5204 - stahl ch 4-8

A patient who has been taking lithium carbonate 300mg tid comes to the Outpatient Department with a list of medications he is taking. Which of the medications on the list would require re-evaluation of lithium dosage? a. HydroDIURIL daily b. Navane bid c. Ativan at bedtime d. Cefobid daily

a. HydroDIURIL daily

Which statement by the patient would indicate the need for additional education regarding the prescribed lithium treatment regimen? a. I will restrict my daily salt intake b. I will take my medications with food. c. I will have my blood drawn on schedule d. I will drink 8-12 glasses of liquids daily

a. I will restrict my daily salt intake

Which outcomes would be appropriate to determine early favorable response to antidepressant medication? a. The patient will complete own self-care activities b. the patient will demonstrate assertive communication skills c. the patient will describe signs and symptoms of major depression d. the patient will make plans to attend one community social activity a week.

a. The patient will complete own self-care activities

A patient has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another patient a jerk without provocation. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. They frobitz me. The patients communication exhibits: a. a neologism b. loose associations c. delusional thinking d. circumstantial speech

a. a neologism

The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication? a. agranulocytosis b. vitamin deficiencies c. clotting abnormalities d. polychythemia

a. agranulocytosis

Your patient with major depression tells you that he suffers from urinary retention. Which medication would be most likely to cause this? a. amitriptyline b. duloxetine c. carbamazepine d. ritalin

a. amitriptyline

Which nursing action is most important when providing care to a patient diagnosed with a mood disorder? a. assess the patient for thoughts of suicide b. provide supplemental feedings as needed c. assists with ADLS d. offer opportunities for interaction with other patients

a. assess the patient for thoughts of suicide

An inappropriately dressed patient has not slept for 3 days while making excessive, expensive long-distance phone calls. When the patient can be heard singing loudly in the examining room, the nurse makes initial plans to focus on: a. assessing needs for food, liquids, and rest b. setting strict limits on dress and behavior c. conducting an in-depth suicide assessment d. obtaining a complete psychosocial assessment

a. assessing needs for food, liquids, and rest

A patient admitted with the diagnosis of schizophrenia disorder R/O organic pathology. Based on this information, hte nurse can expect that the patient will: a. be scheduled for an MRI b. see a mental health specialist for extensive psychological testing c. have an immunologic assay performed within 2 days of admission d. participate in dexamethasone suppression test (DST) administered by the staff

a. be scheduled for an MRI

The nurse is caring for a patient who is taking a newly prescribed drug, nefazodone, for treatment of depression. Which physical assessment finding is most important for the nurse to report to the health care provider immediately? a. bradycardia b. dizziness c. drowsiness d. urinary retention

a. bradycardia

A young male patient taking an antipsychotic is experiencing an oculogyric crisis. The nurse prepares to administer: a. diphenhydramine b. haloperidol c. aripiprazole d. risperidone

a. diphenhydramine

Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis? a. dystonic reactions b. pseudoparkinsonism c. akathisia d. tardive dyskinesia

a. dystonic reactions

Which of the following would be the most effective intervention for a depressed patient? a. establish one small goal to accomplish today b. help the patient develop a goal to complete in the next month c. encourage the patient to talk about recent failures in his/her life d. let the patient guide what is the next best action

a. establish one small goal to accomplish today

Dystonic reaction, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect? a. extrapyramidal symptoms b. allergic reactions c. idiosyncratic responses d. therapeutic responses

a. extrapyramidal symptoms

Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed? a. hypertensive crisis b. syncope c. muscle spasms d. increased depression

a. hypertensive crisis

Which response demonstrates both empathy and understanding of the relationship genetics has to the development of schizophrenia in twins? a. in fraternal twins, the chance of the other twin developing the disorder is quite small b. studies show that 50% of twins develop schizophrenia when it is present in the other twin c. no one can say what will happen, so we will hope for the best for you and both of your sons d. you poor woman! I wish I could tell you that your other son will be free of the disorder

a. in fraternal twins, the chance of the other twin developing the disorder is quite small

Which statement is MOST true about depression? a. it is more common in women than in men b. it is rare to have more than one episode of major depression in ones lifetime c. young children do not suffer from depression d. as one ages, there is reduced risk of depression

a. it is more common in women than in men

Prior to discharge, the nurse plans to teach the patient and family about relapse. Which items will the nurse include in teaching? a. recognizing warning signs of relapse b. using street drugs judiciously and only in small amounts c. lowering medication dosage to manage emerging side effects d. notifying the nurse of warning signs present for more than one month

a. recognizing warning signs of relapse

What is the priority nursing diagnosis for a patient exhibiting signs of acute mania that include exaggerated physical activity, agitation, insomnia, and anorexia? a. risk for injury b. chronic low self-esteem c. noncompliance d. insomnia

a. risk for injury

Your patient with major depression sits in her room for hours staring out the window. Which of the following would be the most appropriate intervention? a. sit with the patient and gently offer your availability to help b. keep encouraging the patient to go to exercise class c. offer the class once and then let the patient decide d. sit with the patient and ask her to list reasons for her depression

a. sit with the patient and gently offer your availability to help

Which response by the nurse would best assist a patient in de-escalating aggressive behavior? a. tell me what's going on b. why are you getting so upset c. if you throw something, you will be restrained d. its time for group therapy. you can talk there

a. tell me what's going on

The wife of a patient newly diagnosed with paranoid schizophrenia is concerned that her husband will be this sick for the rest of his life. What information can the nurse provide to the wife? a. this disorder generally responds well with treatment and follow-up b. all types of schizophrenia by their nature are chronic relapsing disorders c. outcomes are related to the patients pre-hospital symptoms of disorganization d. the typical outcome for this diagnosis is that total remission is not achievable

a. this disorder generally responds well with treatment and follow-up

A patient with catatonic schizophrenia has been standing with his left arm upraised and his right foot off the floor for the majority of the last 20 hours, eating only when allowed to eat standing up. Which nursing intervention has priority for this patient? a. providing high-calorie drinks daily b assessing for lower extremity edema bid c. taking the patient to activities therapy once daily d. encouraging the patient to sit or lie down for 30 minutes hourly

b assessing for lower extremity edema bid

Because of the cognitive disturbances associated with schizophrenia, which technique will be useful as the nurse teaches a patient about self-management? a) Plan the teaching for a time when the patient has been recently medicated. b) Teach material in small segments. c) Use only verbal instruction. d) Offer opportunities for making numerous choices.

b) Teach material in small segments.

The nurse learns at report that a newly admitted manic patient is demonstrating grandiosity. Which statement would be most consistent with this symptom? a. "I can't do anything anymore." b. "I'm the world's most astute financier." c. "I can understand why my wife is upset that I overspend." d. "I can't understand where all the money in our family goes."

b. "I'm the world's most astute financier."

The nurse is teaching a patient about a medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate? a. 3 days b. 1 wk c. 4 wks d. 2 months

b. 1 wk

Which of the following drugs is a tricyclic antidepressant? A. bupropion (Wellbutrin) b. Amitriptyline (Elavil) c. Fluoxetine (Prozac) d. Citalopram (Celexa)

b. Amitriptyline (Elavil)

Helen, a 47-yr-old client with a long history of sever depression, has not responded to antidepressant medications or psychotherapy. The nurse caring for the patient knows that the treatment of choice for depression unresponsive to conventional treatment would be: a. lithium b. ETC c. light therapy d. neurolinguistic programming

b. ETC

A patient with schizophrenia tells the nurse as they sit in the day room, I hear voices telling me bad things. The most therapeutic response the nurse can make is: a. tell me what the voices are saying b. I believe you hear voices, but I don't hear them myself c. the voices are not real. They're a product of your imagination d. do you think the voices would go away if we went into your room to talk?

b. I believe you hear voices, but I don't hear them myself

Your depressed patient is just started duloxetine (Cymbalta). Which statement by the spouse tells you that family teaching has been effective? a. I can't wait for him to be back to his old self in the next day or so b. I realize we cant expect big changes right away c. I have to take him for weekly blood tests to monitor the drug dosage d. I will make sure he doesn't eat any aged cheese for the next 2 months until the dose is stabilized

b. I realize we cant expect big changes right away

Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin? a. Meperidine (Demerol) b. Morphine c. Ibuprofen d. acetaminophen

b. Morphine

Which nursing action best addresses the needs of a paranoid patient who believes the food is poisoned? a. explaining that others eat the food and are not harmed b. allow the patient to select food from vending machines c. encourage the patient to discuss why someone would poison the food d. taking steps to prevent the patient from verbalizing the delusional thoughts

b. allow the patient to select food from vending machines

The wife of a patient diagnosed with paranoid schizophrenia asks, I've been told that my husbands illness is probably related to imbalanced brain chemicals. Can you be more specific? The response based on the dopamine hypothesis is: a. breakdown of dopamine produces LSD, which in large amounts produces psychosis b. an increase in the brain chemical dopamine explains the presence of delusions and hallucinations c. decreased amounts of the brain chemical dopamine explain the presence of delusions and hallucinations d. an increase in the brain chemical dopamine explains the presence of lack of motivation and disordered affect

b. an increase in the brain chemical dopamine explains the presence of delusions and hallucinations

Some medications such as tricyclics cause blurred vision. What is the cause of this effect? a. hyperglycemia b. anticholinergic effect c. hypoxia d. hypertension

b. anticholinergic effect

In planning aftercare for a patient with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the patient to have simulation, structure, socialization, and support. Which option would best incorporate these factors? a. day hospitalization b. attending a psychosocial club c. living with his elder mother d. spending free time in the mall

b. attending a psychosocial club

Which response best describes how dysthymic disorder is different from major depression? a. more severe depression with psychotic features b. chronic low level depression c. mild depression with episodes of hypomania d. depression with more anxiety symptoms

b. chronic low level depression

A 19-yr old patient is admitted for the second time in 9 months and is acutely psychotic with a diagnosis of undifferentiated schizophrenia. The patient sits alone rubbing her arms and smiling. She tells the nurse her thoughts cause earthquakes and that the world is burning. The nurse assesses the primary deficit associated with the patients condition as: a. social isolation b. disturbed thinking c. altered mood states d. poor impulse control

b. disturbed thinking

What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)? a. reduction in the number of brain cells that crave dopamine b. dopamine receptors are blocked, making dopamine less available c. dopamine receptors are enhanced, making more dopamine available d. medication causes an increased cellular production of dopamine

b. dopamine receptors are blocked, making dopamine less available

Which activity would be best for a depressed patient? a. a puzzle b. drawing c. crossword puzzles d. television

b. drawing

What is the main difference between major depression and dysthymic depression? a. dysthymia is a short-term depression and major depression lasts for years b. dysthymia is chronic, low-level depression that lasts for years, while major depression is more severe c. dysthymia is more likely to be caused by psychological factors and major depression is caused by neurological dysfunction d. dysthymia is normally treated with psychotherapy only, while major depression is treated with antidepressants and psychotherapy

b. dysthymia is chronic, low-level depression that lasts for years, while major depression is more severe

Your depressed patient is starting a new medication called phenelzine (Nardil). Which teaching would be most important to emphasize? a. educate the patient to take this medication ongoing, even as symptoms improve b. instruct the patient and family about the many food-drug interactions. c. instruct the patient about interventions to relieve dry mouth d. inform the patient that this medication takes 4-6 weeks to take full effect

b. instruct the patient and family about the many food-drug interactions.

A patient has been admitted with a diagnosis of atypical depression. In planning interventions, the nurse would expect to consider the characteristic symptom of: a. seasonal episodes b. leaden paralysis c. psychomotor agitation d. increased depression in the morning

b. leaden paralysis

which of the following is an important intervention for a patient taking nortriptyline? a. make sure that CBC is ordered to monitor blood counts b. monitor anticholinergic side effects c. ensure that the patient's diet is gluten free d. push fluids to prevent dehydration

b. monitor anticholinergic side effects

Which response is appropriate when a patient's mother expresses guilt over causing my child to be schizophrenic? a. I can see how you would be upset over this turn of events b. new findings suggest this disorder is biological in nature c. don't be so hard on yourself; your daughter needs you to be strong d. its difficult to see what produces stress for the child at the time its occurring

b. new findings suggest this disorder is biological in nature

Which statement is true regarding the adverse effects associated with antipsychotic medications? a. tardive dyskinesia is a common, reversible condition b. painful dystonic reactions can occur in the first 72 hours of initiation of therapy c. neuroleptic malignant syndrome (NMS) is a common adverse effect d. pseuoparkinsonian symptoms can cause parkinson's disease

b. painful dystonic reactions can occur in the first 72 hours of initiation of therapy

On what is the choice of tricyclic antidepressants based? a. the need to decrease the action of NE, DA or SE b. patient age and gender c. an absence of adverse effects, such as orthostatic hypotension d. the need for stimulation and increased mental alertness

b. patient age and gender

A patient admitted to the mental unit has shown a deficit in providing self-care and has a medical diagnosis of major depression. The nursing diagnosis for this would be: a. knowledge deficit r/t personal choices b. self-care deficit r/t impaired ability to provide personal hygiene c. risk for violence r/t poor hygiene d. impaired social interaction r/t poor hygiene

b. self-care deficit r/t impaired ability to provide personal hygiene

Biological theories of depressive disorders include all of the following EXCEPT: a. chemical imbalances are responsible b. the patient experiences maladaptive thought processes c. there are genetic tendencies that run in families d. hormonal factors make women more susceptible than men

b. the patient experiences maladaptive thought processes

A patient has been admitted with disorganized type schizophrenia. The nurse asks the patient how he is feeling, and he responds, Everybody picks on me. they frobitz me. The best response for the nurse to make would be: a. that's really too bad that you are being treated that way b. who do you mean when you say everybody? c. what difference does frobitzing make? d. why do they frobitz?

b. who do you mean when you say everybody?

You are caring for an older adult who is recently widowed. She says, No one cares if I die. Everyone I ever loved is dead. What is the best response? a. I am sure that you still have people who care about you b. you sound like you are feeling all alone c. boy, that's depressing d. I don't believe that

b. you sound like you are feeling all alone

The nurse would evaluate that patient education regarding lithium therapy for an individual with bipolar disorder as effective if the patient states: a. I can stop my lithium when I feel better b. I can continue with my diuretic and cardiac medications c. I will probably need to take the lithium for the rest of my life d. I will taper my lithium when a therapeutic serum level is achieved

c. I will probably need to take the lithium for the rest of my life

Which of the following antidepressants is a tricyclic? a. Bupropion (Wellbutrin) b. Sertraline (Zoloft) c. Nortriptyline (Pamelor) d. Venlafaxine (Effexor)

c. Nortriptyline (Pamelor)

During a treatment team meeting, the point is made that a patient with schizophrenia has recovered from the acute psychosis but continues to demonstrate apathy, avolition, and blunted affect. The nurse relates these symptoms to serotonin (5HT2) excess will suggest that the patient receive: a. Haloperidol (Haldol) b. Chlorpromazine (Thorazine) c. Olanzapine (Zyprexa) d. Phenelzine (Nardil)

c. Olanzapine (Zyprexa) atypical: better at reducing negative symptoms

You are doing patient teaching for Margaret, who has been prescribed amitriptyline (Elavil) for treatment of depression. Which of the following statements suggests that Margaret needs further instruction? a. I know I might not start feeling better for a few weeks, but I'll keep taking the medication just as the doctor prescribed. b. I'll keep some hard candies in my purse in case my mouth gets dry from the medicine c. Once I start feeling better, I'm looking forward to cutting down on this medication d. I'm worried I may gain some weight, but that's a small price to pay for feeling better.

c. Once I start feeling better, I'm looking forward to cutting down on this medication

A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admission to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient? a. daily home nursing visits to administer the prescribed oral medication b. continuous inpatient hospitalization for medication therapy c. administration of depot antipsychotic medication d. subcutaneous medication administration

c. administration of depot antipsychotic medication

lithium is the drug of choice for which of the following disorders? a. psychotic episodes b. OCD c. bipolar disorders d. depressive disorders

c. bipolar disorders

What is the action of MAOIs on neurotransmitters? a. blocking their reuptake b. increasing their production c. blocking their destruction d. increasing their reuptake

c. blocking their destruction

Prior to initiating medication therapy with phenelzine (Nardil), the nurse should plan to determine the patients: a. mood and affect b. activity level c. cognitive ability to understand information about the medication d. support network and its members willingness to participate in treatment

c. cognitive ability to understand information about the medication

Which assessment observation supports a patients diagnosis of disorganized schizophrenia? a. reports suicidal ideations b. last relapse was 6 years ago c. consistent inappropriate laughing d. believes that the government is out to get me

c. consistent inappropriate laughing

Which assessment would the nurse expect to observe in a patient who has been prescribed trazadone for treatment anxiety? a. excessive thirst b. hand tremor c. drowsiness d. diarrhea

c. drowsiness

An appropriate intervention for a patient with an identified nursing diagnosis of situation low self-esteem would be: a. providing large muscle activities to relieve stress b. attempting to determine triggers to hallucinations c. engaging patient in activities designed to permit success d. encouraging verbalization of feelings in a safe environment

c. engaging patient in activities designed to permit success

What is the most common cause of nonadherence to antipsychotic pharmacologic treatment? a. expense b. increased symptoms of chemical dependency c. extrapyramidal effects d. inability of the patient to understand the need to take medications

c. extrapyramidal effects

A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer Haldol. Which action will the nurse take? a. support the patient's decision to refuse the medication b. discreetly ask an assistant to put the medication in the patient's food c. firmly redirect the patient to take the medication d. speak privately with the patient and reinforce medication action

c. firmly redirect the patient to take the medication

A patient taking vilazodone has been vomiting persistently for 12 hours. The priority nursing diagnosis for this patient is: a. nausea b. imbalanced nutrition (less than body requirements) c. fluid volume deficit d. altered peripheral tissue perfusion

c. fluid volume deficit

Which of the following meal choices indicates the patient understands the diet restrictions when taking an MAOI? a. pepperoni pizza and beer b. roast chicken, baked potato, and beer c. fried fish, rice, and cola d. pickled herring, eggs, and coffee

c. fried fish, rice, and cola

A newly admitted client has been diagnosed with major depressive disorder. Which nursing diagnosis takes priority? a. impaired social interaction b. self-esteem deficit c. hopelessness d. self-care deficit

c. hopelessness

By discharge, which outcome is appropriate for a patient who hears voices telling him he is evil? a. respond verbally to the voices b. verbalize the reasons the voices say he is evil c. identify events that increase anxiety and promote hallucinations d. integrate the voices into his personality structure in a positive manner

c. identify events that increase anxiety and promote hallucinations

The nurse is providing education to a patient who has been prescribed bupropion for smoking cessation. Which statement by the patient would indicate the need for further teaching? a. my dose will increase after 3 days. b. I should swallow this medication whole c. if I have the urge to smoke, I will take more medication d. I do not need to taper my dose when the drug is discontinued

c. if I have the urge to smoke, I will take more medication

A patient tried to gouge out his eye in response to auditory hallucinations commanding, If thine eye offends thee, pluck it out. The nurse would analyze this behavior as indicating: a. derealization b. inappropriate affect c. impaired impulse control d. inability to manage anger

c. impaired impulse control

What response would be anticipated when a patient who received chlorpromazine (thorazine) for 15 yrs to treat schizophrenia is switched to Seroquel (quetiapine)? a. development of pseudoparkinsonism b. development of dystonic reactions c. improvement in tardive dyskinesia d. worsening of anticholinergic symptoms

c. improvement in tardive dyskinesia

A patient is admitted to a long term psychiatric setting. The MAOI medication previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. The nurse will provide the first dose of imipramine to the patient ____ the MAOI drug. a. immediately following the last dose of b. in 1 week following the last dose of c. in 14 days following the last dose of d. before discontinuing

c. in 14 days following the last dose of

The nurse will base a discussion of dysthymia on the fact that the condition: a. typically has an acute onset b. involves delusional thinking c. is chronic low-level depression d. does not include suicidal ideation

c. is chronic low-level depression

Light therapy has been shown to be effective in treating patients with: a. bipolar disorder b. dysthymia c. major depression with seasonal pattern d. schizophrenia

c. major depression with seasonal pattern

Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (clozaril)? a. assess for signs and symptoms of hypoglycemia b. encourage a low fiber diet c. measure the patients waist circumference d. monitor for insomnia

c. measure the patients waist circumference

To what does potency of an antipsychotic medication refer? a. severity of adverse effects associated with the drug b. length of time that it takes to reach a therapeutic blood level of the drug c. milligram doses used for the medication d. effectiveness of the drug in alleviating psychotic behavior

c. milligram doses used for the medication

A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication? a. constipation b. hypotension c. neck stiffness d. urinary retention

c. neck stiffness

The nurse knows that the two factors that often differentiate major depression from dysthymia depression are: a. amounts of mania and sadness b. presence or absence of anger and guilt c. severity and duration of symptoms d. patients gender and age

c. severity and duration of symptoms

A patient experiences intrusive, insulting auditory hallucination. Which independent behavior technique can the nurse teach the patient to employ while the voices are troublesome? a. introduce a distraction like reading b. use positive talk to offset the insults c. sing or whistle to compete with the voices d. increase the daily dose of an antipsychotic medication

c. sing or whistle to compete with the voices

What is the major advantage of SSRIs over other types of antidepressant therapy? a. they are less expensive than other classes of antidepressants b. they cure major depressive illnesses c. they do not cause the anticholinergic and cardiovascular adverse effects d. therapeutic relief is immediate

c. they do not cause the anticholinergic and cardiovascular adverse effects

A patient tells the nurse, When I'm in the day room, I hear people whispering about me, and that makes me want to punch them. What direction will the nurse provide the staff regarding interacting with this patient? a. to minimize the need to whisper, utilize nonverbal techniques when possible b. stay physically close to this patient and use touch as a tool to interact with him c. treat this patient matter-of-factly. Be direct; don't talk about him or others in his presence d. interact with this patient only when necessary. The fewer interactions, the fewer misinterpretations there will be.

c. treat this patient matter-of-factly. Be direct; don't talk about him or others in his presence

Patients with major depression commonly display signs of: a. energy b. repetitive, compulsive behaviors c. worthlessness d. visual hallucinations

c. worthlessness

A 34-yr-old male admitted with catatonic schizophrenia has been mute and motionless for several days while at home prior to admission. He still appears stuporous in the hospital. Which nursing intervention would be an initial priority? a. orienting the patient to the unit b. reinforcing reality with the patient c. establishing a nonthreatening relationship d. assessing the patient for physical problems

d. assessing the patient for physical problems

What would be an appropriate short-term outcome for a patient diagnosed with residual schizophrenia who exhibits ambivalence? a. decide their own daily schedule b. decide which unit groups they will attend c. choose which clinic staff member to work with d. choose between two outfits to wear each morning

d. choose between two outfits to wear each morning

Which nursing diagnosis is appropriate for a patient who insists being called Your Highness and demonstrates loosely associated thoughts? a. risk for violence b. defensive coping c. impaired memory d. disturbed thought process

d. disturbed thought process

which initial short term outcome appropriate for a patient expressing delusional thoughts? a. accept that delusion is illogical b. distinguish external boundaries c. explain the basis for the delusions d. engage in reality-oriented conversation

d. engage in reality-oriented conversation

You are admitting a new patient who is depressed. Your initial contact should do what? a. address why he is depressed b. keep communication open c. lift his spirits d. establish trust

d. establish trust

Which of the following interventions should the nurse plan to use to reduce patient focus on delusional thinking? a. confronting the delusion b. refuting the delusion with logic c. exploring reasons the patient has the delusion d. focusing on feelings suggested by the delusion

d. focusing on feelings suggested by the delusion

A patient with schizophrenia is medication compliant and has well-controlled symptoms. He has, however, never been successful in holding a job because of poor social skills and lack of understanding of basic job skills. The nurse case manager should consider referring the patient: a. for cognitive therapy b. to assertiveness training c. to a day hospital program d. for psychosocial rehabilitation

d. for psychosocial rehabilitation

The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing? a. delusions b. flight of ideas c. disorganized thinking d. hallucinations

d. hallucinations

A patient prescribed an antipsychotic medication develops a high fever, unstable blood pressure, and muscle rigidity. Her next dose of medication is due. The nurse should: a. administer the medication and monitor the vital signs every 4 hours b. give a lower dose of the medication for 24 hours and monitor the blood pressure c. prepare to administer a prn dose of the anticholinergic drug benztropine (cogentin) d. hold the medication and immediately describe the patient's symptoms to the doctor

d. hold the medication and immediately describe the patient's symptoms to the doctor

A patient is exhibiting auditory hallucinations in addition to being forgetful and easily confused. Which diagnosis does the nurse base this patients interventions on? a. social isolation b. deficient knowledge c. situational low self-esteem d. impaired cognitive functioning

d. impaired cognitive functioning

A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior observed in the patient supports that diagnosis? a. uses a rhyming form of speech b. refuses to eat any unwrapped foods c. laughs when watching a sad movie d. maintains an immobilized state for hours

d. maintains an immobilized state for hours

Your depressed patient who is taking a tricyclic antidepressant is advised of possible anticholinergic side effects. Which of the following is NOT an anticholinergic side effect? a. blurred vision b. difficulty starting urine stream c. dry mouth d. muscle rigidity

d. muscle rigidity

Your patient has been taking a SSRI antidepressant for 6 weeks. On arrival at the clinic, which observation would indicate a positive outcome from the medication? a. patient reports sleeping 12 hours a night b. patient reports sleeping 3 hours a night c. patient reports a weight loss of 10 lbs d. patient arrives neatly dressed

d. patient arrives neatly dressed

What is the priority nursing diagnosis for a catatonic patient? a. ineffective coping b. impaired physical mobility c. impaired social interaction d. risk for deficient fluid volume

d. risk for deficient fluid volume

Which patient behaviors would support the diagnosis of residual schizophrenia with negative symptoms? a. communicating using only rhyming phases b. claims that worms are crawling in my brain c. maintaining both arms suspended awkwardly overhead d. shows no emotion when telling the story of sisters recent death

d. shows no emotion when telling the story of sisters recent death

Which psychological manifestation of depression will improve in response to antidepressant therapy? a. loss of energy b. palpitations c. sleep disturbances d. social withdrawal

d. social withdrawal

When your patient says I'm depressed, what is the best response? a. we all feel that way now and then b. why do you feel that way c. everything will be OK once you snap out of it d. tell me more about what is going on with you

d. tell me more about what is going on with you

In caring for a patient with major depression, the nurse knows that the patient needs: a. frequent changes in activities b. introduction to multiple new staff members c. behavior modification that restructures feelings. d. well-defined, structured interactions at the beginning of treatment

d. well-defined, structured interactions at the beginning of treatment