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NR 546 FINAL STUDY GUIDE QUESTIONS AND
CORRECT DETAILED ANSWERS AGRADE
Jessica is a 28-year-old client with a diagnosis of generalized anxiety disorder. Her anxiety is well-controlled with escitalopram and therapy. She presents with new complaints of insomnia and states, "I have constant itching and need to move my legs while I am in bed." - ANSWER>>Which of the following diagnostic tests should be completed next? Select all that apply.· caffeine intake · ferritin level · pregnancy test Rationale: Caffeine, alcohol, and nicotine may all increase the risk for RLS. Pregnancy and iron deficiency anemia may cause RLS. Foods high in tyrosine are not associated with RLS. A CT scan is not indicated for this client.
Jessica's lab work is within normal limits, and her pregnancy test is negative. She reports drinking two cups of coffee each morning and denies alcohol or nicotine use. Based on her assessment and diagnostic data, which of the following is the best medication choice to treat Jessica's RLS? - ANSWER>>· ropinirole Rationale: Ropinirole is a first-line agent for RLS. Iron is not appropriate in a client unless serum ferritin indicates deficiency. Gabapentin is appropriate for RLS but is a second-line medication.Diazepam is not appropriate for this client.
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2 Hyperactivity is modulated by the prefrontal cortex - ANSWER>>TRUE
Impulsivity is modulated by the orbitofrontal cortex - ANSWER>>TRUE-dACC is associated with impulsivity
Alzheimer's Association has identified a list of 10 early warning signs and symptoms which include - ANSWER>>· memory loss · challenges in planning or solving problems · trouble understanding visual and spatial relationships · difficulty completing familiar tasks · disorientation · problems with word finding · misplacing things · impaired judgment · social withdrawal · changes in mood
The etiology of AD - ANSWER>>Genes appear to play a strong role, with late-onset AD showing heritability of 58-79% and early-onset AD showing over 90%
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3 The etiology of AD - ANSWER>>Neurons in the brains of clients who develop AD may also have genetic coding abnormalities associated with amyloid precursor protein, while mutations of at least three different chromosomes, 21, 14, and 1, are associated with early-onset AD
Neuroanatomy of AD - ANSWER>>Two hallmarks of AD are amyloid plaques and neurofibrillary tangles. Toxic amyloid plaques are believed to form in the brain of clients with AD due to the abnormal processing of amyloid precursor protein
Neuroanatomy of AD - ANSWER>>Cell death leads to the atrophy of brain tissue, which affects the areas responsible for memory and higher-level thinking, such as the hippocampus and cerebral cortex.
Neural Networks of AD - ANSWER>>In addition to the development of amyloid plaques and neurofibrillary tangles, multiple cellular changes are associated with AD, including damage to synapses, mitochondrial abnormalities, and inflammatory processes. These changes are associated with neurotransmitter failure and neuronal death.
Neural Signaling in AD - ANSWER>>Acetylcholine (ACh) is a neurotransmitter necessary for processing memory and learning. AD leads to decreased acetylcholinesterase activity and a permanent loss of cholinergic neurons.
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4 Neural Signaling in AD - ANSWER>>Decreased cholinergic function is linked to memory dysfunction, particularly short-term memory. Neuronal damage may also occur due to abnormal activation of N-methyl-d-aspartate (NMDA) receptors by glutamate
Diagnosis of AD - ANSWER>>AD is currently diagnosed through the exclusion of other causes of dementia, such as vascular disease, Lewy body dementia, Parkinson's disease, and Creutzfeldt- Jacob disease.
Early symptoms of AD - ANSWER>>Early AD may include anxiety, irritability, and sleep disruption, which could be the presenting symptoms that bring clients to providers for treatment.
Stages of AD - ANSWER>>Preclinical (asymptomatic but brain amyloid is increased) Mild cognitive impairment (neurodegeneration due to elevated tau and brain volume loss) Severe cognitive deficits-(dementia)
Treatment of dementia begins in what stage? - ANSWER>>Mild stage. Pharmacologic treatment focusing on helping the client manage symptoms and behavioral issues that may present.
Medications for Alzheimer's Disease - ANSWER>>Treatment for AD includes cholinesterase inhibitors (ChEIs) and memantine.
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