exam18

which of the following medications are used for treatment of alcoholism. select all a. antabuse b. dilantin c. librium d. lithium

a. antabuse b. dilantin c. librium

your terminally ill patient states i know i am going to die but i want to talk my daughter down the isle this is what a. bargaining b. anger c. acceptance d. denial

a. bargaining

your patient is on Eskalith (Lithium Carbonate) when educating your patient about his med, you would include which of the following a. blood levels must be checked for toxicity b. limit your use of alcohol c. photosensitivity can happen. wear sunscreen daily d. check your BP regularly and report hypertension

a. blood levels must be checked for toxicity

patient is diagnosed with conclusive terminal cancer and refuses to discuss illness with family this is a. denial b. rationalization c. projection d. anger

a. denial

biological indications of schizophrenia include. select all a. enlarged ventricles b. enlarged cerebral cortex c. decrease in dopamine d. organized thinking

a. enlarged ventricles

you suspect your patient has taken too many benzos you know to administer a. flumazenil b. narcan c. actylctsteine d. protamine sulfate

a. flumazenil

client who was hospitalized for depression is being prepared by the nurse for discharge. in evaluating the coping strategies learned during hospitalization, the nurse should recognize which statement by the client is an indication that further teaching is needed a. i know that i won't become depressed again b. i know that i can't be all things to all people c. i need to take my medications just as prescribed d. i have learned ways to deal with the stresses in my life

a. i know that i won't become depressed again

hyperactivity and euphoria are signs of what with bipolar disorders a. mania b. depression c. hypomania d. anxiety

a. mania

what does the success of a patient going through substance abuse treatment program depend on a. motivation of the user b. type of assistance received while in the program c. treatment plan established by the physician d. the effectiveness of group therapy

a. motivation of the user

the nurse reviews the activity schedule for the day and determines that which supervised activity is the best option for the manic client a. ping pong b. paint by number activity c. brown bad lunch and book review d. deep breathing and progressive relaxation group

a. ping pong

the nurse is assigned to care for client who is suicidal. which nursing intervention is appropriate for this client a. provide authority, action, and participation b. display an attitude of detachment, confrontation, and efficiency c. demonstrate confidence in the client's ability to deal with stressors d. provide hope and reassurance that the problems will resolve themselves

a. provide authority, action, and participation

the nurse observes that a client is psychotic, pacing, and agitated and is making aggressive gestures. the client's speech pattern is rapid and the client's effect is belligerent. based on these observations which is the nurse's immediate priority of care a. provide safety for the client and other clients on the unit b. provide the clients on the unit with sense of comfort and safety c. assist the staff with caring for the client in a controlled environment d. offer the client a less stimulating area to calm down and gain control

a. provide safety for the client and other clients on the unit

the omnibus budget reconciliation act (OBRA) impacted mental health by a. reducing funding to mental health allocations b. creating state mental health institutions c. encouraging family units to get involved in mental health d. increasing restrictions on controlled mental health medications

a. reducing funding to mental health allocations

patient has lost child to suicide and is constantly at a youth clinic in her spare time this is a. repression b. acceptance c. identification

a. repression

common side effects of tricyclic antidepressants are. select all a. sedation b. hypertensive crisis c. auditory hallucinations d. orthostatic hypotension

a. sedation d. orthostatic hypotension

your patient has DNR. you know this means. select all a. the DNR order must be current and signed b. CPR will not be conducted c. medications that may save patient's life will be held d. the nurse is responsible for knowing which patients are DNR

a. the DNR order must be current and signed b. CPR will not be conducted d. the nurse is responsible for knowing which patients are DNR

which of the following is not a medication for anxiety a. verapmil b. haldol c. ativan d. bupropion

a. verapamil

side effects of benzos include. select all a. vertigo b. anxiety c. drowsiness d. tachycardia

a. vertigo c. drowsiness

what do the four elements of excessive use or abuse, display of psychological disturbance, decline of social and economic function and uncontrollable consumption indicating dependence define a. alcoholism b. addiction c. abuse d. addictive personality

b. addiction

a patient says that he drinks alcohol on a regular basis. during your discussion, the patient admits to having a problem. to which support group would the nurse refer the patient a. families anonymous b. alcoholics anonymous c. fresh start d. al-anon

b. alcoholics anonymous

the nurse is caring for patient who has been abusing CNS depressant and anticipates finding which signs/symptoms during the assessment process. select all a. agitation b. decreased respirations c. dilated pupils d. increased hunger and thirst e. memory loss f. slurred speech

b. decreased respirations e. memory loss f. slurred speech

what are common side effects of amitriptyline? select all a. polyuria b. dry mouth c. sedation d. weight loss

b. dry mouth c. sedation

while performing an initial assessment on a newly admitted alcoholic patient, the nurse can best ensure honest answers by a. not asking personal questions b. having nonjudgmental attitude c. including the family d. promising the patient not to tell anyone

b. having nonjudgmental attitude

client is admitted to psychiatric unit for observation following severe anxiety attacks. on admission, the client states "there's nothing wrong with me. i should not even be here. i am taking up a room and there is probably someone else who really needs it. although the nurse interprets this response as denial, which findings support severe level of anxiety. select all a. decreased pulse rate b. inability to think clearly c. inability to problem solves d. impulsively reacting to situations e. dry skin and mucous membranes

b. inability to think clearly c. inability to problem solves

a client with history of victim abuse has which signs/symptoms of the physical effects of living with severe level of anxiety and chronic stress? select all a. eupnea b. irritability c. moist skin d. bradycardia e. hypertension f. gastrointestinal disturbances

b. irritability e. hypertension f. gastrointestinal disturbances

group of psychotic disorders characterized by severe and inappropriate emotional responses a. anxiety b. mood c. personality d. normoreactive

b. mood

treatment for personality disorders include. select all a. SSRI and MDI b. psychotherapeutic drug therapy c. inversion therapy d. support groups e. family counseling f. interrupting family processes

b. psychotherapeutic drug therapy d. support groups

the nurse counsels the patient in the late stage of dependence that recovery may not be possible without a. gaining insight into the addiction b. receiving treatment for substance abuse c. pledging to lead a completely different lifestyle d. seeking non drug-oriented support system

b. receiving treatment for substance abuse

the nurse observes patient's behavior to assess thought process disorders characterized by bizarre, non reality thinking. this behavior is indicative of the most profound, disabling mental disease, which is a. manic depressive b. shizophrenia c. paranoia d. bipolar

b. schizophrenia

client who is experiencing suicidal thoughts says to the nurse, it just doesn't seem to be worth it anymore. why not just end it all. which initial nursing response is appropriate a. did you sleep last night b. what do you mean by that c. i am sure your family loves you d. i know you don't feel good about yourself

b. what do you mean by that

a nurse is caring for patient who is suspected of drug dependence. what is the most appropriate question for the nurse to ask a. how long were you going to hide this from your friend b. what type, how much, and what effects do the drugs have on you c. why did you start doing drugs d. the nurse does not ask questions about drugs for fear the patient might deny any problems

b. what type, how much, and what effects do the drugs have on you

nurse is caring for patient who stopped drinking and runs risk of alcohol withdrawal syndrome. the nurse monitors the patient knowing that tremors from alcohol cessation are usually seen ______ after cessation a. within an hour b. within 2 days c. within 1 week d. within 2-3 weeks

b. within 2 days - usually 6-48 hours after last drink and may last for 3-5 days

the nurse is collecting data on a client diagnosed with mild depression. the client says to the nurse i haven't had an appetite at all for the last few weeks. which response by the nurse would be therapeutic a. the last few weeks? b. you haven't had an appetite at all? c. once the medication begins to work, you will begin to feel better d. think about everything you have been through. it will take time for your appetite to improve

b. you haven't had an appetite at all?

__ in __ people need mental health services a. 1 in 3 b. 1 in 5 c. 1 in 8 d. 1 in 10

c. 1 in 8

the nurse instructs ross, who has just been prescribed protocol of fluoxetine HCl (Prozac) that the drug takes how long to take effect a. 2-4 days b. 2-4 hours c. 2-4 weeks d. 2-4 months

c. 2-4 weeks

the nurse assesses an alcoholic patient carefully for signs of withdrawal that usually appear as early as how many hours after cessation of alcohol intake a. 3 b. 1 c. 6 d. 4

c. 6

patient is having troubles abstaining from alcohol. what drug is often prescribed to encourage abstinence a. librium (chlordiazepoxide) b. thorazine (chlorpromazine) c. antabuse (disulfiram) d. wellbutrin (buproprion)

c. antabuse (disulfiram)

patient who has not established self identity, fears being alone, experiences mood swings over short period, relationships with other reveal rapid shifts from adoring to cruel and punishing, impulsive is which personality disorder a. abusive b. dependent c. borderline d. antisocial

c. borderline

patient will be starting antabuse. you explain the med works by a. making alcohol taste worse b. serves as antidepressant to cure underlying cause of alcoholism c. causing extreme nausea when alcohol is consumed d. inhibit function of alcohol, preventing intoxication

c. cause extreme nausea when alcohol is consumed

you are hospice nurse and explain to the family that which of the following is a sign of impending death a. decreased urine output b. tachycardia c. cheyne stokes respirations d. intense emotion

c. cheyne stokes respirations

patient is taking monoamine oxidase inhibitor (MAOI) medication. he comes in for appointment and is asking about adding saint john's wort to help with his depression. the nurse's best response is a. that is a great idea. alternative therapies like herbal medications can be very helpful in conjunction with medication b. you will feel better sooner if you include some other prescribed medications instead c. did you know that st john's wort can raise your blood pressure dramatically d. i cannot answer that question. you need to speak to the physician about that

c. did you know that st john's wort can raise your blood pressure dramatically

callie is not responding well to her antidepressant medications. what is an alternative treatment that might be effective for the depressant patient a. anti-mania agents b. sedative hypnotic agents c. electroconvulsive therapy (ECT) d. anti-parkinson medication

c. electroconvulsive therapy (ECT)

your patient is terminally ill. the family asks you to define hospice care. you know hospice care is a. standardized as dying process is the same for everyone b. focused on curing c. emphasizing quality d. limited to home health

c. emphasizing quality

the E in CAGE stands for a. eliminate b. ethanol usage c. eye opener d. extra stimulants

c. eye opener

patient is taking lithium as mood stabilizer. she should be sure to a. avoid cheese and red wine b. monitor BP once a day for hypertension c. have blood levels drawn once a month d. examine skin for breakouts

c. have blood levels drawn once a month

the home health nurse cautions patient taking Lithium that she should be sure to a. check her skin closely for pimples and warty growths b. take her blood pressure 2x/day watching for HTN c. have her Lithium blood level checked every month d. avoid aged cheese, USDA prime steaks, red wine

c. have her Lithium blood level checked every month

home health nurse cautions the patient taking lithium as mood stabilizer that she should be sure to a. examine her skin closely for breakouts and ulcers b. take her blood pressure twice a day to check for hypertension c. have her blood level checked every month d. avoid aged cheese and red wine

c. have her blood level checked every month

client has been hospitalized and participated in substance abuse therapy group sessions. client has consented to participate in alcohol anonymous (AA) community groups after discharge. which statement by the client best indicates to the nurse that the client has assimilated therapy session topics and coping response styles and has processes information effectively for self use a. i know i am ready to be discharged, i feel like i can say no and leave a group of friends if they are drinking no problem b. i will keep all my appointments and go to all my AA meetings. i will do everything i am supposed to. nothing will go wrong that way c. i am looking forward to leaving here. i know that i will miss all of you. so i am happy and i am sad, i am excited and i am scared. i know that i have to work hard to be strong and everyone is not going to be as helpful as you people d. this group has really helped a lot. i know it will be different when i go back home. but i am sure that my family and friends will all help me like the people in this group have. they will all help me i know they will. they will not let me go back to my old ways

c. i am looking forward to leaving here. i know that i will miss all of you. so i am happy and i am sad, i am excited and i am scared. i know that i have to work hard to be strong and everyone is not going to be as helpful as you people

during a group meeting, a client diagnosed with PTSD verbalizes difficulty with maintaining realistic behavior. which response by the nurse would be therapeutic a. do not worry so much b. everything is going to be all right c. i can see that you are upset about this. let us talk about this some more d. why are you having so much trouble with maintaining realistic behavior

c. i can see that you are upset about this. let us talk about this some more

client with moderate depression who was admitted to mental health unit 2 days ago suddenly begins smiling and reporting that the crisis is over. the client says to the nurse i am finally cured. the nurse interprets this behavior as cue to modify the treatment plan by taking which action a. suggesting a reduction of medication b. allowing increased "in room" activities c. increase the level of suicide precautions d. allow the client off unit privileges as needed (PRN)

c. increase the level of suicide precautions

why are alcohol abuse patients often deficient in vitamin B a. caloric intake on alcohol and not nutrition b. hyperkalemia c. intestinal damage to mucosa leading to decreased absorption d. alcohol interaction with synthesis

c. intestinal damage to mucosa leading to decreased absorption

when patient inquires how alcohol acts so quickly on his system, the nurse answers that the effect is felt quickly because alcohol a. digested quickly b. converted to glycogen immediately c. metabolized into ethanol rapidly d. excreted in urine slowly

c. metabolized into ethanol rapidly

the nurse on behavioral health unit is having therapeutic discussion with client and recognizes that which communication techniques would be nontherapeutic. select all a. offering self b. giving recognition c. minimizing feelings d. changing subject e. asking "why" questions

c. minimizing feelings d. changing subject e. asking "why" questions

group of psychotic disorders characterized by severe and inappropriate emotional responses, by prolong and persistent disturbances of mood and related thought distortions is called _________ disorders a. normoreactive b. anxiety c. mood d. personality

c. mood

a side effect with taking anti-psychotic agents is a. excessive salivation b. pruritus c. neuroleptic malignant syndrome d. extra pyramidal paralysis

c. neuroleptic malignant syndrome

repetitive actions and thoughts are a characteristic of a. anxiety disorder b. delusions c. obsessive compulsion disorder d. positive symptoms of schizophrenia

c. obsessive compulsion disorder

client with OCD who continually cleans the bathroom becomes enraged with the roommate for using the bar of bathing soap for cleaning the bathroom. the client begins to yell and slaps the roommate. what action should the nurse take first a. restrain the client b. fill out an incident report c. remove both clients to separate, safe location d. call the hospital risk management department

c. remove both clients to a separate, safe location

client is scheduled to have electroconvulsive therapy (ECT). which problem should the nurse include in the plan as a priority a. fear b. anxiety c. risk for aspiration d. altered health maintenance

c. risk for aspiration

which drug gained notoriety in the 1990s, is associated with club drug use, and often called the "date rape" drug a. GHB (gamma-hydroxybutyrate) b. opioid analgesic herone c. rohypnol (fluitrazepam) d. morphine

c. rohypnol (flunitrazepam)

other than psychopharmacology, which is medical management for anxiety disorder a. stress enhancement b. sleep deprivation c. systemic desensitzation d. encouraging delusions

c. systemic desensitzation

the nurse observes that a client with potential for violence is agitated, pacing up and down in the hallway, and making aggressive and belligerent gestures at other clients. which statement is appropriate to make to this client a. you need to stop that behavior now b. you will need to be placed in seclusion c. what is causing you to become agitated d. you will need to be restrained if you do not change your behavior

c. what is causing you to become agitated

research has identified that hereditary factors account for what percentage of mood disorders a. 10-15% b. 20-30% c. 35-55% d. 60-80%

d. 60-80%

patient who has history of difficulties with personal relationships, does not profit from experience or punishment, has no loyalties to any person, group or code of ethics, has tendency to rationalize behavior, relies on deceit and manipulation to get his/her way, is what personality disorder a. abusive b. dependent c. borderline d. antisocial

d. antisocial

you are preparing a patient to receive her first electroconvulsive therapy. you identify which nursing diagnosis as your highest priority a. deficient knowledge related to lack of information regarding the procedure b. disturbed thought process related to temporary memory loss c. disturbed self image related to hair loss at electrode sites d. anxiety related to high uncertainty about the procedure process

d. anxiety related to high uncertainty about the procedure process

the nurse clarifies that dementia is a slow, progressive loss of brain function, which is an organic mental disease secondary to a. chemical disease b. emotional problems c. circulatory impairment d. cerebral disease

d. cerebral disease

nurse is caring for 4 clients. which of the following should they see first a. client refusing to eat or sleep until they see a physician b. client being prepared to discharge c. client with tachycardia and anxiety pacing the hall d. client who expresses suicidal thoughts

d. client who expresses suicidal thoughts

rapid change in consciousness over short time is defined as a. schizophrenia b. depression c. dementia d. delirium

d. delirium

the nurse has been assigned a patient who abuses alcohol. the patient is at risk for DT (delirium tremens) while monitoring the patient, what signs would alert the nurse to the development of DT a. hypotension, coarse hand tremors, agitation b. stupor, agitation, muscle rigidity c. hypotension, ataxia, vomiting d. elevated temperature, changes in LOC, hallucinations

d. elevated temperature, changes in LOC, hallucinations

which drug is the most commonly used illegal drug in the US a. cocaine b. MDMA (ecstasy) c. PCP and LSD d. marijuana

d. mairjuana

the national institute of mental health (NIMH) was established by a. mental health recovery act b. healthy equality of American legislations c. american psychology association d. national health act

d. national health act

most commonly tricyclic antidepressants cause sedation. what is another primary concern a. tinnitus b. hallucinations c. hypertension d. orthostatic hypotension

d. orthostatic hypotension

when combined with alcohol, benzodiazepines can a. cause tachycardia and hypertension b. create additional anxiety c. hyperalert state d. over depression of CNS

d. over depression of CNS

the LPN is caring for patient who has been diagnosed with somatoform disorder. this disorder is characterized by which clinical manifestation a. extreme mood swings from mania to depression b. pattern of impulsivity and instability of behaviors, interpersonal relationships and self image c. loss of interest in normal daily activities, feel hopeless, lack productivity and have low self esteem d. psychologically induced conditions that have the characteristics of physical disease but for which no organic cause can be found

d. psychologically induced conditions that have the characteristics of physical disease but for which no organic cause can be found

hormonal imbalances that result in depression during the seasons of shortened daylight a. mania b. bipolar disorder c. depression d. seasonal affectiveness disorder (SAD)

d. seasonal affectiveness disorder (SAD)

patient has been labeled a frequent flyer with many symptoms and no conclusive test this is likely a. anxiety b. depression c. mania d. somatoform

d. somatoform

patient admitted for delirium demonstrates increase disorientation and agitation only during the evening and night time. the nurse documents this as a. evening b. night time c. bed time d. sun downing

d. sun downing

clinical manifestations of extrapyramidal symptoms (EPS) include a. cogwheel rigidity and dry mouth b. constipation, drowsiness, dizziness c. orthostatic hypotension d. tremors and muscle twitching

d. tremors and muscle twitching

T/F antidepressants should start working within a few days

false

T/F healthcare workers are at lower risk for substance abuse

false

the nurse is collecting data from a client recently diagnosed with paranoid schizophrenia. which information best supports that the client is at risk for harming another individual a. numerous bruises are observed on the bands and arms b. sibling states "i do not feel safe around my brother" c. client says "i will defend myself when i am in danger" d. the client has history of being barred from several homeless shelters

sibling states "i do not feel safe around my brother"

T/F some anti-seizure medication is given as a mood stabilizer

true