Mental Health test 5/12/15 ch. 10,11,12,19,20,28

how long does a panic attack last?

15 to 30 minutes

what are a few examples of tricyclic antidepressants?

Amitriptyline, Imipramine, Nortriptyline

A nurse is collecting data from a client 4 hr after receiving an initial dose of fluoxetine (Prozac). Which of the following findings should the nurse report to the provider as an indication of serotonin syndrome? (Select all that apply.) A. Hypothermia B. Hallucinations C. Muscular flaccidity D. Diaphoresis E. Agitation

B. Hallucinations D. Diaphoresis E. Agitation

A nurse is collecting data from a client who is suicidal. Which of the following are appropriate for the nurse to ask the client? (Select all that apply.) A. "Do you have a plan?" B. "Have you thought about hurting yourself?" C. "Do you feel that life is not worth living?" D. "Why do you want to commit suicide?" E. "Have you experienced a recent change in your mood?"

A. "Do you have a plan?" B. "Have you thought about hurting yourself?" C. "Do you feel that life is not worth living?" E. "Have you experienced a recent change in your mood?"

A nurse observes a client who is pacing and wringing his hands. The client states, "I don't know why, but I've worried every day for over a year that my son will die a horrible death." This finding is consistent with which of the following disorders? A. Generalized anxiety disorder B. Panic disorder C. Posttraumatic stress disorder D. Acute stress disorder

A. Generalized anxiety disorder

A nurse working on an acute mental health unit is caring for a client who has posttraumatic stress disorder (PTSD). Which of the following are expected findings? (Select all that apply.) A. Hallucinations B. Obsessive need to talk about the traumatic event C. Exaggerated displays of emotion D. Recurring nightmares E. Diminished reflexes

A. Hallucinations D. Recurring nightmares

A nurse is reinforcing teaching with a client who has a new prescription for amitriptyline. Which of the following client statements indicates understanding of the teaching? A. "While taking this medication, I'll need to stay out of the sun to avoid a skin rash." B. "I may feel drowsy for a few weeks after starting this medication." C. "I cannot eat my favorite pizza with pepperoni while taking this medication." D. "This medication will help me lose the weight that I have gained over the last year."

B. "I may feel drowsy for a few weeks after starting this medication."

A nurse is discussing transcranial magnetic stimulation (TMS) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "TMS is indicated for clients whose depression is not relieved by medication." B. "I will provide postanesthesia care following TMS." C. "TMS is usually performed as an outpatient procedure." D. "I will schedule the client for daily TMS treatments for the first several weeks."

B. "I will provide postanesthesia care following TMS."

A nurse is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following is the priority nursing action? A. Assist with the administration of flumazenil. B. Identify the client's level of orientation. C. Administer a saline cathartic. D. Prepare the client for gastric lavage.

B. Identify the client's level of orientation.

A client says, "I plan to commit suicide." Which of the following should be the nurse's priority when collecting data? A. Client's educational and economic background B. Lethality of the method and availability of means C. Quality of the client's social support D. Client's insight into the reasons for the decision

B. Lethality of the method and availability of means

A nurse is caring for a client who is taking phenelzine (Nardil). For which of the following adverse effects should the nurse observe? (Select all that apply.) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Headache E. Bruxism

B. Orthostatic hypotension D. Headache

A nurse is reviewing the medical record of a client who has a new prescription for bupropion (Wellbutrin) for depression. Which of the following findings is the priority for the nurse to report to the provider? A. The client has a family history of seasonal affective disorder. B. The client currently smokes 1.5 packs of cigarettes per day. C. The client had a motor vehicle crash last year and sustained a head injury. D. The client has a BMI of 25 and has gained 10 lb over the last year.

C. The client had a motor vehicle crash last year and sustained a head injury.

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. Repetitive behavior in a client who has OCD is due to which of the following? A. Narcissistic behavior B. Fear of rejection from staff C. Attempt to reduce anxiety D. Adverse effect of antidepressant medication

C. Attempt to reduce anxiety

know about the drug nardil?

its an MAOI, avoid foods with tyramine, avoid medications before talking to your doctor.

what drugs are mao inhibitors?

nardil, marplan, parnate, emsam

what foods should you avoid if you are taking mao inhibitors?

avocados, smoked meats, liver, fish, cheese, beer and wine

what drugs are benzodiazepines?

diazepam (valium), lorazepam (ativan), chlordiazepoxide (librium), clorazepate (tranxene), oxazepam (serax), clonazepam (klonopin)

what is agoraphobia?

disease that causes you to not want to leave your house

what is systemic desensititization?

its a phobia

what are some symptoms of a panic attack?

palpitations, sob, chest pain, nausea, chills or hot flashes

The nurse on a mental health unit conducts a group meeting for clients diagnosed with obsessive-compulsive disorder (OCD). Which clients can the nurse most likely expect as members of an obsessive-compulsive disorder support group? select all that apply 1. a 30-yr old who performs handwashing five times per hour 2. a 35-yr old who wears gloves when touching a public faucet 3. a 40-yr old who is sexually promiscuous 4. a 45-yr old who drinks a fifth of whiskey daily 5. a 50-yr old who cannot throw anything away 6. a 60-yr old who repeatedly checks the locks on locked doors

1. a 30-yr old who performs handwashing five times per hour 2. a 35-yr old who wears gloves when touching a public faucet 5. a 50-yr old who cannot throw anything away 6. a 60-yr old who repeatedly checks the locks on locked doors

when asked to identify the characteristics of post traumatic stress disorder the nurse correctly responds that most people with this disorder report which findings? select all that apply. 1. recurring nightmares 2. auditory hallucinations 3. rapidly changing emotions 4. anger that erupts easily 5. ease in being startled 6. trouble concentrating

1. recurring nightmares 5. ease in being startled 6. trouble concentrating

when discussing the care of clients with obsessive compulsive disorder with nursing staff, which treatment options are considered most therapeutic? select all that apply? 1. selective serotonin reuptake inhibitors. 2. electroconvulsive therapy 3. cognitive-behavioral therapy 4. surgical prefrontal lobotomy 5. tranquilizers such as diazepam (valium) 6. a self-help class on the internet

1. selective serotonin reuptake inhibitors. 3. cognitive-behavioral therapy

which findings strongly suggests to the nurse that the client is experiencing an exacerbation of the bipolar disorder? select all that apply. 1. the client has been spending money extravagantly 2. the client wants to become a 5-yr old again 3. the client has been methodically cleaning the house 4. the client has been staying up late to read. 5. the client demonstrates increased sexual promiscuity 6. the client has increased anxiety when going outside the house.

1. the client has been spending money extravagantly 5. the client demonstrates increased sexual promiscuity

a home health nurse is scheduled for daily visits to change the abdominal dressing of a 45-yr old with a history of bipolar disorder. while reviewing the clients psychiatric history, the nurse would expect to note which major characteristic of bipolar disorder? 1. ritualistic behavior 2. symbolic aggressiveness 3. cyclic mood swings 4. periodic amnesia

3. cyclic mood swings

which assessment measure is most important for the nurse to monitor to determine whether the client's current dose of lithium carbonate is appropriate? 1. vital signs 2. urine volume 3. drug blood levels 4. brain wave scanse

3. drug blood levels

when the nurse reviews information about lithium carbonate (lithane) with the client, which instructions are most important to stress? select all that apply 1. take a high-potency vitamin each morning. 2. refrain from sexual activity while taking this medication. 3. notify the physician if urine output increases. 4. drink 10 to 12 glasses of water per day 5. maintain a sufficient salt intake daily. 6. avoid eating aged cheeses.

4. drink 10 to 12 glasses of water per day 5. maintain a sufficient salt intake daily.

A nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further reinforcement of teaching? A. "Care during the continuation phase focuses on treating continued manifestations of MDD." B. "The goal of treatment during the maintenance phase is prevention of future episodes of MDD." C. "The client is at greatest risk for suicide during the first weeks of an MDD episode." D. "Medication and psychotherapy are used to prevent a relapse of MDD."

A. "Care during the continuation phase focuses on treating continued manifestations of MDD."

A charge nurse is discussing mirtazapine (Remeron) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? A. "This medication increases the release of serotonin and norepinephrine." B. "I will need to monitor the client for hyponatremia while taking this medication." C. "This medication is contraindicated for clients who have an eating disorder." D. "Sexual dysfunction is a common adverse effect of this medication."

A. "This medication increases the release of serotonin and norepinephrine."

A nurse working in an acute mental health facility is caring for a 35-year-old female client who has clinical findings of depression. The client lives at home with her husband and two young children. She currently smokes and has a history of chronic asthma. The nurse should identify which of the following as risk factors for depression for this client? (Select all that apply.) A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes E. Being married

A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes

A nurse is caring for a client who takes paroxetine (Paxil) to treat posttraumatic stress disorder. The client states that he grinds his teeth during the night which causes pain in his mouth. The nurse should identify which of the following as possible measures to manage the client's bruxism? (Select all that apply.) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of a mouth guard D. Changing to a different class of antianxiety medication E. Increasing the dose of paroxetine

A. Concurrent administration of buspirone C. Use of a mouth guard D. Changing to a different class of antianxiety medication

A nurse working on an acute mental health unit is caring for a client who has major depressive disorder and comorbid anxiety disorder. Which of the following is the highest priority action by the nurse? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling D. Telling the client about medication adverse effects

A. Placing the client on one-to-one observation

A nurse is assisting with the planning of care for a client following surgical implantation of a vagus nerve stimulation (VNS) device. The nurse should monitor for which of the following adverse effects? (Select all that apply.) A. Voice changes B. Seizure activity C. Disorientation D. Dysphagia E. Neck pain

A. Voice changes D. Dysphagia E. Neck pain

A nurse is reinforcing teaching with a client who has a new prescription for imipramine (Tofranil) about how to minimize anticholinergic effects. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Void just before taking the medication. B. Increase the dietary intake of potassium. C. Wear sunglasses when outside. D. Change positions slowly when getting up. E. Chew sugarless gum.

A. Void just before taking the medication. C. Wear sunglasses when outside. E. Chew sugarless gum.

A nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statements by the nurse is appropriate? A. "Tell me about how you are feeling right now." B. "You should focus on the positive things in your life to decrease your anxiety." C. "Why do you believe you are experiencing this anxiety?" D. "Let's discuss the medications your provider is prescribing to decrease your anxiety."

A. "Tell me about how you are feeling right now."

A nurse working in an outpatient clinic is reinforcing teaching to a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? A. "I can expect my problems with PMDD to be worst when I'm menstruating." B. "I will use light therapy 30 min a day to prevent further recurrences of PMDD." C. "I am aware that my PMDD causes me to have rapid mood swings." D. "I should increase my caloric intake with a nutritional supplement when my PMDD is active."

C. "I am aware that my PMDD causes me to have rapid mood swings."

A nurse is caring for a client who is to begin taking fluoxetine (Prozac) for treatment of generalized anxiety disorder. Which of the following statements indicates the client understands the use of this medication? A. "I will take the medication at bedtime." B. "I will follow a low-sodium diet while taking this medication." C. "I will need to discontinue this medication slowly." D. "I will be at risk for weight loss with long-term use of this medication."

C. "I will need to discontinue this medication slowly."

A nurse is leading a peer group discussion about the indications for electroconvulsive therapy (ECT). Which of the following is appropriate to include in the discussion? A. Borderline personality disorder B. Acute withdrawal related to a substance use disorder C. Bipolar disorder with rapid cycling D. Dysthymic disorder

C. Bipolar disorder with rapid cycling

A nurse is monitoring a client immediately following an electroconvulsive therapy (ECT) procedure. Which of the following are expected findings? (Select all that apply.) A. Hypotension B. Paralytic ileus C. Memory loss D. Nausea E. Tachycardia

C. Memory loss D. Nausea E. Tachycardia

A nurse is interviewing a 25-year-old client who has a new diagnosis of dysthymia. Which of the following findings should the nurse expect? A. Wide fluctuations in mood B. Report of five or more clinical findings of depression C. Presence of manifestations for at least 2 years D. Inflated sense of self-esteem

C. Presence of manifestations for at least 2 years

A nurse is collecting data from a client at a community mental health facility using the SAD PERSONS tool. The nurse knows that this tool provides which of the following data related to a client? A. Current anxiety level B. Problem-solving ability C. Suicide potential D. Mood disturbance

C. Suicide potential

A nurse is reinforcing teaching with a client who is scheduled to receive electroconvulsive therapy (ECT) for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching? A. "It is common to treat depression with ECT before trying medications." B. "I can have my depression cured if I receive a series of ECT treatments." C. "I will have seizures lasting 1½ to 2 minutes during ECT." D. "I will receive a muscle relaxant to protect me from injury during ECT."

D. "I will receive a muscle relaxant to protect me from injury during ECT."

A nurse is assisting with the plan of care for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? A. Assign the client to a private room. B. Document the client's behavior every hour. C. Allow the client to keep perfume in her room. D. Ensure that the client swallows medication.

D. Ensure that the client swallows medication.

A nurse working in a mental health clinic is reinforcing teaching with a client who has a new prescription for diazepam (Valium) for generalized anxiety disorder. Which of the following is appropriate for the nurse to include in the teaching? A. 3 to 6 weeks of treatment is required to achieve therapeutic benefit. B. Combining alcohol with diazepam will produce a paradoxical response. C. Diazepam has a lower risk for dependency than other antianxiety medications. D. Report confusion as a potential indication of toxicity.

D. Report confusion as a potential indication of toxicity.

A nurse is caring for a client who is experiencing a panic attack. Which of the following is an appropriate nursing intervention? A. Discuss new relaxation techniques. B. Show the client how to change his behavior. C. Distract the client with a television show. D. Stay with the client, and remain quiet.

D. Stay with the client, and remain quiet.