psych test 2
A client with a history of suicide attempts has been taking fluoxetine (Prozac) for one month. The client suddenly presents with a bright affect, rates mood at 9 out of 10, and is much more communicative. Which action should be the nurses priority at this time? 1. Give the client off-unit privileges as positive reinforcement. 2. Encourage the client to share mood improvement in group. 3. Increase the level of this clients suicide precautions. 4. Request that the psychiatrist reevaluate the current medication protocol.
3
A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. Which theoretical principle best explains the etiology of this clients depressive symptoms? 1. According to psychoanalytic theory, depression is a result of negative perceptions. 2. According to object-loss theory, depression is a result of overprotection. 3. According to learning theory, depression is a result of repeated failures. 4. According to cognitive theory, depression is a result of anger turned inward.
3
A nurse administers 100% oxygen to a client during and after electroconvulsive therapy treatment (ECT). What is the rationale for this procedure? 1. To prevent increased intracranial pressure resulting from anoxia. 2. To prevent decreased blood pressure, pulse, and respiration owing to electrical stimulation. 3. To prevent anoxia resulting from medication-induced paralysis of respiratory muscles. 4. To prevent blocked airway, resulting from seizure activity.
3
A nurse discovers a clients suicide note that details the time, place, and means to commit suicide. What should be the priority nursing action, and why? 1. Administer lorazepam (Ativan) prn, because the client is angry about plan exposure. 2. Establish room restrictions, because the clients threat is an attempt to manipulate the staff. 3. Place client on one-to-one suicide precautions, because specific plans likely lead to attempts. 4. Call an emergency treatment team meeting, because the clients threat must be addressed.
3
A nurse is planning care for a client diagnosed with bipolar disorder: manic episode. In which order should the nurse prioritize the client outcomes in the exhibit? Client Outcomes: 1. Maintains nutritional status 2. Interacts appropriately with peers 3. Remains free from injury 4. Sleeps 6 to 8 hours a night 1. 2, 1, 3, 4 2. 4, 1, 2, 3 3. 3, 1, 4, 2 4. 1, 4, 2, 3
3
A highly agitated client paces the unit and states, I could buy and sell this place. The clients mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this clients behavior? 1. Rates mood 8/10. Exhibiting looseness of association. Euphoric. 2. Mood euthymic. Exhibiting magical thinking. Restless. 3. Mood labile. Exhibiting delusions of reference. Hyperactive. 4. Agitated and pacing. Exhibiting grandiosity. Mood labile.
4
A nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following actions is the nurse's priority? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling' D. Teaching the client about medication adverse effects
A
While caring for a client at high risk for violence, the nurse offers an empathetic response to the client's feelings. Which outcome does the nurse expect from this intervention? a 24 year old male client presents to the ED with rapid speech, pacing, quick movements, poor hygiene, and a disheveled appearance. history of bipolar 1 disorder diagnosed 2 years ago. treated with divalproex sodium, cognitive behavioral therapy, group therapy, and psychoeducation. discontinued use of divalproex sodium without provider approval a month ago because he was feeling weird. has recently lost his job because he couldn't focus on what he was doing. spends most of his time hanging out with his friends and drinking. alcohol use includes daily intake of both beer and hard liquor. is living at home with immediate family but states his family wants him to move out temp: 98.8 HR: 90 RR: 18 SPO2: 98% BP: 130/70 (MAP 90) a) the client develops trust b) the client develops self-esteem c) the client develops a less anxious nature d) the client develops a feeling of some control
A
Which side effects are usually observed in a client who is administered fluoxetine? Select all that apply. a) Insomnia b) Agitation c) Weight gain d) Photophobia
A, B, C
a nurse is working in an acute mental health facility and is caring for a 35-year old female client who has manifestations of depression. the client lives at home with her partner and two young children. she currently smokes and has a history of chronic asthma. which of the following factors put the client at risk for depression? select all that apply a) history of chronic asthma b) gender c) age d) smoking e) being married
A, B, C, D
a nurse is working in an acute mental health facility is caring for a 35-year old female client who has manifestations of depression. the client lives at home with her partner and 2 young children. she currently smokes and has a history of chronic asthma. which of the following factors put the client at risk for depression? a) history of chronic asthma b) gender c) age d) smoking e) being married
A, B, C, D
The nurse develops a plan of care for the client. Which nursing intervention is appropriate based on the client's assessment data? Select all that apply. 14:15 Transfer of 29 year old M client from the ED who presented with extreme anxiety with no known etiology that has been consistent for the past 7 months. History includes feeling keyed up, having difficulty sleeping, having difficulty concentrating, and irritability. States he came in today because he just can't take feeling like this anymore and sattes, "I'm unable to do my job." He admits to feeling sad for the past 3 years. Lately he has been so distraught that he has been calling in sick 1-2 days a week. He has been put on notice that he will be fired if he misses any more days. The client is single and has not been out with friends for months. The client's Hamilton Anxiety Rating Scale score is 27. temp: 98.4 HR: 78 R: 14 SPO2: 96% BP: 142/78 CBC and CMP WNL Toxicology negative alcohol negative TSH 1.99 a) provide structured schedule of activities b) administer prescribed medications c) encourage the client to explore underlying feelings d) encourage the client to verbalize fears and anxieties associated with identified stressful life situations e) ensure that a nonjudgemental attitude is conveyed f) talk to the client in a slow manner, punctuating specific words g) stay with the client and offer reassurance of safety and security
A, B, C, D, E, G
which client has an increased risk for the development of anxiety and will require frequent assessment by the nurse? select all that apply a) exacerbation of asthma signs and symptoms b) history of COPD c) history of TBI d) history of strawberry and peanut allergies e) current treatment of unstable angina pectoris
A, B, C, E
While caring for a client with an anxiety disorder, the nurse finds that the client frequently pulls out hair from the scalp and eyebrows. Which other behavior does the nurse expect this client to exhibit? Select all that apply. a) Biting b) Scratching c) Skin picking d) Head banging e) Mirror checking
A, B, D
The nurse is caring for a client who has just been prescribed antidepressant medication. Which education would the nurse provide to the client? Select all that apply. a) "Do not stop taking this medication suddenly." b) "You may find you forget things when taking this medication." c) "This medication may make you feel more tired than normal." d) "Be sure to wear sunscreen when spending time outside." e) "Call our office right away if you have a stiff or sore neck."
A, C, D, E
Which characteristic symptoms might a client who has social anxiety disorder exhibit? Select all that apply. a) The client has a fear of using public restrooms. b) The client is afraid of snakes. c) The client does not cook food because of the fear of fire. d) The client is afraid to present a speech in an auditorium. e) The client gets embarrassed during stage performances.
A, D, E
The nurse is caring for a client who is diagnosed with hypomania. Which behavior does the nurse find in the client? Select all that apply. a) The client is cheerful and expansive with an underlying irritability. b) The client shows extreme fluctuating emotions. c) The client tries to maintain a close friendship with the nurse. d) The client neglects personal hygiene and grooming. e) The client talks and laughs very loudly while communicating with the nurse.
A, E
A client presents to the clinic exhibiting clinically significant distress, including social impairment and an inability to attend work as normal. Which client-prescribed medications may have induced this condition? Select all that apply. a) hormonal birth control b) antihypertensive c) oral steroid d) antibiotic e) muscle relaxant
A,B,C,E
A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons? a) adverse effect of antidepressant medication b) attempt to reduce anxiety c) narcissistic behavior d) fear of rejection from staff
B
After interacting with the mother of an adolescent client, the nurse finds that the client masturbates frequently, watches pornographic films, and makes calls to phone sex operators often. Which disorder should the nurse expect in the client? a) Hoarding b) Paraphilic c) Body dysmorphic d) Stereotypic movement
B
For the last year, a college student continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia. This behavior is associated with which diagnosis? A. Agoraphobia B. G A D C. Social phobia disorder D. O C D
B
Which is the nurse's priority concern for this client based on the Hamilton Depression Rating Scale score? 11:30 - client presents with severe depression resulting from a 16 week miscarriage that occurred 6 weeks ago. awake with flat affect. answers questions in monotone, one-word answers. hair and clothing appear unkempt, with body odor present. thin female, sallow skin, sunken eyes with dark circles. 12:30 - the client was a direct admit from the PCP office for extreme changes in affect, behavior, and interactions. the client was taken to the PCP by her husband because she had stopped eating for 4 days, is still frequently crying, stays in bed for most of the day, and neglects her basic personal hygeine needs. A Hamilton Depression Rating scale has been completed with a score of >24. a) difficulty eating without urging from others b) suicidal ideas or gestures c) does not engage in any activities d) awakens during the night
B
Which part of the brain mediates the symptoms of psychomotor retardation? a) amygdala b) cerebellum c) hypothalamus d) frontal cortex
B
a nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? a) discuss new relaxation techniques b) stay with the client and remain quiet c) show the client how to change his behavior d) distract the client with a television show
B
a nurse is planning care for a client who has body dysmorphic disorder. which of the following actions should the nurse plan to take first a) instilling hope for positive outcomes b) assessing the client's risk for self-harm c) encouraging the client to participate in treatment decisions d) encouraging the client to participate in group therapy sessions
B
A client with mania reports an inability to sleep. Which appropriate actions does the nurse take to help the client sleep better? Select all that apply. a) Provide a low-protein diet b) Administer sedative agents as prescribed c) Reduce lighting in the room d) Provide tea or coffee before sleep e) Help perform relaxation exercises before sleep
B, C, E
A client with bipolar disorder is at high risk of self-harm. The nurse finds that the client perceives actions of others as threatening. What does the nurse do to ensure the safety of this client? Select all that apply. a) use mechanical restraints b) implement wellness checks every 15 minutes c) provides additional care by adding new staff d) maintains low level of stimuli in the client environment e) notifies the primary health care provider
B, D
A client is diagnosed with disruptive mood dysregulation disorder. Which is a nursing intervention for this client? a) Determining the stage of grief b) Teaching effective communication skills c) Strengthening the client's coping and adaptive skills d) encouraging the client to take responsibility for self-care practices
C
A client who has fear of darkness is exposed to a room with darkness for a prolonged period of time during therapy. Which therapy is the client undergoing? a) psychotherapy b) cognitive c) implosion d) behavior
C
A client who suffered a head injury in an accident complains of frequent sleepiness and loss of appetite. Which part of the client's brain has most likely been affected? a) cerebellum b) hippocampus c) hypothalamus d) frontal cortex
C
A client with severe depressive disorder is found to be obsessively washing hands. Which therapy would be beneficial to control this condition in the client? a) light therapy b) group therapy c) cognitive behavior therapy d) ECT
C
The nurse is caring for a client with impaired social interaction. The nurse sets limits on the manipulative behavior of the client. Which outcome in the client does the nurse expect from this intervention? a) the client develops self-esteem b) the client develops a feeling of security c) the client develops appropriate interaction skills d) the client accepts responsibility for his or her own behavior
C
Which finding may be present in a client with a depressive episode of bipolar disorder? a) increased levels of serotonin b) increased levels of dopamine c) increased levels of acetylcholine d) increased levels of norepinephrine
C
Which intervention should the nurse implement to prevent the effects of drowsiness and dizziness in a client who is prescribed calcium channel blocker (CCB) therapy? a) Encourage the client to eat a fiber-rich diet b) Advise the client to take verapamil along with food c) Instruct the client not to operate heavy machinery d) Record the client's blood pressure before administration of the medication
C
Which nursing action is appropriate while using mechanical restraints on a client with a manic episode of bipolar disorder? a) Observing the client every hour b) Replacing the restraints every 4 hours c) Providing assistance to the client during positioning d) Removing all restraints at a time when the agitation decreases
C
Which stage of mania is associated with the behavior of manipulating others to fulfill the client's wishes? a) psychosis b) hypomania c) acute mania d) delirious mania
C
to maximize the therapeutic effect, which lifestyle should the nurse discourage for a client who has been recently prescribed an antianxiety medication? a) using acetaminophen without first discussing it with a healthcare provider b) taking medications after eating dinner or while having a bedtime snack c) buying a large coffee with sugar and extra cream each morning on the way to work d) eating high protein foods
C
Which are the signs of depression that the nurse may observe in a 7-year-old child? Select all that apply. a) morbid thoughts b) excessive worrying c) aggressive behavior d) lack of social interactions e) lack of emotional expressiveness
C, D
A client with bipolar disorder is diagnosed with migraine. Which medication is effective when the primary health-care provider prefers a single medication for the treatment of both the conditions? a) clonazepam b) lamotrigine c) aripiprazole d) chlorpromazine
D
A nurse in an acute mental health facility is planning care for a client who has bipolar disorder. which of the following is the priority nursing intervention a) set consitent limits for expected client behavior b) provide the client with step by step instructions during hygeine activities c) administer prescribed meds as scheduled d) monitor the client for escalating behavior
D
Which fear supports the nurse's suspicion that the client has algophobia? a) The client has fear of people. b) The client has fear of needles. c) The client has a persistent fear of lightning. d) The client has a persistent fear of pain.
D
a nurse in an acute mental health facility is caring for a client who has bipolar disorder, which of the following is the priority nursing intervention? a) set consistent limits for expected client behavior b) provide the client with step by step instructions during hygiene activities c) administer prescribed meds as scheduled d) monitor the client for escalating behavior
D
Which symptom does the nurse expect to appear in the client whose serum concentration of lithium is 1.8 mEq/L? a) Mental alertness b) Decreased urine output c) Persistent vomiting d) Constipation
C
Which symptom would be a manifestation of a hoarding disorder? a) Sexual urges or fantasies b) Ritualized eating behavior c) Recurrent pulling of one's hair d) Difficulty in parting with possessions
D
A health-care provider infers from a test that a client's depression is somatically treatable. The elevated level of which parameter might be the reason for reaching such a conclusion? a) calcium b) serum cortisol c) sodium bicarbonate d) thyroid stimulating hormone
B
A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate (Lithobid) because of excessive weight gain. In order to increase adherence, which medication should a nurse anticipate that a physician may prescribe? 1. Sertraline (Zoloft) 2. Valproic acid (Depakote) 3. Trazodone (Desyrel) 4. Paroxetine (Paxil)
2
______________________ is a pervasive and sustained emotion that may have a major influence on a persons perception of the world.
mood
A client has been in multiple abusive relationships yet stays with the significant other because the client feels they cannot leave. Which theory can best explain the clients depression? a) learning theory b) cognitive theory c) object loss theory d) psychoanalytical theory
A
A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family members report that the client has experienced anorexia, insomnia, and recent job loss. Which nursing diagnosis should a nurse prioritize? 1. Risk for suicide R/T hopelessness 2. Anxiety: severe R/T hyperactivity 3. Imbalanced nutrition: less than body requirements R/T refusal to eat 4. Dysfunctional grieving R/T loss of employment
1
A client diagnosed with bipolar disorder is distraught over insomnia experienced over the last 3 nights and a 12-pound weight loss over the past 2 weeks. Which should be this clients priority nursing diagnosis? 1. Knowledge deficit R/T bipolar disorder AEB concern about symptoms 2. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss 3. Risk for suicide R/T powerlessness AEB insomnia and anorexia 4. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights
2
Which statement supports the nurse's suspicion that the client has obsessive-compulsive disorder? a) "I wash my hands every 15 minutes." b) "I have 12 puppies and love caring for them." c) "My nose has a deformity even after rhinoplasty." d) "I bite my nails and scratch myself in extreme tension."
A
A client is diagnosed with trichotillomania. Which other comorbid disorders should be evaluated in the client? Select all that apply. a) Mood b) Anxiety c) Schizoid d) Endocrine e) Personality
A, B
Which area of the brain may be affected when a client with anxiety disorder shows symptoms related to respiratory activation and increased heart rate? a) thalamus b) brainstem c) frontal cortex d) hypothalamus
B
A client has been diagnosed with major depression. The psychiatrist prescribes paroxetine (Paxil). Which of the following medication information should the nurse include in the discharge teaching? a) Do not eat chocolate while taking this medication b) The medication may cause priaprism c) The medication should not be stopped abruptly d) The medication may cause photosensitivity
C
While preparing a client for light therapy, the client asks the nurse, "I have read that ultraviolet (UV) rays are harmful. Will I get exposed to them during light therapy?" How does the nurse respond to the client's concern? a)"The fluorescent light tubes used in light therapy will not produce UV rays." b) "UV rays are not harmful to the eyes. Therefore, it's OK to look directly at the light." c) "You will be exposed to UV radiation for less than 10 to 15 minutes, which does not cause any harm." d) The plastic screen covering the fluorescent light tubes blocks UV rays. Therefore, you will not be exposed to UV rays.
D
When you visit a client diagnosed with moderate or mild depression and you walk in their room and say "Mr. Thomas it's time for group" and they just slowly raise their head, what do you do?
Say "Let me help you. Here are your clothes." we aren't taking away the right to choose, we just are stopping isolation.
a 23 year old female pt has been diagnosed with depression. She has just completed her graduate exam and is awaiting results. Her friends have noticed that she has come to class in disheveled clothes, no makeup, and will not go out to lunch with her friends. She is withdrawn and isolated while she is usually very talkative. Her friends find out her mother has been struggling with depression. What are some of her risk factors of a depressive episode?
female family history previous diagnosis disheveled
The nurse is caring for a client with an anxiety disorder who is prescribed antianxiety agent therapy. The nurse instructs the client to rise slowly from a lying or sitting position. Which side effect is the nurse trying to reduce in the client by using this intervention? a)Lethargy b) Nausea c) Drowsiness d) Orthostatic hypotension
D
The nurse is caring for a client with mania who is on lithium carbonate therapy. The nurse monitors the client's skin turgor daily. Which sign or symptom observed in the client supports this nursing intervention? a) polyuria b) dizziness c) dry mouth d) dehydration
D
When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented? A. Leave the client alone to maintain privacy. B. Instruct the client regarding unit rules and regulations. C. Sit with the client in the day room to provide comfort. D. Communicate with simple words and brief messages.
D
After 6 months of taking imipramine (Tofranil) for depressive symptoms, a client complains that the medication doesnt seem as effective as before. Which question should the nurse ask to determine the cause of this problem? 1. Are you consuming foods high in tyramine? 2. How many packs of cigarettes do you smoke daily? 3. Do you drink any alcohol? 4. Are you taking St. Johns wort?
2
The severity of depressive symptoms in the postpartum period varies from a feeling of the blues, to moderate depression, to psychotic depression or melancholia. Which disorder is correctly matched with its presenting symptoms? 1. Maternity blues (lack of concentration, agitation, guilt, and an abnormal attitude toward bodily functions) 2. Postpartum depression (irritability, loss of libido, sleep disturbances, expresses concern about inability to care for baby) 3. Postpartum melancholia (overprotection of infant, expresses concern about inability to care for baby, mysophobia) 4. Postpartum depressive psychosis (transient depressed mood, agitation, abnormal fear of child abduction, suicidal ideations)
2
What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive episode? 1. The attention during the assessment is beneficial in decreasing social isolation. 2. Depression can generate somatic symptoms that can mask actual physical disorders. 3. Physical health complications are likely to arise from antidepressant therapy. 4. Depressed clients avoid addressing physical health and ignore medical problems.
2
A nurse assesses a client suspected of having the diagnosis of major depressive episode. Which client symptom would rule out this diagnosis? 1. The client is disheveled and malodorous. 2. The client refuses to interact with others and isolates self in room. 3. The client is unable to feel any pleasure. 4. The client has maxed-out charge cards and exhibits promiscuous behaviors.
4
A nurse is planning care for a 13 -year-old who is experiencing depression. Which medication is approved by the Food and Drug Administration (FDA) for the treatment of depression in adolescents? 1. Paroxetine (Paxil) 2. Sertraline (Zoloft) 3. Citalopram (Celexa) 4. Escitalopram (Lexipro)
4
A staff nurse is counseling a depressed client. The nurse determines that the client is using the cognitive distortion of automatic thoughts. Which client statement is evidence of the automatic thought of discounting positives? 1. Its all my fault for trusting him. 2. I dont play games. I never win. 3. She never visits because she thinks I dont care. 4. I dont have a green thumb. Any old fool can grow a rose.
4
A client, who is taking transdermal selegiline (Emsam) for depressive symptoms, states, My physician told me there was no need to worry about dietary restrictions. Which would be the most appropriate nursing response? 1. Because your dose of Emsam is 6 mg in 24 hours, dietary restrictions are not recommended. 2. You must have misunderstood. An MAOI like Emsam always has dietary restrictions. 3. Only oral MAOIs require dietary restrictions. 4. All transdermal MAOIs do not require dietary modifications.
1
A nurse reviews the laboratory data of a client suspected of having the diagnosis of major depressive episode. Which lab value would potentially rule out this diagnosis? 1. Thyroid-stimulating hormone (TSH) level of 25 U/mL 2. Potassium (K+) level of 4.2 mEq/L 3. Sodium (Na+) level of 140 mEq/L 4. Calcium (Ca2+) level of 9.5 mg/dL
1
Immediately after electroconvulsive therapy (ECT), in which position should a nurse place the client? 1. On his or her side, to prevent aspiration 2. In high Fowlers position, to prevent increased intracranial pressure 3. In Trendelenburgs position, to promote blood flow to vital organs 4. In prone position, to prevent airway blockage
1
A nursing instructor is teaching about the new DSM-5 diagnostic category of disruptive mood dysregulation disorder (DMDD). Which of the following information should the instructor include? (Select all that apply.) 1. Symptoms include verbal rages or physical aggression toward people or property. 2. Temper outbursts must be present in at least two settings (at home, at school, or with peers). 3. DMDD is characterized by severe recurrent temper outbursts. 4. The temper outbursts are manifested only behaviorally. 5. Symptoms of DMDD must be present for 18 or more months to meet diagnostic criteria.
1, 2, 3
An older client has recently been prescribed sertraline (Zoloft). The clients spouse is taking paroxetine (Paxil). A nurse assesses that the client is experiencing restlessness, tachycardia, diaphoresis, and tremors. Which complication should a nurse suspect, and why? 1. Neuroleptic malignant syndrome; caused by ingestion of two different seratonin reuptake inhibitors (SSRIs) 2. Neuroleptic malignant syndrome; caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) 3. Serotonin syndrome; possibly caused by ingestion of an SSRI and an MAOI 4. Serotonin syndrome; possibly caused by ingestion of two different SSRIs
4
A client is prescribed phenelzine (Nardil). Which of the following statements by the client should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.) 1. Ill have to let my surgeon know about this medication before I have my cholecystectomy. 2. I guess I will have to give up my glass of red wine with dinner. 3. Ill have to be very careful about reading food and medication labels. 4. Im going to miss my caffeinated coffee in the morning. 5. Ill be sure not to stop this medication abruptly.
1, 2, 3, 5
In planning care for a suicidal client, which correctly written outcome should be a nurses first priority? 1. The client will not physically harm self. 2. The client will express hope for the future by day three. 3. The client will establish a trusting relationship with the nurse. 4. The client will remain safe during hospital stay.
4
A nursing home resident has a diagnosis of dysthymic disorder. When planning care for this client, which of the following symptoms should a nurse expect the client to exhibit? (Select all that apply.) 1. Sad mood on most days 2. Mood rating of 2 out of 10 for the past 6 months 3. Labile mood 4. Sad mood for the past 3 years after spouses death 5. Pressured speech when communicating
1, 4
A client is diagnosed with major depressive episode. Which nursing diagnosis should a nurse assign to this client, to address a behavioral symptom of this disorder? 1. Altered communication R/T feelings of worthlessness AEB anhedonia 2. Social isolation R/T poor self-esteem AEB secluding self in room 3. Altered thought processes R/T hopelessness AEB persecutory delusions 4. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia
2
A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, I heard about something called a monoamine oxidase inhibitor (MAOI). Cant my doctor add that to my medications? Which is an appropriate nursing response? 1. This combination of drugs can lead to delirium tremens. 2. A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis. 3. Thats a good idea. There have been good results with the combination of these two drugs. 4. The only disadvantage would be the exorbitant cost of the MAOI.
2
A number of assessment rating scales are available for measuring severity of depressive symptoms. Which scale would a nurse practitioner use to assess a depressed client? 1. Zung Depression Scale 2. Hamilton Depression Rating Scale 3. Beck Depression Inventory 4. AIMS Depression Rating Scale
2
A nurse recently admitted a client to an inpatient unit after a suicide attempt. A health-care provider orders amitriptyline (Elavil) for the client. Which intervention, related to this medication, should be initiated to maintain this clients safety upon discharge? 1. Provide a 6-month supply of Elavil to ensure long-term compliance. 2. Provide a 1-week supply of Elavil, with refills contingent on follow-up appointments. 3. Provide pill dispenser as a memory aid. 4. Provide education regarding the avoidance of foods containing tyramine.
2
A client who is 1 week postpartum begins to cry during a checkup and reports to the nurse, "I feel so sad and tired after caring for my baby. I can't concentrate on anything." How does the nurse respond to the client? a) "These symptoms usually last only for a couple of weeks if you interact with your child." b) "I'll contact your health-care provider to get some medications." c) "Consider supportive psychotherapy with continuous assistance until the symptoms subside." d) "Don't worry. Take the medications you were given as prescribed because they will help you to overcome this feeling."
A
A client with mania who is extremely hyperactive and intensely agitated is admitted into the psychiatric unit. During client care, the nurse instructs the client to perform slow exercises. Which risks does the nurse intend to prevent in the client? a) risk of physical injury b) risk of weight gain c) risk of harming other individuals d) risk of insomnia
A
A newly admitted client diagnosed with O C D, spends 1 hour packing and unpacking, folding and refolding personal belongings. What is the most likely reason for this behavior? A. It relieves anxiety. B. It fosters organizational skills. C. It delays meeting unfamiliar people in the dayroom. D. It makes the client feel good.
A
A nurse is assessing a client who is on monoamine oxidase inhibitor (MAOI) therapy. Which education provided by the nurse can prevent a hypertensive crisis in the client? a) avoid consuming red wine b) avoid cottage cheese on food c) use soy sauce as a topping on food d) use raisins as a snack and side dish
A
A nurse is teaching a newly licensed nurse about the use of ECT for the treatment of bipolar disorder. which of the following statements by the newly licensed nurse indicates understanding. a) ect is effective for clients who are experiencing mania b) ect is prescribed to prevent relapse of bipolar disorder c) ect is the recommended initial treatment for bipolar disorder d) ect is contraindicated for clients who have suicidal ideation
A
23. An individual experiences sadness and melancholia in September continuing through November. Which of the following factors should a nurse identify as most likely to contribute to the etiology of these symptoms? (Select all that apply.) 1. Gender differences in social opportunities that occur with age 2. Drastic temperature and barometric pressure changes 3. A seasonal increase in social interactions 4. Variations in serotonergic functioning 5. Inaccessibility of resources for dealing with life stressors
2, 3, 4
A nurse is teaching a newly licensed nurse about the use of ECT for the tx of bipolar disorder. which of the following statements by the new nurse indicates understanding? a) ECT is effective for clients who are experiencing mania b) ECT is prescribed to prevent relapse of bipolar disorder c) ECT is the recommended initial tx for bipolar disorder d) ECT is contraindicated for clients who have suicidal ideation
A
What daily dose range of lorazepam would the nurse expect the health care provider to prescribe to an adult client with panic disorder?
2-6 mg
13. A nurse admits an older client with memory loss, confused thinking, and apathy. A psychiatrist suspects a depressive disorder. What is the rationale for performing a mini-mental status exam? 1. To rule out bipolar disorder 2. To rule out schizophrenia 3. To rule out neurocognitive disorder 4. To rule out personality disorder
3
A client began taking lithium carbonate (Lithobid) for the treatment of bipolar disorder approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in this time frame. Which is the appropriate nursing response? 1. Thats strange. Weight loss is the typical pattern. 2. What have you been eating? Weight gain is not usually associated with lithium. 3. Weight gain is a common, but troubling, side effect. 4. Weight gain only occurs during the first month of treatment with this drug.
3
A client diagnosed with major depressive episode hears voices commanding self-harm. Which should be the nurses priority intervention at this time? 1. Obtaining an order for locked seclusion until client is no longer suicidal. 2. Conducting 15-minute checks to ensure safety. 3. Placing the client on one-to-one observation while continuing to monitor suicidal ideations. 4. Encouraging client to express feelings related to suicide.
3
What should the nurse plan to teach a client who is taking alprazolam (Xanax) three times a day? A. That there is a potential for dependence and tolerance B. The importance of discontinuing Xanax immediately if addiction is suspected C. That increased caffeine consumption can enhance the effectiveness of Xanax D. That Xanax is not habit forming
A
Which first-line treatment medication should the nurse anticipate will be prescribed by the health care provider for a client recently diagnosed with panic and generalized anxiety disorder? a) buspirone b) alprazolam c) hydroxyzine d) meprobamate
A
Which medication works by reducing the expression of ANK3, which is the protein that determines whether a neuron will fire? a) lithium carbonate b) bupropion c) atomoxetine d) tricyclic antidepressants
A
The guardian of an adolescent client says, "My child keeps talking about calling the U.S. President to give him suggestions." The nurse also finds that the client has increased libido. Which does the nurse interpret from these findings? a) the client is experiencing psychosis b) the client is experiencing hypomania c) the client is experiencing acute mania d) the client is experiencing delirious mania
B
The nurse observes that a client who is diagnosed with anxiety disorder has tremors in their hands. Which area of the client's brain may be affected? a) brainstem b) basal ganglia c) hypothalamus d) locus ceruleus
B
When teaching about the tricyclic group of antidepressant medications, which information should the nurse include? a) Strong or aged cheese should not be eaten while taking this group of medications b) The full therapeutic potential of tricyclics may not be reached for 4 weeks c) Long term use may result in physical dependence d) Tricyclics should not be given with antianxiety agents
B
A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The clients spouse questions the Zyprexa order. Which is the appropriate nursing response? 1. Zyprexa in combination with Eskalith cures manic symptoms. 2. Zyprexa prevents extrapyramidal side effects. 3. Zyprexa increases the effectiveness of the immune system. 4. Zyprexa calms hyperactivity until the Eskalith takes effect.
4
A nurse is caring for a client who has bipolar disorder. The client states, "I am very rich, and I feel I must give my money to you." Which of the following responses should the nurse make? a) "why do you feel the need to give money away?" b) "I can request that your case manager discuss appropriate charity options with you" c) "you should know that giving away your money is not appropriate" d) "I am here to provide care and cannot accept this from you"
D
During a checkup, a client verbally reports having a depressed mood and sometimes having trouble falling asleep. The nurse notices that the client fidgets and twirls a strand of hair throughout the interview. On further interaction, the nurse does not observe any additional symptoms of depression in the client. According to the Hamilton Depression Rating Scale (HDRS), which can be concluded about this client? a) Mild depression b) Severe depression c) Moderate depression d) No evidence of depressive illness
D
Order the depressive disorders and their predominant affective symptoms according to level of severity. 1. Dysthymic disorder (pessimistic outlook, low self-esteem) 2. Grief (feelings of anger, anxiety, guilt, helplessness) 3. Major depressive episode (despair, worthlessness, flat affect, apathy, anhedonia) 4. Transient depression (sadness, dejection, feeling downhearted, having the blues)
4, 2, 1, 3 transient, grief, dysrhythmic, major
The nurse is caring for a client who has taphophobia. The understands that this is a fear of what? a) Fire b) Death c) Insanity d) Being buried alive
D
