Mental Health Final

The nurse is caring for a patient who is a victim of interpersonal violence (IPV). What is the nurse's first priority? 1. Assist the patient to devise a safety or escape plan. 2. Encourage the patient to take charge of the situation. 3. Make it clear to the patient that the partner needs to see a therapist. 4. Offer to contact outpatient services if the patient promises not to return home after discharge.

. Assist the patient to devise a safety or escape plan

The nurse is caring for an older adult patient with a urinary tract infection (UTI). The patient points to the smoke alarm inside the room and asks the nurse, "Would you please turn on the radio?" For which alteration will the nurse assess the patient? 1. Agnosia 2. Delirium 3. Dementia 4. Pseudodementia

. Delirium

The nurse is caring for a family who is seeking family therapy. What is the primary purpose of the family assessment? 1. Determine the family dysfunction. 2. Guide the family's personalized plan of care. 3. Promote the therapeutic nurse-family relationship. 4. Determine the appropriate clinical diagnosis of the family.

. Guide the family's personalized plan of care.

A patient tells the nurse, "I don't want to go home. I'm afraid my spouse will hurt me again." What is the nurse's best response? 1. Invite the abuser to the assessment session. 2. Avoid pressuring the patient to leave the abuser. 3. Acknowledge the patient's inability to change the situation. 4. Ensure not to ask direct questions about abuse, as this will intimidate the patient.

2. Avoid pressuring the patient to leave the abuser

The nurse is caring for a patient with gender dysphoria. When promoting open communication with the patient, what is the nurse's best action? 1. Use closed questions. 2. Convey willingness to learn. 3. Present him or herself as the expert to the patient. 4. Convey sympathy.

2. Convey willingness to learn.

priority assessments & mental status exam - The nurse is conducting a mental status exam on a patient with schizophrenia. The patient reveals to the nurse that he hears voices in his head. What is the nurse's priority assessment? 1. Determine if the voices are fantasy hallucinations. 2. Determine if the voices are command hallucinations. 3. Determine if the patient has a disturbance in orientation. 4. Determine if the patient has a disturbance in thought process.

2. Determine if the voices are command hallucinations.

The nurse is caring for an adolescent patient with a substance abuse disorder. What type of therapy is priority for this patient? 1. Group 2. Family 3. Individual 4. Electroconvulsive

2. Family

risk factors of sleep disorders ) The nurse is planning patient education on obstructive sleep apnea (OSA)? Which will she include as a risk factor for OSA? 1. Opioid addiction 2. Hypertension 3. Narcolepsy 4. Hypersomnolence

2. Hypertension

The nurse is planning care for a patient who is experiencing a crisis. The patient tells the nurse, "I feel out of control, and I can't seem to make any decisions." Which nursing action will best promote effective interventions for this patient? 1. Identifying the patient's level of grief 2. Identifying the origin of the patient's crisis 3. Increasing communication with the patient's significant others 4. Motivating the patient and family to take significant action in relationships

2. Identifying the origin of the patient's crisis

The nurse manager is teaching the staff nurses in the emergency department about violence in health care settings. What information will the nurse include when teaching about hospital risk factors that increase risk of violence? Select all that apply. 1. High census levels 2. Low staffing levels 3. Characteristics of staff 4. Characteristics of services delivered 5. Waiting times for services delivered

2. Low staffing levels 4. Characteristics of services delivered 5. Waiting times for services delivered Answer: 2, 4, 5

A patient with bipolar disorder is being treated with lithium. What laboratory test will provide the nurse with information on the effectiveness and toxicity of the patient's lithium levels? 1. Complete blood count 2. Basic metabolic panel 3. Urinalysis 4. Serum level test

4. Serum level test

A patient tells the nurse, "I have been waiting two hours to be discharged. What is the problem?" The patient is pacing the room and glaring at staff members. What is the nurse's best action to prevent patient aggression? 1. Call hospital security to be prepared if the patient becomes aggressive. 2. Ask the patient to remain seated and retrieve the patient's discharge paperwork. 3. Acknowledge the patient's feelings and leave the room in order to avoid confrontation. 4. Acknowledge the patient's feelings and determine the status of the patient's discharge paperwork.

Acknowledge the patient's feelings and determine the status of the patient's discharge paperwork.

The nurse is caring for a patient with a history of violent behaviors. Which nursing interventions are most likely to prevent the patient from responding with aggressive or violent behavior? Select all that apply. 1. Address the patient's anxiety as needed. 2. Determine the patient's coping mechanisms. 3. Ensure the patient's needs are met in a timely manner. 4. Assess the patient's family history of violent behaviors. 5. Avoid intervention with the patient if he or she is displaying aggression.

Address the patient's anxiety as needed. 2. Determine the patient's coping mechanisms. 3. Ensure the patient's needs are met in a timely manner.

The nurse is caring for a patient with bipolar disorder who is agitated and telling everyone he is the king of England. The nurse will select which nursing diagnosis as appropriate for this patient?

Alteration in thought processes

Treatments and goals for schizophrenia

- have structured and safe environment to decrease anxiety and distract client from constant thinking about hallucinations - address hallucinations and delusions directly

assessment findings of adolescents with behavioral issues

- impairment of social interactions, communication - restricted, repetitive behaviors/interests - watch child alone - allow to fidget/play during interview

s/s of interpersonal violence

- isolation - extreme jealousy - threats to harm partner or relatives or self - aggressive . behavior - sudden anger - rigid sex rules

Neurobiological risks for aggressive behavior

- lower levels of serotonin - high norepinephrine levels - drug use - family history - children that were adopted into disruptive homes

Evaluating Group Learning

- make sure members are learning about themselves and others. ask questions to make sure their quality of life is improving

med assisted treatment for alcohol recovery

- methadone - buprenorphine - naltrexone

s/s of conversion disorder

- one or more changes in voluntary or sensory functions - weakness or paralysis - altered skin or vision difficulties - reduced or altered speech

professional boundaries

- providing any special services - treating patients differently than others - sales of goods - touching

Crisis assessment

- safety status - categorization - adaptation of staging - perceptions and emotions related to the crisis - assessment of potential risks - resources and their current utilization

identifying IPV

- screening - ensure safety and trust in patient -ask questions

drug/fetal adverse effects during pregnancy

- spontaneous abortion - premature - early labor - FAS

A patient has been administered a benzodiazepine one hour ago and is now agitated and angry. What does the nurse suspect the patient is demonstrating? 1. A target effect 2. A paradoxical response 3. An anaphylactic reaction 4. An idiosyncratic response

. A paradoxical response

What does the nurse recognize as a risk factor for the development of delirium in older adults? 1. A lack of rigorous exercise that leads to decreased cerebral blood flow 2. Decreased social interaction that leads to profound isolation and psychosis 3. Administration of multiple medications that may cause medication interactions or toxicity 4. Age-related cognitive changes that make older adult patients more susceptible to changes in mental status

. Administration of multiple medications that may cause medication interactions or toxicity

) The nurse is caring for a patient who has gender dysphoria. What is the nurse's best action to reduce and eliminate discrimination when caring for this patient? 1. Ask close-ended questions to elicit direct answers when talking about sex with the patient. 2. Ask open-ended questions that engage the patient to actively participate in care. 3. Ask the charge nurse to reassign the nurse if the nurse is uncomfortable. 4. Ask the nurse's co-worker to discuss the patient's condition, in order to avoid direct questions with the patient.

. Ask open-ended questions that engage the patient to actively participate in care.

A patient presents for an annual physical. As the nurse conducts the assessment, which statement will suggest the patient is experiencing workplace bullying? 1. "My manager has not given me a raise in over 10 years." 2. "My manager criticizes my work all the time, despite the fact that my annual performance review is always positive." 3. "My manager does not invite me to team meetings and I miss out on important information, affecting my annual performance review." 4. "My manager does not provide any positive feedback on my work at all and my annual performance review remains unchanged."

My manager does not invite me to team meetings and I miss out on important information, affecting my annual performance review

In order to minimize neuromuscular side effects, which medication is likely to be prescribed for psychotic symptoms? 1. Lithium 2. Olanzapine 3. Galantamine 4. Haldoperidol

Olanzapine

The nurse manager is reviewing risk factors for workplace aggression during a monthly staff meeting. The nurse manager includes risk factors for aggression related to the psychiatric patient population. Which statement by the staff nurse indicates that teaching has been effective? 1. "Patients who are being treated for depression have an increased risk for aggression." 2. "Patients who have been diagnosed with dementia have an increased risk for aggression." 3. "Patients who are receiving group therapy for somatic symptom disorders have an increased risk for aggression." 4. "Patients who are receiving cognitive-behavioral therapy for eating disorders have an increased risk for aggression."

Patients who have been diagnosed with dementia have an increased risk for aggression."

What is the best action by the nurse to intervene effectively with patients who have been diagnosed with somatic symptom disorder? 1. Address patient's anxiety at a later time. 2. Help the patient express a decreased degree of comfort regarding physical symptoms. 3. Encourage the patient's expression of feelings symbolically through physical symptoms. 4. Recognize and understand the patient conceptualizes the symptoms to be physical in nature.

Recognize and understand the patient conceptualizes the symptoms to be physical in nature.

The nurse is teaching a patient with bipolar disorder about lithium carbonate (Lithobid), which the provider has just prescribed for the patient. What information will the nurse provide the patient regarding the use of lithium? 1. Test serum levels regularly. 2. Decrease salt and fluid intake. 3. Increase the dose if fine hand tremors appear. 4. Discontinue the medication when feeling better.

Test serum levels regularly.

The parent of a patient in physical restraints asks the nurse, "Why is my son tied down? He wouldn't hurt anyone." What is the nurse's best response? 1. "The restraints are placed to control his behavior." 2. "The restraints are placed to prevent harm to him and others." 3. "The restraints are placed because he was angry to the staff." 4. "The restraints are placed to keep him from falling off the bed."

The restraints are placed to prevent harm to him and others."

A patient tells the nurse that he is experiencing gastrointestinal problems since he began taking a selective serotonin-reuptake inhibitor (SSRI) for depression. Which response by the nurse would be most appropriate? 1. "Try taking the medication will a full glass of water." 2. "Try taking the medication at bedtime." 3. "Try taking the medication with food." 4. "Try taking the medication at least an hour before eating."

Try taking the medication with food."

postpartum psychosis

a rare and severe form of depression that occurs in women just after giving birth and includes delusional thinking and hallucinations

Postpartum issues

biological changes - mood symptoms - social changes - memories from past traumas - current relationships may improve or worsen

therapeutic nurse-patient relationship

critical connection, it is planned and goal directed relationship that exists to help the patient with goal attainment

Panic +4 ss of anxiety

distorted perception (delusions) loss of rational thought, immobility

privacy and confidentiality

do not disclose private information

task groups

found in the community, business and educational setting. There is a clear purpose, members address conflict and give feedback.

akinesia

loss of involuntary movement

therapeutic communication & use of self

maintain self awareness and actively maintaining a non judegmental or neutral stance during interactions with patients.

crisis intervention

maintaining safety managing mood symptoms developing coping skills promoting connections and resources - taking a directive and instructional approach to interventions

psychoeducational groups

members gain increased knowledge on certain topic, stress management skills, assertiveness training, anger or symptom management. - nurses attend to elements of group dynamics

s/s of delirium for older adults

o Abrupt, short-term change in mental state marked by confusing, disorientation, perceptual disturbances, agitation, and mood swings. o Results from underlying medical conditions, substance intoxication or withdrawal, exposure to toxin, or other etiology. o Often resolves from treatment of the condition.

Escitalopram (Lexapro)

o Action of selective serotonin reuptake inhibitors (SSRIs) pg. 343 § Block the function of the presynaptic transporter for serotonin reuptake, resulting in more serotonin being available in the synaptic cleft to activate postsynaptic receptors for serotonin § ... basically block serotonin reuptake ® more serotonin

· fluphenazine (Prolixin)

o Adverse reactions § Sedation, tarditive dyskinesia, restlessness, tremor, arrhythmias, neuroleptic malignant syndrome

· Benztropine (Cogentin)

o Indication for use § Antiparkinson agent, anticholinergic § Treats Parkinsons disease (tremors), drug-induced extrapyrmadial sx, or chronic drooling in disables patients

· Contraindications to yoga

o Nurses should instruct patients to seek out appropriately trained instructors and to inform yoga instructors of any physical injuries, limitations, or illnesses that may require they avoid or modify certain types of yoga or specific moves or poses

Elder Abuse

o Physical, emotional, sexual, or financial abuse of an older adult. o Neglect is also a form of elder abuse and older adults suffering from dementia or other mental illnesses are most at risk for abuse

· Fluoxetine (Prozac)

o SSRI o Common side effects Nausea, constipation, headaches, anxiety, insomnia, drowsiness, dizziness, heart palpitations, weight changes, cold

Components of culturally competent psychiatric nursing:

race ethnicity cultural humility biological variations social organization space communication perception and use of time environmental concepts

dystonia

uncomfortable muscle movements

A kindergarten teacher refers a student to the school nurse because he appears unable to engage in play with the other children and insists on playing alone with a particular toy. He also shows delayed language development. What disorder might the nurse suspect? 1. Conduct disorder 2. Autism spectrum disorder (ASD) 3. Posttraumatic stress disorder (PTSD) 4. Attention-deficit/hyperactivity disorder (ADHD)

Autism spectrum disorder (ASD)

A nurse is planning care for a patient who is experiencing a situational crisis. What is the most effective way for the nurse to plan for the patient's crisis intervention? 1. Organized with follow-up 2. Based on complete assessment 3. Focused on long-term problems 4. Developed prior to meeting with the patient

Based on complete assessment

) The nurse manager is providing education to staff regarding the prevention of workplace aggression. Which statement, made by a staff nurse, best displays that teaching has been effective? 1. "Cyberbullying does not typically occur in the hospital environment." 2. "Bullying may occur in social groups as well as professional groups." 3. "Type IV aggression may occur if a staff member is injured by a patient." 4. "Type I aggression may occur if a staff member is injured by another staff member."

Bullying may occur in social groups as well as professional groups."

A 71-year-old patient has primary responsibility for a 47-year-old son, who is diagnosed with schizophrenia. The patient is concerned that her health is suffering from the aggravation she feels because her son is reluctant to take his medication and complains about the food she prepares for him. She is also worried about what will happen to him is she does become ill. Which factor will the nurse discuss with the patient? 1. Depression 2. Elder abuse 3. Palliative care 4. Caregiver burden

Caregiver burden

A patient is complaining of being unable to get to sleep. There is a PRN order for temazepam. What should the nurse do? Select all that apply. 1. Check the PRN protocol. 2. Assess the patient's need. 3. Assess the patient's safety. 4. Review the patient's diagnosis. 5. Explore the patient's expectations.

Check the PRN protocol. 2. Assess the patient's need. 3. Assess the patient's safety

A patient tells the mental health nurse that he is unable to get his life back together since the death of his spouse two years ago and that he feels the loss as strongly as he did the day his spouse died. What does the nurse suspect the patient is experiencing? 1. Delayed grief 2. Anticipatory grief 3. Complicated grief 4. Disenfranchised grief

Complicated grief

The school nurse recommends that the parents of a student seek help because the student is constantly in trouble and recently has set several small fires on school grounds. What condition is the school nurse suspecting? 1. Depression 2. Conduct disorder 3. Oppositional defiant disorder 4. Attention-deficit/hyperactivity disorder

Conduct disorder

78-year-old patient diagnosed with depression presents for a follow-up appointment. At the previous appointment six weeks ago, the patient was prescribed paroxetine (Paxil). Which symptom reported by the patient would indicate to the nurse that the patient is experiencing paroxetine toxicity? 1. Constipation 2. Neuropathy 3. Sexual dysfunction 4. Urinary tract infections (UTI)

Constipation

A patient has had what appeared to be an epileptic seizure; however, the patient's MRI and EEG results that do not show seizure activity. After a thorough assessment and appropriate tests by the patient's health care professional, the nurse begins to suspect which psychological disorder?

Conversion disorder

The nurse working on an inpatient psychiatric unit is caring for a patient with depression and substance use disorder. The nurse administers the patient's medication as ordered. Which patient response will the nurse report immediately to the health care provider? 1. Increased appetite 2. Dry mouth 3. Drowsiness 4. Decreased level of consciousness

Decreased level of consciousness

The nurse is caring for a patient who appears anxious and is pacing the room and clenching his fists. What action best demonstrates the core concept of effective intervention for this patient? 1. Administering a medication to the patient 2. Deciding to promptly isolate the patient from others 3. Assessing the patient's perception of his level of anxiety 4. Demonstrating therapeutic communication with the patient

Demonstrating therapeutic communication with the patient

The nurse is caring for an individual who has been diagnosed with depression. The patient tells the nurse that, in addition to prescription antidepressants, the patient is practicing yoga and meditation. What type of CAM is the patient using? 1. Allopathic medicine 2. Integrative medicine 3. Alternative medicine 4. Complementary medicine

Integrative medicine

· The nurse is caring for a patient with insomnia who asks the nurse about possible complementary and alternative (CAM) practices which may help with the patient's disorder. What is the nurse's best response? 1. "DHEA has been shown to be effective in sleep-wake disorders." 2. "Acupuncture has been shown to be effective in all sleep-wake disorders." 3. "Natural products have been shown more effective in sleep-wake disorders than mind and body practices." 4. "Mindfulness-based meditation has been shown to be effective in sleep-interfering cognitive processes."

Mindfulness-based meditation has been shown to be effective in sleep-interfering cognitive

The emergency department nurse educator is providing an in-service to the nursing staff on recognizing the signs and symptoms of interpersonal violence (IPV) and rape. Which assessment finding will the educator include in the teaching? 1. Sores around the mouth, brittle hair 2. Multiple bruises, abrasions at various stages of healing 3. Acting-out behaviors, disobedience, trouble with the law 4. Poor eye contact, depressed mood, unwillingness to give history data

Multiple bruises, abrasions at various stages of healing

19) A mental health nurse is interviewing a flood victim whose partner was killed in the disaster. What possible patient response should the nurse anticipate in planning patient care? 1. Anticipatory grief 2. Survivor guilt 3. Unresolved grief 4. Ambiguous loss

Survivor guilt

A patient with bipolar disorder has been prescribed valproate. What precautions should the nurse explain to the patient as a result of possible drug interactions? 1. Taking valproate with clozapine decreases the effect of valproate. 2. Taking valproate with antacids can result in toxic levels of valproate. 3. Taking valproate with aspirin can result in toxic levels of valproate. 4. Taking valproate with lithium decreases the effectiveness of lithium.

Taking valproate with aspirin can result in toxic levels of valproate.

The nurse educator is teaching a review course to the staff nurses on the role of neurobiology in aggressive behavior. The nurse educator asks a staff nurse to identify the patient on the unit who is most at risk for aggression, based on neurobiology. Which statement by the staff nurse indicates that the teaching has been effective? 1. "A 73-year-old female with a history of chronic neuropathy." 2. "A 42-year-old female with a history of multiple sclerosis (MS)." 3. "A 55-year-old male with a history of chronic migraine headaches." 4. "A 32-year-old male with a history of a traumatic brain injury (TBI)."

"A 32-year-old male with a history of a traumatic brain injury (TBI)."

paraxetine (paxil) common side effects

- SSRI! - headache nervousness -restlessness - drowsiness insomnia nausea weight changes

halperidol (haldol) adverse effects

- acute dystonia - akathia - liver impairment - tartive dyskinesia

populations at risk for a situational crisis

- adolescents - illegal immigrants - acute/chronic mental illness - significant others - older adults - caregivers of individuals with dementia

levetiracetam (keppra)

- anticonvulsant - TIRED -- thoughts of suicide and depression

lamotrigine

- antiepileptic medication - stevens johnsons syndrome - can create thoughts of suicide - pt will need to use another form of birth control

Which statements by the patient indicate the patient may be experiencing intimate partner violence (IPV)? Select all that apply. 1. "My partner uses our children as messengers." 2. "My partner humiliates me in front of our friends." 3. "My partner gets upset at me for spending too much money." 4. "My partner will not allow my family to visit, and I cannot visit any of my friends." 5. "My partner gives me a weekly allowance and does not allow me to access our bank account."

1. "My partner uses our children as messengers." 2. "My partner humiliates me in front of our friends." 4. "My partner will not allow my family to visit, and I cannot visit any of my friends." 5. "My partner gives me a weekly allowance and does not allow me to access our bank account."

The school nurse is a member of the school's student support team. The team is meeting with parents of one of the football players to discuss his increasingly aggressive behaviors. Which risk factors will the nurse be prepared to discuss? Select all that apply. 1. Age 2. Ethnicity 3. Substance use 4. Parental occupation 5. History of head injury

1. Age 3. Substance use 5. History of head injury

The nurse knows that a patient with a mood disorder who is exhibiting slurred speech and muscle weakness has likely developed which condition? 1. Lithium toxicity 2. Steven-Johnson syndrome 3. Aplastic anemia 4. QT interval prolongation

1. Lithium toxicity

The nurse is caring for a patient with borderline personality disorder (BPD) who is experiencing psychotic symptoms. Which medication will the nurse anticipate the health care provider ordering for the patient? Select all that apply. 1. Olanzapine (Zyprexa) 2. Lorazepam (Ativan) 3. Ripiprazole (Abilify) 4. Haloperidol (Haldol) 5. Thiothixene (Navane)

1. Olanzapine (Zyprexa) 3. Ripiprazole (Abilify)

The nurse is caring for a patient with mental illness who attends group therapy. The patient tells the nurse, "I like to go because I feel so much better when I can offer my experience to help the others in the group." What curative factor of group dynamics is the patient describing? 1. Catharsis 2. Altruism 3. Universality 4. Instillation of hope

2. Altruism

A nurse is very upset at a patient's death. Her supervisor tells her to get over it and get on with her job. What is the nurse experiencing? 1. Delayed grief 2. Ambiguous loss 3. Complicated grief 4. Disenfranchised grief

Disenfranchised grief

) Which intervention will increase the patient's likelihood of taking psychotropic medications for the treatment of schizophrenia? 1. Encourage the patient to use measures to manage side effects. 2. Encourage the patient to take all medications at the same time. 3. Give family members information about the patient's medication.

Encourage the patient to use measures to manage side effects.

Which action is the first step in the integrated problem-solving family therapy framework? 1. Increasing family members' awareness of their own affective reactions to the problematic situation 2. Evaluating repeated transactions that establish patterns of how, when, and to whom individuals relate within the family system 3. Evaluating the family system's power distribution, communication of affect, quality of structural boundaries, and assignment of roles 4. Identifying and working on unresolved conflicts from earlier relationships and personality defects that interfere with present functioning

Evaluating repeated transactions that establish patterns of how, when, and to whom individuals relate within the family system

The nurse knows that the patient taking aripiprazole (Abilify) 20 mg/day PO requires which specific follow-up assessment? 1. Vital signs each visit 2. Height and weight at each visit 3. Weekly assessment for extrapyramidal symptoms 4. Every six month checks for tardive dyskinesia

Every six month checks for tardive dyskinesia

The nurse is caring for a patient with gender dysphoria who underwent gender reassignment surgery 14 months ago. The patient tells the nurse that she regrets her decision of having the surgery. What is the most common reason individuals feel regret after gender reassignment surgery? 1. Failure to acknowledge the social implications of living as a member of the opposite gender. 2. Failure to live as a member of the opposite gender for a significant period of time prior to undergoing surgery. 3. Failure to comply with long-term pharmacologic and hormonal therapy after surgery. 4. Failure to go through diagnostic testing prior to undergoing surgery.

Failure to live as a member of the opposite gender for a significant period of time prior to undergoing surgery.

The nurse assesses a patient and finds several old and fresh bruises in the abdominal area, as well as signs of malnutrition. What is the most appropriate question for the nurse to ask? 1. "Are you dieting?" 2. "Has someone been hurting you?" 3. "Do you have an alcohol problem?" 4. "Have you had any falls lately?"

Has someone been hurting you?"

The nurse is caring for a patient with gender dysphoria who is in the process of gender reassignment. The patient tells the nurse, "Why does this process take so long? I'm tired of living like the opposite sex." What is the nurse's best response? 1. "It allows you to reflect on the whether or not you are serious about the procedure." 2. "It allows you to make a social transition to the opposite gender before any hormonal or surgical procedure begins." 3. "It allows the health care provider time to decide whether you are a good candidate for the procedure." 4. "It allows you time to make a physical transition to the opposite gender before any hormonal procedure."

It allows you to make a social transition to the opposite gender before any hormonal or surgical procedure begins."

The nurse preceptor is caring for a patient in physical restraints who is aggressive and threatening the safety of the staff. The nurse preceptor discusses the implications and requirements of this procedure with a novice nurse. What statement made by the graduate nurse indicates that the nurse preceptor's teaching has been effective? 1. "It is acceptable for the nurse to monitor the patient in physical restraints every hour to ensure the patient's safety." 2. "It is acceptable to place the patient in physical restraints if pharmacological methods have been unsuccessful." 3. "It is acceptable for the health care provider to assess the patient in restraints within 24 hours of restraint application." 4. "It is acceptable for the nurse to turn and reposition the patient in physical restraints every 2 hours to ensure the patient's skin integrity."

It is acceptable for the nurse to turn and reposition the patient in physical restraints every 2 hours to ensure the patient's skin integrity."

A nurse is working with a patient who is taking lithium for bipolar disorder. In addition to performing regular monitoring of lithium levels, what should the nurse tell the patient to educate them about using lithium. 1. "Avoid grapefruit juice." 2. "Never take the medication with food or milk." 3. "Lithium may interfere with your birth control medications." 4. "It is important to drink plenty of water and avoid overheating."

It is important to drink plenty of water and avoid overheating."

The community health nurse is teaching a group of adults about crisis experienced by various populations. Which statement by one of the group members indicates that the nurse's teaching has been effective? 1. "A good example of an adventitious crisis is a complicated divorce." 2. "I will be aware that maturational crisis may occur more frequently among my older adult patients." 3. "Patients with chronic illness are at greater risk for situational crisis than individuals without chronic illness." 4. "Adventitious crisis may occur in patients who have miscarried during pregnancy or have delivered a preterm infant."

Patients with chronic illness are at greater risk for situational crisis than individuals without chronic illness."

The nurse is conducting teaching on stress management for a group of adults. What type of therapeutic group best describes the purpose of this group? 1. Activity 2. Support 3. Psychodynamic 4. Psychoeducational

Psychoeducational

An older adult patient is brought to the emergency department (ED) by family members. The patient is disoriented and confused and has difficulty with attention. Family members report that the symptoms came on suddenly. Which is the nurse's priority for assessment? 1. Risk factors for depression 2. Risk factors for dementia 3. Risk factors for schizophrenia 4. Risk factors for delirium

Risk factors for delirium

A 67-year-old patient was forced to retire at age 65. The patient reports that age has interfered with getting another job and the retirement income does not cover expenses. The patient does not want to be a retiree. Which loss should the nurse address as a treatment priority? 1. Role 2. Health 3. Support system 4. Cognitive functions

Role

The nurse is caring for a patient with depression. When obtaining the patient's current medication list, the nurse notes that the patient is taking St. John's wort. What additional class of medication would most concern the nurse if the patient reports taking a medication in that class? 1. MAOI 2. SSRI 3. Antipsychotics 4. Barbiturate

SSRI

A 7-year-old child recently experienced the death of the family's pet dog. The dog was the child's constant companion. What does the nurse understand the child is at risk for developing as a result of the pet's death? 1. Agoraphobia 2. Conduct disorder 3. Elimination disorder 4. Separation anxiety disorder

Separation anxiety disorder

An 82-year-old man is admitted to a medical-surgical unit for diagnostic confirmation and management of suspected delirium. Which statement by the patient's daughter best supports the diagnosis? 1. "Dad has always been so independent. He's lived alone for years since my mom died." 2. "Dad just hasn't seemed to know what he's been doing lately. He has been very forgetful these last few months." 3. "Maybe it's just caused by aging. This usually happens by age 82." 4. "The changes in his behavior came on so quickly. I wasn't sure what was happening."

The changes in his behavior came on so quickly. I wasn't sure what was happening."

A patient diagnosed with depression has been taking paroxetine (Paxil) 10mg PO daily for the past month. The patient presents to the clinic with complaints of restlessness and abdominal pain. Which factor does the nurse consider during the assessment? 1. The patient has been taking medication with grapefruit juice at breakfast. 2. The patient is experiencing severe side effects and will be taken off the medication. 3. The patient is taking too much of the drug and is experiencing unexpected side effects. 4. The patient expresses that she is nervous that the side effects will increase with continued use.

The patient has been taking medication with grapefruit juice at breakfast

A nurse is monitoring a patient who is taking lithium to make certain that the lithium levels are between 0.8 and 1.1 mmol/L. The nurse documents that the patient's levels comply with what criteria? 1. Potency 2. Target effect 3. Drug dependence 4. Therapeutic range

Therapeutic range

· Lorazepam (Ativan)

o Use in alcohol withdrawal pg. 456 o Benzos can treat many of the sx included in alcohol withdrawal such as: § Seizures/tremors, restlessness, nausea, vomiting, irritability, chils/sweats, headaches, pain, anxiety, panic o Doses may need to be titrated based on sx, caution about dependency, confusion, memory loss, drowsiness o Avoid alcohol and other CNS depressants which can lead to respiratory depression/apnea o When discontinuing use, taper off to avoid seizures and other withdrawal sx o Long term use is discouraged due to dependence rates o Determine normal liver function before starting medication o Treatment from withdrawal may take 4-7 days with impaired functioning for a few weeks-months

· Methyphenidate (Ritalin)

o stimulant o S/E: headache, GI distress, agitation, poor appetite ® weight loss, sleep disruption if taken too late in the day

Psychodynamic groups

require a leader with advanced degree, specific training

Support/Self Help Groups

run by members. (AA, NA, OA) Formal or informal membership rules

· MAOIs (monoamine oxidase inhibitors)

§ Cannot be used with food/products containing tyramine (can result in dangerous increase in BP) · Products include aged cheeses, red wines, some BC pills, some pain relievers, cold & allergy medications, and herbal supplements § Used with SSRIs can result in serotonin syndrome (confusion, hallucinations, muscle stiffness, and changes in BP and heart rhythm)

· Naltrexone (ReVia)

§ Naltrexone is an opioid/opiate agonist so pain management is hard if required § Initially used for alcohol abstinence, now being used as opiate/opioid abstinence as well § Any form of override to this medication should be done in a controlled environment by professionals

The nurse caring for a patient with schizophrenic spectrum disorder notes that the patient imitates the nurse's movements during the assessment. Which symptom is the patient experiencing? 1. Echolalia 2. Echopraxia 3. Loose associations 4. Automatic obedience

Echopraxia

The nurse is providing information to the spouse of a patient who has been diagnosed with bipolar disorder. What treatment will the nurse share as being most effective for a patient with acute mania? 1. Group therapy 2. Fluoxetine (Prozac) 3. Seclusion and restraint 4. Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT)

The nurse caring for a patient with bipolar disorder understands that which is a priority consideration when planning patient care goals? 1. Establishing a therapeutic alliance 2. Improving mood symptoms through psychotherapy 3. Educating patients about the trajectory of improvement 4. Determining the therapeutic efficacy of the patient's lithium therapy

Establishing a therapeutic alliance

The nurse is conducting a patient education session on major depression. Which factor will the nurse explain has a strong association with major depression? 1. Being male 2. Schizophrenia 3. First-degree relatives 4. Environmental influences

First-degree relatives

The nurse is caring for a patient with a personality disorder who has manifestations of emotional reactivity. According to the biological perspective, which neurotransmitter is most likely altered? 1. Norepinephrine 2. Serotonin 3. Acetylcholine 4. Dopamine

Norepinephrine

The nurse knows that which is the priority nursing diagnosis for patient with anorexia nervosa who is exhibiting signs and symptoms of refeeding syndrome? 1. Anxiety 2. Body Image, Disturbed 3. Self-Esteem, Chronic Low 4. Nutrition, Imbalanced: Less Than Body Requirements

Nutrition, Imbalanced: Less Than Body Requirements

1) Which behavior will the nurse anticipate in the patient with anorexia nervosa? 1. Positive self-image 2. Constant overeating 3. Flexible rules regarding food 4. Obsessive rituals regarding food

Obsessive rituals regarding food

The nurse is providing education for a patient with a mood disorder. The patient asks about using complementary therapies. Which will the nurse discuss as a reasonable augmentation to the care plan for patients with mood disorders? 1. Kava 2. Ginger root 3. B-12 supplements 4. Omega-3 fatty acids

Omega-3 fatty acids

An ICU nurse diagnosed with acute anxiety is scheduled to take the CCRN exam for the second time in 2 weeks after being unsuccessful the first time. The nurse knows that which medication may be prescribed to help him with his anxiety? 1. Buspirone (Buspar) 2. Citalopram (Celexa) 3. Alprazolam (Xanax) 4. Propranolol (Inderal)

Propranolol (Inderal

The novice nurse is learning about the use of boundaries in the therapeutic nurse-patient relationship. What examples will the nurse recognize as boundary violations? Select all that apply. 1. Sexual misconduct 2. Last-minute appointment changes 3. Inappropriate self-disclosure 4. Giving or receiving small gifts 5. Disclosing bits of personal information

1. Sexual misconduct 3. Inappropriate self-disclosure

A community health nurse is preparing education on opioid use in the community. Which topic will the nurse focus on as a priority in the education session? 1. Seizure precautions 2. Risk for long-term vision problems 3. Dangers of overdose 4. Signs of withdrawal

Dangers of overdose

A patient tells the nurse, "I refuse to take quetiapine (Seroquel) because it is manufactured by terrorists. If I take it, I'll die." The nurse recognizes the patient's statement as indicative of what symptoms commonly seen in schizophrenia? 1. Alogia 2. Delusion 3. Ambivalence 4. Avolition

Delusion

Treatment for considerations when working with patients with somatic symptoms

- may report pain as primary symptom - see patients view point - team approach - do not use meds

signs & symptoms of generalized anxiety disorder

- restlessness - muscle tension - avoidance of stressful activities or events with negative outcomes - increases time and effort required to prepare for events with procrastination - sleep disturbances

s/s of bipolar disorder

- sleep disruption - mania - poor decisions

priorities of care for patient with anorexia

- use interdisciplinary team to treat - restore healthy weight - treat physical conditions - education - family support

s/s of major depression

-most common mood disorder - vegetative symptoms - lack of pleasure

The patient tells the nurse, "The world will end tonight at midnight. Armageddon is upon us!!" This statement indicates the patient is experiencing which type of delusion? 1. Religious 2. Grandiose 3. Nihilistic 4. Persecutory

Nihilistic

A patient with a major depressive disorder states, "I don't care about anything anymore." What is the nurse's best response? 1. "You have such a good life!" 2. "Are you feeling suicidal?" 3. "Don't worry. You'll feel better tomorrow." 4. "What about your children? They are so cute and wonderful!"

"Are you feeling suicidal?"

Spiritual assessment

"do you have a religious preference?" - goal is to learn how the patient answers questions and how satisfied they are with their answers

Cerebellum

- Coordination - Balance/posture - sequential movements

therapeutic communication skills

- active listening - eye contact - observing - restating (use common sense)

why would a client have anxiety?

- acute medical condition - adverse effects can mimic anxiety - family history

symptoms of antipsychotics

- akathisia - akinesia - tardive dyskinesia - dystonia

rights of patient

- be informed - get info - get appropriate individualized treatment

Behavioral Modification Therapy

- can be used to facilitate changes in an individuals behavior patterns. (adding/removing something to encourage better behavior)

spiritual distress

- disruption of an individuals capacity to assimilate or find meaning and purpose in his or her life.

borderline personality disorder

- divide people - blames people unregulated emotions

s/s of neuroleptic malignant syndrome

- elevated fever over 105 - muscle rigidity - sweating, temors, and difficulty swallowing

blocks to therapeutic communication

- false reassurance - judging - devaluing - arguing - giving advice or opinions

s/s of anorexia

- fear of gaining weight - restriction of food - Mild BMI

antisocial personality disorder

- feeling manipulated, exploited, and deceived as well as sensing that the individual is disloyal and lacks remorse

histrionic personality disorder

- liable moods - vanity -self centered - center of attention

dependent personality disorder

- low self esteem - insecure - dependent - anxiety

The nurse is assessing a patient who has come to the mental health clinic complaining that inability to focus at work is making it difficult to keep a job. The nurse observes that the patient has cuts along the arms that are in various stages of healing. Which statements by the patient indicate that the patient may need to be evaluated for borderline personality disorder? Select all that apply.

. "My grades and work performance have always been erratic." 2. "I often drink alcohol to relieve stress." 3. "It's hard to maintain friendships. People seem to get tired of me."

A patient diagnosed with depression has been taking paroxetine (Paxil) 10mg PO daily for the past month. The patient presents to the clinic with complaints of restlessness and abdominal pain. Which factor does the nurse consider during the assessment? 1. The patient has been taking medication with grapefruit juice at breakfast. 2. The patient is experiencing severe side effects and will be taken off the medication. 3. The patient is taking too much of the drug and is experiencing unexpected side effects. 4. The patient expresses that she is nervous that the side effects will increase with continued use.

. The patient has been taking medication with grapefruit juice at breakfast.

The mental health nurse is speaking with primary care providers about treatment options for anxiety disorders, including pharmacologic options. Why are selective serotonin-reuptake inhibitors (SSRIs) the choice class of medications for treating anxiety disorders? 1. They have a short half-life. 2. They are metabolized by the liver. 3. They are adrenergic blocking agents. 4. They have fewer side effects than other anti-anxiety medications.

. They have fewer side effects than other anti-anxiety medications

The nurse is caring for a patient who is experiencing dysfunctional grieving following the traumatic death of spouse due to an automobile accident. The nurse also experienced the death of a loved one in the same manner. What statement made by the nurse best exemplifies the nurse using empathy toward the patient? 1. "Many people may feel angry when faced in this situation. How do you feel?" 2. "Many people may feel angry when faced in this situation. I know I felt very angry." 3. "I am so sorry you feel angry about this situation. How do you diffuse your anger?" 4. "I am so sorry you feel angry about this situation. I feel bad you have to experience this."

1. "Many people may feel angry when faced in this situation. How do you feel?"

The nurse is planning care for a newly admitted patient. Which concepts are considered essential in establishing a therapeutic nurse-patient relationship? Select all that apply. 1. An emphasis on patient-centered care 2. The nurse's view of health and mental health 3. The nurse's ability to sympathize with the patient 4. Unconditional positive regard for the patient and family 5. The nurse's ability to make judgments regarding the patient's condition

1. An emphasis on patient-centered care 2. The nurse's view of health and mental health 4. Unconditional positive regard for the patient and family

Which actions made by the nurse best exemplify the orientation phase of the nurse-patient therapeutic relationship? Select all that apply. 1. Assessing the patient's limitations 2. Clarifying the patient's expectations for care 3. Educating the patient about the patient's health problem 4. Identifying resources that will be used in the first interaction 5. Reviewing the patient's history in the patient's medical record

1. Assessing the patient's limitations 3. Educating the patient about the patient's health problem

A 16-year-old patient is brought into the emergency department (ED) after being attacked in an alley. The patient states that she "can't see," but that she is otherwise "okay." The initial assessment reveals no physiological reason for the blindness, but several bruises, cuts, and abrasions are noted. After a thorough assessment, the patient is diagnosed with posttraumatic stress disorder (PTSD). The nurse knows that the patient is employing which defense mechanisms? Select all that apply. 1. Denial 2. Projection 3. Conversion 4. Suppression 5. Displacement

1. Denial 3. Conversion 4. Suppression

12) The nurse is performing a spiritual assessment on a newly admitted patient. In addition to asking a patient how he or she answers life's questions, what is also important for the nurse to ask during the patient's spiritual assessment? 1. How well the patient's answers are working for him or her 2. How well the patient's answers fit into his or her religion 3. How well the patient's answers are accepted by family members 4. How well the patient's answers are working for his or her family

1. How well the patient's answers are working for him or her

The nurse is caring for a patient with borderline personality disorder (BPD) who is experiencing psychotic symptoms. Which medication will the nurse anticipate the health care provider ordering for the patient? Select all that apply. 1. Olanzapine (Zyprexa) 2. Lorazepam (Ativan) 3. Ripiprazole (Abilify) 4. Haloperidol (Haldol) 5. Thiothixene (Navane)

1. Olanzapine (Zyprexa) 2. Lorazepam (Ativan)

14) During the first interaction with a client, the nurse makes an introduction and identifies the purpose of the interaction. This serves to accomplish which stage of the nurse-patient relationship? 1. Orienting 2. Evaluating 3. Identifying 4. Implementing

1. Orienting

A novice nurse is working in a community health center that serves a diverse client population. The nurse says, "The first thing I need to do is learn everything possible about the cultures of all the clients." What is the best response that the experienced nurse can give the novice nurse? 1. "You should always be nonjudgmental." 2. "You need to first understand who you are." 3. "I will give you a great book that describes all of the critical factors." 4. "This will come with time as you get to know clients and then encounter problems."

2. "You need to first understand who you are."

The nurse is caring for a patient with schizophrenia who is admitted to the hospital after being found incoherent and combative at a local grocery store. The patient tells the nurse that he has not taken his medications for over two weeks. The nurse is assessing the patient's needs, symptoms, and strengths. What stage of the nurse-patient relationship is being demonstrated? 1. Working 2. Orientation 3. Identification 4. Pre-orientation

2. Orientation

3) A nurse is caring for a patient who has undergone an open abdominal surgery. The nurse notes that the patient will only drink warm liquids. The patient tells the nurse, "The cold liquids will make my condition worse." What response by the nurse best demonstrates cultural humility? 1. "The cold liquids will not make your condition worse." 2. "The warm liquids will not make your condition better." 3. "Can you tell me why the cold liquids will make your condition worse?" 4. "Can you tell me why you do not follow the health provider's suggestion?"

3. "Can you tell me why the cold liquids will make your condition worse?"

The nurse is learning about active listening techniques that will improve nurse-patient relationships. What is active listening's influence on communication? 1. It acknowledges the nurse's interest in a nonjudgmental attitude. 2. It facilitates spontaneous responses and interactive conversation. 3. It offers a way to hear, observe, and understand what patients communicate. 4. It offers a way to seek information or clarification of the patient's thoughts or ideas.

3. It offers a way to hear, observe, and understand what patients communicate.

The psychiatric-mental health nurse is receiving a report on a patient who is being transferred to the hospital from a local emergency department (ED) after expressing suicidal ideations. The ED nurse tells the psychiatric-mental health nurse that the patient is "crazy, just like my aunt!" Which quality that commonly occurs in the pre-interaction stage of the nurse-patient relationship does the ED nurse's statement demonstrate? 1. Transference 2. Ethnocentrism 3. Cultural relativism 4. Countertransference

4. Countertransference

When planning care for a client with somatic symptom disorder the nurse knows that which activity is the most important? 1. Determine patient needs in each of the five domains. 2. Determine patient willingness to try new interventions. 3. Review patient daily journal to obtain a realistic view of the patient's activities. 4. Encourage interactions with family and friends to keep the patient's mind off of somatic issues

Determine patient needs in each of the five domains.

12) A novice nurse is learning how to effectively communicate within a therapeutic nurse-patient relationship. What struggle is most harmful when the nurse is new to therapeutic relationships? 1. Feeling uncomfortable with the relationship 2. Feeling anxious about developing the relationship 3. Falling back on knowledge learned from nursing school and not accounting for practical knowledge 4. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

4. Falling back on relationship skills learned in friendships, family relationships, or other personal relationships

A novice nurse caring for patients with mental illness wants to use empathy as a therapeutic tool. How is empathy used as a therapeutic tool for nurses? 1. To validate the nurse's expertise 2. To validate the nurse's perceptions 3. To validate the nurse-patient relationship 4. To validate the experiences of the patient

4. To validate the experiences of the patient

The nurse knows that which action is most important prior to implementing care for a patient with anorexia nervosa? 1. Determining patient willingness 2. Developing a therapeutic relationship 3. Educating the patient about the disorder 4. Establishing specific, realistic, and measurable goals

Determining patient willingness

A new nurse has just taken his state board exams and passed, but he has not yet found a job. He also married the month after graduation, and his new wife just announced that she is pregnant. He has recently been experiencing sleep disturbances, difficulty concentrating, and irritability. The nurse at the clinic suspects which disorder? 1. Obsessive-compulsive disorder 2. Generalized anxiety disorder 3. Adjustment disorder 4. Reactive attachment disorder

Adjustment disorder

Ten hours after admission to the ICU following an auto accident, a patient begins to exhibit mild tachycardia, irritability, and tremors. Three hours later the patient has a grand mal seizure. Which condition does the nurse suspect? 1. Wernicke encephalopathy 2. Korsakoff syndrome 3. Undetected internal bleeding 4. Alcohol withdrawal syndrome

Alcohol withdrawal syndrome

A nurse is caring for a patient with schizophrenia who is prescribed antipsychotic medications. Which statement is accurate regarding schizophrenia and medication treatment? 1. Typical antipsychotic medications block serotonin and dopamine. 2. Dopamine receptors exist in only one region of the brain, making treatment difficult. 3. Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications. 4. Positive symptoms of schizophrenia respond more readily to atypical antipsychotic medications than traditional medications.

Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications

A nurse is caring for a patient with schizophrenia who is prescribed antipsychotic medications. Which statement is accurate regarding schizophrenia and medication treatment? 1. Typical antipsychotic medications block serotonin and dopamine. 2. Dopamine receptors exist in only one region of the brain, making treatment difficult. 3. Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications. 4. Positive symptoms of schizophrenia respond more readily to atypical antipsychotic medications than traditional medications.

Atypical antipsychotic medications cause fewer extrapyramidal side effects than traditional antipsychotic medications.

When planning nursing care for patients with schizophrenia spectrum disorders whose symptoms do not respond to medication, the nurse will discuss which therapy with the prescribing provider? 1. Exercise therapy 2. Social skills therapy 3. Cognitive-behavioral therapy 4. Alternative medication therapy

Cognitive-behavioral therapy

A nurse is caring for a patient with schizophrenia. Which accurately describes genetic and environmental causes of schizophrenia? 1. One single gene is responsible for producing schizophrenia. 2. The chance of both monozygotic twins having schizophrenia is 100%. 3. Environmental factors do not affect the risk of developing schizophrenia. 4. First-degree relatives have an increased risk of developing schizophrenia.

First-degree relatives have an increased risk of developing schizophrenia.

The nurse is working with a patient who was diagnosed two days ago with severe depression. Reflecting on the diathesis-stress model, the nurse recognizes that which event is most likely to be a factor in the development of depression? 1. Losing his job last week 2. His mother's suicide when he was ten years old 3. Breaking up with his girlfriend the week before his diagnosis 4. The death of his 12-year-old dog three years ago

His mother's suicide when he was ten years old

The nurse knows that depression is the primary abnormal mood state for patients who are diagnosed with bipolar disorder. What other mood state might the nurse recognize in the patient with bipolar disorder? 1. Hypomania 2. Hypersexuality 3. Inappropriate intimacy 4. Exaggerated sense of importance Answer: 1

Hypomania

A nurse is caring for patient with depression who is exhibiting vegetative signs. Which symptom is associated with vegetative signs of depression? 1. Insomnia 2. Helplessness 3. Hopelessness 4. Suicidal ideation

Insomnia

A nurse flying home is called to the front of the airplane by the flight attendant because a woman in the first row is having a panic attack and stating, "I have got to get off of this plane!" The nurse knows that which treatment is best at this time? 1. Ask the woman to focus on the nurse's voice. 2. Ask the other patrons if someone has any alprazalom (Xanax) available. 3. Administer an emergency epinephrine shot to counteract the panic symptoms. 4. Instruct the woman to breathe in through the nose and blow out through the mouth.

Instruct the woman to breathe in through the nose and blow out through the mouth.

18) What is the key concept that allows the nurse to maintain professional boundaries when first developing the nurse-patient relationship? 1. Intentional development of the relationship 2. Use of caring in the relationship 3. Shared goals of the relationship 4. Shared knowledge occurring in the relationship

Intentional development of the relationship

A nurse is performing a spiritual assessment on a patient with depression. What does the nurse recognize as the key concept to a spiritual assessment? 1. Learn how the patient answers questions about his or her religion and how satisfied the patient is with those answers. 2. Learn how the patient answers questions about the meaning of life and how satisfied the patient is with those answers. 3. Assess how the patient answers questions about formal spiritual practices and how his or her symptoms interfere with these practices. 4. Assess how the patient answers a series of standardized questions that reveal the patient's choices of health care practices and religious choices.

Learn how the patient answers questions about the meaning of life and how satisfied the patient is with those answers

The nurse knows that a patient with a mood disorder who is exhibiting slurred speech and muscle weakness has likely developed which condition? 1. Lithium toxicity 2. Steven-Johnson syndrome 3. Aplastic anemia 4. QT interval prolongation

Lithium toxicity

) The nurse caring for a patient with schizophrenia spectrum disorder (SSD) knows that, as a result of severe impairments in the sociocultural domain, the patient may experience which type of event? 1. Loss of job 2. Re-establishment of identity 3. Return to independent functioning 4. Distraction from symptoms

Loss of job

The nurse is explaining the differences between bipolar disorder and major depressive disorder. Which factor will she discuss as being a defining feature of bipolar disorder that is not present in major depressive disorder? 1. Suicidal ideation 2. Mania 3. Short duration of symptoms 4. No history of depressive symptoms

Mania

The nurse caring for a 5-year-old diagnosed with posttraumatic stress disorder (PTSD) knows that which coping mechanisms and/or symptoms may manifest during treatment? 1. Crying and pacing 2. Hoarding and migraines 3. Nausea and separation anxiety 4. Repetitive play and temper tantrums

Repetitive play and temper tantrums

The nurse is caring for a patient who is experiencing alcohol withdrawal. Which nursing diagnosis receives priority for a patient in alcohol withdrawal? 1. Risk for Injury 2. Ineffective Coping 3. Disturbed Sensory Perception 4. Disturbed Thought Processes

Risk for Injury

The nurse taking care of a patient recently diagnosed with anxiety disorder knows that the patient's symptoms of hyperventilation, insomnia, and nausea are at which level according to Peplau? 1. Severe +3 2. Panic +4 3. Mild +1 4. Moderate +2

Severe +3

Which information related to the physiology of circadian rhythms would be most significant in the assessment of a patient suspected of having bipolar disorder? 1. Personality patterns 2. Psychiatric diagnosis 3. Negative thought patterns 4. Sleep and appetite patterns

Sleep and appetite patterns

The nurse is caring for a patient with somatic symptom disorder. What information is most important for the nurse to include in the report to the staff on the next shift? 1. The trigger for the patient's worries 2. The original source of the patient's anxiety 3. The amount of time the patient talked about physical complaints 4. The patient's use of abdominal breathing at the first sign of anxiety

The amount of time the patient talked about physical complaints

The nurse is preparing to discharge a patient diagnosed with anxiety and depression. During evaluation, the nurse determines that which of the patient's outcomes indicate an improvement? 1. The patient reports a decrease in physical symptoms. 2. The patient is able to verbalize anxiety-causing activities. 3. The patient is able to stay focused for a limited amount of time. 4. The patient is sleeping six hours 5 days/week.

The patient is sleeping six hours 5 days/week.

A nurse manager experiences an increased heart rate, GI discomfort, and perspiration when preparing to give presentations to his staff. He has prepared three presentations, and his charge nurse has given them all. The nurse manager knows he is experiencing which level of anxiety and that which treatment will help? 1. Trait anxiety; Thiamine therapy 2. State anxiety; propranolol (Inderal) 3. Panic anxiety; buspirone (Buspar) 4. Moderate anxiety; alprazalom (Xanax)

Trait anxiety; Thiamine therapy

When working with patients who have had psychotic episodes, the nurse knows to monitor for which laboratory analysis for the patient taking clozapine (Clozaril)? 1. WBC 2. RBC count 3. Fasting blood sugar 4. Pro-times and creatine kinase

WBC

signs and symptoms of anxiety - moderate +2

agitation muscle tightness tachycardia and tachypnea

When planning care for an older patient diagnosed with depression which is the priority nursing action? 1. Screening the patient for suicide risk 2. Assessing the patient for low-grade depressive symptoms 3. Assessing to distinguish depressive symptoms from a grief response 4. Promoting physical activity and maintain meaningful social connections for wellness Answer: 1

screening the patient for suicide risk

empathy

sensing the feelings or an individuals situation (empathizing with them)

tardive dyskinesia

stiff, jerking, repetitive movements of the tongue, lips, face

lab values of patient with anorexia

electrolyte imbalances (potassium 3.5-5.5) Magnesium 1.7-2.5, and phosphate 2.5-4.5)

severe +3 ss of anxiety

inability to function, ritualistic behavior, unresponsive

alkathisia

inability to stay still

signs and symptoms of anxiety - mild +1 symptoms

restlessness increased motivation and irritability