Mental Health Exam 2

A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems? Select all that apply. 1 Dementia 2 Multiple losses 3 Declines in health 4 A milestone birthday 5 An injury requiring hospitalization

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After a client has a spontaneous abortion at 12 weeks' gestation, the nurse notes that she and her partner are visibly upset. The partner has tears in his eyes, and the client is sobbing quietly with her face turned to the wall. At this time, what is the nurse's most therapeutic statement? 1. ill be here if you want to talk 2. try to relax, it'll speed the healing process 3. with any luck you'll get pregnant again soon 4. it's best that this happened early rather than having the baby die after it was born

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The nurse identifies that a client who had extensive abdominal surgery appears depressed. The most appropriate nursing action is: 1Talking with the client and encouraging exploration of feelings 2Asking the client's primary health care provider to prescribe an antidepressant medication 3Understanding that the client's depression is an expected response to surgery 4Reassuring the client that feelings of depression will lift after returning home

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A depressed client has been sitting alone in a chair most of the day and displays no interest in eating. How should the nurse plan to meet this client's nutritional needs? 1. stay with the client during meals 2. take the client to the dining room 3. bring the client a tray of finger foods 4. talk with the client about the importance of nutrition

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A client is lonely and extremely depressed, and the health care provider prescribes a tricyclic antidepressant. The client asks the nurse what the medication will do. What is the best response by the nurse? 1. this drug will help you forget why you're lonely and depressed 2. the medication will increase your appetite and make you feel better 3. you'll start to feel much better after taking this medication for 2-3 days 4. you'll feel less depressed when you take this with the monoamine oxidase inhibitor

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A nurse facilitating a support group of widows and widowers recalls that research indicates that the probability of a spouse having a pathological or morbid grief response will be greater in what case? 1The couple had an ambivalent relationship 2The cause of the spouse's death was suicide 3The relationship between the spouses was satisfying 4There was a long preparatory grief period before a spouse's death.

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Which recommendation is best to minimize the risk of hypertension? 1 1200 calorie diet 2 no added salt to diet 3 low cholesterol diet 4 high protein, low fiber diet

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a nurse is caring for a client with bipolar I disorder. what should the plan of care for this client include? select all that apply. 1. touching the client to provide reassurance 2. providing a structured environment for the client 3. ensuring that the client's nutritional needs are met 4. engaging the client in conversation about current affairs 5. designing activities that require the client to maintain contact with reality

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A client with the diagnosis of bipolar disorder, depressive episode, has been hospitalized on a psychiatric unit for 1 week. What is the most appropriate activity for this client? 1. completing a jigsaw puzzle alone 2. playing cards with several other clients 3. talking with the nurse several times during the day 4. engaging in a game of table tennis with another client

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An 89-year-old client with osteoporosis is admitted to the hospital with a compression fracture of the spine. The nurse identifies that a factor of special concern when caring for this client is the client's: 1. the client's irritability in response to deprivation 2. the client's increased ability to recall recent facts 3. the client's inability to maintain an optimal level of functioning 4. the client's gradual memory loss resulting from change in the environment

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When should Abigail begin to feel less depressed? 1. 4 weeks 2. 3-4 days 3. 1-3 weeks 4. 6 weeks

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the nurse is reviewing the medical data of four clients with depression. which client is most likely to exhibit the clinical manifestation of irritability? 1. 2 year old 2. 3 year old 3. 13 year old 4. 35 year old

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what is the greatest difficulty for nurses caring for the severely depressed client? 1. client's lack of energy 2. negative cognitive processes 3. contagious quality of depression 4. client's psychomotor retardation

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What signs and symptoms should the PN expect if a client taking an MAO antidepressant ingests foods containing tyramine? 1 muscle stiffness and shuffling gait 2 diarrhea and increased thirst 3 confusion and sore throat 4 headache and palpitations

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a woman with bipolar disorder, manic episode. has been spending thousands of dollars on clothing and makeup. she has been partying in bars every night and rarely sleeps or eats. the nurse in the outpatient clinic, knowing that this client rarely eats, recognizes that her eating problems most likely result from what? 1. feelings of guilt 2. need to control others 3. desire for punishment 4. excessive physical activity

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A nurse is assigned to care for a group of clients who have been found to have depression. Which clinical manifestations does the nurse anticipate? Select all that apply. a) Lability of affect b) Specific food cravings c) Neglect of personal hygiene d) "I don't know" answers to questions e) Apathetic response to the environment

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Relatives of the victims of a home invasion in which several family members were killed receive crisis intervention services. Which therapy is most beneficial after the immediate event has passed? 1. grief 2. family 3. psychoanalytical 4. psychoeducational

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Since Abigail has decreased energy, which intervention is best? 1. plan a scheduled rest period 2. allow for short, frequent naps 3. minimize caffeine in the morning 4. excuse Abigail from exercise

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What role do thyroid levels play in depression? 1. hypothyroidism cal lead to feeling sluggish and depressed 2. hyperthyroidism can cause fatigue, weight gain, and depression 3. the results can be helpful for determining medication therapy for depression 4. baseline thyroid levels are required prior to antidepressant medication therapy

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Which behavior is inconsistent with depression? 1. hearing a man's voice 2. poor concentration 3. poor grooming and hygiene 4. slow motor activity

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Which explanation is best? 1. this medication will help you think more clearly 2. several medications can help you sleep better 3. this will control impulsive feelings you may experience 4.it will enhance the effectiveness of antidepressant

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which behavior justifies short-term involuntary treatment? 1. unable to meet basic self care 2. experiencing auditory hallucinations 3. living alone and lack of social support 4. prior hospitalizations for depression

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Which activity is the least therapeutic for a severely depressed client? 1. simple short term activity 2. activity selected by the client 3. monotonous repetitive activity 4. specific activity to be followed

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Which specific nursing consideration is most important? 1 Monitor blood pressure and orthostatic blood pressure. 2 Maintain a low- or tyramine-free diet for 10 to 14 days. 3 Arrange for liver function tests for hepatic dysfunction. 4 Observe Abigail's mood and affect.

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what is true about the effect of grief and loss in toddlers? 1. they show resilience after a loss 2. they express a sense of change in sleeping 3. they understand the concepts of performance 4. they get disrupted in developing an autonomous sense of self

2

which of these symptoms are depression commonly observed in older adults? select all that apply 1. fatigue 2. sadness 3. agitation 4. increased sleep 5. increased appetite

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the nurse is working with a client who talks freely about feeling depressed. during the interaction the client states "things will never change". what findings support the nurse's conclusion that the client is experiencing hopelessness? select all that apply. 1. bouts of crying 2. self destructive acts 3. presence of delusions 4. feelings of worthlessness 5. intense interpersonal relationships

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When Abigail awakens from the treatment, the PN should be prepared to perform which nursing action(s)? (Select all that apply). 1 give Tylenol for headache and muscle aches 2 determine level of consciousness and orientation 3 begin 24 hour seizure precautions 4 take vital signs and 02 level 5 provide stimulation to increase

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A client is admitted to the hospital with a diagnosis of depression. What clinical manifestations of depression does the nurse expect when assessing this client? 1Flight of ideas 2Suspicion of others 3Psychomotor retardation 4Intrusive social behaviors

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A depressed client has feelings of failure and a low self-esteem. In what activity should the client initially be encouraged to become involved? 1. joining other clients in playing board game 2. singing in a karaoke contest to be held at the end of the week 3. assisting a staff member in working on the monthly bulletin board 4. selecting the movie to be played during the evening recreation period

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A parent whose daughter is killed in a school bus accident tearfully tells the nurse, "My daughter was just getting over the chickenpox and didn't want to go to school, but I insisted that she go. It's my fault that she's dead." How should the nurse anticipate that perceiving a death as preventable will likely influence the grieving process? 1.The loss may be easier to understand and accept 2.The mourner may experience pathological grief 3.Bereavement may be of greater intensity and duration 4.The grieving process may progress to a psychiatric illness

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According to this data, what is the priority nursing problem? 1. disturbed thought processes 2. impaired social interaction 3. sleep disturbance 4. nutrition imbalance

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A client is admitted to the hospital after sustaining serious burns that involve a large surface of the skin. The nurse is caring for the client during the emergent phase after the injury. Which nursing objective is the priority during this phase? 1 Alleviate pain 2 Prevent infection 3 Replace blood loss 4 Restore fluid volume

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A client with a history of sleeplessness, lack of interest in eating, and excessive purchases on charge accounts is seen in the mental health clinic. The adaptation that the nurse should expect the client to exhibit is: 1. depressed mood 2. increased insight into behavior 3. decreased psychomotor activity 4. intrusive involvement with environmental activities

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A nurse is caring for a group of depressed clients. What should the nurse attempt to provide? 1 a variety of stimuli 2 many varied activities 3 opportunities to make decisions 4 an uncomplicated daily schedule

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A primary healthcare provider tells a client about the diagnosis of inoperable cancer and that the client does not have long to live. After the primary healthcare provider leaves, the client says to the nurse, "I feel fine. I probably only have the flu." The nurse determines that the client is in the denial stage of grief. What should the nurse do to help meet the client's emotional needs? 1. reassurance the client that everything will be alright 2. leave the client alone to confront feelings of impending loss 3. encourage the denial until the client is able to accept reality 4. allow the denial and be available to discuss the situation with the client

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What will ensure that Abigail will be safe? 1 Abigail reports feeling less depressed and sleeping better. 2 Staff document that Abigail's mood is less depressed. 3 There are no items in Abigail's room to cause self-harm. 4 Abigail agrees to talk with the staff if thoughts of self-harm occur.

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The nurse is caring for a client with the diagnosis of bipolar disorder, manic episode. Which clinical findings support the diagnosis? select all that apply. 1. passivity 2. dysphoria 3. anhedonia 4. grandiosity 5. talkativeness 6. distractibility

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As the PN initially communicates with Abigail, which communication technique is important? 1. reinforce that Abigail will progressively feel better 2. calmly reassure abigail that everything will be fine 3. calmly reassure abigail that everything will be fine 4. explain that antidepressants are the best treatment option

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A client presents to the emergency department with weakness and dizziness. The blood pressure is 90/60 mm Hg, pulse is 92 and weak, and body weight reflects a 3-pound (1.4 kilogram) loss in two days. The weather has been hot. Which condition should the nurse conclude is the priority for this client?1Deficient fluid volume 2Impaired skin integrity 3Inadequate nutritional intake 4Decreased participation in activities

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a client who was forced into early retirement is found to have severe depression. the client says "I feel useless, and I've got nothing to do". what is the best initial response by the nurse? 1. tell me more about feeling useless 2. volunteering can help you fill your time 3. your illness is adding to your current feelings 4. let's talk about what you'd like to be doing right now

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an antidepressant is prescribed for a depressed older client. after 1 week the client's son expresses concern that there does not seem to be much improvement. how should the nurse respond? 1. antidepressant therapy requires several weeks before it become effective 2. antidepressants therapy will be more effective as the physical condition improves 3. additional medications may be required before behavioral changed in observed 4. additional time is needed for the medication to become effective because of the prolonged depression

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During a home visit the nurse obtains information regarding a postpartum client's behavior and suspects that she is experiencing postpartum depression. Which assessments support this conclusion? Select all that apply 1. lethargy 2. ambivalence 3. emotional lability 4. increased appetite 5. long periods of sleep

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which feelings and behavior can be observed in early preschool children in response to the divorce of parents? select all that apply. 1. regressive behavior 2. increased tantrums 3. blaming themselves for the divorce 4. depression and immature behavior 5. bewilderment regarding all human relationships

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The nurse understands that a VDRL is routinely done on admission for which reason? 1. routine screenings for STDs are necessary 2. it is a screening test for syphilis 3. abnormal thyroid levels require treatment 4. if positive isolation is necessary

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A client is admitted to the mental health hospital with the diagnosis of major depression. What is a common problem that clients experience with this diagnosis? 1Loss of faith in God 2Visual hallucinations 3Decreased social interaction 4Ambivalent feelings about the future

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A client scheduled to begin electroconvulsive therapy (ECT) to treat severe depression that has not responded to any of the antidepressant medications tells the nurse, "I'm scared that I'll lose my memory forever after the treatment." What is the most therapeutic response by the nurse? 1. your memory loss may be permanent, but usually it's just temporary 2. you won't experience a permanent memory loss, so there's no need to be frightened 3. you'll experience a temporary loss of memory, and feeling frightened about it is expected 4. your memory loss will be temporary, and it will help block out many of your painful past experiences

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What is the major action of SSRI antidepressants? 1. enhance GABA 2. potentiate seretonin and norepinephrine 3. increase availability of serotonin 4. stimulate the release of serotonin

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Which DSM-IV-TR axis would the PN use to interpret for the presence of hypertension? 1 axis I 2 axis II 3 axis III 4 axis IV

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Which side effects commonly occur in clients who are taking SSRI antidepressants? 1. anticholinergic effects 2. extrapyramidal side effects 3. gastrointestinal disturbances 4. neuroleptic malignant effects

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a depressed client says "im no good im better off dead" what is the priority nursing intervention? 1. responding "I stay with you until you're less depressed" 2. replying "I think you're good; you should think about living" 3. alerting the staff to schedule 24-hour observation of the client 4. unobtrusively removing those articles that may be used in suicide attempt

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a health care provider prescribes divalproex. what does the nurse consider an appropriate indication for the use of this drug? 1. control of acute agitation of schizophrenia 2. treatment of the agitated phase of a paranoid state 3. management of manic episodes of bipolar disorder 4. modification of the depressive phase of major depression

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A depressed client is admitted to the mental health unit. What factor should the nurse consider most important when evaluating the client's current risk for suicide? 1. history of suicide attempts 2. lack of interest in appearance 3. how long the depression has existed 4. impending anniversary of the loss of a loved one

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A nurse is working with a client experiencing a major depressive episode. What is a long-term outcome for this client? 1. talking openly about the depressed feelings 2. identifying and using new defense mechanisms 3. discussing the unconscious source of the anger 4. verbalizing realistic perceptions of self and others

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During an interview a 32-year-old man describes symptoms of decreased appetite, insomnia, anhedonia, and feelings of worthlessness that have been present for the past few weeks. He reports having had a few episodes of feeling depressed in the past but says that the feelings subsided. Recently he has felt worse, and he is now concerned that his symptoms are negatively affecting his job performance and fears he may lose his job "if someone doesn't help me soon." The nurse suspects these symptoms are related to: 1Schizophrenia 2Bipolar disorder 3Dysthymic disorder 4Major depressive disorder

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a client is an acute mental health unit appears severely depressed. the client does not initiate conversations or perform personal care. questions are answered with a barely audible one or two words response. the nurse sits with the client makes no demands. on what premise is the nurse's intervention for this client based? 1. nurse are required to spend time with assigned clients 2. environmental stimulation helps depressed clients feel more worthwhile 3. nurses are expected to initiate one to one interactions on an acute care unit 4. spending time with depressed clients demonstrates that they are worthy of attention

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