Mental Health Chapters 8-12

Which of the following is TRUE in the stage of "fight or flight" of the general adaptation syndrome? A. Heart rate is decreased. B. The blood vessels constrict. C. The blood vessels dilate. D. Exhaustion occurs.

B

When developing a care plan for Ms. Smith, who was diagnosed with schizophrenia and is receiving haloperidol, which of the following medications would Nurse Janet expect to administer if the patient developed extrapyramidal side effects (EPS)?

Benztropine mesylate (Cogentin)

According to Hans Seyle, if a person does not adapt to the stress in his or her surroundings, eventually the person will experience:

Exhaustion

When planning care for a female patient diagnosed with obsessive and compulsive behavior, Nurse Barbara and case manager Marc must recognize that the ritual:

Helps the patient to be in control of their anxiety.

Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed?

Hypertensive Crisis

Which statement is most likely to be from a patient in a manic episode?

I dont need to sleep

Somatic symptoms are mild, anxiety is severe. Hypochondriasis was previous term for this disorder. "Fear of getting a disease"

Illness Anxiety

Which of the following is true about lithium? A. It is available in multiple formulations, including IV and suppository. B. It is generally discontinued for 2 weeks prior to any major surgery. C. It is used on a prn basis when the patient feels anxious. D. None of the above

None of the above

Neurological short circuit that causes repetitive behaviors. Reoccurring thoughts, ideas, and actions that interfere with persons ability to function. Perfectionists

Obsessive Compulsive Disorder (OCD)

Symptoms include- diaphoresis, chest pain, increased pulse, paralysis. Recurrent condition that cannot be controlled. Reaches its peak in a short period but can lead to intense fear it will happen again.

Panic

Most common of anxiety disorders- most start in childhood but can develop later in life. Irrational fear that may or may not be displaced

Phobia

Your new patient admitted to the psychiatric unit is pacing and agitated. Which of the following is the most appropriate intervention

Place him in a quiet area away from other patients

Recurring, disturbing memories that last over a period of time. Flashbacks.

Post Traumatic Stress Disorder (PTSD)

Marnie is a 16-year-old patient with bipolar disorder. She is manic right now and is in the hallway naked, making sexual requests of the staff and other patients. What is your best course of action?

Quietly approach her, escort her to her room, and assist her in getting dressed.

Nurse Janet is aware that the symptoms that distinguish post-traumatic stress disorder (PTSD) from anxiety disorders include:

Re-experiencing the trauma in dreams or flashback.

The nurse knows that the two factors that often differentiate major depression from dysthymia depression are:

Severity and duration of symptoms

Pete has recently been admitted to the hospital and is being treated for bipolar disorder. When you go to check in on him, he tells you that he is feeling very drowsy and has been vomiting. He is also running a fever. You suspect that Pete's problem is caused by:

Side effects of the lithium therapy he is receiving.

Your patient has been taking Buspar for 1 month. On returning to the clinic for a follow-up visit, which statement would describe medication effectiveness?

Sleeping better

Results in significant disruption of functioning. excessive and disproportionate thoughts, feelings, behaviors. Must be present for 6 months. Focus on physical symptoms that interferes with ones daily functioning.

Somatic Symptom Disorder (SSD)

Your new patient is admitted to the ER after a car accident. She is extremely anxious. Which intervention is most helpful?

Stay with her in the exam room

A patient being medicated with haloperidol for over 4 weeks has started to display symptoms of involuntary movements of the mouth that resemble chewing. Of the following extrapyramidal adverse reactions, the client is showing signs of:

Tardive Dyskinesia

A 30-year-old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. His family reports that for the past 2 months he has been in constant motion, sleeping very little, spending lots of money, and has been "full of ideas." During the initial assessment with the client, the nurse would expect him to exhibit which of the following?

exaggerated self importance

. Lithium toxicity is most likely with which of the following patients? A. Elderly man with diarrhea from food poisoning B. Teenage girl on oral contraceptives C.40-year-old man who smokes marijuana on the weekend D. All of the above are at high risk

A

Which of the following best describes bipolar I disorder? A. Full manic cycles with possibility of depression. B. Disturbance in mood that is a direct result of physiological effects of substance abuse. C. Periods of mild mania followed by mild depression. D. Intense depression followed by normal mood.

A

Which of the following is a priority in dealing with a highly anxious patient? A. Provide support to reinforce a sense of security. B. Implement strict limit setting to control behavior. C. Increase environmental stimuli to distract the patient. D. Provide more freedom to promote self-expression.

A

Which of the following medications would generally NOT used to treat anxiety? (Select all that apply) A. Haloperidol B. Carbamazepine C. Buspirone D. Alprazolam E. Clonidine F. Lorazepam

A,B

The following are levels of anxiety (select all that apply): A. Mild. B. Moderate. C. Severe. D. Panic.

A,B,C,D

Commonly used typical antipsychotic agents are (select all that apply): A. Thorazine. B. Stelazine. C. Prolixin. D. Risperdal. E. Haldol.

A,B,C,E

Nursing preparations for a client undergoing electroconvulsive therapy (ECT) resemble those used for general anesthesia (select all that apply): A. Monitors the patient's vital signs before and after the procedure. B. Medicate prior to procedure if ordered. C. Educate patient and patient's family. D. Consent is not required. E. The patient may be slightly confused after the procedure.

A,B,C,E

The following conditions can be stress related (select all that apply): A. Asthma. B. Cancer. C. Burnout. D. Hunger. E. Immunity impairment.

A,B,C,E

The side effects of ginkgo biloba include (select all that apply): A. Bleeding. B. Nausea and vomiting. C. Diarrhea. D. Fishy reflux. E. Headache.

A,B,C,E

While assessing your patient, you realize the patient is experiencing a manic episode. You will most likely expect (select all that apply): A. Decreased need for sleep. B. Extreme irritability. C. Extreme depression. D. A surge of energy. E. A loss of interest in ordinary activities.

A,B,D

While observing a female patient on the oncology unit who has a secondary diagnosis of panic attacks, the nurse would expect to observe which of the following symptoms (select all that apply): A. Nausea. B. Diaphoresis. C. Ritualistic behavior. D. Increased pulse.

A,B,D

Annie has been diagnosed as having dysthymic depression. The nurse knows that symptoms of this disorder include: (Select all that apply) A. A depressed mood that lasts for most of each day over a 2-year period B. Low self-esteem C. Hallucinations D. Difficulty in making decisions E. Periods of euphoria F. Sleep pattern disturbances

A,B,D,F

Which of the following may be seen in a patient experiencing panic attacks? (Select all that apply) A. Feels faint B. Thinks he or she is having a heart attack C. Gains a sense of serenity D. Able to focus on minute details E. Dry mouth and trembling hands

A,B,E

When teaching patients taking St. John's wort about drug and food interactions, the nurse will inform them of the following precautions (select all that apply): A. Avoid foods containing large amounts of tyramine. B. Eat adequate amounts of meat and cheese. C. Increase the length of time in sunlight. D. Consult your physician before taking any over-the-counter flu and cold medications. E. It may decrease the effects of MAOIs.

A,D

The following medications are used for treatment in mental health disorders (select all that apply): A. Antipsychotics. B. Antibiotics. C. Antifungals. D. Stimulants. E. Mood stabilizers.

A,D,E

Which of the following nursing interventions apply to all depressed patients? (Select all that apply) A. Show patience B. Monitor lithium levels C. Monitor for suicidal ideation D. Communicate effectively E. Provide meaningful activities F. Include alternative therapies in the treatment plan

A,D,E

A client is unwilling to go out of the house for fear of "having to get on a elevator or be in small room." Because of this fear, the client remains home except when accompanied outside by the spouse. The nurse suspects that the client has:

Agoraphobia

Your patient with major depression tells you he suffers from urinary retention. Which medication would be most likely to cause this?

Amitriptyline

Some medications such as tricyclics cause blurred vision. What is the cause of this effect?

Anticholinergic effect

When working with a female client experiencing a phobia about spiders, Nurse Toni should anticipate that a problem for this client would be:

Anxiety when speaking of the feared item.

Which of the following are signs of mania? (Select all that apply) A. Pessimistic feelings B. Increased sexual drive C. Denial that anything is wrong D. Decreased energy E. Decreased need for sleep

B,C,E

Which of the following should be included in patient teaching about antidepressants (select all that apply)? A. Medications take 1 week to become effective. B. Encourage patients to continue taking the medication. C. Not all antidepressant medications have to be tapered gradually. D. Patients don't have to be monitored for suicidal ideations. E. If it is an MAOI antidepressant, the patient should avoid foods containing the amino acid tyramine.

B,E

What type of behavior modification is being used when the patient transforms into a relaxed state? (Documented by checking their heart rate and blood pressure.)

Biofeedback

. A newly admitted client has been diagnosed with major depressive disorder. Which nursing diagnosis takes priority? A. Impaired social interaction B. Self-esteem deficit C. Hopelessness D. Self-care deficit

C

Which of the following best explains why tricyclic antidepressants (TCA) are used cautiously with the elderly population?

Cardiovascular system effects

Nurse Arlene recognizes that the focus of environmental (MILIEU) therapy is

Control the environment to bring about a positive behavior change.

Illness emerged from overuse of defense mechanism. Loss in physical functioning that cannot be explained by any known medical disorder. Symptoms feel very real to the patient.

Conversion Disorder

Which activity would be best for a depressed patient

Drawing

What is the main difference between major depression and dysthymic depression?

Dysthymia is a chronic, low-level depression that lasts for years, while major depression is more severe

Helen, a 47-year-old client with a long history of severe depression, has not responded to antidepressant medications or psychotherapy. The nurse caring for the patient knows that the treatment of choice for depression unresponsive to conventional treatment would be:

ECT

Lynn, the LPN/LVN, is providing care for a patient diagnosed with depression. The patient is not responding to any of the medications ordered. The nurse foresees this patient may be a candidate for:

Electroconvulsive Therapy.

When an individual is taking secretive actions to misrepresent, simulate or cause signs/symptoms of an illness in the absence of obvious external rewards

Factitious

All aspects of life become involved, disorder is debilitating, restlessness, difficulty concentrating, last 6 months or longer

Generalized Anxiety Disorder (GAD)

Linda says that she feels confused and anxious. In addition, Linda feels unorganized and states, "It is as not bad as it seems." What phase of crisis is Linda experiencing?

Impact.

Your depressed patient is starting a new medication called phenelzine (Nardil). Which teaching would be most important to emphasize?

Instruct the patient and family about the many food-drug interactions.

Light therapy has been shown to be effective in treating patients with:

Major Depression with seasonal pattern

Which of the following is an important intervention for a patient taking nortriptyline

Monitor for anticholinergic side effects

Your depressed patient who is taking a tricyclic antidepressant is advised of possible anticholinergic side effects. Which of the following is NOT an anticholinergic side effect?

Muscle rigidity.

Albert Ellis, who developed the theory of RET, thought that people teach themselves to be ill. He used the following terminology:

Musturbation and awfulizing

. When preparing the discharge plans for a patient with chronic anxiety, Nurse Barbara evaluates the goals that were set for the patient. Nurse Barbara also evaluates if the patient has achieved the discharge long-term goals. Which goal would be most appropriate to be include in the plan of care requiring evaluation?

Patient is able to identify triggers that produce anxiety

You are working with the RN to plan short-term goals for a 28-year-old hospitalized manic client. Which is the most important goal?

Protection from self inflicted harm.

Your manic patient is being discharged on lithium. Which of the following would NOT be in the teaching plan?

Restrict fluids while taking this drug.

When teaching Mary, who has depression, about foods to avoid while taking phenelzine (Nardil), which of the following would Audrey LPN include A. Peanut butter B. Fresh fish C. Salami D. Soup

Salami.

During electroconvulsive therapy (ECT), the patient is monitored carefully before and after the procedure. The nurse assisting with this procedure is aware that monitoring is necessary because the patient may suffer from:

Seizure activity.

The home health nurse is informed by her patient that she is taking a herbal over-the-counter medication. What action should the nurse take with this information?

The nurse should document this information and add it to the patient's medication list and notify the charge nurse of the change.

Andrea, the charge nurse, spoke to the director of nursing about one of the staff nurses having a crisis. The nurse suggested a crisis intervention group to the staff nurse. Crisis intervention groups are successful because:

The patient is assisted to develop new insights and return to the precrisis phase

. Counseling is a field that requires licensing. This licensing is providing by:

The state

Reiki is a term that means:

Universal life energy

When observing a patient receiving tricyclic antidepressant therapy, ________________would bring attention to the nurse that the patient was undergoing anticholinergic effects.

Urine retention and changes in blood glucose.

In caring for a patient with major depression, the nurse knows that the patient needs:

Well-defined, structured interactions at the beginning of treatment