exam #3 mental health
What is the therapeutic action of Ativan, a member of benzodiazepine classification? 1 Potentiate effects of GABA. 2 Block reuptake of dopamine. 3 Block reuptake of serotonin. 4 Activate opioid receptors.
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Which of his belongings can the PN allow Nathan to keep in his room? 1 Unlaced tennis shoes. 2 Aftershave lotion. 3 Over-the-counter vitamins. 4 Pack of cigarettes.
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a female client is admitted to the hospital after attempting suicide she reveal that her desire for sex has diminished since her child's birth 3 years ago. what is most directly related to the client's loss of interest in sex? 1 depression 2 dependency 3 martial stress 4 identity confusion
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the nurse anticipates that which med will be used to prevent symptoms of withdrawal in clients with a long history of alcohol abuse? 1 lorazepam 2 phenobarbital 3 chlorpromazine 4 methadone hydrochloride
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what is a warning sign of suicide? 1 sleeping soundly 2 giving away prized possessions 3 spending more time with family 4 complaining about physical problems with organic cause
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what is the primary reason that the nurse encourages the family of an alcoholic to become involved in the treatment program? 1 alcoholism involves the entire family 2 alcoholics try to hide their drinking from their families 3 family members provide insights into the dynamics behind the drinking 4 family members have been most successful providing necessary support
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What is the purpose of Antabuse? 1 Decrease Nathan's cravings for alcohol. 2 Precipitate a reaction if alcohol is ingested. 3 Block the effects of endorphins. 4 Prevent Nathan from binge drinking.
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what is a warning sign of suicide? 1 sleeping soundly 2 giving away prized possessions 3 spending more with family 4 complaining about physical problems with organic causes
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Which product is acceptable for Nathan to use? 1 cough medicine 2 mouthwash 3 aftershave lotion 4 peroleum jelly
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A client is admitted to the psychiatric unit for severe depression with the potential for suicide. What is the most therapeutic nursing intervention when the client becomes more energized and communicative? 1 continuing to assess the client at regular intervals 2 encouraging the client to participate in group activities 3 giving the client more autonomy to decide about privileges 4 starting to teach the client about medications in preparation for discharge
1
A hospitalized, depressed, suicidal client has been taking a mood-elevating medication for several weeks. The client's energy is returning and the client no longer talks about suicide. What should the nurse do in response to this client's behavior? 1 keep the client under closer observation 2 arrange for the client to have more visitors 3 engage the client in preliminary discharge planning 4 observe the client for side effects of the medication
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A nurse knows individuals who are alcoholics use alcohol for what reason 1 To blunt reality 2 To precipitate euphoria 3 To promote social interaction 4 To stimulate the CNS
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An obese client with type 2 diabetes asks about the intake of alcohol or special "dietetic" food in the diet. What should the nurse include in teaching? 1 Alcohol can be consumed, with its calories counted in the diet 2 Unlimited amounts of sugar substitutes can be used as desired 3 Alcohol should not be used in cooking because it adds too many calories 4 Special "dietetic" foods are needed because many regular foods cannot be used
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What mechanism of action accounts for symptoms of alcohol withdrawal delirium? 1 Increased dopamine. 2 Increased Gamma-aminobutyric acid (GABA). 3 Decreased norepinephrine. 4 Increased serotonin.
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When should the PN begin observation for withdrawal? 1 Within 4 to 6 hours of Nathan's last drink. 2 24 hours after admission. 3 If blood pressure is elevated. 4 When hand tremors are visible.
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a client who is obese and has type 2 diabetes asks about the intake of alcohol and special "dietetic" food in the diet. what should the nurse include in teaching 1 alcohol can be consumed, with its calories counted in the diet 2 unlimited amounts of sugar substitutes can be used as desired 3 alcohol should not be used in cooking because it adds too many calories 4 special "dietetic" foods are needed because many regular foods cannot be used
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which medication may be used to encourage abstinence in a client with alcoholism? 1 Disulfiram 2 Lorazepam 3 Methadone 4 Chlordiazepoxide
1
A nurse caring for a hospitalized woman begins to suspect during assessment that the woman is experiencing domestic abuse. Which behavioral findings might lead the nurse to this suspicion? Select all that apply. 1 Depression 2 Suicide attempt 3 Chronic pelvic pain 4 Urinary tract infections 5 Irritable bowel syndrome
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An adolescent with a major depressive disorder is prescribed venlafaxine. What signs or symptoms related to the medication will the nurse communicate immediately to the prescribing provider? 1 Blurred vision 2 Suicidal ideation 3 Difficult urination 4 Tardive dyskinesia 5 Transient hypoglycemia
123
which precautions should be taken for a client who may be inclined to attempt suicide in the hospital? select all that apply 1 staying with the client during meals 2 making sure the client swallows all medications 3 assigning a room close to the front desk of the unit 4 allowing visitors to leave unchecked gifts in the room 5 making frequent therapeutic nonverbal contact with the client
123
A client who attempted suicide by slashing her wrists is transferred from the emergency department to a mental health unit. What important nursing interventions must be implanted when the client arrives on the unit? (Select all that apply.) 1 Obtaining vital signs 2 Assessing for suicidal thoughts 3 Instituting continuous monitoring 4 Initiating a therapeutic relationship 5 Inspecting the bandages for bleeding
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A 25-year-old woman is seeking outpatient counseling after thinking about suicide. The nurse realizes that there some factors place individuals at a higher risk for suicide. Which of these factors increases the risk for suicide? (Select all that apply.) 1 Impulsivity 2 Panic attacks 3 Unemployment 4 religious beliefs 5 Substance abuse 6 sense of responsibility to family
1235
when presenting a workshop on adolescent suicide, a community health nurse identifies which risk factors? select all that apply 1 victim of family violence 2 limited or strained family finances 3 member of a single parent household 4 dependence on alcohol, drugs, or both 5 uncertainty related to sexual orientation 6 repeated demonstration of poor impulse control
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A client has just been admitted with the diagnosis of borderline personality disorder. There is a history of suicidal behavior and self-mutilation. The nurse remembers that the main reason that clients use self-mutilation? 1 to control others 2 to express anger or frustration 3 to convey feelings of autonomy 4 to manipulate family and friends
2
A nurse uses the CAGE screening test for alcoholism to determine an individual's potential for a drinking problem. What is one of the four questions included on this test? 1 "Do you feel that you are a normal drinker?" 2 "Have you ever felt bad or guilty about your drinking?" 3 "Are you always able to stop drinking when you want to?" 4 "How often did you have a drink containing alcohol in the past year?"
2
Since the PN needs to give medications to a few other clients, what is the PN's best response? 1 I'll help you after I finish administering these medications. 2 Let me find one of the staff to help you. 3 Let's wait until you are feeling less shaky. 4 How shaky are you feeling right now?
2
What is the best advice a nurse can provide to a pregnant woman in her first trimester? 1 Cut down on drugs, alcohol, and cigarettes 2 Avoid drugs and don't smoke or drink alcohol 3 Avoid smoking, limit alcohol consumption, and don't take aspirin 4 Take only prescription drugs, especially in the second and third trimesters
2
What should the PN do next? 1 Take precautions for possible alcohol withdrawal. 2 Report Nathan's drinking behavior to the registered nurse (RN). 3 Obtain blood alcohol content with a breathalyzer. 4 Obtain a urine drug screen for poly substance use.
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When caring for clients who are at risk for suicide, the nurse should consider that: 1A client who fails in a suicide attempt will probably not try again. 2Formal suicide plans increase the likelihood that a client will attempt suicide. 3It is best not to talk to clients about suicide because it may give them the idea. 4Clients who talk about suicide are not planning it; they are using the threat to gain attention.
2
Which finding supports that Nathan has probable liver disease? 1 Hyperkalemia. 2 Increased aspartate aminotransferase (AST). 3 Reduced alkaline phosphatase. 4 Decreased uric acid.
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Which goal is most important for alcohol detoxification? 1 Discourage drug-seeking behaviors. 2 Physiologic stabilization. 3 Monitor liver function tests. 4 Enhancement of coping skills.
2
Which intervention should the PN anticipate next? 1 Administer promethazine (Phenergan) 12.5 mg PO. 2 Administer lorazepam (Ativan) 2 mg PO. 3 Take vital signs in 2 hours. 4 Ask Nathan how he is feeling.
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which condition is a physical condition in an alcoholic client? 1 social isolation 2 risk for poisoning 3 ineffective impulse control 4 risk for compromised human dignity
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Using the CAGE, what is the first question that the practical nurse (PN) should anticipate Nathan will be asked? 1 Using the CAGE, what is the first question that the practical nurse (PN) should anticipate Nathan will be asked? 2 Have you ever felt bad or guilty about your drinking? 3 Have you ever thought that you should cut down on your drinking? 4 Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?
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A client who has been admitted to the hospital for an elective prostatectomy is extremely anxious and has hand tremors. The client's partner informs the nurse that the client has been drinking heavily for the last 5 years. While the client is unpacking the nurse sees him hiding a bottle of whiskey in the rear of a drawer. How should the nurse respond initially to this behavior? 1 Try to catch the client drinking the alcohol 2 Confiscate the alcohol when the client is not looking 3 Wait for the client to bring up the subject of drinking 4 Ask the client how much alcohol he consumes in a week
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A licensed practical nurse (LPN) is learning about delirium tremens (DTs), an alcoholism-associated disorder that occurs as a complication of alcohol withdrawal. Which statement made by the LPN indicates effective understanding? 1 It causes damage in the temporal lobes of the brain 2 It occurs 5 or 6 days after the cessation of alcohol intake and lasts 1 or 2 days 3 It is a chronic psychotic reaction that results from excessive alcohol consumption over a long period 4 It is characterized by shaking, an increase in activity, disorientation, hallucinations, and increased temperature
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A nurse in a mental health unit of the emergency department of a hospital frequently cares for adolescents who attempt suicide. What is important for the nurse to remember about adolescent suicide behavior? 1 boys account for more attempts than do girls 2 girls use more dramatic methods than do boys 3 girls talk more about suicide before attempting it 4 boys are more likely to use lethal methods than girls
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A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism, the client asks what does my drinking have to do with my diagnosis, what effect of alcohol should the nurse include when responding? 1 Promotes the formation of calculi in the cystic duct 2 Stimulates the pancreas to secrete more insulin than it can immediately produce 3 Alters the composition of enzymes so they are capable of damaging the pancreas 4 Increases enzyme secretion and pancreatic duct pressure that causes backflow enzymes
4
A nurse is discussing plans with a client who has decided to withdraw from alcohol. What should the nurse recommend as one of the most effective treatments for alcoholism? 1 Daily administration of disulfiram 2 Individual or group psychotherapy 3 Admission to an alcoholic unit in a hospital 4 Active membership in Alcoholics Anonymous
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what behavior by a client with long history of alcohol abuse is an indication that the client may be ready for treatment? 1 drinking only socially 2 not drinking for a week 2 hospitalization for detox 4 verbalizing an honest desire for help
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while educating a group of nursing students about the various effects of commonly abused substances, a nurse explains delirium tremens. which statement made by a student nurse indicates effective understanding? 1 It may cause damage in the temporal lobes to the client's brain 2 It can be treated by supporting ventilation and administering naloxone as prescribed 3 It is characterized by short-term memory loss, disorientation, muttering, and delirium 4 It often occurs one to four days after cessation of alcohol use and lasts from two days to a week
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A nurse has been caring for a suicidal client for 3 weeks on an inpatient unit. One morning the client greets the nurse cheerfully and states, "Everything is looking up. I'm not going to have problems for very long." What does the client's behavior and statement indicate? 1 increased risk of suicide 2 increased level of anxiety 3 positive response to treatment 4 resolution of suicidal ideation
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What is the most important consideration for discharge planning? 1 Resources available to Nathan after discharge. 2 Nathan's knowledge of the ongoing disease process. 3 Longest period of sobriety and potential for relapse. 4 Acceptance of Alcoholics Anonymous for abstinence.
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What is the rationale for giving thiamine (B1) and a multivitamin? 1 Reduce the risk of Wernicke's disease. 2 Prevent occurrence of delirium tremens. 3 Lessen alcohol withdrawal symptoms. 4 Help increase Nathan's appetite.
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Which data is the most important indication for safe alcohol detoxification? 1 Vital signs every 4 hours. 2 Type of alcohol consumed recently. 3 Amount and last use of alcohol. 4 History of delirium tremens.
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a client who is obese and has a history of alcohol abuse is admitted to the hospital with a diagnosis of acute pancreatitis. what is the priority expected client outcome in response to therapy at this time? 1 report decreased pain 2 remain in fluid balance 3 lose 4 pounds a week 4 join alcoholics anonymous
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The nurse is working with a client who talks freely about feeling depressed. During the interaction the client states, "Things will never change." What findings support the nurse's conclusion that the client is experiencing hopelessness? (Select all that apply.) 1 bouts of crying 2 self destructive acts 3 presence of delusions 4 feelings of worthlessness 5 intense interpersonal relationships
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a student nurse is aware that the american nurse association believes that practitioner assisted suicide is not consistent with the philosophy of nursing. which ethical principles are not part of the basis for this ANA stand? select all that apply 1 justice 2 autonomy 3 beneficence 4 truthfulness 5 nonmalefience
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A pregnant woman continues consuming alcohol during pregnancy. Which teratogenic effects might be seen in the fetus or neonate? Select all that apply. 1 - Stillbirth 2 - Ebstein anomaly 3 - Neural tube defects 4 - Spontaneous abortion 5 - Intellectual disabilities
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A client is admitted to the surgical unit with superficial wounds of both wrists, the result of a suicide attempt. When the nurse enters the room, the client says, "I suppose you're going to ask me about my suicide attempt." What is the best response by the nurse? 1 do you want me to talk about it? 2 tell me how you feel about it 3 it's best not to dwell on it right now 4 why do you think i'd ask you about it
2
A nurse is assessing several depressed clients. Which behavior should alert the nurse to closely monitor a client for a suicide attempt? 1. When the client does not eat 2. If the client describes a plan for suicide 3. If the client cannot list any future goals 4. When the client's depression appears to deepen
2
A nurse plans to evaluate a newly admitted depressed client's potential for suicide. What is the best approach to obtain this information? 1. Question the client about plans for the future 2. Inquire whether the client is now considering suicide 3. Discuss suicide with other clients while the client is in the group 4. Ask family members whether the client has ever attempted suicide
2
a nurse who is talking to a client suspects the client has agoraphobia. which of these responses by the client support the nurse's suspicion? select all that apply 1 the client repeats words frequently 2 the client is afraid to talk in parking lots 3 the client is withdrawing from friends and family 4 the client is afraid to venture out of the house alone 5 the client refuses to use a public bus of transportation
245
discharge instructions for the client diagnosed with cirrhosis with varies should include information about the importance of what? select all that apply. 1 adhering to a low car diet 2 avoiding aspirin and aspirin containing products 3 limiting alcohol consumption to two drinks weekly 4 avoiding acetaminophen and products containing acetaminophen 5 avoiding coughing, sneezing, and straining to have a bowel movement
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A depressed client says, "I'm no good. I'm better off dead." What is the priority nursing intervention? 1 responding "i'll stay with you until you're less depressed 2 replying "i think you're good; you should think about living" 3 alerting the staff to schedule 24 hour observation of the client 4 unobtrusively removing those articles that may be used in a suicide attempt
3
A nurse is caring for a client who has been hospitalized for alcohol withdrawal. The client decides to attend an Alcoholics Anonymous meeting. What is a basic principle of this group? 1 Spouses should attend Al-Anon meetings 2 A commitment to permanent abstinence must be made 3 Amends must be made to each person who has been harmed 4 People have the power to overcome alcoholism if they truly want to stop drinking
3
A nurse moves into the working phase of a therapeutic relationship with a depressed client who has a history of suicide attempts. What question should the nurse ask the client when exploring alternative coping strategies? 1 how have you managed your problems in the past 2 what do you feel that you've learned from this suicide attempt 3 how will you manage the next time your problems start piling up 4 were there other things going on in your life that made you want to die
3
A nurse on a psychiatric unit has been working with a suicidal college student for 2 days. The comment by the student that indicates relief from suicidal thinking is: 1"I can be a burden to others." 2"I feel very alone sometimes." 3"I plan to go to school next semester." 4"I don't know whether I can talk about my feelings."
3
What is the purpose of administering intravenous (IV) fluids as prescribed while performing detoxification of an alcoholic client? 1 To raise the seizure threshold 2 To encourage better air exchange 3 To correct the client's fluid and electrolyte imbalance 4 To manage the client's tremors, nervousness, and restlessness
3
Who should the PN ask to complete the incident report? 1 As a licensed staff member, the PN should complete the report. 2 The PN should help Nathan complete as much as possible. 3 The PN should ask the UAP to complete the report. 4 The RN and the healthcare provider should complete the report.
3
a client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. the client reports frequent nausea, pain that increases after meals, and black tarry stools. the client recently joined alcoholics anonymous. the nurse should give priority to which patient history item? 1 pain that increases after meals 2 frequent nausea 3 black tarry stools 4 joining alcoholics anonymous
3
naltrexone is used to treat clients with substance abuse problems. in which situations does the nurse anticipate that naltrexone will be administered? 1 to treat opioid overdose 2 to block the systemic effects of cocaine 3 to decrease the recovering alcoholic's desire to drink alcohol 4 to prevent severe withdrawal symptoms for anti anxiety agents
3
suicide precautions are ordered for a newly admitted client. what is the most therapeutic way to provide these precautions? 1 keeping the client in the lounge during the daytime 2 encouraging the client to express feelings frequently 3 assigning a staff member to be with the client at all times 4 having a nursing aide observe the client every half hour at night
3
which alcoholism-associated disorder causes damage to the client's temporal lobes of the brain? 1 Delirium tremens 2 Fetal alcohol syndrome 3 Wernicke encephalopathy 4 Alcohol withdrawal syndrome
3
A family member brings a relative to the local community hospital because the relative "has been acting strange." Which statements meet involuntary hospitalization criteria? SATA 1. "I cry all the time; I'm just so sad." 2. "Since I retired I've been so depressed." 3. "I'd like to end it all with sleeping pills." 4. "The voices say I should kill all prostitutes." 5. "My boss makes me so angry—he's always picking on me."
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a nurse is interacting with depressed, suicidal client. what themes in the client's conversation are of most concern to the nurse? select all that apply 1 power 2 betrayal 3 loneliness 4 hopelessness 5 indecisiveness
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a client who is on the third day of detoxification therapy becomes agitated and restless. what are the signs and symptoms that indicate impending alcohol withdrawal delirium? select all that apply. 1 polydipsia 2 drowsiness 3 diaphoresis 4 tachycardia 5 hypertension
345
which disorders are complications associated with alcoholism? select all that apply 1 rhinitis 2 sinusitis 3 delirium tremens 4 Korsakoff psychosis 5 Wernicke encephalopathy
345
A client confides to the nurse, "I've been thinking about suicide lately." What conclusion should the nurse make about the client? 1 the client intends to frighten the nurse 2 the client wants attention from the staff 3 the client feels safe and can share feelings with the nurse 4 the client is fearful of the impulses and is seeking protection from them
4
A nurse is providing information about Alcoholics Anonymous (AA) meetings to a client with a history of alcohol abuse. What will be required when the client attends AA meetings? 1. Speaking aloud at weekly meetings 2. Maintaining controlled drinking after 6 months 3. Promising to attend at least 12 meetings yearly 4. Acknowledging an inability to control the alcoholism
4
A nurse tells the family member of an alcoholic client, "This condition occurs in individuals who have developed physiologic dependence on alcohol and then quit drinking abruptly." To which condition is the nurse referring? 1. Korsakoff psychosis 2. Fetal alcohol syndrome 3. Wernicke encephalopathy 4. Alcohol withdrawal syndrome
4
A practitioner prescribes disulfiram (Antabuse) for a client who abuses alcohol. The nurse remembers that disulfiram will: 1 Affect short-term memory 2 Permit a healthier lifestyle 3 Allow him to tolerate small amounts of alcohol 4 Cause a severe adverse reaction if alcohol is consumed
4
The PN recognizes which nursing problem takes priority for Nathan during the initial crisis plan? 1 Drinking alcohol to ineffectively cope. 2 Ineffective denial about severity of problem. 3 Elevated vital signs and liver disease. 4 Thoughts of wanting to jump off of a bridge.
4
What data supports Nathan's need for hospitalization? 1 Drinking alcohol and potential withdrawal. 2 Ineffective denial about severity of problem. 3 Elevated vital signs and liver disease. 4 Thoughts of wanting to jump off a bridge.
4
What other priority nursing diagnosis should the PN address within 72 hours of admission? 1 Ineffective denial. 2 Risk for injury. 3 Ineffective coping. 4 Imbalanced nutrition.
4
a client being admitted for alcoholism reports having had alcoholic blackouts. the nurse knows that an alcoholic blackout is best described how? 1 a fugue state resembling absence seizures 2 fainting spells followed by a loss of memory 3 loss of conscious lasting less than 10 minutes 4 absence of memory in relation to drinking episodes
4
a client is admitted to the mental health unit after attempting suicide. when a nurse approaches, the client is tearful and silent. what is the nurse's best initial intervention? 1 Observe the behavior, record it, and notify the health care provider 2 Sit quietly next to the client and wait for the client to start speaking 3 Say, "you are crying. That means you feel badly about attempting suicide and really want to live." 4 Say, "i see you are tearful. Tell me about what is going on in your life, and we can work on helping you."
4
A client is admitted to the hospital with ascites. The client reports drinking a quart (liter) of vodka mixed in orange juice every day for the past three months. To assess the potential for withdrawal symptoms, which question would be appropriate for the nurse to ask the client? 1 When was your last drink of vodka?"" 2 What prompts your drinking episodes?" 3 "Do you also eat when you drink?" 4 "Why do you mix the vodka with orange juice?"
1
A nurse is caring for an older adult who is taking acetaminophen (Tylenol) for the relief of chronic pain. Which substance is most important for the nurse to determine if the client is taking because it intensifies the most serious adverse effect of acetaminophen? 1 Alcohol 2 Caffeine 3 Saw palmetto 4 St. John's wort
1
In which situation is the use of seclusion contraindicated? 1 the client has expressed severe suicidal thoughts 2 the client appears to want to be placed in seclusion 3 the client has been voluntarily admitted for treatment 4 the client had minimal improvement despite being secluded before
1
Which nursing intervention is most important to obtain before beginning Antabuse therapy? 1 Place Nathan's written consent to comply with instructions in the record. 2 Monitor Nathan's vital signs prior to starting Antabuse. 3 Determine the longest period of sobriety and need for abstinence. 4 Help Nathan identify triggers leading to possible alcohol abuse.
1
Which question should the PN ask Nathan in order to determine whether or not he is able to return to a pre-crisis level of functioning? 1 Do you have support and people who can help you? 2 How have you handled other crises? 3 When did you begin to feel sad? 4 What are some of your previous strengths?
1
Which question is most likely to predict the onset of withdrawal symptoms if Nathan is dependent on alcohol? 1 How often do you usually drink? 2 When did you last have something to drink? 3 How much alcohol do you usually drink? 4 What is your experience with withdrawal?
2
On the day after admission a suicidal client asks a nurse, "Why am I being watched around the clock, and why can't I walk around the whole unit?" Which reply is most appropriate? 1 why don't you think were observing you? 2 what makes you think we're observing you 3 we're concerned that you might try to harm yourself 4 we're following your doctor's instructions, so there must be a reason
3
What action should the PN take? 1 Document that the UAP completed the client teaching. 2 Praise the UAP for saving the nurses' time to complete higher priority tasks. 3 Instruct the UAP that initial client teaching must be performed by the RN. 4 Request that the UAP be assigned to another unit.
3