Practicum Mental Health

The nurse is monitoring a client with schizophrenia who is prescribed clozapine. During the morning mental health team meeting, which symptoms indicating adverse effects of the medication would immediately be brought to the psychiatrists attention? Select all that apply. 1. Sore throat 2. Pill rolling movements 3. Polyuria 4. Fever 5. Polydipsia 6. Orthostatic hypotensikn

1,4,6

A nurse is caring for a client with agoraphobia. Which signs and symptoms would the nurse anticipate? Select all that apply. 1. hallucinations 2. panic attacks 3. inability to leave home 4. eating disorders 5. alcohol consumption 6. tobacco use

2,3

After interviewing a client diagnosed with recurrent depression, a nurse determines the client's potential for death by suicide. Which factors listed below might contribute to the client's risk? Select all that apply. 1. psychomotor retardation 2. impulsive behavior 3. overwhelming feelings of guilt 4. chronic, debilitating illness 5. decreased physical activity 6. repression of anger

2,3,4,6

A nurse is explaining client rights for psychiatric clients to a client who has voluntarily sought admission to an inpatient psychiatric facility. Which rights would the nurse include in the discussion? Select all that apply. 1. right to select health care team members 2. right to refuse treatment 3. right to a written treatment plan 4. right to obtain disability benefits 5. right to confidentiality 6. right to personal mail

2,3,5,6

A nurse interviews the family of a client hospitalized with severe depression and suicidal ideation. What family assessment information is essential when formulating an effective discharge plan? Select all that apply. 1. physical pain 2. personal responsibilities 3. employment skills 4. communication patterns 5. role expectations 6. current family stressors

4,5,6

The nurse is assessing a client who is a poly substance abuser; with cocaine being one of the drugs most frequently used. Which physiological symptom is suggestive of early (phase 1) cocaine intoxication? Selection all that apply. 1. Tremors 2. Pyschomtor agitiation 3. Cardiac arrhythmias 4. Dilated pupils 5. Flaccid paralysis 6. Slurred speech

1,2,3,4

During the nurses assessment of a 15 year old client diagnosed with bulimia nervosa, the nurse evaluates for dining's that accompany binge eating. What are most applicable? Select all that apply. 1. Guilt 2. Dental caries 3. Self-induced vomiting 4. Weight loss 5. Normal weight 6. Introverted behavior

1,2,3,5

An 8 year old child, diagnosed with obsessives compulsive disorder, is admitted by the nurse to a psychiatric facility. During the admission assessment, which behaviors would be characterized as compulsions? Select all that apply. 1. checking and rechecking that the television is turned off before going to school 2. repeated washing the hands 3. brushing teeth three times per day 4. routinely climbing up and down a flight of stairs three times before leaving the house 5. spending the night at only one friend's house 6. wanting to play the same video game each night

1,2,4

A client is prescribed sertraline, a selective serotonin reuptake inhibitor. Which adverse effects would the nurse review when creating a medication teaching plan? Select all that apply. 1. agitation 2. agranulocytosis 3. sleep disturbance 4. persistent cough 5. dry mouth 6. seizures

1,3,5

A nurse is caring for a client who exhibits behaviors that test the nurse-client relationship. When discussing this behavior at a multidisciplinary team conference, which behaviors would the nurse provide as examples of this behavior? Select all that apply. 1. placing the nurse in the role of parent 2. dressing in a flamboyant or seductive manner 3. requesting personal information from the nurse 4. displaying tattoos and piercings 5. stating information to try to shock the nurse 6. violating the nurse's personal space

1,3,5,6

A nurse is developing a care plan for a client with acute mania. Place the following behaviors according to the order in which they progress from normal through acute mania. 1. has delusions of grandeur 2. uses relevant, calm speech patterns 3. shows high productivity and competitive attitude in work and leisure activities 4. becomes easily irritated 5. demonstrates poor judgement and impulse control

2,3,4,5,1

A nurse is assessing a new client and notices clang associations in the speech pattern. From this assessment finding the nurse begins to evaluate for the potential of which psychiatric conditions? Select all that apply. 1. Dissociative identity disorder 2. Schizophrenia 3. Narcolepsy 4. Mania 5. Cognitive disorders 6. Intermittent explosive disorder

2,4,5

A nurse is caring for a client who has experienced frontal lobe damage in a car accident. Which psychosocial behaviors are indications of this damage. Select all that apply. 1. A change in personality 2. Overt sexual behavior 3. Difficulty controlling temper 4. Fewer spontaneous facial expressions 5. Inability to gout out in public settings 6. A disinterest in family relationships

1,2,3,4

A nurse is working with a schizophrenic client who suddenly begins experiencing auditory hallucinations. Which interactions are appropriate at this time? Select all that apply. 1. Ask the client, "what are you experiencing right now?" 2. Encourage the client to relate the history of the hallucinations. 3. Tell the client. "I'd like to spend time with you to discuss your hallucinations. Is that okay with you?" 4. Ask the client if she or he has recently taken any drugs or alcohol. 5. State, "do you understand the effects of your medication?" 6. Notify the health care provider of hallucinations.

1,2,3,4

The nurse is teaching a client diagnosed with a generalized anxiety disorder how to effectively cope with severe distress. Which interventions would the nurse use to promote effective coping with anxiety? Select all that apply. 1. Discuss previous methods that were effective in handling stress 2. Encourage the client to limit a mutually decided amount of time spent on worrying 3. Help the client to establish a goal and develop a plan to meet the goal 4. Teach the client how to label feelings and how to express them 5. Discuss ways to examine the reality of fears 6. Assist the client to acknowledge the major consequences of blaming others

1,2,3,4

A nurse is caring for an anorexic client with a nursing diagnosis of imbalanced nutrition: less than body requirements related to dysfunctional eating patterns. Which interventions would be supportive for this client? Select all that apply. 1. Provide small frequent meals 2. Monitor weight gain 3. Allow the client to determine food choices from a menu 4. Encourage the client to keep a journal 5. Monitor the client during meals and 1 hour afterward 6. Encourage the client to eat three substantial meals per day

1,2,3,4,5

In the emergency department, a client reveals to the nurse a lethal plan for dying by suicide and agrees to a voluntary admission to the psychiatric unit. Which information would the nurse discuss with the client to answer the question, "How long do I have to stay here?" Select all that apply. 1. "You ma leave the hospital at any time unless you're suicidal or homicidal or unable to meet your basic needs" 2. "Let's talk more after the health care team has assessed you" 3. "Once you've signed the papers, you are required to follow the treatment plan" 4. "Because you have stated that you want to hurt yourself, you must be safe before discharged" 5. "You need legal representation to help you make an informed decision" 6. "All clients need a court hearing before they leave the hospital"

1,2,4

While assessing a client diagnosed with impulse control disorder the nurse observes the clients violent, aggressive, and assaultive behavior when having to wait for lunch tray to be delivered from the dietary department. Which history and assessment findings documented in the medical record is the nurse also likely to find? Select all that apply. 1. The client functions well in other areas of life 2. The degree of aggressiveness is out of proportion to the stressor 3. The violent behavior is usually justified by a stressor 4. The client has a history of parental alcoholism and a chaotic abusive family life 5. The client has no remorse about the inability to control behavior

1,2,4

A hospitalized client becomes angry and belligerent toward a nurse after speaking on the phone with his or her mother. The nurse learns that the mother cannot visit as expected because of her work. Which interventions will the nurse use to help the client deal with the displaced anger? 1. Explore the clients unmet needs 2. Acknowledge the client's behavior as inappropriate. 3. Suggest that the client direct the anger at his or her mother's employee. 4. Invite the client to a quiet place to talk after he or she has settled down. 5. Assist the client in identifying alternate ways of approaching the problem.

1,2,4,5

A nurse is assessing a client who talks freely about feeling depressed. During the interaction, the nurse hears the client state, "Things will never change." What other indications of hopelessness would the nurse look for? Select all that apply. 1. bouts of anger 2. periods of irritability 3. preoccupation with delusions 4.. feelings of worthlessness 5. self-destructive behaviors 6. reliance on family members

1,2,4,5

A nurse is assessing a client for neurocognitive disorder such as dementia. What history findings would the nurse anticipate while talking with the client and family? Select all that apply. 1. The progression of symptoms have been slow. 2. The client admits to feelings of wanting to be alone. 3. The client acts apathetic and pessimistic. 4. The family cannot determine when the symptoms first appeared. 5. The client has been exhibiting basic personality changes. 6. The client has great difficulty paying attention to others.

1,2,4,5,6

When beginning a client on newly prescribed antipsychotic medications which symptoms are commonly seen within the first few weeks of treatment? Select all that apply. 1. Acute systemic reactions 2. Akathisia 3. Tardive dyskinsensia 4. Neuroleptic malignant syndrome 5. Hearing loss 6. Orthostatic hypotension

1,2,4,6

A male client states feelings of sadness and is seeking suggestions for strategies to keep active after the loss of his spouse. Which activities might the nurse suggest to the client? Select all that apply. 1. joining a golf league at a club 2. attending regular spiritual / church services 3. walking alone at sunrise at the local track 4. attending a midday movie at the theater 5. participating in a community charity event

1,2,5

A client who is taking antipsychotic medication to control schizophrenia asks the nurse to explain the causes of this disorder. The nurse knows that an overactive dopamine system in the brain is one of the leading causes of schizophrenia and tells the client that excessive dopamine activity is responsible for symptoms. Which symptoms is the nurse referring to? Select all that apply. 1. Hallucinations 2. Withdrawn behavior 3. Suspiciousness 4. Delusional thinking 5. Excessive tearfulness 6. Hypotension

1,3,4

A nurse is caring for a client recently diagnosed with cancer and experiencing moderate situational anxiety. Which interventions would the nurse include in the care plan? Select all that apply. 1. Maintain a calm, nonthreatening environment 2. Explain relevant aspects of chemotherapy 3. Encourage the client to verbalize concerns regarding the diagnosis 4. Encourage the client to use deep breathing exercises and other relaxation techniques during periods of increased stress 5. Provide positive thinking strategies for the client during periods of stress 6. Teach the stages of grieving to the client.

1,3,4

A nurse is employed at an outpatient rehabilitation facility caring for clients withdrawing from opioids. When assessing clients who present for their counseling session, which findings are anticipated at this time? Select all that apply. 1. Abdominal cramps 2. Dry, warm skin 3. Rhinorrhea 4. Dilated pupils 5. Hypersomnia 6. Feelings of hunger

1,3,4

A nurse selects a priority nursing diagnosis of fear related to being embarrassed in the presence of others for a client who exhibits symptoms of social phobia. Which outcomes, if met, would demonstrate improvement in client's symptoms? Select all that apply. 1. The client manages fear in group situations. 2. The client develops a plan to avoid situations that may cause stress. 3. The client verbalizes feelings that occur in stressful situations. 4. The client develops a plan for responding to stressful situations. 5. The client denies feelings that may contribute to irrational fears. 6. The client uses antianxiety medication to deal with underlying fears.

1,3,4

A nurse has developed a therapeutic relationship with a client who has an addiction disorder. Which client behaviors would indicate that the therapeutic interaction is in the working phase? Select all that apply. 1. The client discusses how the addiction has contributed to family distress. 2. The client reluctantly shares the family history of addiction. 3. The client verbalizes difficulty identifying personal strengths. 4. The client discusses the financial problems related to the addiction. 5. The client expresses uncertainty about what topic to discuss. 6. The client acknowledges the addiction's effects on his or her children.

1,3,4,6

A client is prescribed chlordiazepoxide as needed to control the symptoms of alcohol withdrawal. Which symptoms may indicate the need for an additional dose of this medication? Select all that apply. 1. Tachycardia 2. Mood swings 3. Elevated blood pressure and temperature 4. Piloerection 5. Tremors 6. Increasing anxiety

1,3,5,6

A client on a mental health unit becomes increasingly agitated and barricades himself in a corner room holding another client hostage. Verbal exchanges indicate an escalation in client desperation. Which nursing actions would be taken at this time? Select all that apply. 1. Identify one nurse to interact with the client. 2. Yell for assistance to obtain help quickly. 3. Direct other clients away from the area 4. Speak to the client in an authoritarian manner. 5. Discreetly notify security to assist. 6. Identify with the client's perspective and reason for agitation.

1,3,5,6

A nurse is working in the emergency room when a police officer walks in with a rape victim to be examined. If the nursing goal is to reduce client anxiety, which interventions would be appropriate? Select all that apply. 1. Admit the client to the treatment area right away. 2. Begin the examination immediately in order to get it behind her. 3. Assure the client of safety in the examination room. 4. Touch the client early on demonstrating the nurse is supportive. 5. Allow a third party to be present if the client requests it. 6. Ask factual questions to determine the type of assault.

1,3,5,6

A nurse is caring for a client diagnosed with persistent depressive disorder. Which defining characteristics are associated with this disorder? Select all that apply. 1. insomnia or hypersomnia 2. delusions or hallucinations 3. loss of interest in daily activities 4. onset of symptoms within a 2 week period 5. symptoms that occur in the winter and resolve in the spring 6. appetite disturbance

1,3,6

A nurse is preparing discharge instructions for a client with resistant depression who was prescribed a new medication regimen that includes phenelzine, a monoamine oxidase inhibitor (MAOI). If the teaching was successful, what foods would the client state that he or she needs to avoid? Select all that apply. 1. aged cheese 2. cottage cheese 3. milk 4. wine 5. salami 6. grapefruit

1,4,5

A rehabilitation nurse is caring for a young client recovering from a motor vehicle accident in which he lost both legs. The client states, "I will never be able to work again or live a normal life" Which responses by the nurse would be considered therapeutic? Select all that apply. 1. "Losing both legs is hard to accept, how are you feeling now?" 2. "With a prosthesis you will be up and walking again soon." 3. "The occupational therapist will teach the use of adaptive equipment promoting independence" 4. "You must be devastated with your loss, Have you sough legal advice?" 5. "I am here to help you. Let's devise a plan so that you are working toward your goals"

1,4,5

A client brought to the emergency department by the police is found wondering streets of town and appears to be disoriented. During initial contact by the nurse, the client begins to laugh inappropriately and states feeling dizzy. Which client behaviors suggest that the client is symptomatic for huffing aerosols? Select all that apply. 1. Unsteady gait 2. An elevated temperature 3. Multiple bruises on the skin 4. Impaired memory of where he or she had been 5. A slurred speech during conversation 6. Hallucinations of spiders crawling on the bed

1,4,5,6

A delusional client says to the nurse, "I am an alien from Mars", and insists that the nurse refer to him or her as such. The belief appears to be fixed and unchanging. Which nursing interventions would the nurse implement when working with this client? Select all that apply. 1. Consistently use the clients name in interactions. 2. Kindly, but firmly stated that aliens are in movies 3. Allow the client to believe that he or she is an alien as long as there are no safety concerns 4. Logically point out why the client could not be an alien 5. Provide as needed medication 6. Redirect the client with structured activities

1,6

The nurse is leading a group session when the nurse notices that a member of the group is tearful and shaking. Which nursing actions would be therapeutic at this time? Select all that apply. 1. Ask the client to share the emotions that the client is feeling. 2. Allow the client to remain in the group and ignore the behavior. 3. Ask the client to leave the group and rejoin once feeling better. 4. Apologize to the client and state that you did not mean to cause emotional pain. 5. Redirect the group to another topic, which may evoke a less emotional response 6. Direct a staff member to assist the client and continue with the group.

1,6

A client has been diagnosed with an adjustment disorder with mixed anxiety and depression. What are the primary nursing diagnoses the nurse would associate with this type of adjustment disorder? Select all that apply. 1. activity intolerance 2. impaired social interaction 3. risk for situational low self-esteem 4. self-neglect 5. acute confusion 6. impaired memory

2,3

The nurse is meeting a client on the mental health unit. When beginning a therapeutic relationship, which nursing actions are appropriate? Select all that apply. 1. Meet the needs and specific desires of the client. 2. Help the client explore different problem solving techniques. 3. Encourage the practice of new coping skills. 4. Provide health advice to the client. 5. Exchange social media information with the client. 6. Discuss the client's feelings with family members.

2,3

During the nurses shift in the emergency department a nurse assessed a client who is suspected of being under the influence of amphetamines. Which symptoms are indicate of amphetamine use? Select all that apply. 1. Depressed affect 2. Diaphoresis 3. Shallow respiration's 4. Hypotension 5. Tremors 6. Dilated pupils

2,3,,5,6

A client, diagnose with Alzheimer's disease, is a new resident in a long-term care facility. The client has difficulty finding his or her room and is seen wandering into the room of others. When discussing the situation at a multidisciplinary conference, which client-centered actions would the nurse suggest? 1. Provide a map of the unit as a guide with the room highlighted. 2. Ensure that the client has prescribed hearing aids and glasses on throughout the day. 3. Place a box with familiar personal items outside the client's door for visual recognition. 4. Assign the client to a room close to the nursing station for close monitoring. 5. Provide verbal cueing as to where the client's room is located. 6. Place the client with a roommate having similar cognitive deficits.

2,3,4,5

A client is being seen in the clinic after returning from military service abroad. The nurse documents restlessness at night with nightmares leaving the veteran irritable and fatigued during the day. When discussing the possibility of posttraumatic stress disorder (PTSD), which statements about PTSD are accurate? Select all that apply. 1. PTSD is a syndrome that is only associated with military personnel. 2. PTSD is characterized by nightmares and flashbacks. 3. Hypervigilance is characteristics of clients with PTSD. 4. Substance abuse is a common coping mechanism used by clients with PTSD. 5. Psychotic episodes can occur in clients with PTSD. 6. Clients with PTSD may complain of feeling empty inside.

2,3,4,5,6

A health care provider prescribed haloperidol p.o. 1 mg tid. When assessing the client for extra-pyramidal adverse effects, which nursing measures would be initiated? Select all that apply. 1. Pad side rails in case of seizure activity. 2. Closely monitor vital signs, especially temperature. 3. Observe for increased pacing and restlessness. 4. Reorient the client during delusions. 5. Provide the client with sugar free hard candy. 6. Monitor for signs and symptoms of urticaria.

2,3,5

The nurse is caring for a client with severe depression. In which conditions would the nurse anticipate the use of electroconvulsive therapy (ECT) as an option? Select all that apply. 1. The client also has a neurocognitive disorder. 2. The client cannot tolerate MAOIs. 3. The client has not responded to conventional and antidepressant medication therapy. 4. The client is undergoing a stressful life change. 5. The client is having acute suicidal thoughts.

2,3,5

A nurse is caring for a client with borderline personality disorder. Which interventions are appropriate for clients with this disorder? Select all that apply. 1. Providing anti anxiety medications 2. Providing emotional consistency 3. Exploring anger in appropriate ways 4. Identifying a reduction in suicide risk 5. Promoting gradual separation and individuation 6. Ensuring the clients safety

2,3,5,6

A nurse is monitoring a client who appears to be hallucinating. The client is gesturing at a figure on the television and appears agitated with speech containing paranoid content. Which nursing interventions are appropriate at this time? Select all that apply. 1. In a firm voice, instruct the client to stop the behavior 2: reassure the client that there is no danger 3. Acknowledge the presence of the hallucinations 4. Instruct the other team members to ignore the clients behavior 5. Delegate client assessment to a LPN 6. Give simple commands in a calm voice

2,3,6

The nurse is caring for a mental health client who exhibits passive aggressive behavior when interacting with the nursing staff. When reporting client behaviors to the next shift, which actions are consistent with this assessment? Select all that apply. 1. The client states that problems are not his or her fault. 2. The client agrees with the staff but then complains to others. 3. The client pouts when he or she does not get his or her way. 4. The client feels angry about the group session so he or she scatters papers in the lunchroom. 5. The client attacks the nurse and later cries feeling remorse.

2,4

A client with a diagnosis of schizophrenia spectrum disorder is admitted to the inpatient unit after developing water intoxication. Once the client is medically stable and no longer exhibiting the behavior of seeking water, which nursing interventions are appropriate at this time? Select all that apply. 1. Medicate the client at night. 2. Provide gum for the client. 3. Lock the units kitchen and bathroom 4. Weigh the client everyday 5. Monitor the clients intake and output 6. Maintain a structured environment

2,4,5,6

A nurse is conducting a group session for children and adolescents who have been diagnosed with depression. Which behaviors would a nurse anticipate in this group? Select all that apply. 1. delusions 2. anxiety 3. mania 4. irritability 5. somatic symptoms 6. suicidal thoughts

2,4,5,6

A nurse is caring for a client displaying extreme mood swings with suicidal tendencies. A health care provider prescribes lithium and diagnoses the client with bipolar disorder. When teaching the client, which statements, verbalized by the client, indicate a good understanding of medication management? Select all that apply. 1. "I understand that there is a potential for addiction." 2. "I need to watch for signs and symptoms of drug toxicity including blurred vision and ringing in the ears" 3. "I will adjust my medication depending upon my symptoms" 4. "I will need to be on a low-tyramine diet" 5. "I will need to consistently monitor blood levels" 6. "The therapeutic effect of the medication takes time to occur"

2,5,6