6007 Module 2 Depression/Bipolar Disorders/ Suicide Prevention Prep U Questions

A client is prescribed sertaline as part of the treatment plan for major depression. After teaching the client about possible side effects, the nurse determines that the teaching was successful when the client identifies which effect as possible with this drug? Select all that apply. a. Sedation b. Sexual dysfunction c. Dizziness d. Photosensitivity e. Abnormal dreams

a. Sedation b. Sexual dysfunction c. Dizziness

A client with major depression is prescribed paroxetine. The nurse develops an education plan for the client based on the understanding that this drug belongs to which class of drugs? a. Selective serotonin reuptake inhibitors b. Serotonin norepinephrine reuptake inhibitors c. Monoamine oxidase inhibitors d. Tricyclic antidepressants

a. Selective serotonin reuptake inhibitors

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder? a. Bananas b. Broccoli c. Spaghetti d. Steak

a. Bananas

A client who was receiving a monoamine oxidase inhibitor (MAOI) is to be switched to a selective serotonin reuptake inhibitor (SSRI). The nurse would expect to begin administering the SSRI how many days after the MAOI is discontinued? a. 7 days b. 14 days c. 21 days d. 28 days

b. 14 days

A client who was receiving a monoamine oxidase inhibitor (MAOI) is to be switched to a selective serotonin reuptake inhibitor (SSRI). The nurse would expect to begin administering the SSRI how many days after the MAOI is discontinued? a. 7 days b. 14 days c. 21 days d. 28 days

b. 14 days

A client with depression has been taking a selective serotonin reuptake inhibitor (SSRI), fluoxetine, for the last 3 months and has noticed improvement of symptoms. As the client inquires about any side effects, which would the nurse expect the client to report? a. A headache after eating wine and cheese b. A decrease in sexual pleasure during intimacy c. An intense need to move about d. Persistent runny nose

b. A decrease in sexual pleasure during intimacy

A client has been diagnosed with major depressive disorder. The clinical symptom that would be included when the clinician makes this diagnosis is what? a. Self-report of being sad after a break up b. A significant decrease in appetite c. Demonstrated examples of unwise decisions d. Claims by family, friends, or coworkers that the client is depressed

b. A significant decrease in appetite

Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with what? a. Anaclitic depression b. Moderate depression c. A mood disorder due to a general medical condition d. Postpartum psychosis

b. Moderate depression

A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply. a. Flight of ideas b. Obsessive rumination c. Hypersomnia d. Widespread shopping sprees e. Difficulty concentrating

b. Obsessive rumination c. Hypersomnia e. Difficulty concentrating

Which meal would the nurse provide to best meet the nutritional needs of a client who is manic? a. Peanut butter sandwich, chips, cola b. Fried chicken, mashed potatoes, milk c. Ham sandwich, cheese slices, milk d. Spaghetti, garlic bread, salad, tea

c. Ham sandwich, cheese slices, milk

Which type of antidepressants are rarely fatal in overdose? a. SSRIs b. MAOIs c. Tricyclics d. Atypical

a. SSRIs

A client who is depressed states, "I think my family would be better off without me. They don't need to worry." Which would be the most appropriate response by the nurse? a. "Are you planning to commit suicide?" b. "What do you think they are worried about?" c. "Where are you going?" d. "You don't mean that. Your family loves you."

a. "Are you planning to commit suicide?"

The client with mania attempts to hit the nurse. Which is the best response by the nurse? a. "Do not swing at me again. If you cannot control yourself, we will help you." b. "If you do that one more time, you will be put in seclusion immediately." c. "Stop that. I didn't do anything to provoke an attack." d. "Why do you continue that kind of behavior? You know I won't let you do it."

a. "Do not swing at me again. If you cannot control yourself, we will help you."

The nurse is working with a client who has been diagnosed with depression. When performing a strength assessment with the client, what is the nurse's best statement or question? a. "How have you dealt with feelings like this in the past?" b. "It's important that you remember that you're an exceptionally strong and capable person." c. "Do you consider yourself to be a strong person overall?" d. "What can the care team do to help you become a stronger person?"

a. "How have you dealt with feelings like this in the past?"

A client with a history of self-harm reports lethargy, loss of appetite and insomnia to the nurse. The client states that she relies heavily on sleep medications that her primary care provider prescribed. What is the nurse's priority assessment question? a. "How many of the sleeping pills do you have at home right now?" b. "Have you ever had to take sleeping pills at any other point in your life?" c. "Are their any strategies you've tried so that you wouldn't need sleeping pills?" d. "How do you feel about having to take medication to help you sleep?"

a. "How many of the sleeping pills do you have at home right now?"

A client was abandoned by the parents at age 3, resulting in the client's perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of what? a. A psychodynamic interpretation of the client's major depressive disorder. b. A reason the client has become lesbian at the age of 23. c. A biological explanation for the client's depressive disorder. d. A feminist viewpoint of depression.

a. A psychodynamic interpretation of the client's major depressive disorder.

The nurse provides medication teaching to a client who is newly prescribed a serotonin norepinephrine reuptake inhibitor (SNRI) for the treatment of depression. Which client statement indicates a need for additional teaching? a. "I might experience an increased appetite." b. "I can use sugar-free gum to treat dry mouth." c. "I should wear sunscreen due to photosensitivity." d. "I should change positions slowly to decrease my risk for falls."

a. "I might experience an increased appetite."

A client with bipolar disorder is receiving lithium therapy. The nurse is reviewing the client's serum plasma drug levels and determines that the client's level is therapeutic based on what? a. 1.0 mEq/L b. 1.6 mEq/L c. 2.0 mEq/L d. 2.6 mEq/L

a. 1.0 mEq/L

Research has shown that risk of suicide increases within which time frame for initiation of antidepressant therapy? a. 14 days b. 28 days c. 35 days d. 42 days

a. 14 days

The mental health nurse appropriately provides education on light therapy to which client? a. 20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term b. 58-year-old showing signs of early Alzheimer's disease c. 45-year-old lawyer whose medication therapy needs an additional treatment d. 50-year-old farmer whose major depression has not responded to any treatment modality

a. 20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term

A 46-year-old client has been diagnosed with major depressive disorder. The client is seeing a nurse practitioner who is deciding on an appropriate treatment regimen. The nurse practitioner knows that which will be the most effective treatment for this client's depressive disorder? a. A combination of psychotherapy and medication b. A combination of medication and electroconvulsive therapy c . Psychotherapy alone d. Medication alone

a. A combination of psychotherapy and medication

A client taking a monoamine-oxidase inhibitor (MAOI) for depression should be instructed to avoid which of the following when taking the medication? Select all that apply. a. Aged cheese b. Beer c. Red meat d. Red wine e. Spinach

a. Aged cheese b. Beer d. Red wine

Which signs would a nurse expect in a client diagnosed with serotonin syndrome? Select all that apply. a. Agitation b. Hyporeflexia c. Elevated heart rate d. Constipation e. Elevated temperature

a. Agitation c. Elevated heart rate e. Elevated temperature

A loss of pleasure or interest in a client diagnosed with depression would be documented as what? a. Anhedonia b. Flat affect c. Hopelessness d. Discouragement

a. Anhedonia

A client's depression is being treated in the community with phenelzine. The client has presented to the clinic stating, "I had a few beers and I'm feeling absolutely miserable." What is the nurse's best action? a. Assess the client's blood pressure b. Perform a Mini Mental Status Examination (MMSE) c. Assess the client's jugular venous pressure d. Call an emergency code

a. Assess the client's blood pressure

A psychiatric-mental health nurse is conducting a refresher class for a group of psychiatric-mental health nurses returning to the field. After teaching about depressive disorders, the nurse determines a need for additional teaching when the class identifies which physical or psychological symptom as being associated with depression? a. Catatonia b. Fatigue c. Insomnia d. Worthlessness

a. Catatonia

A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which of the following would the nurse do first? a. Decrease the client's environmental stimuli b. Give the client feedback about his behavior c. Introduce the client to other staff on the unit d. Tell the client about hospital rules and policies

a. Decrease the client's environmental stimuli

Which disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode? a. Dysthymic disorder b. Cyclothymic disorder c. Seasonal affective disorder d. Hypomania

a. Dysthymic disorder

A client is prescribed a selective serotonin reuptake inhibitor (SSRI) as treatment for depression. Which would the nurse most likely administer? a. Escitalopram b. Venlafaxine c. Maprotiline d. Phenelzine

a. Escitalopram

Which antidepressant medication is classified as a selective serotonin reuptake inhibitor (SSRI)? a. Fluoxetine b. Phenelzine c. Isocarboxazid d. Tranylcypromine

a. Fluoxetine

Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension? a. Increase hydration b. Take medication with food c. Get daily exercise d. Eat a nutritionally balanced diet

a. Increase hydration

A client who has liver damage is receiving lithium for treatment of bipolar disorder. The nurse understands that which of the following may occur when the client is receiving lithium? a. Increased plasma concentration b. Decreased plasma concentration c. No alteration in plasma levels d. Monitoring of plasma levels is not needed

a. Increased plasma concentration

A psychiatric-mental health nurse is preparing a review class for a group of nurses at the community mental health center. The topic is mood-stabilizing drugs. After teaching the class about the different drugs that may be prescribed, the nurse determines that the teaching was successful when the group identifies which drug as being prescribed most often? a. Lithium b. Divalproex c. Carbamazepine d. Lamotrigine

a. Lithium

A client is prescribed lithium to treat mania. The client also has a history of hypertension for which the client takes lisinopril and hydrocholorothiazide. When monitoring this client, the nurse would be especially alert for signs and symptoms of which condition? a. Lithium toxicity b. Hypokalemia c. Hypertensive crisis d. Hypernatremia

a. Lithium toxicity

Both valproate and carbamazepine may be lethal if high doses are ingested. Toxic symptoms appear in 1 to 3 hours and include what? a. Neuromuscular disturbances b. Bradycardia c. Urinary frequency d. Tinnitus

a. Neuromuscular disturbances

A depressed older adult client is being treated with a tricyclic antidepressant (TCA). For which clinical manifestations should the nurse monitor the client? a. Orthostatic hypotension and urinary retention b. Photosensitivity and skin rashes c. Pseudoparkinsonism and tardive dyskinesia d. Diarrhea and electrolyte imbalance

a. Orthostatic hypotension and urinary retention

A client is admitted to a mental health unit with reports of fatigue, poor appetite, and difficulty making decisions. The client also reports having felt unhappy most of the time for "as long as I can remember." Which diagnosis should the nurse anticipate for this client? a. Persistent depressive disorder b. Bipolar disorder c. Rapid cycling disorder d. Mild depressive disorder

a. Persistent depressive disorder

The nurse is reviewing the history of a client diagnosed with bipolar I disorder. The history reveals that the client, in between manic episodes, consistently uses self-negating statements when describing the self, expresses feelings of being ashamed, and describes self as being unable to deal with events. The client also demonstrates little to any eye contact during interactions. The nurse interprets this information as reflecting a problem in which area? a. Self-esteem b. Anxiety c. Denial d. Coping

a. Self-esteem

A nurse is caring for a client diagnosed with bipolar disorder. The client is experiencing a manic episode. The nurse would be especially alert for signs indicating what? a. Self-injury b. Sleep disruption c. Dehydration d. Weight loss

a. Self-injury

A nurse is assessing a client who is brought to the emergency department. The nurse suspects that the client is experiencing mania. Which finding would support the nurse's suspicion? Select all that apply. a. Statements of self-importance b. Slowness of speech c. Flight of ideas d. Easily distractible e. Sleepiness

a. Statements of self-importance c. Flight of ideas d. Easily distractible

Which outcome would be appropriate to determine an early favorable response to antidepressant medication? a. The client will establish a balance of rest, sleep, and activity. b. The client will demonstrate assertive communication skills. c. The client will describe signs and symptoms of major depression. d. The client will make plans to attend one community social activity a week.

a. The client will establish a balance of rest, sleep, and activity.

The client is taking a monoamine oxidase inhibitor (MAOI) for depression. The nurse educates the client to avoid foods containing what while taking this medication? a. Tyramine b. Calcium c. Potassium d. Sugar

a. Tyramine

The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should ... a. assess for depression in the client's family history. b. prepare the client for diagnostic genetic testing to confirm the diagnosis. c. educate the client regarding the symptoms of related physical disorders. d. encourage the client to seek genetic counseling before considering a pregnancy.

a. assess for depression in the client's family history.

Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is ... a. assessing Carrie's current suicidal ideation and putting her on suicide precautions. b. rehydrating Carrie by forcing fluids. c. assisting Carrie with her activities of daily living, including a shower and clean clothing. d. assessing Carrie's recent suicide attempt and identifying factors that may have contributed to it.

a. assessing Carrie's current suicidal ideation and putting her on suicide precautions.

A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation? a. The client is tolerating the initial drug therapy. b. The level of depression is mild to moderate. c. The client is experiencing catatonia. d. Suicidality is of little concern.

c. The client is experiencing catatonia.

The nurse reviews the medication list for a client who is newly prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which client statement indicates a need to assess the client for serotonin syndrome? a. "I stopped taking St. John's wort 4 weeks ago." b. "I started taking diet pills to assist with weight loss." c. "I stopped drinking red wine when I started taking my new prescription." d. "I used to enjoy taking ecstasy, but I know it isn't safe with my new medication."

b. "I started taking diet pills to assist with weight loss."

A client's physician has prescribed paroxetine for the treatment of the client's depression. Which teaching points should the nurse include in the client education related to this treatment? a. "If you don't feel noticeably better within 3 weeks, increase your dose by 50 %." b. "Make sure that you don't change the quantity or timing of your medication without first consulting your doctor." c. "If you forget to take a dose one day, take a double dose the next day and be sure to let your doctor know." d. "The advantage of paroxetine is that it will normally relieve depression in a few weeks and it has no side effects."

b. "Make sure that you don't change the quantity or timing of your medication without first consulting your doctor."

The nurse working on a mental health unit is teaching a nursing student. The student asks the nurse about what constitutes a diagnosis for major depressive disorder. What is the nurse's best response? a. "Depression is a mood variation to life events." b. "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." c. "The physician diagnoses depression when a client has feelings of sadness several times a year." d. "Feelings of anxiety and sadness as a response to a life event are the most important qualifiers for depression."

b. "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present."

A client who is depressed begins to cry and states, "I'm just really sick of feeling this way. Nothing ever seems to go right in my life." Which would be the most appropriate response by the nurse? a. "Don't cry. Try to look at the positive side of things." b. "You are feeling really sad right now. It's a hard time." c. "Hang in there. Your medication will start helping in a few days." d. "Nothing ever goes right?"

b. "You are feeling really sad right now. It's a hard time."

The nurse is seeing a 26-year-old client and the client's family. The client's family describes the client as being "very, very different." The family describes a history of periods of unpredictable behavior and disregard for consequences occurring a few times each year. The client has recently been diagnosed with bipolar I disorder, a condition that is characterized by what? a. The presence of objective signs of depression without the presence of anhedonia b. An elevated mood that lasts for at least 1 week c. Failure to respond to conventional pharmacological treatments for mood disorders d. The client's admission of a mood disorder

b. An elevated mood that lasts for at least 1 week

A psychiatric-mental health nurse is working at a community mental health center that serves a large pediatric population. When assessing children for depression, which information would be most important for the nurse to keep in mind? a. Children commonly experience the same symptoms of depression as adults. b. Anxiety symptoms are more commonly noted in children who are depressed. c. The risk of suicide is low in children and adolescents. d. The mood observed in children with depression is more often sad than irritable.

b. Anxiety symptoms are more commonly noted in children who are depressed.

A nurse is caring for a client receiving a tricyclic antidepressant and is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following? a. Hyperactive bowel sounds b. Blurred vision c. Urinary incontinence d. Moist skin

b. Blurred vision

An elderly client is admitted to the hospital with fatigue and weight loss of 20 pounds in 1 month. Upon further assessment, the client is diagnosed with depression. What other thing should the nurse assess this client for based on the weight loss? a. Suicide b. Dehydration c. Sleep disturbance d. Decreased energy

b. Dehydration

Which statement regarding depression and gender is correct? a. Depressive disorders are more common in men than women. b. Depressive disorders are more common in women than men. c. Depressive disorders equally affect men and women. d. Depressive disorders affect young men more than older women.

b. Depressive disorders are more common in women than men.

A 35-year-old client with bipolar disorder has a history of discontinuing medication when feeling well and then becoming manic again. During the client's last episode of mania, the client lost several thousand dollars in risky investments. Which intervention will be most helpful in achieving medication adherence? a. Point out that each time the client stops taking medication, the client becomes manic again. b. During stabilization, discuss the client's individual signs, symptoms, and consequences of relapse. c.Ensure that a family member takes responsibility for administering medications. d. Remind the client that the client owes it to the client's spouse and children to stay well.

b. During stabilization, discuss the client's individual signs, symptoms, and consequences of relapse.

On admission to the psychiatric unit, a client is dressed in a red leotard and exercise bra, with an assortment of chains and brightly colored scarves on the client's head, waist, wrists, and ankles. The client's first words to the nurse are, "I'll punch you, munch you, crunch you," as the client dances into the room, shadow boxing. The client shakes the nurse's hand and says cheerfully, "We need to become better acquainted. I have the world's greatest intellect, and you are probably an intellectual midget." How can the nurse document the client's mood? a. Belligerent and blunted. b. Expansive and grandiose. c. Anxious and unpredictable. d. Suspicious and paranoid.

b. Expansive and grandiose.

The police bring a client to the hospital. They found the client in a hospital gown, swimming in a local creek. The client states that the client was "being baptized by Mother Nature, who loves and worships me." How would the nurse describe the client's current alterations in mental status? a. Visual hallucinations b. Grandiose delusions c. Neologisms d. Dysphoria

b. Grandiose delusions

A patient with bipolar disorder is prescribed divalproex. Before initiating this therapy, which laboratory test would be most important for the nurse to obtain? a. Clotting function tests b. Liver function tests c. Renal function tests d. Blood glucose level

b. Liver function tests

A client taking lithium therapy has a serum therapeutic level of 0.8 mEq/L. What priority dietary instruction should the nurse include in the teaching plan? a. Limit fluid intake to 6-8 oz (180-340 mL) glasses a day. b. Maintain daily sodium intake. c. Switch to a DASH diet. d. Monitor weight pattern.

b. Maintain daily sodium intake.

A client with mania is in the dining room at lunchtime and is observed taking food from other clients' trays. The nurse's intervention should be based on which rationale? a. As soon as lunch is over, the client will calm down. b. Other clients need to be protected from the intrusive behavior. c. The client's behavior is not an imminent threat to anyone's physical safety. d. The client needs food and fluids in any way possible.

b. Other clients need to be protected from the intrusive behavior.

A nurse who works primarily with clients who have bipolar disorder identifies which group of clients as not being candidates to take lithium as treatment? a. Patients who take bronchodilators b. Patients who take ACE inhibitors c. Patients who drink decaffeinated coffee d. Patients with diabetes who take oral antidiabetic agents

b. Patients who take ACE inhibitors

A client with major depression and a suicide attempt is admitted to the inpatient facility. The client is started on antidepressant therapy. The next day, the client demonstrates significantly higher energy and says, "I'll feel much better." The nurse would interpret this behavior as suggesting what? a. Effectiveness of the drug therapy b. Possible decision to complete a suicide attempt c. An act to cover up the client's true feelings d. A typical response to the medication

b. Possible decision to complete a suicide attempt

A nurse is preparing to administer pharmacotherapy as part of the treatment plan for a client with bipolar disorder. The nurse understands that this therapy is designed to achieve which goal? Select all that apply. a. Cure of the disorder b. Rapid control of symptoms c. Decreased frequency of manic episodes d. Prevention of future episodes e. Decreased severity of manic episodes

b. Rapid control of symptoms c. Decreased frequency of manic episodes d. Prevention of future episodes e. Decreased severity of manic episodes

A client taking lithium for bipolar disorder is having mild diarrhea. The nurse informs the client that this is an example of what? a. Toxic effect b. Side effect c. Desired effect d. Therapeutic effect

b. Side effect

Before a client became depressed, the client was an active, involved parent with three children, often attending their school functions and serving as a volunteer. The client is hospitalized for a major depressive episode and now reveals that the client feels like an unnecessary burden on the client's family. Which nursing diagnosis is most appropriate? a. Anxiety related to side effects of medication b. Situational low self-esteem c. Ineffective coping related to marital disagreements d. Ineffective activity planning related to depression

b. Situational low self-esteem

A client who has been discharged home on citalopram calls the nurse reporting that the medication causes the client to feel too drowsy. The nurse should make which suggestion? a. Make an appointment to change to a different medication. b. Take the medication at night. c. Be patient while this early side effect subsides. d. Skip a dose if drowsiness is excessive.

b. Take the medication at night.

A mental health nurse has identified a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. Which outcome would be most appropriate for this nursing diagnosis? a. The client will discuss the cause of the fatigue. b. The client will reframe negative thoughts in a more positive way. c. The client will identify factors that contribute to depression. d. The client will differentiate between reality and fantasy.

b. The client will reframe negative thoughts in a more positive way.

A psychiatric-mental health nurse is assessing a client who is suspected of experiencing depression. During the interview, the client says, "I just don't care any more. I used to enjoy doing all sorts of things outdoors, but now, I don't. Nothing seems to make me happy." The nurse interprets this statement as: a. labile mood. b. anhedonia. c. affect. d. aphasia.

b. anhedonia.

Electroconvulsive therapy would be contraindicated for a client with: a. myocardial infarction, five years ago. b. increased intracranial pressure. c. stroke, 10 years ago. d. hypertension.

b. increased intracranial pressure.

After educating a client with bipolar disorder on his prescribed lithium therapy, the nurse determines that additional education is needed when the client states which of the following? a. "I need to report any problems with severe diarrhea or slurred speech." b. "I need to avoid drinking any alcohol." c. "I need to cut back on my salt intake when it's really hot outside." d. "I can use sugarless candies to help with any metallic taste."

c. "I need to cut back on my salt intake when it's really hot outside."

A client with major depression is admitted to the health facility and expresses feelings of worthlessness and abandonment by significant others. Which replies by the nurse would convey empathy? a. "I can understand what is going on with you." b. "Are you feeling like others have abandoned you?" c. "It sounds like this is a really difficult time for you." d. "Can you tell me what you are thinking right now?"

c. "It sounds like this is a really difficult time for you."

During report, the nurse learns that a client with mania has not slept since admission 2 days ago. On entering the day room, the nurse finds this client dancing to loud music. Which would be the most appropriate statement by the nurse? a. "Do you think you could sit still for a few minutes so we can talk?" b. "How are you ever going to get any rest if you keep that music on?" c. "Let's go to the conference room and talk for a while." d. "Turn the radio down so we can hear ourselves talk."

c. "Let's go to the conference room and talk for a while."

A 46-year-old client comes to the community mental health center because the client thinks they might be suffering from depression. When assessing this client, which symptom would the nurse identify as being necessary for the diagnosis of major depressive disorder to be made? a. Euphoria along with poor decision making ability b. Disregard for personal hygiene including cleanliness and appearance c. A loss of interest or inability to derive pleasure for previously enjoyed activities d. A stooped posture and nonverbal signs of a depressed mood

c. A loss of interest or inability to derive pleasure for previously enjoyed activities

When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate? a. Renal function tests b. Coagulation profile c. Thyroid function tests d. Abdominal ultrasound

c. Thyroid function tests

Which type of therapy involves increasing the frequency of the client's positively reinforcing interactions with the environment and decreasing negative interactions? a. Cognitive therapy b. Interpersonal therapy c. Behavior therapy d. Electroconvulsive therapy

c. Behavior therapy

A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications? a. Mannitol b. Lithium c. Carbamazepine d. Methyldopa

c. Carbamazepine

Following a change in job position, a minister asks a client how the client likes the new job. The client states, "Oh everything is great. I can really see myself going far in this new position." However, the client's voice is monotone and the client's face is nearly absent of affective expression. The minister is worried about this client and describes this facial expression as what? a. Inappropriate b. Blunted c. Flat d. Constricted

c. Flat

A client with bipolar disorder takes lithium 300 mg 3 times daily. The nurse is educating the client on its use, side effects, and need for compliance. The nurse evaluates that the dose is appropriate when the client reports what? a. Feeling sleepy and less energetic. b. Weight gain of 7 pounds in the last 6 months. c. Minimal mood swings. d. Increased feelings of self-worth.

c. Minimal mood swings

Police officers bring a client to the mental health unit for admission. The client had been directing traffic on a busy city street, shouting rhymes such as "to work, you jerk, for perks" and making obscene gestures at cars that came close to the client. When the client's spouse is contacted at work, the spouse reports that the client stopped taking lithium 3 weeks ago and has not slept or eaten for 3 days. With which two features characteristic of the manic phase of bipolar disorder can the nurse identify? a. Increased muscle tension and anxiety b. Disinhibition and elevated mood c. Poor judgment and hyperactivity d. Vegetative signs and poor grooming

c. Poor judgment and hyperactivity

A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to the client's feelings of sadness and hopelessness, the nurse would expect to assess what? a. Increased focus b. Decreased complaints of pain c. Psychomotor retardation d. Increased energy level

c. Psychomotor retardation

According to the neurobiologic theory of mood disorders, a client with a diagnosis of depression is likely to have alterations in the levels and function of which neurotransmitters? a. Epinephrine, histamine, and melatonin b. Acetylcholine, adenosine, and glutamate c. Serotonin, norepinephrine, and dopamine d. Aspartate, gamma-Aminobutyric acid (GABA), and serine

c. Serotonin, norepinephrine, and dopamine

Administration of lithium affects which of the following electrolytes? a. Chloride b. Magnesium c. Sodium d. Potassium

c. Sodium

The client has been diagnosed with severe depression. During the assessment of the client, the nurse is aware of which primary consideration with clients taking antidepressants? a. decreased mobility b. emotional changes c. suicide d. increased sleep

c. suicide

A client is exhibiting rapid shifts in mood. The nurse documents this as which of the following? a. Elevated mood b. Expansive mood c. Irritable mood d. Mood lability

d. Mood lability

Once a client's condition is stabilized on lithium, serum levels should be monitored every ... a. week. b. 2 weeks. c. month. d. 2 months.

d. 2 months.

A client has been diagnosed with bipolar disorder. After teaching the client about the different medication classifications used to help stabilize mood, the nurse determines tha the teaching was successful when the client identifies which class of medications? a. Antianxiety b. Anticoagulants c. Antibiotics d. Anticonvulsants

d. Anticonvulsants

A client has been diagnosed with bipolar disorder. After teaching the client about the different medication classifications used to help stabilize mood, the nurse determines tha the teaching was successful when the client identifies which class of medications? a. Antianxiety b. Anticoagulants c. Antibiotics d. Anticonvulsants

d. Anticonvulsants

A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm? a. Immediately after a family visit b. On the anniversary of significant life events in the client's life c. During the first few days after admission d. Approximately 2 weeks after starting antidepressant medication

d. Approximately 2 weeks after starting antidepressant medication

A client has been taking a tricyclic antidepressant (TCA) for several months and is now reporting urinary hesitation. What is the nurse's best action? a. Ask the primary care provider to prescribe a diuretic b. Encourage the client to use a low dose of an over the counter diuretic c. Encourage the client to drink low-pH beverages d. Encourage the client to increase fluid intake

d. Encourage the client to increase fluid intake

A client who has experienced the recent loss of an infant child and recent immigration to the United States is admitted to the inpatient psychiatric unit with severe symptoms of depression. The client has expressed thoughts of suicide. Which is the nurse's priority intervention for this client? a. Exploring the grief and loss issues concerning the baby's death. b. Encouraging the client to express feelings of isolation following the recent immigration. c. Encouraging attendance at group cognitive-behavioral therapy on the unit. d. Ensuring that the client is not permitted to use anything that would be potentially dangerous.

d. Ensuring that the client is not permitted to use anything that would be potentially dangerous.

Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder? a. Bizarre, colorful, inappropriate dress b. Grandiose thinking and poor concentration c. Insulting, provocative behavior directed at staff d. Hyperactivity, dismissing meals, and sleep disturbance

d. Hyperactivity, dismissing meals, and sleep disturbance

A client with bipolar disorder I is experiencing a depressive episode. Which of the following would the nurse expect to be prescribed? a. Lithium b. Valproate c. Carbamazepine d. Lamotrigine

d. Lamotrigine

A 56-year-old client who suffers from seasonal affective disorder is being assessed by the nurse in an outpatient mental health clinic. The nurse is aware which treatment is the most effective type of treatment for this condition? a. Antidepressant therapy b. Psychotherapy c. Electroconvulsive therapy d. Light therapy

d. Light therapy

A client has been diagnosed with major depression. The client reports that the client often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as suggesting what? a. Initial insomnia b. Terminal insomnia c. Hypersomnia d. Middle insomnia

d. Middle insomnia

A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which nursing diagnosis has priority? a. Hopelessness related to recent divorce b. Ineffective coping related to inadequate stress management c. Spiritual distress related to conflicting thoughts about suicide and sin d. Risk for suicide related to highly lethal plan

d. Risk for suicide related to highly lethal plan

A psychiatric-mental health nurse is conducting a pharmacology review class for a group of nurses. The topic is antidepressant medications. The nurse determines that the review was successful when the group identifies which class of antidepressant as associated with fewer side effects? a. Tricyclic antidepressants (TCAs) b. Monoamine oxidase inhibitors (MAOIs) c. Serotonin norepinephrine reuptake inhibitors (SNRIs) d. Selective serotonin reuptake inhibitors (SSRIs)

d. Selective serotonin reuptake inhibitors (SSRIs)

The spouse of a client with bipolar disorder calls the nurse expressing distress about recent spending patterns of the client. The nurse suggests the spouse implement the limit-setting skills the spouse has learned in family therapy. In this instance, the nurse's action would be considered ... a. inappropriate; the nurse should not give advice to the spouse. b. inappropriate; the client has the legal right to spend personal money. c. appropriate; the spouse is responsible for the client's actions since the client has a mental illness. d. appropriate; the spouse needs support in setting boundaries.

d. appropriate; the spouse needs support in setting boundaries.