COMMONLY ASKED PSYCHIATRIC NURSING TOPICS in the ACTUAL EXAM.

A. PSYCHIATRIC DRUGS
1. Psychiatric drugs are preferably given after meal except minor tranquilizers (anxiolytics).
2. Haloperidol is commonly given for psychotic patients.
3. Extrapyramidal Syndrome (EPS) is commonly caused by Haloperidol.
4. Cogentin and Benadryl are drugs usually administered to decrease symptoms of EPS.
5. Clozaril causes Agranulocytosis and Leukopenia.
6. Diazepam (valium) is commonly prescribed for individuals with anxiety disorder.
7. Sedation is a common effect of diazepam (valium) thus, safety should be prioritized.
8. Paxil and Zoloft are antidepressants under the category of Serotonin Selective Reuptake Inhibitors (SSRI’s) that can cause
Sexual Dysfunction.
9. Tofranil and Elavil are commonly prescribed for depressed clients under the category of Tricyclic Antidepressants (TCA’s).
10. Hypotension and Urinary retention are anticholinergic side effects of TCA’s.
11. MAOI’s (Parnate, Nardil, Marplan) should not be given along with Tyramine rich foods e.g. Avocado, Banana, Cheese
(except cream and cottage), and Soy sauce (hint: usually processed and fermented foods contain tyramine).
12. Sedation is an expected effect of antidepressants.
13. Energizing the patient to commit suicide is a paradoxical effect of antidepressants therefore suicidal precaution should
be instituted.
14. Levodopa is the drug of choice for patients with Parkinson’s disease
15. Drowsiness and hypotension are side effects of L-dopa.
16. Dilantin is usually administered for patients with grand mal seizure (tonic-clonic).
17. Gingival hyperplasia is associated with Dilantin use. Meticulous oral care is required.
18. Tapering the drug is strongly required if an anticonvulsant is withdrawn to avoid status epilepticus (this is due to abrupt
withdrawal of the drug).
19. Diazepam (valium) is commonly administered to combat status epilepticus.
20. Bone marrow depression and Steven-Johnson’s Syndrome (severe pruritus and blood-shot eyes) are worst effects of
anticonvulsants.
21. Lithium carbonate is the drug of choice for manic patients.
22. Tegretol could also be given for bipolar manic client due to its mood stabilizing effect.
23. 3gms of Sodium and 3L of fluids per day are recommended for patients under lithium therapy.
24. Nausea and Vomiting are early signs of lithium toxicity.
25. Mannitol and Diamox are antidotes used to lower the toxicity (lithium).
26. Cognex and Aricept are drugs used to treat Dementia. These drugs increases liver enzymes, therefore liver function test is
required (ALT/AST).
27. Ritalin and Dexedrine are drugs commonly prescribed for children with ADHD. Insomnia and Anorexia are side effects of
these drugs. Growth suppression is the worst effect.

B. PERSONALITY THEORIES
1. Commonly asked Developmental milestones in the board exam according to Erickson:
a. trust vs. mistrust (0-1 or Infancy).
b. initiative vs. guilt (3-6 or Preschooler).
c. identity vs. role confusion (12-19 or Adolescence).
d. intimacy vs. isolation (20-40 or Young Adult).

2. Piaget’s Cognitive Development Theory

a. Logical thinking (Concrete Operational) is present in ages 7-12 years old.
b. Abstract thinking (Formal Operational) is expected for 12 years old and above.

3. Kohlberg’s Moral Theory

a. Toddlers and Preschoolers are guided by punishment and obedience orientation (Preconventional).
b. School- age children are rules oriented and viewed accidents as punishment for bad behavior (Conventional
Morality).
c. Teenagers and Adult individuals are guided by ethics as a basis of our conscience.
4. Freud’s Psychosexual Theory
a. Foundation of personality, id, and stranger’s anxiety develop during Oral Stage (0-1 year old).
b. Toilet training (2 years old), temper tantrums, and separation anxiety are common during the Anal Stage
(1-3 years old).
c. Fear of mutilation and Complexes (oedipal and elektral) develop during the Phallic Stage (3-6 years old).

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 d. Silahis behavior (bisexuality) is associated with the absence of a “father figure” and is only resolved in
latency stage when the child identifies the parent of the same sex.

C. SCHIZOPHRENIA
1. Increased dopamine level is the main problem in patients with Schizophrenia.
2. Hallucination and Delusion are positive signs of schizophrenia.
3. Safety (self and others) and offering Sealed Foods are main nursing interventions to Paranoid Schizophrenic patients.
4. Major Tranquilizers (Haldol, Thorazine, Clozaril) are drug of choice for schizophrenics.
5. Altered thought process is the priority nursing diagnosis.

D. CHILDREN and ADOLESCENTS Psychiatric Conditions

1. Safety and Nutrition (finger foods) should be prioritized for ADHD.
2. Impulsiveness, Hyperactivity, and Inattention are hallmark signs of ADHD.
3. Ritalin and Dexedrine are drugs commonly administered for ADHD.
4. Provide helmet for Autistic children, head banging is common.
5. Poor-mother child relationship is the possible etiology of Autism (most accepted psychobehavioral theory).
6. Involuntary muscle movements (motor tics) and vocalizations (vocal tics) are hallmark signs of Tourette Syndrome
(TS).
7. TS is genetically transmitted.

E. COMMONLY ASKED PSYCHIATRIC PROBLEMS in ELDERLY

1. Parkinson’s disease (PD) results from decreased dopamine and increased level of acetylcholine due to
degeneration of substantia nigra.
2. Tremors (pill rolling and resting), Rigidity (cog wheel), and Shuffling gait (scissors gait) are common symptoms of
Parksonism.
3. L-dopa is the drug of choice for PD.
4. Alzheimer’s disease (AD) is due to decrease Acetylcholine (Ach) and Cognex
(or Aricept as another drug of choice) is usually administered to improve memory.
5. Altered thought process is the priority nursing diagnosis for AD.
6. Confabulation and hyperorality are commonly seen in patients with AD.

F. ANXIETY and ANXIETY DISORDERS

1. Alertness is a characteristic of mild anxiety.
2. Client with moderate anxiety will have narrowed perception and selective inattention.
3. Greatly reduced perception and many scattered detail are manifestations of severe anxiety.
4. During Panic-attack, reality is distorted.
5. Flashback is the hallmark symptom of Post-traumatic Stress Disorder (PTSD).
6. Systematic Desensitization (gradual exposure to specific fear) is the best management for Phobic Disorders (Phobias).

G. EATING DISORDERS (Anorexia nervosa and Bulimia nervosa)

1. Refusal to eat is the main problem in Anorexia nervosa.
2. Amenorrhea and Lanugo are symptoms of Anorexia nervosa.
3. Lack of control over eating (binge eating and purging) is the main problem in Bulimic clients.
4. Russel signs (callus on fingers) and Perimyolysis (front teeth erosion) are commonly seen in Bulimia nervosa.
5. Altered nutrition: less than body requirement is the priority nursing diagnosis for eating disorders.
6. Socialization and staying with the client during snack or meal prevents them from exercising or inducing vomiting.
7. Weight gain is an indication that nursing intervention(s) especially for anorexic client is(are) effective.

H. MOOD DISORDERS (Bipolar manic and Major Depression)

1. All depressed clients are potentially suicidal.
2. Depression is associated with decreased level of norepinephrine and serotonin.
3. Introjection (blaming self) is a common defense mechanism used during depression.
4. Antidepressants and ECT are therapies used to treat depression.
5. Mania is associated with increased level of norepinephrine and serotonin.
6. Projection (blaming others) is commonly used as defense mechanism by manic patients.
7. Lithium is the drug of choice to lessen symptoms of mania.
8. Finger foods (usually in tetra packs) and avoidance of stimulants are recommended diets for manic clients.
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I. SUBSTANCE ABUSE and DEPENDENCE
1. Alcohol is a CNS depressant by nature and the most widely abused drug according to WHO.
2. Normal alcohol blood level is less than 1 % or 100 mg%.
3. Narcotics are the second widely abused drugs (next to alcohol).
4. Wernicke’s-Korsakoff’s Syndrome is (are) neurologic complication(s) of alcoholism that results from severe vit. B1
deficiency (thiamine).
5. Antabuse (disulfiram) is the drug used for alcohol Aversion Therapy.
6. Narcotics usually constrict pupils.
7. Yawning indicates brain hypoxia and is common in heroin withdrawal.
8. Perforated nasal septum is a physical complication of cocaine, a stimulant.
9. Hallucination, Pica, and Blood-shot eyes are common manifestations of a person using Marijuana.
10. Amotivational Syndrome (absence of motivation) is a withdrawal effect of Marijuana.

J. CRISES INTERVENTIONS
1. Safety and Reporting of cases within 48 hours to authorities are highest in priority for child abuse case (Brgy.
Captain, Police Station, DSWD, Bantay Bata).
2. Provide shelter for battered wives.
3. Gather evidence (no bathing nor changing of clothes) for a suspected rape case for legal purposes.
4. Ineffective individual coping is the priority nursing diagnosis for victims of abuses.

K. CONCEPTS ON DEATH and DYING

1. Denial, Anger, Bargaining, Depression, and Acceptance (DABDA) are grief reactions according to Kubler-Ross.
2. Hearing ability is the last to disappear in a dying person.
3. Flat EEG is the most accepted criterion or definition of death
4. Between 9-10 years old develops the universal concept of death, that it is a permanent biology