Mental Health test4
A nurse is reinforcing teaching with a client who has a prescription for nortriptyline. Which of the following client statements indicates an understanding of the teaching?
"I should sit on the side of the bed before standing up in the morning."
A nurse is providing medication teaching for client with depression and who is taking a monoamine oxidase inhibitor (MAOI) instead of a selective serotonin reuptake inhibitor (SSRI). Which of the following nursing statements is appropriate to include in teaching?
"You will need to be off the SSRI for a period of time before starting the MAOI.
A client with schizophrenia is admitted to the psychiatric unit in an acutely disturbed violent state. The client is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds, the nurses notices the client has the head rotated to one side in the stiffly fixed position. The lower jaw is thrust forward and the client appears severely anxious. The client i mostly experiencing what?
A dystonic reaction
A client has a new prescription for citalopram (Celexa). Which of the following must the nurse make sure the client is not also taking? (Select all that apply)
A monoamine oxidase inhibitor (MAOI) A tricyclic antidepressant (TCA) St John's wort
Affects men more than women Characteristics can be seen in children Smooth talkers Deceitful, manipulative, risk takers
Anti social personality disorder
Treatment is usually forced and substance abuse is often present No capacity for intimacy
Anti social personality disorder
What drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages?
Antipsychotics
Requires firm consistent limits, need to outline inappropriate behavior and be aware they may attempt to split staff
Antisocial personality disorder and borderline personality disorder
Selective serotonin reuptake inhibitors are the first line of treatment for which of the following disorders?
Anxiety disorders
Approach when taking care of wounds or injuries with someone that has Borderline personality disorder
Avoid rescuing or rejecting
Displays low self esteem, terrified in social situations. Linked to excessive parental criticism and peer rejection
Avoidant Personality Disorder
Characterized by unstable moods, poor relationships with others, impulsivity Can be self destructive
Borderline personality disorder
May see abuse -physical, sexual and emotional abuse in the history of these individuals. Suicidal and aggressive behaviors are usually present
Borderline personality disorder
May be related to profound learning experiences as a child with a chronic illness. "Learned helplessness"
Dependent personality disorder
These individuals have moderate to low problems in functioning. Are submissive and like to be taken care of
Dependent personality disorder
A client diagnosed with major depression began taking escitalopram (Lexapro) 5 days ago. The client now says, "This medicine isn't working." The nurse's best intervention would be to:
Explain the time lag before antidepressants relieve symptoms.
A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for Lithium. The nurse should reinforce teaching on which of the following behaviors that could cause lithium toxicity?
Fasting
These individuals have a good quality of life. Display excessive emotion, can be provocative and impulsive
Histrionic personality disorder
A client is experiencing a sudden severe episode of anxiety. The nurse understands that _______ will assist in decreasing the client's anxiety and is often ordered PRN?
Lorazepram (Ativan)
An outpatient diagnosed with bipolar disorder takes lithium carbonate 300 mg three times daily. The client reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with:
Meals
The nurse is caring for a client that was recently started on a second generation antipsychotic medication. The nurse understands that the generation antipsychotic medications can cause which of the following?
Metabolic syndrome
Not very common. Display self importance, entitlement Poor relationships Actually feel shame, fear of abandonment
Narcissistic personality disorder
Nursing approach with this disorder is to convey confidence, avoid power struggles and defensiveness
Narcissistic personality disorder
Strive for perfectionism and orderliness is a must
OCD disorder
May see in the workplace. Display rigidity, are inflexible. Actions/behaviors may be self defeating but have no insight Their way or highway
Obsessive compulsive personality disorder
Characterized by suspiciousness, hypervigilant behavior. Can be hostile and controlling
Paranoid personality disorder
What people see, what makes us "us"
Personality
A nurse cares for a client diagnosed with a morphine (opioid) overdose. Which focused assessment has the highest priority?
Respiratory
For these personality disorders, you want to avoid being "too nice" or friendly. You want to be calm and confident.
Schizoid and paranoid personality disorder
Uncommon Characteristics: "loner, shy, emotionally detached."
Schizoid personality disorder
You are able to reason with the person that has this personality disorder and these individuals have very odd beliefs. They have severe social and interpersonal deficits
Schizotypal personality disorder
A client diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the client says, "I don't think I can keep taking these pills. They make me so dizzy, especially when i stand up." The nurse will:
Teach the client strategies to manage postural hypotension
Key feature of all individuals with personality disorders
They accept and are comfortable with their altered behaviors and personality
Client has begun taking psychotropic medication. The nurse is providing education to the client on the purpose of psychotropic drug therapy and is correct in stating that the drug therapy is used for which of the following reasons?
To decrease symptoms and facilitate other therapies
A client has been started on Clozapine to treat the positive and negative symptoms of schizophrenia. Which lab result noted by the nurse would be of concern for this client?
White blood cell count of 3000