Mental Health Exam 1

A client who has a severe mental illness will soon be ready for discharge from an acute mental health facility, but he still requires supervision much of the time. His wife works all day but is home by late afternoon. Which of the following should the nurse suggest as appropriate follow up care?

Adult day care

A nurse is teaching a child with a new prescription for paroxetine (paxi) and his parents about reactions to watch for during the first 3 days of treatment. For which of the following manifestations should the nurse teach the family to discontinue the medication and notify the provider immediately? Select all that apply

Agitation, fever, and tremors, hyperflexia, hallucinations (Seritonin syndrome)

A client is taking Olanzapine (Zyprexa). The client who states he is being poisoned, refuses to take his scheduled medicaiton. The nurse states, "If you don't take your medication, you will be put into seclusion." The nurse statement is an example of which legal concept?

Assault

When alprazolam (xanax) is prescribed for acute anxiety, health teaching should include instruction to:

Avoid alcohol, heavy machinery, and caffeine.

Faith, a hospice nurse visits a client dying of ovarian cancer. During the visit, the client expresses that "If I can just live long enough to attend my daughter's graduation, I'll be ready to die." Which phases of coping is the client experiencing?

Bargaining

A patient with generalized anxiety ,disorder comes to the clinic with severe anxiety. Of these medication in the patient's medical record, which is most appropriate to give as a PRN:

Benzodiazepine ( any drug ending in pam).

A patient tells the nurse, "I wanted my health care provider to prescribe diazepam (valium) for my anxiety disorder but buspirone (BuSpar) was prescribed instead. Why?? The nurse's reply should be based on the knowledge that buspirone;

BuSpar is less sedating than valium. Does not produce physical or psychological dependence.

"Let me out, I don't belong here" refects what?

Denial

The termination phase of the nurse-client relationship focuses on which of the following?

Discussing ways to use new behaviors.

A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate (haldol depot injection) to a patient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop, stop. I don't want to take that medicine anymore because I hate the side effects." Which is the nurse's initial action?

Do not give it, Hold and ask why they don't want to take it.

A nurse is providing teaching to a client who is prescribed clonidine (Catapres) to assist with maintenance of abstinence from opiods. For which of the following side effects should the nurse instruct the client to observe?

Dry mouth

A nurse is caring for an older client who is prescribed amitriptyline (Elavil). Which of the following diagnostic tests should the nurse anticipate will be ordered prior to starting the client on this medication?

ECG because it causes arythmias

A client in an acute care setting tells nurse Gio, " I don't think I can face going home tomorrow." The nurse replies, "Do you want to talk more about it?" The nurse is using which of the following techniques?

Exploring

Signs and symptoms of neuroleptic malignant syndrome.

Fever, agitation, decreased level of consciousness, and tremors.

Which of the following medications, if given concurrently with lithium, could produce a toxic effect?

Furosemide (Lasix)

A nurse is providing teaching to an adolescent who is to begin taking buspirone (BuSpar) for an anxiety disorder. Which of the following foods should the nurse instruct the client to avoid?

Grapefruit

Which of the following is an example of a client who requires emergency admission to a mental health facility?

Harm to self or others

A nurse plans health teaching for a patient with generalized anxiety disorder who takes lorazepam (Ativan). What information should be included? Select all that apply

Heavy machinery, caffeine, and no alcohol.

A nurse is providing teaching to a client with a new prescription for amitripyline (Elavil). Which of the following client statements indicates understanding of the teaching?

I may feel drowsy for a few weeks after starting this medication.

When a family asks a nurse for reassurance about a client's condition, which of the following is an appropriate response?

I understand your need for reassurance. Let's talk about what concerns you specifically.

An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father but you can't tell anyone." Which is the nurse's best response?

I will have to tell your father

A client says to a nurse, "why should I talk to you? Everybody knows talking doesn't help!" Which of the following is an appropriate response by the nurse?

I'm here to talk with you about your concerns

Claudine, a nurse educator is providing in-service education to the nursing staff regarding trans-cultural nursing care when a staff member asks the nurse educator to describe the concept of acculturation. The appropriate response is which of the following?

It is a process of learning a different culture to adapt to a new of changing environment.

Lester, a nursing student is discussing cultural diversity issues in a clinical conference when a nursing instructor asks the student to describe ethnocentrism. Which statement by the student indicates a lack of understanding of the issue of ethnocentrism?

It is imposing one's beliefs on individuals from another culture

A child who has received an order for dextroamphetamine ( Addral) ADHD should be monitored for which of the following

Liver function tes/ALT/AST

The nurse is conducting an admission interview with a client and is assessing for risk factors related to client's safety. The nurse should include which of the following in this targeted assessment? Select all that apply:

Mental thoughts, allergies, testing for drugs

Which of the following client statements indicates understanding to the nurse's teaching regarding antipsychotic medication?

My symptoms can come back if I don't take the medication exactly as ordered.

Prescribing stimulants is controversial because these drugs are easily abused and their effectiveness is often debated, except for treatment of:

Narcolepsy

Which patient should be considered for involuntary commitment for psychiatric treatment?

Necessary when a person is danger to self or others or unable to meet basic needs as a result of psychiatric condition.

Which of the following is a barrier to therapeutic communication?

Offering advice

A nurse is caring for a client who is taking phenelzine (Nardil). For which of the following side effects should the nurse observe?

Orthostatic hypotension and headache

A nurse is providing teaching to a client prescribed lithium carbonate for bipolar disorder. For which of the following side effects should the nurse instruct the client to watch and report to the provider?

Parkinson-like symptoms, involuntary pelvic and hip movements, muscle spasm in the neck , and restlessness and jitterness

In which situation might the psychiatric mental health nurse incur liability?

Placing a client with annoying behavior in seclusion

An HCP has prescribed valproic acid (Depakene) for a client with bipolar disorder who has achieved limited success with lithium carbonate (Lithane). The nurse should instruct the client about which of the following?

Pt will need frequent blood draws. the levels should be 50-100 mEq.

A client who has been on lithium therapy for 6 months has recently developed symptoms of mild arthritis. He tells the nurse that he wants to start taking ibuprofen for his pain. Which of the following is an appropriate response?

Regular aspirin would be a better choice because ibuprofen can raise your lithium level too high

When interviewing and planning care for a patient with a fear of public speaking, the nurse should be aware that social phobia are often treated with:

SSRI and betablockers PROPLANOLOL

A new admission has just reviewed a diagnosis of generalized anxiety disorder ans has received orders for cialopram (Celexa). The nurse knows that citalopram is a SSRI and recognizes that the possible side effects of SSRI medications include: Select all that apply.

Seritonon syndrome, weight gain, steven Johnson syndrome.

The presence of which symptom will exert the greatest pressure to admit an individual to an inpatient psychiatric unit?

Suicidal ideation

A nurse is teaching the parents of a child taking methylphenidate (Ritalin) for ADHD how to administer the medication. Which of the following response by the nurse is most appropriate?

Take in the morning, no stimulants, cough medicine, no sugar, frequent small meals also prescribed for narcolepsy.

A patient has heralized anxiety disorder and takes buspirone (BuSpar) daily. Other wise, this patient is healthy. Which topics should be included in the medication teaching plan?

Take same time everyday, takes 3-6 months to be effective, potential side effects, and what to do with the side effects.dizziness, nausea, headache, nervousness, lightheadedness, excitement, and insomnia.

A client who has been taking an antipsychotic medication for several years begins to exhibit hip smacking, tongue protrusion, and facial grimaces. Which of the following should the nurse suspect?

Tardive Dyskinesia

A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my a mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take?

Tell the client that this must be reported to health care staff because it concerns the lives and safety of the client and others.

A client has been prescribed bupropion (Wellbutrin) for depression. Upon reviewing the client's chart, the nurse should report which of the following findings to the client's provider immediately?

The client had a motor vehicle crash last year and sustained a head injury.

To provide appropriate care for a patient who has been admitted involuntarily to a psychiatric unit, the nurse must be aware of the fact that the patient has the right to:

To refuse psychotropic medications

An adolescent client has just begun taking amitriptyline (Elavil) for depression. Which of the following nursing interventions should the nurse teach the client to minimize one of the adverse effects of his medication?

Wear sunglasses when going outdoors.

After taking fluoxetine (prozac) 20 mg by mouth every morning for 3 weeks, the client reports to the outpatient clinic today. The client reports a weight loss of 10 pounds during the past 2 weeks. Based on this assessment data, the nurse should take which action?

Zofran, anti emetic or phenothiazines

A nurse decides to put a client with psychosis in seclusion overnight, because the unit is very short staffed, and the client frequently fights with other clients. this is an example of.

a tort

Effective communication with clients and families includes

attending to verbal and nonverbal behaviors.