Good? ATI Mood Disorder and Suicide Questions

The nurse is reviewing the medical record. Select the findings that require immediate follow-up. Client was brought into the emergency department by emergency medical services from their extended care facility for reports of altered mental status and decreased oral intake for past 2 days because of nausea. Client claims to be unaware of the reason for ED visit and reports blurry vision and feeling tired. Client is somnolent yet easily arousable. Client's speech is slow but answers simple questions. Observed dry dry oral mucous membranes, poor skin turgor, pronounced intention tremor. Client was seen by primary care provider 1 week ago for low back pain after helping friends move a piano out of the house. No acute injury was found. Client was educated on the use of heat and massage therapy for the low back pain and was instructed to take ibuprofen three times a day. Lithium carbonate 300 mg by mouth three times a

-altered mental status -blurry vision -dry oral mucous membranes, poor skin turgor, pronounced intention tremor -ibuprofen 600 mg by mouth three times a day -BUN 48 mg/dL, Creatinine 2.4 mg/dL -lithium level 2.5 mEq/dL -12-lead ECG revealed sinus bradycardia rate 52 When evaluating outcomes, the nurse should recognize that altered mental status and blurred vision are associated with lithium toxicity and require immediate follow-up. Tremor is one of the earliest findings of lithium intoxication and nurses should be vigilant to recognize this finding. Dry mucous membranes and poor skin turgor are signs of dehydration and can raise lithium to toxic levels. The nurse should recognize the patient's use of ibuprofen as a nonsteroidal anti-inflammatory drug three times a day can cause changes in lithium concentrations. The elevated BUN and creatinine suggest altered fluid balance and altered renal function. The lithium value is elevated. Bradycardia with these other symptoms is indicative of lithium toxicity and warrants further follow-up.

A nurse is caring for a client in an outpatient clinic. 0800: Adult client whose spouse died recently reports headache and fatigue. "I worry that I am just getting worse." Reports being "always tired" yet waking "well before the alarm." Headache is dull but persistent despite intervention. Client reports no appetite and no interest in doing anything. Client has had troubles at work because they "cannot seem to concentrate. "Client alert and oriented. Thought process clear. Client tearful during interview, stating, "I'm sad all the time." 0900: Client reports being active with family and friends until 3 months ago. "I feel like I have nobody." "I thought the death of my spouse was hard. It seems the months after have been worse. I am not sure I can do this anymore. My family doctor prescribed me some medicine for my depression but I stopped taking it after a week because it did nothing for me."

Complete the following sentence by using the list of options. The nurse should address the client's________ as evidenced by the client's ________. a. support system b. safety c. lack of interest d. medication regimen a. noncompliance b. lack of interest c. statements Answers: The nurse should address the client's: b. safety As evidenced by the client's: c. statements

A nurse is caring for a client in a behavioral health clinic. The nurse is providing education to the client regarding phenelzine. Which of the following 3 statements indicate that the client needs further instruction? a. "I can expect my blood pressure to go up with this medication." b. "I need to avoid smoked meats when taking this medication." c. "I will check with my provider before taking cold medications." d. "It is okay of I drink imported beer, but I must avoid wine." e. "I love overripe bananas. I am glad I don't have to give them up."

a, d, e

A nurse is caring for a client who has persistent depressive disorder. When educating the client about their illness, which of the following statements should the nurse make? a. "Persistent depressive disorder is a mild chronic form of depression." b. "Persistent depressive disorder is characterized by delusions and hallucinations." c. "Persistent depressive disorder occurs shortly after taking or withdrawing from a substance." d. "Persistent depressive disorder is characterized by both manic and depressive disorder."

a. "Persistent depressive disorder is a mild chronic form of depression."

A nurse is discussing findings of depression with a group of clients. Which of the following client statements indicates an understanding of the information? a. "Thyroid problems can cause depression" b. "Staying awake for days can be a finding of depression." c. "Hyperactivity is a finding associated with depression." d. "Impulsiveness is a finding that is commonly associated with depression."

a. "Thyroid problems can cause depression" The nurse should identify that depression can be induced by medical conditions, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and hypothyroidism. The nurse should identify that not sleeping is consistent with mania, not depression.

A public health nurse is preparing a suicide prevention program for patrons of the local library. The nurse should inform the attendees that suicide is the second leading cause of death in which of the following age groups? a. 10-34 years old b. 35-44 years old c. 45-54 years old d. over 65 years old

a. 10-34 years old

A school nurse is preparing a presentation for high school students on the relationship between substances and depression. Which of the following substances should the nurse plan to include as a contributing factor in the development of substance-induced depressive disorder? a. Amphetamines b. Selective serotonin reuptake inhibitors (SSRIs) c. Nonsteroidal anti-inflammatory drugs (NSAIDs) d. Monoamine oxidase inhibitors (MAOIs)

a. Amphetamines The nurse should identify that substance/medication-induced depressive disorder occurs soon after a client begins taking or withdrawing from a substance, with the most common occurrences when the client is using alcohol, phencyclidine, hallucinogens, inhalants, opioids, and amphetamines.

A nurse is assessing a newly admitted client who states that they do not want to live anymore and plan to end their life. Which of the following actions should the nurse take? a. Ask the client about the lethality of their plan. b. Reassure the client that everything is going to work out. c. Encourage the client to focus on the positive aspects of life. d. Allow the client time alone to self-reflect.

a. Ask the client about the lethality of their plan. Ask the client about the lethality of their plan. The nurse should identify that clients who are having suicidal ideation should be assessed for plans they have made as well as the lethality of their plans. Asking the client about the lethality of their plans will allow the nurse to learn more about the client's plans. The nurse should notify the client's treatment team of the client's suicide lethality plans.

A nurse is caring for a child who is exhibiting tantrums, dysfunction in school, trouble with peers, and suicidal ideation. Which of the following should the nurse identify as being consistent with the client's findings? a. Disruptive mood disregulation disorder b. Dysthmia c. Bipolar I disorder d. Bipolar II disorder

a. Disruptive mood dysregulation disorder The nurse should recognize that disruptive mood dysregulation disorder is a disorder diagnosed in children who exhibit extreme irritability, tantrums, and trouble in school. Dysthymic disorder is a milder form of bipolar disorder characterized by difficulty sleeping and experiencing a mild level of depression. Bipolar I Disorder is the most severe form of bipolar disorder and is characterized by shifts in mood, energy, and functioning. Bipolar II Disorder is characterized hypomanic episodes, which are lower level and less dramatic manic shifts in mood.

A nurse is caring for a client who is hyperactive, pacing down the hallway, and exhibiting poor concentration during group therapy. Which of the following is characteristic of the client's manifestations? a. Mania b. Depression c. Hallucinations d. Delusions

a. Mania

A nurse on an inpatient unit is assisting in the care of a group of clients who have depression. when planning care, which of the following clients should the nurse see first? a. A newly admitted client who has bipolar I disorder. b. A client on day 3 of admission who has a history of dysthymic disorder. c. A client on day 2 of admission who has disruptive mood dysregulation disorder. d. A client who was admitted 1 week ago with premenstrual dysphoric disorder.

a. a newly admitted client who has bipolar I disorder. The nurse should identify that clients who have bipolar disorder can have severe manifestations of depression and mania. Client safety should remain the priority and the nurse should conduct a thorough history regarding the client's illness.

A nurse is reinforcing education for a client who is scheduled for electroconvulsive therapy. which of the following client statements indicates an understanding of the procedure? a. "I will be able to eat breakfast prior to my procedure." b. "This procedure will cause me to have brief seizures." c. "I will not need to have a pre-ECT work up before the procedure." d. "One ECT treatment will be effective for my depression."

b. "This procedure will cause me to have brief seizures." While an electrocardiograph (ECG) and electroencephalograph (EEG) monitor the client, brief seizures are induced by electrical current attached to one or both sides of the forehead. The client will not be able to have anything by mouth prior to the procedure to decrease the risk of aspiration. Clients are usually given general anesthetic before the procedure begins. A pre-ECT workup should be scheduled with the client and will include a chest x-ray, ECG, complete blood count, BUN, urinalysis, and electrolyte panel. The client should expect to have several ECT treatments performed over a period of several weeks.

A nurse on an inpatient mental health unit is evaluating a client who was admitted for suicidal ideation for readiness for discharge. Which of the following statements by the client indicates they may be ready for discharge? a. "I plan to go hunting when I get home." b. "When I get home, I will reach out to my friends if I start to feel down." c. "I am going to make a will as soon as I get home." d. "When I get home, I will eventually get even with my boss for firing me from my job."

b. "When I get home, I will reach out to my friends if I start to feel down." The nurse should identify that this statement by the client indicates future planning and a solution to problems. Clients who are experiencing suicidal ideation do not make future plans and feel trapped without solutions to problems.

A school nurse is preparing a presentation about suicide prevention for high school. Which of the following should the nurse include as modifiable risk factors for suicide? a. Sexual orientation b. Access to firearms c. Ethnicity d. Race

b. Access to firearms The nurse should identify that firearms are one of the most common means of suicide. The family or client can modify the risk of suicide by removing access of firearms.

A nurse is providing teaching to a client who is to undergo electroconvulsive therapy (ECT) for depression. Which of the following information should the nurse provide? a. "Electrical current will flow through electrodes placed on your torso." b. "You will be awake during the procedure." c. "Your provider will likely schedule you for several treatments over a period of weeks." d. "It is not necessary to fast before the procedure."

c. "Your provider will likely schedule you for several treatments over a period of weeks."

A nurse in an outpatient clinic is caring for a client who has major depressive disorder and has reported suicidal thoughts. Which of the following is the first information the nurse should try to obtain from the client? a. How lethal are the client's thoughts of self-harm? b. Does the client have access to committing self-harm? c. Does the client have a suicide plan? d. Does the client have someone to call when they are feeling suicidal?

c. Does the client have a suicide plan? Using the safety/risk reduction priority framework, the first information the nurse should try to obtain is whether the client has a definite suicide plan.

A nurse in a mental health clinic is taking a medical history on a client. The nurse should identify that which of the following factors in the client's history increases their risk for mental illness? a. Living in a rural area b. Being raised by a single parent c. Early exposure to violence d. Being in a family with numerous siblings

c. Early exposure to violence

A nurse is providing teaching to a client who is to undergo transcranial magnetic stimulation (TMS) for depression. Which of the following information should the nurse provide? a. "The procedure will take about two hours." b. "You will be asleep during the procedure." c. "Most people only require one treatment to eliminate their depression." d. "You may experience a mild headache following the procedure."

d. "You may experience a mild headache following the procedure."

A nurse on a mental health unit is using the SAD PERSONS scale to assess the risk of suicide among several clients. Which of the following clients should the nurse identify as having the highest risk? a. A 43-year-old female client b. A 21-year-old female client c. A 35-year-old male client d. A 15-year-old male client

d. A 15-year-old male client The nurse should identify that clients who are less than 19 years of age and older than 45 years of age have an increased risk of suicide. Clients who are male also have an increased risk of suicide.

A nurse is reviewing the medical record of a client who has major depressive disorder. Which of the following assessment findings should the nurse expect for a client who has major depressive disorder? a. Client is hyperactive b. Client has had a recent intentional weight loss c. Client reports sleeping 8 hours each night d. Client reports having thoughts of death

d. Client reports having thoughts of death

A nurse is caring for a client who was admitted with suicidal ideation. The client tells the nurse they have several guns in their home. Which of the following types of interventions is the priority for the nurse to initiate? a. Teach coping and problem-solving skills b. Strengthen access to and delivery of suicide care c. Promote connectedness d. Create a protective environment

d. Create a protective environment

A school nurse is creating a presentation about mental health for a group of middle school students. Which of the following topics should the nurse prioritize when preparing this presentation? a. Tyramine restrictions when taking a monoamine oxidase inhibitor (MAOI) b. The prevalence of postpartum depression c. Signs and manifestations of lithium toxicity d. Factors that contribute to suicide

d. Factors that contribute to suicide

A nurse in the clinic is collecting data on a postpartum client. the client states that they sleep all the time and are hearing voices telling them to harm their child. the nurse should identify that the client is likely experiencing which of the following? a. bipolar disorder. b. postpartum depression. c. premenstrual dysphoric disorder. d. psychotic depression.

d. psychotic depression. The nurse should recognize that the client is exhibiting manifestations of depression with psychotic features, such as hallucinations. Premenstrual dysphoric disorder only occurs the week before a client menstruates.

A nurse is creating a presentation about depression for a community health fair. The nurse should plan to report that depression is more prevalent among which of the following demographics? a. Adult males b. Adult females c. Adolescents between the ages of 15 and 17 d. Children ages 10 to 14

b. Adult females The nurse should identify that the prevalence of depression in U.S. adults ages 18 or older in 2017 was estimated at 17.3 million, with higher prevalence among females.

A nurse on an inpatient mental health unit is teaching a newly licensed nurse about suicide prevention. Which of the following statements made by the newly licensed nurse indicates an understanding of the information presented? a. "The client can eat their meal alone in their room." b. "The blinds in the client's room will need to stay closed to prevent overstimulation." c. "All sharp objects should be removed from the clients room." d. "Family members should be encouraged to look up the warning signs of suicide."

c. "All sharp objects should be removed from the clients room."

A nurse is assessing a client who has a diagnosis of mania related to bipolar disorder. Which of the following behaviors should the nurse expect the client to exhibit? a. The client is giving away their possessions b. The client is demonstrating risky behavior c. The client is sleeping excessively d. The client states they feel worthless

b. The client is demonstrating risky behavior The nurse should expect a client who is experiencing mania to exhibit risky behavior. Other behaviors of mania include impulsivity, overactivity, pacing, sleeplessness, fast speech, and being overconfident.

A nurse is assisting in the care of a client, in an outpatient setting, who is experiencing poor appetite, fatigue, and thoughts of hopelessness. which of the following items is included in SAD PERSON? a. parent with history of depression. b. previous attempt of suicide. c. history of trauma. d. smoking tobacco.

b. previous attempt of suicide. S - Sex (male) A - Age (young or old) D - Depression P - Previous suicide attempt E - Excessive alcohol or substance use R - Rational thinking loss (psychotic or organic disorders) S - Social supports lacking O - Organized plan (lethality of the suicide plan) N - No spouse (divorced, widowed, separated) S - Sickness (physical illness, especially chronic)

A nurse is caring for a client who is scheduled for transcranial magnetic stimulation. When preparing the client for the procedure, which of the following statements should the nurse make? a. "The procedure will last about 1 hour." b. "During the procedure you may notice slight relaxation of the jaw." c. "This procedure is effective when combined with psychotherapy." d. "The treatments will take about 6 months."

c. "This procedure is effective when combined with psychotherapy." The nurse should identify that transcranial magnetic stimulation has been proven to be very effective in the treatment of depression when coupled with psychotherapy. The nurse should identify that during the transcranial magnetic stimulation procedure, the client may feel a slight tapping on the head, scalp contraction, and tightening of the jaw. The nurse should identify that transcranial magnetic stimulation is an outpatient procedure that lasts about 30 min. The client usually comes for treatment 5 days a week for 4 to 6 weeks.