Mental Health Final Review

A nurse is caring for a client who has bipolar disorder and is experiencing acute mania. The client is doing calisthenics in the client dining room during lunchtime instead of eating. Which of the following statements should the nurse make?

"Come with me. Here is a milkshake to drink"

A nurse is discussing stress management techniques with a group of clients. Which of the following techniques mentioned by a client should the nurse recognize as the least effective?

"I fix myself a pot of coffee when I get anxious"

A nurse is assessing an adolescent client who has anorexia neevosa. Which of the following client statements is a sign of cognitive distortion?

"If I eat one piece of candy, I may as well eat ten

A nurse is performing a psychosocial assessment on an adolescent client. Which of the following should indicate to the nurse a potential risk for suicide? (Select all that apply)

- Death of a parent at a young age - Recent or impending move - Low parental expectations - Sudden decline in school performance

A nurse is caring for a school-age child who has a history of conduct disorder. Which of the following actions should the nurse take? (Select all that apply)

- Introduce some humor during interactions with the child - Explain to the child the need to pick up crayons when thrown on the floor - Shorten a reading activity when the child appears to become frustrated - Redirect with physical activities when the child's disruptive behavior begins

A nurse is teaching a class about pharmacological therapies to decrease stress. The nurse should include which is the following therapies? (Select all that apply)

- Meditation - Yoga - Biofeedback

A nurse is providing any community health education class about suicide prevention. Which of the following should the nurse identify as risk factors for suicide? (Select all that apply)

- Substance use disorder - Age greater than 45 years old - Schizophrenia

A nurse is planning care for a client for a client who has paranoid schizophrenia. Which of the following interventions should be included in the plan of care?

Check the client's mouth after the client takes medication

A nurse is caring for a client who has severe manifestions of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?

Dysrhythmias

A nurse is caring for a client who refuses treatment and asked to be discharged from the hospital against medical advice. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse?

False imprisonment

A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestions should the nurse tell the family to expect?

Forgetfulness gradually processing to disorientation

A nurse is developing a plan is care for a newly admitted client who has schizophrenia and experiences frequent hallucinations and paranoid delusions. Which of the following actions should the nurse plan to take?

Limit the number of questions asked during assessments

A nurse is assessing a client who has schizophrenia and is taking aripiprazole. The nurse should notify the provider of which of the following findings?

Muscle Stiffness

A nurse us caring for a client who has dementia. Which of the following actions should the nurse take to reduce the client's risk of aspiration pneumonia?

Provide the client with oral hygiene

A newly licensed nurse is applying prescribed wrist restraints on a client. Which of the following actions should the nurse take?

Secure the restraints using a quick-release tie.

A nurse is documenting information in a computerized health record. Which of the following nursing actions jeopardizes client confidentiality?

Sharing computer passwords with coworkers

A nurse in a long-term care facility is caring for an older client who has dementia and begins to have frequent episodes of urinary incontinence. After the provider determines no medical cause for the client's incontinence, which of the following interventions should the nurse initiate to manage this behavior?

Take the client to the bathroom every 2 hr

A nurse in acute care mental health facility is assessing a client who has dipolar disorder. Which of the following findings indicates the client is at risk for suicide?

The client's behavior has become impulsive in the past few weeks

A nurse is assessing a client who has schizophrenia. Which of the following findings should the nurse identify as a negative manifestation of schizophrenia?

Thought blocking

A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed?

Thyroid hormone assay

A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?

affective flattening

Conversion disorder (previously called hysterical neurosis, conversion type)

allows a patient to resolve a psychological conflict through the loss of a specific physical function, for example, through paralysis, blindness, or the inability to swallow.

Regression

an individual returns to an earlier developmental stage.

Global Deterioration Scale

assesses and stages primary degenerative dementia based on orientation, memory, and neurologic function.

Positive conditioning

attempts to gradually instill a positive or neutral attitude toward a phobia.

A nurse is caring for an adolescent who was admitted with anorexia nervosa. Which of the following finding should the nurse except?

bloating

Toxicologic studies

blood and urine tests that can detect the presence of many drugs and quantify the blood levels of these drugs.

conduct disorder

characterized by aggressive behavior.

A charge nurse is conducting a staff education in-service about depressive disorders. Which of the following should the nurse identify as a risk factor for depression?

chronic illness

Self-destructive behavior

death-seeking behavior, including suicidal tendencies

Voyeurism

deriving sexual pleasure from looking at sexual objects or sexually arousing situations such as an unsuspecting couple engaged in sex.

Eating Attitudes Test

detects patterns that suggest an eating

Bulimia nervosa

disorder marked by eating binges followed by feelings of guilt, humiliation, and self-deprecation.

Projection

displacement of negative feelings onto another person.

Schizoid disorder

emotional detachment from other people.

pharmacophobia

fear of drugs

social phobia

fear of embarrassing oneself in public

agoraphobia

fear of leaving familiar settings or of open space

triskaidekaphobia

fear of the number 13

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?

give positive feedback when client is assertive with staff or clients

Minnesota Multiphasic Personality Inventory

helps assess personality traits and ego function in adolescents and adults

Thought stopping

helps break the habit of fear-inducing anticipatory thoughts by focusing attention on calmness and muscle relaxation.

Beck Depression Inventory

helps diagnose depression and determine its severity.

Cognitive therapy

helps identify and change the patient's negative generalizations and expectations and thereby reduces depression, distress, and other emotional problems.

Transvestic fetishism

heterosexual male dressing in female clothes to produce or enhance sexual arousal.

Arousal disorder

inability to experience sexual pleasure. It's one of the most severe forms of female sexual dysfunction

A nurse is assessing a client who has posttraumatic stress disorder (PTSD) following sexual assault. Which of the following is an expected finding?

increasing feelings of anger

Body dysmorphic disorder

involves a preoccupation with an imagined (or, if present, slight) defect in physical appearance.

Flooding (also called implosion therapy)

involves direct exposure to an anxiety-producing situation. It also uses the idea that confrontation helps the patient overcome fear.

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instruction should the nurse to give the client about the use of this medication?

liver function tests must be monitored

A nurse on a mental health unit is caring for clients who have various depressive disorders. The nurse should identify which of the following client diagnoses as presenting the greatest risk for suicide?

major depressive disorder

Exhibitionism

marked by sexual fantasies, urges, or behaviors involving surprise exposure of the genitals to strangers.

Antisocial disorder

marked by the disregard for social norms.

Functional Dementia Scale

measures orientation, affect, and the ability to perform activities of daily living.

A nurse overhears a client who has schizophrenia talking to herself. The client keeps stating."The flakalas are here. The flakalas are here." The nurse correctly recognizes the client's use of the word flakala as an example of which of the following alterations in speech?

neologism

demographic data

patients: - age - sex - ethnic origin - primary lang. - birthplace - religion - marital status

A charge nurse us discussing suicide interventions with nursing staff. Which of the following should the nurse identify as an example of secondary intervention?

performing life-saving measures following a suicide attempt

Depersonalization disorder

persistent or recurrent episodes of detachment. During these episodes, self-awareness is temporarily altered or lost

socioeconomic data

persons economic & personal situation & how it impacts current psychological status - education level, housing, income

somatoform disorder

physical signs and symptoms and typically travels from doctor to doctor in search of treatment.

personality disorder

possesses chronic, inflexible, and maladaptive patterns of behavior that cause social discomfort and impair social and occupational functioning.

somatization disorder

primarily affects females, the patient has multiple unintentional physical complaints from different systems.

Gender identity disorder

produces persistent feelings of gender discomfort and dissatisfaction.

Detoxification

programs offer a relatively safe alternative to self-withdrawal after prolonged dependence on alcohol or drugs.

A nurse is caring for a client who is discussing his post-traumatic stress disorder and states: "Everyone thinks you should be able to put it out of your mind. It happened so long ago - just get over it!" The nurse responds, "It must be very frustrating to encountered this kind of attitude." The nurse is using which of the following therapeutic communication techniques?

reflection

acting out

repeating certain actions to ward of anxiety w/o consequences of those actions

Frotteurism

sexual arousal from touching or rubbing against a nonconsenting person.

Thought switching

teaches the patient to replace fear-inducing self-instructions with competent self-instructions.

A nurse is assisting a client who has a score of 6 on the Glasgow Coma Scale. The nurse should expect which of fbe following outcomes based on this score?

the client needs total nursing care

Orgasmic disorder

the most common type of female sexual dysfunction, is an inability to achieve orgasm

In token economy

the therapist rewards acceptable behavior by giving out tokens, which the patient uses to "buy" a privilege or object.

Sublimation

transforming unacceptable needs into acceptable ambitions and actions. For example, a person with highly aggressive tendencies may study and excel in the martial arts.

A nurse is caring for a client who has bipolar disorder and is taking lithium. The client reports blurred vision and ataxia. Which of the following actions should the nurse take?

withhold the medication

A nurse is discussing the manifestations of alcohol withdrawal with a client who has a history of alcohol use disorder. Which of the following client statements indicates understanding?

"I should expect tremors to start less than 24 hours after I stop drinking"

A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

The client runs 4 miles outdoors every afternoon

Dissociation

an unconscious defense mechanism that keeps troubling thoughts out of a person's awareness.

Hypochondriasis (previously referred to as hypochondriacal neurosis)

an unrealistic misinterpretation of the severity and significance of physical signs or sensations.

Autistic disorder

severe, pervasive developmental disorder marked by unresponsiveness to social contact, gross deficits in cognitive and language development, ritualistic and compulsive behaviors, restricted capacity for developmentally appropriate activities and interests, and bizarre responses to the environment

Sexual masochism

sexual gratification from being physically or sexually abused.

Desensitization

slowly exposes the patient to something he or she fear

Behavior therapy

ssumes that problematic behaviors are learned and, through special training, these behaviors can be unlearned and replaced by acceptable behaviors.

Rationalization

substituting acceptable reasons for the real or actual reasons that are motivating the patient's behavior

Dissociative amnesia

sudden inability to recall important personal information that can't be explained by ordinary forgetfulness.

Repression

unconsciously blocking out painful or unacceptable thoughts and feelings, leaving the feelings to operate in the subconscious.

Drug therapy

use of antidepressants, antianxiety agents, and antipsychotics.

Milieu therapy

uses the patient's environment as a tool for treating mental and emotional disorders

Cyclothymia

variant of bipolar disorder in which numerous episodes of hypomania and depressive symptoms are too mild to meet the criteria for major depression or bipolar illness.

Paraphilias

complex psychosexual disorders and are characterized by a dependence on unusual behaviors or fantasies to achieve sexual excitement.

A nurse is providing teaching to client who has schizophrenia and is to begin taking haloperidol. Which of the following information should the nurse include in the teaching?

"You make experience dizziness upon standing while taking this medication."

A nurse is caring for a client who major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make?

"You've been feeling that your life has no meaning"

A nurse is teaching the parents of a school-age child who has ADHD about atomoxetine. Which is the following instructions should the nurse include in the teaching?

"give the dose in the morning to help prevent insomnia"

A nurse is teaching the parents of a child who has ADHD about methylphenidate. Which of the following statements should the nurse include in the teaching?

"restrict your child's intake of caffeine while she is taking this medication."

A nurse is preparing to administer clozapine 300 mg PO daily to a client who has schizophrenia. The amount available is clozapine 200 mg tablets. How many tablets should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

1.5 mL

A nurse is preparing to administer lithium 300 mg PO every 8 hr. Available is lithium carbonate 150 mg capsules. How many capsules should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 capsules

A nurse is caring for a client who has schizophrenia and is experiencing hallucinations. The provider prescribes chlorpromazine 50 mg IM every 4 hr as needed. Available is chlorpromazine injection 25 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

2 mL

A nurse in an acute care facility is admitting an older adult client who has demntia due to Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his wife. Which of the following interventions is the nurse's priority?

Ask the partner to talk about his difficulties in caring for the client

A nurse is caring for a client who has a mental health disorder. The client asks about his medications and their effects. The nurse asks the client why he needs to know this. Which of the following no therapeutic communication techniques is nurse using?

Asking for an explanation

Crisis intervention

Crisis intervention seeks to help the patient develop adequate coping skills to resolve an immediate problem.

A nurse in a drug and alcohol detoxification center is planning care for a client who has alcohol use disorder. Which of the following interventions should the nurse identify as the priority?

Providing for adequate hydration and rest

A nurse us caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse except to see?

Decresed tremors

A nurse is assessing a child who has attention-deficit/hyperactivity disorder (ADHD). Which of the following findings should the nurse except?

Impulsive actions

A nurse is assessing an adolescent client who has attention deficit hyperactivity disorder (ADHD). Which of the following findings should the nurse except?

Impulsivity

A nurse is caring for a client following a suicide attempt. The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurse's priority?

Initiating suicide precautions

A nurse reviews the laboratory report for a client who is receiving lithium three times daily PO. The client's current blood lithium level is 1.8 mEq/L. The nurse identifies that this lab value indicates which of the following?

The lithium level is at the toxic level A blood lithium level greater than 1.5 mEq/L indicates toxicity. A therapeutic initial blood level of lithium is 0.8 to 1.4 mEq/L. Blood levels for lithium maintenance should be between 0.4 and 1.3 mEq/L.

A nurse is teaching a client who has bipolar disorder and prescription for lithium to recognize the manifestations of toxicity. Which of the following statements by the client indicates an understanding of the teaching.

Vomiting is an indication of toxicity

A nurse is reviewing the medical record of a client who has a new prescription for clozapine for the treatment of schizophrenia. Which of the following findings indicates a contraindication to clozapine?

WBC count 3,300mm3

A nurse is caring for a client who has Wernicke-Korsakoff psychosis as a result of chronic alcohol use disorder. Which is the following interventions should the nurse anticipate?

administration of thiamine

delusional disorders

characterized by false beliefs despite contradictory information

Fetishism

characterized by sexual fantasies, urges, or behaviors that involve the use of a fetish—a nonhuman object or a nonsexual part of the body—to produce or enhance sexual arousal.

A charge nurse is teaching a newly licensed nurse, the importance of client confidentiality. Which of the following professional standards should the charge nurse referred to in the teaching?

code of ethics for nurses

A nurse is discussing a clients needs at an interdisciplinary team conference. The nurse had a smoke and requires inpatient rehabilitation incorporated into their plan of care. Which of the nursing competencies is the nurse demonstrating?

collaborator

Dissociative identity disorder

complex disturbance of identity and memory characterized by the existence of two or mo

Introjection

individual adopting someone else's values and standards without exploring whether they're appropriate for him or her.

Intellectualization aka isolation

individual removing self from emotional events. The patient may discuss painful events in a detached, impersonal way because describing true feelings is too difficult.

Histrionic disorder

individual who's excessively emotional and constantly seeking attention.

compulsion

ritualistic, repetitive & involuntary defensive behavior to reduce anxiety

A nurse is proving care for a client who has anorexia nervosa. Which of the following nursing interventions should the nurse take?

schedule regular weigh-in times

Edinburg Postnatal Depression Scale (EPDS)

screens for signs of postnatal depression and can be used through the postnatal year.

Response prevention

seeks to prevent compulsive behavior through distraction, persuasion, or redirection of activity.

A nurse is discussing the use of mechanical restraints with a newly licensed nurse. Which of the following situations should the nurse include as an indication for placing a client in mechanical restraints?

self-destructive behavior despite alternative interventions

Anorexia nervosa

self-imposed starvation resulting from a distorted body image and an intense and irrational fear of gaining weight, even when obviously emaciated.

Aversion therapy

ses a painful stimulus to create an aversion to the obsession underlying the patient's undesirable behavior.

A nurse is assessing a client who has a history of alcohol use disorder. Which of the following questions should the nurse include to determine how the use of alcohol affects the client's psychosocial behaviors?

"Has alcohol use affected your performance at work?"

Is school nurse is speaking to the mother of a 16 year old male adolescent. The mother has concerns about her son. Which of the following statements about the mother should indicate to the nurse that the adolescent is at risk for suicide?

"His favorite teacher committed suicide a few weeks ago."

A nurse is caring for a client who has borderline personality disorder (BPD). As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

"I don't like it when you address me with that tone of voice"

A nurse is evaluating the outcomes of an outpatient client who has depression. Which of the following client statements indicates a need for further evaluation?

"I just don't like going to the movies like I used to."

A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder? (Select all that apply)

- Paroxetine - Lithium - Valproate - Carbamazepine

A nurse is caring for a client who has dementia. When performing a Mental Status Examination (MSE) the nurse should include which of the following date? (Select all that apply)

- ability to perform calculations - recall ability - long-term memory - level of orientation

A nurse in a mental health clinic is conducting a staff education session on schizophrenia. Which of the following manifestations should the nurse identify as negative symptoms? (Select all that apply)

- anhedonia - blunt affect

Cognitive Capacity Screening Examination

measures orientation, memory, calculation, and language.

Mini-Mental Status Examination

measures orientation, registration (the ability of a patient to name three objects previously mentioned by the examiner), recall, calculation, language, and graphomotor (the movements required in writing) function.

displacement

misdirecting pent-up feelings toward something/someone that's less threatening than what triggered the response

Undoing

trying to undo the harm the individual feels he or she has done to others.

Identification

unconsciously adopting the personality characteristics, attitudes, values, and behavior of someone else as a way to alleviate anxiety

Which of the following findings in the clients medical record indicates the client has bulimia nervosa? Click to highlight the findings in the clients medical record that indicate the client has bulimia nervosa. To deselect a finding, click on the finding again.

- BMI 20.1 - erosion of teeth, numerous dental caries - overeating with subsequent episodes of induced vomiting every weekday evening - taking over-the-counter laxative and diuretic medication every morning - frequent premature ventricular contractions (PVCs) - potassium 3.2 mEq/L

Reaction formation

display of behavior that's opposite of the individual's true feelings.

A nurse is planning care for a client who has anorexia nervosa. The nurse should make which of the following client goals the priority?

Gain 2 pounds of weight per week

A nurse is caring for a 2-mouth-old infant, who is post office to following repair of a cliff lip and palate. The provider prescribes restraints. The nurse should apply which of the following types of restaurants for this infant?

elbow

A nurse is caring for an adolescent client who has conduct disorder. The client reports that she has received five speeding tickets in the past 6 months. Which of the following interventions should the nurse take?

make a contract with the client not to drive over the speed limit

A nurse is reviewing abnormal laboratory values for four clients who have schizophrenia and take clozapine. For which of the following clients should the nurse withhold the medication and notify the provider immediately to have clozapine therapy discontinued?

A client who has a WBC of 2,900 cells/mm3

The nurse is assessing the client for manifestations of anorexia nervosa. Which of the following findings should the nurse expect? (Select all that apply)

- client has soft, unpigmented hair on arms is correct - clients hair appears brittle and thin - client reports consuming around 600 calories each day - client reports preoccupation with thoughts about food

A nurse is planning care for a client who has become increasingly anxious and confused. Which of the following actions should the nurse include to avoid the use of physical restraints? (Select all that apply)

- ensure effective pain management - attend to the client's needs for toileting - assign the client to a room near the nurses' station - orient client frequently to the environment

A nurse is caring for a client who frequently attempts to remove his IV catheter. A family member requests that the nurse apply restraints. Which of the following responses should the nurse make?

"I will cover the catheter so he cannot see it."

A nurse is preparing to collaborate with interdisciplinary team about the child's care. After reviewing the child's information, which of the following potential providers prescriptions, should the nurse identify as anticipated, nonessential, or contraindicated? For each potential providers prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the child.

- oral steroids is anticipated - cranial radiation is contraindicated - fluid restriction is contraindicated - viscous lidocaine oral rinse is contraindicated - varicella vaccine is contraindicated - ondansetron is anticipated

A nurse is caring for a client who has schizophrenia. Which of the following statements by the client indicates understanding of a relapse prevention plan?

"I know which of my hallucinations trigger a relapse."

A nurse is caring for a client who has schizophrenia and is having difficulty with performing ADLs. The nurse should consult with which of the following members of the interdisciplinary team to assist the client?

occupational therapist

A nurse is discussing treatment of depressive disorders with a client who has major depression. Which of the following client statements indicates an understanding of the teaching?

"I will attend psychotherapy to help manage my depression"