exam #4 mental health

What is the most important reason for this teaching? 1 Encourage Bill to continue compliance with medications. 2 Documentation of Bill's response to the medication education. 3 Monitor for early tardive dyskinesia, which can be reversible. 4 Reinforce education done throughout the hospitalization.

3

a client has clinical manifestations of rigidity, tremor, bradykinesia, and impaired postural reflexes. which condition can be suspected in the client? 1 myasthenia gravis 2 alzheimer's disease 3 parkinson's disease 4 trigeminal neuralgia

3

What effect should the PN observe after Bill has started the Cogentin? 1 Reduce the severity of extrapyramidal effects. 2 Prevent the risk for tardive dyskinesia. 3 Potentiate Haldol so it will be more effective. 4 Further control the dystonic reaction.

1

What is the most important benefit Bill can receive from his attendance at the community meeting? 1 provide reality orientation 2 set limits on behavior 3 teach psychosocial skills 4 promote mutual goal setting

1

which subtypes of schizophrenia have a poor prognosis? select all that apple 1 residual 2 paranoid 3 catatonic 4 disorganized 5 undifferentiated

14

while caring for a client who is demonstrating bizarre behavior, impaired communication, delusions, illusions, and hallucinations, a nurse tries to establish a therapeutic relationship with the client. which actions on the part of the nurse are appropriate efforts in establishing a therapeutic relationship? 1 using hand gestures when talking 2 using simple and clear statements 3 encouraging self care by the client 4 being available and actively listening 5 instructing the client to make choices

24

the nurse is caring for a 60 year old client who is diagnosed with dementia. which antipsychotic drugs would be contraindicated for the client? sata 1 quetiapine 2 haloperidol 3 aripiprazole 4 risperdione 5 chlorpromazine

25

A client with the diagnosis of schizophrenia refuses to eat meals. Which nursing action is most beneficial for this client? 1 directing the client repeatedly to eat the food 2 explaining to the client the importance of eating 3 waiting and allowing the client to eat whenever the client is ready 4 having a staff member sit with the client in a quiet area during mealtimes

4

A widow who is hospitalized for a medical problem has dementia of the Alzheimer type and is no longer able to live alone. The client is to be transferred from the hospital to a long-term care facility. When should the staff begin preparation for the transfer? 1 as soon as the transfer is approved 2 when the client talks about future plans 3 when the practitioner writes the prescription 4 immediately after the client's admission to the hospital

4

when a nurse is admitting an older client to the mental health unit, it is important to identify any signs of dementia. what signs and symptoms denote the presence of dementia of the Alzheimer type? sata 1 ambivalance 2 forgetfulness 3 flight of ideas 4 loose associations 5 expressive aphasia

25

What side effect of the medication should the PN suspect? 1 akathisia 2 dystonia 3 tardive dyskinesia 4 Parkinsonism

2

what response should a nurse be particularly alert for when assessing a client for side effects of long term cortisone therapy? 1 hypoglycemia 2 severe anorexia 3 anaphylactic shock 4 behavioral changes

4

When Bill explains that someone has been following him and is waiting outside the emergency department, how should the PN respond? 1 Believe me. No one has followed you here. 2 You must be concerned, but you are safe here. 3 The staff will make sure no one is out there. 4 Why do you think that someone is out there?

2

When Bill looks around the room and mumbles to himself, how should the PN respond? 1 how are you feeling? 2 are you hearing voices? 3 have you been here before? 4 tell me what you're thinking

2

which nursing intervention is most helpful in meeting the needs of an older adult with the diagnosis of dementia of the Alzheimer type? 1 providing nutritious foods that are high in carbs and protein 2 offering opportunities for choices in the daily schedule to stimulate interest 3 developing a consistent plan with a fixed time schedule to fulfill emotional needs 4 simplifying the environment as much as possible and eliminating the need for decisions and choices

4

Which response from Bill indicates the Haldol has been effective? 1 feels less anxious and nervous 2 reports mood is more stable 3 initiates more social interactions 4 experiences fewer hallucinations

4

What is the most important part of this admission process? 1 Ask Bill if he has any valuables that need to be locked in a safe place. 2 Allow Bill to explain his understanding of the reason for his hospital admission. 3 Introduce Bill to the nursing staff and explain the role of the case manager and staff. 4 Take away Bill's cigarettes and lighter.

4

What additional intervention is essential to a successful plan? 1 isolations 2 daily activities 3 consistency 4 adequate rest

3

What teaching should be included in Bill's education plan that was initiated early after admission and will be reinforced until discharge? 1 An understanding of psychosis and the causes of it. 2 The importance of attending support groups after discharge. 3 Depression and anxiety are common causes of psychosis. 4 The purpose and side effects of psychotropic medications.

4

Which nursing action is appropriate for this request? 1 Direct Bill to talk with the pharmacist. 2 Ask for Bill's permission to obtain medications. 3 Explain that the PN can return the medications. 4 Obtain a prescription from the healthcare provider to return medications.

4

Which question should the PN ask next? 1 what helps the voices go away? 2 how long have you heard voices? 3 when do they get louder? 4 what do the voices say?

4

a client w schizophrenia is admitted to an acute care psychiatric unit. which clinical findings indicate positive signs and symptoms o schizophrenia? 1 withdrawal, poverty of speech, inattentiveness 2 flat affect, decreased spontaneity, asocial behavior 3 hypomania, labile mood swings, episodes of euphoria 4 hyperactivity, auditory hallucinations, loose associations

4

a client with a diagnosis of dementia of the Alzheimer type has been taking donepezil 10 mg/day for 3 months. the client's partner calls the clinic and reports that the client has been increasing restlessness and agitation accompanied by nausea. what does the nurse advise the partner to do? 1 give the med with food 2 administer the med to the partner at bedtime 3 omit one dose today and start with a lower dose tomorrow 4 bring the client to the clinic for testing and a physical examination

4

a client with schizophrenia is unable to feel happiness and joy. what is the name of this condition? 1 alogia 2 apathy 3 flat affect 4 anhedonia

4

What neurotransmitter is targeted by haloperidol (Haldol)? 1 GABA 2 serotonin 3 dopamine 4 norepinephrine

3

Which nursing diagnosis is best to include in Bill's care plan? 1 Disturbed sensory perception alteration related to withdrawal into self. 2 Chronic low self-esteem related to impaired cognition. 3 Ineffective coping related to personal vulnerability. 4 Knowledge deficit related to medication compliance.

1

The PN understands that the purpose of the urine drug screen is to assess Bill for what important information? 1 Detection of substances that may have caused Bill's delusions and/or hallucinations. 2 Determine the approximate time Bill stopped taking his medications. 3 Provide information about the type of psychosis Bill is experiencing. 4 Document medication noncompliance and reinforce the need for hospitalization.

1

a client with a history of schizophrenia attends the mental health clinic for a regular scheduled group of therapy session. the client arrives agitated and exhibits behaviors that indicates that she is hearing voices. when a nurse begins to walk toward her, the client pulls out a large knife. what is the best approach by the nurse? 1 firm 2 passive 3 empathetic 4 confrontational

1

an acutely ill client with the diagnosis of schizophrenia has just been admitted to the mental health unit. what is the most therapeutic initial nursing intervention? 1 spending time with the client to build trust and demonstrate acceptance 2 involving the client in OT and using diversional activity 3 delaying one on one client interactions until meds has eased the psychotic symptoms 4 involving the client in multiples small group discussions to distract attention from the fantasy world

1

schizophrenia is associated with negative symptoms. in the assessment of a client with schizophrenia, which symptoms are classified as negative symptoms? 1 lack of energy 2 poor grooming 3 illogical speech 4 ideas of reference 5 agitated behavior

12

a client with a diagnosis of schizophrenia, undifferentiated type, is being admitted to the psychiatric unit. what clinical manifestations does the nurse expect when assessing this client? select all that apply 1 excited behavior 2 loose associations 3 inappropriate affect 4 feelings of depression 5 hypervigilant behavior

123

the nurse support cognitive ability in clients with Alzheimer dementia, by doing what? sata 1 using calendars, clocks, and pictures to support memory 2 encouraging caregivers to support protected independence 3 providing a limited number of choices to support decision making 4 quizzing the client regularly to assess orientation to person, place, and time 5 administering prescribed rivastigmine to the client with severe Alzheimer's dementia

123

a nurse is assessing a client with chronic schizophrenia. which effects will the client most likely exhibit? select all that apply 1 apathy 2 hostility 3 flatness 4 sadness 5 happiness 6 depression

13

On the afternoon of admission to a psychiatric unit, an adolescent boy with the diagnosis of schizophrenia exposes his genitals to a female nurse. What should the nurse's immediate therapeutic response be? 1 Ignoring the client at this time 2 Stating that this behavior is unacceptable 3 Moving him to his room for a short time-out 4 Telling the client to come to the office later to discuss the behavior

2

Which action should the PN implement first? 1 Offer the client a glass of juice and ask him if he ate breakfast. 2 Take Bill's blood pressure, sitting and standing. 3 Tell Bill that dizziness, described as orthostatic hypotension, should be expected and will subside after he eats. 4 Hold the morning dose of Haldol, and notify the healthcare provider.

2

Which lab value from the urinalysis can the PN expect to be related to Bill's recent 20-pound weight loss? 1 positive for red blood cells 2 positive ketones 3 decreased urine pH 4 increased urine specific gravity

2

Which medication should the PN anticipate giving the client after securing a prescription from the healthcare provider? 1 Short-acting anxiolytic (antianxiety agent). 2 Antipsychotic medication. 3 Mood-stabilizing medication. 4 Nonbenzodiazepine anxiolytic (antianxiety agent).

2

a 54 year old client has demonstrated increasing forgetfulness, irritability, and antisocial behavior. after being found walking down a street, disoriented, and semi naked, the client is admitted to the hospital, and a diagnosis of dementia of the Alzheimer is made. the client expresses fear and anxiety. what is the best approach for the nurse to take? 1 exploring the reasons for the client's concerns 2 reassuring the client with the frequent presence of staff 3 initiating the program of planned interaction and activity 4 explaining the purpose of the unit and why admissions was necessary

2

a client with schizophrenia is actively psychotic, and a new medication regimen is prescribed. a student nurse asks the nurse 'which of the medications will be the most helpful against the psychotic signs and symptoms?' what response should the nurse give? 1 citalopram 2 ziprasidone 3 benztropine 4 acetaminophen with hydrocodone

2

a health agency is providing private nursing care to a client with Alzheimer disease. a paid board of directors appointed by the owners govern this agency. how is this agency classified? 1 public nonprofit freestanding 2 private for profit freestanding 3 private for profit institution based 4 private nonprofit institution based

2

a nurse is caring for a client with the diagnosis of schizophrenia. what is a common problem for clients with this diagnosis? 1 chronic confusions 2 disordered thinking 3 rigid personal boundaries 4 violence directed toward others

2

a young adult client is admitted to the hospital with a diagnosis of schizophrenia, paranoid type. the client has been saying ' the voices in heaven are telling me to come home to God'. initial nursing care should be focused on the client's: 1 disturbed self-esteem 2 potential for self-harm 3 dysfunctional verbal communication 4 impaired perception of environmental stimuli

2

which mental disorder is considered a thought process disorder? 1 depression 2 schizophrenia 3 panic disorder 4 obsessive compulsive disorder

2

A client who has exhibited bizarre behavior and an inability to relate to other people reports to the nurse, "I hear my father calling me. He died 2 years ago." Which psychological condition does the nurse suspect on the basis of the client's statement? 1 delirium 2 dementia 3 schizophrenia 4 personality disorder

3

Which medication should the PN anticipate giving to immediately relieve the muscles in Bill's neck and jaw? 1 lorazepam IM 2 benztropine PO 3 diphenhydramine IM 4 acetaminophen

3

What factor is most important for the PN to consider before discharge? 1 Contracts to follow discharge plans. 2 Resources to provide community support. 3 Thoughts of harm to self or others. 4 Significant others for support.

3

What is a goal of being in this activity group? 1 Learn social behaviors and gain insight about one's personality. 2 Provide information about Bill's disorders, symptoms, and medications. 3 Promotes self-acceptance and expression of feelings. 4 Identify and resolve specific problems related to Bill's treatment plan.

3

What is the purpose of a baseline complete blood count (CBC) prior to initiation of the antipsychotic medication? 1 determine the presence of cardiac disease 2 monitor for hepatoxicity 3 monitor for agranulocytosis 4 review for elevations in liver enzymes

3

Which behavior describes the PN's observation that Bill looks to the corner of the room and mumbles to himself? 1 Delusions. 2 Depersonalization. 3 Hallucinations. 4 Disorientation.

3

Which data are the best indicators of the potential for violence? 1 gender and age 2 past suicide attempts 3 history of violence 4 medication compliance

3

Which thought process describes Bill's inability to leave his apartment because he thought someone was waiting to kill him? 1 Hallucination 2 Phobia 3 Delusions. 4 Confabulation.

3

a client with mild Alzheimer disease has been taking galantamine, and the primary healthcare provider prescribes paroxetine for depression. for what effect will a nurse assess the client when these meds are taken concurrently? 1 allergic 2 dystonic 3 additive 4 extrapyramidal

3

What is the difference between group content and group process? 1 Group content refers to the group rules, and group process is how clients react to the rules. 2 Content refers to the type of group, and process is where the group meets. 3 The clients decide the group content, and group process is facilitated by the staff. 4 Content includes the clients' words, and group process is how clients communicate.

4

What mechanism of Haldol causes this side effect? 1 histamine blockade 2 muscarinic blockade 3 excess dopamine 4 alpha adrenergic blockade

4

an older client with the diagnosis i dementia of the Alzheimer type is admitted to a long term care facility. when planning for this client, the nurse recalls what about confusion? 1 it occurs with a transfer to new surroundings 2 it will be unchanged despite reality orientation 3 it is common finding and is expected with aging 4 it results from brain changes that make interventions futile

1

while educating a group of nursing students about the various effects of commonly abused substances, a nurse explains DTs. which statement made by a student nurse indicates effective understanding? 1 it may cause damage in the temporal lobes to the client's brain 2 it can be treated by supporting ventilation and administering naloxone as prescribed 3 it is characterized by short term memory loss, disorientation, muttering and delirium 4 it often occurs one to four days after cessation of alcohol use and lasts from two days to a week

4

the health care provider prescribed donepezil 5 mg by mouth once a day for a client exhibiting initial signs of dementia of the Alzheimer type. the client is already taking digoxin 0.125 mg in the morning and alprazolam 0.5 mg twice a day. what should the nurse teach the client's spouse to do? 1 hang a list of meds with the times at which the spouse should take them 2 prefill a weekly drug box with the meds for the spouse to self administer 3 remind the spouse in the morning which meds must be taken during the day 4 provide the spouse with the meds at the appropriate times they should be taken

2

when answering questions from the family of a client with Alzheimer disease the nurse explains what about the disease? 1 it emerges in the 4th decade of life 2 it is a slow, relentless deterioration of the mind 3 it is functional in origin and occurs in the later years 4 it is diagnosed through laboratory and psychological tests

2

which subtype of schizophrenia may have good prognosis with treatment? 1 residual 2 paranoid 3 catatonic 4 disorganized

2

A client with paranoid schizophrenia tells the nurse, "My neighbors are spying on me because they want to rob me and take money." While hospitalized, the client complains of being poisoned by the food and of being given the wrong medication. The nurse evaluates the client's response to medications and therapy. Which assessment finding leads the nurse to conclude that the client's reality testing has improved? 1 The client eats the food provided on the hospital tray 2 The client discusses his discharge plans with the staff 3 The client questions each medication when it is administered 4 The client asks permission to make phone calls to the hospital administration

1

an older client with the diagnosis of dementia, alzheimer type, is admitted to a nursing home. the client is confused and forgetful, wanders, and has intermittent episodes of urinary incontinence. how should the nurse plan to meet this client's elimination needs? 1 by pointing out the behavior to the client 2 by obtaining incontinence pads for this client 3 by taking the client to the bathroom at regular intervals 4 by encouraging the client to call for help when there is an urge to urinate

3

during assessment, the nurse finds that a client with Alzheimer's disease is having difficulty in communicating by writing. what does the nurse in the medical chart of the client? 1 apraxia 2 agnosis 3 dysgraphia 4 sundowning

3

the nurse is preparing discharge instructions for a client who has begun to demonstrate signs of early Alzheimer's dementia. the client lives alone. the client's adult children live nearby. according to the prescribed medication regimen the client is to take medications six times throughout the day. what is the priority nursing intervention to assist the client with compliance of the medication regimen? 1 contact the client's children and ask them to private a private duty aide who will provide round the clock care 2 develop a chart for the client, listing the times the med should be taken 3 contact the primary healthcare provider and discuss the possibility of simplifying the med regiment 4 instruct the client and client's children to put meds in a weekly pill organizer

3

an older client is hospitalized with the diagnosis of dementia of the Alzheimer type. the son tearfully tells the nurse ' i should never have allowed my father to live alone like he wanted to do, but he hasnt been this bad! im to blame! he didn't even recognize me right off the bat' what response by the nurse is most therapeutic? 1 i dont think that anybody can blame you. you did what he wanted. your being here tells us that you care 2 i realize that you're upset now. you can visit again when he is more responsive. im sure youll see a change 3 why do you think your father's condition has deteriorated? his forgetfulness is temporary. youll help if you dont cry 4 this must be a difficult time for both of you. please share some of your other observations with us that will help us plan his care

4

Which anticholinergic side effect(s) are related to the use of haloperidol (Haldol)? 1 feeling tired 2 dizziness 3 urinary retention 4 hand tremors 5 dry mouth

35

A client with the diagnosis of schizophrenia watches the nurse pour juice for the morning medication from an almost-empty pitcher and screams, "That juice is no good! It's poisoned." What is the most therapeutic response by the nurse? 1 Assure the client, "The juice is not poisoned." 2 Pour the client a glass of juice from a full pitcher. 3 Take a drink of the juice to show the client that it is safe. 4 Remark, "You sound frightened. Is there something else I can give you to take your medication with?

4

a client is to receive donepezil for treatment of dementia of the Alzheimer type. the nurse sits down with the primary caregiver and the client and reviews the purpose of the drug, its dosage, and the usual side effects. what side effect is identified by the caregiver leads the nurse to conclude that further teaching is needed? 1 nausea 2 dizziness 3 headache 4 constipation

4

a client with a diagnosis of schizophrenia is discharged from the hospital. at home the client forgets to take the med, is unable to function, and must be rehospitalized. what med may be prescribed that can be administered on an outpatient basis every 2 to 3 weeks? 1 lithium 2 diazepam 3 fluvoxamine 4 fluphenazine

4

a client with schizophrenia is started on an antipsychotic/neuroleptic med. the nurse explains to family member that this drug primarily is used to do what? 1 keep the client quiet and relaxed 2 control the client's behavior and reduce stress 3 reduce the client's need for physical restraints 4 make the client more receptive to psychotherapy

4

a nurse is caring for several client who have severe psychiatric disorders. what is the major reason a health care provider prescribes an antipsychotic medication for these clients? 1 to improve judgement 2 to promote social skills 3 to diminish neurotic behavior 4 to reduce the positive symptoms of psychosis

4

an 80 year old client with dementia of the Alzheimer's type is admitted to a nursing home. a family member visits and remarks how thin and wrinkled the client has become. which response by the nurse will help the family member most to understand the aging process? 1 most people at the age should be careful about weight gain 2 this is typical of older adults; they really don't eat well 3 it looks as though the frequent tanning has taken its toll 4 as we age, we lose the tissue that help puff out the skin

4

what is the priority nursing intervention for a forgetful, disoriented client with the diagnosis of dementia of the alzheimer type? 1 restricting gross motor activity 2 preventing further deterioration 3 keeping the client oriented to time 4 managing the client's unsafe behaviors

4