Psych exam 2 part 1

A client diagnosed with schizophrenia begins to talks about "macnabs" hiding in the warehouse at work. The client's use of "macnabs" should be documented using what term? a. a neologism. b. concrete thinking. c. thought insertion. d. an idea of reference.

a. a neologism.

Four new clients were admitted to the behavioral health unit in the past 12 hours. The nurse directs a psychiatric technician to monitor these clients for safety. Which client diagnosis will need the most watchful supervision? a. bipolar I disorder. b. bipolar II disorder. c. dysthymic disorder. d. cyclothymic disorder.

a. bipolar I disorder.

The nurse assesses a client diagnosed with schizophrenia. Which assessment finding would the nurse regard as a negative symptom of schizophrenia? a. Auditory hallucinations b. Delusions of grandeur c. Poor personal hygiene d. Psychomotor agitation

c. Poor personal hygiene

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

a. "Converses with few interruptions; clothing matches; participates in activities."

A nurse at the mental health clinic plans a series of psychoeducational groups for persons newly diagnosed with schizophrenia. Which two topics take priority? (Select all that apply.) a. "The importance of taking your medication correctly" b. "How to complete an application for employment" c. "How to dress when attending community events" d. "How to give and receive compliments" e. "Ways to quit smoking"

a. "The importance of taking your medication correctly" e. "Ways to quit smoking"

A nurse asks a client diagnosed with schizophrenia, "What is meant by the old saying 'You can't judge a book by looking at the cover.'?" Which response by the client indicates concrete thinking? a. "The table of contents tells what a book is about." b. "You can't judge a book by looking at the cover." c. "Things are not always as they first appear." d. "Why are you asking me about books?"

a. "The table of contents tells what a book is about."

An acutely violent client diagnosed with schizophrenia received several doses of haloperidol. Two hours later the nurse notices the client's head rotated to one side in a stiffly fixed position, the lower jaw thrust forward, and drooling. Which intervention by the nurse is indicated? a. Administer diphenhydramine 50 mg IM from the prn medication administration record. b. Reassure the client that the symptoms will subside. Practice relaxation exercises with the client. c. Give trihexyphenidyl 5 mg orally at the next regularly scheduled medicationadministration time. d. Administer atropine sulfate 2 mg subcut from the prn medication administration record.

a. Administer diphenhydramine 50 mg IM from the prn medication administration record.

A client diagnosed with schizophrenia is very disturbed and violent. After several doses of haloperidol, the client is calm. Two hours later the nurse sees the client's head rotated to one side in a stiff position, the lower jaw thrust forward, and drooling. Which problem is most likely? a. An acute dystonic reaction b. Tardive dyskinesia c. Waxy flexibility d. Akathisia

a. An acute dystonic reaction

A client diagnosed with bipolar disorder will be discharged tomorrow. The client is taking a mood stabilizing medication. What is the priority nursing intervention for the client as well as the client's family during this phase of treatment? a. Attending psychoeducation sessions b. Decreasing physical activity c. Increasing food and fluids d. Meeting self-care needs

a. Attending psychoeducation sessions

A client diagnosed with bipolar disorder commands other clients, "Get me a book. Take this stuff out of here," and other similar demands. The nurse wants to interrupt this behavior without entering into a power struggle. Which initial approach should the nurse select? a. Distraction: "Let's go to the dining room for a snack." b. Humor: "How much are you paying servants these days?" c. Limit setting: "You must stop ordering other clients around." d. Honest feedback: "Your controlling behavior is annoying others."

a. Distraction: "Let's go to the dining room for a snack."

A client diagnosed with bipolar disorder is dressed in a red leotard and bright scarves. The client twirls and shadow boxes. The client says gaily, "Do you like my scarves? Here they are my gift to you." How should the nurse document the client's mood? a. Euphoric b. Irritable c. Suspicious d. Confident

a. Euphoric

A client was diagnosed with seasonal affective disorder (SAD). During which month would this client's symptoms be most acute? a. January b. April c. June d. September

a. January

Which suggestions are appropriate for the family of a client diagnosed with bipolar disorder who is being treated as an outpatient during a hypomanic episode? (Select all that apply.) a. Limit credit card access. b. Provide a structured environment. c. Encourage group social interaction. d. Supervise medication administration. e. Monitor the client's sleep patterns.

a. Limit credit card access. b. Provide a structured environment. d. Supervise medication administration. e. Monitor the client's sleep patterns.

A client tells the nurse, "I'm ashamed of being bipolar. When I'm manic, my behavior embarrasses everyone. Even if I take my medication, there are no guarantees. I'm a burden to my family." These statements support which nursing diagnoses? (Select all that apply.) a. Powerlessness b. Defensive coping c. Chronic low self-esteem d. Impaired social interaction e. Risk-prone health behavior

a. Powerlessness c. Chronic low self-esteem

The family of a client diagnosed with schizophrenia is unfamiliar with the illness and family's role in recovery. Which type of therapy should the nurse recommend? a. Psychoeducational b. Psychoanalytic c. Transactional d. Family

a. Psychoeducational

A client diagnosed with acute mania has distributed pamphlets about a new business venture on a street corner for 2 days. Which nursing diagnosis has priority? a. Risk for injury b. Ineffective coping c. Impaired social interaction d. Ineffective therapeutic regimen management

a. Risk for injury

What assessment findings mark the prodromal stage of schizophrenia? a. Withdrawal, misinterpreting, poor concentration, and preoccupation with religion b. Auditory hallucinations, ideas of reference, thought insertion, and broadcasting c. Stereotyped behavior, echopraxia, echolalia, and waxy flexibility d. Loose associations, concrete thinking, and echolalia neologisms

a. Withdrawal, misinterpreting, poor concentration, and preoccupation with religion

A newly hospitalized client experiencing psychosis says, "Red chair out town board." Which term should the nurse use to document this finding? a. Word salad b. Neologism c. Anhedonia d. Echolalia

a. Word salad

While the exact cause of bipolar disorder has not been determined; however, what is consistent for most clients? a. several factors, including genetics, are implicated. b. brain structures were altered by stress early in life. c. excess sensitivity in dopamine receptors may trigger episodes. d. inadequate norepinephrine reuptake disturbs circadian rhythms.

a. several factors, including genetics, are implicated.

The nurse receives a laboratory report indicating a client's serum level is 1 mEq/L. The client's last dose of lithium was 8 hours ago. What does this result indicate? a. within therapeutic limits. b. below therapeutic limits. c. above therapeutic limits. d. invalid because of the time lapse since the last dose.

a. within therapeutic limits.

The spouse of a client diagnosed with bipolar disorder asks what evidence supports the possibility of genetic transmission of bipolar disorders. Which response should the nurse provide? a. "A high proportion of clients with bipolar disorders are found among creative writers." b. "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder." c. "Clients with bipolar disorder have higher rates of relatives who respond in an exaggerated way to daily stress." d. "More individuals with bipolar disorder come from high socioeconomic and educational backgrounds."

b. "A higher rate of relatives with bipolar disorder is found among clients with bipolar disorder."

A client has had difficulty keeping a job because of arguing with co-workers and accusing them of conspiracy. Today this client shouts, "They're all plotting to destroy me. Isn't that true?" what is the nurse's most therapeutic response? a. "Everyone here is trying to help you. No one wants to harm you." b. "Feeling that people want to destroy you must be very frightening." c. "That is not true. People here are trying to help you if you will let them." d. "Staff members are health care professionals who are qualified to help you."

b. "Feeling that people want to destroy you must be very frightening."

A client diagnosed with major depressive disorder says, "No one cares about me anymore. I'm not worth anything." Today the client is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this client? a. "You look nice this morning." b. "You're wearing a new shirt." c. "I like the shirt you are wearing." d. "You must be feeling better today."

b. "You're wearing a new shirt."

A nurse observes a catatonic client standing immobile, facing the wall with one arm extended in a salute. The client remains immobile in this position for 15 minutes, moving only when the nurse gently lowers the arm. What is the name of this phenomenon? a. Echolalia b. Catatonia c. Depersonalization d. Thought withdrawal

b. Catatonia

A client diagnosed with schizophrenia says, "My co-workers are out to get me. I also saw two doctors plotting to kill me." How does this client perceive the environment? a. Disorganized b. Dangerous c. Supportive d. Bizarre

b. Dangerous

A client's care plan includes monitoring for auditory hallucinations. Which assessment findings suggest the client may be hallucinating? a. Detachment and overconfidence b. Darting eyes, tilted head, mumbling to self c. Euphoric mood, hyperactivity, distractibility d. Foot tapping and repeatedly writing the same phrase

b. Darting eyes, tilted head, mumbling to self

Which nursing diagnosis would most likely apply to a client diagnosed with major depressive disorder as well as one experiencing acute mania? a. Deficient diversional activity b. Disturbed sleep pattern c. Fluid volume excess d. Defensive coping

b. Disturbed sleep pattern

A nurse leads a psychoeducational group about first-generation antipsychotic medications with six adult men diagnosed with schizophrenia. The nurse will monitor for concerns regarding body image with respect to which potential side effect of these medications? a. Constipation b. Gynecomastia c. Visual changes d. Photosensitivity

b. Gynecomastia

A client demonstrating behaviors associated with acute mania has exhausted the staff by noon. Staff members are feeling defensive and fatigued. Which action will the staff take initially? a. Confer with the health care provider to consider use of seclusion for this client. b. Hold a staff meeting to discuss consistency and limit-setting approaches. c. Conduct a meeting with all staff and clients to discuss the behavior. d. Explain to the client that the behavior is unacceptable.

b. Hold a staff meeting to discuss consistency and limit-setting approaches.

A client insistently states, "I can decipher codes of DNA just by looking at someone." Which problem is evident? a. Visual hallucinations b. Magical thinking c. Idea of reference d. Thought insertion

b. Magical thinking

A nurse taught a client about a tyramine-restricted diet. Which menu selection would the indicate the client understood the information? a. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee b. Mashed potatoes, ground beef patty, corn, green beans, apple pie c. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls

b. Mashed potatoes, ground beef patty, corn, green beans, apple pie

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

b. Neutral walls with pale, simple accessories

A client says, "Facebook has a new tracking capacity. If I use the Internet, Homeland Securitywill detain me as a terrorist." What is the nurse's best initial action? a. Tell the client, "Facebook is a safe website. You don't need to worry about Homeland Security." b. Tell the client, "You are in a safe place where you will be helped." c. Administer a prn dose of an antipsychotic medication. d. Tell the client, "You don't need to worry about that."

b. Tell the client, "You are in a safe place where you will be helped."

A client demonstrating characteristics of acute mania relapsed after discontinuing lithium. New orders are written to resume lithium twice daily and begin olanzapine. What is the rationale for the addition of olanzapine to the medication regimen? a. To minimize the side effects of lithium. b. To bring hyperactivity under rapid control. c. To enhance the antimanic actions of lithium. d. To be used for long-term control of hyperactivity.

b. To bring hyperactivity under rapid control.

A client diagnosed with bipolar disorder is prescribed lithium. The client telephones the nurse to say, "I've had severe diarrhea for 4 days. I feel very weak and unsteady when I walk. My usual hand tremor has gotten worse. What should I do?" What advise will they give to the client? a. restrict food and fluids for 24 hours and stay in bed. b. have someone bring the client to the clinic immediately. c. drink a large glass of water with 1 teaspoon of salt added. d. take one dose of an over-the-counter antidiarrheal medication now.

b. have someone bring the client to the clinic immediately.

A client 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." What is the nurse's appropriate intervention? a. suggesting the client have a friend do the shopping and bring purchases to the unit. b. inviting the client to sit together and look at new fashion magazines. c. telling the client computer use is not allowed until self-control improves. d. asking whether the client has enough money to pay for the purchases.

b. inviting the client to sit together and look at new fashion magazines.

A newly admitted client diagnosed with schizophrenia is hypervigilant and constantly scans the environment. The client states, "I saw two doctors talking in the hall. They were plotting to kill me." The nurse may correctly assess this behavior using which term? a. echolalia. b. paranoia c. a delusion of infidelity. d. an auditory hallucination.

b. paranoia

A newly admitted client diagnosed with schizophrenia says, "The voices are bothering me. They yell and tell me I am bad. I have got to get away from them." Select the nurse's most helpful reply. a. "Do you hear the voices often?" b. "Do you have a plan for getting away from the voices?" c. "I'll stay with you. Focus on what we are talking about, not the voices. " d. "Forget the voices and ask some other clients to play cards with you."

c. "I'll stay with you. Focus on what we are talking about, not the voices. "

A client being treated for depression has taken sertraline daily for a year. The client 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 client to: a. "Go to the nearest emergency department immediately." b. "Do not to be alarmed. Take two aspirin and drink plenty of fluids." c. "Take a dose of your antidepressant now and come to the clinic to see the health care provider." d. "Resume taking your antidepressants for 2 more weeks and then discontinue them again."

c. "Take a dose of your antidepressant now and come to the clinic to see the health care provider."

A nurse educates a client about the antipsychotic medication regime. Afterward, which comment by the client indicates the teaching was effective? a. "I will need higher and higher doses of my medication as time goes on." b. "I need to store my medication in a cool dark place, such as the refrigerator." c. "Taking this medication regularly will reduce the severity of my symptoms." d. "If I run out or stop taking my medication, I will experience withdrawal symptoms."

c. "Taking this medication regularly will reduce the severity of my symptoms."

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

c. Diaphoresis, weakness, and nausea

Which finding constitutes a negative symptom associated with schizophrenia? a. Hostility b. Bizarre behavior c. Poverty of thought d. Auditory hallucinations

c. Poverty of thought

The plan of care for a client in the manic state of bipolar disorder should include which interventions? (Select all that apply.) a. Touch the client to provide reassurance. b. Invite the client to lead a community meeting. c. Provide a structured environment for the client. d. Ensure that the client's nutritional needs are met. e. Design activities that require the client's concentration.

c. Provide a structured environment for the client. d. Ensure that the client's nutritional needs are met.

A client diagnosed with schizophrenia has taken fluphenazine 5 mg po bid for 3 weeks. The nurse now observes a shuffling propulsive gait, a mask-like face, and drooling. Which term applies to these symptoms? a. Neuroleptic malignant syndrome b. Hepatocellular effects c. Pseudoparkinsonism d. Akathisia

c. Pseudoparkinsonism

Major depressive disorder resulted after a client's employment was terminated. The client now says to the nurse, "I'm not worth the time you spend with me. I am the most useless person in the world." Which nursing diagnosis applies? a. Powerlessness b. Defensive coping c. Situational low self-esteem d. Disturbed personal identity

c. Situational low self-esteem

A client diagnosed with schizophrenia begins a new prescription for ziprasidone. The client is 5'6'' and currently weighs 204 lbs. The client has dry flaky skin, headaches about twice a month, and a family history of colon cancer. Which intervention has the highest priority for the nurse to include in the client's plan of care? a. Skin care techniques b. Scheduling a colonoscopy c. Weight management strategies d. Teaching to limit caffeine intake

c. Weight management strategies

A client diagnosed with schizophrenia tells the nurse, "I eat skiller. Tend to end. Easter. It blows away. Get it?" What is the nurse's most therapeutic response? a. "Nothing you are saying is clear." b. "Your thoughts are very disconnected." c. "Try to organize your thoughts and then tell me again." d. "I am having difficulty understanding what you are saying."

d. "I am having difficulty understanding what you are saying."

A client with diagnosed bipolar disorder was hospitalized 7 days ago and has been taking lithium 600 mg tid. Staff observes increased agitation, pressured speech, poor personal hygiene, and hyperactivity. Which action demonstrates that the nurse understands the most likely cause of the client's behavior? a. Educate the client about the proper ways to perform personal hygiene and coordinate clothing. b. Continue to monitor and document the client's speech patterns and motor activity. c. Ask the health care provider to prescribe an increased dose and frequency of lithium. d. Consider the need to check the lithium level. The client may not be swallowing medications.

d. Consider the need to check the lithium level. The client may not be swallowing medications.

A client newly diagnosed with bipolar disorder is prescribed lithium. Which information from the client's medical history indicates that monitoring of serum concentrations of the drug will be challenging and critical? a. Arthritis b. Epilepsy c. Psoriasis d. Heart failure

d. Heart failure

A nurse leads a psychoeducational group about problem solving with six adults diagnosed with schizophrenia. Which teaching strategy is likely to be most effective? a. Suggest analogies that might apply to a common daily problem. b. Assign each participant a problem to solve independently and present to the group. c. Ask each client to read aloud a short segment from a book about problem solving. d. Invite participants to come up with solution to getting incorrect change for a purchase.

d. Invite participants to come up with solution to getting incorrect change for a purchase.

A client diagnosed with major depressive disorder refuses solid foods. In order to meet nutritional needs, which beverage will the nurse offer to this client? a. Tomato juice b. Orange juice c. Hot tea d. Milk

d. Milk

A client diagnosed with schizophrenia says, "Contagious bacteria are everywhere. When they get in your body, you will be locked up with other infected people." Which problem is evident? a. Poverty of content b. Concrete thinking c. Neologisms d. Paranoia

d. Paranoia

A client diagnosed with acute mania has disrobed in the hall three times in 2 hours. What intervention should the nurse implement? a. direct the client to wear clothes at all times. b. ask if the client finds clothes bothersome. c. tell the client that others feel embarrassed. d. arrange for one-on-one supervision.

d. arrange for one-on-one supervision.

A client 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? a. phenytoin b. clonidine c. risperidone d. carbamazepine

d. carbamazepine

A client diagnosed with schizophrenia has been stable for a year; however, the family now reports the client is tense, sleeps 3 to 4 hours per night, and has difficulty concentrating. The client says, "My computer is sending out infected radiation beams." The nurse can correctly assess this information as an indication of what? a. the need for psychoeducation. b. medication nonadherence. c. chronic deterioration. d. relapse.

d. relapse.

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

c. lamotrigine

A client diagnosed with major depressive disorder does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgmental acceptance and support for the client. Which communication technique will be effective? a. Make observations. b. Ask the client direct questions. c. Phrase questions to require yes or no answers. d. Frequently reassure the client to reduce guilt feelings.

a. Make observations.

A client diagnosed with schizophrenia was hospitalized after arguing with co-workers and threatening to harm them. The client is aloof, suspicious, and says, "Two staff members I saw talking were plotting to kill me." Based on data gathered at this point, which nursing diagnoses relate? (Select all that apply.) a. Risk for other-directed violence b. Disturbed thought processes c. Risk for loneliness d. Spiritual distress e. Social isolation

a. Risk for other-directed violence b. Disturbed thought processes

When a client diagnosed with schizophrenia was discharged 6 months ago, haloperidol was prescribed. The client now says, "I stopped taking those pills. They made me feel like a robot." What are common side effects the nurse should validate with the client? a. Sedation and muscle stiffness b. Sweating, nausea, and diarrhea c. Mild fever, sore throat, and skin rash d. Headache, watery eyes, and runny nose

a. Sedation and muscle stiffness

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

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

An adult diagnosed with major depressive disorder was treated with medication and cognitive-behavioral therapy. The client now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest? a. Social skills training b. Relaxation training classes c. Desensitization techniques d. Use of complementary therapy

a. Social skills training

A client became depressed after the last of the family's six children moved out of the home 4 months ago. Select the best initial outcome for the nursing diagnosis Situational low self-esteem related to feelings of abandonment. a. The client will verbalize realistic positive characteristics about self by (date). b. The client will agree to take an antidepressant medication regularly by (date). c. The client will initiate social interaction with another person daily by (date). d. The client will identify two personal behaviors that alienate others by (date).

a. The client will verbalize realistic positive characteristics about self by (date).

A client diagnosed with bipolar disorder who takes lithium carbonate 300 mg three times daily reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with what? a. food. b. an antacid. c. an antiemetic. d. a large glass of juice.

a. food.

A health teaching plan for a client taking lithium should include which instructions? a. maintain normal salt and fluids in the diet. b. drink twice the usual daily amount of fluid. c. double the lithium dose if diarrhea or vomiting occurs. d. avoid eating aged cheese, processed meats, and red wine.

a. maintain normal salt and fluids in the diet.

A client diagnosed with schizophrenia has received fluphenazine decanoate twice a month for 3 years. The clinic nurse notes that the client grimaces and constantly smacks both lips. The client's neck and shoulders twist in a slow, snakelike motion. Which problem would the nurse suspect? a. Agranulocytosis b. Tardive dyskinesia c. Tourette's syndrome d. Anticholinergic effects

b. Tardive dyskinesia

A client diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." Which response by the nurse will best assist the client to reframe this overgeneralization? a. "I really doubt that one person can be blamed for all the bad things that happen." b. "Let's look at one bad thing that happened to see if another explanation exists." c. "You are being extremely hard on yourself. Try to have a positive focus." d. "Are you saying that you don't have any good things happen?"

b. "Let's look at one bad thing that happened to see if another explanation exists."

A client diagnosed with bipolar disorder is in the maintenance phase of treatment. The client asks, "Do I have to keep taking this lithium even though my mood is stable now?" What is the nurse's most appropriate response? a. "You will be able to stop the medication in about 1 month." b. "Taking the medication every day helps reduce the risk of a relapse." c. "Most clients take medication for approximately 6 months after discharge." d. "It's unusual that the health care provider hasn't already stopped your medication."

b. "Taking the medication every day helps reduce the risk of a relapse."

Which hallucination expressed by a client necessitates the nurse to implement safety measures? a. "I hear angels playing harps." b. "The voices say everyone is trying to kill me." c. "My dead father tells me I am a good person." d. "The voices talk only at night when I'm trying to sleep."

b. "The voices say everyone is trying to kill me."

A nurse prepares the plan of care for a client experiencing an acute manic episode. Which nursing diagnoses are most likely? (Select all that apply.) a. Imbalanced nutrition: more than body requirements b. Impaired mood regulation c. Sleep deprivation d. Chronic confusion e. Social isolation

b. Impaired mood regulation c. Sleep deprivation

A client diagnosed with schizophrenia has taken a conventional antipsychotic medication for a year. Hallucinations are less intrusive, but the client continues to have apathy, poverty of thought, and social isolation. The nurse would expect a change to which medication? a. Haloperidol b. Olanzapine c. Chlorpromazine d. Diphenhydramine

b. Olanzapine

A client experiencing acute mania dances around the unit, seldom sits, monopolizes conversations, interrupts, and intrudes. Which nursing intervention will best assist the client with energy conservation? a. Monitor physiological functioning. b. Provide a subdued environment. c. Supervise personal hygiene. d. Observe for mood changes.

b. Provide a subdued environment.

A client diagnosed with major depressive disorder repeatedly tells staff, "I have cancer. It's my punishment for being a bad person." Diagnostic tests reveal no cancer. What is the priority nursing diagnosis? a. Powerlessness b. Risk for suicide c. Stress overload d. Spiritual distress

b. Risk for suicide

When a hyperactive client diagnosed with acute mania is hospitalized, what is the initial nursing intervention? a. Allow the client to act out feelings. b. Set limits on client behavior as necessary. c. Provide verbal instructions to the client to remain calm. d. Restrain the client to reduce hyperactivity and aggression.

b. Set limits on client behavior as necessary.

What is the focus of priority nursing interventions for the period immediately after electroconvulsive therapy (ECT) treatment? a. Nutrition and hydration b. Supporting physiological stability c. Reducing disorientation and confusion d. Assisting the client to identify and test negative thoughts

b. Supporting physiological stability

A client 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 using what medical term? a. dysthymia. b. anhedonia. c. euphoria. d. anergia.

b. anhedonia.

What is the priority intervention for a client diagnosed with major depressive disorder and feelings of worthlessness? a. distracting the client from self-absorption. b. careful unobtrusive observation around the clock. c. allowing the client to spend long periods alone in meditation. d. opportunities to assume a leadership role in the therapeutic milieu.

b. careful unobtrusive observation around the clock.

A client experiencing acute mania is dancing atop a pool table in the recreation room. The client waves a cue in one hand and says, "I'll throw the pool balls if anyone comes near me." To best assure safety, what is the nurse's first intervention? a. tell the client, "You need to be secluded." b. clear the room of all other clients. c. help the client down from the table. d. assemble a show of force.

b. clear the room of all other clients.

Outcome identification for the treatment plan of a client experiencing grandiose thinking associated with acute mania will focus on what? a. developing an optimistic outlook. b. distorted thought self-control. c. interest in the environment. d. sleep pattern stabilization.

b. distorted thought self-control.

This nursing diagnosis applies to a client 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. What is an appropriate outcome for this client? a. ask staff for assistance with feeding within 4 days. b. drink six servings of a high-calorie, high-protein drink each day. c. consistently sit with others for at least 30 minutes at mealtime within 1 week. d. consistently wear appropriate attire for age and sex within 1 week while on the psychiatric unit.

b. drink six servings of a high-calorie, high-protein drink each day.

A client diagnosed with schizophrenia demonstrates little spontaneous movement and has catatonia. The client's activities of daily living are severely compromised. What will be an appropriate outcome for this client? a. demonstrates increased interest in the environment by the end of week 1. b. performs self-care activities with coaching by the end of day 3. c. gradually takes the initiative for self-care by the end of week 2. d. accepts tube feeding without objection by day 2.

b. performs self-care activities with coaching by the end of day 3.

A client diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. The client threatens to hit another client. Which comment by the nurse is appropriate? a. "Stop that! No one did anything to provoke an attack by you." b. "If you do that one more time, you will be secluded immediately." c. "Do not hit anyone. If you are unable to control yourself, we will help you." d. "You know we will not let you hit anyone. Why do you continue this behavior?"

c. "Do not hit anyone. If you are unable to control yourself, we will help you."

Which dinner menu is best suited for a client with acute mania? a. Spaghetti and meatballs, salad, and a banana b. Beef and vegetable stew, a roll, and chocolate pudding c. Broiled chicken breast on a roll, an ear of corn, and an apple d. Chicken casserole, green beans, and flavored gelatin with whipped cream

c. Broiled chicken breast on a roll, an ear of corn, and an apple

A person was directing traffic on a busy street, rapidly shouting, "To work, you jerk, for perks" and making obscene gestures at cars. The person has not slept or eaten for 3 days. Which assessment findings will have priority concern for this client's plan of care? a. Insulting, aggressive behavior b. Pressured speech and grandiosity c. Hyperactivity; not eating and sleeping d. Poor concentration and decision making

c. Hyperactivity; not eating and sleeping

A client diagnosed with depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. What information should the nurse provide to the client and family? a. Need to restrict sodium intake to 1 gram daily. b. Need to minimize exposure to bright sunlight. c. Importance of reporting increased suicidal thoughts. d. Importance of maintaining a tyramine-free diet.

c. Importance of reporting increased suicidal thoughts.

A client diagnosed with schizophrenia exhibits little spontaneous movement and demonstrates catatonia. Which client needs are of priority importance? a. Self-esteem b. Psychosocial c. Physiological d. Self-actualization

c. Physiological

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? a. Increased muscle tension and anxiety b. Vegetative signs and poor grooming c. Poor judgment and hyperactivity d. Cognitive deficits and paranoia

c. Poor judgment and hyperactivity

When counseling clients diagnosed with major depressive disorder, what therapy would an advanced practice nurse address the client's negative thought patterns? a. psychoanalytic b. desensitization c. cognitive-behavioral d. alternative and complementary

c. cognitive-behavioral

A client experiencing acute mania undresses in the group room and dances. How should the nurse intervene initially? a. quietly asking the client, "Why don't you put your clothes on?" b. firmly telling the client, "Stop dancing and put on your clothing." c. putting a blanket around the client and walking with the client to a quiet room. d. letting the client stay in the group room and moving the other clients to a different area.

c. putting a blanket around the client and walking with the client to a quiet room.

A client diagnosed with major depressive disorder 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 implement which intervention? a. limit the client's activities to those that can be performed in a sitting position. b. withhold the drug, force oral fluids, and notify the health care provider. c. teach the client strategies to manage postural hypotension. d. update the client's mental status examination.

c. teach the client strategies to manage postural hypotension.

A client became severely depressed when the last of the family's six children moved out of the home 4 months ago. The client repeatedly says, "No one cares about me. I'm not worth anything." Which response by the nurse would be the most helpful? a. "Things will look brighter soon. Everyone feels down once in a while." b. "Our staff members care about you and want to try to help you get better." c. "It is difficult for others to care about you when you repeatedly say the same negative things." d. "I'd to sit with you for 10 minutes now and 10 minutes after lunch because I value spending time with you."

d. "I'd to sit with you for 10 minutes now and 10 minutes after lunch because I value spending time with you."

A client diagnosed with schizophrenia anxiously tells the nurse, "The voice is telling me to do things." What is the nurse's priority assessment question? a. "How long has the voice been directing your behavior?" b. "Does what the voice tell you to do frighten you?" c. "Do you recognize the voice speaking to you?' d. "What is the voice telling you to do?"

d. "What is the voice telling you to do?"

A nurse sits with a client diagnosed with schizophrenia. The client starts to laugh uncontrollably, although the nurse has not said anything funny. What is the nurse's most therapeutic response? a. "Why are you laughing?" b. "Please share the joke with me." c. "I don't think I said anything funny." d. "You're laughing. Tell me what's happening."

d. "You're laughing. Tell me what's happening."

A health care provider considers which antipsychotic medication to prescribe for a client diagnosed with schizophrenia who has auditory hallucinations and poor social function. The client is also overweight and hypertensive. Which drug should the nurse advocate? a. Clozapine b. Ziprasidone c. Olanzapine d. Aripiprazole

d. Aripiprazole

A client diagnosed with schizophrenia says, "It's beat. Time to eat. No room for the cat." What type of verbalization is evident? a. Neologism b. Idea of reference c. Thought broadcasting d. Associative looseness

d. Associative looseness

A client receiving risperidone reports severe muscle stiffness at 1030. By 1200, the client has difficulty swallowing and is drooling. By 1600, vital signs are 102.8° F; pulse 110; respirations 26; 150/90. The client is diaphoretic. What is the nurse's best analysis and action? a. Agranulocytosis; institute reverse isolation. b. Tardive dyskinesia; withhold the next dose of medication. c. Cholestatic jaundice; begin a high-protein, high-cholesterol diet. d. Neuroleptic malignant syndrome; notify health care provider stat.

d. Neuroleptic malignant syndrome; notify health care provider stat.

A client diagnosed with major depressive disorder is receiving imipramine 200 mg at bedtime. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug? a. Dry mouth b. Blurred vision c. Nasal congestion d. Urinary retention

d. Urinary retention

A nurse provided medication education for a client diagnosed with major depressive disorder who began a new prescription for phenelzine. Which behavior indicates effective learning? The client a. monitors sodium intake and weight daily. b. wears support stockings and elevates the legs when sitting. c. can identify foods with high selenium content that should be avoided. d. confers with a pharmacist when selecting over-the-counter medications.

d. confers with a pharmacist when selecting over-the-counter medications.

The nurse is developing a plan for psychoeducational sessions for a small group of adults diagnosed with schizophrenia. Which goal is best for this group's members? a. gain insight into unconscious factors that contribute to their illness. b. explore situations that trigger hostility and anger. c. learn to manage delusional thinking. d. demonstrate improved social skills.

d. demonstrate improved social skills.

A nurse worked with a client diagnosed with major depressive disorder, severe withdrawal, and psychomotor retardation. After 3 weeks, the client did not improve. The nurse is most at risk for what feelings? a. guilt and despair. b. over-involvement. c. interest and pleasure. d. ineffectiveness and frustration.

d. ineffectiveness and frustration.

A client diagnosed with schizophrenia anxiously says, "I can see the left side of my body merging with the wall, then my face appears and disappears in the mirror." While listening, the nurse should engage in what behavior? a. sit close to the client. b. place an arm protectively around the client's shoulders. c. place a hand on the client's arm and exert light pressure. d. maintain a normal social interaction distance from the client.

d. maintain a normal social interaction distance from the client.