Psych Final Review!

You have a female manic patient who is hyper sexual, blowing kisses to all the males in the day room and is dressed inappropriately. What is the best intervention to implement?

Accompany the patient to the room and help them get dressed

What's an intervention you can do to deal with pt hallucinations?

Distract the pt's attention

Which is likely to be most effective for adolescents with conduct disorder?

Early intervention

Which of the following would be most supportive for family/friends of a client with an eating disorder?

Emotional support, love, and attention

You have a patient who is withdrawing from cocaine. What are some side effects you might expect?

Irritability, depression, fatigue

Pt is newly prescribed Zoloft. What is essential in this pt teaching?

Take this medication in the morning, it may cause insomnia

When dealing with pts with somatoform disorder, what must the nurse understand?

The symptoms will provide relief from anxiety

What's an example of a non-SSRI that is used to treat anxiety?

Wellbutrin (Proprion) All antidepressants treat anxiety

What med will you give for extrapyramidal symptoms?

Benztropine (Cogentin)

Which is the most effective intervention for clients with delirium?

Managing environmental stimuli

You're planning care for a pt with major depression. What's a good expected outcome?

Pt will not injure themselves

You have a manic patient who is threatening others. What would be the best intervention to implement?

Set limits. Tell patient they need to stop threatening the other patients

The medication Lamotrigine can cause what life-threatening side effect?

Steven Johnsons syndrome, greater in children younger than 16

You have an OCD pt that makes a statement. What would they say that may show improvement in their condition?

"I have more control over my thoughts and behaviors."

Before eating a meal, a client with OCD must wash their hands for 14 mins, comb their hair by 114 strokes, and switch the light off and on 44 times. When evaluating the progress of this client, which of the following is the most important treatment objective?

Gradually decrease the amount of time spent performing rituals

Pt is schizo but are refusing their medication, what's the most therapeutic response to give?

Is there something about Zyprexa (the medication they are taking) that you don't like?

What are some characteristic S&S of psuedoparkinsons?

Stooped posture, Shuffling gait, Drooling

What is an expected outcome for a patient diagnosed with major depression?

The patient won't harm self or others

You have a pt admitted for major depression. To best assess the level of their depression, what do you ask?

"How would you rate your depression on a scale of 1-10, 10 being the highest?"

The daughter of a woman with dementia asks the nurse if her mother will ever be able to live independently again. Which would be the most appropriate response by the nurse?

"Symptoms of dementia gradually get worse. Unfortunately, she will not be independent again."

The patient is prescribed Ativan/Lorazepam. Which statement by the patient would indicate to the nurse that the education was effective?

"The medication will help me relax so I can focus on problem solving" (Ativan decreases anxiety)

Who would be at highest risk for planning suicide?

A pt who has a private gun collection

What life-threatening side effect should you watch out for when administering the medication Clozapine (Clozaril)?

Agranulocytosis. - You must watch the WBC count weekly for the first 6 months and periodically after therapy has ended - S&S of Agranulocytosis: pallor, high fever, mouth ulcers

Which statement(s) are important reasons for why substance abuse must be addressed? Select all that apply.

Alcohol abuse is a too frequent cause/contributor to early death Drug abuse costs businesses in the industry an estimated 102 billion annually Chemical abuse results in increased violence Increased numbers of infants are suffering from physiological/emotional consequences of prenatal exposure to drugs/alcohol

A student nurse is taking a test. Which is a statement that's true?

Anxiety is unavoidable

Which may help a person to overcome an eating disorder that causes weight gain?

Believing that gaining weight is a side effect of unhealthy lifestyle behaviors and losing weight is a side effect of healthy lifestyle behaviors You're just explaining the relationship between food and weight gain basically

What best explains neurochemical processes that are responsible for depression?

Decrease in serotonin and norepinephrine activity ↓ in serotonin = depression.

What are some characteristics you'll see from bipolar 1 (manic phase)?

Delusions of grandeur Decreased need for sleep Flight of ideas Easily distracted

The nurse is questioning the family of a client brought in with cognitive impairment as she assesses and evaluates the client's condition. Which distinguishes delirium from dementia?

Dementia has a gradual onset and is progressive in course.

The nurse is encouraging a group of clients with dementia to join in upper body range of motion exercises using light dumbbells. Which technique will most likely result in the greatest amount of participation?

Demonstrate the exercises while clients simultaneously perform them.

A pt who is suffering from frequent panic attacks describe the attack as feeling "disconnected from themselves". How would you document this

Depersonalization (you're outside your own body but the world is real; a detachment from yourself)

Describe a panic disorder r/t anxiety

Distorted perceptions Loss of rational thinking Failure to perceive potential harm

You have a pt who has a somatoform disorder who wants to try to get out of what is being expected of them. What will you not allow them to do to you?

Do not allow them to manipulate you. Granting privileges and excusing them from responsibilities are all forms of secondary gain.

What's a family characteristic that the nurse can identify as a significant risk factor?

If one of the patient's parents was an alcoholic

A mother brings in her child that has speech difficulties for evaluation. Which of the following disorders involves problems with forming sounds associated with speech?

Phonologic disorder

A nurse inspection of the teeth/gums of a patient with bulimia will most likely reveal deterioration because of which of the following?

The high acidity of emesis

Pt is schizo and is displaying a flat affect, how do you describe it?

They exhibit no emotional expression

You have a patient who is taking lithium, but they tell you that they don't like the way it makes them feel. What is another medication they can take instead?

Valproic acid a.k.a Depakote (divalproex sodium)

What is confabulation?

making up a story, filling in the blanks

What are illusions?

misperception of a real external stimulus (something that's really there but is being misinterpreted)

You have a manic patient who is walking fast up and down the hall. What would be the best intervention to implement?

nurse should walk with the pt, talk slow, calm them down.

The nurse is assessing the client who states he is a spiritual healer. Which term describes the extent to which a person considers himself to be an integral part of the universe?

self-transcendence

Define off-label use

the use of pharmaceutical drugs for an unapproved indication or in an unapproved age group, dosage, or route of administration

Pt on the unit has no facial expression. How would you describe that?

A flat affect. Your affect is the way that you look

Pt is admitted after attempting suicide. What's the highest priority?

Arrange for suicide precautions

Pt is schizo, making facial grimaces staring at the wall...

Ask pt if they see something on the wall

You're talking to a pt who has an anxiety disorder. How do you approach them?

Ask questions r/t their anxiety that are simple, specific, and direct

When weighing a client with anorexia nervosa, the nurse finds the client has gained 6 pounds since being weighed 1 week ago. The nurse should

Asses vital signs and lung sounds to indicate if pulmonary edema is the cause

Pt is going to ECT, what can you expect after?

Brief disorientation upon awaking from the procedure

You have a pt who is having a panic episode. The nurse is assisting the pt to stop and examine their thoughts for the distortions and focus on a time they felt in control, and the pt's anxiety decreases as a result. What type of therapy did the nurse assist the pt to perform?

Cognitive therapy The nurse helped the pt focus on something positive that made them feel calm and in control to change the way they're thinking

A client has gone from 115 pounds to 75 pounds within the last 6 months. Which other physical S&S on examination of the client would indicate anorexia nervosa?

Constipation Amenorrhea Abnormal EKG

You have a patient who states, "can you just call in my narcotic prescription to the h-e-b pharmacy?". The nurse states "no, you need a written-out prescription". The patient asks, "why it is so difficult to get a prescription?". What would you say in response?

Controlled substances like opiates are controlled by the FDA and the DEA

You're a nursing student on the unit talking to a pt, you say something, and it comes out the wrong way. How would you fix it?

Correct yourself "that didn't come out right, what I meant was..."

You're trying to have a conversation w/ a pt when they begin to become very defensive. What could be one positive outcome for using defense mechanisms?

Defense mechanisms can help a person reduce anxiety

The nurse is performing a health history and assessment of a client exhibiting signs of delirium. The nurse asks the client and family members about possible causes of the delirious state. Which would the nurse likely attribute as underlying causes for the client's delirium? Select all that apply.

Dehydration Recent alcohol use Use of antihistamines/amphetamines Sleep disturbances Exposure to paint or gasoline

You have a newly admitted pt who had heart surgery 2 weeks ago, not eating well, feeling sad, difficulty falling asleep. What's your conclusion & how would you describe it?

Depressed mood

What treatment modality for depression causes electrical stimulation of the brain that induces a seizure?

ECT

A nurse asks an assigned client diagnosed with a Tic disorder, "How are you doing today?" The client responds with "doing today, doing today, doing today." Which of the following speech pattern disturbances is this an example of?

Echolalia

When teaching a pt diagnosed with alcohol use disorder about nutritional needs, which should you emphasize?

Emphasize taking multivitamin supplementation that includes thiamin and folic acid

You have a female pt w/ an anxiety disorder. When you start to take her history, you find out she is repeatedly sexually abused by her husband. What's an appropriate intervention in relation to this?

Encourage her to talk about her feelings r/t the abuse

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate?

Explore the use of antipsychotic medications to control tantrums.

The nurse is going to administer a barbiturate (a sedative hypnotic/downer), but the nurse is concerned when they look at the patient's history. What data would indicate contraindications to the use of barbiturates? Select all that apply.

History of addiction to sedative/hypnotics History of porphyria (a rare hereditary disease in which the blood pigment hemoglobin is abnormally metabolized) Severe respiratory dysfunction Nephrititis (inflammation of the kidneys)

You're a nurse working on the psych unit. What must the nurse understand in how anxiety works to better help them in providing care?

How to provide better client care for the pt How to help the pt understand their role in anxiety How to help the nurse function at a higher level to help the pt

A pt believes the have cancer. They've gone to several cancer clinics, several oncologists, and have undergone many tests. There is no evidence of cancer but the pt remains certain that they have cancer and states "I don't think I have long to live." What kind of somatoform disorder is this?

Hypochondritis

You have a bulimic patient who admits to a recent use of diuretics and laxatives. The nurse is most concerned about which of the following possible physiological complications of this behavior?

Hypokalemia (low potassium)

A malnourished pt diagnosed with anorexia nervosa has mutually developed an eating plan contract with the nursing staff. Which is the most appropriate nursing response when the patient is refusing to eat their lunch?

I see you haven't eaten lunch. Let's review your contract to implement the consequences of your choices.

Which nursing statement is most effective in communicating a positive expectation of a patient with anorexia nervosa?

I will sit here quietly with you while you eat

You have a schizo pt whose interacting w/ others, but they have an incongruent affect and mood. How would you describe/document that?

Inappropriate affect Incongruent means their expressions don't match what they're saying (I'm the happiest person in the world, but they're crying), Affect is your outwardly appearance. If the outward appearance and what they're saying/behaving are opposite, you could document as incongruent (What they're saying doesn't add up)

You have a pt who has a somatoform disorder. What would you NOT teach the family?

Increase specific attention when the pt complains of their physical symptoms

The nurse teaches an antisocial client to take a time-out in his room when challenged by another person instigating an argument. What is the main reason for the time-out?

It allows an opportunity for the client to regain control of emotions.

What is something to be aware of when administering the medication Iloperidone (Fanapt)?

It can lower BP, you must administer slowly

Which factors may contribute to the frequency of eating disorders in adolescents? Select all that apply.

Media portrayal of sliminess as an ideal Body dissatisfaction in adolescent females Body image disturbance Seeking autonomy (independence, they want to be able to do what they want w/o someone telling them what to do) Seeking to develop a unique identity

You have a depressed patient who states "I don't want to go to therapy. Just give me my meds". What should you tell this patient?

Medication helps the brain function better, but therapy promotes lasting behavioral changes

You have a pt who asks "why do I have to go to counseling? Can't I just take the medications instead?". How will you respond?

Medications combined w/ therapy will help to change how well you function

Which nursing intervention would be most likely to help a patient with anorexia nervosa to establish healthy eating habits?

Offer liquid protein supplements if the patient is unable to complete a meal

The nursing supervisor in an extended care facility is managing the environment to best help the clients with dementia. Which should the nurse include in planning the living environment?

Plan for the same caregivers to provide care to individuals as much as possible.

A child has been displaying behaviors associated with conduct disorder. As the nurse evaluates these behaviors, she will further assess for which common risk factors seen in children with conduct disorder? Select all that apply.

Poor family functioning Family history of substance abuse Possible child abuse Poverty conditions

Staff Splitting

Pt tries to say I like you, but I don't like her

What schedule is morphine sulfate?

Schedule 2 (drugs w/ high potential for abuse, but less than schedule 1)

Lithium levels

Serum Level of less than 0.5mEq/L are rarely therapeutic Serum Level of more than 1.5 mEq/L is considered TOXIC!!!

When you're assessing a pt w/ paranoid schizo, what would you see?

Suspicious towards others Increased aggression

A client with dementia is starting pharmacotherapy to slow the progression of cognitive decline. The client has a history of moderate but steady alcohol use over the past 45 years. Which medication should the nurse question as least suitable for this client?

Tacrine

What's the best intervention when a person is experiencing severe anxiety?

The highest priority is to reduce the anxiety level

You have a patient who has had surgery but is reluctant to ask for pain meds despite showing signs of pain. They state to the nurse "i don't want to become addicted". How should the nurse respond?

There is only an extremely small chance that you will become addicted to this drug

You have a patient with a history of heavy alcohol use. Their last drink was 24 hours ago and are currently in the emergency room. The patient is orientated, weak, sweaty, has stomach upset, and are displaying tremors. What are these symptoms typical of?

These symptoms are typical of alcohol withdrawal

What would be an appropriate goal for someone who has a social phobia?

They will not experience disabling fear of public performance

Teaching the pt and family about why the pt is experiencing a conversion disorder is helpful because...

They're able to see the correlation between a stressor and the conversion disorder Conversion disorder - la belle indifference (when they don't care about the somatic symptoms associated w/ the conversion disorder) - EX: Pt sees their father murdered in front of them as a child and now they claim that they're blind even though they're really not

You have a patient that is being discharged on lithium. What are some things that you should include in their teaching plan?

Weigh yourself daily see the doctor if you're experiencing any flu-like symptoms do NOT change your dietary intake of sodium and drink 2 L of water

You have a pt whose verbalizing their depression by saying "I think my family would be better off without me. They don't need to worry about me anymore." What should you say?

"Are you planning to commit suicide?"

You have a client who is being discharged after being treated for a cocaine addiction. The patient makes a statement that causes concern. What is something they may have said to cause concern for the nurse?

"I can still hang out with my old friends; I'm just not going to use with them"

What's a statement by the pt that suggests improvement with their depression?

"I made a toy for my son in craft therapy today. I'm looking forward to seeing him."

You're trying to open up a convo w/ a depressed pt, who sat with some others at a coffee shop this afternoon. What's some therapeutic feedback you can give them?

"I saw that you sat with some others in a coffee shop this afternoon."

A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse?

"I'm here to help you just as all the staff members are."

A mother of a teenager with anorexia nervosa reports on her daughter's progress. Which of the following statements indicates further teaching is necessary?

"My daughter enjoys cooking for my family"

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step?

"Stop that right now."

You're doing pt teaching for discharge. The pt states "the doctor prescribed me Ativan/Lorazepam". What would show that the pt understands how their medication works?

"This medication will help me relax so I can focus on problem solving."

Which statement made by the nurse would be most appropriate to an 89-year-old patient who is confused but has no history of dementia, and is hospitalized for an acute urinary tract infection?

"This should be just a temporary situation."

A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, "It is just this once, and she will be so hurt if I don't call her." Which would be the most appropriate response by the nurse?

"You may not use the phone to call your wife."

You have a pt who is depressed, crying, stating "I'm really sick of feeling this way.". What should you say?

"You're feeling really sad right now? Is it a hard time for you?" Open responses to get them to talk more

A client who has an eating disorder is becoming dependent on the nurse for direction in food choices. Which approach by the nurse would demonstrate the nurse's self-awareness?

Approaching the client with an adult-like objectivity Being matter of fact and objective w/ the patient. Treating them like an adult.

You're planning care for a pt. You want to teach them about the medication Ativan. What should you tell them?

Avoid drinking diet coke when taking this anxiety medication

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

Break tasks into small steps.

A pt is admitted for generalized anxiety disorder and they are placed in access 1. What would be a possible other access 1 diagnosis for this patient when doing a mental status assessment? (what other psych disorder might they present with?)

Depression Everyone who has depression has anxiety

The nurse should assess for which of the following behaviors r/t cocaine withdrawal?

Depression, Irritability, Fatigue

A pt tells you or a staff member that they have current thoughts of suicide (suicidal ideations). What is the highest priority?

Determine whether the pt has a specific plan to commit suicide

Which techniques are important for nurses caring for clients with personality disorders to use in order to effectively provide care? Select all that apply.

Discuss feelings of anger or frustration with colleagues to help them recognize and cope with their own feelings. Employ ongoing communication with team members to remain firm and consistent about expectations for clients.

A female client with borderline personality was formerly cooperative with the treatment regimen. Suddenly, the client believes the staff is working against her and is refusing all interaction and participation in treatment. The nurse feels very frustrated by this client's behavior. What is the best action for the nurse to take regarding personal frustration with this client?

Discuss the frustration with a colleague or supervisor in a private setting.

You have a pt who is depressed and states, "My family doesn't want me anymore". What is the first question you should ask them?

Do you have a plan to hurt yourself?

What's important when you have an OCD pt when you're teaching them about relaxation behavioral techniques? Select all that apply.

Encourage the pt to engage in exposure and response prevention Teach relaxation techniques so they can cope w/ the experience of anxiety Teach them about when they experience anxiety

Which of the following is a psychosocial explanation for the development of personality disorders?

Failure to complete a developmental task jeopardizes future personality development.

The client states that decisions that are made by him are superior to everyone else's. Which of the following would the nurse expect to assess in a client with narcissistic personality disorder?

Grandiose and superior self-concept

You have a manic patient who is not eating or drinking and is losing weight. What is a good food choice to present to this patient?

Ham, cheese, and milk

A patient is trying to manage the side effects of their antipsychotic medications. What should you include in their teaching plan?

Have hard candy, use a stool softener, increase fluid intake, implement a calorie-controlled diet

A child with ADHD reports to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice?

Have the child eat a good breakfast and snacks late in the day and at bedtime.

Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder?

Having a tantrum if not getting enough attention

You have a pt diagnosed with anorexia nervosa has the nursing dx "disturbed body image". Which nursing intervention addresses this dx?

Help pt to realize that achieving perfection is unrealistic

A patient with anorexia nervosa has amenorrhea and weighs less than 85% of their BMI (their expected weight). What other assessment data would you expect to find? Select all that apply.

Hypotension Bradycardia Constipation Sensitivity to cold Dry skin

Pt is taking a med for suicide/depression (Effexor). You notice the pt has more energy and are communicating more.

Increase your vigilance regarding the pt's suicide precautions They have more energy and might be more likely to carry out a suicide attempt

The nurse uses cognitive behavioral approaches to assist the client w/ bulimia toward recovery. Which statement by the nurse would be consistent w/ this approach?

Is there any way you can look at that sandwich as fuel for your body? Cognitive therapy is retraining your brain to look at things differently

Which challenges are posed when working with clients with personality disorders? Select all that apply.

It can take a long time to change their behaviors, attitudes, or coping skills. The nurse can easily but mistakenly believe the client simply lacks motivation or the willingness to make changes. Clients with personality disorders challenge the ability of therapeutic staff to work as a team. Team members may have differing opinions about individual clients.

You have an OCD pt. The nurse understands that which of the following represents an experience by the pt when giving in to the compulsion? (why do they give into their compulsions?)

It decreases their anxiety. This is why they give into their compulsions

The nurse is co-leading a family group therapy for drug-addicted individuals and their families. The family of a cocaine addict is angry and can't understand why their loved one can't stop using. The nurse guides the group to discuss their understanding of the nature of addiction. Which statement will the nurse identify as an accurate understanding of the nature of addiction? Select all that apply.

It is a medical illness that's progressive Relapses and re-admissions are part of the illness

The nurse is teaching a client with paranoid personality disorder to validate ideas with another person before taking action on him. Which is the best rationale for this intervention?

It will assist the client to start basing decisions and actions on reality.

A teenager is evaluated for anorexia nervosa. Which of the following symptoms suggest anorexia nervosa? Select all that apply.

Lanugo (baby hair peach fuzz) Muscle weakness Amenorrhea (lack of period)

A person is experiencing restlessness, diaphoresis, and can't focus on the conversation w/ the nurse. Which interventions are appropriate?

Maintain a calm manner Move the pt to a quieter setting Speak slowly to the pt Stay w/ the pt

What is waxy flexibility?

Maintenance of posture/position over time even when it is awkward/uncomfortable Putting the pt's arm in an upright position, letting go, and they keep their arm in that position for a good while

You have a student who is about to do a presentation. They're nervous and distracted. They blank out/freeze when someone asks a question during their presentation. What kind of anxiety/level of stress is this?

Moderate level of stress/anxiety

A client is admitted with anorexia nervosa. To assess the client's physical health, the nurse would initially plan to...

Monitor vital signs and serum electrolyte levels

The nurse is caring for a client with Alzheimer's disease. The nurse observes that the client's pacing and mumbling to himself increasingly at mealtime and shift change. Which intervention should the nurse implement first?

Move the client to a quieter area during these times.

While assessing the family dynamics of a client with an eating disorder, which of the following is the nurse most likely to discover?

Over-controlling parents

Primary gain vs. Secondary gain

PRIMARY: developing physical symptoms in response to stress; get out of the situation you don't want to do bc you're sick SECONDARY: when people feel bad for you and indirectly enable your behavior by asking if you need anything; the internal/personal benefits received from others when they are sick from fam and friends - Calling in sick from work Monday morning, your friend calls you and says, "I heard you called in sick, is there anything I can do for you?" And you take advantage of that

The nurse is assessing the client that has been diagnosed with a Tic disorder. Which of the following terms describes the repeating of one's own words or sounds?

Paralalia

What would be a priority for a short-term outcome for a pt w/ dissociative identity disorder (multiple personality disorder)?

Pt will inform staff when she has the urge to harm herself (safety contract)

The client says to the nurse he is having trouble keeping up with things. The nurse is assessing a client with early signs of dementia. What is the nurse trying to determine when the nurse asks the client what he ate for breakfast that morning?

Recent/short-term memory

A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. Which is an example of a cognitive restructuring technique that would be helpful for this client?

Recognize negative thoughts and replace them with positive ones.

What does serotonin do?

Regulates sleep, mood, and appetite (That's why antidepressants work on serotonin)

Which nursing intervention concerning mealtimes is most important for patients with eating disorders?

Remaining with the patient for at least 1 hour after meals to prevent discarding of stashed food or self-induced vomiting

A key point for nurses to remember when working w/ pts that have anxiety disorders

Remember to practice techniques to manage stress/anxiety in your own life

A behavior therapy intervention for anorexia nervosa would be to?

Restrict the client's privileges until she gains 1-2 pounds

Pt is threatening to commit suicide with a handgun. What's the highest nursing priority?

Risk for suicide r/t a highly lethal plan

Pt is admitted for paranoid schizo, what's a nursing diagnosis that would be the highest priority

Risk for violence directed at others

The nurse encourages the client with dementia to meet nutritional needs. Which is the best approach to assist in meeting adequate dietary intake?

Serve meals in small, bite-size pieces.

You're trying to plan care for a pt w/ hypochondriasis (hypochondriac) disorder. The nurse tells you to spend time w/ the pt only when they're not showing somatic symptoms. What's the rationale behind this?

Showing the pt attention during these times reinforces their somatic behavior

What's a negative symptom of schizophrenia?

Social isolation - Positive symptoms are the delusions, hallucinations, etc. - Negative symptoms are the "lack of"

The client is an adult and has been diagnosed with ADHD. The client is experiencing some additional symptoms. Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.

Social phobia Bipolar disorder Major depression Alcohol dependence

Pt avoids going out to eat w/ his family. He claims the food is better at home and people look at him disapprovingly while he eats. What would the nurse suspect the pt is experiencing?

Social phobia disorder

What is a manipulation tactic that borderline patients are notorious for?

Staff splitting, tries to split the staff by getting them fired. They like to get people in trouble.

How do you approach someone who is swinging at you?

State "Don't swing at me, I can help you". You must talk straight with them

The client is talking to staff members individually and attempting to manipulate them. Which of the following are important in the limit-setting technique to deal with manipulative behavior? Select all that apply

Stating the behavioral limit Identifying the consequences if the limit is exceeded Identifying the expected or desired behavior

You're teaching a pt w/ generalized anxiety disorder about nutrition/food intake. What's the highest priority for a pt to avoid?

Stay away from caffeinated drinks bc it will increase your anxiety

Pt has been admitted to hospital w/ major depression, what can you anticipate they will say?

Suicidal thoughts / plan of hurting themselves last 2 weeks Loss of appetite for last 2 weeks Loss of interest in activities they once enjoyed for last month

During the admission of a client with an eating disorder, the nurse discovers a bottle of pills in their suitcase. The client reports they are pills she takes when her stomach hurts. The nurse's initial response is to state...

Tell me more about your stomach pain

The nurse is assisting the client with anorexia nervosa to express feelings more openly. Which response by the nurse would be most likely to encourage expression of feelings?

Tell me what you're feeling right now

You have a manic patient who hasn't slept in 2 days and is dancing around their room. What should you do to get them to settle down?

Tell the patient "Lets go to the conference room and talk for awhile"

You have a manic pt who is verbalizing a million words a second. What is the best intervention to implement?

Tell the patient "Slow down, I'm not sure what you need first".

What is Schizophreniform disorder?

The client exhibits an acute, reactive psychosis for less than the 6 months necessary to meet the diagnostic criteria for schizophrenia. If symptoms persist over 6 months, the diagnosis is changed to schizophrenia. S Social or occupational functioning may or may not be impaired. Must have symptoms for AT LEAST 1 month, if symptoms persist for more than 6 months diagnosis will be changed to schizophrenic disorder. Schizophreniform pts are more likely to develop schizophrenia

The primary difference between anorexia nervosa and bulimia nervosa is...

The clients with anorexia are proud over their control of their eating while clients with bulimia are ashamed of their behavior

A client with dementia gets angry and begins to yell at the nurse during mealtime. The nurse leaves the client's side for 5 to 10 minutes and then returns. Which of the following best explains the nurse's behavior?

The nurse gave the client a chance to calm down before resuming the meal.

A patient is in recovery. Which statement is consistent with the principles of a 12-step program?

The patient will need to abstain from all substances for a successful recovery

What is an appropriate outcome for a depressed patient?

The patient won't hurt themselves

What would be an expected outcome for a pt w/ somatization disorder?

The pt by discharge will verbalize increasing levels of anxiety that cause their somatic disorder/symptoms

A family member is concerned for their brother. They state that he's acting differently lately, and that there is a family history of bipolar disorder. What is an indicator that the brother may have bipolar disorder?

The pt has been taking unnecessary risks lately

You have a pt with a history of mania who is hospitalized after a suicide attempt, but they get a diagnosis of bipolar-2 (depressive phase). Why would the physician give this diagnosis instead of depression?

The pt has experienced a manic episode in the past

You have a paranoid schizo pt. They come up to you and say that they don't trust you.

The pt's behavior is part of the illness. It's not personal. It has nothing to do with you.

You have a cancer patient who is receiving morphine sulfate for several days, but the medication is no longer effective in controlling their pain so they will have to increase the dose. How would the nurse explain this phenomenon to the patient?

This is likely a result of your developing tolerance to the medication

You have a client who has been re-admitted to detox for the 4th time in the last 3 years. The nurse states in the morning "not again. Why should we keep trying to help this guy when he obviously doesn't want it." What does this statement reflect?

This statement reflects the nurses lack of self-awareness to work effectively with addicted clients

The nurse caring for an elderly woman with dementia has asked the woman's children to bring old photo albums when they visit. The nurse observes the actions of the client as she talks about the photos. Which best describes the usefulness of viewing photos when caring for the dementia client?

Viewing photos is a form of reminiscence therapy for the client.