Mental Health Exam 3 Review

The body can metabolize how much beer per hour without intoxication? A. 12 oz B. 28 oz C. 16 oz D. 14 oz

A) 12 Oz

What is therapeutic lithium level?

0.6-1.2 mEq/L

A client with a recent diagnosis of OCD is scheduled to begin pharmacotherapy. What health education is most relevant to the clients likely drug regimen? a) "You'll likely be given pills that you will take once a day" b) "You'll need to have your blood drawn once a week after starting but no more after that" c) "It will likely take 3 to 5 days before you feel the benefits" d) "You'll probably be given tablets dissolve under your tongue when your obsessions worsen"

a) "You'll likely be given pills that you will take once a day"

The onset of major depressive disorder is most common among people who are in their: a) 20s b) Teens c) 30s d) 40s

a) 20s

A client has recently been diagnosed with OCD. When performing an assessment of a client, the nurse would most likely identify what comorbid signs and symptoms? a) Anhedonia, insomnia, and thoughts of hopelessness b) Narcissism, agitation, and lack of empathy c) Substance abuse, and history of aggression d) Hallucinations and delusions

a) Anhedonia, insomnia, and thoughts of hopelessness Depression is present in approximately 1/3 of clients with OCD. Clients with depression commonly experience anhedonia, insomnia,and hopelessness

A client diagnosed with Alzheimer's disease has an alteration in language ability. This alteration would be documented as what? a) Aphasia b) Akinesia c) Agnosia d) Apraxia

a) Aphasia

When administering and monitoring antidepressant therapy in a client, what would be the most appropriate for the nurse to do? Select all that apply a) Assess orthostatic vital signs before beginning therapy b) Observed the client for cheeking of the medicines c) Obtain liver functions studies at least once a week d) Ask the client about the use of any herbal supplements e) Check plasma drug concentrations one hour before the next dose

a) Assess orthostatic vital signs before beginning therapy b) Observed the client for cheeking of the medicines d) Ask the client about the use of any herbal supplements

A nurse is developing a plan of care for a client with bipolar disorder. When preparing to administer medication, which agent with the nurse and his feet as being prescribed as the mainstay of pharmacotherapy? Select all that apply a) Carbamazepine b) Lithium c) Fluoxetine d) Lamotrigine e) Divalproex

a) Carbamazepine b) Lithium d) Lamotrigine e) Divalproex SSRIs are not used for people with bipolar disorder because of risk of triggering mania

What is an assumption of a solution focused behavior therapy? a) Change is most likely to occur when the focus is on what is changeable b) It is necessary to know a lot about the report and it's origins or functions in order to resolve it c) There is only a right way to see things d) Usually, long-standing issues cannot be resolved in short periods of time

a) Change is most likely to occur when the focus is on what is changeable According to solution focused behavior therapy change is most likely to occur when the focus is on what is changeable. It isn't necessary to know a lot about the report and it's origins to solve it.

Nurses taking admission history from a client suspects that the physician will diagnose major depression. For the physician to make this diagnosis, the client will have to demonstrate specific symptoms. What are some of the symptoms? Select all that apply a) Disruption in appetite b) Disruption in concentration c) Excessive guilt d) obsessive desire to exercise e) disruption in sleep

a) Disruption in appetite b) Disruption in concentration c) Excessive guilt e) disruption in sleep

A client is prescribed a SSRI is treatment for depression. Which would the nurse most likely administer? a) Escitaloprom b) Maprotiline c) Venlafaxine d) Phenelzine

a) Escitaloprom

When describing the dementia associated with Huntington's disease, a nurse understands that the problems involving behavior and attention arise from a disruption in which lobe of the brain? a) Frontal b) Occipital c) Parietal d) Temporal

a) Frontal

Concurrent use of anti-depressants with MAOIs can cause which life-threatening interaction? a) Hypertensive crisis b) Hypotensive crisis c) Sedation d) Seizures

a) Hypertensive crisis

A client is scheduled to receive CBT. During which step with a client be required to complete homework assignments? a) Intervention b) Engagement c) Evaluation d) Assessment

a) Intervention

Psychiatric mental health nurse is working with a client diagnosed with depression who is to receive cognitive interventions. As part of these interventions, the nurse assesses the clients cognition. On which area with the nurse most likely focus? Select all that apply a) Judgment b) Memory c) Level of orientation d) Perception e) Executive functions

a) Judgment b) Memory d) Perception Level of orientation and executive functioning are not associated with cognition

Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension? a) Take medication with food b) Increase hydration c) Eat a nutritionally balanced diet d) daily exercise

b) Increase hydration

A client with OCD has obsessions related to the threat of contamination and compulsions of handwashing. Protect the client skin integrity, the nurse should: a) Provide soap that has moisturizers in it b) Establish a "no handwashing" contract c) Provide the client with a supply of nonsterile gloves d) Encourage the use of alcohol-based hand rub

a) Provide soap that has moisturizers in it

A psychiatric mental health nurse is conducting a presentation for a group of nurses at the local community center about depression. After the presentation the nurse that determines that it was successful when the group identifies which substances as potentially playing role in depression? Select all that apply a) Serotonin b) GABA c) Epinephrine d) Dopamine e) Norepinephrine

a) Serotonin d) Dopamine e) Norepinephrine

A nurse is preparing a presentation about suicide for a local community group. What were the nurse most likely include? a) Suffocation is a common means of suicide among children b) Men often use pills to commit suicide c) Women typically use firearms in their attempts d) Hispanic individuals have the highest rate of suicide

a) Suffocation is a common means of suicide among children

A client with OCD has been taught thought stopping techniques. The nurse should recognize what potential benefit of this intervention? a) The client will be able to take control of obsessions b) The client will acknowledge the harm caused by compulsions c) The client will be free of anxiety d) The client will understand the relationship between obsessions and compulsions

a) The client will be able to take control of obsessions

A psychiatric health nurse is preparing a presentation for a group of colleagues on anxiety disorders. As part of the presentation the nurse plans to discuss the concept of interoceptive conditioning. Which information with the nurse most likely include in this discussion? a) There is an association between physical symptoms and a panic attack b) The person experiences a phobic avoidance of the event c) A recent loss is the initiating event d) A person links an adverse event with a previous neutral event

a) There is an association between physical symptoms and a panic attack Internal septic conditioning involved in association between physical discomfort, such as dizziness or palpitations, and an impending panic attack.

Which of the following is a cognitive interventions for a client diagnosed with depression? a) Thought stopping b) Problem solving c) Social skills training d) Activity scheduling

a) Thought stopping a COGNITIVE intervention such as thought stopping and positive self talk can help dispel irrational beliefs

The nurse is preparing to administer the prescribed anti-depressant to a client with OCD. When comparing the dose used for OCD with that of depression, the nurse would expect to administer a dose that is: a) higher b) titrated based on weight c) same d) lower

a) higher Antidepressants used to treat clients with OCD are given in higher doses than those normally used to treat depression

Which of the following is the treatment setting of choice for a person who is severely psychotic? a) inpatient admission b) partial hospitalization c) residential apartments d) intensive outpatient programs

a) inpatient admission

When clients are asked to consider the points of view of significant others in their lives, the nurse is asking which type of question? a) relationship b) scaling c) compliments d) exception

a) relationship

When the nurse asked the client to write the issue or problem on a scale of 1 to 10, the nurse is using which question type? a) scaling b) relationship c) exception d) compliments

a) scaling

A psychiatric mental health nurse is assessing a clients cognitive triad. The nurse would focus the assessment on the clients thoughts about which area? Select all that apply a) self b) past events c) present situation d) world e) family members

a) self d) world The cognitive triad includes the world, the self, and the future

What is accurate about schema? a) they are the individual's life rules b) They are expressly the accumulation of learning c) They develop late in childhood d) They become fixed in adulthood

a) they are the individual's life rules They develop early in childhood and become fixed by middle childhood

A client who is prescribed a tricyclic antidepressant is brought to the emergency department with a suspected overdose. Which with the nurse assess to support the suspicion? Select all that apply a) urinary retention b) pale, moist skin c) headache d) blurred vision e) diarrhea

a) urinary retention d) blurred vision

Which type of hallucination most commonly occurs in clients diagnosed with dementia? a) visual b) olfactory c) auditory d) gustatory

a) visual

A nurse is reviewing information about the drug lithium carbonate. Nurse demonstrates understanding of the information by identifying which situation as a potential cause of lithium toxicity? Select all that apply a) vomiting b) strenuous exercise c) hot climate d) hypernatremia e) diarrhea

a) vomiting b) strenuous exercise c) hot climate e) diarrhea If body fluid decreases significantly because of a hot climate, strenuous exercise, vomiting, diarrhea, or a drastic reduction in fluid intake, then lithium concentration can rise to toxic levels. The higher the sodium concentrations, the lower the lithium concentrations will be. HYPOnatremia can lead to lithium toxicity.

A nurse is preparing a presentation for families of clients with Alzheimer's disease. When describing the underlying mechanisms associated with this condition, which of the following would the nurse most likely include? Select all that apply. a) Enhances neurotransmission b) Neurofibrillary tangles c) Oxidative stress d) Beta-amyloid destruction e) inflammation

b) Neurofibrillary tangles c) Oxidative stress e) inflammation

After educating the client with bipolar disorder on his prescribed lithium therapy, the nurse demonstrates that additional education is needed when the client states which of the following? a) "I can use sugarless candy to help with metallic taste" b) "I need to cut back on my salt intake when it's really hot outside" c) "I need to report any problems with severe diarrhea or slurred speech" d) "I need to avoid drinking any alcohol"

b) "I need to cut back on my salt intake when it's really hot outside" Client should increase intake of salt during periods of perspiration and increased exercise and dehydration.

A 25-year-old pregnant mother of two kids under the age of six is very protective and will not allow her children to play outdoors for fear of tick bites. She is worn out from cleaning the house top to bottom every day. She has a nurse how she can stop worrying so much. What is the most appropriate response for the nurse? a) "Why do you worry about the children getting tick bites?" b) "Tell me your concerns about the children playing in your backyard" c) "Have you considered spraying your children with an insect repellent?" d) "Have you sprayed in your backyard for ticks or other pest?"

b) "Tell me your concerns about the children playing in your backyard"

Disulfiram should not be administered until a client has abstained from alcohol for at least how long? a) 16 hours b) 12 hours c) 8 hours d) 4 hours

b) 12 hours

A psychiatric mental health nurse is reading a journal article about general and preferential rational emotive behavior therapy. The nurse demonstrates understanding of the information, identifying that preferential rational emotive behavior therapy includes general rational emotive behavior therapy as well as emphasis on which concept? a) Relationships among thoughts, feelings, and behaviors b) A profound philosophic change c) Solutions rather than problems d) That's about oneself, the world, and the future

b) A profound philosophic change Preferential rational emotive behavior therapy includes general rational emotive behavior therapy but also emphasizes a profound philosophical change.

The nurse is interviewing a client with a history of OCD involving fears of contamination. The client is delivering a long and detailed monologue about the topics of emerging viruses and antibiotic resistance. What is the nurses best action? a) Ask the client what she believes to be a reasonable response to those threats b) Allow the client to express her thoughts without interrupting c) Acknowledge the client statements are accurate and ask another interview question d) Gently redirect the client toward the topic of her compulsions

b) Allow the client to express her thoughts without interrupting

A loss of pleasure or interest in a client diagnosed with depression would be documented as what? a) Hopelessness b) Anhedonia c) Discouragement d) Flat affect

b) Anhedonia

Which must be present in a client diagnosed with serotonin syndrome? Select all that apply a) Hyporeflexia b) Ataxia c) Diaphoresis d) constipation e) fever f) agitation

b) Ataxia c) Diaphoresis e) fever f) agitation

Which of the following is a behavioral symptom of anxiety? a) Tremors b) Avoidance c) Apprehension d) Impatience

b) Avoidance

A nurse is providing care to a client diagnosed with delirium. When developing the clients plan of care, the nurse would identify what goals as a priority? a) Resolution of confusion b) Correction of the underlying physiologic alteration c) prevention of recurrence d) family member verbalization of understanding the clients confusion

b) Correction of the underlying physiologic alteration

A client diagnosed with Alzheimer's disease has decided that he is more comfortable naked than in clothes. This would be documented as which of the following? a) Bradykinesia b) Disinhibition c) Hypersexuality d) cognitive reserve

b) Disinhibition

A client who is to receive cognitive behavior therapy as a nurse, "what will we be focusing on with this type of therapy? "Which information with the nurse integrate into the response? a) Achieving more rational thoughts to reduce stress by changing irrational beliefs b) Dysfunctional thinking through the examination of the cognitive triad c) Identification of possible solutions before addressing the problem d) Identification of irrational beliefs that lead to negative consequences

b) Dysfunctional thinking through the examination of the cognitive triad Rational emotive behavior therapy focuses on identifying and changing irrational beliefs that lead to negative consequences

Which is the most common obsession experienced by a client diagnosed with OCD? a) Fear of water b) Fear of contamination c) Fear of abandonment d) Fear of snakes

b) Fear of contamination

A client with bipolar disorder is experiencing acute mania. The client is unable to sit still, moving from place to place. Medication therapy has been prescribed but not yet initiated. Which would the nurse include in the plan of care to meet the clients physical needs? a) Encouraging frequent rest periods b) Providing high energy snacks c) Instituting a sleep hygiene program d) Increasing environmental stimuli

b) Providing high energy snacks For a client experiencing acute mania the nurse would provide snacks in high energy foods, because it is unlikely the client is able to sit long enough to eat. Sleep hygiene is a priority but may not be realistic until medication to take affect.

A nurse is reading a journal article about bipolar disorder and common comorbidities. The nurse demonstrates understanding of the article by identifying which condition as a common comorbidity? Select all that apply a) Eating disorders b) Substance use c) Personality disorders d) Anxiety disorders e) Schizophrenia

b) Substance use d) Anxiety disorders

A 79-year-old client was diagnosed with late onset OCD related to fear of infection. What characteristic of the clients earlier life may have constituted a sub clinical symptoms? a) The client expresses discuss with people who she characterizes as messy b) The client always lined up to get her seasonal flu vaccine on the first day it was made available c) The client was highly critical of her husband when he started gaining weight in middle age d) The client exercised vigorously each morning even when she felt tired

b) The client always lined up to get her seasonal flu vaccine on the first day it was made available

Wernicke's encephalopathy is a degenerative brain disorder characterized by which type of deficiency? a) vitamin A b) Thiamine c) Vitamin C d) Vitamin D

b) Thiamine

Which types of questions reinforce the client successes and the strengths needed to achieve those successes? a) exception b) compliments c) scaling d) relationship

b) compliments

Disulfiram has which effect on prothrombin time? a) decrease b) increase c) no effect d) remains normal

b) increase

Electro convulsive therapy (ECT) has been shown to be an effective treatment for people with severe depression. However, ECT is contraindicated in which of the following? a) diabetes b) increased intracranial pressure c) hypertension d) anxiety disorder

b) increased intracranial pressure

Client with bipolar 1 disorder is experiencing a depressive episode. Which of the following with the nurse expect to be prescribed? a) lithium b) lamotrigine c) carbamazepine d) valproate

b) lamotrigine

Which of the following is the most consistent and dramatic cognitive impairment seen in dementia? a) executive functioning b) memory c) language d) visuospacial

b) memory

A nurse is reading a journal article about cognitive behavioral therapy and cognitive processes involved in the development of common mental disorders such as depression. The nurse demonstrates understanding of the information by identifying which area as being included in the cognitive triad? Select all that apply a) nurse b) oneself c) present d) world e) future

b) oneself d) world e) future

According to psychodynamic theories, anxiety develops from which of the following? a) Interoceptive conditioning b) Separation and loss c) Exposure to panicogenic substances d) learned response

b) separation and loss Psychodynamic theories explain that anxiety develops after separation and loss.

A psychiatric mental health nurse clinical specialist is conducting an in-service program for a group of psychiatric mental health nurses about the different types of interventions used for patients with psychiatric disorders. After teaching a group about cognitive interventions, the nurse determines that the teaching was successful based on which statement? a) "Cognitive interventions are the primary treatment option used during inpatient stays" b) "Cognitive interventions are specifically designed for use with clients experiencing depression" c) "Cognitive interventions are appropriate for use by any discipline" d) "Cognitive interventions focus on having the client maintain the current view of self"

c) "Cognitive interventions are appropriate for use by any discipline"

A client is prescribed carbamazepine as part of the treatment plan for bipolar disorder. The nurse obtains a CBC before starting therapy. The nurse would instruct the client to return for repeat blood testing at which time? a) 6 months b) 3 months c) 1 month d) 12 months

c) 1 month Should be done 1 month after first starting treatment

When assessing a client with dementia, the nurse notes that the client is having difficulty identifying common items, such as a ball or a book. The nurse interprets this finding as what? a) Apraxia b) Aphasia c) Agnosia d) Disturbance of executive function

c) Agnosia The clients difficulty in identifying objects is called agnosia. Aphasia is alterations in speech ability. Apraxia is impaired ability to execute motor activities.

The nurse has been working with a client who has OCD and the nurses meeting the clients mother and father for the first time. During this interaction, the nurse should: a). Teach the parents about the bio chemical factors that cause OCD b) Screen the clients mother and father for signs and symptoms of OCD c) Assess the parents willingness to assist with behavioral techniques that the client has been taught d) Discuss the events in the clients childhood that may have caused OCD

c) Assess the parents willingness to assist with behavioral techniques that the client has been taught

A nurse is caring for a client receiving a tricyclic antidepressant is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following? a) Moist skin b) Urinary incontinence c) Blurred vision d) Hyperactive bowel sounds

c) Blurred vision Anticholinergic effects are, dry mucous membranes, blurred vision, decreased bowel motility, and urinary retention

While interviewing a client, the client says "I will never get promoted, no matter how hard I work or what great ideas I have. I'm just not as talented as my colleagues are". Which is the correct interpretation by the nurse about the client statement? a) The cognitive triad b) Complement c) Cognitive distortion d) Schema

c) Cognitive distortion The client is exhibiting cognitive distortion, or twisted thinking.

The nurse is assessing a client in fines to enlarged supraclavicular lymph nodes. The nurse asked the client how long these in large notes have been there. Client states "I can't remember. A long time I think. Do I have cancer?" The nurse is aware that the body responds to stress. Which is an immediate physiologic response to stress the nurse would expect to see in the client? a) Vasodilation of peripheral blood vessels b) Pupil construction c) Increase blood pressure d) Decreased blood glucose

c) Increase blood pressure

Psychiatric mental health nurse is reading a journal article about CBT. The article is about the effectiveness of this type of therapy in the psychiatric population. Which information with the nurse most likely find as being cited as a major limitation/barrier? a) Limited adherence to specific techniques b) Lack of understanding by clients c) Lack of focus on the therapeutic relationship d) Lack of concrete data supporting its effectiveness

c) Lack of focus on the therapeutic relationship The major limitation with critics of this technique is that in rigid adherence to the specific technique the therapeutic relationship might be forgotten

A client is prescribed lithium to treat mania. Client also has a history of hypertension for which the client takes lisinopril and hydrochlorothiazide. When monitoring this client, the nurse would especially be alert for signs and symptoms of which condition? a) Hypokalemia b) Hypernatremia c) Lithium toxicity d) Hypertensive crisis

c) Lithium toxicity Lisinopril is an ace inhibitor, and hydrochlorothiazide is a diuretic. Both drugs interact with lithium to increase serum lithium levels.

Which medication class has most commonly been used to treat social phobia? a) Tricyclic antidepressants b) MAOIs c) SSRIs d) Non-benzodiazepines

c) SSRIs

When developing a plan of care for a client with depression who is receiving medication therapy, what would the nurse identify as a primary goal during the acute phase? a) Discontinuation b) Relapse reduction c) Symptom reduction d) Effective prophylaxis

c) Symptom reduction

In clients with Alzheimer's disease, neurotransmission is reduced, neurons are lost, and the hippocampal neurons degenerate. Which neurotransmitter is most involved in cognitive functioning? a) epinephrine b) norepinephrine c) acetylcholine d) serotonin

c) acetylcholine

Which of the following is the most abused substance in the United States? a) cocaine b) benzodiazepines c) alcohol d) marijuana

c) alcohol

Which is an example of a benzodiazepine? a) haldol b) naloxone c) diazepam d) disulfiram

c) diazepam

When developing a plan of care for a client diagnosed with panic disorder, which nursing diagnosis would be considered the priority? a) anxiety b) social isolation c) risk for self directed violence d) powerlessness

c) risk for self directed violence

A client is diagnosed with dementia that has progressed significantly. Which would be the priority for the client? a) support b) cognitive interventions c) safety d) education

c) safety

A nurse is caring for a client with bipolar disorder who is experiencing a manic episode. The nurse would be especially aware for signs indicating what? a) sleep disruption b) dehydration c) self injury d) weight loss

c) self injury

To manage voiding issues, such as incontinence, male clients diagnosed with dementia would best be managed by what? a) condom catheter b) intermittent catheterization c) use of disposable adult diapers d) indwelling catheters

c) use of disposable adult diapers This is the most economical and safest option

A client has experienced a first episode of major depression and has received medication and treatment, which has led to a complete remission of the symptoms. The client asked the nurse "how much longer will I need to take the medication?" Which response by the nurse would be most appropriate? a) "The medication has eliminated your symptoms so you'll need to keep taking it for the rest of your life" b) "Since you have no more symptoms you can stop taking the medicines tomorrow" c) "It's probably best to continue the medicine for another month, and gradually decrease the dosage over that time" d) "You'll need to continue the medicine for about 6 to 12 months to see how things go"

d) "You'll need to continue the medicine for about 6 to 12 months to see how things go"

Which would be most important to assess and document in a client with depression? a) Sleep disturbance b) Appetite c) Weight changes d) Suicide risk

d) Suicide risk

A client with OCD performs elaborate Rachel's involving opening and closing doors and turning lights on and off before leaving a room. The client is scheduled to begin exposure and response prevention. ERP what should the nurse teach the client about this intervention? a) "your therapist will give you some tools for rejecting your thoughts your face when leaving a room" b) "Your therapist will help you identify the relationship between your childhood experience and compulsions" c) "You and your therapist will explore some of the thinking that underlies your obsessions" d) "Your therapist will help you leave a room without touching the lights in face the resulting anxiety"

d) "Your therapist will help you leave a room without touching the lights in face the resulting anxiety"

In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption? a) 48 hours b) 24 hours c) 18 hours d) 12 hours

d) 12 hours

Cognitive interventions are based on the concept of cognition. Who developed cognitive behavioral therapy? a) Insoo Kim Berg b) Albert Ellis c) Steven DeShazer d) Aaron Beck

d) Aaron Beck

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder? a) Steak b) Spaghetti c) Broccoli d) Bananas

d) Bananas For a client who is unable to sit long enough to eat snacks and high energy foods that can be eaten while moving should be provided.

A client with a diagnosis of OCD has been admitted to the psych unit prior to undergoing psycho surgery. I knew she was caring for this client should understand that: a) The client has recently been diagnosed with OCD b) The client likely has a psychiatric advance directive in place c). The client likely has a comorbid diagnosis of depression d) Behavioral therapy and drug treatment have failed

d) Behavioral therapy and drug treatment have failed

What medication classification used in the treatment of panic disorder can cause physical dependence? a) SSRIs b) Tricyclic antidepressants c) SNRIs d) Benzodiazepines

d) Benzodiazepines

A client with OCDs be getting educational sessions that will focus on cognitive restructuring. What outcome should the nurse identify when planning this intervention? a) Client will identify his strengths b) Client will develop assertiveness skills c) Client will control his physiologic response to anxiety d) Client will identify inaccuracies in his thinking process

d) Client will identify inaccuracies in his thinking process

The psychiatric mental health nurse is providing care for a client who has OCD. The clients recovery and has therapeutic rapport by: a) Affirming the client in avoiding any explicit mention of the clients rituals b) Allowing the client all the time and space needed to perform compulsive rituals c) Taking all opportunities to initiate dialogue about the harmful effects of the rituals d) Disguising any surprised at the clients rituals and demonstrating empathy

d) Disguising any surprised at the clients rituals and demonstrating empathy The nurse may find the clients obsessions unusual or surprising, but this is not to be divulged to the client. Empathy is an essential part of the therapeutic relationship.

A child is suspected of having OCD. Which of the following would be the first step in assessing the child? a) Severity of the families response to the child's behavior b) The frequency of which the child engages in the compulsions c) The amount of interference the rituals have on the child's functioning d) Distinguishing between normal childhood rituals and those that are pathologic

d) Distinguishing between normal childhood rituals and those that are pathologic Although frequency, amount of interference and severity of the family's response would be important, the first assessment of OCD in children is to distinguish between normal childhood rituals and worries, and pathologic rituals and obsessive thoughts

The client is involved with CBT. While working with a client, the therapist explains that the clients problems are manageable The therapist is engaged in which step? a) Termination b) Evaluation c) Intervention d) Engagement

d) Engagement The first step in CBT is engagement and assessment. In this phase, the therapist establishes rapport with the client and develops the theme that problems are manageable.

A nurse is providing care to a client with a specific phobia. When developing the clients plan of care, what type of therapy with the nurse most likely expect to include as a treatment of choice? a) flooding b) Systematic desensitization c) Implosive therapy d) Exposure therapy

d) Exposure therapy

Which antidepressant medication is classified as a SSRI? a) Isocarboxazid b) Phenelzine c) Tranylcypromine d) Fluoxetine

d) Fluoxetine

Psychiatric mental health nurse is reviewing the interdisciplinary treatment plan for a client who is receiving CBT. Which goal with the nurse most likely identify as the ultimate goal? a) Control of the future b) Enhanced personal strengths c) Improved problem-solving d) Independent self care

d) Independent self care Although enhancing personal strengths and improving problem-solving are associated with CBT, the over arching treatment goal is to improve self-care

A client is exhibiting rapid shifts in mood. The nurse documents this as which of the following? a) Elevated mood b) Irritable mood c) Expansive mood d) Mood lability

d) Mood lability

The clients family describes the client as being "utterly debilitated" by the severity of the clients compulsions and depression. During the clients next scheduled appointment with the psychiatrist, the nurse should encourage the client to discuss which intervention? a)The possible use of benzodiazepines as needed b) Possible benefits and risks of Vegus nerve stimulation c) Possible benefits and risks of monoamine oxidase inhibitor's d) Possibility of electroconvulsive therapy (ECT)

d) Possibility of electroconvulsive therapy (ECT) ECT is a possibility when a client has severe concurrent depression and OCD

A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which nursing diagnosis has priority? a) Spiritual distress related to conflicting thoughts about suicide and sin b) Ineffective coping related to an adequate stress management c) Hopelessness related to recent divorce d) Risk for suicide related to highly lethal plan

d) Risk for suicide related to highly lethal plan

Teen girl has been diagnosed with OCD that manifest with excessive handwashing. The father is exacerbated stating "the simplest solution would be to take away her access to soap and water." How should the nurse best interpret the father suggestion? a) This action would exacerbate the long-term severity of the clients compulsion b). This action would be effective but unethical c) The client would likely replace her handwashing compulsion with another compulsion d) The action would cause the client significant anxiety and distress

d) The action would cause the client significant anxiety and distress

Which is accurate regarding solution focused brief therapy? a) The focus is on problems b) The approach challenges the existence of problems c) Solution focused approach is emphasize the uniqueness of groups d) The emphasis is on what is functional and healthful

d) The emphasis is on what is functional and healthful

A client with acute mania is prescribed lithium. During this time the nurse would anticipate obtaining blood concentration is how often? a) Every three weeks b) Monthly c) Weekly d) Twice weekly

d) Twice weekly In acute mania it is important for the client to obtain serum concentrations twice weekly in the acute phase. In uncomplicated maintenance, serum concentration should be obtained every 2 to 3 months.

Carbamazepine has a boxed warning for which adverse effect? a) birth defects b) skin rash c) liver damage d) agranulocytosis

d) agranulocytosis

Changes that are found during the mental status examination of a client diagnosed with delirium include what? a) clear memory b) increased attention to detail c) no impairment of consciousness d) difficulty focusing

d) difficulty focusing

A client has a blood alcohol level of 0.05. The nurse would expect which behavior to occur? a) stupor b) difficulty driving c) coma d) impaired judgement

d) impaired judgement

During which type of anxiety does a person's perceptual field actually increase? a) severe b) panic c) moderate d) mild

d) mild

The priority concern for people with mood disorders is what? a) occupational functioning b) social functioning c) basic care d) safety

d) safety

Both valproate and carbamazepine may be lethal if high doses are ingested, Toxic symptoms appear in 1 to 3 hours and include which of the following? A. Tinnitus B. Bradycardia C. Urinary Frequency D. Neuromuscular disturbances

d. neuromuscular disturbances