PP questions

A patient with major depression walks and moves slowly. Which term should the nurse use to document this finding? a. Psychomotor retardation b. Psychomotor agitation c. Vegetative sign d. Anhedonia

a. Psychomotor retardation

Which term is most applicable to crisis? a. Self-limiting b. Boundaries c. Amnesia d. Chronic

a. Self-limiting

In GAS, which stage occurs first? a. Alarm b. Resistance c. Exhaustion

a. Alarm

A person with which psychiatric problem is most likely to complete suicide? a. Personality disorder b. Major depression c. Substance abuse d. Schizophrenia

b. Major depression

Dorothea Dix is credited with...

establishment of a system of state asylums.

Definition of Mental Health

the successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms

Which reaction to stress is healthy? a. Distress b. Eustress c. Stressor d. None of the above.

b. Eustress

Major Depressive Disorder

- Depressed mood - Symptoms cause distress or impaired function - Loss of interest or pleasure(anhedonia)

Lithium Carbonate

- Treats bipolar disorder - therapeutic level: 0.8-1.4 - toxic level: 1.5 & up - dehydration increases level in blood

Maladaptive Grief

- individual is not able to satisfactorily progress through the stages of grieving to achieve resolution - occur when an individual becomes fixed in the denial or anger stage of the grief process

MAOIs

- less used - treats MDD **AVOID FOODS W/ TYRAMINES (beer, wine, cheese, smoked meats) --> SEVER HYPERTENSIVE CRISIS ex. Phenelzine (Nardil)

What class of drugs are the first line in treating Major Depressive Disorder?

Selective serotonin reuptake inhibitors (SSRIs) ex. Fluoxetine (Prozac) ex. Sertraline (Zoloft) **risk of serotonin syndrome

Tricyclic Antidepressants

- less used - treats MDD ex. Amitriptyline (Elavil) **risk of orthostatic hypotension

Depakote

- treats Bipolar Disorder - off label use for mood stabilization - causes nausea - therapeutic levels: 60-100

5 Stages of Grief

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

Mood Stabilizer Drugs

1. Lithium 2. Depakote

Nursing Ethics Principles

Beneficence Autonomy Justice Fidelity (nonmaleficence) Veracity

As a nurse assesses a new client, the nurse makes sure the door remains open. Which type of communication factor is this action? a. Environmental b. Relationship c. Personal

a. Environmental

Mrs. M comes to the clinic reporting a feeling of hopelessness. She works full time and is dealing with a troubled teenage son and her elderly parents. She confides in you that she "can't deal with her life right now." As you work through Mrs. M's assessment, you evaluate her possible level of resilience. Which other characteristic would you expect her to have? a. Optimism b. Patriotism c. Aggressiveness d. Depressed affect

a. Optimism

A nurse spends extra time with a client who has personality features similar to the nurse's estranged spouse. Which aspect of countertransference is most likely to result? a. Overinvolvement b. Misuse of honesty c. Indifference d. Rescue

a. Overinvolvement

Jeff was just diagnosed with a major depressive disorder. Which medication is the health care provider most likely to start the patient on? a. SSRI b. SNRI c. Tricyclic antidepressant d. Monoamine oxidase inhibitor

a. SSRI

Which of the following identifies the titles that registered nurses will use and what they are legally allowed to do? a. State Boards of Nursing b. Professional Organizations c. Custom as a Standard of Care d. Institutional Policies and Procedures

a. State Boards of Nursing

The nurse is assessing a client for side effects of electroconvulsive therapy (ECT). Which side effects are common and to be expected? a. Temporary disorientation b. Enduring memory loss c. Residual seizure disorders d. Cardiovascular complications

a. Temporary disorientation

As Becky is preparing for discharge, she presents you with a handmade card of appreciation for the care you provided. Should you accept the card? a. Yes b. No c. Depends on state laws d. Depends on her illness

a. Yes

After your first conversation, Becky withdraws from you again before you've even really begun. Which statement will contribute most to establishing Becky's trust? a. "Weren't you complying with your medication regimen?" b. "It must be discouraging to be readmitted to the hospital so soon." c. "Everyone with bipolar disorder ends up in the hospital occasionally." d. "You must take your drugs as prescribed or you will be rehospitalized."

b. "It must be discouraging to be readmitted to the hospital so soon."

Which question would be a priority when assessing for symptoms of major depression? a. "Tell me about any special powers you believe you have." b. "You look really sad. Have you ever thought of harming yourself?" c. "Your family says you never stop. How much sleep do you get?" d. Do you ever find that you don't remember where you've been or what you've done?"

b. "You look really sad. Have you ever thought of harming yourself?"

Becky tells you, "I have something secret to tell you, but you can't tell anyone else." The nurse agrees. What is the likely consequence of the nurse's action? a. Healthy feelings of sympathy by the nurse toward the client. b. Blurred boundaries in the nurse-client relationship. c. Improved rapport between the nurse and client. d. Enhanced trust between the nurse and client.

b. Blurred boundaries in the nurse-client relationship.

JS continues to argue with staff. He is not aggressive, but refuses all treatment. Legal and clients' rights are suspended when a client is hospitalized involuntarily. a. True b. False c. Depends on the state d. Depends on the physician assessment

b. False

Which assessment finding in a patient with major depression represents a vegetative sign? a. Restlessness b. Hypersomnia c. Feelings of guilt d. Frequent crying

b. Hypersomnia

A nurse was the case manager for a client with serious mental illness for 6 years. The client died by suicide 1 week ago. Today, the client's spouse asks, "I always wondered if my spouse was a victim of sexual abuse in childhood. What can you tell me about that?" Can the nurse disclose information to the surviving spouse? a. Yes b. No c. It depends on state law d. It depends on how damaging the physician feels this would be to all concerned.

b. No

Maggie, our college student, is aware that she needs help. On the three afternoons a week before she starts classes, she has lunch with her 2-year-old daughter on campus than goes to a yoga class right on campus that also provides child care. After yoga, her sister picks up her daughter, and Maggie goes on to class. "I'm trying," Maggie says. "It's still not easy, and I still feel a bit overloaded, but this is at least making some difference! It's a start, a step." Which stage of GAS is Maggie most likely experiencing? a. Alarm b. Resistance c. Exhaustion d. None of the above.

b. Resistance

Gina is hospitalized suicidal ideation after two suicide attempts. For the first 2 days of hospitalization, the patient eats 20% of meals and stays in her room between groups. By the fourth day, the nurse observes that the patient is more sociable, is eating meals, and has a bright affect. Considering Gina's behavior on the fourth day of hospitalization, which factor should the nurse consider? a. The patient is showing improvement and may be ready for discharge. b. The patient may have decided to commit suicide; the nurse should reassess suicidality. c. The patient is feeling rested, supported by the therapeutic milieu, and less depressed. d. The patient is benefiting from the antidepressant she has been taking for 4 days.

b. The patient may have decided to commit suicide; the nurse should reassess suicidality

A client is preparing to undergo ECT. Which nursing intervention is appropriate? a. Keep the client NPO 24 hours before the procedure. b. Verify that informed consent has been granted. c. Ascertain that client has dentures securely in place. d. Place side rails down for easy access to the restroom.

b. Verify that informed consent has been granted.

In the posttreatment period of electroconvulsive therapy (ECT), which is an appropriate nursing intervention? a. Monitor vital signs every 30 minutes during the first hour. b. Place client on back to facilitate comfort. c. Orient client to time and place. d. Ambulate immediately to promote adequate circulation.

c. Orient client to time and place. Orienting to time and place assists with overcoming the temporary confusion and disorientation that often follow the ECT treatments.

Which individual may need involuntary hospitalization? a. A person with alcoholism who has been sober for 6 months but begins drinking again b. An individual with schizophrenia who stops taking prescribed antipsychotic drugs c. An individual with bipolar disorder, manic phase, who has not eaten in 4 days d. Someone who repeatedly phones a national TV broadcasting service with news tips

c. An individual with bipolar disorder, manic phase, who has not eaten in 4 days

As you prepare for the initial interview with 15-year-old Noah, you learn that he has a history of cutting himself. His parents have separated and are getting a divorce; his father has left and Noah is living with his mother. Noah has been smoking for about a year and a half and his mother suspects that he has come home smelling of marijuana twice now. All three behaviors were ongoing before the father left. Which behavior from Noah would be considered a double-bind message? a. He winks at you and says, "Do you date 15-year-old guys?" b. He puts his head in his hands, shakes it, and snaps, "I don't want to do this. Just get me out of here!" c. He sneers at you and almost purrs as he says, "Oh yes. I will tell you anything you want to know. Of course. Of course, I will." d. He cries and shakes, jiggling one leg, as he says softly, "Please. Let's just not talk about Dad, okay? God, please?"

c. He sneers at you and almost purrs as he says, "Oh yes. I will tell you anything you want to know. Of course. Of course, I will."

Which of these mental health problems has the highest annual prevalence in the United States? a. Schizophrenia b. Panic disorder c. Major depressive disorder d. Generalized anxiety disorder

c. Major depressive disorder

During therapy, the nurse and Mr. Alessandro propose a move to a nicer, larger apartment while they wait for insurance to begin the process of helping them build a new home. "There's that new complex near the park where we used to walk," Mr. Alessandro says. "We could take walks there like we used to without having to drive so far. And when you're ready, we can think about adopting a cat." "I'm not ready to replace Alfie!" his wife says. But after a moment, she softens and says, "I'm sorry, Robert. Those new apartments by the park, though. I'd like to see those." Which phase best describes how the Alessandros are doing right now? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4

c. Phase 3 Although identifying these phases is seldom completely cut-and-dried, students are correct in choosing either phase 2 or 3, though phase 3 is more likely. Trial-and-error has failed and while Mrs. Alessandro uses withdrawal as a coping mechanism, her husband's anxiety has turned to panic. This is not phase 4 because no one is suicidal, and both are open to considering a realistic solution.

Jeff's parents have described his lack of interest in things he used to enjoy, like games with his friends, and his classes, which he used to like. This may be best described by the term a. Inappetance b. Impetance c. Indolence d. Anhedonia

d. Anhedonia

Noah has made it clear he doesn't want to talk about his dad. But the truth is, as the interview proceeds, he becomes anxious and tries to evade all questions about why he is here. Which type of communication might be most appropriate right now? a. Stop questioning so much and just give him some good advice so he'll trust you. b. Express honest disapproval of his resistance to help. c. Ask him pointblank why he is evading you. d. Ask a miracle question.

d. Ask a miracle question.

You notice that you look forward to talking to Becky because her dark sense of humor reminds you of your best friend in high school. You also begin to make little cynical jokes, hoping to have a good laugh together. What is this relationship showing early signs of? a. Accountability b. Self-reflection c. Transference d. Countertransference

d. Countertransference

A category 5 hurricane destroys homes and businesses in a community. How would this crisis be classified? a. Maturational crisis b. Situational crisis c. Disequilibrium d. Disaster

d. Disaster A disaster results from events that are unplanned and may be accidental, caused by nature, or human made. This type of crisis results from a natural disaster, a national disaster, or a crime of violence.

One of Mrs. M's complaints is about insurance. Which of the following does the Mental Health Parity Act provide? a. Coverage for most uninsured Americans through expanded Medicaid eligibility b. Health insurance exchanges c. "Insurance mandate" for coverage d. Equal coverage for mental health disorders

d. Equal coverage for mental health disorders

You are a new nurse in a psychiatric ward for adolescents. Noah is your first patient. He is depressed and has fresh cuts on his wrist, which is why his mother has had him admitted. While taking his pulse, you see that Noah also has a number of older scars on his arm. When he sees you looking at them, he shakes his head and whispers, "Yeah, well. It's just gonna keep on happening." Noah's whispered statement of "Yeah, well. It's just gonna keep on happening" does not involve which of the following? a. Channel b. Stimulus c. Message d. Feedback

d. Feedback

Which method of suicide has the highest lethality? a. Ingesting pills b. Cutting one's wrists c. Inhaling natural gas d. Self-inflicted gunshot wound

d. Self-inflicted gunshot wound