Psych EXAM 2

Which documentation indicates that the treatment plan for a patient diagnosed with acute mania has been effective? "Converses with few interruptions; clothing matches; participates in activities." "Irritable, suggestible, distractible; napped for 10 minutes in afternoon." "Attention span short; writing copious notes; intrudes in conversations." "Heavy makeup; seductive toward staff; pressured speech."

"Converses with few interruptions; clothing matches; participates in activities." The descriptors given indicate the patient is functioning at an optimal level, using appropriate behavior, and thinking without becoming overstimulated by unit activities. The incorrect options reflect manic behavior.

An adolescent acts out in disruptive ways. When this adolescent threatens to throw a heavy pool ball at another adolescent, which comment by the nurse would set appropriate limits? "Attention everyone: we are all going to the craft room." "You will be taken to seclusion if you throw that ball." "Do not throw the ball. Put it back on the pool table." "Please do not lose control of your emotions."

"Do not throw the ball. Put it back on the pool table." Setting limits uses clear, sharp statements about prohibited behavior and guidance for performing a behavior that is expected. The incorrect options represent a threat, use of restructuring (which would be inappropriate in this instance), and a direct appeal to the child's developing self-control that may be ineffective.

Select the most critical question for the nurse to ask an adolescent who has threatened to take an overdose of pills. "Why do you want to kill yourself?" "Do you have access to medications?" "Have you been taking drugs and alcohol?" "Did something happen with your parents?"

"Do you have access to medications?" (The nurse must assess the patient's access to means to carry out the plan and, if there is access, alert the parents to remove from the home and take additional actions to assure the patient's safety. The information in the other questions may be important to ask but are not the most critical.)

A nurse assesses a patient who reports a 3-week history of depression and periods of uncontrolled crying. The patient says, "My business is bankrupt, and I was served with divorce papers." Which subsequent statement by the patient alerts the nurse to a concealed suicidal message? "I wish I were dead." "Life is not worth living." "I have a plan that will fix everything." "My family will be better off without me."

"I have a plan that will fix everything." (Verbal clues to suicide may be overt or covert. The incorrect options are overt references to suicide. The correct option is more veiled. It alludes to the patient's suicide as being a way to "fix everything" but does not say it outright.)

An adolescent was recently diagnosed with Oppositional Defiant Disorder. The parents say to the nurse, "Isn't there some medication that will help with this problem?" Select the nurse's best response. "There are no medications to treat this problem. This diagnosis is behavioral in nature." "It's a common misconception that there is a medication available to treat every health problem." "Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use." "There are many medications that will help your child manage aggression and destructiveness. The health care provider will discuss them with you."

"Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use." The parents are seeking a quick solution. Medications are generally not indicated for ODD. Comorbid conditions that increase defiant symptoms, such as ADHD, should be managed with medication, but no comorbid problem is identified in the question. The nurse should give information on helpful strategies to manage the adolescent's behavior.

A patient being treated for depression has taken sertraline daily for a year. The patient calls the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having nausea, nervous feelings, and I can't sleep." The nurse will advise the patient to: "Go to the nearest emergency department immediately." "Do not to be alarmed. Take two aspirin and drink plenty of fluids." "Take a dose of your antidepressant now and come to the clinic to see the health care provider." "Resume taking your antidepressants for 2 more weeks and then discontinue them again."

"Take a dose of your antidepressant now and come to the clinic to see the health care provider." (The patient has symptoms associated with abrupt withdrawal of the antidepressant. Taking a dose of the drug will ameliorate the symptoms. Seeing the health care provider will allow the patient to discuss the advisability of going off the medication and to be given a gradual withdrawal schedule if discontinuation is the decision. This situation is not a medical emergency, although it calls for medical advice. Resuming taking the antidepressant for 2 more weeks and then discontinuing again would produce the same symptoms the patient is experiencing.)

Which child demonstrates behaviors indicative of a neurodevelopmental disorder? A 4-year-old who stuttered for 3 weeks after the birth of a sibling A 9-month-old who does not eat vegetables and likes to be rocked A 3-month-old who cries after feeding until burped and sucks a thumb A 3-year-old who is mute, passive toward adults, and twirls while walking

A 3-year-old who is mute, passive toward adults, and twirls while walking Symptoms consistent with autistic spectrum disorders (ASD) are evident in the correct answer. ASD is one type of neurodevelopmental disorder. The behaviors of the other children are within normal ranges.

Which individual in the emergency department should be considered at highest risk for completing suicide? An adolescent Asian American girl with superior athletic and academic skills who has asthma A 38-year-old single, African American female church member with fibrocystic breast disease A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate

A 79-year-old single, white male diagnosed recently with terminal cancer of the prostate (High-risk factors include being an older adult, single, male, and having a co-occurring medical illness. Cancer is one of the somatic conditions associated with increased suicide risk. Protective factors for African American women and Hispanic individuals include strong religious and family ties. Asian Americans have a suicide rate that increases with age.)

Which intervention will the nurse recommend for the distressed family and friends of someone who has committed suicide? Participating in reminiscence therapy Psychological postmortem assessment Attending a self-help group for survivors Contracting for at least two sessions of group therapy

Attending a self-help group for survivors (Survivors need outlets for their feelings about the loss and the deceased person. Self-help groups provide peer support while survivors work through feelings of loss, anger, and guilt. Psychological postmortem assessment would not provide the support necessary to work through feelings of loss associated with the suicide. Reminiscence therapy is not geared to loss resolution. Contracting for two sessions of group therapy would not provide sufficient time to work through the issues associated with a death by suicide.)

The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for communication disorder. stereotypic movement disorder. intellectual development disorder. Attention Deficit Hyperactivity Disorder.

Attention Deficit Hyperactivity Disorder. Excessive motion, distractibility, and excessive talkativeness are seen in ADHD. The behaviors presented in the scenario do not suggest intellectual development, stereotypic, or communication disorder.

A 12-year-old has engaged in bullying for several years. The parents say, "We can't believe anything our child says." Recently this child shot a dog with a pellet gun and set fire to a neighbor's trash bin. The child's behaviors support the diagnosis of ADHD. intermittent explosive disorder. oppositional defiant disorder (ODD). Conduct Disorder

Conduct Disorder The behaviors mentioned are most consistent with criteria for CD, including aggression against people and animals; destruction of property; deceitfulness; rule violations; and impairment in social, academic, or occupational functioning. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. The behaviors are not consistent with attention deficit or oppositional defiant disorder (ODD).

A 15-year-old ran away from home six times and was arrested for shoplifting. The parents told the Court, "We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the father. Which diagnosis is supported by this adolescent's behavior? Attention deficit hyperactivity disorder (ADHD) Post-traumatic stress disorder (PTSD) Intermittent explosive disorder Conduct disorder

Conduct disorder CDs are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. Criteria for ADHD and PTSD are not met in the scenario.

The family of a child diagnosed with an impulse control disorder needs help to function more adaptively. Which aspect of the child's plan of care will be provided by an advanced practice nurse rather than a staff nurse? Leading an activity group Providing positive feedback Formulating nursing diagnoses Dialectical behavioral therapy (DBT)

Dialectical behavioral therapy (DBT) The advanced practice nurse role includes individual, group, and family psychotherapist; educator of nurses, other professions, and the community; clinical supervisor; consultant to professional and nonprofessional groups; and researcher. DBT is an aspect of psychotherapy. The distracters describe actions of a nurse generalist.

A nurse assesses a patient who takes lithium. Which findings demonstrate evidence of complications? Pharyngitis, mydriasis, and dystonia Alopecia, purpura, and drowsiness Diaphoresis, weakness, and nausea Ascites, dyspnea, and edem

Diaphoresis, weakness, and nausea Diaphoresis, weakness, and nausea are early signs of lithium toxicity. Problems mentioned in the incorrect options are unrelated to lithium therapy.

A nurse on an adolescent psychiatric unit assesses a newly admitted 14-year-old. An impulse control disorder is suspected. Which aspects of the patient's history support the suspected diagnosis? (Select all that apply.) Family history of mental illness Allergies to multiple antibiotics Long history of severe facial acne Father with history of alcohol abuse History of an abusive relationship with one parent

Family history of mental illness Father with history of alcohol abuse History of an abusive relationship with one parent (Parents who are abusive, rejecting, or overly controlling cause a child to suffer detrimental effects. Other stressors associated with impulse control disorders can include major disruptions such as placement in foster care, severe marital discord, or a separation of parents. Substance abuse by a parent is common. Acne and allergies are not aspects of the history that relate to the behavior.)

An adult outpatient diagnosed with major depressive disorder has a history of several suicide attempts by overdose. Given this patient's history and diagnosis, which antidepressant medication would the nurse expect to be prescribed? Amitriptyline Fluoxetine Desipramine Tranylcypromine sulfate

Fluoxetine Selective serotonin reuptake inhibitor antidepressants are very safe in overdosage situations, which is not true of the other medications listed. Given this patient's history of overdosing, it is important that the medication be as safe as possible in the event of another overdose of prescribed medication.

Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies? Encourage the child to observe others talking. Include the child in small group activities. Give the child a small treat for speaking. Teach the child relaxation techniques.

Give the child a small treat for speaking. Operant conditioning involves giving positive reinforcement for a desired behavior. Treats are rewards and reinforce speech through positive reinforcement.

A college student who failed two tests cried for hours and then tried to telephone a parent but got no answer. The student then gave several expensive sweaters to a roommate and asked to be left alone for a few hours. Which behavior provides the strongest clue of an impending suicide attempt? Calling parents Excessive crying Giving away sweaters Staying alone in dorm room

Giving away sweaters (Giving away prized possessions may signal that the individual thinks he or she will have no further need for the item, such as when a suicide plan has been formulated. Calling parents, remaining in a dorm, and crying do not provide direct clues to suicide.)

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? Impaired social interaction related to difficulty maintaining relationships Chronic low self-esteem related to excessive negative feedback Deficient fluid volume related to abnormal eating habits Anxiety related to nightmares and repetitive activities

Impaired social interaction related to difficulty maintaining relationships Children diagnosed with autism spectrum disorders display profoundly disturbed social relatedness. They seem aloof and indifferent to others, often preferring inanimate objects to human interaction. Language is often delayed and deviant, further complicating relationship issues. The other nursing diagnoses might not be appropriate in all cases.

A patient diagnosed with bipolar disorder displays aggressiveness, agitation, talkativeness, and irritability. The nurse expects the health care provider to prescribe a medication from which group? Psychostimulants Mood stabilizers Anticholinergics Antidepressants

Mood stabilizers The symptoms describe mania, which is effectively treated by mood stabilizers, such as lithium, and selected anticonvulsants (carbamazepine, valproic acid, and lamotrigine). Drugs from the other classifications listed are not effective in the treatment of mania.

Which assessment findings support a diagnosis of Oppositional Defiant Disorder? Negative, hostile, and spiteful toward parents. Blames others for misbehavior. Exhibits involuntary facial twitching and blinking; makes barking sounds. Violates others' rights; cruelty toward people or animals; steals; truancy. Displays poor academic performance and reports frequent nightmares.

Negative, hostile, and spiteful toward parents. Blames others for misbehavior. ODD is a repeated and persistent pattern of having an angry and irritable mood in conjunction with demonstrating defiant and vindictive behavior. The distracters identify findings associated with CD, anxiety disorder, and Tourette's syndrome.

At a unit meeting, the staff discusses decor for a special room for patients with acute mania. Which suggestion is appropriate? An extra-large window with a view of the street Neutral walls with pale, simple accessories Brightly colored walls and print drapes Deep colors for walls and upholstery

Neutral walls with pale, simple accessories The environment for a manic patient should be as simple and nonstimulating as possible. Manic patients are highly sensitive to environmental distractions and stimulation.

A child known as the neighborhood bully says, "Nobody can tell me what to do." After receiving a poor grade on a science project, this child secretly loaded a virus on the teacher's computer. These behaviors support a diagnosis of Conduct Disorder Oppositional Defiant Disorder intermittent explosive disorder. Attention Deficit Hyperactivity Disorder

Oppositional Defiant Disorder ODD is a repeated and persistent pattern of having an angry and irritable mood in conjunction with demonstrating defiant and vindictive behavior. Loading a virus is a vindictive behavior in retribution for a poor grade. Persons with CD are aggressive against people and animals; destroy property; are deceitful; violate rules; and have impaired social, academic, or occupational functioning. There is no evidence of explosiveness or distractibility.

Parents of an adolescent diagnosed with a Conduct Disorder say, "We don't know how to respond when our child breaks the rules in our house. Is there any treatment that might help us?" Which therapy is likely to be helpful for these parents? Parent-child interaction therapy (PCIT) Behavior modification therapy Multi-systemic therapy (MST) Pharmacotherapy

Parent-child interaction therapy (PCIT) In PCIT, the therapist sits behind one-way mirrors and coaches parents through an ear audio device while they interact with their children. The therapist can suggest strategies that reinforce positive behavior in the adolescent. The goal is to improve parenting strategies and thereby reduce problematic behavior. Behavior modification therapy may help the adolescent, but the parents are seeking help for themselves. MST is much broader and does not target the parents' need.

A person was online continuously for over 24 hours, posting rhymes on official government websites and inviting politicians to join social networks. The person has not slept or eaten for 3 days. What features of mania are evident? Increased muscle tension and anxiety Vegetative signs and poor grooming Poor judgment and hyperactivity Cognitive deficits and paranoia

Poor judgment and hyperactivity Hyperactivity (activity without sleep) and poor judgment (posting rhymes on government websites) are characteristic of manic episodes. The distracters do not specifically apply to mania.

A patient tells the nurse, "My doctor prescribed paroxetine for my depression. I assume I'll have side effects like I had when I was taking imipramine." The nurse's reply should be based on the knowledge that paroxetine is a(n) selective norepinephrine reuptake inhibitor. tricyclic antidepressant. monoamine oxidase (MAO) inhibitor. SSRI.

SSRI Paroxetine is an SSRI and will not produce the same side effects as imipramine, a tricyclic antidepressant. The patient will probably not experience dry mouth, constipation, or orthostatic hypotension.

An adolescent diagnosed with Conduct Disorder has aggression, impulsivity, hyperactivity, and mood symptoms. The treatment team believes this adolescent may benefit from medication. The nurse anticipates the health care provider will prescribe which type of medication? Second-generation antipsychotic Antianxiety medication Calcium channel blocker β-blocker

Second-generation antipsychotic Medications for CD are directed at problematic behaviors such as aggression, impulsivity, hyperactivity, and mood symptoms. Second-generation antipsychotics are likely to be prescribed. β-blocking medications may help to calm individuals with intermittent explosive disorder by slowing the heart rate and reducing blood pressure. Calcium channel blockers reduce blood pressure but are not used for persons with impulse control problems. An antianxiety medication will not assist with impulse control.

What is the nurse's priority focused assessment for side effects in a child taking methylphenidate for Attention Deficit Hyperactivity Disorder? Dystonia, akinesia, and extrapyramidal symptoms Bradycardia and hypotensive episodes Sleep disturbances and weight loss Neuroleptic malignant syndrome

Sleep disturbances and weight loss The most common side effects are gastrointestinal disturbances, reduced appetite, weight loss, urinary retention, dizziness, fatigue, and insomnia. Weight loss has the potential to interfere with the child's growth and development. The distracters relate to side effects of conventional antipsychotic medications.

Which documentation for a patient diagnosed with major depressive disorder indicates the treatment plan was effective? Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild. Slept 10 hours uninterrupted. Attended craft group; stated "project was a failure, just like me." Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound. Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, "I feel tired all the time."

Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.

When a 5-year-old diagnosed with Attention Deficet Hyperactivity Disorder bounces out of a chair and runs over and slaps another child, what is the nurse's best action? Instruct the parents to take the aggressive child home. Direct the aggressive child to stop immediately. Call for emergency assistance from other staff. Take the aggressive child to another room.

Take the aggressive child to another room. The nurse should manage the milieu with structure and limit setting. Removing the aggressive child to another room is an appropriate consequence for the aggressiveness. Directing the child to stop will not be effective. This is not an emergency. Intervention is needed rather than sending the child home.

An 11-year-old diagnosed with Oppositional Defiant Disorder becomes angry over the rules at a residential treatment program and begins cursing at the nurse. Select the best method for the nurse to defuse the situation. Ignore the child's behavior. Send the child to time-out for 2 hours. Take the child to the gym and engage in an activity. Role-play a more appropriate behavior with the child.

Take the child to the gym and engage in an activity. The child's behavior warrants an active response. Redirecting the expression of feelings into nondestructive age-appropriate behaviors, such as a physical activity, helps defuse the situation here and now. This response helps the child learn how to modulate the expression of feelings and exert self-control. This is the least restrictive alternative and should be tried before resorting to a more restrictive measure. Role playing is appropriate after the child's anger is defused.

A 16-year-old diagnosed with a conduct disorder (CD) has been in a residential program for 3 months. Which outcome should occur before discharge? The adolescent and parents create and agree to a behavioral contract with rules, rewards, and consequences. The adolescent identifies friends in the home community who are a positive influence. Temporary placement is arranged with a foster family until the parents complete a parenting skills class. The adolescent experiences no anger and frustration for 1 week.

The adolescent and parents create and agree to a behavioral contract with rules, rewards, and consequences. (The adolescent and the parents must agree on a behavioral contract that clearly outlines rules, expected behaviors, and consequences for misbehavior. It must also include rewards for following the rules. The adolescent will continue to experience anger and frustration. The adolescent and parents must continue with family therapy to work on boundary and communication issues. It is not necessary to separate the adolescent from the family to work on these issues. Separation is detrimental to the healing process. While it is helpful for the adolescent to identify peers who are a positive influence, it is more important for behavior to be managed for an adolescent diagnosed with a CD.)

A patient says to the nurse, "My life doesn't have any happiness in it anymore. I once enjoyed holidays, but now they're just another day." The nurse documents this report as an example of dysthymia. anhedonia. euphoria. anergia.

anhedonia. Anhedonia is a common finding in many types of depression. It refers to feelings of a loss of pleasure in formerly pleasurable activities. Dysthymia is a diagnosis. Euphoria refers to an elated mood. Anergia means "without energy."

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed? phenytoin clonidine risperidone carbamazepine

carbamazepine Some patients diagnosed with bipolar disorder, especially those who have only short periods between episodes, have a favorable response to the anticonvulsants carbamazepine and valproate. Carbamazepine seems to work better in patients with rapid cycling and in severely paranoid, angry manic patients. Phenytoin is also an anticonvulsant but not used for mood stabilization. Risperidone is not an anticonvulsant.

Priority interventions for a patient diagnosed with major depressive disorder and feelings of worthlessness should include distracting the patient from self-absorption. careful unobtrusive observation around the clock. allowing the patient to spend long periods alone in meditation. opportunities to assume a leadership role in the therapeutic milieu.

careful unobtrusive observation around the clock. Approximately two-thirds of people with depression contemplate suicide. Patients with depressive disorder who exhibit feelings of worthlessness are at higher risk. Regular planned observations of the patient diagnosed with depression may prevent a suicide attempt on the unit.

A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child displays resiliency. has a passive temperament. is at risk for Post Traumatic Stress Disorder. uses intellectualization to deal with problems.

displays resiliency. Resiliency enables a child to handle the stresses of a difficult childhood. Resilient children can adapt to changes in the environment, take advantage of nurturing relationships with adults other than parents, distance themselves from emotional chaos occurring within the family, learn, and use problem-solving skills.

This nursing diagnosis applies to a patient experiencing acute mania: Imbalanced nutrition: less than body requirements related to insufficient caloric intake and hyperactivity as evidenced by 5-pound weight loss in 4 days. Select an appropriate outcome. The patient will ask staff for assistance with feeding within 4 days. drink six servings of a high-calorie, high-protein drink each day. consistently sit with others for at least 30 minutes at meal time within 1 week. consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit.

drink six servings of a high-calorie, high-protein drink each day. High-calorie, high-protein food supplements will provide the additional calories needed to offset the patient's extreme hyperactivity. Sitting with others or asking for assistance does not mean the patient ate or drank. The other indicator is unrelated to the nursing diagnosis.

A child diagnosed with Attention Deficit Hyperactivity Disorder had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child has an improved ability to identify anxiety and use self-control strategies. has increased expressiveness in communication with others. shows increased responsiveness to authority figures. engages in cooperative play with other children.

engages in cooperative play with other children. The goal should be directly related to the defining characteristics of the nursing diagnosis, in this case, improvement in the child's aggressiveness and play. The distracters are more relevant for a child with autism spectrum or anxiety disorder.

A patient diagnosed with major depressive disorder began taking escitalopram 5 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to discuss with the health care provider the need to increase the dose. reassure the patient that the medication will be effective soon. explain the time lag before antidepressants relieve symptoms. critically assess the patient for symptoms of improvement.

explain the time lag before antidepressants relieve symptoms. (Escitalopram is an SSRI antidepressant. One to three weeks of treatment is usually necessary before symptom relief occurs. This information is important to share with patients.)

An adolescent was arrested for prostitution and assault on a parent. The adolescent says, "I hate my parents. They focus all attention on my brother, who's perfect in their eyes." Which type of therapy might promote the greatest change in the adolescent's behavior? Family therapy Bibliotherapy Play therapy Art therapy

family therapy (Family therapy focuses on problematic family relationships and interactions. The patient has identified problems within the family. Play therapy is more appropriate for younger patients. Art therapy and bibliotherapy would not focus specifically on the identified problem.)

An adolescent diagnosed with an impulse control disorder says, "I want to die. I spend my time getting even with people who hurt me." When asked about a suicide plan, the adolescent replies, "I'll jump from a bridge near my home. My father threw kittens off that bridge and they died." Rate the suicide risk. Absent Low Moderate High

high The suicide risk is high. The child is experiencing feelings of hopelessness and helplessness. The method described is lethal, and the means to carry out the plan are available.

The feeling experienced by a patient that should be assessed by the nurse as most predictive of elevated suicide risk is hopelessness. sadness. elation. anger.

hopelessness (Of the feelings listed, hopelessness is most closely associated with increased suicide risk. Depression, aggression, impulsivity, and shame are other feelings noted as risk factors for suicide.)

A nurse instructs a patient taking a drug that inhibits MAO to avoid certain foods and drugs because of the risk of cardiac dysrhythmia. hypotensive shock. hypertensive crisis. hypoglycemia.

hypertensive crisis. Patients taking MAO-inhibiting drugs must be on a low tyramine diet to prevent hypertensive crisis. In the presence of MAO inhibitors, tyramine is not destroyed by the liver and in high levels produces intense vasoconstriction, resulting in elevated blood pressure.

A patient waves a newspaper and says, "I must have my credit card and use the computer right now. A store is having a big sale, and I need to order 10 dresses and four pairs of shoes." Select the nurse's appropriate intervention. The nurse suggests the patient have a friend do the shopping and bring purchases to the unit. invites the patient to sit together and look at new fashion magazines. tells the patient computer use is not allowed until self-control improves. asks whether the patient has enough money to pay for the purchases.

invites the patient to sit together and look at new fashion magazines. Situations such as this offer an opportunity to use the patient's distractibility to staff's advantage. Patients become frustrated when staff deny requests that the patient sees as entirely reasonable. Distracting the patient can avoid power struggles. Suggesting that a friend do the shopping would not satisfy the patient's need for immediacy and would ultimately result in the extravagant expenditure. Asking whether the patient has enough money would likely precipitate an angry response.

Consider these three anticonvulsant medications: divalproex, carbamazepine, and gabapentin. Which medication also belongs to this classification? clonazepam risperidone lamotrigine aripiprazole

lamotrigine The three drugs in the stem of the question are all anticonvulsants. Lamotrigine is also an anticonvulsant. Clonazepam is an anxiolytic; aripiprazole and risperidone are antipsychotic drugs.

An outpatient diagnosed with bipolar disorder takes lithium carbonate 300 mg three times daily. The patient reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with meals. an antacid. an antiemetic. a large glass of juice.

meals Some patients find that taking lithium with meals diminishes nausea. The incorrect options are less helpful.

When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses guided imagery. talk focused on a specific issue. play and talk about a play activity. group discussion about selected topics.

play and talk about a play activity. Group therapy for young children takes the form of play. For elementary school children, therapy combines play and talk about the activity. For adolescents, group therapy involves more talking.

A patient is hospitalized for severe major depressive disorder. Of the medications listed below, the nurse can expect to provide the patient with teaching about chlordiazepoxide. clozapine. sertraline. tacrine.

sertraline. Sertraline (Zoloft) is an selective serotonin reuptake inhibitor (SSRI). This antidepressant blocks the reuptake of serotonin, with few anticholinergic and sedating side effects. Clozapine is an antipsychotic. Chlordiazepoxide is an anxiolytic. Tacrine treats Alzheimer's disease.

When a 5-year-old is disruptive, the nurse says, "You must take a time-out." The expectation is that the child will go to a quiet room until called for the next activity. slowly count to 20 before returning to the group activity. sit on the edge of the activity until able to regain self-control. sit quietly on the lap of a staff member until able to apologize for the behavior.

sit on the edge of the activity until able to regain self-control Time-out is designed so that staff can be consistent in their interventions. Time-out may require going to a designated room or sitting on the periphery of an activity until the child gains self-control and reviews the episode with a staff member. Time-out may not require going to a designated room and does not involve special attention such as holding. Counting to 10 or 20 is not sufficient.

The nurse receives a laboratory report indicating a patient's serum level is 1 mEq/L. The patient's last dose of lithium was 8 hours ago. This result is within therapeutic limits. below therapeutic limits. above therapeutic limits. invalid because of the time lapse since the last dose.

within therapeutic limits. Normal range for a blood sample taken 8 to 12 hours after the last dose of lithium is 0.6 to 1.2 mEq/L.