Exam 3 Nursing psych/mental health

The client with bulimia reports feeling helpless and says, "What's the use?" As the nurse plans the client's care, the priority diagnosis is which?

Risk for self directed violence

When obtaining a client's history, a nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems with the ability to function at work. The client also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. Which condition does the nurse suspect?

Schizophreniform Disorder

A client is receiving antipsychotic therapy. When describing dystonic reactions to the client, the nurse would instruct the client to watch for:

Spasms of the eye muscle

The nurse is counseling a client who has lost a spouse. According to the dual-process model, which of the client's statements to the nurse relate to restoration-oriented coping?

"With my spouse gone, I don't know how I can pay the bills."

Approximately what percentage of clients who have fully recovered from bulimia nervosa later experience a relapse?

30%

A nurse is talking to a client who has been told the client has a terminal illness and is responding in an angry manner. What statement by the nurse would best facilitate the best possible client outcomes?

"How much do you know and what do you want to know?"

The nurse is interviewing an 18-year-old client about eating behaviors. The client's parents have brought the client to treatment because the client's mother suspects that the client has been binge eating and vomiting. The nurse asks the client if the client ever feels that the client cannot control the client's eating. The client's mother states, "I know the client can't control it; the client ate an entire cake last night!" Which comment by the nurse is best?

"I see. Do you ever feel as though you cannot control your eating?"

The nurse is providing a high-school prevention program for adolescents and parents about eating disorders. Which important preventative measure(s) will the nurse educate the group regarding? Select all that apply.

-Find outcomes that are achievable to increase self-esteem. -Work on the development of coping strategies to handle emotional issues that arise. -Although the peer group is very important to the adolescent, avoid the pitfalls of peer pressure to diet. -Develop realistic ideas about body shape and size and avoid comparing self to the "ideal."

A client who has a recent diagnosis of bipolar I disorder is scheduled to begin therapy with lithium. Which instruction should the nurse provide to this client?

Avoid exercise at the hottest times of day

A nursing instructor is reviewing a case study with students about a client with mania who was admitted to a mental health unit. The instructor asks the students what medical diagnosis is most likely responsible for the mania. Which would be the best answer by a student?

Bipolar disorder

A psychiatric-mental health nurse is conducting a review class for a group of colleagues about schizoaffective disorder. The nurse determines that the class was successful based on which description of the condition by the group?

Clients are often misdiagnosed as having schizophrenia.

A client who otherwise is healthy is admitted for depression and reports feeling "all alone" following a recent divorce. The client admits to drinking at least 12 beers every day. The client has which risk factors for the depression? Select all that apply.

Current substance use or abuse Life and environmental stressors Lack of coping abilities

Despite being admitted to the hospital yesterday for the treatment of complications of anorexia nervosa, a 19-year-old client continues to have only bites of food and small sips of fluids. Which of the following nursing diagnoses is paramount in this client's care?

Deficient fluid volume related to inability to meet bodily fluid requirements

A nurse is assessing a client diagnosed with delusional disorder. The nurse would expect to find what?

Delusions with a prominent theme

The relationships and associations among the words used to express thoughts are markedly disturbed in clients with schizophrenia. What is this disturbance characterized by?

Disorganized speech

The nurse suspects that a client is experiencing a brief psychotic episode based on what? Select all that apply

Evidence of hallucinations Intense changes in affect Recent life stressor

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

Which is a metabolic complication related to weight loss?

Hypothyroidism

The nurse meets with a client who reports meeting with siblings yesterday to chose a coffin for the deceased mother. How can the nurse most accurately describe this process to the client?

Mourning

Which has not been proposed as a potential mechanism for the etiology of thought disorders?

Neglect in childhood

A client with schizoaffective disorder (SAD) is prescribed clozapine. The nurse understands that in addition to the drug's antipsychotic effects, it is also effective in which area?

Reducing the risk for suicide

The nurse is caring for a hospitalized client who just received the news that a mass in the neck is malignant. As the nurse engages in an assessment of the client's needs, the nurse asks, "Who has been a helpful person to you in the past when you were having a difficult time?" Which component of the assessment is the nurse exploring?

Support while grieving

The nurse is assessing a client who is deeply upset and is not expressing feelings. At the end of the assessment, the nurse concludes that the client is extremely depressed because of the death of a loved one. The client has disenfranchised grief. What is the most likely reason for the client not being willing to speak about it to the nurse?

The client feels uncomfortable speaking about the relationship with the deceased.

Which outcome will the nurse evaluate to determine whether a client has successfully stabilized when engaged in the grieving process?

The client will verbalize acceptance of his or her terminal diagnosis.

A client with major depression has been prescribed escitalopram. The nurse should address what topic in client education?

The possibility of gastrointestinal upset

Which is a cognitive response to grief?

attempting to keep lost one present

The nurse is caring for a client with schizoaffective disorder with depression. The nurse should instruct the client that the most effective medication therapy for this disorder is:

atypical antipsychotic medications

The nurse is facilitating a support group for people who have lost a family member or friend to suicide. When discussing strategies for coping with grief, which should the nurse include? Select all that apply.

completing a daily journal entry before bedtime writing out the events leading up to the loved one's suicide cognitive behavioral therapy

Which client will the nurse identify as having the greatest risk for developing disenfranchised grief?

the wife of a man who was shot to death by police during a robbery