Psychiatric Mental Health Nurse Practitioner 4th edition with complete verified solutions already graded A+

Is risperidone high or low potency?

high

what is the difference between high and low potency antipsychotics?

high potency more likely to cause EPS, low potency more likely to cause sedation or muscle weakness. low potency also more likely to cause DM.

A positive babinski is_______ and is normal until the age of ________

fanning of toes and dorsiflexion of the great toe is normal until the age of two.

CN 1 is_______and it is tested by

smell, test for familiar odors

CN 2 is the

optic nerve, test with the confrontation test. (finger moves in with one eye closed, each provider)

CN three is the

oculomotor. Tests with 3,4,6. Testing the five extrinsic eye muscles. (I call this cat whiskers).

Three is also the equality of pupils, reaction to light, and ability to accomodate.

Test corneal light reflex (when shining a light at bridge of nose the light should appear symetrical on both eyes.

Trochlear CN is #? what does it do

4th CN, test with CN3 and 6 with extrinsic eye muscles.

Trigeminal nerve has two types? What are they?

motor division and sensory division

Trigeminal (5th CN) motor division

palpate masseter muscles with fingertips while client clenches, look for paralysis on one side or weakness, look for tremor of lips, involuntary chewing movements, and spasms of the masticatory muscles.

Trigeminal (5th CN) sensory dividsin

touch skin with wisp of cotton, test corneal reflex with cotton, superficial pain with pinpricks, sense of touch in the oral mucosa.

Abducens is the

6th cranial nerve. tested with 3, 6 in 5 extrinsic eye muscles exercises

7th CN is the (motor)

Facial nerve. inspect face for evidence of flaccid paralysis. Ask patient to elevate eyebrows, wrinkle forehead, close eyes, frown, smile puff out cheeks

7th CN is divied into

motor and sensory

7th CN sensory test by

taste test sugar, vinegar, salt

Acoustic is what CN

8. do whisper test, weber and Rinne test

CN 9 is the

Glossopharyngeal, it is tested with 10

CN 10 is Vagus

when patient says "Ah" test for elevatuion in uvula. Test for GAG reflex

Accessory spinal is what CN

11

how to test accessory spinal 11th CN

test SCD and trapezius muscle against resistance to hands.

12th CN is the

Hypoglossal-look for tremors and other involuntary movement when the client protrudes his tongue.

how to check for equilibrium

romberg test: have client stand up straight with feet together, arms by side, eyes closed. only slight swaying would be normal. assess for a full 5 seconds.

diadochokinesia is

the ability to perform rapid alternating movements

dyssynergia

Finger-to-nose test

Heel-to-knee test

sensory fx include

pain, temperature, superficial touch, two point discrimination, sterognosis, graphesthesia

what is sterognosis:

test to distinguish forms by placing objects in the clients hands while his eyes are closed.

What is graphesthesia?

ability to "read" a number by having it traced on the skin

what is muscle tone?

tension present when muscle is resting

what neurological soft sign is used to assess for a lesion in the pareietal lobe

astereognosis

If a client presents with elevated temperature and is also taking psychotropic medications be on the look out for (tegretol and clozaril for example)

agranulocytosis (LOW NEUTROPHIL COUNT)

seroquel may cause ___________with the eyes

cataracts

anticholergic effects of antipsychotics may cause?

blurry vision

What conditions cause peripheral edema in psychiatry?

lithium and anorexia nervosa.

WHat is a normal free T4 value range?

0.8-2.8

in renal failure, cushing syndrome, and cirrhosis __________thyroid levels of FT4 are found

decreased

what drugs can increase thyroid values (FT4)

heparin, aspirin, propronolol

what meds an decrease thyroid values (FT4)

methadone and lasix

What is a normal

Thyroid-stimulating hormone normal value

2-10 mU/I

who should not receive MMR vaccine?

not for pregnant women, people with cancer, weakned immune system or HIV or AIDS with T cell counts below 200. Or people who got a blood tranfusion in the last two weeks.

Shingles vaccine is reccomended to people 60 and older who ____________________had chickpox

HAVE.

Tanner stage in female with "breast bud, enlargement of areola"

Stage 2

Tanner stage with enlargement of breast, no seperation of contour

stage 3

Tanner stage where areola and papilla form a mount seperate from the level of the breast

Stage 4

Tanner stage where the projection of pailla only, related to RECESSION of areola

stage 5

Stage one tanner stage for boys and girls is

prepubertal

Enlargement of scrotum and testes in what tanner stage

stage 2

enlargement of penis length is what tanner stage

3

enlargement in penis girth, darker scrotal skin is what tanner stage

stage 4

what tanner stage is adult male genitalia found in

Stage 5

Max heart rate calculations

220-age=max HR. 75 percent of this is moderate-high intensity workout target HR

should you ever do self-disclosure with a client?

yes, but only if it serves a purpose (an example of a time you wish you kept regular appts, etc).