Child abuse and neglect is the topicAfter determining the most effective service models, the next step is to determine what legal and ethical guidelines must be followed when addressing the child welfare needs of the issue. . A. Explain the state and federal laws around the issue and how these protect children and families. What are the laws around the issue and what are the repercussions for breaking these laws? How do these laws protect children in the issue? What legal rights do the children have? What legal rights does the family have as a whole? B. Discuss the ethical principles around this issue and how these principles inform the human services practitioner’s interactions with the family.

First paragraph : Chapter 7 The listening and responding process is an important part of our life’s, its where we can cultivate deeper meaningful relationships. I feel if we want to have more than a surface level relationship with others, we must mindfully listen to them. I do understand that not all conversations even with the most important people in our life’s will be deep and call for mindful listening. We should aspire to learn when it is necessary to change our listening types. In our textbook Chapter 7, 196 It states, “When a group of adults was asked to rank various communication skills according to their importance, listening topped the family/social list as well as the career list.” I believe we can all benefit from working on improving our listening skills. The other day I had a text conversation with my dad about communication. I believe we were both using mindful listening and advising response. Dad: “What classes are you taking this semester?” Myself “I’m taking Biology and Communication” Dad “Good Communication is important; I am not one who does well at it.” Myself “I am learning that it can be hard to communicate effectively because we all understand communication differently” Dad “I drop subtle things then after nothing is taken, I blow up. Not very good on my part” Myself “You could try approaching those situations differently, maybe trying to be more direct with your needs”. I felt that we were both analyzing each other’s messages and responding in appropriate hopefully helpful ways. In our textbook Chapter 7, 219 it states, “There’s often a temptation to tell others how you would behave in their place, but it’s important to realize that what’s right for one person may not be right for another.” I try to give helpful advice but understand everyone must do what they feel is best for themselves. An example of a conversation I perceived the person wasn’t listening to me was over Instagram with a past coworker: Myself “Let’s go to lunch soon” Coworkers: “Yes, we should let’s plan something soon” Myself: “When works best for you? I’m open most days”, my coworker never responded. I don’t think her lack of response was done out of anger or on purpose I think maybe she had allot going on in her personal life and it was not high on her to priority list at that time. In our textbook Chapter 7, 202 it states, “A second reason we don’t always listen carefully is that we’re often wrapped up in personal concerns of more immediate importance to us than the messages others are sending.”. For the most part I don’t think that people really listen to each other via social media. I feel I am more likely to engaged in a meaningful conversation in person or sometimes by text message then over social media. You can tell when someone really wants to have a conversation with you or is just mindlessly listening to you, our textbook defines mindless listening, occurs when we react to others’ messages automatically and routinely without much mental investment. Chapter 8 This article really hit home for me, I was discussing this concept with a coworker yesterday. I have been and am affected daily by other coworkers’ emotions. I shared this reading with my coworker and my manager she appreciated the reading and agreed with the concept. Emotions are catching out textbook states in Chapter 8, 237 “We catch feelings from one another as though they were some kind of social virus.” I can say this happens to me. I try to avoid it, but I fall victim. Whether it is becoming negative along with people around me or becoming negative because of others around me. I think as a younger adult I may not have noticed this happening even though it was but now a days I can see it happening often. I work in an office that is open concept, we are all in small cubicles next to each other. This can be positive and negative, the concept behind it is that we are all together and can discuss things as issues come up and work together. It can be helpful but there are some people who make it a negative aspect of my job. There are a few employees that come in every morning and complain about how long it takes for our computer system to get up and running for them to log in. It takes the same amount of time everyday yet everyday they come in a complain about it. Over time it has gotten annoying to the point I want to tell them to suck it up it happens everyday and will continue to happen so stop complaining but I don’t, in our textbook Chapter 8, 242 it states, “Often the first flush of strong feeling is not the best time to speak out. If you’re awakened by the racket caused by a noisy neighbor, storming over to complain might result in your saying things you’ll later regret.”. Hearing this every morning can put me in a negative mood to begin the day. I believe in the concept of mood contagion; I think its simple concept if others are in a bad mood it is contagious and brings everyone down. As well as when people are in great moods it can bring everyone up; I see it at work and at home. When me and my husband have conversations about things that are upsetting to us the reaction of the other person can fuel the fire or bring us back down. I use my husband as a tool to try and control emotions despite what other people are feeling. I can tell him how I am feeling, and he is pretty good at bringing me back to reality. I try and use Emotional agility to control my emotions despite my surroundings. It is a constant process for me, I have found that doing meditation has helped to control my thoughts. In our textbook Chapter 8, 255 in states, “Emotional agility is a skill set that builds our ability to face our emotions, label them, understand them and then choose to move forward deliberately. It is the ability to recognize when you’re feeling stressed be able to step out of your stress, and then decide how to act in a way that is congruent with your person values and aligned with your goals.”. It can be hard because we don’t want to be influenced by others negative emotions but its nice to be affected by others positive emotions. I do have to take responsibility for allowing other people’s emotions to affect me and work on changing that. Second paragraph : Chapter 7 : The rise of social media in political discourse has changed the way we communicate and listen to the ideas of others. One of the most common problems I see with communication online is lack of understanding- understanding, as defined by the text, is attaching meaning to a message (Chapter 7, Page 205). Too often online, whether it is facebook or reddit threads, people make broad statements seeking to incite a reaction from another group and proceed to engage in the back and forth slinging of fallacious arguments without listening or finding a message within the arguments. This is not exclusive to one side of the political spectrum. Additionally, many users of these sites engage in counterfeit questions; questions which do not encourage discourse or seek to gain any new information, but are veiled attempt to make a statement (Chapter7, 210). One day while reading a comment thread on the Economics subreddit, I was speaking with another econ student about the merits of a universal healthcare. He had stated " the overall deadweight loss from taxation would be prohibitively expensive in American healthcare and would only serve to lower standards while raising costs.". I countered " not all cases of taxes produce deadweight loss and, while this would undoubtedly not be a perfect system, the net benefit to the country and reduction of administrative waste would likely even out any loss of market efficiency". In this instance I had listened and understood his message and had responded with my own thoughts to encourage the debate to continue rather than to silence his opinion. In a very different scenario while arguing with another redditor on plant and water sustainability I was engaged in a conversation that had very little listening. I will paraphrase my original comment as it would take up half of this page: "Global sustainability in terms of water usage and the distributive efficiency of calories produced seems to favor the idea that a diet based largely or even solely in plant-based items will become necessary as the population grows and arable land diminishes. Additionally, plants take up significantly lower land space while preserving the ground beneath in most cases; the same cannot be said of animal agriculture.". I linked to three different primary sources as I am genuinely passionate about the issue and the response I received was "plants take up a lot of space, your vegan diet isn't sustainable". While this had the potential to be a listening and responding conversation, this man had essentially ignored that wall of text and articles I had presented and simply restated his original assertion without any rebuttal to any of my points let alone provide any evidence of his own. I feel that asynchronous nature of social media often lends itself to many bad-faith responses. Frequently, online forums are places for people to beg the question or make questions based on unchecked assumptions.; often people, ask questions that assume a fact and then proceed to question based upon an initial incorrect assumption (Chapter 7, Page 211). Chapter 8 : In my own experience at work as a manager, I have seen the firsthand effects of contagious morale. On days where I would come in with a positive attitude and go over production numbers with the back of house staff, I found that the overall day was much more productive. In this same food service setting (I would argue one of the most volatile morale settings in employment), I was frequently at the mercy of the mood of both my staff and the owner. If the owner came in "on a good one" the trickle down of bad emotions and lower performance would always follow. This idea that emotions move from person to person not unlike a disease is called emotional contagion (Chapter 8, Page 236). In the moments, trying to be the stopping point for the aggression and frustration that the owner brought in that day became paramount. I prided myself on being reasonably successful in being the calming influence in my team and bringing bout positivity wherever I can. The article above states "Positive emotion contagion is also a powerful tool for creating a workplace culture of “companionate love”... which has been shown to boost employee satisfaction and teamwork, and reduce absenteeism and emotional burnout." (Barsade 1). In respect to managing my own emotional impact, i have found that using the right words and tone is key. Emotionally counterfeit words can often have a detrimental impact on the morale of a workplace; simply saying "we need to work harder" is not an adequate or particularly helpful way to motivate your team. " Many communicators think they are expressing feelings, when in fact, their statements are emotionally counterfeit" (Chapter 8, Page 239).

Module 6 knowledge checkTop of Form QUESTION 1 A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 1 of 4: Describe the positive symptoms of schizophrenia and relate those symptoms to the case study patient. 1 points QUESTION 2 A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 2 of 4: Explain the genetics of schizophrenia. 1 points QUESTION 3 A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 3 of 4: The APRN reviews recent literature and reads that neurotransmitters are involved in the development of schizophrenia. What roles do neurotransmitters play in the development of schizophrenia? 1 points QUESTION 4 A 21-year-old male college student was brought to Student Health Services by his girlfriend who was concerned about changes in her boyfriend’s behaviors. The girlfriend says that recently he began hearing voices and believes everyone is out to get him. The student says he is unable to finish school because the voices told him he was not smart enough. The girlfriend relates episodes of unexpected rage and crying. Past medical history noncontributory but family history positive for a first cousin who “had mental problems”. Denies current drug abuse but states he smoked marijuana every day during his junior and senior years of high school. He admits to drinking heavily on weekends at various fraternity houses. Physical exam reveals thin, anxious disheveled male who, during conversations, stops talking, cocks his head and appears to be listening to something. There is poor eye contact and conversation is rambling. Based on the observed behaviors and information from girlfriend, the APRN believes the student has schizophrenia. Question 4 of 4: The APRN reviews recent literature and reads that structural problems in the brain may be involved in the development of schizophrenia. Explain what structural abnormalities are seen in people with schizophrenia. 1 points QUESTION 5 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 1 of 6: Discuss the role genetics plays in the development of bipolar 2 disorders. 1 points QUESTION 6 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 2 of 6: Explain how the hypothalamic-pituitary-adrenal (HPA) system may be associated with bipolar type 2 disease. 1 points QUESTION 7 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 3 of 6: Discuss the role inflammatory cytokines play in the development and exacerbation of bipolar type 2 symptoms 1 points QUESTION 8 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 4 of 6: Discuss the role of the amygdala in bipolar disorder. 1 points QUESTION 9 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 6 of 6: How does neurochemical dysregulation contribute to bipolar disorders? 1 points QUESTION 10 A 34-year-old female was brought to the Urgent Care Center by her husband who is very concerned about the changes he has seen in his wife for the past 3 months. He states that his wife has had been depressed and irritable, has complaints of extreme fatigue, has lost 10 pounds and has had insomnia. He has come home from work to find his wife sitting in front of the TV and not moving for hours. In the past few days, she suddenly has become very hyperactive, has been talking incessantly, has been easily distracted and seems to “flit from one thing to another.”. She hasn’t slept in 3 days. The wife went on an excessive shopping spree for new clothes that resulted in their credit card being denied for exceeding the line of credit. The wife is unable to sit in the exam room and is currently pacing the hallway muttering to herself and is reluctant to talk with or be examined the ARNP. Physical observation shows agitated movements, rapid fire speech, and hyperactivity. Based on the history and observable symptoms, the APRN suspects that the patient has bipolar type 2 disorder. The APRN refers the patient and husband to the Psychiatric Mental Health Nurse Practitioner for evaluation and treatment. Question 6 of 6: What is the current status of the use of nutraceuticals in management of depression? 1 points QUESTION 11 A 27-year-old female presents to the Emergency Room, with a chief complaint of palpitations, rapid heart rate, sweating, tremors, and inability to catch her breath. The symptoms started about 10 hour ago and have gotten worse. She states she has some chest pain that remains constant no matter what. She also has numbness and tingling around her mouth and lips. She says she knows something “terrible is going to happen”. She denies having any similar episode in the past. Past medical history noncontributory. Social history significant for recent stressor of applying for medical school and taking the Medical College Admission Test (MCAT). She had not received the results prior to the episode but is sure that the failed the test. Says she doesn’t know if anyone else in her family has had similar episodes. Physical exam reveals a thin, anxious appearing female who is profusely sweating despite cool ambient air temperature. BP 176/88, Pulse 136, and respirations 26. Electrocardiogram negative for evidence of myocardial infarction and all lab data within normal limits except for mild respiratory alkalosis. The patient’s symptoms are subsiding and the patient states she is feeling better. The APRN suspects the patient has just experienced a panic attack. Question 1 of 2: What are panicogens and how do they contribute to the development of panic attack symptoms? 1 points QUESTION 12 A 27-year-old female presents to the Emergency Room, with a chief complaint of palpitations, rapid heart rate, sweating, tremors, and inability to catch her breath. The symptoms started about 10 hour ago and have gotten worse. She states she has some chest pain that remains constant no matter what. She also has numbness and tingling around her mouth and lips. She says she knows something “terrible is going to happen”. She denies having any similar episode in the past. Past medical history noncontributory. Social history significant for recent stressor of applying for medical school and taking the Medical College Admission Test (MCAT). She had not received the results prior to the episode but is sure that the failed the test. Says she doesn’t know if anyone else in her family has had similar episodes. Physical exam reveals a thin, anxious appearing female who is profusely sweating despite cool ambient air temperature. BP 176/88, Pulse 136, and respirations 26. Electrocardiogram negative for evidence of myocardial infarction and all lab data within normal limits except for mild respiratory alkalosis. The patient’s symptoms are subsiding and the patient states she is feeling better. The APRN suspects the patient has just experienced a panic attack. Question 2 of 2: How does the GABA-benzodiazepine (BZ) receptor systems contribute to panic attacks/disorders? 1 points QUESTION 13 A 21-year-old female college junior makes an appointment to see the APRN in the Student Health Clinic. The student tells the APRN that it has gotten harder and harder for her to attend classes, especially her history class where the class is preparing for the semester’s end presentations. She says she is terrified to speak to the class and is considering dropping the class so she will not have to present. She has a significant impairment in social activities and has resigned from her sorority. She is unable to go to the library to study as she feels everyone is looking at her and mocking her. She admits to having some of these symptoms in high school, but the guidance counselor was able to work with her to decrease some of her symptoms. Past medical history noncontributory except for the milder symptoms exhibited in high school. Family history noncontributory. Social history positive for anxiety related to social situations that has had a negative impact on both her scholarly and social endeavors. The APRN diagnoses the student with social anxiety disorder (SAD). Question 1 of 2: Describe the areas of the brain that are associated with social anxiety disorder. 1 points QUESTION 14 A 21-year-old female college junior makes an appointment to see the APRN in the Student Health Clinic. The student tells the APRN that it has gotten harder and harder for her to attend classes, especially her history class where the class is preparing for the semester’s end presentations. She says she is terrified to speak to the class and is considering dropping the class so she will not have to present. She has a significant impairment in social activities and has resigned from her sorority. She is unable to go to the library to study as she feels everyone is looking at her and mocking her. She admits to having some of these symptoms in high school, but the guidance counselor was able to work with her to decrease some of her symptoms. Past medical history noncontributory except for the milder symptoms exhibited in high school. Family history noncontributory. Social history positive for anxiety related to social situations that has had a negative impact on both her scholarly and social endeavors. The APRN diagnoses the student with social anxiety disorder (SAD). Question 2 of 2: How is oxytocin associated with SAD? 1 points QUESTION 15 A 36-year-old female comes to see the APRN in clinic with a chief complaint of “I’m so and I feel all keyed up all the time”. She states she feels restless, keyed up, and on edge most of the time. She fatigues easily and has difficulty concentrating and says her mind goes blank. She admits to being irritable and snapping at her coworkers which she worries will affect her job. She says the symptoms have been present for about 8 or 9 months. and Increased muscle tension. She has had difficulty falling asleep or stay sleeping. Further questioning revealed that prior to her symptoms, her parents got divorced which has been a great stressor for her. Past medical history noncontributory. Social history positive for a case of “nerves” when she was in high school that seemed to resolve after she graduated from college. No drug or alcohol history. The APRN believes the patient has generalized anxiety disorder (GAD). Question 1 of 2: Discuss the role of neurotransmitters in the expression of GAD. 1 points QUESTION 16 A 36-year-old female comes to see the APRN in clinic with a chief complaint of “I’m so and I feel all keyed up all the time”. She states she feels restless, keyed up, and on edge most of the time. She fatigues easily and has difficulty concentrating and says her mind goes blank. She admits to being irritable and snapping at her coworkers which she worries will affect her job. She says the symptoms have been present for about 8 or 9 months. and Increased muscle tension. She has had difficulty falling asleep or stay sleeping. Further questioning revealed that prior to her symptoms, her parents got divorced which has been a great stressor for her. Past medical history noncontributory. Social history positive for a case of “nerves” when she was in high school that seemed to resolve after she graduated from college. No drug or alcohol history. The APRN believes the patient has generalized anxiety disorder (GAD). Question 2 of 2: Explain the structural brain changes that occur in people with GAD. 1 points QUESTION 17 A 27-year-old man comes to the Veteran’s Administration Hospital at the insistence of his fiancée who accompanies him to the appointment. She tells the APRN that her fiancée has not “been the same” since he returned from his second tour in Iraq. He was an infantryman with a local Marine Reserve unit and served 2 tours and was honorably discharged. Since his return, he has had difficulty sleeping, and says he “sleeps with one eye open” and fears sleep. Deep sleep brings vivid nightmares. He grudgingly admits to having experienced several traumatic events during his second tour of duty. He is unwilling to discuss them and will not reveal specific details. He is short tempered and irritable and is afraid to be around people as he doesn’t want to snap at people and alienate them. He startles easily at loud noises, especially the sounds of cars backfiring. He admits to thinking there are threats everywhere and spends an excessive amount of time searching for them but never finding any. He has intrusive memories almost every day and says he really isn’t interested in doing much of anything. He is very worried that these symptoms are irreparably hurting his relationship with his fiancée who he loves very much. The APRN diagnoses him with post-traumatic stress disorder (PTSD). Question 1 of 2: Describe the changes seen in the brain structure in patients with PTSD. 1 points QUESTION 18 A 27-year-old man comes to the Veteran’s Administration Hospital at the insistence of his fiancée who accompanies him to the appointment. She tells the APRN that her fiancée has not “been the same” since he returned from his second tour in Iraq. He was an infantryman with a local Marine Reserve unit and served 2 tours and was honorably discharged. Since his return, he has had difficulty sleeping, and says he “sleeps with one eye open” and fears sleep. Deep sleep brings vivid nightmares. He grudgingly admits to having experienced several traumatic events during his second tour of duty. He is unwilling to discuss them and will not reveal specific details. He is short tempered and irritable and is afraid to be around people as he doesn’t want to snap at people and alienate them. He startles easily at loud noises, especially the sounds of cars backfiring. He admits to thinking there are threats everywhere and spends an excessive amount of time searching for them but never finding any. He has intrusive memories almost every day and says he really isn’t interested in doing much of anything. He is very worried that these symptoms are irreparably hurting his relationship with his fiancée who he loves very much. The APRN diagnoses him with post-traumatic stress disorder (PTSD). Question 2 of 2: Briefly discuss the role glucocorticoids may have on the development of PTSD. 1 points QUESTION 19 A 17-year-old male high school junior comes to the clinic to establish care. He recently moved from a relatively urban area to a very rural area and has just started his junior year in a new school. The mother states that she has noticed that her son has been frequently washing his hands and avoids contact with any dirty or soiled object. He uses paper towels or napkins over the knob on a door when opening it. According to the mother, this behavior has just appeared since moving. The patient, upon close questioning, admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is worried about all the germs the boys are carrying around. Past medical history is noncontributory. Social history -lives with parents and 2 siblings in a house in a new town. Is an honors student. Based on these behaviors, The APRN thinks the patient has obsessive-compulsive disorder (OCD). Question 1 of 2: What is primary pathophysiology of OCD? 1 points QUESTION 20 A 17-year-old male high school junior comes to the clinic to establish care. He recently moved from a relatively urban area to a very rural area and has just started his junior year in a new school. The mother states that she has noticed that her son has been frequently washing his hands and avoids contact with any dirty or soiled object. He uses paper towels or napkins over the knob on a door when opening it. According to the mother, this behavior has just appeared since moving. The patient, upon close questioning, admits that he is “grossed out” by some of the boys in the boys’ room since they use the toilet and do not wash their hand afterwards. He is worried about all the germs the boys are carrying around. Past medical history is noncontributory. Social history -lives with parents and 2 siblings in a house in a new town. Is an honors student. Based on these behaviors, The APRN thinks the patient has obsessive-compulsive disorder (OCD). Question 2 of 2: Describe the role the dorsal anterior cingulate cortex (dACC) has in reinforcement of obsessive behaviors. -- Font family -- Andale Mono Arial Arial Black Book Antiqua Comic Sans MS Courier New Georgia Helvetica Impact Symbol Tahoma Terminal Times New Roman Trebuchet MS Verdana Webdings Wingdings -- Font size -- 1 (8pt) 2 (10pt) 3 (12pt) 4 (14pt) 5 (18pt) 6 (24pt) 7 (36pt) -- Format -- Heading Sub Heading 1 Sub Heading 2 Paragraph Formatted Code -- Font family -- -- Font size -- Path: p Words:0 1 points Click Save and Submit to save and submit. Click Save All Answers to save all answers.