NURS 6640 wk 9 Essay Discussion - Hyperactivity Disorder

NURS 6640 wk 9 Essay Discussion – Hyperactivity Disorder

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects both children and adults.¹ ADHD develops when the brain and central nervous system suffer impairments related to growth and development. A person with ADHD will show varying degrees of these three behaviors: inattention, impulsivity and hyperactivity. ²

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What causes ADHD?

It’s not clear what exactly causes ADHD, though there are factors that may increase the chances of developing the condition. While researchers haven’t identified a specific ADHD gene, lots of studies show a genetic link. It’s quite common for a person diagnosed with ADHD to have at least one close relative with the condition.^{9, 10}Environmental factors may also play a role. These include exposure to pesticides and lead, a brain injury, being born prematurely or with a low birth weight. ¹¹

“The brain is essentially a huge electrical system that has multiple sub-systems that need to communicate with one another constantly to get anything done,” explains Thomas Brown, Ph.D., director of the Brown Clinic for Attention & Related Disorders in Hamden, CT. Brown is considered a leading global authority on the assessment and treatment of ADHD. In his book A New Understanding of ADHD in Children And Adults: Executive Function Impairments (Taylor and Francis Group, LLC, 2013), he explains why someone with ADHD really struggles with things like listening and completing assignments in a timely manner: The brain communicates messages through neurons in the brain. But at the end of every neuron there is a gap called a synapse.

The message needs to jump between the gaps, and does this with the aid of a chemical called a neurotransmitter produced by the body. “Persons with ADHD tend not to release enough of these essential chemicals, or to release and reload them too quickly before an adequate connection has been made.” In effect, messages struggle to get where they need to go to be acted on. Medications, including stimulants and non-stimulants, help make up for these deficits by triggering the release of certain chemicals, which in turn help the neurons to communicate with each other. NURS 6640 wk 9 Essay Discussion – Hyperactivity Disorder.

The most commonly used and recommended test for evaluating a child or adult for ADHD is a standard assessment that is designed to identify behavioral patterns and traits associated with ADHD.¹⁴

If your child is between age 4 and 18 and you suspect he or she may have ADHD, the American Academy of Pediatrics recommends that your child’s primary doctor/pediatrician do the initial behavioral screening evaluation. During an office visit, the doctor will meet with your child and you and ask a series of questions to determine if your child shows persistent signs of inattention and/or impulsivity and hyperactivity and whether they occur in more than one situation, such as at home and in school.

NURS 6640 wk 9 Essay Discussion If your child’s pediatrician suspects ADHD, he will likely recommend a formal evaluation by a mental health professional such as neurologist or psychologist who can do neuropsychological testing. This type of testing goes more in-depth than the standard screening. This testing will include screening for auditory and visual processing and sensory development, among other things.¹⁵The idea is that by identifying the contributing factors of ADHD, the doctor can recommend a treatment approach that addresses the underlying cause(s) as well as the ADHD. NURS 6640 wk 9 Essay Discussion – Hyperactivity Disorder.

If a doctor is having difficulty pinning down the diagnosis, she may recommend neurological imaging. A SPECT (single photon emission computed tomography) scan measures blood flow in the brain. A radioactive dye is injected in the arm, and a series of pictures are taken of the head. These are turned into 3-D images and screened to see where the brain appears more and less active.¹⁶Children diagnosed under age 6 were much more likely to have had neurological imaging compared to those 6 and older (41.8 % versus 25 %).

NURS 6640 WALDEN – ONLINE MID TERM EXAM QUESTIONS AND ANSWERS

QUESTION 1

The PMHNP understands that anxiety and depression are two disorders in which their symptoms may overlap. When discussing this, you explain that the autonomic nervous system is activated and further helps distinguish anxiety symptoms by making the following points:

A.”You may experience an elevated heart rate, constant worrying, and diarrhea.

“B.”You may experience fear, sweating, and muscle tension.

“C.”You may experience an elevated heart rate, the need to urinate, and fear.

“D.”You may experience sleepiness, decreased blood pressure, and fear.”

1 points

QUESTION 2

The PMHNP is working with a school-aged child who has been diagnosed with depression. The child has attended several sessions with the PMNHP, but recently presents with avoidant behavior by showing increased distress and being late to sessions. What approach does the PMHNP need to employ with the child to continue making therapeutic progress?

A.Remaining quiet until the child is ready to talk

B.Using communication techniques that are expressive

C.Inviting the child’s parents to speak on behalf of the child

D.All of the above

1 points

QUESTION 3

After informing a prospective patient about limits of confidentiality, the patient consents to the “conditions” of confidentiality and signs an informed consent form. Several weeks later, a lawyer representing the patient’s spouse for a court case, asks the PMHNP for the disclosure of information about the patient. The PMHNP should:

A.Disclose all patient information as requested

B.Refuse to disclose any confidential information

C.Limit disclosure to the extent legally possible

D.Ignore the request based on ethical reasons

1 points

QUESTION 4

In your office, you see a 58-year-old patient with PTSD who reports having nightmares, making it impossible for her to sleep. What recommendations based on principles of sleep hygiene will the PMHNP make?

A.Eat a heavy meal before bedtime to induce sleepiness

B.Maintain a warm bedroom temperature

C.Avoid watching television or reading in bed

D.Try going to sleep at different times throughout the week to avoid monotony

1 points

QUESTION 5

An 11-year-old patient has been exhibiting low self-esteem at school and acting out. According to Maslow’s hierarchy of needs, which of the following questions would best be addressed first by the PMHNP?

A.”Are Joel’s peers including him at recess?

“B.”Does Joel feel safe and secure at school?”

C.”Is Joel getting enough sleep at home?”

D.”How can Joel feel that he is loved?”

QUESTION 13

You are seeing a 29-year-old widow whose husband recently died overseas while serving his country in the military. She has been mourning the loss of her husband for several months, and continues to grieve. She refuses to go to group grieving sessions, but reports that she is still able to go to work and her fitness classes sometimes, and even makes attempts to stay social. She says, “Sometimes it’s like he’s not even gone. Other times it feels like it’s been an eternity since I’ve seen him. It’s hard to talk about this type of stuff with my girlfriends, especially since all of their husbands are still alive.” The PMHNP understands that it is appropriate to employ which therapeutic principle?

A. Encouraging catharsis

B.Encouraging abreaction to repressed feelings

C.Identifying conflict-resolution techniques

D.All of the above

QUESTION 19

The PMHNP is meeting with a 38-year-old divorced, single mother who has been seeing the PMHNP for anxiety and anger management. During one of the sessions, the patient tells the PMHNP that she is having a problem getting her child support payments from her ex-husband, which is triggering increased anxiety and anger, which she admittedly takes out on her children. How does the PMHNP respond in a way that upholds the supportive psychodynamic psychotherapy approach?
Telling the patient to take a vacation to get away and relaxB.Suggesting that she seek legal helpC.Giving her advice about men and how to get them to pay child supportD.Suggesting that the patient start going to church to help find more solace.

QUESTION 60

The PMHNP is treating a patient with a substantial fear of feeling closed in (claustrophobia). Thus, the patient will not get into an elevator. The office where he works is on the 10th floor and this requires that he walk up and down the stairs in the morning and evening to get to his office. With permission from the patient, the PMHNP is beginning systematic desensitization to address the patient’s need to use the elevator. What is the PMHNP’s best plan of action?Begin by having the patient stand in front of the elevator and write down his feelings

B.Complete a 30-minute therapy session in an elevator

C.Allow the patient to watch an elevator go up and down

D.Allow the patient to see the PMHNP getting into an elevator

QUESTION 63

During a session, the PMHNP asks a patient with a history of sexual abuse to recall the relationship she had as a child with her parents. The patient responds by saying she has a headache and her stomach hurts, and starts talking about her physical ailments. What is the appropriate response by the PMHNP?
Assure the patient that she does not have to discuss these memories

B.Explain why it is important for the patient to discuss these memories openly

C.Tell the patient that she may not get better if she does not face her fears

D.Let the patient know that plenty of other people have similar painful memories, too

A 35-year-old patient has been seeking treatment for depression for several months. The PMHNP does an assessment to see if processing has led to adaptive change. The patient’s self-references are positive in relation to past events, work is productive, relationships are adaptive, and there is congruence between behavior, thoughts, and affect. Based on this information, the PMHNP decides the patient ____________.
will require more processing strategies B.would benefit from the stabilization stage C.is ready to move to Stage III, future visioning D.no longer needs to continue with therapy