Mood, Adjustment, and Dementia Disorders

A 3-year-old is seen in the well child clinic. The parent is concerned that the child may be autistic. Which assessment data would indicate a concern to the nurse? Select all that apply. inability to separate from mother inability to stay on task lack of communication abilities withdrawing into a private world inability to develop social skills

lack of communication abilities withdrawing into a private world inability to develop social skills

In assessing an adolescent client at an outpatient clinic, the nurse is able to recognize that depression in adolescents is often what? similar in symptomology to that of adult clients often masked by aggressive behaviors situational and not as serious as that of adult clients a sign that the teenager needs to be admitted to the hospital

often masked by aggressive behaviors

A client diagnosed with a cognitive disorder is showing signs of confusion, short-term memory loss, and a short attention span. Which therapy group would be best suited for this client? insight oriented medication management problem solving reality orientation

reality observation

A client begins clozapine therapy after several other antipsychotic agents fail to relieve her psychotic symptoms. The client is instructed to return to the office laboratory weekly for 6 months to have blood drawn. Which laboratory results would be of concern to the nurse after the third test? white blood count (WBC) of 3000 hemoglobin of 13.2 blood urea nitrogen (BUN) of 18 mg/dL creatinine clearance of 88 mL/min

white blood count (WBC) of 3000

The nurse is working with a client with depression and suicidal ideation. The nurse heard the client say, "I am disappointed because thought I'd be feeling better by now since I started medication and therapy a week ago." What would be the primary nurse therapist's most therapeutic response? "It probably took a while for you to get into this state, and you can't expect for things to get better overnight." "I'm glad you are taking ownership of your problems and trying to see how you can move things along for your recovery." "Try to be patient and hopeful. The medication takes several weeks to reach a therapeutic level." "It takes time and can be frustrating to experience the physical and emotional symptoms of depression all while you learn more about yourself and try new strategies as your medication takes effect."

"It takes time and can be frustrating to experience the physical and emotional symptoms of depression all while you learn more about yourself and try new strategies as your medication takes effect."

A nurse should intervene when a depressed client makes which statement?' "Nobody cares about me." "I have trouble falling asleep." "Television doesn't interest me anymore." "I've gained some weight."

"Nobody cares about me."

The client with rapid-cycling bipolar disorder who is about to receive the 1700 hours dose of carbamazepine reports a sore throat and chills. What should the nurse do next? Administer the prescribed amount of carbamazepine. Give the client acetaminophen as prescribed PRN. Report the symptoms to the health care provider (HCP) in the morning. Call the health care provider (HCP) immediately to report changes.

Call the health care provider (HCP) immediately to report changes.

A depressed client on a psychiatric unit asks the nurse to call the hospital lawyer to discuss writing out a will. What is the nurse's priority intervention? Call a lawyer as requested by the client. Discuss thoughts and explore intent for suicide with the client. Inform the physician first, and place the client on suicide watch. Offer the client medication for anxiety.

Discuss thoughts and explore intent for suicide with the client.

A client with bipolar disorder, manic phase, is scheduled for a chest x-ray. What should the nurse do before taking the client to the radiology department? Give a thorough explanation of the procedure. Explain the procedure in simple terms. Call security to be on standby for possible problems. Cancel the appointment until the client can go unescorted.

Explain the procedure in simple terms.

A health care provider (HCP) has prescribed valproic acid for a client with bipolar disorder who has achieved limited success with lithium carbonate. Which information should the nurse teach the client about taking valproic acid? Follow-up blood tests are necessary while on this medication. The extended-release tablet can be crushed if necessary for ease of swallowing. Tachycardia and upset stomach are common side effects. Consumption of a moderate amount of alcohol is safe if the medication is taken in the morning.

Follow-up blood tests are necessary while on this medication.

The mental health unit provides a unit landline for clients to use for telephone calls. A client with bipolar disorder is monopolizing the use of the telephone by making several calls each day, interfering with the ability of other clients to use the telephone. What should the nurse do? Allow the client to use his personal cell phone for calls. Limit the amount of calls the client can make each day. Remind the client that others need to use the telephone. Take away the client's telephone privileges.

Limit the amount of calls the client can make each day.

A nurse assesses an 82-year-old client for depression. Because of the client's age, the nurse's assessment should be guided by which factor? Sadness of mood may be masked by other symptoms. Impairment of cognition usually is not present. Psychosomatic tendencies do not tend to dominate. Antidepressant therapies are less effective in older adults.

Sadness of mood may be masked by other symptoms.

The nurse administers an antipsychotic drug to a client with acute mania. The client still refuses to lie down on the bed, pushes other clients in the hallways, and screams threatening remarks to the staff. What should the nurse do next? Follow the client and ask her to calm down. Tell the client to lie down on the sofa in the community room. Seclude the client, and use restraints if necessary. Tell the staff to ignore the client's remarks.

Seclude the client, and use restraints if necessary.

An adult calls the crisis center expressing concern about his grandparent, who lost their spouse a month ago. Ther family member states, "My grandparent has been in bed for a week and is not eating or showering. They told me that they didn't want to kill themself, but it's not like them to lay in bed and not shower. They won't even talk to me when I visit." The nurse encourages the grandchild to bring their grandparent to the center for evaluation based on which reason? The behaviors may reflect passive suicidal thoughts. The behaviors reflect altered role performance. Seeing the grandson and grandparent together will be helpful. Refusing to talk to the grandchild alone indicates a major problem.

The behaviors may reflect passive suicidal thoughts.

A client diagnosed with major depression and substance use disorder is being admitted to the concurrent disorder treatment unit. In explaining the focus of this program, the nurse should provide which information to the client? The addiction will be treated first, then the depression. The depression will be treated first, then the addiction. There will be simultaneous treatment of the addiction and the depression. As the addiction is treated, the depression will clear up on its own.

There will be simultaneous treatment of the addiction and the depression.

A nurse is caring for a severely depressed client who is barely functioning. The priority nursing goal for this client would be to: assess for level of depression and continue antidepressant medication. assess for the client's hygiene needs and ensure that these needs are met. assess for and maintain adequate nutrition and hydration. involve the family in the client's care as much as possible.

assess for and maintain adequate nutrition and hydration.

An adolescent client took 300 acetaminophen tablets in an attempt to kill themself after a relationship breakup. The client is admitted to the adolescent psychiatric unit and is refusing to talk with the nurse. What is the most important nursing approach at this stage of the helping relationship? appropriate self-disclosure to support a trusting relationship challenging the client so that they begin to look not at the embarrassment for being admitted but at the realities of the client's feelings and actions allowing the client time for self-reflection and insight development supporting suicide precautions and safety measures for the client on the unit

challenging the client so that they begin to look not at the embarrassment for being admitted but at the realities of the client's feelings and actions

A physician orders lithium carbonate for a client who has just been diagnosed with bipolar disorder. The nurse is teaching the client about signs and symptoms of lithium toxicity, which include: skeletal muscle contractions, cogwheel rigidity, and a thick tongue. dry mouth, blurred vision, and urine retention. edema, orthostatic hypotension, and rash. lethargy, vomiting, and diarrhea.

lethargy, vomiting, and diarrhea.

A young adult client is being treated for depression. The client reports having nightmares about being raped as a child and still fears older men. Which other illness does the nurse suspect the client is experiencing? posttraumatic stress disorder, delayed onset dissociative identity disorder generalized anxiety disorder acute paranoid schizophrenia

posttraumatic stress disorder, delayed onset

A client is in the first stage of Alzheimer's disease. The nurse should plan to focus this client's care on: offering nourishing finger foods to help maintain the client's nutritional status. providing emotional support and individual counseling. monitoring the client to prevent minor illnesses from turning into major problems. suggesting new activities for the client and family to enjoy together.

providing emotional support and individual counseling.

A client, age 87, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find: transitory short-term memory loss and permanent long-term memory loss. transitory short- and long-term memory loss and confusion. permanent short-term memory loss and hypertension. permanent long-term memory loss and hypomania.

transitory short- and long-term memory loss and confusion.

A client with Alzheimer's disease tells the nurse, "I'm so afraid. Where am I? Where is my family?" What is the best response by the nurse? "You're in the hospital, and you're safe here. Your family will return at 10 o'clock, which is one hour from now." "You know where you are. You were admitted here two weeks ago. Don't worry, your family will be back soon." "Can you tell me what year it is? Do you know your name? How many fingers am I holding up right now?" "Are you hungry or thirsty? Would you like me to take you for a walk to the kitchen for a snack?"

"You're in the hospital, and you're safe here. Your family will return at 10 o'clock, which is one hour from now."

The nurse is caring for a severely depressed client. Which statement by the nurse is best when talking to the client on the patient care unit? "Everybody feels down once in a while." "Things will get better." "You're wearing a new shirt today." "I like the shoes you wore yesterday."

"You're wearing a new shirt today."

One day after being admitted with bipolar disorder, a client becomes verbally aggressive during a group therapy session. Which response by the nurse is most therapeutic? "You're behaving in an unacceptable manner, and you need to control yourself." "If you continue to talk like that, no one will want to be around you." "Your behavior is disturbing to other clients. I'll walk with you to help you release some energy." "You're scaring everyone in the group. Leave the room immediately."

"Your behavior is disturbing to other clients. I'll walk with you to help you release some energy."

The child of a client with Alzheimer disease excitedly tells the nurse, "My parent was singing a favorite old song. I think they're getting their memory back!" What response by the nurse is most appropriate? "Your parent still has long-term memory, but short-term memory will not return." "I'm so happy to hear that. Maybe your parent is getting better." "Don't get your hopes up. This is only a temporary improvement." "I'm glad your parent can sing even if they can't talk to you."

"Your parent still has long-term memory, but short-term memory will not return."

The nurse develops appropriate assignments for the staff. Which client should the nurse judge to be at highest risk for suicide completion? 85-year-old White man who lives alone after their spouse's death 34-year-old single Latino woman who has recently been diagnosed with cancer 15-year-old girl of African descent whose partner broke up with them 52-year-old man of Asian descent who was terminated from their job because of downsizing

85-year-old White man who lives alone after their spouse's death

A client with a history of suicidal thoughts and depression has just attended an outpatient day therapy group session. The nurse hears from the client that they plan to forgo lunch and the afternoon session, stating, "I just need to go home and have a nap." What would be the day therapy nurse's best response? Ask the client if they are angry. Remind the client that the program schedule will benefit the client only if the client stays for the whole day. Ask the client if they are hungry or if they have not been enjoying the food at the outpatient program. Ask the client to sit for a few minutes to discuss missing the afternoon session.

Ask the client to sit for a few minutes to discuss missing the afternoon session.

A nurse meets frequently with a depressed client. The client stays mostly in their room and speaks only when addressed, answering briefly and abruptly while keeping their eyes on the floor. Initially, the nurse should focus on the client's ability to do which function? Make decisions. Relate to other clients. Function independently. Express themself verbally.

Express themself verbally.

The nurse is assessing a client who has been admitted to the acute care facility. The client experiences an acute onset of altered level of consciousness and recent memory loss. What does the nurse anticipate the client will be evaluated for? dementia tertiary syphilis delirium depression

delirium

A client states, "I feel so sad. I don't think I can go on anymore." Which is the most therapeutic response the nurse can offer the client? "Things will look better tomorrow." "You feel like you can't go on anymore?" "Why do you feel like that?" "I will tell your doctor about your feelings.

"You feel like you can't go on anymore?"

A client was found unconscious on the bathroom floor with self-inflicted wrist lacerations. An ambulance was called and the client was transferred to the inpatient psychiatric unit for observation and treatment with antidepressants. Which nursing intervention is most appropriate? Observe for extrapyramidal symptoms. Begin a therapeutic relationship. Explore precipitating factors for the suicide attempt. Continue suicide precautions.

Continue suicide precautions.

While assessing a client diagnosed with dementia, the nurse notes that the client's spouse is concerned about what they should do when the client uses vulgar language with them. What should the nurse tell the spouse? Tell the client that they are very rude. Ignore the vulgarity and distract the client. Tell the client to stop swearing immediately. Say nothing and leave the room.

Ignore the vulgarity and distract the client.

A physician orders a tricyclic antidepressant for a client who has suffered an acute myocardial infarction (MI) within the previous 6 months. Which action should the nurse take? Administer the medication as ordered. Discontinue the medication. Question the physician about the order. Advise the client to discuss the MI with the physician.

Question the physician about the order.

A client with depression is exhibiting a brighter affect and an ability to attend to hygiene and grooming tasks and is beginning to participate in group activities. The nurse asks the client to identify three personal strengths. After much hesitation and thinking, the client identifies being a nice person, a good cook, and a hard worker. What should the nurse do next? Ask the client to identify an additional three strengths. Volunteer the client to lead the cooking group later in the day. Educate the client about the importance of medication. Reinforce the client for identifying and sharing strengths.

Reinforce the client for identifying and sharing strengths.

A nurse is caring for a client who has been diagnosed with somatic symptom disorder. The client attributes a cough to tuberculosis. A chest X-ray and skin test are negative for tuberculosis. The client begins to complain about the sudden onset of chest pain. How should the nurse react initially? Express understanding of the client's fears of serious illness. Encourage the client to discuss the fear of having a serious illness. Report the client's complaint of chest pain to a physician. Determine if the illness is fulfilling a psychological need for the client.

Report the client's complaint of chest pain to a physician.

A client was admitted with a diagnosis of schizophrenia and exhibiting behaviors of hostility, paranoia, and isolation. The student nurse discussed with the nurse what the most therapeutic approach to take with the client would be. Which would indicate to the nurse that the student understands the best approach? Inform the client that they need to receive care and that you will assist them. Greet the client by gently touching their arm and telling the client that they can trust you. Respect the client's need for personal space and avoid physical contact with the client. Tell the client that if they do not comply with the rules, you will inform the physician.

Respect the client's need for personal space and avoid physical contact with the client.

A client attends a follow-up visit to a clinic after being diagnosed with atypical depression. The practitioner prescribed tranylcypromine sulfate, 10 mg by mouth twice a day during the last visit 14 days ago. Which would be the priority action by the nurse for this client? Screen the client for new, worsened, or increased depression. Ask the client if they have been taking any over-the-counter medications. Remind the client to stay out of sunlight and tanning booths. Take the client's heart rate.

Screen the client for new, worsened, or increased depression.

A client who is taking fluoxetine 20 mg at bedtime tells the nurse the drug is interfering with their sleep. What conclusion should the nurse make? The client should take fluoxetine in the morning. The dosage is too high. The client's symptoms of depression seem to be getting worse. The client is on the wrong medication.

The client should take fluoxetine in the morning.

A client was hospitalized for 1 week with major depression with suicidal ideation. They are taking venlafaxine 75 mg three times a day and planning to return to work. The nurse asks the client if they are experiencing thoughts of self-harm. The client responds, "I hardly think about it anymore and wouldn't do anything to hurt myself." The nurse should make which judgment about the client? The client is decompensating and in need of being readmitted to the hospital. The client needs an adjustment or increase in their dose of antidepressant. The depression is improving, and the suicidal ideation is lessening. The presence of suicidal ideation warrants a telephone call to the client's health care provider.

The depression is improving, and the suicidal ideation is lessening.

An elderly client's lithium level is 1.4 mEq/L. The client complains of diarrhea, tremors, and nausea. The nurse should: hold the lithium and notify the physician. reassure the client that these are normal adverse effects. administer another lithium dose. discontinue the lithium.

hold the lithium and notify the physician.

A client with depression doesn't respond to drug therapy. At a team conference, staff members recommend electroconvulsive therapy (ECT). The nurse knows that most people respond emotionally to the thought of an electric current passing through the brain. Therefore, when discussing ECT with the client, the nurse should: use the term "shock therapy" in a neutral, calm manner. refer to the procedure as a "treatment" instead of "shock therapy." refer to the procedure as ECT. explain how the seizures are artificially induced.

refer to the procedure as a "treatment" instead of "shock therapy."

During the initial assessment, a client exhibits pressured speech. The client points to certain patterns on the wallpaper and says, "This is the writing about the tsunami. Thousands of people died because I read the writing. I should never have read the writing; it was my fault." Which would be central to the nurse's interventions? reduction of environmental stimuli challenging the client's personal space replying to the client with feedback about reality and the client's behaviors preparing the staff and the environment for escalation of behaviors

replying to the client with feedback about reality and the client's behaviors

The spouse of a client with bipolar disorder, manic phase, states to the nurse, "My spouse is acting so crazy. What did they do to get this way?" The nurse bases the response on which understanding of this disorder? Bipolar disorder is: caused by underlying psychological difficulties. caused by disturbed family dynamics in the client's early life. the result of an imbalance of chemicals in the brain. the result of a genetic inheritance from someone in the family.

the result of an imbalance of chemicals in the brain.

A client has been treated for major depression and is taking antidepressants. They ask the nurse, "How long do I have to take these pills?" How should the nurse respond to the client's question? "Once you're feeling better, the medication can be discontinued." "You'll need to take the medication for at least 3 months." "Antidepressants are prescribed for 6 to 12 months before considering discontinuation." "The medication can be discontinued when you don't have suicidal thoughts."

"Antidepressants are prescribed for 6 to 12 months before considering discontinuation."

A client who was treated for depression is ready for discharge from the mental health unit. The client tells the nurse, "It would be really good for me if we could meet for coffee if I am feeling depressed again." Which statement indicates that the nurse understands the boundaries of the therapeutic relationship? "That would be okay as long as we go to a public place. Where would you like to meet?" "Before you leave the hospital, I will give you information for the crisis center." "It would be better for us to go for a walk because exercise helps with depression." "It would be good to meet because it can be difficult after leaving the hospital."

"Before you leave the hospital, I will give you information for the crisis center."

A client with acute mania brings six suitcases and three shopping bags of personal belongings on admission to the unit. When informed that some of the suitcases and bags need to be returned home because of a lack of storage space, the client begins to use profanity against the nurse. Which response by the nurse is most therapeutic? "You're acting inappropriately." "I won't tolerate you talking to me like that." "Swearing and profanity are unacceptable here." "We don't want to put you in seclusion yet."

"Swearing and profanity are unacceptable here."

A client has just been admitted with acute delirium of unknown etiology. The client's daughter states that she is worried about her mom because she has never been this sick before. Which would be the most helpful statement to make to the daughter? "Please don't worry. We'll take good care of your mother." "The health care provider will prescribe tests to find out what's causing her condition." "We can help you learn how to take care of her after she's discharged." "It helps if you avoid arguing when she talks about seeing people who aren't there."

"The health care provider will prescribe tests to find out what's causing her condition."

A client was found wandering in a local park, unable to state who or where the client is or where the client lives. The client is brought to the emergency department, where an identification is eventually made. The client's spouse states that client was diagnosed with Alzheimer's disease 3 years earlier and has experienced increasing memory loss. The spouse reports worry about how to continue to care for the client. Which response by the nurse is most helpful? "Because of the nature of your spouse's disease, you should start looking into nursing homes for your husband." "What aspect of caring for your spouse is causing you the greatest concern?" "You may benefit from a support group called Mates of Alzheimer's Disease Clients." "Do you have any children or friends who could give you a break from your spouse's care every now and then?"

"What aspect of caring for your spouse is causing you the greatest concern?"

A client with acute mania exhibits euphoria, pressured speech, and flight of ideas. The client has been talking to the nurse nonstop for 5 minutes, and lunch has arrived on the unit. What should the nurse do next? Request to be excused and tell the client to come to the dining room for lunch. Tell the client to stop talking because it is time to eat lunch. Do not interrupt the client, but wait for them to finish talking. Walk away, and approach the client in a few minutes before the food gets cold.

Request to be excused and tell the client to come to the dining room for lunch.

A nurse is taking an admission history, including a medication list, from a client. The listing of which herbal medication would prompt the nurse to ask the client more questions regarding any history of depressive symptoms? ginkgo biloba echinacea St. John's wort ephedra

St. John's wort

A client admitted to the nursing unit with bipolar disorder, manic phase, is accompanied by their spouse. The spouse states that the client has been overly energetic and happy, talking constantly, purchasing many unneeded items, and sleeping about 4 hours a night for the past 5 days. When completing the client's daily assessment, the nurse should be especially alert for which finding? exhaustion vertigo gastritis bradycardia

exhaustion

A depressed client remains alone in their room most of the time. Which statement by the nurse would most help the client become involved with a unit activity? "Would you like to go to the movie with me today?" "I'll be back at 4 o'clock to take you to the movie." "I hope you go to the movie this afternoon. It will cheer you up." "You might want to go to the movie in the dayroom this afternoon."

"I'll be back at 4 o'clock to take you to the movie."

A client with dementia must be temporarily hospitalized. The family wants to take proactive measures to assure the client does not experience further confusion. Which measure if suggested by the family would the nurse discourage? providing for uninterrupted sleep bringing familiar objects from home to the room keeping lights dimmed during daylight hours posting a calendar in the room

keeping lights dimmed during daylight hours

A nurse notices that a depressed client who has been taking amitriptyline hydrochloride for 2 weeks has become very outgoing, cheerful, and talkative. The nurse suspects that the client: is responding appropriately to the antipsychotic. may be experiencing increased energy and is at increased risk for suicide. is ready to be discharged from treatment. is experiencing a split personality.

may be experiencing increased energy and is at increased risk for suicide.

A young woman comes to the mental health clinic for their routine medication follow-up. The client has been married for 2 years and reports that they and their spouse are ready to start a family. The client has a diagnosis of bipolar disorder that has been well-managed with divalproex sodium for at least 3 years. What is the most essential counsel for the nurse to give the client? "Schedule an appointment for a complete gynecological exam if you haven't had one in the past year." "Pay careful attention to eating healthy from this point on to maximize the health of both you and your baby." "Check with your health care provider as divalproex carries an increased risk for birth defects." "Learning to reduce stress now is important to reduce your chances of developing postpartum depression."

"Check with your health care provider as divalproex carries an increased risk for birth defects."

A client is taking lithium carbonate. The client asks for explanations of why regular blood tests are needed. The nurse explains that it is to detect lithium toxicity. Which statement, if made by the client, indicates to the nurse that the teaching about lithium toxicity has been effective? "There may be too much medication in my bloodstream." "This blood test tells the doctor if the medication is effective." "I should get my blood checked if I don't feel well." "Blood tests will prevent common side effects of taking the medication."

"There may be too much medication in my bloodstream."

A nurse is prioritizing care for four new admissions to the inpatient psychiatric unit. Which client should the nurse assess first? a significantly depressed client with decreased energy who was isolated in the bedroom. a client who is anxious and is washing hands excessively. a client who periodically burns self with cigarettes when feeling anxious. a client with new-onset confusion and disorientation.

a client with new-onset confusion and disorientation.

A client with a diagnosis of schizophrenia is experiencing paranoia and tells the nurse about hearing a voice saying, "Don't take those poisoned pills from that nurse!" Which objective assessment regarding this statement will the nurse report to the healthcare team? impaired verbal communication disturbed thought processes disturbed perceptions anxiety

disturbed perceptions

The client with depression has been hospitalized for 3 days on the psychiatric unit. This is the second hospitalization during the past year. The health care provider prescribes tranylcypromine sulfate because the client did not respond positively to a tricyclic antidepressant. If the client's diet includes foods containing tyramine, the nurse should teach the client about which possible reaction? heart block generalized tonic-clonic seizure respiratory arrest hypertensive crisis

hypertensive crisis

A client who has paranoid personality disorder is participating in a treatment group. Which behavior should the nurse observe for as the client participates in the group? indecisiveness exploitation hypervigilance passive resistance

hypervigilance

fter a period of unsuccessful treatment with amitriptyline, a client diagnosed with depression is switched to tranylcypromine. Which statement by the client indicates the client understands the side effects of tranylcypromine? "I need to increase my intake of sodium." "I must refrain from strenuous exercise." "I must refrain from eating aged cheese or yeast products." "I should decrease my intake of foods containing sugar."

"I must refrain from eating aged cheese or yeast products."

A client is admitted with conversion disorder after the death of a spouse. The client's major symptom is the inability to walk forward. The client seems to be unconcerned about the problem. Which nursing intervention(s) are appropriate? Select all that apply. Adopt a matter-of-fact, but caring, approach to prevent secondary gains. Focus on the death of the spouse and the inability to move forward in life. Help the client learn ways to express feelings more appropriately. Reinforce any positive improvements in the way the client deals with needs and feelings. Encourage participation in milieu and recreational activities (diversion).

Adopt a matter-of-fact, but caring, approach to prevent secondary gains. Help the client learn ways to express feelings more appropriately. Reinforce any positive improvements in the way the client deals with needs and feelings. Encourage participation in milieu and recreational activities (diversion).

A client is prescribed phenelzine. Which food should the nurse tell the client to avoid while taking the medication? roasted chicken salami fresh fish hamburger

salami

After the nurse teaches a client and family about lithium therapy, which client statement would indicate the need for further teaching? "I need to eliminate salt in my diet." "I should drink 10 to 12 glasses of water daily." "I should avoid driving until I am stabilized." "I will report any vomiting, diarrhea, blurred vision, or weakness."

"I need to eliminate salt in my diet."

A client is admitted to a psychiatric unit after a suicide attempt. The client is withdrawn, has poor hygiene, and appears underweight. What is the priority for a nurse in keeping a therapeutic milieu for this client? Encourage the client to participate in group therapy sessions. Give the client structure and support until the client is able to function. Validate a client's worth and respect for life. Manage the client's spiritual needs.

Give the client structure and support until the client is able to function.

A client who was recently discharged from the psychiatric unit telephones the unit to speak to the nurse. The client reports taking their children to the neighbor's house and has turned on the gas to attempt suicide. Which action should the nurse take next? Refer the caller to a 24-hour suicide hotline. Tell the caller that another nurse will telephone the police. Ask whether the caller telephoned their health care provider (HCP). Instruct the caller to telephone their family for help.

Tell the caller that another nurse will telephone the police.

A nurse is monitoring a client receiving tranylcypromine sulfate. Which serious adverse reaction can occur with high dosages of this monoamine oxidase (MAO) inhibitor? hypotensive episodes hypertensive crisis muscle flaccidity hypoglycemia

hypertensive crisis

When preparing a client for electroconvulsive therapy (ECT), the nurse should make sure that the client: sees family members immediately before the procedure. is scheduled for a brain scan immediately after the procedure. has undergone a thorough medical evaluation. has been on nothing-by-mouth (NPO) status for no more than 2 hours before the procedure.

has undergone a thorough medical evaluation.

The family caregiver of a client with Alzheimer disease tells the nurse that the client thinks someone is stealing their things. Which response by the nurse would be most helpful? "That behavior is typical of people with Alzheimer disease and will become worse." "The client has problems remembering where they put things." "We have checked their room and nothing was missing." "We asked the health care provider to evaluate the client for paranoid delusions, which are common in people with Alzheimer's disease."

"We asked the health care provider to evaluate the client for paranoid delusions, which are common in people with Alzheimer's disease."

A nurse is frustrated by inability to make much progress establishing a therapeutic relationship with a client with bipolar disorder. The nurse's most professional response would be to: ask to be reassigned to another, less-challenging client. keep trying to talk with the client even though the nurse is frustrated. discuss the situation with a more experienced peer. ask the physician to reevaluate the client's medication.

discuss the situation with a more experienced peer.

A client with bipolar disorder has been taking lithium carbonate for the past 2 years. Recently, the client has been experiencing a recurrence of manic symptoms approximately once a month. The client's psychiatrist has added clonazepam to help manage the client's mood swings. Which statement should the nurse include in medication teaching? "This medication may cause a severe rash which should be reported to your physician immediately." "This medication should not be taken with any other medication." "This medication will help steady your moods by reducing the overstimulation of chemical messengers in your brain." "This medication should not be taken with foods that contain tyramine, such as aged cheese."

"This medication will help steady your moods by reducing the overstimulation of chemical messengers in your brain."

The community psychiatric nurse conducts a weekly education group for older adult clients. The nurse suspects that one of the clients with cognitive impairment is experiencing elder abuse based on bruising, but the client mentions experiencing falls at home. What is the nurse's priority action? Make an immediate appointment to visit the home to assess the situation. Notify the family of the suspected abuse and impending investigation. Encourage the installation of railings and raised toilet seats in the home. Wait a few weeks to assess whether the client has any new bruises.

Make an immediate appointment to visit the home to assess the situation.

The nurse is caring for a client with an irritable mood, grandiose thinking, impulsive hyperactive behaviors, and little sleep. What is the nurse's best initial approach? Use a calm, firm approach, offering clear directions. Ensure the client knows staff are in charge on the unit. Confine the client to a quiet setting away from others. Administer mood stabilizer medications as prescribed.

Use a calm, firm approach, offering clear directions.

Which foods are contraindicated for a client taking tranylcypromine? whole grain cereals and bagels chicken livers, Chianti wine, and beer oranges and vodka chicken, rice, and apples

chicken livers, Chianti wine, and beer

A client with bipolar disorder, manic phase, shows little interest in eating. What should the nurse do to help the client obtain recommended daily allowances of nutrients? Give the client half of a meat and cheese sandwich to carry with them. Inform the client that snacks are available only if they eat properly at mealtime. Tell the client to sit alone at mealtime so that they will not be distracted by others. Teach the client about proper nutrition.

Give the client half of a meat and cheese sandwich to carry with them.

The nurse is assisting a client diagnosed with dementia during meal time. Which nursing would best prevent complications? Provide a plate with a variety of foods to give a more complete choice of foods. Serve one course at a time with the appropriate utensil. Keep mealtimes short to prevent loss of attention. Encourage the client to open containers to allow for independence.

Serve one course at a time with the appropriate utensil.

A client with acute mania has been admitted to the inpatient unit voluntarily. The nurse approaches the client with medication to be taken orally as prescribed by the health care provider. The client states, "I don't need that stuff." Which response by the nurse is best? "You can't refuse to take this medication." "If you don't take it orally, I'll give you a shot." "I'll get you some written information about the medication." "The medication will help you feel calmer."

"The medication will help you feel calmer."

A client takes lithium carbonate daily, and their most recent lithium carbonate level is 1.8 mEq/L. What response by the nurse is best for this client? Tell the client to continue taking their lithium. Tell the client to take half their dose of lithium and to follow up in 1 week. Tell the client to hold his/her intake of lithium and to call the physician. Instruct the client to switch to thioridazine instead of continuing their current therapy.

Tell the client to hold his/her intake of lithium and to call the physician.

The multidisciplinary team is meeting for the morning rounds. While discussing the care plan for a 45-year-old client experiencing command auditory hallucinations, which would be the priority assessment finding for the nurse to report to the team? The client has refused to perform daily hygiene tasks. The client is not speaking or communicating with the staff. The client is pacing and mumbling that they don't want to hurt anyone. The client missed breakfast and lunch meals in the community room.

The client is pacing and mumbling that they don't want to hurt anyone.

The nurse cares for a client with changes in cognition. Which characteristic would make the nurse suspect that a client has delirium? disturbances in cognition and consciousness that fluctuate during the day the failure to identify objects despite intact sensory functions significant impairment in social or occupational functioning over time memory impairment to the degree of being called amnesia

disturbances in cognition and consciousness that fluctuate during the day

A client in the manic phase of bipolar disorder constantly belittles other clients and is demanding special favors from the nurses. Which intervention by the nurse would be most appropriate for this client? Ask other clients and staff members to ignore the client's behavior. Provide the client with an anti-anxiety agent whenever their belittling or demanding behavior occurs. Set limits with specific and consistent consequences for belittling or demanding behavior. Offer the client a variety of stimulating activities to distract them from other clients and from making demands on the nurses.

Set limits with specific and consistent consequences for belittling or demanding behavior.

A nurse is caring for a client with bipolar disorder. The care plan for a client in a manic state would include: offering high-calorie meals and strongly encouraging the client to finish all food. insisting that the client remain active through the day to be more likely to sleep at night. allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting limits. listening attentively to the client's requests with a neutral attitude, and avoiding power struggles.

listening attentively to the client's requests with a neutral attitude, and avoiding power struggles.

A nurse on the geropsychiatric unit receives a call from the caregiver of a recently discharged client. The caregiver reports that the client just got a prescription for memantine to take "on top of their donepezil." The caregiver then asks, "Why do they have to take extra medicines?" What should the nurse tell the son? "Maybe the donepezil alone is not improving their dementia fast enough or well enough." "Memantine and donepezil are commonly used together to slow the progression of dementia." "Memantine is more effective than donepezil. Your parent will be tapered off the donepezil." "Donepezil has a short half-life, and memantine has a long half-life. They work well together."

"Memantine and donepezil are commonly used together to slow the progression of dementia."

A 72-year-old client is brought by ambulance to the hospital's psychiatric unit from a nursing home where they have been a client for 3 months. Transfer data indicate that the client has become increasingly confused and disoriented. In which way should the hospital admission process be modified for the client? Leave the client alone to promote recovery of their faculties and composure. Medicate the client to ensure their calm cooperation during the admission procedure. Allow the client sufficient time in which to gain an understanding of what is happening to them. Give the client a tour of the unit to acquaint them with the new environment in which they will live.

Allow the client sufficient time in which to gain an understanding of what is happening to them.