ch22-23 test practice
When performing discharge planning for a client who has schizophrenia, the nurse anticipates barriers to adhering to the medication regimen. The nurse assesses which as improving the likelihood that the client will follow the prescribed medication regimen? Select all that apply.
-States location of pharmacy nearest the client's residence -Short-term memory intact -Receives monthly disability checks
A nurse taking an admission history from a client suspects that the physician will diagnose major depression. For the physician to make this diagnosis, the client will have to demonstrate specific symptoms. What are some of these symptoms? Select all that apply.
-disruption in sleep -disruption in appetite -disruption in concentration -excessive guilt
A client is diagnosed with schizophreniform disorder. The nurse is reviewing the client's medical record and finds that the client's symptoms have been present for at least how long?
1 month
A diagnosis of delusional disorder is based on the presence of one or more nonbizarre delusions for at least what period of time?
1 month
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?
14 days
Research has shown that risk of suicide increases within which time frame for initiation of antidepressant therapy?
14 days
The mental health nurse appropriately provides education on light therapy to which client?
20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term
A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than:
6 months.
Which client best exhibits the characteristics that are typical of the prodromal period of schizophrenia?
A 20-year-old man who is exhibiting a gradual decrease in his ability to concentrate and function in daily activities
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 decrease in sexual pleasure during intimacy
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 decrease in sexual pleasure during intimacy
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 loss of interest or inability to derive pleasure for previously enjoyed activities
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 psychodynamic interpretation of the client's major depressive disorder.
A loss of pleasure or interest in a client diagnosed with depression would be documented as what?
Anhedonia
After assessing a client with schizophrenia, the nurse notes that the client exhibits signs and symptoms related to being unable to experience pleasure. The nurse documents this finding as what?
Anhedonia
Which of the following would the nurse identify as a negative symptom associated with schizophrenia?
Anhedonia
Which term is used to describe decreased attention to and enjoyment from previously pleasurable activities?
Anhedonia
A client is admitted for major depression. The client has stated that nothing seems to bring the client pleasure anymore. What should the nurse expect to find during assessment?
Anhedonia, feelings of worthlessness, and difficulty focusing
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?
Anxiety symptoms are more commonly noted in children who are depressed.
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?
Assess the client's blood pressure
A client has been diagnosed with depression and states that the client is reluctant to receive treatment, stating that the client "would prefer to just wait this out." What is the nurse's most appropriate action?
Explain to the client that untreated depression often becomes increasingly severe and frequent over time
A client has been taking haloperidol for 5 years when the client is admitted to the inpatient unit for relapse of symptoms of schizophrenia. Upon assessment, the client demonstrates akathisia, dystonia, a stiff gait, and rigid posture. The nurse correctly identifies these symptoms are indicative of what?
Extrapyramidal side effects
When describing delusional disorder to a group of nurses, what would the group leader most likely include?
Few risk factors have been identified for this disorder because the behavior is normal.
Which type of antipsychotic medication is most likely to produce extrapyramidal effects?
First-generation antipsychotic drugs
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?
Flat
Which antidepressant medication is classified as a selective serotonin reuptake inhibitor (SSRI)?
Fluoxetine
A client on the unit suddenly cries out in fear. The nurse notices that the client's head is twisted to one side, the client's back is arched, and the client's eyes have rolled back in the sockets. The client has recently begun drug therapy with haloperidol. Based on this assessment, which would be the first action of the nurse?
Give a PRN dose of benztropine IM
During an admission assessment, a client with schizoaffective disorder states that the client hears the voice of God in the client's head and the voice is telling the client that the client is worthless. What would the nurse document this symptom as?
Hallucination
Clients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which may occur as a result of water intoxication?
Hyponatremia
A client diagnosed with delusional disorder is experiencing persecutory delusions involving the belief that someone is putting poison in his food. When developing the client's plan of care, which nursing diagnosis would be most likely?
Imbalanced Nutrition, Less than Body Requirements
Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension?
Increase hydration
Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?
Increased amount of dopamine
Electroconvulsive therapy (ECT) has been shown to be an effective treatment for people with severe depression. However, ECT is contraindicated in which of the following disease processes?
Increased intracranial pressure
A client begins to exhibit hallucinations and delusions along with disorganized speech after forgetting to take antipsychotic medication. The nurse suspects that the client is at which point in the clinical course of the disorder?
Relapse
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?
Risk for suicide related to highly lethal plan
Which type of antidepressants are rarely fatal in overdose?
SSRIs
A nurse is caring for a client diagnosed with schizophreniform disorder. The nurse demonstrates understanding of this disorder when identifying that the client is at risk for developing what?
Schizophrenia
When reviewing the diagnostic criteria for schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), which would be most accurate?
Schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms.
A nursing student is caring for an elderly client who is taking sertraline for depression. The instructor quizzes the student about the medication and its actions. To what classification of drugs should the student assign sertraline?
Selective serotonin reuptake inhibitor
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?
Selective serotonin reuptake inhibitors
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?
Selective serotonin reuptake inhibitors (SSRIs)
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?
Situational low self-esteem
A client with depression is admitted to an inpatient psychiatric unit. The nurse provides a unit orientation. While observing the client's unpacking, the nurse can expect the client to exhibit what?
Slow movements and flat affect
The nurse should consider which during a psychiatric assessment of a newly immigrated client who is being evaluated for possible religious delusions?
Some cultures hold religious beliefs that might be confused with delusional thought
A client diagnosed with schizophrenia is laughing and talking while sitting alone. Which is the best response by the nurse?
State, "Tell me what's happening."
A client is diagnosed with schizoaffective disorder. The interdisciplinary plan of care includes key family members. The nurse understands that a major reason for doing so involves which of the following?
Strengthening the client's recovery
A nurse is preparing a presentation about suicide for a local community group. What would the nurse most likely include?
Suffocation is a common means of suicide among children.
A client who is taking paroxetine reports to the nurse that the client has been nauseated since beginning the medication. Which action is indicated initially?
Suggest that the client take the medication with food.
A parent of four small children lost a spouse in an automobile accident 3 months ago and is admitted to the hospital with severe depression. Since the spouse's death, the client's mood has been somber; until now, the client has refused treatment. What is this client at high risk for?
Suicide
When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?
Suicide
Clients with schizoaffective disorder have similar symptoms of schizophrenia with the exception of the increased risk for which of the following?
Susceptibility to suicide
The nurse notices the client with a shuffling gait walking in the hall. Which would not be included as a symptom of drug-induced parkinsonism?
Tachycardia
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?
Take the medication at night.
A client with severe and persistent mental illness has been taking antipsychotic medication for 20 years. The nurse observes during a therapy session that the client's behavior includes repetitive movements of the mouth and tongue, facial grimacing, and rocking back and forth. The nurse recognizes these behaviors as indicative of what?
Tardive dyskinesia
The student nurse correctly recognizes that which finding is best supported by genetic studies in the etiology of schizophrenia?
That schizophrenia is at least partially inherited.
A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation?
The client is experiencing catatonia.
The nurse is planning care for a client with major depression. Which is an appropriate expected outcome?
The client will independently carry out activities of daily living.
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?
The client will reframe negative thoughts in a more positive way.
Research related to the development of schizophrenia has shown what?
The disorder is thought to arise from the interaction of a biological predisposition and environmental stressors.
A client with major depression has been prescribed escitalopram. The nurse should address what topic in client education?
The possibility of gastrointestinal upset
A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication?
The potential for sedation
When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate?
Thyroid function tests
Assessment of genetic predisposition supports asking a client who is exhibiting symptoms of a delusional disorder what?
Whether any family members have been diagnosed with schizophrenia
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
assessing Carrie's current suicidal ideation and putting her on suicide precautions.
A client has a history of schizophrenia, controlled by haloperidol. During an assessment, the nurse notes sudden muscular tension with client's neck being pulled to the side. Which medication would nurse expect to be prescribed for this client?
benztropine mesylate
Throughout the assessment, the client displays disorganized thinking, jumping from one idea to another with no clear relationship between the thoughts. The nurse interprets the client's behavior as:
loose associations.
A week after beginning therapy with thiothixene, the client demonstrates muscle rigidity, a temperature of 103°F, an elevated serum creatinine phosphokinase level, stupor, and incontinence. The nurse should notify the physician because these symptoms are indicative of:
neuroleptic malignant syndrome.
Which is the most common subtype of delusion?
persecutory
A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?
somatic
The onset of major depressive disorder is most common among people who are in their:
twenties
A client has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug?
white blood cells
A client has just been diagnosed with a major depressive disorder following recent problems with the client's mood, work performance, and sleep quality. When planning this client's care, the nurse should anticipate what interventions? Select all that apply.
-Administration of a sustained serotonin reuptake inhibitor (SSRI) -Cognitive therapy
A client taking an antidepressant has experienced a 12-pound weight gain in 1 month as a side effect of the medication. Which of the following are nursing interventions to help this patient with this problem? Select all that apply.
-Advocate with the physician to consider changing the medication. -Recommend a nutritionally balanced diet. -Recommend daily exercise.
A psychiatric-mental health nurse is assessing a client with schizophrenia. Which finding would the nurse document as reflecting disorganized thinking? Select all that apply.
-Clang associations -Neologisms -Circumstantiality
A nurse is reviewing a journal article about the etiology of schizophrenia.The nurse would expect to find information about the dysfunction of which neurotransmitter? Select all that apply.
-Dopamine -Glutamine -Serotonin -Gamma-aminobutyric acid (GABA)
A nurse suspects that a client with schizophrenia who is receiving antipsychotic therapy is developing neuroleptic malignant syndrome (NMS). Which finding would support the nurse's suspicion? Select all that apply.
-Fever -Tachycardia -Diaphoresis -Incontinence
A client is being diagnosed with major depressive disorder based on reports of depressed mood, insomnia, loss of pleasure, extreme fatigue, and poor concentration. To confirm this diagnosis, which condition related to the client's report of symptoms must be present? Select all that apply.
-Issues must be among the recognized symptoms for this disorder -Symptoms cause a noticeable negative effect on the client's ability to function -Symptoms interfere with the client's ability to maintain social and employment relationships -The client's symptoms are unrelated to an underlying medical condition
A psychiatric-mental health nurse is conducting a presentation for a group of nurses at the local community center about depression. After the presentation, the nurse determines that it was successful when the group identifies which substances as potentially playing roles in depression? Select all that apply.
-Norepinephrine -Serotonin -Dopamine
Delusional disorders are primarily characterized by which of the following? Select all that apply.
-Paranoia -Jealousy -Distrust
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.
-Sedation -Sexual dysfunction -Dizziness
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?
"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?
"How many of the sleeping pills do you have at home right now?"
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?
"It sounds like this is a really difficult time for you."
The nurse is teaching a client with schizoaffective disorders (SAD) about the client's prescribed medication therapy. The nurse determines that additional education is needed when the client states what?
"One day, I won't have to worry about taking any medication."
A psychiatric-mental health nurse is providing care to a client with depression. The client spends most of the day in bed and only gets up to go to the bathroom or get a drink from the kitchen. The nurse is working with the client to increase activity. Which suggestion would be most appropriate?
"Try getting dressed every day and then go for a 5-minute walk."
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?
"You are feeling really sad right now. It's a hard time."
A client has experienced a first episode of major depression and has received medication and treatment, which has led to a complete remission of the symptoms. The client asks the nurse, "How much longer will I need to take the medication?" Which response by the nurse would be most appropriate?
"You'll need to continue the medication for about 6 to 12 months to see how things go."
A nurse monitoring client medication needs to recognize side effects quickly and intervene promptly for which reason?
Alleviate the side effects and help client maintain adherence
A nurse is preparing a presentation for a local community group about antidepressant therapy and suicidality. When describing those who would be at increased risk for suicide, which group would the nurse include?
Adolescents
A client diagnosed with schizophrenia has been prescribed Clozapine (Clozaril). Which of the following is a potentially fatal side effect of this medication?
Agranulocytosis
Which type of therapy involves increasing the frequency of the client's positively reinforcing interactions with the environment and decreasing negative interactions?
Behavior therapy
A patient with severe depression is being treated with medications and is told to increase activity and to exercise at least 4 times a week. Which of the following domains would these nursing interventions address?
Biologic
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?
Blurred vision
A client with schizophrenia is exhibiting hallucinations and delusions. The mental health nurse knows that these symptoms are associated with hyperactivity of which neurotransmitter?
Dopamine
A client with schizoaffective disorder is engaging in an extremely long conversation about a current affairs in the world. The client goes on to provide the nurse with minute details. The nurse interprets this as suggesting what?
Circumstantiality
A nurse is developing a plan of care for a client diagnosed with delusional disorder. Which of the following would the nurse need to keep in mind?
Clients with delusional disorder typically have problems with medication adherence.
The nurse is planning the inpatient care of a client who has been admitted with major depression. The client's plan of care includes regular exercise, but the client is reluctant to participate due to a lack of energy and motivation. What is the nurse's best action?
Collaborate with the client to choose a manageable amount of exercise and acknowledge the client's subsequent effort
Schizoaffective disorder is most likely to be diagnosed at which of the following stages of life?
Early adulthood
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?
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?
Ensuring that the client is not permitted to use anything that would be potentially dangerous.
A client is prescribed a selective serotonin reuptake inhibitor (SSRI) as treatment for depression. Which would the nurse most likely administer?
Escitalopram
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?
Psychomotor retardation
A nurse is providing care to a client with recurrent major depression. The nurse would most likely expect a combination of medications and which treatment to be used to achieve maximum effectiveness?
Psychotherapy
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?
Dehydration
Which is the central focus of persecutory delusions?
Injustice that must be remedied by legal action
The nurse is providing teaching to a client diagnosed with schizoaffective disorder. The nurse should explain to the client that which is true about this disorder?
It is a mix of psychotic and mood symptoms.
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?
Light therapy
A psychiatric-mental health nurse is conducting a teaching session for family members of clients with schizophrenia. When describing relapse, which factor would the nurse address as a major cause?
Medication noncompliance
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?
Middle insomnia
Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with what?
Moderate depression
A client diagnosed with schizoaffective disorder exhibits the symptoms of a psychosis in addition to which of the following?
Mood disorder
Schizoaffective disorder has symptoms typical of both schizophrenia and which type of disorder?
Mood disorders
A psychiatric-mental health nurse is conducting a seminar for a group of colleagues about delusional disorder. The nurse determines that the teaching was successful based on which statement by the group?
Most individuals experience little or no psychological deficits.
During an assessment of a client with schizophrenia, the client states, "The end of the world is coming. I just know it." The nurse interprets this as which type of delusion?
Nihilistic
The client was conversing with the nurse when noticeable changes occurred with the client. Which is a term used to describe the occurrence of the eye rolling back in a locked position, which occurs with acute dystonia?
Oculogyric crisis
A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?
Offering reassurance in a soft, nonthreatening voice
Which should the nurse anticipate when providing therapy and evaluating outcomes for a client with delusional disorder?
Often not met completely
A depressed older adult client is being treated with a tricyclic antidepressant (TCA). For which clinical manifestations should the nurse monitor the client?
Orthostatic hypotension and urinary retention
Which type of delusion refers to a situation whereby a person or someone close to person is being malevolently treated in some way?
Persecutory type
A client is admitted to a mental health unit with reports of fatigue, poor appetite, and difficulty making decisions. The client also states feeling unhappy most of the time for "as long as the client can remember." Which diagnosis should the nurse anticipate for this client?
Persistent depressive disorder
When describing the difference between schizoaffective disorder (SAD) and schizophrenia, the nurse would address which as associated with SAD?
increased mood responses
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:
anhedonia.
