Good Stuff for Mental Health Final
The psychiatric-mental health nurse knows that the patient's spouse clearly understands the side effects of lithium carbonate (Eskalith), when he or she says: a. "I should call the doctor if my spouse shakes badly." b. "I should make sure my spouse drinks as much water as she or he can." c. "My spouse must remain on a salt-free diet." d. "When the lithium level is 1.6 mEq/L, my spouse can go back to work."
a. I should call the doctor if my spouse shakes badly
Nurse Walter knows that which of the following medications can be used to treat bulimia? a. Prozac b. Zyprexa c. Elavil d. Nardil e. Tofranil f. Nortryptiline g. Norpramine
a. Prozac; c. Elavil; d. Nardil; e. Tofranil; g. Norpramine
What short-acting, CNS stimulants can be administered for clients with ADHD? a. Ritalin b. Adderral c. Guanfacine d. Focalin e. Bupropion f. Dexedrine
a. Ritalin; b. Adderral; d. Focalin; f. Dexedrine Guanfacine = alpha agonist treatment for ADHD Bupropion = miscellaneous med for ADHD
Select the medications that can be used to treat anorexia: a. Thorazine b. Zyprexa c. Elavil d. Bupropion e. Prozac f. Methylphenidate g. Anafranil
a. Thorazine; b. Zyprexa; e. Prozac; g. Anafranil
A male client is admitted to a psychiatric facility by court order for evaluation for antisocial personality disorder. This client has a long history of initiating fights and abusing animals and recently was arrested for setting a neighbor's dog on fire. When evaluating this client for the potential for violence, nurse Perry should assess for which behavioral clues? a. A rigid posture, restlessness, and glaring b. Depression and physical withdrawal c. Silence and noncompliance d. Hypervigilance and talk of past violent acts
a. a rigid posture, restlessness, and glaring
The nurse is aware that this outcome criteria would be appropriate for a child diagnosed with oppositional defiant disorder? a. Accept responsibility for own behaviors b. Be able to verbalize own needs and assert rights c. Set firm and consistent limits with the client d. Allow the child to establish his own limits and boundaries
a. accept responsibility for own behaviors
The severe feeling of restlessness produced by some psychotropic medications, which is often misinterpreted by patients as anxiety or a recurrence of psychiatric symptoms, is known as: a. akathisia b. akinesia c. bradykinesia d. dystonia.
a. akathisia
Kevin is remanded by the courts for psychiatric treatment. His police record, which dates to his early teenage years, includes delinquency, running away, auto theft, and vandalism. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping, which is associated with: a. antisocial personality disorder b. borderline personality disorder c. obsessive-compulsive personality disorder d. narcissistic personality disorder
a. antisocial personality disorder this maladaptive coping pattern is manifested by a disregard for societal norms of behavior and an inability to relate meaningfully to others
When working with a male client suffering phobia about black cats, Nurse Trish should anticipate that a problem for this client would be? a. Anxiety when discussing phobia b. Anger toward the feared object c. Denying that the phobia exist d. Distortion of reality when completing daily routines
a. anxiety when discussing phobia
During an initial patient interview, the psychiatric and mental health nurse begins by asking the patient to describe his or her: a. current situation b. feelings about the current situation c. personal history d. thoughts about the current situation
a. current situation
Nurse Tony was caring for a 41-year-old female client. Which behavior by the client indicates adult cognitive development? a. Generates new levels of awareness b. Assumes responsibility for her actions c. Has maximum ability to solve problems and learn new skills d. Her perception is based on reality
a. generates new levels of awareness
Nurse Bella is aware that this assessment finding is most consistent with early alcohol withdrawal? a. Heart rate of 120 to 140 beats/minute b. Heart rate of 50 to 60 beats/minute c. Blood pressure of 100/70 mm Hg d. Blood pressure of 140/80 mm Hg
a. heart rate of 120 to 140 beats/minute tachycardia is common sign of alcohol withdrawal
A short-term goal for a patient with Alzheimer's disease is: a. improved functioning in the least restrictive environment b. improved problem solving in ADLs c. increased self-esteem and self-concept d. regained cognitive function
a. improved functioning in the least restrictive environment
After taking an antidepressant for about a week, a patient reports constipation and blurred vision, with no improvement in mood. The psychiatric-mental health nurse informs the patient: a. "It takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time." b. "Stop the medication immediately and contact your primary care physician." c. "You should contact your doctor. The doctor may need to change your medication." d. "You should schedule an appointment with your ophthalmologist."
a. it takes approximately two to four weeks for depression to lessen, and side effects usually diminish over time
Which of the following is NOT an example of a group norm? a. most members are caucasian b. no cell phone use during the group c. be respectful of different opinions d. allow opportunities for all to speak
a. most members are caucasian
A male client is diagnosed with schizotypal personality disorder. Which signs would this client exhibit during social situations? a. Paranoid thoughts b. Emotional affect c. Independence need d. Aggressive behavior
a. paranoid thoughts
Joe's IQ is 11, Tara's IQ is 91, and Arthur's IQ is 57. In respective order, how would these IQs be graded? a. profound; normal; mild b. weak; profound; average c. mild; profound; normal d. weak; strong; mild
a. profound; normal; mild
The Psychological Recovery Model is founded on: a. self-determination and one's personal philosophy b. a doctor's orders c. lack of motivation d. herbal medicine
a. self-determination and one's personal philosophy
When interviewing the parents of an injured child, which of the following is the strongest indicator that child abuse may be a problem? a. The injury isn't consistent with the history or the child's age b. The mother and father tell different stories regarding what happened c. The family is poor d. The parents are argumentative and demanding with emergency department personnel
a. the injury isn't consistent with the history or the child's age
For a female client with anorexia nervosa, nurse Rose plans to include the parents in therapy sessions along with the client. What fact should the nurse remember to be typical of parents of clients with anorexia nervosa? a. They tend to overprotect their children b. They usually have a history of substance abuse c. They maintain emotional distance from their children d. They alternate between loving and rejecting their children
a. they tend to overprotect their children clients with anorexia nervosa typically come from a family with parents who are controlling and overprotective, thus these clients use eating to gain control of an aspect of their lives
What statement by a newly diagnosed client with Alzheimer's dementia (AD) indicates a need for further teaching? a. "If I have difficulty with speech and communication, I know this is called aphasia." b. "The mortality rate for this disease is low because complications hardly arise." c. "I have mild dementia because I can still brush my teeth and take care of the house, but it's hard for me to recall information." d. "I will take Donezepil because it is an acetylcholine increaser that will help to slow the progress of my disease."
b. "The mortality rate for this disease is low because complications hardly arise."
Select the medications that have been approved for behavior symptoms of autism spectrum disorder. a. Fluoxetine b. Abilify c. Lorazepam d. Ritalin e. Risperdal
b. Abilify; e. Risperdal
A patient who was admitted yesterday with an adjustment disorder and depressed mood has not left his or her room. The psychiatric-mental health nurse's most appropriate approach at meal time today is to respond: a. "I will bring your tray to your room, if it will make you more comfortable." b. "I will walk with you to the dining room and sit with you while you eat." c. "Where would you like to eat your meal this noon?" d. "You will feel better if you go to the dining room and eat with the others."
b. I will walk with you to the dining room and sit with you while you eat
Nurse Alice is caring for a client being treated for alcoholism. Before initiating therapy with disulfiram (Antabuse), the nurse teaches the client that he must read labels carefully on which of the following products? a. Carbonated beverages b. Aftershave lotion c. Toothpaste d. Cheese
b. aftershave lotion the client receiving disulfiram must be taught to read ingredient labels carefully to avoid products containing alcohol such as aftershave lotions carbonated beverages, toothpaste, and cheese don't contain alcohol and don't need to be avoided by the client
Symptoms of dementia include: a. depression b. aphasia c. apraxia d. agnosia
b. aphasia; c. apraxia; d. agnosia
In the emergency department, a client with facial lacerations states that her husband beat her with a shoe. After the health care team repairs her lacerations, she waits to be seen by the crisis intake nurse, who will evaluate the continued threat of violence. Suddenly the client's husband arrives, shouting that he wants to "finish the job." What is the first priority of the health care worker who witnesses this scene? a. Remaining with the client and staying calm b. Calling a security guard and another staff member for assistance c. Telling the client's husband that he must leave at once d. Determining why the husband feels so angry
b. calling a security guard and another staff member for assistance NEVER handle such situations alone!!
What symptom of a patient with anorexia nervosa would not be expected? a. bradycardia b. cyanosis c. lanugo d. edema
b. cyanosis
Conney with borderline personality disorder who is to be discharged soon threatens to "do something" to herself if discharged. Which of the following actions by the nurse would be most important? a. Ask a family member to stay with the client at home temporarily b. Discuss the meaning of the client's statement with her c. Request an immediate extension for the client d. Ignore the client's statement because it's a sign of manipulation
b. discuss the meaning of the client's statement with her any suicidal statement MUST be ASSESSED first
A selective serotonin reuptake inhibitor targets which part of the brain? a. Basal ganglia b. Frontal cortex c. Hippocampus d. Putamen
b. frontal cortex
The 5 steps of a neurocognitive disorder assessment for an older adult includes: a. dietitian consulting (what foods should they eat?) b. geriatric assessment (head-to-toe, cognitive and sensory deficits, meds examined) c. functional baseline d. family or support system e. advance directives (Durable Power of Attorney for Health Care) f. spirituality baseline (religious or spiritual? how?) g. labs (measure kidney function, urinalysis, electrolytes, CBC)
b. geriatric assessment; c. functional baseline; d. family or support system; e. advance directives; g. labs
When planning care for a female client using ritualistic behavior, Nurse Gina must recognize that the ritual: a. Helps the client focus on the inability to deal with reality b. Helps the client control the anxiety c. Is under the client's conscious control d. Is used by the client primarily for secondary gains
b. helps the client control the anxiety
A parent of a client recently diagnosed with conduct disorder wonders about the biochemical factors that influence this condition. What answer would you give? a. high lithium levels b. high serotonin levels and low cerebral spinal fluid levels c. low serotonin levels and high lithium levels d. absence of epinephrine
b. high serotonin levels and low cerebral spinal fluid levels
A school-aged patient with attention-deficit/hyperactivity disorder is displaying disruptive behaviors at home. The psychiatric-mental health nurse modifies the treatment plan for the social domain, by advising the patient's parents to: a. establish eye contact before giving directions b. initiate a point system, to reward the patient for appropriate behavior c. instruct the patient to work on one homework assignment at a time d. maintain a predictable environment in the home
b. initiate a point system, to reward the patient for appropriate behavior
When screening families for post-traumatic stress disorder following a major natural disaster, psychiatric-mental health nurses are practicing which type of disease prevention? a. Primary b. Secondary c. Tertiary d. Universal
b. secondary
Nurse Perri knows that this general mindset should be applied when planning to administer psychotropics to an older adult: a. start with high dosages and go slowly b. start with low dosages and go slowly c. start with high dosages and fluctuate its speed regularly d. start with low dosages and go quickly
b. start with low dosages and go slowly
Kellan, a high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome? a. The student discusses conflicts over drug use b. The student accepts a referral to a substance abuse counselor c. The student agrees to inform his parents of the problem d. The student reports increased comfort with making choice
b. the student accepts a referral to a substance abuse counselor best to seek a professional!!
Three members of a group are engaged in a discussion surrounding the best ways to calm their anxiety when they are preparing for a medical treatment. Nurse Ella knows that the group is undergoing which phase of group development? a. orientation b. working c. termination d. camaraderie
b. working
Linda is pacing the floor and appears extremely anxious. The duty nurse approaches in an attempt to alleviate Linda's anxiety. The most therapeutic question by the nurse would be? a. Would you like to watch TV? b. Would you like me to talk with you? c. Are you feeling upset now? d. Ignore the client
b. would you like me to talk with you?
A male client admitted to the psychiatric unit for treatment of substance abuse says to the nurse, "It felt so wonderful to get high." Which of the following is the most appropriate response? a. "If you continue to talk like that, I'm going to stop speaking to you." b. "You told me you got fired from your last job for missing too many days after taking drugs all night." c. "Tell me more about how it felt to get high." d. "Don't you know it's illegal to use drugs?"
b. you told me you got fired from your last job for missing too many days after taking drugs all night confronting the client with the consequences of substance abuse helps to break through denial
Liam skips school, lies, shoplifts, and hurts his pets. These behaviors started around his 11th birthday. According to the DSM 5, Liam's conduct disorder had which onset? a. unspecified onset b. behavior-induced onset c. adolescent onset d. childhood onset
c. adolescent onset
SAMHSA states that recovery is supported by 4 major dimensions. Which dimension takes loneliness and/or supportive friends into account? a. health b. home c. community d. spirituality e. purpose
c. community
Nurse Benjie is communicating with a male client with substance-induced persisting dementia; the client cannot remember facts and fills in the gaps with imaginary information. Nurse Benjie is aware that this is typical of? a. Flight of ideas b. Associative looseness c. Confabulation d. Concretism
c. confabulation
Nurse Penny is aware that the following medical conditions is commonly found in clients with bulimia nervosa? a. Allergies b. Cancer c. Diabetes mellitus d. Hepatitis A
c. diabetes mellitus
A 32-year-old male graduate student, who has become increasingly withdrawn and neglectful of his work and personal hygiene, is brought to the psychiatric hospital by his parents. After detailed assessment, a diagnosis of schizophrenia is made. It is unlikely that the client will demonstrate: a. Low self-esteem b. Concrete thinking c. Effective self-boundaries d. Weak ego
c. effective self-boundaries someone with this disorder would NOT have adequate boundaries!!
A 39-year-old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often: a. Problems with being too conscientious b. Problems with anger and remorse c. Feelings of guilt and inadequacy d. Feeling of unworthiness and hopelessness
c. feelings of guilt and inadequacy ritualistic behavior seen in this disorder is aimed at controlling guilt and inadequacy by maintaining an absolute set pattern of behavior
A long-term goal for a paranoid male client who has unjustifiably accused his wife of having many extramarital affairs would be to help the client develop: a. Insight into his behavior b. Better self-control c. Feelings of self-worth d. Faith in his wife
c. feelings of self-worth
Nurse Tamara is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to: a. avoid shopping for large amounts of food b. control eating impulses c. identify anxiety-causing situations d. eat only three meals per day
c. identify anxiety-causing situations bulimic behavior is generally a maladaptive coping response to stress and underlying issues
Nurse Mary is caring for a client with bulimia. Strict management of dietary intake is necessary. Which intervention is also important? a. Fill out the client's menu and make sure she eats at least half of what is on her tray. b. Let the client eat her meals in private. Then engage her in social activities for at least 2 hours after each meal c. Let the client choose her own food. If she eats everything she orders, then stay with her for 1 hour after each meal d. Let the client eat food brought in by the family if she chooses, but she should keep a strict calorie count.
c. let the client choose her own food. if she eats everything she orders, then stay with her for 1 hour after each meal allowing the client to select her own food from the menu will help her feel some sense of control she must then eat 100% of what she selected; remaining with the client for at least 1 hour after eating will prevent purging bulimic clients should only be allowed to eat food provided by the dietary department
A male client who reportedly consumes 1 qt of vodka daily is admitted for alcohol detoxification. To try to prevent alcohol withdrawal symptoms, Dr. Smith is most likely to prescribe which drug? a. clozapine (Clozaril) b. thiothixene (Navane) c. lorazepam (Ativan) d. lithium carbonate (Eskalith)
c. lorazepam (Ativan)
Cely is experiencing alcohol withdrawal exhibits tremors, diaphoresis, and hyperactivity. Blood pressure is 190/87 mmHg and pulse is 92 bpm. Which of the medications would the nurse expect to administer? a. Naloxone (Narcan) b. Benztropine (Cogentin) c. Lorazepam (Ativan) d. Haloperidol (Haldol)
c. lorazepam (Ativan)
A female client is admitted to the psychiatric clinic for treatment of anorexia nervosa. To promote the client's physical health, nurse Tair should plan to: a. severely restrict the client's physical activities b. weigh the client daily, after the evening meal c. monitor vital signs, serum electrolyte levels, and acid-base balance d. instruct the client to keep an accurate record of food and fluid intake
c. monitor vital signs, serum electrolyte levels, and acid base balance
When planning inpatient psychotherapeutic activities for a patient who has antisocial personality disorder, the psychiatric-mental health nurse: a. focuses on group, rather than individual, therapy b. provides a permissive atmosphere, so the patient feels a sense of control c. provides an organized, structured environment d. recognizes that the disorder is characterized by social withdrawal
c. provides an organized, structured environment
When dementia is mistaken for depression, the condition is referred to as: a. pseudodepression b. depressive dementia c. pseudodementia d. dementia misinterpretation
c. pseudodementia
Nurse Harry is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan? a. Restrict visits with the family until the client begins to eat b. Provide privacy during meals c. Set up a strict eating plan for the client d. Encourage the client to exercise, which will reduce her anxiety
c. set up a strict eating plan for the client
A parent brings a preschooler to the emergency department for treatment of a dislocated shoulder, which allegedly happened when the child fell down the stairs. Which action should make the nurse suspect that the child was abused? a. The child cries uncontrollably throughout the examination. b. The child pulls away from contact with the physician. c. The child doesn't cry when the shoulder is examined. d. The child doesn't make eye contact with the nurse.
c. the child doesn't cry when the shoulder is examined a characteristic behavior of abused children is lack of crying when they undergo a painful procedure or are examined by a health care professional
Nurse Kim knows that Ann has anorexia nervosa because she is less than what percent of her expected weight? a. 70% b. 68% c. 50% d. 85%
d. 85%
Ernie has had dementia since he was 58. Due to this onset occurring before age 65, this places him at greater risk for what? a. delirium b. schizophrenia c. obesity d. Alzheimer's disease
d. Alzheimer's disease
During postprandial monitoring, a female client with bulimia nervosa tells the nurse, "You can sit with me, but you're just wasting your time. After you sat with me yesterday, I was still able to purge. Today, my goal is to do it twice." What is the nurse's best response? a. "I trust you not to purge." b. "How are you purging and when do you do it?" c. "Don't worry. I won't allow you to purge today." d. "I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat."
d. I know it's important for you to feel in control, but I'll monitor you for 90 minutes after you eat this acknowledges that the client is testing limits and that the nurse is setting them clients with bulimia nervosa need to feel in control of the diet because they feel they lack control over all other aspects of their lives they commonly plot purging and rarely share their secrets about it; an authoritarian or challenging response may trigger a power struggle between the nurse and client
Nurse Jeremy is preparing an intervention for a family seeking resources for family functioning support. He knows that he should refer the family to: a. American Nurses Association (ANA) b. American Psychiatric Association (APA) c. Alliance for Family Affairs (AFA) d. National Alliance on Mental Illness (NAMI)
d. National Alliance on Mental Illness
A male client is found sitting on the floor of the bathroom in the day treatment clinic with moderate lacerations on both wrists. Surrounded by broken glass, she sits staring blankly at her bleeding wrists while staff members call for an ambulance. How should Nurse Terri approach her initially? a. Enter the room quietly and move beside her to assess her injuries b. Call for staff back-up before entering the room and restraining her c. Move as much glass away from her as possible and sit next to her quietly d. Approach her slowly while speaking in a calm voice, calling her name, and telling her that the nurse is here to help her
d. approach her slowly while speaking in a calm voice, calling her name, and telling her that the nurse is here to help her the nurse shouldn't attempt to sit next to the client or examine injuries without first announcing the nurse's presence and assessing the dangers of the situation
Which of the following would an advanced psychiatric registered nurse practitioner typically NOT provide for a family? a. family therapy b. individual psychotherapy c. psychiatric medication prescriptions d. assertive communication groups
d. assertive communication groups
A male adult client voluntarily admits himself to the substance abuse unit. He confesses that he drinks 1 qt or more of vodka each day and uses cocaine occasionally. Later that afternoon, he begins to show signs of alcohol withdrawal. What are some early signs of this condition? a. Vomiting, diarrhea, and bradycardia b. Dehydration, temperature above 101° F (38.3° C), and pruritus c. Hypertension, diaphoresis, and seizures d. Diaphoresis, tremors, and nervousness
d. diaphoresis, tremors, and nervousness
Nurse Perry is aware that language development in an autistic child resembles: a. Scanning speech b. Speech lag c. Shuttering d. Echolalia
d. echolalia the autistic child repeats sounds or words spoken by others
Which of the following is true regarding the Wellness Recovery Action Plan (WRAP)? a. once signed, it is a legal document b. it is used to help formulate an escape route from domestic or sexual violence c. it should be approved by your primary care doctor d. it should be created when you are feeling well
d. it should be created when you are feeling well
A 23-year-old client that has been admitted with a diagnosis of schizophrenia says to the nurse "Yes, its march, March is little woman". That's literal you know". These statements illustrate: a. Neologisms b. Echolalia c. Flight of ideas d. Loosening of association
d. loosening of association
Nurse Trish is working in a mental health facility; the nurse's priority nursing intervention for a newly admitted client with bulimia nervosa would be... a. Teach client to measure I & O b. Involve client in planning daily meal c. Observe client during meals d. Monitor client continuously
d. monitor client continuously these clients often hide food or force vomiting; therefore they must be carefully monitored even during off-meal times
An Alzheimer's dementia patient named Carl tells Nurse Finn, "I remember that time, I remember that time...I remember that time..." while explaining a story from college. This defense mechanism of repeating the same phrases because of memory gaps is called: a. confabulation b. world salad c. sublimation d. perseveration
d. perseveration
A 24-year old client with anorexia nervosa tells the nurse, "When I look in the mirror, I hate what I see. I look so fat and ugly." Which strategy should the nurse use to deal with the client's distorted perceptions and feelings? a. Avoid discussing the client's perceptions and feelings b. Focus discussions on food and weight c. Avoid discussing unrealistic cultural standards regarding weight d. Provide objective data and feedback regarding the client's weight and attractiveness
d. provide objective data and feedback regarding the client's weight and attractiveness by focusing on reality, this strategy may help the client develop a more realistic body image and gain self-esteem
Accompanied by many family members, a 16-year-old Chinese-American female patient is admitted to the unit with reports of sadness and suicidal ideation. The patient and her family emigrated from mainland China five years ago. Regarding the family, the psychiatric and mental health nurse: a. encourages the patient to communicate her need for privacy to her family b. gently asks the family members to leave the room c. privately asks the mother for her assistance in clearing the room d. provides care for the patient while the family members are present
d. provides care for the patient while the family members are present
Nurse Penny is aware that the symptoms that distinguish post-traumatic stress disorder from other anxiety disorders would be: a. Avoidance of situation & certain activities that resemble the stress b. Depression and a blunted affect when discussing the traumatic situation c. Lack of interest in family & others d. Re-experiencing the trauma in dreams or flashback
d. re-experiencing the trauma in dreams or flashbacks
To establish an open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should? a. Encourage the staff to have frequent interaction with the client b. Share an activity with the client c. Give client feedback on behavior d. Respect client's need for personal space
d. respect client's need for personal space
Mario is complaining to other clients about not being allowed by staff to keep food in his room. Which of the following interventions would be most appropriate? a. Allowing a snack to be kept in his room b. Reprimanding the client c. Ignoring the client's behavior d. Setting limits on the behavior
d. setting limits on the behavior limits need to be set on the client's manipulative behavior to help the client control dysfunctional behavior a consistent approach by the staff is necessary to decrease manipulation
Which of the following would Nurse Hazel expect to assess for a client who is exhibiting late signs of heroin withdrawal? a. Yawning & diaphoresis b. Restlessness & Irritability c. Constipation & steatorrhea d. Vomiting and Diarrhea
d. vomiting and diarrhea
Which of the following does NOT contribute to one's risk of obtaining an intellectual disability? a. sociocultural factors b. genetics c. damage in utero d. general medical conditions e. gender
e. gender