Psych Exam 2
When a nurse assesses the style of behavior a child habitually uses to cope with the demands and expectations of the environment, he or she is assessing characteristic? Temperament Resilience Vulnerability Cultural assimilation
Temperament
Which activity is most appropriate for a child with ADHD? a. Reading an adventure novel b. Monopoly c. Checkers d. Tennis
Tennis
Which statement demonstrates a well-structured attempt at limit setting? a. "Hitting me when you are angry in unacceptable." b. "I expect you to behave yourself during dinner." c. "Come here, right now!" d. "Good boys don't bite."
"Hitting me when you are angry is unacceptable."
A child diagnosed with attention deficit hyperactivity disorder (ADHD) is reprimanded for taking the nurse's pen without asking first. He responds by shouting, "You don't like me! You won't let me have anything, even a pen!" The nurse is most therapeutic when responding with which statement? "I do like you, but I don't like it when you grab my pen." "Liking you has nothing to do with whether I will loan you my pen." "It sounds as though you are feeling helpless and insecure." "You must ask for permission before taking someone else's things."
"I do like you, but I don't like it when you grab my pen."
A 38-year-old patient is admitted with major depression. Which statement made by the patient alerts the nurse to a common accompaniment to depression? "I still pray and read my Bible every day." "My mother wants to move in with me, but I want to independent." "I still feel bad about my sister dying of cancer. I should have done more for her!" "I've heard others say that depression is a sign of weakness."
"I still feel bad about my sister dying of cancer. I should have done more for her!"
Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met? "I really think I can succeed in school now." "I'm experiencing much less anxiety about school now." "Going back to school is hard and I'll need support." "I know that I'm not the only person who has a difficult time in school."
"I'm experiencing much less anxiety about school now."
A depressed, socially withdrawn client tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse can best address this cognitive distortion with which response? "Let's look at what you just said, that you can 'never do anything right.'" "Tell me what things you think you are not able to do correctly." "Is this part of the reason you think no one likes you?" "That is the most unrealistic thing I have ever heard."
"Let's look at what you just said, that you can 'never do anything right."
The mother of a 3-year-old boy just diagnosed with autism spectrum is tearful and states, "The doctor said we need to start therapy right away. I just don't understand how helpful it will be—he's only 3 years old!" What response should the nurse provide to the mother's statement? "You are right, 3 years old is very young to start therapy, but it will make you feel better to be doing something." "Starting him on treatment now gives Taylor a much greater chance for a productive life." "If your child starts therapy now, he will be able to stop therapy sooner." "If you have questions, its best to ask the doctor."
"Starting him on treatment now gives Taylor a much greater chance for a productive life."
A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement? "What I did was stupid." "I am not as smart as others." "Things usually go wrong for me." "Things like this should not happen to anyone."
"What I did was stupid."
Which child is demonstrating behaviors that support a diagnosis of adolescent onset conduct disorder? A 12-year-old male who steals a bicycle as a gang initiation A 9-year-old male who smokes half a pack of cigarettes a day A 12-year-old female who regularly bullies her younger siblings A 9-year-old female who engages in sexually provocative behaviors
A 12-year-old male who steals a bicycle as a gang initiation
How does Harry Stack Sullivan's Interpersonal Theory view anxiety? An emotional experience felt after the age of 5 years. A sign of guilt in adults. A painful emotion arising from social insecurity. The result of trying to go beyond experiences of guilt and pain.
A painful emotion arising from social insecurity.
Which room placement would be best for a client experiencing a manic episode? A shared room with a client with dementia A single room near the unit activities area A single room near the nurses' station A shared room away from the unit entrance
A single room near the nurses' station
Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? SATA: a. limited language skills b. level of cognitive development c. level of emotional development d. parental denial that a problem exists e. severity of the typical mental illnesses observed in young children
A, B, C
In pediatric mental health there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: SATA a. Children of color and poor economic conditions being underserved b. Increased stress in the family unit c. Markedly increased funding d. Premature termination of services
A, B, D
What assessment question should the nurse ask when attempting to determine a teenager's mental health resilience? SATA: a. "How did you cope when your father deployed with the Army for a year in Iraq?" b. "Who did you go to for advice while your father was away for a year in Iraq?" c. "How do you feel about talking to a mental health counselor?" d. "Where do you see yourself in 10 years?" e. "Do you like the school you go to?"
A, B, D
Which comorbid conditions are commonly associated with oppositional defiant disorder? Select all that apply. Conversion disorder Attention deficit hyperactivity disorder (ADHD) Depression Anxiety Substance abuse
ADHD Depression Anxiety
The family of a child diagnosed with attention deficit hyperactivity disorder (ADHD), inattentive type, is told the evaluation of their child's care will focus on symptom patterns and severity. What is the focus of child's evaluation? SATA: Academic performance Activities of daily living Physical growth Social relationships Personal perception
Academic performance Activities of daily living Social relationships Personal perception
What is a desired outcome for the maintenance phase of treatment for a manic client? Exhibit optimistic, energetic, playful behavior. Adhere to follow-up medical appointments. Take medication more than 50% of the time. Use alcohol to moderate occasional mood "highs."
Adhere to follow-up medical appointments.
According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory? Recent memory Long-term memory All memories Painful memories
All memories
A 12-year-old male patient diagnosed with Tourette's disorder is visiting his provider. The nurse will prepare medication teaching on which class of medication to help manage the tics associated with this disorder? SATA: Mood stabilizers Antianxiety agents Anticholinesterase inhibitors First-generation antipsychotics Second-generation antipsychotics
Antianxiety agents First-generation antipsychotics Second-generation antipsychotics
As an adult, a client who has been diagnosed with childhood-onset conduct disorder is at high risk for developing which comorbid disorder? Antipersonality disorder Obsessive-compulsive disorder Kleptomania Depression
Antipersonality disorder
A new psychiatric technician mentions to the nurse, "Depression seems to be a disease of old people. All the depressed clients on the unit are older than 60 years." How should the nurse respond to this statement? "That is a good observation. Depression does mostly strike people older than 50 years." "Depression is seen in people of all ages, from childhood to old age." "Depression is most often seen among the middle adult age group." "The age of onset for most depressive episodes is given as 18 years."
"Depression is seen in people of all ages, from childhood to old age."
Which social behavior is often a result of a child having been exposed to some form of abuse? Speech disorders Bullying others Eating disorders Delayed motor skills
Bullying others
Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence D/T: a. Limited executive function b. Cerebellum maturation c. Cerebral stasis and hormonal change d. A slight reduction in brain volume
Cerebellum maturation
The nurse is preparing to set goals for a 10-year-old diagnosed with an impulse control disorder. To best ensure the expected therapeutic outcomes, the nurse includes goals that focus on what client need? Client centered and includes the client's input Age appropriate and achievable in a short period of time Simple and easily defined Family centered and long term in nature
Client centered and includes the client's input
A nurse is providing teaching to an adolescent client who has a new prescription for clomipramine for OCD. Which of the following information should the nurse provide? a. Eat a diet high in fiber b. Check temperature daily c. Take medication first thing in the morning before eating d. Add extra calories to the diet as between-meal snacks
Eat a diet high in fiber (Eating a diet high in fiber will decrease constipation, an anticholinergic effect associated with TCA use)
When treating impulse control disorders, psychodynamic psychotherapy is directed toward which goal? Mastering relaxation techniques Identifying the triggers of the rage Teaching the client self-distracting techniques Helping the client replace the rage with acceptable alternative feelings
Identifying the triggers of the rage
The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention? Giving the child what he/she is asking for Scolding the child when he/she displays tantrum behaviors Spanking the child at the onset of the tantrum behaviors Ignoring the tantrum and giving attention when the child acts appropriately
Ignoring the tantrum and giving attention when the child acts appropriately
A nurse is providing care to a 28-year-old patient diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which patient symptom as having priority? Rapid, pressured speech Grandiose thoughts Lack of sleep Hyperactive behavior
Lack of sleep
Which nursing intervention demonstrates the theory behind operant conditioning? Rewarding the client with a token for avoiding an argument with another client Showing the client how to be assertive without being aggressive Demonstrating deep breathing techniques to a group of clients Explaining to the client the consequences of not following unit rules
Rewarding the client with a token for avoiding an argument with another client
Cognitive-behavioral therapy is going well when a 12-year old patient in therapy reports to the practitioner: a. "I was so mad I wanted to hit my mother." b. "I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd." c. "I forgot that you told me to breathe when I become angry." d. "I scream as loud as I can when the train goes by the house."
"I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd."
A client prescribed fluoxetine demonstrates an understanding of the medication teaching when making which statement? "I will make sure to get plenty of sunshine and not use sunscreen to avoid a skin reaction." "I will not take any over-the-counter medication while on the fluoxetine." "I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away." "I will report increased thirst and urination to my provider."
"I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away."
Which statement would best show acceptance of a depressed, mute client? "I will be spending time with you each day to try to improve your mood." "I would like to sit with you for 15 minutes now and again this afternoon." "Each day we will spend time together to talk about things that are bothering you." "It is important for you to share your thoughts with someone who can help you evaluate your thinking."
"I would like to sit with you for 15 minutes now and again this afternoon."
What are the foundational concerns regarding the use of restraint and seclusion when providing care to children? SATA: Parents may initiate a lawsuit if injury occurs. Staff have conflicted feelings leading to ineffectiveness. Research suggests both are psychologically and physically harmful. Staff tends to be undertrained in use of restraints in children. The principle of least restrictive intervention is a primary concern.
Research suggests both are psychologically and physically harmful. The principle of least restrictive intervention is a primary concern.
Which factor can reduce the vulnerability of a child to etiological influences predisposing to the development of psychopathology? Resilience Malnutrition Child abuse Having a depressed parent
Resilience
A client prescribed a monamine oxidase inhibitor (MOA) has a pass to go out to lunch. Given a choice of the following entrees, the client can safely eat avocado salad plate. fruit and cottage cheese plate. kielbasa and sauerkraut. liver and onion sandwich.
fruit and cottage cheese plate
A child diagnosed with autism will demonstrate impaired development in which area? Adhering to routines playing with other children swallowing and chewing eye-hand coordination
playing with other children
When a hyperactive manic client expresses the intent to strike another client, the initial nursing intervention would be to question the client's motive. set verbal limits. initiate physical confrontation. prepare the client for seclusion.
set verbal limits
A poorly developed sense of empathy is thought to be the result of having what life experience? A family history of mental illness a low serum testosterone level suffered head trauma at an early age unmet physical and emotional needs
unmet physical and emotional needs
Which behavior consistently demonstrated by a child is a predictor of future antisocial personality disorder in adults? Sadness Remorse Guilt Callousness
Callousness
Pam, the nurse educator, is teaching a new nurse about seclusion and restraint. Order the following interventions from least (1) to most (5) restrictive: a. With the patient identify the behaviors that are unacceptable and consequences associated with harmful behaviors b. Placing the patient in physical restraints c. Allowing the patient to take a time-out and sit in his or her room d. Offering a PRN medication by mouth e. Placing the patient in a locked seclusion room
a- 1 b- 5 c- 3 d- 2 e- 4
Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority? Assessing the client's ability to fulfill appropriate developmental level tasks Assessing the client for strengths upon which a nurse-client relationship can be based Planning one-on-one time to assist in identifying the fears trigger the client's anxiety Evaluating the client's ability to learn and retain essential information regarding their current condition
Assessing the client for strengths upon which a nurse-client relationship can be based
Dysthymia cannot be diagnosed unless it has existed for what period of time? At least 3 months At least 6 months At least 1 year At least 2 years
At least 2 years
A 7-year-old, who is described as impulsive and hyperactive, tells the nurse, "I am a dummy, because I don't pay attention, and I can't read like the other kids." The nurse notes that these behaviors are most consistent with which diagnosis? Attention deficit disorder Attention deficit hyperactivity disorder Autism Conduct disorder
Attention deficit hyperactivity disorder
A nurse is teaching a client who has intermittent explosive disorder about a new prescription for fluoxetine. Which of the following information should the nurse provide? SATA: a. An adverse effect of this medication is CNS depression b. Administer the medication in the morning c. Monitor for weight loss while taking this medication d. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop e. This medication blocks the blocking the synaptic reuptake of serotonin in the brain
B, C, E Fluoxetine should be administered in the morning d/t potential for insomnia. Can cause weight loss. Works by blocking the synaptic reuptake of serotonin, allowing more serotonin to stay at the junction of the neurons. An adverse effect is CNS stimulation.
What is the premise underlying behavioral therapy? Behavior is learned and can be modified. Behavior is a product of unconscious drives. Motives must change before behavior changes. Behavior is determined by cognitions; change in cognitions produces new behavior.
Behavior is learned and can be modified.
When a child demonstrates a temperament that prompts the mother to say, "She is just so different from me; I just can't seem to connect with her." The nurse should plan to provide which intervention? Suggest that the child's father become her primary caregiver. Encourage the mother to consider attending parenting classes. Counsel the mother regarding ways to better bond with her child. Educate the father regarding signs that the child is being physically abused.
Counsel the mother regarding ways to better bond with her child.
What term is used to identify the condition demonstrated by a person who has numerous hypomanic and dysthymic episodes over a two-year period? Bipolar II disorder. Bipolar I disorder. Cyclothymia. Seasonal affective disorder.
Cyclothymia.
A client hospitalized for a psychotic relapse is being discharged home to family. Which topic is important to address when teaching both the patient and the family to recognize possible signs of impending mania? Increased appetite Decreased social interaction Increased attention to bodily functions Decreased sleep
Decreased sleep
Freud believed that individuals cope with anxiety by implementing which mechanism? The superego Defense mechanisms Security operations Cognitive distortions
Defense mechanisms
What statement about the comorbidity of depression is accurate? Depression most often exists in an individual as a single entity. Depression is commonly seen in individuals with medical disorders. Substance abuse and depression are seldom seen as comorbid disorders. Depression may coexist with other disorders but is rarely seen with schizophrenia.
Depression is commonly seen in individuals with medical disorders.
A manic client tells a nurse "Bud. Crud. Dud. I'm a real stud! You'd like what I have to offer. Let's go to my room." What is the best initial approach to managing this behavior? Reprimand the client by stating, "What an offensive thing to suggest!" Clarifying the nurse-client relationship by stating, "I don't have sex with clients." Distracting the client by suggesting, "It's time to work on your art project." Enforcing consequences by responding, "Let's walk down to the seclusion room."
Distracting the client by suggesting, "It's time to work on your art project."
Which client problem would be most suited to the use of interpersonal therapy? Disturbed sensory perception Impaired sensory perception Medication noncompliance Dysfunctional grieving
Dysfunctional grieving
The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience? Spending one-on-one time with staff to establish trust Providing them with the opportunity to select which unit activities they will participate in to gain autonomy Encouraging them to talk about their school plans to help achieve identity Assign them to help clean up the dayroom to develop a sense of industry
Encouraging them to talk about their school plans to help achieve identity
Which of the following describe the symptoms of the manic phase of bipolar disorder? Select all that apply. Excessive energy Fatigue and increased sleep Low self-esteem Pressured speech Purposeless movement Racing thoughts Withdrawal from environment Distractibility
Excessive energy Pressured speech Purposeless movement Racing thoughts Distractibility
A client diagnosed with conduct disorder craves what experience? Excitement without concern for possible negative outcomes Control of situations and constantly strategizes for such power Friendship but from those older than themselves Material possessions but lacks focus and direction
Excitement without concern for possible negative outcomes
A client prescribed a selective serotonin reuptake inhibitor mentions taking the medication along with the St. John's wort daily. The nurse should provide the client with what information regarding this practice? Agreeing that this will help the client to remember the medications. Caution the client to drink several glasses of water daily. Suggest that the client also use a sun lamp daily. Explain the high possibility of an adverse reaction.
Explain the high possibility of an adverse reaction.
A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement? The biological model is the oldest and most reliable model for explaining mental illness. The biological model has been proven to be successful in finding the cause of most symptoms of mental illness. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.
In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.
The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of the "id" and the ability to function as an adult? It has control over the emotional frustration felt as an adult. It is the source of one's survival instincts. It is severely damaged by abuse experienced before the age of 5 years. It provides an individual with the ability to differentiate believed and real experiences.
It is the source of one's survival instincts.
Pyromania, a behavior associated with impulse control disorders, causes an individual to engage in what behavior? Starting fires Stealing for thrill Self-mutilate Directing anger toward others
Starting fires
A depressed client tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse should identify this cognitive distortion as what response? Self-blame Catatonia Learned helplessness Discounting positive attributes
Learned helplessness
What is the first-line drug used to treat mania? Lithium carbonate Carbamazepine Lamotrigine Clonazepam
Lithium carbonate
An 8-year-old patient is newly diagnosed with attention deficit hyperactivity disorder (ADHD). It is important that the parents be educated to the fact that symptoms will take which form? (Select all that apply). of, inattention, and impulsivity have to be apparent: Low frustration tolerance Poor school performance Impulsive behaviors Easily intimidated Mood swings
Low frustration tolerance Poor school performance Impulsive behaviors Mood swings
The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority? Making the client feel physically and emotionally safe Teaching the client effective coping skills Identifying the client's positive traits Focusing on preparing the client for a speedy discharge
Making the client feel physically and emotionally safe
Role-playing is associated with which type of psychotherapy? Psychoanalysis Modeling Operant conditioning Systematic desensitization
Modeling
Beck's cognitive theory suggests that the etiology of depression is related to what factor? Sleep abnormalities Serotonin circuit dysfunction Negative processing of information S belief that one has no control over outcomes
Negative processing of information
When the clinician mentions that a client has anhedonia, the nurse can expect that the client will demonstrate what behavior? Poor retention of recent events A weight loss from anorexia No pleasure from previously enjoyed activities Difficulty with tasks requiring fine motor skills
No pleasure from previously enjoyed activities
Which statement about antidepressant medications, in general, can serve as a basis for client and family teaching? Onset of action is from 1 to 3 weeks or longer. They tend to be more effective for men. Recent memory impairment is commonly observed. They often cause the client to have diurnal variation.
Onset of action is from 1 to 3 weeks or longer.
When working with a client demonstrating impulse control disorders, which nursing interventions have initial priority? Select all that apply. Providing a safe environment Establishing a therapeutic nurse-client relationship Setting and enforcing limits Confronting the client concerning the disruptive behavior Presenting appropriate expectations
Providing a safe environment Establishing a therapeutic nurse-client relationship Setting and enforcing limits Presenting appropriate expectations
A depressed client is noted to pace most of the time, pull at her clothes, and wring her hands. These behaviors are consistent with which term? Senile dementia Hypertensive crisis Psychomotor agitation Central serotonin syndrome
Psychomotor agitation
When a client experiences four or more mood episodes in a 12-month period, which term is used to describe this behavior? Dyssynchronous Incongruent Cyclothymic Rapid cycling
Rapid cycling
A nurse is caring for a school age child who has conduct disorder and a new prescription for methylphenidate transdermal patches. Which of the following information should the nurse provide about the medication? a. Apply the patch once daily at bedtime b. Place the patch carefully in a trash can after removal c. Apply the transdermal patch to the anterior waist area d. Remove the patch each day after 9 hours
Remove the patch each day after 9 hr Applied once daily in morning on the hip- avoiding the waist- and removed after 9 hours. Old patches should be folded and flushed down the toilet.
What is the priority nursing diagnosis for a hyperactive manic client during the acute phase of treatment? Risk for injury Ineffective role performance Risk for other-directed violence Impaired verbal communication
Risk for injury
Which nursing diagnosis should be considered for a child with attention deficit hyperactivity disorder ADHD? Anxiety risk for injury defensive coping impaired verbal communication
Risk for injury
A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept? Emotional consequence Schema Actualization Aversion
Schema Schemas are unique assumptions about ourselves, according to Beck's theory. This statement is an example of a negative schema. Emotional consequence is the end result of negative thinking process, as described by Ellis. Actualization is a level of Maslow's Hierarchy of Needs. Aversion is a therapy characterized by punishment.
A nurse is teaching the parents of a child who has autism spectrum disorder and a new prescription for imipramine about indications of toxicity. Which of the following should the nurse include in the teaching? SATA: a. Seizures b. Agitation c. Photophobia d. Dry mouth e. Irregular pulse
Seizures, agitation and irregular pulse are all indications of TCA toxicity
Assessment of the thought processes of a client diagnosed with depression is most likely to reveal what characteristic? Good memory and concentration Delusions of persecution Self-deprecatory ideation Sexual preoccupation
Self-deprecatory ideation
Which theorist is associated with behavioral therapy? Freud Skinner Sullivan Peplau
Skinner
A 5-year-old who consistently omits the sound for 'r' and 's' when speaking is demonstrating which type of disorder? Speech Language Social communication Specific learning
Speech
Which of the following is true of the relationship between bipolar disorder and suicide? Patients need to be monitored only in the depressed phase because this is when suicides occur. Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide. Patients with bipolar disorder are not considered high risk for suicide. As long as patients with bipolar disorder adhere to their medication regimen, there is little risk for suicide.
Suicide is a serious risk because nearly 20% of those diagnosed with bipolar disorder commit suicide.
When the nurse asks whether a client is having any thoughts of suicide, the client becomes angry and defensive, shouting, "I'm sick of you people! Are you ever do is ask me the same question over and over. Get out of here!" The nurse's response is based on what fact concerning hostility? The client is getting better and is able to be assertive. The client may be at high risk for self-harm. The client is probably experiencing transference. The client may be angry at someone else and projecting that anger to staff.
The client may be at high risk for self-harm.
When the wife of a manic client asks about genetic transmission of bipolar disorder, the nurse's answer should be predicated on which information? No research exists to suggest genetic transmission. Much depends on the socioeconomic class of the individuals. Highly creative people tend toward development of the disorder. The rate of bipolar disorder is higher in relatives of people with bipolar disorder.
The rate of bipolar disorder is higher in relatives of people with bipolar disorder.
A client admitted with major depression and suicidal ideation with a plan to overdose is preparing for discharge and asks you, "Why did I get a prescription for only 7 days of amitriptyline?" The nurse's response is based on what fact? Amitriptyline is very expensive, so the patient may have to buy fewer at a time. The goal is to see how the client responds to the first week of medication to evaluate its effectiveness. The health care provider wants to see whether any side effects occur within the first week of administration. Amitriptyline is lethal in overdose.
Amitriptyline is lethal in overdose.
The nurse can expect a client demonstrating typical manic behavior to be attired in clothing that includes with characteristics? Dark colored and modest Colorful and outlandish Compulsively neat and clean Ill-fitted and ragged
Colorful and outlandish
Which side effects of lithium can be expected at therapeutic levels? Fine hand tremor and polyuria Nausea and thirst Coarse hand tremor and gastrointestinal upset Ataxia and hypotension
Fine hand tremor and polyuria
Which behavior is most indicative of a 4-year-old child diagnosed with Tourette's syndrome? Difficulty in social relationships Humming while performing activities that require concentration Frequent eye blinking Difficulty in completing tasks on time
Frequent eye blinking
Which behavior would be characteristic of a client during a manic episode? Going rapidly from one activity to another Taking frequent rest periods and naps during the day Being unwilling to leave home to see other people Watching others intently and talking little
Going rapidly from one activity to another
A 31-year-old patient admitted with acute mania tells the staff and the other patients that he is on a secret mission for the President of the United States. He states, "I am the only one he trusts, because I am the best!" What term will the nurse use when documenting this behavior? Unpredictability Rapid cycling Grandiosity Flight of ideas
Grandiosity
A bipolar client tells the nurse, "I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can't compete with me." What term should the nurse use to identify this behavior? Flight of ideas Distractibility Limit testing Grandiosity
Grandiosity Exaggerated belief in one's own importance, identity, or capabilities is seen with grandiosity.
What is the major reason for the hospitalization of a depressed patient? Inability to go to work Suicidal ideation Loss of appetite Psychomotor agitation
Suicidal ideation
Which statement is true about the characteristics of the oppositional defiant child? The defiance is generally directed toward parents and siblings. These behaviors are a predictor of future mental health disorders. Arguing tends to be more prevalent in boys. Girls display more blaming than do boys.
These behaviors are a predictor of future mental health disorders.
April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that: a. Time-out is an important part of April's baseline discipline. b. Time-out is no longer an effective therapeutic measure. c. April enjoys time-out, and acts out to get some alone time. d. Time-out will need to be replaced with seclusion and restraint.
Time-out is no longer an effective therapeutic measure
A 10-year-old who is frequently disruptive in the classroom begins to fidget and then moves on to disruptive behavior. What is the most appropriate initial technique for managing this sort of disruptive behavior? Therapeutic holding Seclusion Quiet room Touch control
Touch Control
A 9-year-old patient has been diagnosed with an intellectual development disorder (IDD). Which assessment findings support this diagnosis? SATA: Unable to explain the phrase, "Raining cats and dogs" Reads below age level Is capable of providing effective oral self care Enjoy interacting with developmentally similar peers Physically lashes out when frustrated
Unable to explain the phrase, "Raining cats and dogs" Reads below age level Physically lashes out when frustrated
When the nurse remarks to a depressed client, "I see you are trying not to cry. Tell me what is happening." The nurse should be prepared to implement which intervention? Waiting quietly for the client to reply Prompting the client if the reply is slow Repeating the question if the client does not answer promptly Reviewing the client's medical record to support the client's response
Waiting quietly for the client to reply
When a client reports that lithium causes an upset stomach, the nurse should make which suggestion associated with taking the medication? With meals With an antacid 30 minutes before meals 2 hours after meals
With meals
What action should the nurse take on learning that a manic client's serum lithium level is 1.8 mEq/L? Withhold medication and notify the physician. Continue to administer medication as ordered. Advise the client to limit fluids for 12 hours. Advise the client to curtail salt intake for 24 hours.
Withhold medication and notify the physician. The client's lithium level has exceeded desirable limits. Additional doses of the medication should be withheld and the physician notified.
An acute phase nursing intervention aimed at reducing hyperactivity is demonstrated by which intervention? Writing in a diary Exercising in the gym Directing unit activities Orienting a new client to the unit
Writing in a diary
A nurse is providing teaching to an adolescent client who is to begin taking atomoxetine for ADHD. The nurse should instruct the client to monitor for which of the following adverse effects? SATA: a. Somnolence b. Yellowing skin c. Increased appetite d. Fever e. Malaise
Yellowing skin, fever and malaise (Potential indications of hepatotoxicity)
Child protective services have removed 10-year-old Christopher from his parents' home D/T neglect. Christopher reveals to the nurse that he considers the woman next door his "nice" mom, that he loves school and gets above average grades. The strongest explanation of this response is: a. Temperament b. Genetic factors c. Resilience d. Paradoxical effects of neglect
resilience