! specialist curbside |! consults |! - |! Correct |! answer |! ✔PMHNP |! consulting |! with |! other |! providers |! in |! integrative |! system what |! is |! one |! of |! the |! most |! significant |! factors |! of |! enacting |! NP |! leadership |! in |! primary |! care? |! - |! Correct |! answer |! ✔physician |! resistance what |! additional |! leadership |! attribute |! is |! identified |! in |! NP |! leadership |! article? |! - |! Correct |! answer |! ✔risk-taking health |! homes |! - |! Correct |! answer |! ✔funded |! by |! the |! Affordable |! Care |! Act; |! similar |! services |! to |! Patient-Centered |! Medical |! Home, |! but |! with |! expanded |! coverage |! for |! mental |! health |! and |! substance |! use |! services, |! health |! promotion, |! and |! patient |! and |! family |! support |! services builds |! linkages |! to |! community |! supports |! and |! resources; |! enhances |! coordination |! and |! integration |! of |! primary |! and |! BHC |! to |! better |! meet |! needs |! of |! people |! w/ |! multiple |! chronic |! illnesses SAMHSA |! 3 |! categories |! of |! implementation |! of |! integrated |! health |! system |! - |! Correct |! answer |! ✔1. |! coordination: |! communication
when |! does |! paraphilia |! become |! paraphilia |! d/o? |! - |! Correct |! answer |! ✔when |! criteria |! B |! -harm |! to |! self |! or |! others |! is |! met what |! must |! you |! differentiate |! from |! paraphilia |! d/o's? |! - |! Correct |! answer |! ✔1. |! non |! pathological |! sexual |! fantasies |! (most |! important)
- |! dementia
- |! personality |! change |! d/t |! medical |! condition
- |! manic |! episode |! and |! substance |! intoxication |!
- |! schizophrenia most |! common |! of |! potentially |! law-breaking |! sexual |! behaviors |! - |! Correct |! answer |! ✔voyeuristic |! d/o's when |! is |! voyeuristic |! d/o |! considered |! to |! be |! in |! full |! remission |! - |! Correct |! answer |! ✔at |! least |! 5 |! years |! w/in |! controlled |! environment pedophilic |! sexual |! orientation |! vs |! d/o |! - |! Correct |! answer |! ✔d/o |! causes |! distress |! and |! impairment |! in |! invidividual orientation |! when |! no |! acting |! on |! impulses |! and |! are |! not |! functionally |! limited |! from |! them age |! criteria |! for |! pedophilic |! d/o |! - |! Correct |! answer |! ✔age |! is |! at |! least |! 16 |! YO |! and |! victim |! is |! at |! least |! 5 |! years |! younger |!
doesn't |! include |! individuals |! in |! late |! adolescence |! in |! relationship |! w |! 12 |! or |! 13 |! YO autogynephilia |! - |! Correct |! answer |! ✔Sexual |! arousal |! of |! genital |! male |! associated |! with |! the |! idea |! or |! image |! of |! being |! a |! woman. new |! subcategory |! of |! pedophilia |! - |! Correct |! answer |! ✔infantophilia who |! is |! most |! vulnerable |! to |! paraophilic |! d/o's? |! - |! Correct |! answer |! ✔personality |! d/os |! with |! low |! self |! esteem, |! anger |! management, |! low |! empathy, |! delaying |! gratification fewer |! than |! ___% |! of |! sex |! offenders |! in |! US |! have |! sexual |! sadism |! d/o |! ___% |! of |! those |! that |! have |! committed |! sexually |! motivated |! homicides |! have |! d/o |! - |! Correct |! answer |! ✔ 10 |! % 35-75% poor |! prognosis |! for |! pharaphilic |! d/o's |! - |! Correct |! answer |! ✔1. |! early |! onset |!
- |! legal |! charges
- |! unmotivated/uncooperative |! attitude
- |! paraphilia |! as |! only |! sexual |! activity |!
- |! comorbidity |! and |! lack |! of |! remorse possible |! comorbidities |! of |! paraphilia |! - |! Correct |! answer |! ✔1. |! other |! paraphilic |! d/o's |!
- |! HDL |! <40 |! in |! men |! and |! <50 |! in |! women |!
- |! fasting |! blood |! glucose |! >100 |! or |! on |! tx |! for |! T2DM |!
- |! BP |! >/=130/85 |! or |! on |! tx |! for |! HTN what |! federation |! specifies |! waist |! circumference |! by |! ethnicity |! in |! metabolic |! syndrome? |! - |! Correct |! answer |! ✔international |! diabetes |! federation |! (IDF) metabolic |! syndrome |! risk |! factors |! - |! Correct |! answer |! ✔elevated |! BP |! dyslipidemia raised |! fasting |! glucose central |! obesity / |! have |! HTN |! ___ |! have |! controlled |! HTN |! - |! Correct |! answer |! ✔ 1 |! in |! 3 1/2 |! have |! controlled |! BP |! (w/ |! dx |! HTN) when |! is |! pt |! screen |! for |! evelated |! BP |! - |! Correct |! answer |! ✔USPFTF: |! 18-39 |! q3-5 |! years age |! 40 |! yearly |! screen |! AHA: |! screen |! starting |! at |! age |! 20 |! for |! q2years BP |! normal
elevated HTN: |! stage |! 1 |! stage |! 2 |! - |! Correct |! answer |! ✔normal: |! <120/< elevated: |! 120-129/< stage |! 1: |! 130-139 |! or |! diastolic |! 80- stage |! 2: |! >/=140 |! or |! diastolic |! at |! least |! 90 HTN |! medications |! - |! Correct |! answer |! ✔thiazides, |! ACEI's, |! ARBs, |! CCB BB |! no |! longer |! many |! now |! only |! CAD, |! post |! MI, |! HF |! etc people |! with |! high |! cholesterol |! have |! ___ |! the |! risk |! for |! heart |! disease |! - |! Correct |! answer |! ✔twice |! the |! risk dyslipidemia |! screening |! criteria |! - |! Correct |! answer |! ✔NIH: |! all |! ages |! 9-11 |! and |! again |! at |! 17-21 |! YO |! adults: |! age |! 20 |! then |! q5 |! years criteria |! to |! perform |! full |! lipid |! panel |! on |! no |! cardiac |! risk |! factors |! lipid |! panel |! vs |! cardiac |! risk |! factors |! - |! Correct |! answer |! ✔1. |! total-C |! >240 |!
- |! total-C |! >200 |!
what |! is |! a |! possible |! side |! effect |! of |! statins |! - |! Correct |! answer |! ✔myalgias |! - weak/achy |! sx DM |! risk |! factors |! - |! Correct |! answer |! ✔1. |! >45 |! YO
- |! overweight
- |! first |! degree |! relative
- |! gestational |! DM |!
- |! physical |! inactivity
- |! race: |! AA, |! latino, |! indian, |! asian, |! Pacific |! Islander, |! Hawaiians DM |! labs |! - |! Correct |! answer |! ✔BMP hgb |! A1C UA |! for |! micro |! albumin A1C |! healthy |! pre |! diabetes diabetes |! - |! Correct |! answer |! ✔1. |! below |! 5.
- |! 5.7-6.
- |! 6.5 |! and |! above FBGC |! healthy |!
pre |! dm |! diabetes |! - |! Correct |! answer |! ✔1. |! <
- |! 100-
- |! > what |! are |! you |! looking |! for |! in |! UA |! in |! diabetes |! pt |! - |! Correct |! answer |! ✔ketones |! protein what |! is |! first |! sign |! of |! kidney |! disease |! - |! Correct |! answer |! ✔protein |! in |! urine UTI |! positive |! urine |! - |! Correct |! answer |! ✔leukocytes |! and |! nitrates DM |! meds |! - |! Correct |! answer |! ✔biguanides GLP-1 |! (metformin) SGLT-1/2 |! (glucoseuria |! caused) DPP4 |! (genuvia-watch |! high |! tryglycerides |! and |! don't |! want |! pancreatitis) BMI |! underweight normal overweight obese |! - |! Correct |! answer |! ✔1. |! <18.
- |! 18.5-24.
T2DM
new |! addiction |! in |! DSM5 |! - |! Correct |! answer |! ✔gambling 2 |! neurobiological |! processes |! of |! addiction |! - |! Correct |! answer |! ✔1. |! reinforcements-DA |! reward |! center |!
- |! neuroadaptation-brain |! changes |! in |! structure |! leading |! to |! tolerance |! and |! w/d age |! group |! with |! highest |! prevalence |! of |! substance |! use |! - |! Correct |! answer |! ✔18- 24 |! YO diagnoses |! w/ |! highest |! prevalence |! of |! SUD |! - |! Correct |! answer |! ✔schizophrenia |! 4x bipolar |! d/o |! 5x specific |! criteria |! needed |! to |! identify |! substance |! use |! as |! abuse |! - |! Correct |! answer |! ✔1. |! 12 |! mo |! period |! of |! sustained |! use
- |! continued |! use |! in |! physically |! hazardous |! situations
- |! continued |! use |! despite |! inability |! to |! fulfill |! major |! role |! obligations
- |! continues |! despite |! multiple |! negative |! consequences |! in |! social |! relationships |! and |! legal |! problems behavioral |! health |! in |! primary |! care |! - |! Correct |! answer |! ✔impact |! model cherokee |! model |! (TN) diamond |! (Minnesota)
MCPAP |! (MA)
primary |! care |! in |! BH |! settins |! - |! Correct |! answer |! ✔health |! homes universal |! screenings navigators |! (nurses, |! SW_ fiscal |! integration STABLE |! project |! - |! Correct |! answer |! ✔standard |! for |! bipolar |! excellence |! project -identification |! and |! management |! of |! bipolar |! d/o what |! does |! stable |! resource |! kit |! include |! - |! Correct |! answer |! ✔1. |! 2 |! depression |! screening |! tools |!
- |! Bipolar |! d/o |! screening-MDQ, |! CIDI
- |! suicide |! risk |! assessment-SBQ-R
- |! substance |! use |! screening-AUDIT, |! CAGE
- |! level |! of |! functioning-AIMS preferred |! tx |! for |! hallucinogen |! intoxication |! - |! Correct |! answer |! ✔"guiding" |! haldol/bzds |! to |! maintain |! safety |! sometimes MAT |! goals |! - |! Correct |! answer |! ✔1. |! reduce |! adverse |! effects |! of |! SUD
- |! reduce |! cravings
- |! stabilize |! brain
