mental health ati review

adverse affects of ECT that should be communicated to patient?

temproary disorientation and confusion memory deficits are possible

drug class of methylphenidate?

CNS stimulant adverse effect: tachycardia, weight loss, dry mouth

a nurse is assessing a client who has borderline personality disorder. which of the following should the nurse expect? a. emotional lability b. self sacrificing c. suspicious of others d. grandiosity

a.

what is emotional lability

the rapid transition from one emotion to another and is a primary feature of borderline personality disorder.

what herbal should not be taken with paroxetine and why ?

st. johns wort because it decreases the reuptake of serotonin and so does this SSRi so it puts the client at risk for serotonin syndrome

a client who is experiencing alcohol withdrawal is expected to have what manifestations?

HTN tachycardia fever greater than 101

while observing group therapy, a nurse recognizes that a client is behaving in a way suggestive of dependent personality disorder. which of the following behaviors is consistent with this condition? a. the client needs excessive external input to make everyday decisions b. the client demonstrates a dedication to his job that excludes time for leisure c. the client adheres to a rigid set of rules d. the client has difficulty starting new relationships unless he feels accepted

a.

a nurse is caring for a client who has schizo and was prescribed a conventional antipsychotic medication yesterday. which of the following findings indicates the nurse should administer benztropine 2 mg IM?? a. shuffling gait b. hypotension c. decreased WBC d. blurred vision

a. benztropine is used to treat parkinsonism manifestations such as shuffling gait all the rest are AE of conventional antipsychotics however they are not treated with benztropine.

a nurse is reviewing laboratory results for a client who has schizophrenia and is taking clozapine. which ofthe following values should the nurse ID as a contraindication for receiving clozapine> a. WBC 2500 b. Hgb 11.5 c. platelets 150,000 d. RBC 3.5 million

a. clozapine can cause agranulocytosis which can be fatal.

a nurse is admitting a client who has anorexia nervosa and is at 60% of ideal body weight. which of the following interventions should the nurse include in care? a. encourage the client to drink 125 ml of fluid each hour while awake b. allow the client to eat independently in their room. c. weight the client twice weekly d. measure the clients VS once a day

a. the nurse should to this to maintain hydration.

when should client with Alzheimer's take donepezil?

at bedtime for optimal effectiveness

clients with _________ are unwilling to get involved socially unless they feel accepted

avoidant personality disorder

being suspicious of others is a feature of ________. these clients also ______ and can be ______

paranoid personality disorder. also project blame onto others and can be hostile and violent

a charge nurse enters a clients room and observes an AP hitting the client. after moving the client to safety, which of the following actions is the priority? a. complete an incident report b. determine if the client has been physically harmed c. provide emotional support to the client d. discipline the AP

b.

a nurse is planning prevention strategies for intimate partner abuse in the community. which of the following strategies should the nurse include as a method of secondary prevention? a. provide teaching about the use of positive coping mechanisms b. establish screening programs to ID at risk clients c. refer survivors of intimate partner abuse to a legal advocacy program d. organize rehab therapy for clients who have experienced intimate partner abuse

b. a is primary prevention because it can prevent the abuse. c and d are tertiary prevention because it is after the abuse

a nurse is planning care for a client with a new prescription for olanzapine. which of the following interventions should the nurse id as the priority? a. advise the client to take freq. sips of water. b. instruct the client to avoid driving during initial therapy c. consult a dietitian for a calorie controlled diet plan d. recommend that the client exercise daily

b. the greatest risk to this client is injury resulting from drowsiness or dizziness.

a nurse in a mental health clinic is caring for a client who has bipolar disorder and reports that she stopped taking lithium 2 weeks ago. the nurse should recognize which of the following as an expected AE that could have caused her to stop taking it ? a. sore throat b. fine hand tremor c. photophobia d. constipation

c. fine hand tremors are an expected AE of lithium and can interfere with ADLs causing them to stop taking.

client with anorexia. which requires hospitalization? a. weight loss of 10% of body weight in 3 mo. b. potassium 3.8 c. temperature of 96.1 d. HR 54/ min

c. severe hypothermia is less than 96.8 d/t loss of SQ tissue. if they lost 30% of body weight in 6 mo it would require hospitalization.

during morning rounds, a nurse finds a client who has schizo trembling and reports that a bomb was placed in her room by a family member during visitation. what action should the nurse take? a. ask the client to identify the bomb in the room b. initiate disaster protocols c. assess the client for evidence of a perceptual disturbance d. convince the client there is no bomb in her room

c. determine if they are hallucinating or illusions

a nurse is planning care for a client who is to undergo ECT. which of the following should be included in the plan? a. administer phenytoin 30 min prior to the procedure. b. instruct the client to expect a HA following the procedure c. place client in 4 point restraints prior to the procedure d. monitor cardiac rhythm during procedure

d. a seizure induced during ECT can stress the heart.

a nurse is caring for a child who has conduct disorder and is being very aggressive, throwing objects and kicking others. which is the priority? a. encourage expression of feelings b. promote attendance at an assertiveness training group c. assist the client to perform relaxation breathing. d. reduce environmental stimuli

d. the greatest risk is harm so this intervention is used to attempt to de escalate their behavior and prevent injury. the other options are correct but not the priority

which is an example of justice? a. allowing a client to choose which unit activities to attend. b. attempting alternative therapies instead of restraints for client who is combative c. providing client with accurate info about prognosis d. spending adequate time with a client who is verbally abusive

d. when the nurse spends an appropriate amount of time with each client regardless of their behavior and in keeping with their individual needs, the nurse guarantees that all clients receive equal care. a is autonomy b is nonmaleficence c is veracity

goal of operant conditioning?

provide positive reinforcement in return for desired behavior.

what otc should you instruct client being prescribed tranylcypromine to avoid a. lansoprazole b. naproxen c. mag hydroxide d. phenylephrine

d. or any other otc meds for sinus congestion, colds, or allergies d/t their actions on the sympathetic NS which can result in severe HTN

self sacrificing is a feature of what disorder

dependent personality disorder also excessively clingy and submissive

what therapy is usually used to treat phobias?

desensitization therapy

how often should nurse weight anorexic client

during the first week of treatment, when they wake up, after voiding, and before having anything to drink of eat. then, 3 times a week.

how often do seclusion orders have to be renewed

every 4 hours for up to 24 hours

light therapy can cause what? what should you teach the client?

eye strain and sensitivity to light. teach client to wear sunglasses when outdoors

drug class of tranylcypromine

maoi

feelings of grandiosity are a feature of _____. these clients are also___

narcissistic personality disorder. these clients are also exploitive, filled with rage and are sensitive to criticism