Ch, 10-12 Mood,Psychotic & Personality disorders

1-serotonin-specific reuptake inhibitors (SSRIs) 2-unipolar 3-akathisia

1-antidepressant drug agents used in the treatment of depression. 2-having depressive episodes but does not experience mania or hypomania. 3-motor restlessness, inability to sit still.

1-antidepressant 2-bipolar disorder 3-clang association

1-central nervous system depressant that acts to prevent, cure, or alleviate mental depression. 2-brain dysfunction that causes abnormal and erratic shifts in mood, energy- and functional ability. 3-words strung together in rhyming phrases that have no connected meaning.

1-water intoxication 2-waxy flexibility 3-word salad

1-condition in which an excessive amount of water is consumed leading to abdominal cramps dizziness, lethargy, nausea and vomiting, convulsions, and possible coma. 2-posturing in which a person's body part can be moved and it will remain in that position until moved by another person. 3-meaningless and incoherent mixture of words or phrases.

1-alogia 2-antipsychotic agents 3-avolition

1-decrease in amount or speed of speech where person may not answer questions or stop talking in the middle of a thought (see also, poverty of speech). 2-drug agents, also referred to as neuroleptics, that are used to treat serious mental illness such as bipolar affective disorder, depressive and drug-induced psychosis, schizophrenia, and autism. They may be used in some cases of movement disorders (Tourette's syndrome) and nausea or intractable hiccups. 3-lack of motivation

1-personality traits 2-self mutilation 3-splitting

1-defining characteristics that are unique to each individual. 2-intentional act of inflicting bodily injury to oneself without an intent to die as a result. 3-extreme view of an all or none relationship with the world.

1-narcissism 2-passive-aggressive 3-personality disorders

1-derived from the Greek, meaning "excessive love and attention given to one's own self-image"; person has continued need for lavish attention and admiration with little regard for the feeling of others. 2-anger expressed in an indirect and subtle way that acts on hostile feelings. 3-extreme pathological and maladaptive behavior patterns that are destructive to the person and others.

1-affect 2-anergia 3-anhedonia

1-describes facial expression that is displayed in association with the mood 2-marked decrease in energy level that may slow a person to a dependency on others for even basic needs. 3-lack of interest in previously enjoyed activities.

1-catalepsy 2-catatonic 3-delusion of reference

1-extreme form of posturing for extended periods of time. 2-involve a decreased reaction to environmental surroundings. 3-false belief that the behavior of other in the environment refers to oneself.

1-thought broadcasting 2-thought insertion 3-thought withdrawal

1-false belief that one's thoughts can be heard bv others. 2-false belief that thoughts of others can be implanted in one's mind. 3-false belief that others can remove thoughts from one's mind.

1-hallucinations 2-illusions 3-loose associations.

1-false sensory perceptions unrelated to actual external stimuli. 2-mental misperception of actual sensory stimuli 3-vague, unfocused illogical collection of thoughts seen in psychosis.

1-delusion 2-derailment 3-dystonia

1-fixed false belief without appropriate external stimuli that is inconsistent with reality and the person's own knowledge or experience. 2-vague, unfocused, illogical, gradual, or sudden change in thought process without thought blocking (see also loose associations)- 3-muscle rigidity that affects posture gait, eye movements.

1-schizoaffective 2-stupor 3-tardive dyskinesia

1-form of schizophrenia in which the person demonstrates symptoms of major depression or mania in addition to the primary symptoms of delusions, hallucinations, and disorganized behaviors of schizophrenia. 2-lack of awareness or orientation. 3-extrapyramidal syndrome after long' term use of antipsychotic drugs with irreversible movements of the mouth and face that include grimacing, lip-smacking, grinding of teeth and protruding tongue movements- cogwheel rigidity, pill-rolling and tremors.

1-monoamine oxidase inhibitor (MAOI) 2-mood 3-mood disorder

1-group of drugs that inhibit monoamine oxidase; effective in treating depression. 2-emotion that is prolonged to the point that it colors a person's entire psychological thinking. 3-refers to a condition in which the person experiences a prolonged alteration in mood.

1-echolalia 2-echopraxia 3-extrapyramidal side effects

1-involuntary parrot-like repetition of words spoken by others often accompanied by twitching of muscles. 2-repetitive tic-like movements. 3-effects produced by antipsychotic drugs that block dopamine causing irritation of the pyramidal tracts of the central nervous system that coordinate involuntary movements.

1-negativism 2-Persecution 3-rapid cycling

1-learned sense of helplessness. 2-false belief that one is being threatened or in danger of being harmed. 3-four or more mood shifts within 1 year.

1-poverty of speech 2-prodromal phase 3-psychosis

1-little or no verbal speech. 2-beginning of schizophrenia with insidious onset of symptoms of increasing anxiety, inability to concentrate or complete goal-oriented tasks. 3-mental state in which there is mental disorganiza tion and loss of contact with reality.

1-entitlement 2-ideas of references 3-magical thinking

1-narcissistic claim of being superior and owed by others. 2-belief that some events have a special personal meaning. 3-belief that thoughts words and actions can cause or prevent an occurrence by extraordinary means.

1-depression 2-euphoria 3-grandiosity

1-persistent and prolonged mood of sadness that extends beyond 2 weeks duration. 2-excessive feeling of happiness or elation. 3-unrealistic or exaggerated sense of self-worth, importance, wealth, or ability.

1-mannerisms 2-neuroleptic malignant syndrome 3-posturing

1-repetitive goal-directed movements. 2-potentially fatal reaction most often seen with high-potency antipsychotic drugs causing muscular rigidity, tremors, inability to speak, altered level of consciousness, hyperthermia, autonomic dysfunction, and elevated blood count. 3-person in stupor assumes a rigid bizarre posture held against gravity resisting efforts to be moved for extended periods of rime.

1-hypomania 2-labile 3-mania

1-state of mild or moderate mania that lasts for a period of at least 4 days. 2- 3-frenzied unstable mood in which the person may be out of touch with reality.

1. Low-potency antipsychotic drugs cause more___side effects whereas high-potency antipsychotic drugs cause more____ side effects.

1. Anticholinergic; extrapyramidal

1. The symptoms; in personalitv disorders tend to be ___and ____.

1. Consistent: stable

1. The average person with major depressive disorder experiences_____episodes over a lifetime.

1. Four

2. Extrapyramidal reactions are monitored by the ____.

2. AIMS Assessment Scale

2. People with personality disorders tend to have a(n) ___mindset in which underlying hostility is indirectly exhibited in subtle behaviors.

2. Ambivalent

2.____disorder is a milder form of bipolar-related disorder characterized by recurrent symptoms of hypomania and dysthymia.

2. Cyclothymic

3._____ is a recurrent state of depression over a period of at least 2 years

3. Dysthymia

3.____ are perceptual disturbances in which the person misinterprets sensory stimuli that actually exist.

3. Illusions

3. A type of self-destruction is involvement in ____ relationships with people who are emotionally unstable and abusive.

3. No-win

4. Those who exhibit a sense of____feel that others owe them because of their superior and powerful status.

4. Entitlement

4. Delusions of ____ occur during interpersonal conflicts where a perceived injustice is viewed as a threat of harm

4. Persecution

4. A psychosis-induced metabolic state of overhydration in the schizophrenic client is referred to as _____.

4. Water intoxication

5. ____ is an intentional act of inflicting bodily injury to oneself that demonstrates an outward focus of control over inner pain.

5, Self-mutilation

5. Delusions of_____centralize on false beliefs that the person is very powerful and important.

5. Grandeur

5. ____ is the most common mood-stabilizing drug agent used in the treatment of bipolar illness.

5. Lithium carbonate

6. Antidepressant drug agents require______ weeks of continuous blood levels to produce significant mood elevation.

6. 3

6. A persistent parttern of disregard and infringement on the rights of others in a society is characteristic of the ___ personality.

6. Antisocial

6. The person with schizophrenia typically has a _____ affect that is expressionless and blank.

6. Blunted or fiat

7. Clients on suicide precautions should be monitored at______time intervals to prevent anticipated checks.

7. Random

____Cheeking is a) Excessive feeling of happiness b) Holding medication in the mouth without swallowing c) Thinking of self as excessively important

Holding medication in the mouth without swallowing

____ Thought broadcasting is a) "I know all the judges can hear what I am thinking. b) Lack of motivation to make decisions or do self-care. c) "Our bowl is loud star to a wet red noodle carried by the military in excess of the earth

a) "I know all the judges can hear what I am thinking.

____ Avolition is a) "Tom Brokaw is telling me I hold the kev to security in outer space. b) Person remains in one position until changed bv another person. c) "1 know all the judges can hear what I am thinking.''

a) "Tom Brokaw is telling me I hold the kev to security in outer space.

____Labile is a) Alternating from euphoria to dysphoria and irritability b) Holding medication in the mouth without swallowing c) Thinking of self as excessively important

a) Alternating from euphoria to dysphoria and

____ Projection is a) Defense mechanism in which faults are attributed to others b) Perceived state of helplessness leading to extreme reliance on others c) Withdrawal related to extreme self-doubt and tear of disapproval

a) Defense mechanism in which faults are attributed to others

____Unipolar is a) Depressive episode without hypomania or mania b) Thinking of self as excessively important c) Alternating from euphoria to dysphoria and irritability

a) Depressive episode without hypomania or mania

____Euphoria is a) Excessive feelings of happiness b) Being tired with decreased energy c) Learned sense of helplessness

a) Excessive feelings of happiness

____Negativism is a) Learned sense of helplessness b) Alternating from euphoria to dysphoria and irritability c) Lack of pleasure in previously enjoyed activities

a) Learned sense of helplessness

____ Dependency is a) Perceived state of helplessness leading to extreme reliance on others b) Grandiose sense ol seli-impomnce c) Defense mechanism in which faults are attributed to others

a) Perceived state of helplessness leading to extreme reliance on others

____ Personality traits is a) Persistent ways of viewing and relating to the world b) Defense mechanism in which faults are attributed to others c) Person who disregards the rights of others without remorse

a) Persistent ways of viewing and relating to the world

____ Delusion of reference is a) Person remains in one position until changed bv another person b) ''I know all the judges can hear what I am thinking." c) Lack of motivation to make decisions or do self-ore,

a) Person remains in one position until changed bv another person

____ Avoidance is a) Withdrawal related to extreme self-doubt and fear of disapproval b) Extreme view of all good or all bad c) Aggressive response to underlying negative teelinas

a) Withdrawal related to extreme self-doubt and fear of disapproval

3. A client approaches the nurse and states, "This little elf keeps following me with a leash, and it really is getting on my nerves." W^ich of the following would be the most appropriate response for the nurse to make at this time a. "I know seeing the elf is frustrating to you but no one else sees it." b. "Why don't you just tell the elf to sit down and leave you alone." c. "You are only making that up in your mind." d- "That is sillv. There is no one following vou.

a. "I know seeing the elf is frustrating to you but no one else sees it."

8. A client tells the nurse how difficult recent weeks have been. She states she used to enjoy taking her grandchildren to the park but this is no longer pleasurable for her. The client is describing feelings related to which of the following symptoms? a. Anhedonia b. Anergia c. Euphoria d. Negativism

a. Anhedonia

2. The nurse is documenting observations of a client experiencing a manic episode who is very talkative, extremely happy, and laughing. Which of the following would be most appropriate to include regarding this client? a. Euphoric with appropriate affect b. Dysthymic with inappropriate affect c. Bright affect with dysphoric mood d. Flat affect with elated mood

a. Euphoric with appropriate affect

10. Which of the following terms would be characteristics common to all personality disorders? a. Inflexible and maladaptive behaviors b. Odd or eccentric behaviors c. Cold aloof, and suspicious tendencies d. Display ideas of reference in everyday occurrences

a. Inflexible and maladaptive behaviors

10. A client with paranoid schizophrenia believes her medications are tainted with poisonous substances and refuses to take them. Which action should the nurse take? a. Matter-of-fact reinforcement of the need to take the medication b. Ask the clienr what the medication is tainted with c. Ask the client why he thinks the medication is tainted d- Withhold the medication and try again later

a. Matter-of-fact reinforcement of the need to take the medication

4. The nurse who observes protruding tongue movements and finger-rolling motions in a client taking the drug haloperidol (Haldol) would recognize this as: a. Signs of extrapyramidal side effects to the drug b. Normal response to long-term use of the medication c. Part of the illness and unrelated to the medication d. Indications an increased dosage may be needed

a. Signs of extrapyramidal side effects to the drug

____ Word salad is a) "Take the pill up the hill winter kill..■ b) "Our bowl is loud star to a wet red noodle carried by the military in excess of the earth c) ''Tom Brokaw is telling me I hold the key to security in outer space.

b) "Our bowl is loud star to a wet red noodle carried by the military in excess of the earth

____ Acting-out behavior is a) Persistent ways of viewing and relating to the world b) Aggressive response to underlying negative feelings c) Perceived state of helplessness leading to extreme reliance on others

b) Aggressive response to underlying negative feelings

____ Splitting is a) Withdrawal related to extreme self-doubt and fear of disapproval b) Extreme view of all good or all bad c) Persistent ways of viewing and relating to the world

b) Extreme view of all good or all bad

____Rapid cycling is a) Thinking of self as excessively important b) Four or more mood shifts within 1 year c) Being tired with decreased energy

b) Four or more mood shifts within 1 year

____Anhedonia is a) Strings of words in rhyming phrases b) Lack of pleasure in previously enjoyed activities c) Alternating from euphoria to dysphoria and irritability

b) Lack of pleasure in previously enjoyed activities

____ Derailment is a) "Take the pill up the Kill winter kill b) Loose associations that are off track or not connected to each other. c) Lack of motivation to make decisions or do self-are.

b) Loose associations that are off track or not connected to each other.

____ Sociopath is a) Perceived state of helplessness leading to extreme reliance on others b) Person who disregards the rights of others without remorse c) Grandiose sense of selt-importance

b) Person who disregards the rights of others without remorse

1 • The nurse is assessing a client who states, "The radio is sending signals to my intellectual processes to inflict damage on myself." Which of the following would the nurse include in documenting the delusional pattern of this client? a. Experiencing auditory hallucinations b. Having delusions of persecution c. Demonstrating thought insertion d. Speaking in loose associations

b. Having delusions of persecution

8. Creating an overly dramatic scene of emotional behavior to attract the attention of others is typical in which of the following personalities? a. Schizotypal b. Histrionic c. Dependent d. Obsessive-compulsive

b. Histrionic

4. Which of the following types of behavior could be interpreted as a form of self-destruction? a. Avoiding close relationships and intimacy b. Involvement in no-win relationships c. Eccentric dress habits and mannerisms d. Exaggerated sense of importance

b. Involvement in no-win relationships

3. Which of the following statements is true regarding clients with personality disorders? a. They are aware that they have a behavior problem b. Manipulative patterns often render treatment ineffective c. Most have a sincere motivation to change behaviors d. Most recognize how their behavior affects others

b. Manipulative patterns often render treatment ineffective

8. The nurse administering the antipsychotic agent haloperidol (Haldol) to a client would recognize the importance of which additional intervention to combat the adverse effects of this drug? a. Adding extra salt to prepared foods or beverages b. Offering sugar-free hard candy or frequent liquids c. Rinsing the mouth after taking the drug d. Observing for grayish discoloration of tongue

b. Offering sugar-free hard candy or frequent liquids

4. The plan of care for a client with a diagnosis of major depressive disorder should include which of the following interventions? a. Group physical activity that will provide exercise and socialization b. Provide a structured schedule of activities that offers client participation c. no socializing activities unless the client asks to be included d. Encourage participation in competitive games of chess or ping pong

b. Provide a structured schedule of activities that offers client participation

10. The nurse planning interventions for a client with major depressive disorder would give first priority to which of the following individual needs? a. Social isolation b. Self-care deficit c. Low self-esteem d. Ineffective individual coping

b. Self-care deficit

7. The client for whom an MAOI is prescribed should be taught to avoid which of the following dietary items? a. Milk or milk products b. Smoked or processed meat c. Foods high in sodium d. Legumes and nuts

b. Smoked or processed meat

1. The nurse is caring for a client admitted with selfinflicted burns to her abdomen. While the nurse is doing an assessment of the wounds, the client says, "I deserve to be in pain." Which of the following best describes the underlying feelings in this statement? a. Arrogance b. Worthlessness c, Suspicion d. Egocentricity

b. Worthlessness

____ Clang associations is a) Person remains in one position until changed by another person. b) i know all the judges can hear what I am thinking.' c) "Take the pill up the hill winter kill..."

c) "Take the pill up the hill winter kill..."

____Anergia is a) Four or more mood shifts within 1 year b) Holding medication in the mouth without swallowing c) Being tired with decreased energy

c) Being tired with decreased energy

____ Jekyll and Hyde" characteristic is a) Defense mechanism in which faults are attributed to others b) Person who disregards the rights of others without remorse c) Extreme mood shift from clingy dependent behavior to angry outbursts

c) Extreme mood shift from clingy dependent behavior to angry outbursts

____ Narcissism is a) Extreme mood shift from clingy dependent behavior to angrv outbursts b) Perceived state of helplessness leading to extreme reliance on others c) Grandiose sense of self-importance

c) Grandiose sense of self-importance

____ Waxv flexibility is a) Person remains in one position until changed bv another person. b) "I know all the judges can hear what I am thinking." c) Lack of motivation to make decisions or do self-care.

c) Lack of motivation to make decisions or do self-care.

____ Clang association is a) Depressive episode without hvpomania b) Lack of pleasure in previously enjoyed activities c) Strings of words in rhyming phrases

c) Strings of words in rhyming phrases

____Grandiosity is a) Strings of words in rhyming phrases b) Holding medication in the mouth without swallowing c) Thinking of self as excessively important

c) Thinking of self as excessively important

3- When caring for a client with a manic episode which of the following nursing interventions would convey a therapeutic attitude of acceptance? a. Tell the client to remain isolated until impulsive actions are controlled b. Allow the client to describe delusional thoughts as long as needed c, Walk alongside the client at intervals as long as pacing continues d. Reprimand the client for inappropriate sexual hand gestures

c, Walk alongside the client at intervals as long as pacing continues

5. A voung man who loudly demands to see the manager of a restaurant when he and his date are not seated immediately upon their arrival is displaying the narcissistic behavior referred to as: a. Projection b. Splitting c. Entitlement d. Ambivalence

c. Entitlement

7. The nurse is documenting observations made during an initial contact with a client who has recently been diagnosed with acute schizophrenia, undifferentiated type. Which of the following behavior assessments would be considered a positive symptom of schizophrenia? a. Presents with a blunted affect b. Expresses indications of avolition c. Having auditorv hallucinations d. Disheveled and unkempt appearance

c. Having auditorv hallucinations

5. The nurse is providing patient teaching to a client for whom the antipsychotic agent risperidone (Risperdal) has been prescribed. Which statement by the client would indicate a need for further teaching? a. "I need to take the medication when I eat so it doesn't upset my stomach." b. "It may be a week or two before X feel really good." c. I can still riding on my bike in the afternoon like I usually do." d. "I better sit on the edge of the bed awhile before I get up in the morning.

c. I can still riding on my bike in the afternoon like I usually do."

5. The nurse is caring for a client whose serum lithium carbonate level is 1.5 mEq/L. The nurse would expect the physician to: a. Order an additional dose to be given one time onlv b. Increase the daily dosage of the medication c. Order the next dose of the drug to be held d. Stop the medication

c. Order the next dose of the drug to be held

7. The individual with an antisocial personality demonstrates a false sense of privileged revenge against others. Which of the following best describes the result of this thinking? a. An outward focus of control over inner pain b. Repeated unsuccessful attempts to secure stability in relationships c. Persistent disregard and indifference to laws of society and humanity d. Unrealistic expectations and standards of perfection

c. Persistent disregard and indifference to laws of society and humanity

1• The nurse is monitoring a client with mania who is constantly pacing the hallway and unable to be seated when the other clients are eating. Which of the following nursing interventions would best meet the needs of the client at this time? a. Keep food at the nurse's station until the client asks for something to eat b. Allow the client to eat in a separate area to avoid distraction c. Provide finger sandwiches and juice for client during the activity d. Teach dient the importance of nutrition in providing energy

c. Provide finger sandwiches and juice for client during the activity

9. A client who has been admitted after a suicide attempt from an overdose of antidepressant medication tells the nurse, "Why couldn't I just die. There is nothing left here for me," The most therapeutic response for the nurse is: a. "Why did you want to die?" b. "There is always a reason things happen as they do." c. "What do vou mean there is nothing here for vou?" d. "You are feeling as though life is meaningless right now

d. "You are feeling as though life is meaningless right now

9. The nurse is planning care for a client who has been newly diagnosed with paranoid schizophrenia. Which of the following perceptual changes should the nurse anticipate? a. Client does not notice nor respond to changes in t}ie environment b. Client recognizes that he is not responding norma ro stimuli c. Client accepts and understands the irrational nature of his ideations d. Client frequently misinterprets social and environMental stimuli

d. Client frequently misinterprets social and environMental stimuli

2. which of the following statements best describes poverty of speech? a. a jumble of unconnected and disorganized thoughts b. Insignificant rhyming of words c. Thoughts of others can be inserted in one's mind d. Decrease in amount or speed with which a person talks

d. Decrease in amount or speed with which a person talks

6. Which of the following indicators is most demonstrarive that improvement has occurred related to treatment strategies? a. Is able to define what is meant by a personality disorder b. Ability' to recognize personality traits in others c. Relates the requirements for compliance with treatment plan d. Demonstrates behavior changes following discharge

d. Demonstrates behavior changes following discharge

6. The physician has ordered the drag benzetropine (Cogentin) for a client who has been taking the antipsychotic medication haloperidol (Haldol). Which of the following would the nurse expect to assess in this client? a. Increased delusional thinking b. Intractable hiccups c. Diminished drive and apathy d. Protruding tongue movements

d. Protruding tongue movements

2. The nurse notes that a client is monopolizing most of the conversation during breakfast. He is loud and criticizing other clients. Which of the following is the most appropriate intervention for the nurse to make at this time? a. Reprimand him for his inappropriate behavior b. Provide him with medication to calm him down c. Put him in seclusion until he can control his actions d. Redirect and reinforce limits on his behavior

d. Redirect and reinforce limits on his behavior

6. It is important for the nurse to include which of the following instructions when doing client teaching for the client taking a tricyclic antidepressant medication-' a. Take the medication with coffee or tea to enhance its effect b. The medication can be discontinued after a few weeks of therapy c. You can omit the morning dose of your medication if it makes you too sleepy d. Wear a hat and long-sleeve shirt when you are outdoors in the sun

d. Wear a hat and long-sleeve shirt when you are outdoors in the sun

9. Which of the following correctly describes the person with a narcissistic personality disorder? a. Has a profound insecurity, sense of self-doubt, and a fear of being alone b. Rigid and controlling with unrealistic expectations and standards c. Exhibit strange and unusual patterns of thinking and communicating d. iMay use other people unfairly to satisfy a selfish need for lavish attention

d. iMay use other people unfairly to satisfy a selfish need for lavish attention