NSG 470 Exam 3

C. Feeling of self worth

A long term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop: A. Insight into his behavior B. Better self control C. Feeling of self worth D. Faith in his wife

A. Paranoid thoughts

A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situation? A. Paranoid thoughts B. Emotional affect C. Independence need D. Aggressive behavior

c. Around the clock (ATC)

When developing the plan of care for a patient with chronic pain, the nurse plans interventions based on the knowledge that chronic pain is most effectively relieved when analgesics are administered in what matter? a. On a PRN (as needed) basis b. Conservatively c. Around the clock (ATC) d. Intramuscularly

D. The client's social and cultural norms.

Which assessment is most important when evaluating signs and symptoms of mental illness? A. The decreased amount of creativity a client exhibits. B. The inability to face problems within one's life. C. The intensity of an emotional reaction. D. The client's social and cultural norms.

B. Using open ended question and silence

A male client who is experiencing disordered thinking about food being poisoned is admitted to the mental health unit. The nurse uses which communication technique to encourage the client to eat dinner? A. Focusing on self-disclosure of own food preference B. Using open ended question and silence C. Offering opinion about the need to eat D. Verbalizing reasons that the client may not choose to eat

D. Inability to make choices and decision without advise

A 20 year old client was diagnosed with dependent personality disorder. Which behavior is most likely to be evidence of ineffective individual coping? A. Recurrent self-destructive behavior B. Avoiding relationship C. Showing interest in solitary activities D. Inability to make choices and decision without advise

C. Flight of ideas

A 23 year old client has been admitted with a diagnosis of schizophrenia says to the nurse "Yes, its march, March is little woman". That's literal you know". These statement illustrate: A. Neologisms B. Echolalia C. Flight of ideas D. Loosening of association

C. Effective self boundaries

A 32 year old male graduate student, who has become increasingly withdrawn and neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely that the client will demonstrate: A. Low self esteem B. Concrete thinking C. Effective self boundaries D. Weak ego

C. Feelings of guilt and inadequacy

A 39 year old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often: A. Problems with being too conscientious B. Problems with anger and remorse C. Feelings of guilt and inadequacy D. Feeling of unworthiness and hopelessness

D. Denial

A 60 year old female client who lives alone tells the nurse at the community health center "I really don't need anyone to talk to". The TV is my best friend. The nurse recognizes that the client is using the defense mechanism known as? A. Displacement B. Projection C. Sublimation D. Denial

C. Shallow of labile effect

A 75 year old client is admitted to the hospital with the diagnosis of dementia of the Alzheimer's type and depression. The symptom that is unrelated to depression would be? A. Apathetic response to the environment B. "I don't know" answer to questions C. Shallow of labile effect D. Neglect of personal hygiene

noxious stimuli

A painful stimuli.

a. Mechanical

An elderly patient is confined to bedrest following cervical spine surgery to treat nerve pinching. The nurse is vigilant about turning the patient and assessing the patient regularly to prevent the formation of pressure ulcers. What type of agent is the stimulus for pressure ulcers? a. Mechanical b. Thermal c. Chemical d. Electrical

A. Failure to evaluate and report epidural injection for signs of infection

Duty is established when a professional relationship is established between the nurse and patient. Which of the following best defines breach of duty? A. Failure to evaluate and report epidural injection for signs of infection B. Failure to report addiction to legal authorities C. Administration of opioids for pain D. Failure to employ staff with pain management background

D. Ask the client to acknowledge one positive person in his or her life to assist the client after discharge

Which is an example of an interpersonal intervention for a client on an in-patient psychiatric unit? A. Assist the client to note common defense mechanisms used. B. Discuss "acting out" behaviors, and assist the client in understanding why they occur. C. Ask the client to use a journal to record thoughts he or she is having before acting-out behaviors occur. D. Ask the client to acknowledge one positive person in his or her life to assist the client after discharge

B. Supportive confrontation

Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exist? A. Rationalization B. Supportive confrontation C. Limit setting D. Consistency

D. Regular Coffee

Which of the following foods would the nurse Trish eliminate from the diet of a client in alcohol withdrawal? A. Milk B. Orange Juice C. Tea D. Regular Coffee

A. Myocardial oxygen consumption B. Tachycardia D. Hypercoagulability (leading to increase in deep vein thrombosis) E. Immunosuppression G. Decreased gastric motility H. Catabolism

Which of the following negative physical effects can occur from unresolved pain? Select all that apply: A. Myocardial oxygen consumption B. Tachycardia C. Weight gain D. Hypercoagulability (leading to increase in deep vein thrombosis) E. Immunosuppression F. Night terrors G. Decreased gastric motility H. Catabolism

D. Vomiting and Diarrhea

Which of the following would Nurse Hazel expect to assess for a client who is exhibiting late signs of heroin withdrawal? A. Yawning & diaphoresis B. Restlessness & Irritability C. Constipation & steatorrhea D. Vomiting and Diarrhea

I have decided to solve all my problems

Which statement from a depressed patient might precede a suicide attempt?

Interpersonal Therapy (IPT)

Working on personal relationships that play a key role in the depression

Thyroid

______ disorders/abnormalities are commonly associated with mood disorders. 10% hospitalized depressed patients have hypothyroidism

b. A sedation level of 4

When assessing a patient receiving a continuous opioid infusion, the nurse immediately notifies the physician when the patient has: a. A respiratory rate of 10/min with normal depth b. A sedation level of 4 c. Mild confusion d. Reported constipation

A. Explain the time lag before antidepressants relieve symptoms

A patient was started on Prozac 5 days ago and now says "this medicine isn't working" the nurses's best intervention would be to: A. Explain the time lag before antidepressants relieve symptoms B. Contact the provider and request an alternative medication for the patient C. Tell the patient this is normal D. Encourage the patient to work on mindfulness and deep breathing exercises

d. Respiratory depression

A pregnant woman is receiving an epidural analgesic prior to delivery. The nurse provides vigilant monitoring of this patient to prevent the occurrence of: a. Pruritus b. Urinary retention c. Vomiting d. Respiratory depression

It increases the amount of serotonin available in the synapse.

What is the mechanism of action of Lexapro?

It serves as a protective mechanism to warn us about potential or actual physical damage.

What is the primary function of pain?

Sleep disturbance Appetite disturbance Fatigue Decreased sex drive Psychomotor retardation Variation in mood Impaired concentration Anhedonia

What symptoms of depression to antidepressants help treat?

Depression

-Biologically heterogeneous systemic disorder -Abnormalities in multiple NT's, neurohormones, & neuronal pathways

Group Therapy

-Common modality for treatment -Increases access to care -Offers opportunity for clients to socialize and share common feelings and concerns -Offers opportunity to reach out to find support or offer support -Can offer sense of belonging to decrease symptoms of isolation, hopelessness, helplessness, alienation -Also available for families

Serotonin (5-HT)

-Regulates sleep, appetite & libido -Decrease in this neurotransmitter may result in irritability, poor impulse control, decreased appetite & sex drive

Selective Serotonin Reuptake Inhibitors (SSRIs)

-Selectively block reuptake of serotonin (5-HT, 5- HT1) =more serotonin in synaptic space Uses Depression Obsessive compulsive disorder bulimia nervosa panic disorder PTSD Bipolar disorder

pain

1. Basic bodily sensation that is induced by a noxious stimulus. (elicited pain response to a stimulus) 2. Protective mechanism to warn us to potential or actual physical damage. 3. A state of physical, emotional, or mental lack well-being.

C. The client performs ritualistic hand washing to manage anxiety

A client newly admitted to an in-patient psych unit is diagnosed with OCD which which behavioral symptoms would the nurse expect to assess? A. The client is forgetful and must repeat activities multiple times throughout the day B. The client really enjoys cleaning the house C. The client performs ritualistic hand washing to manage anxiety D. The client develops an obsession with another coworker

C. Sit with the client and speak in a calm voice

A client with panic level anxiety that is experiencing headaches, palpitations, inability to concentrate is admitted to a medical floor. which nursing intervention would take priority? A. Take the patient's vitals B. Administer a benzodiazepine C. Sit with the client and speak in a calm voice D. Ask the client what they were doing before the anxiety started

d. Referred pain

A female patient who is having a myocardial infarction complains of pain that is situated in her jaw. The nurse documents this as what type of pain? a. Transient pain b. Superficial pain c. Phantom pain d. Referred pain

A. Respiratory difficulties

A neuromuscular blocking agent is administered to a client before ECT therapy. The Nurse should carefully observe the client for? A. Respiratory difficulties B. Nausea and vomiting C. Dizziness D. Seizures

b. Pain exists whenever the person experiencing it says it exists. c. Pain is an emotional and sensory reaction to tissue damage. d. Pain is a simple, universal, and easy-to-describe phenomenon. e.. Pain that occurs without a known cause is psychological in nature. f. Pain is classified by duration, location, source, transmission, and etiology.

A nurse instructor is teaching a class of student nurses about the nature of pain. Which statements accurately describe this phenomenon? Select all that apply. a. Pain is whatever the physician treating the pain says it is. b. Pain exists whenever the person experiencing it says it exists. c. Pain is an emotional and sensory reaction to tissue damage. d. Pain is a simple, universal, and easy-to-describe phenomenon. e.. Pain that occurs without a known cause is psychological in nature. f. Pain is classified by duration, location, source, transmission, and etiology.

c. Endorphins

A nurse uses a whirlpool to relax a patient following intense physical therapy to restore movement in her legs. What is a potent pain-blocking neuromodulator, released through relaxation techniques? a. Prostaglandins b. Substance P c. Endorphins d. Serotonin

A. Providing a structured environment

A nursing care plan for a male client with bipolar I disorder should include: A. Providing a structured environment B. Designing activities that will require the client to maintain contact with reality C. Engaging the client in conversing about current affairs D. Touching the client provide assurance

B. visceral

A patient complains of abdominal pain that is difficult to localize. The nurse documents this as which type of pain? A. Cutaneous B. Visceral C. Superficial D. Somatic

Evaluate patient blood work including thyroid panel and electrolytes to rule out other health issues

A patient is admitted to the hospital after increased thoughts of suicide. What is the first thing the nurse should do/assess?

C. Lorazepam (Ativan)

A patient is experiencing alcohol withdrawal exhibits tremors, diaphoresis and hyperactivity. Her blood pressure is 190/87 and pulse is 92. Which of the medications would the nurse expect to administer? A. Naloxone (Narcan) B. Benzlropine (Cogentin) C. Lorazepam (Ativan) D. Haloperidol (Haldol)

d. "Your doctor has ordered pain medications for you, which you should not be afraid to request any time you have pain."

A patient is postoperative following an emergency cesarean section birth. The patient asks the nurse about the use of pain medications following surgery. What would be a correct response by the nurse? a. "It's not a good idea to ask for pain medication regularly as it can be addictive." b. "It is better to wait until the pain gets unbearable before asking for pain medication." c. "It's natural to have to put up with pain after surgery and it will lessen in intensity in a few days." d. "Your doctor has ordered pain medications for you, which you should not be afraid to request any time you have pain."

B. A client exhibits hostile and angry behaviors toward another client.

According to Maslow's hierarchy of needs, which situation on an in-patient psychiatric unit would require priority intervention? A. A client is disturbed that family can be seen only during visiting hours. B. A client exhibits hostile and angry behaviors toward another client. C. A client states, "I have no one who cares about me." D. A client states, "I have never met my career goals."

pain

An unpleasant sensory and emotional experience associated with actual or potential tissue damage.

b. Applying a moist heating pad to the area at prescribed intervals

Applying the gate control theory of pain, what would be an effective nursing intervention for a patient with lower back pain? a. Encouraging regular use of analgesics b. Applying a moist heating pad to the area at prescribed intervals c. Reviewing the pain experience with the patient d. Ambulating the patient after administering medication

A. Numeric Pain Intensity Scale and Visual Analog Scale

Assessment of acute pain includes determining the location of the pain, a description of the type of pain (in the patient's own words), and an evaluation of the pain intensity and duration. What are some of the tools used to establish the intensity of the pain? A. Numeric Pain Intensity Scale and Visual Analog Scale B. McGill Pain Questionnaire C. Pain Outcomes Questionnaire D. Brief Pain Inventory

Cognitive Behavioral Therapy (CBT)

Changes negative patterns of thinking and behavior More successful in preventing relapse than meds Helps prevent against relapse

mania

Characterized by: thoughts of grandiosity pressured speech psychomotor agitation flight of ideas

Beck's cognitive triad

Cognitive view on depression, negative ways of thinking about their experiences, themselves and their futures cause depression Negative thoughts about the self, the world, and the future

Mindfulness-Based Cognitive Therapy (MBCT)

Combination of cognitive behavioral therapy and mindfulness-based stress reduction (MBSR) Effective for relapse/recurrence of major depressive disorder

B. Discuss the meaning of the client's statement with her

Conney with borderline personality disorder who is to be discharge soon threatens to "do something" to herself if discharged. Which of the following actions by the nurse would be most important? A. Ask a family member to stay with the client at home temporarily B. Discuss the meaning of the client's statement with her C. Request an immediate extension for the client D. Ignore the clients statement because it's a sign of manipulation

Norepinephrine (NE)

Decrease in this neurotransmitter can cause: anergia anhedonia decreased concentration decreased libido

Genetic factors must interact with environmental factors and neurobiological preconditions for depression to develop

Describe how genetics are linked to the development of depression.

D. Muscle relaxations given to prevent injury during seizure activity depress respirations.

During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is necessary because? A. Anesthesia is administered during the procedure B. Decrease oxygen to the brain increases confusion and disorientation C. Grand mal seizure activity depresses respirations D. Muscle relaxations given to prevent injury during seizure activity depress respirations.

Anti-depressants do not cause suicide (at least it hasn't been proven yet). They do help give a person increased energy and make them feel better, which might give them the motivation to commit suicide.

Explain the relationship between anti depressants and suicide.

B. Report increased suicidal thoughts

Information given to a depressed 20-year-old client and family when the client begins selective serotonin re-uptake inhibitor antidepressant therapy should include the directive to: A. Report and s/s of headache, nausea, or weight gain B. Report increased suicidal thoughts C. Expect the drug's full therapeutic effect to occur after the first week D. Do not drink milk with an SSRI

A. Defensiveness

Joey a client with antisocial personality disorder belches loudly. A staff member asks Joey, "Do you know why people find you repulsive?" this statement most likely would elicit which of the following client reaction? A. Defensiveness B. Embarrassment C. Shame D. Remorseful

B. Would you like me to talk with you?

Linda is pacing the floor and appears extremely anxious. The duty nurse approaches in an attempt to alleviate Linda's anxiety. The most therapeutic question by the nurse would be? A. Would you like to watch TV? B. Would you like me to talk with you? C. Are you feeling upset now? D. Ignore the client

B. This information is incorrectly placed because Axis III reports medical diagnoses.

Looking at a client's history and physical examination, the nursing student notes that borderline personality disorder is placed on Axis III. Based on knowledge of the DSM-IV-TR, which is a correct statement? A. This information is correctly placed because Axis III reports personality disorders. B. This information is incorrectly placed because Axis III reports medical diagnoses. C. This information is incorrectly placed because Axis III reports a Global Assessment of Functioning (GAF). D. This information is correctly placed because Axis III reports major psychiatric diagnoses.

D. Aversion Therapy

Marco approached Nurse Trish asking for advice on how to deal with his alcohol addiction. Nurse Trish should tell the client that the only effective treatment for alcoholism is: A. Psychotherapy B. Alcoholics anonymous (A.A.) C. Total abstinence D. Aversion Therapy

B. Name of the ingested medication & the amount ingested

Mario is admitted to the emergency room with drug-included anxiety related to over ingestion of prescribed antipsychotic medication. The most important piece of information the nurse in charge should obtain initially is the: A. Length of time on the med. B. Name of the ingested medication & the amount ingested C. Reason for the suicide attempt D. Name of the nearest relative & their phone number

a. Acute Pain related to fear of taking prescribed postoperative medications

Mr. Wright is recovering from abdominal surgery. When the nurse assists him to walk, she observes that he grimaces, moves stiffly, and becomes pale. She is aware that he has consistently refused his pain medication. What would be a priority nursing diagnosis for this patient? a. Acute Pain related to fear of taking prescribed postoperative medications b. Impaired Physical Mobility related to surgical procedure c. Anxiety related to outcome of surgery d. Risk for Infection related to surgical incision

B. limiting unnecessary interaction

Nurse Anna can minimize agitation in a disturbed client by? A. Increasing stimulation B. limiting unnecessary interaction C. increasing appropriate sensory perception D. ensuring constant client and staff contact

C. Confabulation

Nurse Benjie is communicating with a male client with substance-induced persisting dementia; the client cannot remember facts and fills in the gaps with imaginary information. Nurse Benjie is aware that this is typical of? A. Flight of ideas B. Associative looseness C. Confabulation D. Concretism

A. Hallucinations

Nurse Hazel is caring for a male client who experience false sensory perceptions with no basis in reality. This perception is known as: A. Hallucinations B. Delusions C. Loose associations D. Neologisms

A. Excessive weight loss, amenorrhea & abdominal distension

Nurse Joey is aware that the signs & symptoms that would be most specific for diagnosis anorexia are? A. Excessive weight loss, amenorrhea & abdominal distension B. Slow pulse, 10% weight loss & alopecia C. Compulsive behavior, excessive fears & nausea D. Excessive activity, memory lapses & an increased pulse

A. "Abuse occurs more in low income families"

Nurse Jonel is providing information to a community group about violence in the family. Which statement by a group member would indicate a need to provide additional information? A. "Abuse occurs more in low income families" B. "Abuser Are often jealous or self-centered" C. "Abuser use fear and intimidation" D. "Abuser usually have poor self-esteem"

B. Set-up a strict eating plan for the client

Nurse Maureen is developing a plan of care for a female client with anorexia nervosa. Which action should the nurse include in the plan? A. Provide privacy during meals B. Set-up a strict eating plan for the client C. Encourage client to exercise to reduce anxiety D. Restrict visits with the family

B. Routine Activities

Nurse Monette is aware that extremely depressed clients seem to do best in settings where they have: A. Multiple stimuli B. Routine Activities C. Minimal decision making D. Varied Activities

A. Manipulate the environment to bring about positive changes in behavior

Nurse Monette recognizes that the focus of environmental (MILIEU) therapy is to: A. Manipulate the environment to bring about positive changes in behavior B. Allow the client's freedom to determine whether or not they will be involved in activities C. Role play life events to meet individual needs D. Use natural remedies rather than drugs to control behavior

C. Sit beside the client in silence and occasionally ask open-ended question

Nurse Nina is assigned to care for a client diagnosed with Catatonic Stupor. When Nurse Nina enters the client's room, the client is found lying on the bed with a body pulled into a fetal position. Nurse Nina should? A. Ask the client direct questions to encourage talking B. Take the client into the dayroom to be with other clients C. Sit beside the client in silence and occasionally ask open-ended question D. Leave the client alone and continue with providing care to the other clients

A. Cardiac dysrhythmias resulting to cardiac arrest

Nurse Patricia is aware that the major health complication associated with intractable anorexia nervosa would be? A. Cardiac dysrhythmias resulting to cardiac arrest B. Glucose intolerance resulting in protracted hypoglycemia C. Endocrine imbalance causing cold amenorrhea D. Decreased metabolism causing cold intolerance

D. Re-experiencing the trauma in dreams or flashback

Nurse Penny is aware that the symptoms that distinguish post traumatic stress disorder from other anxiety disorder would be: A. Avoidance of situation & certain activities that resemble the stress B. Depression and a blunted affect when discussing the traumatic situation C. Lack of interest in family & others D. Re-experiencing the trauma in dreams or flashback

D. "I know you are frightened, but I do not see spiders on the wall"

Nurse Tina is caring for a client with delirium and states that "look at the spiders on the wall". What should the nurse respond to the client? A. "You're having hallucination, there are no spiders in this room at all" B. "I can see the spiders on the wall, but they are not going to hurt you" C. "Would you like me to kill the spiders" D. "I know you are frightened, but I do not see spiders on the wall"

D. Electroconvulsive therapy

Nurse Tina is caring for a client with depression who has not responded to antidepressant medication. The nurse anticipates that what treatment procedure may be prescribed? A. Neuroleptic medication B. Short term seclusion C. Psychosurgery D. Electroconvulsive therapy

A. Generates new levels of awareness

Nurse Tony is caring for a 41 year old female client. Which behavior by the client indicates adult cognitive development? A. Generates new levels of awareness B. Assumes responsibility for her actions C. Has maximum ability to solve problems and learn new skills D. Her perception are based on reality

C. Be able to develop only superficial relation with the others

Nurse Trish would expect a child with a diagnosis of reactive attachment disorder to: A. Have more positive relation with the father than the mother B. Cling to mother & cry on separation C. Be able to develop only superficial relation with the others D. Have been physically abuse

A. Setting strict limits and communicating these limits to all staff members.

On an in-patient psychiatric unit, a client diagnosed with borderline personality dis-order is challenging other clients and splitting staff. Which response by the nurse reflects the nurse's role of milieu manager? A. Setting strict limits and communicating these limits to all staff members. B. Using role-play to demonstrate ways of dealing with frustration. C. Seeking orders from the physician to force medications. D. Holding a group session on relationship skills

D. "This medication will probably take 2 to 4 weeks to be effective."

On an in-patient psychiatric unit, a client diagnosed with major depressive disorderstates, "I'm so glad that the Zoloft that my doctor just prescribed will quickly help me with my mood." Which nursing response reflects the role of teacher? A. "I'll set up a time with your doctor to clarify information about this medication." B. "Let's talk about how you feel about taking this new medication." C. "It's great that you have learned this information about your new medication." D. "This medication will probably take 2 to 4 weeks to be effective."

a. A patient is receiving chemotherapy for bladder cancer. d. A patient who has fibromyalgia requests pain medication. e. A patient has back pain related to an accident that occurred last year.

One of the most common distinctions of pain is whether it is acute or chronic. Which examples describe chronic pain? Select all that apply. a. A patient is receiving chemotherapy for bladder cancer. b. An adolescent is admitted to the hospital for an appendectomy. c. A patient is experiencing a ruptured aneurysm. d. A patient who has fibromyalgia requests pain medication. e. A patient has back pain related to an accident that occurred last year. f. A patient is experiencing pain from second-degree burns.

neuropathic pain

Pain is caused by damage to the brain, spinal cord, or peripheral nerves. Typically presents as a burning, tingling, shooting, stinging, or "pins and needles" sensation.

somatic pain

Pain that is caused by the activation of pain receptors in either the body surface or musculoskeletal tissues. It is usually described as dull or aching. Is usually aggravated by activity and relieved by rest. There may be an abnormality of neurotransmitters contributing to the perception of pain.

visceral pain

Pain that is mediated by nociceptors. It is described as deep, aching and colicky (achey/cranky/comes and goes). It is often dispersed throughout the body and referred to cutaneous sites, which may be tender. Example may include damage to internal organs

B. Teaching physical and psychosocial effects of stress to elementary school students.

Primary prevention in a community mental health setting is exemplified by which of the following concepts? A. Ongoing assessment of individuals at high risk for illness exacerbation. B. Teaching physical and psychosocial effects of stress to elementary school students. C. Referral for treatment of individuals in whom illness symptoms have been assessed. D. Monitoring effectiveness of aftercare services

Selective Serotonin Reuptake Inhibitors (SSRIs)

The following drugs belong in what category of antidepressants? Fluoxetine (Prozac) Paroxetine (Paxil) Fluvoxamine (Luvox) Sertraline (Zoloft) Citalopram (Celexa) Escitalopram (Lexapro)

a. CRIES scale

The nurse is assessing the pain of a neonate who is admitted to the NICU with a heart defect. Which pain assessment scale would be the best tool to use with this patient? a. CRIES scale b. COMFORT scale c. FLACC scale d. FACES scale

a. A patient cradles a wrist that was injured in a car accident. b. A child is moaning and crying due to a stomachache. f. A child pulls away from a nurse trying to give him an injection.

The three types of responses to pain are physiologic, behavioral, and affective. Which are examples of behavioral responses to pain? Select all that apply. a. A patient cradles a wrist that was injured in a car accident. b. A child is moaning and crying due to a stomachache. c. A patient's pulse is increased following a myocardial infarction. d. A patient in pain strikes out at a nurse who attempts to bathe him. e. A patient who has chronic cancer pain is depressed and withdrawn. f. A child pulls away from a nurse trying to give him an injection.

D. Respect client's need for personal space

To establish open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should? A. Encourage the staff to have frequent interaction with the client B. Share an activity with the client C. Give client feedback about behavior D. Respect client's need for personal space

D. A and C A. Increased myocardial oxygen consumption and catabolism C. Immunosuppression and increase in deep vein thrombosis

Unresolved pain results in the body's stress response and the release of stress hormones. Which of the following conditions occur when pain is unrelieved? A. Increased myocardial oxygen consumption and catabolism B. Bradycardia and fluid retention C. Immunosuppression and increase in deep vein thrombosis D. A and C

1. Selective Serotonin Re-Uptake Inhibitors (SSRI's) 2. Tricyclics (TCA's) 3. Serotonin/Norepinephrine Re-Uptake Inhibitors (SNRI's/NRIs) 4. Atypical Antidepressants 5. Monoamine Oxidase Inhibitors (MAOI's)

What are 5 drug categories used to treat depression?

1. Psychotropic medications 2. Antidepressant Medications (Ads) 3. Electroconvulsive Therapy (ECT) 4. Vagus Nerve Stimulation (VNS) 5. Transcranial Magnetic Stimulation (TMS) 6. Light Therapy

What are 5 examples of somatic treatments?

-Parkinson's -Huntington's -Stroke/Cardiovascular disease -Metabolic dysfunctions (Diabetes, Thyroid, Adrenal) -Lupus -Infections -Cancer -MS

What are some diseases/disorders that might increase a person's risk of developing depression?

-Death of a loved one, divorce, romantic break-up (Losses) -Loss of job, bankruptcy, legal difficulties -Moving -Medical illness, trauma -Conflicts with a boss or coworker -Childbirth (post-partum) -Academic failure or pressures

What are some environmental triggers for depression?

Depressive disorder rates vary across cultural/ethnicity Symptom presentation can be substantially different among different cultures (e.g. somatic complaints)

What are some of the cultural considerations of depression?

-History of previous episodes/Family HX -History of suicide attempts -Chronic illness -Stressful life events/Lack of social supports -Alcohol or substance abuse -Hx of sexual abuse -Female gender -Postpartum -Early life trauma

What are some risk factors for developing depression?

-Lethality (do not forget you are mandated reporters) -Suicidality (previous attempts?, plan?, means?, FH of suicide?) -Homicidality -Medical/Neurological examination -R/O organic causes -Comorbid medical conditions -Substance use -Other mental health disorders (e.g. eating d/o, personality d/o, anxiety d/o, etc.) -History of depression -Support systems -Triggers -Psychosocial, cultural, spiritual beliefs

What are some things the nurse should assess for when caring for a client with depression?

-abdominal cramping -tremors -restlessness -inability to sleep -increased HR/BP, respirations, temp -palpitations -nausea/vomiting -seizures -transitory illusions - misinterpretations of objects in environment

What are the signs and symptoms of alcohol withdrawal? (9)

b. Inadequate or inconsistent relief of pain is widespread.

When assessing pain in a child, the nurse needs to be aware of what considerations? a. Immature neurologic development results in reduced sensation of pain. b. Inadequate or inconsistent relief of pain is widespread. c. Reliable assessment tools are currently unavailable. d. Narcotic analgesic use should be avoided.