Mental Health Exam 2

The nurse is caring for a psychiatric client age 70 years who has been prescribed a number of medications. When educating the client on the medications, which explanation would be most appropriate?

"Because of your age and related changes in liver functioning, you may have medication levels in your system with the potential to be toxic."

A client with schizophrenia tells the nurse, "I'm being watched constantly by the FBI because of my job." Which response by the nurse would be most appropriate?

"It must be frightening to feel like you're always been watched."

A client receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?

"These are side effects that can be easily treated; your illness is not getting worse."

A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After educating the client and family about the drug, the nurse determines that the education was successful when they state which of the following?

"We'll need to make sure that he has his blood count checked at least weekly."

A client has been prescribed clozapine (Clozaril) for treatment of schizophrenia. What should the nurse include in the education plan for this client and family?

"You may experience noticeable weight gain while taking this medication."

A client is prescribed medication for a psychiatric disorder. After three days, the client tells the nurse that he has been constipated. Which instruction would the nurse give the client?

"You need to eat more fruits and vegetables and drink more water."

In treating bipolar disorder, what is the desired therapeutic range for lithium (Lithobid)?

0.5 - 1.5 mEq.

A psychiatric-mental health nurse is integrating Carl Rogers's theory into the plan of care for a client with a mental illness. What does the nurse incorporate when using this theory?

A sense of genuineness, empathy, and unconditional positive regard for the client

The nurse is caring for a client who has been taking clozapine (Clozaril) for two weeks. The client tells the nurse, "My throat is sore, and I feel weak." The nurse assesses the client's vital signs and finds that the client has a fever. The nurse notifies the physician, expecting an order to obtain which laboratory test?

A white blood cell count

The nurse is caring for a client who has been receiving treatment for schizophrenia with chlorpromazine (Thorazine) for the past year. It would be essential for the nurse to monitor the client using which tool?

Abnormal Involuntary Movement Scale

When describing the various neurotransmitters, which is the primary cholinergic neurotransmitter?

Acetylcholine

A client who has been taking clozapine (Clozaril) for six weeks visits the clinic complaining of fever, sore throat, and mouth sores. The nurse immediately notifies the client's physician because the nurse suspects:

Agranulocytosis

A hospitalized client who has been taking a typical antipsychotic medication for two weeks begins pacing and walking throughout the unit. He tells the nurse that he "cannot sit still." This side effect is known as:

Akathisia

A client is experiencing hallucinations and delusions. The nurse would expect the physician to order which class of drug?

Antipsychotic

The nurse is integrating Peplau's model when providing care to a client with a mental illness. Which key component would the nurse identify?

Anxiety

During the stabilization phase of drug therapy for a patient who is hospitalized with a psychiatric disorder, which action would be most appropriate?

Assessing the patient for target symptoms and side effects

A client has been diagnosed with schizophrenia. Assessment reveals that the client lives alone. His clothing is disheveled, his hair is uncombed and matted, and his body has a strange odor. During an interview, the client's family voices a desire for the client to live with them when he is discharged. Based on the assessment findings, which nursing diagnosis would be the priority?

Bathing Self-Care Deficit related to symptoms of schizophrenia

A psychiatric-mental health nurse is working on an inpatient unit that uses levels of responsibility and a token economy. The nurse understands that this intervention integrates which group of theories?

Behavioral

The nurse is preparing to document information obtained from a client diagnosed with a delusional disorder who is experiencing somatic delusions. Which of the following would the nurse most likely document?

Body complaints

The nurse is interviewing a client with schizophrenia when the client begins to say, "Kite, night, right, height, fright." The nurse documents this as which of the following?

Clang association

Which psychiatric disorder is NOT associated with serotonin dysfunction?

Delusional disorder

A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past two months. The nurse should be especially alert for signs and symptoms of:

Diabetes

A nurse is providing care to a client just recently diagnosed with schizophrenia during an inpatient hospital stay. Throughout the day, the nurse observes the client drinking from the water fountain quite frequently, as well as carrying cans of soda and bottles of water with him wherever he goes. Upon entering the client's room, the nurse sees numerous empty cups that had been filled with fluids on his table and in the trash can. The room has an odor of urine. The nurse suspects which of the following?

Disordered water balance

Assessment of a client with schizophrenia reveals that he is hearing voices that tell him that people are staring at him, and that he is seeing illusions. When developing the plan of care for this client, which nursing diagnosis would be most appropriate?

Disturbed sensory perception

The nurse observes an older adult client who has been taking antipsychotic medications for eight months. The client is smacking her lips and blinking her eyes rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?

Document the client's symptoms of tardive dyskinesia

A group of nursing students is reviewing the various theories related to the etiology of schizophrenia. The students demonstrate understanding of the information when they identify which neurotransmitter as being responsible for hallucinations and delusions?

Dopamine

A nurse is developing a plan of care for a client diagnosed with schizophrenia. Which neurotransmitter is primarily involved?

Dopamine

After educating a client who is receiving phenelzine (Nardil), the nurse asks the client what foods or drinks should be avoided. The client shows understanding when replying:

Draft beers

When describing the influence of Harry Stack Sullivan on psychiatric-mental health nursing, which would the instructor address as a major concept?

Drive for satisfaction and security

The client in a long-term care mental health setting repeats what the nurse says word for word. The nurse interprets this finding and documents it as:

Echolalia

While working with an older male client, the nurse decides that reminiscence therapy would be beneficial. Which theorist believed that life review was an important psychosocial task to be achieved in order to avoid despair?

Erik Erikson

A client is being released from the inpatient psychiatric unit with a diagnosis of schizophrenia and treatment with antipsychotic medications. After teaching the client and family about managing the disorder, the nurse determines that the education was effective when they state this symptom should be reported immediately.

Fever

In a therapeutic session, the client is asked to say whatever comes to mind. What intervention is the therapist using?

Free associations

A nursing instructor asks a student to explain the influence of circadian rhythm on depression. Which of the following would the student include when responding?

Influences of sunlight on sleeping and eating cycles causing clinical depression

During an admission assessment, the client complains that manic episodes are occurring more and more frequently, despite taking lithium as prescribed. Based on this information, the nurse interprets the client is developing:

Kindling

The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find?

Living with one or more delusions for a period of time

A nursing instructor is developing an education plan for a group of students about schizophrenia and schizoaffective disorders. The instructor identifies that in addition to psychosis, what other condition must be present at the same time for a diagnosis of schizoaffective disorder?

Mood disturbance

A nurse is preparing an in-service program for a group of psychiatric-mental health nurses about schizophrenia. Which of the following would the nurse include as a major reason for relapse?

Nonadherence to prescribed medications

The nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for one week when the client suddenly says: "I've gone blind!" The nurse sees only the sclera when examining the client's eye reflex. What is this drug reaction called?

Oculogyric crisis

While assessing a client with schizophrenia, the client states, "Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies." The nurse interprets this statement as indicating which type of delusion?

Persecutory

After teaching a class on antipsychotic agents, the instructor determines that the education was successful when the class identifies which of the following as an example of a second-generation antipsychotic agent?

Quetiapine (Seroquel)

After watching the evening news on television, the client with schizophrenia tells the nurse that the TV news anchor is speaking directly to him. How would the nurse interpret this statement in the mental status section of the electronic medical record?

Referential thinking

A client who has a major depressive episode tells the nurse that, for the past two weeks, he has been hearing voices and at times thinks that someone is following him. History reveals that he had these alternating symptoms before. He also has experienced time with neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which of the following?

Schizoaffective disorder

A female client is brought to the emergency department by her brother, who reports that she became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The brother states that his sister is taking paroxetine (Paxil) for depression and fluoxetine (Prozac) for obsessive-compulsive disorder. What would the nurse suspect?

Serotonin syndrome

In order to promote recovery, which of the following would be most important for the nurse to keep in mind when establishing the nurse-client relationship with a client who has schizophrenia?

Short, time-limited interactions are best for the client experiencing psychosis.

When describing neuronal transmission, where does an electrical impulse become transferred to a chemical signal?

Synaptic gap

A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate a need for additional review when they identify which of the following about schizophreniform disorder?

The majority of individuals with the disorder recover completely.

The nurse is caring for an older adult client who has been taking an antipsychotic medication for one week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinson's disease. Which agent would the nurse expect the physician to prescribe?

benztropine (Cogentin)

A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs of a slight dystonic reaction. Which agent would the nurse offer to the client to relieve dystonic side effects?

diphenhydramine (Benadryl)