Chapter 16

A parent tells the nurse they are concerned because their child is easily distracted in school, cannot complete assignments on time, and interrupts other children while they are speaking. Which response should the nurse provide the parent? 1) "This sounds like your child is depressed; depression looks different in children and is very serious." 2) "This sounds like bipolar disorder; you might want to have your child tested by a child psychiatrist." 3) "This could be attention-deficit/hyperactivity disorder (ADHD); you might want to have your child tested." 4) "This sounds like typical 7-year-old behaviors to me; if they do not resolve, have your child tested."

3) "This could be attention-deficit/hyperactivity disorder (ADHD); you might want to have your child tested." p. 199

The nurse is caring for a client suspected of having bipolar disorder. Which assessment findings that have occurred over the period of a week support the nurse's suspicion? 1) Difficulty sleeping, obsession with death, hallucinations 2) Delusions, unkempt appearance, fatigue 3) Abnormal eating patterns, feelings of despair, flight of ideas 4) Increased goal-directed behavior and talkativeness, distractibility

3) Abnormal eating patterns, feelings of despair, flight of ideas p. 195

Which should the nurse recognize are the traditionally prescribed drug classifications used to treat attention-deficit/hyperactivity disorder (ADHD)? 1) CNS depressants 2) Parasympathomimetics 3) CNS stimulants 4) Sympathomimetics

3) CNS stimulants p. 200-202

Which food items should the nurse advise a client taking a monoamine oxidase inhibitor (MAOI) to avoid? 1) Orange juice, cottage cheese, and turkey 2) Spring water, ice cream, and salmon 3) Chocolate, wine, and fava beans 4) Spinach, rice, and venison

3) Chocolate, wine, and fava beans p. 195

A client tells the nurse they feel depressed during the winter. Which type of depression should the nurse suspect the client is experiencing? 1) Baby blues 2) Bipolar disorder 3) Seasonal affective disorder 4) Obsessive-compulsive disorder

3) Seasonal affective disorder p. 187

Which is the priority outcome for a 6-year-old child that has been prescribed methylphenidate (Ritalin)? 1) The child will avoid altercations with peers. 2) The child will be able to complete age-appropriate chores at home. 3) The child will use age-appropriate play with peers. 4) The child will maintain weight within norms for this age group.

3) The child will use age-appropriate play with peers. p. 193, 201-202

A client asks the nurse about bipolar disorder. Which response should the nurse provide? 1) "Bipolar disorder is just another type of depression, except the depression occurs in cycles." 2) "Bipolar disorder is a type of depression that includes attention deficit disorder symptoms." 3) "Bipolar disorder just means that the mood alternates with the seasons, and becomes worse in the winter." 4) "Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania."

4) "Bipolar disorder means you have cycles of depression as well as hyperactivity, or mania." p. 195

A client is to be prescribed an antidepressant. Which question is most important when performing the initial assessment ?1) "How much alcohol do you consume during the week?" 2) "Are you allergic to any medications?" 3) "How long have you been depressed?" 4) "Have you had any thoughts about killing yourself?"

4) "Have you had any thoughts about killing yourself?" p. 188

Which prescription should the nurse recognize would most benefit a client experiencing periods of mania and depression? 1) Atomoxetine (Strattera) 2) Amitriptyline (Elavil) 3) Methylphenidate (Ritalin) 4) Carbamazepine (Tegretol)

4) Carbamazepine (Tegretol) p. 196

Which classification of prescription used to treat depression works by preventing enzymatic destruction of the neurotransmitter norepinephrine? 1) Serotonin-norepinephrine reuptake inhibitors (SNRIs) 2) Selective serotonin reuptake inhibitors (SSRIs) 3) Tricyclic antidepressants (TCAs) 4) Monoamine oxidase inhibitors (MAOIs)

4) Monoamine oxidase inhibitors (MAOIs) p. 194

Which classification of prescription is often used as a first-line treatment for depression due to their safety profile? 1) Monoamine oxidase inhibitors (MAOIs) 2) Beta-adrenergic blockers 3) Tricyclic antidepressants (TCAs) 4) Selective serotonin reuptake inhibitors (SSRIs)

4) Selective serotonin reuptake inhibitors (SSRIs) p. 191-192

The nurse has provided education for a patient with depression. Which statement made by the patient indicates an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "Depression has many causes which include brain-based disorders." 2) "Depression can be an inherited illness." 3) "We really don't know what causes depression." 4) "Depression results from unresolved conflicts in your childhood." 5) "Depression results from parental neglect."

1) "Depression has many causes which include brain-based disorders." 2) "Depression can be an inherited illness." p. 187

A parent of a child pharmacologically treated for ADHD asks the nurse to explain a "drug holiday." Which information should the nurse provide about the treatment option? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply 1) "Drug holidays may be used to reduce dependence on medications or to assess symptoms." 2) "If you feel like the medication is sedating your child too much, you can hold doses for up to 3 or 4 days." 3) "Drug holidays are used when the dosage will be increased to assess the patient's tolerance to the prescription. 4) "You should not consider using a drug holiday until you have discussed that option with your healthcare provider." 5) "Drug holidays require careful scheduling."

1) "Drug holidays may be used to reduce dependence on medications or to assess symptoms." 4) "You should not consider using a drug holiday until you have discussed that option with your healthcare provider." 5) "Drug holidays require careful scheduling." p. 203

The nurse is preparing to assess an older adult for depression. Which questions should the nurse include in the assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) "How often do you go out to socialize with friends?" 2) "Can you tell me about your self-care activities." 3) "How much alcohol do you consume every day?" 4) "How is living with your oldest daughter and her family working out for you?" 5) "Are you feeling depressed?"

1) "How often do you go out to socialize with friends?" 2) "Can you tell me about your self-care activities." 3) "How much alcohol do you consume every day?" 4) "How is living with your oldest daughter and her family working out for you?" p. 187-188

A client prescribed sertraline (Zoloft) reports to the nurse that he is experiencing delayed ejaculation. Which response should the nurse provide the client? 1) "I will let your healthcare provider know and most likely your prescription will be changed." 2) "This is a side effect of the prescription, but treating your depression is the priority." 3) "I am concerned that you may become suicidal if you stop the prescription." 4) "Continue to take the prescription, as this usually goes away after a few months."

1) "I will let your healthcare provider know and most likely your prescription will be changed." p. 191

A client taking amitriptyline (Elavil) for 2 weeks tells the nurse the prescription is not working. Which response should the nurse provide the client? 1) "The prescription can take several weeks to have an effect." 2) "You might still feel depressed, but you are looking much better." 3) "This may not be the best prescription for you; I will notify your healthcare provider" 4) "You may need additional pharmacotherapy."

1) "The prescription can take several weeks to have an effect." p. 193

A client asks the nurse which types of therapies are most helpful for depression. Which therapies should the nurse plan to discuss with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply .1) Behavioral therapy 2) Interpersonal therapy 3) Cognitive-behavioral therapy 4) Psychodynamic therapy 5) Crisis therapy

1) Behavioral therapy 2) Interpersonal therapy 3) Cognitive-behavioral therapy 4) Psychodynamic therapy p. 188

A client is brought to the emergency department suspected of overdosing on imipramine (Tofranil). Which is the nurse's priority assessment? 1) Cardiac function 2) Liver function 3) Renal function 4) Neurological function

1) Cardiac function p. 193

Which symptoms should the nurse assess a client for who is at risk for mania? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Decreased sleep 2) Weight loss 3) Sluggish activity 4) Muscle pain 5) Increased talkativeness

1) Decreased sleep 2) Weight loss 5) Increased talkativeness p. 195

A client asks the nurse what causes bipolar disorder. Which neurotransmitters should the nurse include when discussing the manic phase of the disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply. 1) Excessive glutamate 2) Excessive norepinephrine 3) Deficiency of gamma-aminobutyric acid 4) Deficiency of dopamine 5) Excessive serotonin

1) Excessive glutamate 2) Excessive norepinephrine 3) Deficiency of gamma-aminobutyric acid p. 195-197

Which assessment findings should the nurse associated with a risk for suicide? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply .1) The client states that "suicide is always an option." 2) The client describes a previous unsuccessful attempt at suicide by aspirin overdose. 3) The client states that the prescribed medication is not working and that feelings of depression are worse. 4) The client requests prescriptions for pain medication and a sleeping aid. 5) The client expresses interest in meeting with friends more often.

1) The client states that "suicide is always an option." 2) The client describes a previous unsuccessful attempt at suicide by aspirin overdose. 3) The client states that the prescribed medication is not working and that feelings of depression are worse. 4) The client requests prescriptions for pain medication and a sleeping aid. p. 188

The nurse is providing client teaching about the side effects of amitriptyline (Elavil). Which information should the nurse include in the teaching to promote prescription adherence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply 1) Use ice chips to help alleviate dry mouth. 2) Chew gum or use hard candy to help alleviate dry mouth. 3) Avoid alcohol-based mouthwash to help alleviate dry mouth. 4) Use "dry eye" drops to help with eye dryness. 5) Request the pharmacist to fill the prescription from a different manufacturer.

1) Use ice chips to help alleviate dry mouth. 2) Chew gum or use hard candy to help alleviate dry mouth. 3) Avoid alcohol-based mouthwash to help alleviate dry mouth. 4) Use "dry eye" drops to help with eye dryness. p. 190

The patient has bipolar disorder and is in a manic phase. The physician prescribes lithium (Eskalith). The client's current lithium level is 0.4. Which assessment findings should the nurse anticipate? 1) A return to baseline behavior 2) Hyperactivity and pressured speech 3) Signs and symptoms of depression 4) A decrease in manic behavior

2) Hyperactivity and pressured speech p. 196

The nurse has completed the education for a client prescribed lithium (Eskalith). Which should the nurse anticipate is a priority outcome of the treatment? 1) The client will be able to work a normal work schedule and will receive adequate sleep. 2) The client will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it. 3) The client will engage in activities of daily living and report enjoyment with them. 4) The client will report stabilization of mood, including absence of mania or depression.

2) The client will identify signs of lithium (Eskalith) toxicity and verbalize measures to avoid it. p. 196-197

A parent of an 8-year-old child prescribed methylphenidate (Ritalin) tells the nurse the child will not eat. Which response should the nurse provide the parent? 1) "It sounds like your child may be experiencing depression." 2) "Administer the prescription after meals and encourage snacks between meals." 3) "Your child may require an appetite stimulant." 4) "I will get you a consult with a nutritionist."

2) "Administer the prescription after meals and encourage snacks between meals." p. 201

The nurse has completed medication education for a client prescribed phenelzine (Nardil). Which statements made by the client indicate an understanding of the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply .1) "I am really going to miss my morning coffee and sweet roll." 2) "I'll have to give up my beer at the football games." 3) "I can't eat fried chicken and gravy." 4) "I am not supposed to have processed meats or cheese." 5) "I really shouldn't eat at a restaurant; too many foods are on my restricted list."

2) "I'll have to give up my beer at the football games." 4) "I am not supposed to have processed p. 195-196

A client prescribed sertraline (Zoloft) calls the clinic reporting increased moodiness and feeling disconnected from life. Which response should the nurse provide the client? 1) "Try taking diphenhydramine (Benadryl) to help you relax." 2) "It is important that you come into the clinic today." 3) "Do not take your prescription until your mood improves." 4) "Double the prescribed dose of sertraline (Zoloft) today."

2) "It is important that you come into the clinic today." p. 191

A client prescribed lithium (Eskalith) asks the nurse why they should continue to use salt. Which response should the nurse provide the client? 1) "You should use sea salt to avoid lithium (Eskalith) toxicity. 2) "You must use table salt or your kidneys will retain lithium (Eskalith), and you will become toxic." 3) "The amount of salt is not important; just increase your table salt if you notice signs of lithium (Eskalith) toxicity." 4) "Salt is very important to avoid lithium (Eskalith) toxicity, but not as important as drinking 1 to 1.5 L of water per day."

2) "You must use table salt or your kidneys will retain lithium (Eskalith), and you will become toxic. p. 197

Which statement best explains the action of the prescriptions used to treat attention-deficit/hyperactivity disorder (ADHD)? 1) Neurotransmitters are blocked, limiting the effects they can produce within the PNS. 2) Activation of certain areas of the brain causes increased attention and ability to focus. 3) Neurotransmitter levels are reduced, which produces a calming effect within the CNS. 4) Certain areas of the brain are deactivated, resulting in a calming effect.

2) Activation of certain areas of the brain causes increased attention and ability to focus. p. 200-202

Which statement is accurate regarding attention-deficit/hyperactivity disorder (ADHD)? 1) ADHD is characterized by periods of mania and periods of depression. 2) Anxiety and social withdrawal are more frequently seen in girls than in boys. 3) There is a higher incidence of ADHD in girls than in boys. 4) ADHD is generally diagnosed later in life.

2) Anxiety and social withdrawal are more frequently seen in girls than in boys. p. 199