Mental Health

What is schizophrenia

A disorder that affects a person's ability to think, feel, and behave clearly. - causes distorted or bizarre thoughts - symptoms over 6 months - increase in dopamine

Stages of Generalized Adaptation Syndrome

Alarm, Resistance, Exhaustion

Antipsychotic Side effects

Dystonia Akathisias Tarditive Dyskanesia Neurolyptic Malignant Syndrome

Types of antipsychotics

First generation - EPS - side effects Atypical - less EPS side effect

What is Generalized Anxiety Disorder

a reaction to perceived threats

The nurse is caring for a client with generalized anxiety disorder requiring treatment. Which of the following treatments does the nurse anticipate the client will need? Select all that apply. a. SSRI b. Buspar c. CBT d. psychoanalysis e. antipsychotic medications

a, b, c

A nurse has given her client a nursing diagnosis of Anxiety because of her behavior when she found out that she was pregnant. Which of the following interventions would be most appropriate for this type of nursing diagnosis? Select all that apply a. assist the client with identifying coping mechanisms b. maintain a calm demeanor c. encourage the client to talk d. reassure the client that she is safe e. assist with admitting the client to the psychiatric unit

a, b, c, d

A client with anxiety disorder is in a state of panic after becoming injured while outside. The nurse caring for this client would most likely observe which behaviors? Select all that apply. a. the client needs direction to focus b. the client demonstrates fear c. the client is disorganized d. the client is moody e. the client has a loss of rational thought

a, b, c, e - moodiness does not indicate state of panic

A client is scheduled for surgery and admits that he has never been so anxious in his life. Which of the following symptoms are common for a client in this situation? Select all that apply. a. chest pain b. nausea c. blurry vision d. tachycardia e. headache

a, b, d, e

The nurse is preparing a presentation on stress and anxiety. Which of the following is included as part of this presentation? Select all that apply a. severe anxiety can lead to suicidal thoughts b. stress can cause anxiety c. severe anxiety does not lead to psychosis d. prolonged anxiety can cause illness e. anxiety can be motivating and increase learning.

a, b, d, e

A client who is being prepared for surgery is experiencing severe anxiety about the procedure. Which of the following interventions could the nurse employ to decrease this client's anxiety levels? Select all that apply. a. provide reassurance by answering the client's questions b. employ music therapy or aromatherapy if available c. administer sedative medications to help the client sleep d. ask the client to help with certain task, such as starting an IV e. Encourage the client's own coping mechanisms.

a, b, e

A client is suffering from stress and anxiety and is being seen at a healthcare clinic for help and management. Which best describes the initial physical effects of stress and anxiety in the body? Select all that apply. a. increased heart rate b. pinpoint pupils c. changes in appetite d. vasodilation e. increased respiratory rate

a, c, e - increased heart rate , respiratory rate, and changes in appetite

A client was recently treated for sepsis and may have developed post-sepsis PTSD. Which information is accurate for the nurse to give the client about how this condition is treated? a. it can be managed through counseling or CBT b. the client should utilize motivational interviewing to manage symptoms c. exposure therapy is the most reliable form of treatment of PTSD d. Post-sepsis PTSD often goes away over time, so the client should wait for symptoms to resolve.

a. it can be managed through counseling or CBT

A client is being seen for care at her PCP. The client tells the nurse that she has difficulty sleeping because of nightmares. Identify which description best explains the difference between night terrors and nightmares. a. night terrors are frightening but are not remembered by the client, while nightmares can be easily remembered b. night terrors cause a person to sleep walk while nightmares usually result in trashing in bed c. night terrors are the sign of more significant mental illness while nightmares are considered benign d. night terrors result in the person waking up while nightmares result in the person staying asleep.

a. night terrors are frightening but are not remembered by the client, while nightmares can be easily remembered

A 29-year-old client suffered a subarachnoid hemorrhage 4 months ago and has now been diagnosed with PTSD. Based on this diagnosis, the nurse knows that the client would most likely demonstrate which fo the following symptoms? a. nightmares, avoidance, and numbing b. upset stomach, constipation, and difficulties eating c. fatigue, increased sleep needs, and weight gain d. increased sensory perceptions

a. nightmares, avoidance, and numbing

Indications of GAD

anxiety for over one month with decreased motor tension and ANS

A nurse is caring for a client who is hospitalized in a very busy unit. The client complains to the nurse that it is too noisy to sleep and that he is not getting rest. Which of the following nursing interventions is most appropriate to better help this client sleep? a. provide instructions to the client about the importance of going to bed and getting up at the same time every day b evaluate for the appropriate timing of client care tasks c. help with client to choose foods on the menu that promotes sleep, such as broccoli d. encourage the client to verbalize his sleep difficulties

b evaluate for the appropriate timing of client care tasks

A nurse is providing care to a client who has just witnessed a shooting at a shopping mall. Which of the following interventions would the nurse employ to help the client cope with this traumatic event? Select all that apply. a. provide help with visual imaging surrounding the client response during the event b. assist the client with identifying concrete needs to help c. incorporate massage and therapeutic touch into treatment d. help the client keep his usual hygienic routine e. assist the client with finding sources of support

b, d, e

A client is experiencing an anxiety attack. The nurse review the client's home medication and notes that they take an anti-anxiety medication. Which os the following medications is likely prescribed to this client? a. alendronate b. alprazolam c. amiodarone d. amitryptiline

b. alprazolam

The best goal for a client learning a relaxation technique is that the client will a. confront the source of anxiety directly b. experience anxiety without feeling overwhelmed c. report no episodes of anxiety d. suppress anxious feelings

b. experience anxiety without feeling overwhelmed

A case management nurse is reviewing the chart for a client in a psychiatric hospital who has been diagnosed with panic disorders. The client is anxious and irritable. The nurse has done teaching on relaxation techniques, but the client requires close monitoring due to lack of adherence to the regimen. Which action of the case manager will most likely support this client? a. plan for a home health nurse to visit the client daily to watch the client perform the relaxation techniques b. help the client to learn about tother complementary or alternative treatments available c. arrange for the client to be committed to a long-term impatient care d. call t inform the provider that the client most likely needs surgery.

b. help the client to learn about tother complementary or alternative treatments available

A client who has been diagnosed with anxiety tells the nurse that his thoughts contribute to his problems. Which information can the nurse give the client that is true about automatic negative thoughts? a. persons with anxiety must accept that things are the way they are b. how you think about the world determines how you feel and behave c. everything happens for a reason, and good will come out of the experience d. when you continue to struggle with anxiety, you are not putting enough effort into changing.

b. how you think about the world determines how you feel and behave

Which would be the best intervention for a client having a panic attack? a. Involve the client in a physical activity b. Offer a distraction such as music c. Remain with the client d. Teach the client a relaxation technique

c. Remain with the client

A client with GAD states, "I have learned that the best thing I can do is to forget my worries." How would the nurse evaluate this statement? a. The client is developing insight b. The client's coping skills have improved c. The client needs encouragement to verbalize feelings d. The client's treatment has been successful

c. The client needs encouragement to verbalize feelings

A nurse is working with a client to use biofeedback as a method of controlling anxiety. Which of the following outcomes would most likely result from correct use of this mechanism? a. the client being able to recognize that he suffers from anxiety b. a form of sedation that is calming when an anxiety attack occurs c. an ability to recognize and. control the body's response d. a resolution of the client's anxiety symptoms

c. an ability to recognize and control the body's stress response

The nurse observes a client who is becoming increasing upset. He is rapidly pacing, hyperventilating, clenching his jaw, wringing his hands, and trembling. His speech is high-pitched and random; he seems preoccupied with his thoughts. He is pounding his fist into his other hand,. The nurse identifies his anxiety as. a. mild b. moderate c. severe d. panic

c. severe

A 46 year old client is experiencing symptoms of PTSD after being involved in a traumatic accident. The client has symptoms of nightmares and flashbacks about the event. The nurse knows that these symptoms most likely develop because of which of the following? a. the client's pituitary gland works in overdrive and consistently causes flashbacks b. the client is no longer able to regulate levels of serotonin c. the client may have a hyperactive amygdala that leads to an increase of feelings of fear d. the body secretes too much melatonin, which leads to an increase in nightmares

c. the client may have a hyperactive amygdala that leads to an increase of feelings of fear

Which of the four classes of medications used for panic disorders is considered the safest because of low incidence of side effects and lack of physiological dependence? a. Benzodiazepines b. Tricyclics c. MAOI's d. SSRI's

d. SSRI's

An emergency department nurse is working with a client who sought care for a sudden panic attack. The client tells the nurse that she feels like she is dying and is sweating and shaking. Which statement by the nurse is best? a. It is time to calm down now because you are finally in the hospital b. I have panic attacks too, and they are terrible c. This is nothing serious and is related to stress d. You are not in a medical emergency, but you are having an abnormal fight-or-flight response.

d. You are not in a medical emergency, but you are having an abnormal fight-or-flight response

A 51 year old client is getting ready to undergo a cardiac catheterization and is very anxious about the procedure. Which intervention can the nurse provide that will most likely help this client to remain calm? a. tell the client that he will receive a sedative medication so he will not be alert during the procedure b. have the client's family sit next to him during the procedure c. give the client literature about the procedure ahead of time so that he can read about the process. d. explain what the client will see, hear, feel, and experience during the procedure in terms that he can understand.

d. explain what the client will see, hear, feel, and experience during the procedure in terms that he can understand.

A client presents to the emergency department with an anxiety attack, stating that he has had multiple attacks over the last six months. The client is hyperventilating, so the nurse administers a bento to help with the acute attack the nurse anticipates that the client will begin to take which of the following medications on a regular basis to help with the anxiety? a. fentanyl b. furosemide c. famotidine d. fluoxetine

d. fluoxetine

A nurse is working with a client who is having sleep difficulties at night. The nurse recommends that the client keep a sleep diary and write down the times he goes to bed, the times he gets up, and how many times he awakens each night. The nurse can best describe the purpose of keeping a sleep diary as which of the following? a. assisting the client with malign cup all of his lost sleep b. helping the client to discover if he is a morning person c. determining the client type of sleep disorder d. helping the client see how to improve his sleep

d. helping the client see how to improve his sleep

A nurse is caring for a 20-year-old client with testicular cancer The client has expressed feelings of anxiety related to his diagnosis and appears restless and agitated every time the nurse tries to talk with him. Which intervention would be the most appropriate for the nurse to help this client with anxiety? a. explain that the client most likely needs antidepressants to get him through this time b. offer to have the provider talk with the client about this diagnosis c. tell the client he will feel better if he talks about it d. offer information about support groups

d. offer information about support groups

A nurse is caring for a 40 year old client with PTSD following a severe injury last year. The client requires a morning dose of antidepressant meds and is scheduled for EMDR therapy in 2 hours. The provider has been in to see the client for the day and has also left new orders. Which task can the nurse delegate to the nursing assistant? a. administering the meds b. performing the EMDR c. checking the provider's orders d. serving the client breakfast to eat with the medication

d. serving the client breakfast to eat with the medication

When assessing a client with anxiety, the nurse's questions should be a. avoided until the anxiety is gone b. open-ended c. postponed until the client volunteers information d. specific and direct

d. specific and direct

A client is experiencing stress response syndrome after losing his job where he had worked for 21 years. What described the difference between stress response syndrome and clinical depression? a. stress response syndrome last for months to years while clinical depression may last for several weeks b. stress response syndrome involves an increase of pulse, BP, and RR, while clinical depression involves a decrease in these vitals c. stress response syndrome often appears after a life-threatening event, while clinical depression appears after a life-changing event d. stress response syndrome causes hopelessness and loss of interest in activities, but not suicidal ideation such as with clinical depression

d. stress response syndrome causes hopelessness and loss of interest in activities, but not suicidal ideation such as with clinical depression

A client with anxiety is beginning treatment with lorazepam (Ativan). It is most important for the nurse to assess the client's a. motivation for treatment b. family and social support c. use of coping mechanisms d. use of alcohol

d. use of alcohol

What is the purpose of meds for schizophrenia

decrease hard and improve soft

Hard (positive)

delusions, hallucinations, grossly disorganized thinking, speech and behavior

Symptoms of panic disorder

dyspnea, cp, dizziness, unsteadiness, sense of unreality, sweating, shaking, fear of dying or going crazy out of control

Soft (negative)

flat affect (decrease emotional expression) social withdrawal or discomfort apathy alogia (poverty of speech)

When is schizophrenia usually diagnosed?

late adolescent to early adult

S/S PTSD

may be immediate or 6 months out psychic mumbling, unable to feel, detached or estranged, environment can cause flashbacks - dreams awaken in terror. excess ANS arousal - exaggerated startle response, hyper alertness, insomnia

What to monitor with Clozapine (Clozaril)

monitor WBC levels (agranulocytosis)

Treatment for schizophrenia

neuroleptic, antipsychotic (dopamine antagonist)

Types of schizophrenia

paranoid (worst) - sense of distrust - won't take meds disorganized - can't keep things in order catatonic - rigid movement undifferentiated - don't care - no matter what residual - refuse all types of meds

How to treat OCD

psychotherapy and SSRI

How to treat agoraphobia

psychotherapy and antidepressants

Treatment for PTSD

return to environment ASAP support group, relaxation therapy

What is PTSD

symptoms followed by a stressful event

Schizoaffective Disorder

symptoms look like disorder but mood can be manic, depressed, or mixed