mental midterm

A nurse provides instructions to a client taking citalopram (Celexa) a selective serotonin reuptake inhibitors (SSRI) antidepressant. The nurse tells the client to take the medication:

Early in the morning

A person with antisocial personality disorder has difficulty relating to others because of never having learned to:

Empathize with others

Parkinson's disease and Extrapyramidal side effects (EPS) of antipsychotics medications are the result of too little:

Dopamine

An involuntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice (AMA) so I can leave the hospital now." What is the nurse's best initial response?

"I can't give you those forms without your health care provider's knowledge, you need to stay here until your provider see you."

A patient's spouse filed charges of battery. The patient says, "I'm sorry for what I did. I need psychiatric help." The patient has a long history of acting-out behaviors and several arrests. Which statement by the patient suggests an antisocial personality disorder?

"I hit because I'm tired of being nagged. My spouse deserves the beating."

A new admitted voluntarily patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave the hospital now." What is the nurse's best initial response?

"I will get them for you, but let's talk about your decision to leave treatment."

A 24-month-old child displays negative behaviors. The parent says, "My child refuses toilet training and shouts, 'No, no, no, no!' when given direction. What do you think is wrong?" Select the nurse's best reply.

"This is normal for your child's age. The child is striving for independence.

A young adult female client is seen in the emergency department for a minor injury following a motor vehicle collision. She states she is very angry at the person who hit her car. What is the best nursing response?

"You are upset that this incident has brought you here."

One specific type of antidepressant medication works by blocking the removal of neurotransmitters. Which of the following neurotransmitters is most likely the target of the antidepressant medication?

. Serotonin

The spouse of a patient who has delusions asks the nurse, "Are there any circumstances under which the treatment team is justified in violating the patient's right to confidentiality?" The nurse must reply that confidentiality may be breached:

. under no circumstances.

Which of these clinical manifestations would the mental health nurse anticipate observing in a patient experiencing an acute panic attack?

: Palpitations, Dilated pupils, Increased pulse rate

A single parent is experiencing feelings of inadequacy related to work and family since one teenaged child ran away 2 weeks ago. The parent seeks the help of a therapist specializing in cognitive therapy. The psychotherapist who uses cognitive therapy will treat the patient by:

: helping the patient how to identify and change faulty thinking

Which describes the primary focus of milieu therapy?

A living, learning, or working environment

On review of the client's record, the nurse notes that the mental health admission was voluntary. Based on this information, the nurse anticipates which client behavior?

A willingness to participate in the planning of the care and treatment plan.

The depletion of Acetylcholine is associated with:

Alzheimer's disese

Over the past six months, a woman has cooked gourmet meals for her family but eats only tiny servings. She wears layered, loose clothing and now has lanugo. Her current weight is 97 pounds, a loss 32 pounds. Which medical diagnosis is most likely?

Anorexia nervosa

A nurse wishes to teach alternative coping strategies to a patient who is experiencing severe anxiety. The nurse will first need to:

Assess the patient's current anxiety level.

A mental health nurse is giving instructions to a client receiving lithium carbonate medication twice a day. The nurse tells the client to do which of the following to prevent lithium toxicity

Avoid becoming dehydrated during exercise

A mental health nurse is giving instructions to a client receiving lithium carbonate medication twice a day. The nurse tells the client to do which of the following to prevent lithium toxicity:

Avoid becoming dehydrated during exercise

A medical-surgical nurse works with a patient diagnosed with a somatic system disorder. Care planning is facilitated by understanding that the patient will probably:

Be resistant to accepting psychiatric help.

A patient has symptoms of anxiety related to the death of a parent in an automobile accident 2 weeks ago. The nurse should anticipate administering a medication from which group in order to....?

Benzodiazepines to increase the effect of GABA

A woman is 5'8" tall, weighs 155 pounds, and wears a size 7.5 shoe. She says, "My feet are huge. I've asked tfour orthopedists to surgically reduce my feet, but they don't want." The patient tries to buy shoes to make her feet look smaller, and in social settings conceals both feet under a table or chair. Which health problem is likely?

Body dysmorphic disorder

Which of the following nursing interventions is MOST important when caring for a client who has just been placed in physical restraints?

Check that the restraints have been applied correctly to avoid lack of circulation in the limbs

A female client who's at high risk for suicide needs close supervision. To best ensure the client's safety, the Registered Nurse should:

Check the client frequently at irregular intervals throughout the night

What is a neurotransmitter?

Chemical messenger gap between n

A client with depression is taking phenelzine (Nardil). The nurse advises the client to avoid consuming which foods while taking the medication

Chocolate

A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "The patient is like one of my grandparents, so helpless and needy." What feelings does the nurse describe?

Countertransference

A client admitted to a mental health unit for treatment of psychotic behavior spends hours at the locked exit door shouting, "Let me out. There's nothing wrong with me. I don't belong here." What defense mechanism is the client implementing?

Denial

Low levels of serotonin are linked to

Depression

A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information due to the patient has narrow perception. Which nursing intervention is appropriate?

Describe the procedure again in a calm manner using simple language.

Patients taking MAOIs have the tendency to experience hypertensive crisis especially during an interaction with other drugs such as epinephrine. Which of the following is a sign of hypertensive crisis?

Diplopia

A woman brings her husband to the outpatient psychiatric unit and describes his behavior to the admitting nurse. She states that patient has been weird during the last several months, cannot remember who he is, and exhibits different personalities. Which disorder manifests these behaviors?

Dissociative identity disorder (DID)

The registered nurse has written an outcome statement of "Client will feel less anxious by the end of session" for a client with generalized anxiety disorder (GAD). Which interventions should the licensed practical nurse use to assist this client in meeting this goal? Select all that apply.

Ensure the client feels he/she is in a safe environment. Administer anxiolytics medications if prescribed. Stay with the client.

A patient is diagnosed with agoraphobia. Which of the following would the healthcare identify as a characteristic of this disorder?

Fears the use of public transportation

A patient has anxiety, fear, and insomnia. The mental health nurse would suspect the presence of a decrease concentration of which neurotransmitter?

GABA

A client who is being treated with lithium carbonate for bipolar disorder develops diarrhea, vomiting, and drowsiness. What action should the mental health nurse take?

Hold the next dose of the medication and notify the healthcare provider of the symptoms prior to the next administration of the drug

Which statement made by a patient during an initial assessment interview should serve as the priority focus for the plan of care?

I am hearing voices that tell me to jump in from of the car"

Which statement made by a patient during an initial assessment interview should serve as the priority focus for the plan of care?

I hear voices that tell me to hurt myself."

A new admitted patient who is experiencing moderate anxiety says, "I feel weird." An appropriate response for the nurse would be:

I'm not sure I understand. Give me an example...

A Patient tells the nurse at the clinic, ``I haven´t been taking my antidepressant medication as directed. I leave out the midday dose. I have lunch with friends and don´t want them to ask me about the pills.´´ Select the nurse´s most appropriate intervention.

Investigate the possibility of once-daily dosing of the antidepressant medication.

In a team meeting, a nurse says, "I am concerned if we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated issues calls for one-on-one supervision management ." Which ethical principle most clearly applies to this situation?

Justice

When preparing a teaching plan for a client who is to be discharged with a prescription for lithium carbonate (Lithonate), it is most important for the nurse to include which instruction?

Keep your dietary salt intake consistent.

A client is diagnosed with cancer and is told that surgery followed by chemotherapy will be necessary. The client states to the nurse, "I have read a lot about complementary therapies. Do you think I should try any?" The nurse should respond by making which appropriate statement?

Let's talk more about the different forms of complementary therapies."

The nurse is preparing a client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task that is most appropriate for this phase?

Making appropriate referrals

Which research evidence would most influence a group of nurses to change their practice?

Meta-analysis

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client?

Monitor closely for harm to self or others.

Which nursing intervention has priority as a patient diagnosed with anorexia nervosa begins to gain weight after initiated therapy?

Observe for adverse effects of refeeding and new onset of cardiac symptoms.

The nurse recognizes which of these symptoms as characteristic of a panic attack?

Palpitations, decreased perceptual field, diaphoresis, shortness of breath.

To plan effective care for patients with somatic system disorders, the nurse should understand that patients have difficulty giving up the symptoms because the symptoms:

Provide relief from health anxiety.

A nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which finding the nurse would be expected?

Reduced anxiety

A mental health nurse administers a medication that potentiates the action of gamma-aminobutyric acid (GABA). Which finding would be expected?

Reduced level of anxiety

Which technique will best communicate to a patient that the nurse is interested in listening?

Restate a feeling or thought the patient has expressed.

The nurse in the mental health unit recognizes which as being therapeutic communication techniques? Select all that apply.

Restating Providing acknowledgment and feedback

Which psychological characteristic is a mental health nurse most likely to assess in a patient diagnosed with anorexia nervosa?

Rigidity, perfectionism

A patient with a high level of motor activity runs from chair to chair and cries, "They're coming! They're coming!" The patient is unable to follow staff direction or respond to verbal interventions. Which nursing diagnosis has the highest priority?

Risk for injury

Which diet selection by a client who is depressed and taking the MAO inhibitor tranylcypromine sulfate (Parnate) indicates to the nurse that the client understands the dietary restrictions imposed by this medication regimen?

Roast beef, baked potato with butter, and orange juice.

Too much dopamine is linked with

Schizophrenia (SCPT)

Which principle should guide the nurse in determining the extent of silence to use during patient interview sessions?

Silence can provide meaningful moments for reflection and it is therapeutic

Cognitive therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective?

Sometimes I do stupid things."

A person received an invitation to be in the wedding of a friend who lives across the country. The individual is afraid of flying. What type of therapy should the nurse recommend?

Systematic desensitization

A school-age child tells the school nurse, "Other kids call me mean names and will not sit with me at lunch. Nobody likes me." Select the nurse's most therapeutic response.

Tell me more about how you feel when ii happens"

The nurse is assisting with the data collection on a client admitted to the psychiatric unit. After review of the data obtained, the nurse should identify which as a priority concern?

The client's report of self-destructive thoughts

A patient cries as the nurse explores the patient's relationship with a deceased parent. The patient says, "I shouldn't be crying like this. It happened a long time ago." Which responses by the nurse will facilitate communication? Select all that apply.

The loss of your parent should be very painful for you I can see that you feel sad about this situation."

After several therapeutic sessions with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of transference?

The patient states, "Talking to you feels like talking to my parents."

A client taking lithium carbonate (Lithobid) started complaining of nausea, vomiting, diarrhea, drowsiness, muscle weakness, tremor, blurred vision and ringing in the ears. The lithium level is 2.2 mEq/L. The nurse interprets this value as:

Toxic level

A nurse plans teaching for a patient diagnosed with generalized anxiety disorder (GAD) who takes lorazepam (Ativan). What information should be included? (Select all that apply.)

Use caution when operating machinery. Avoid using alcohol and other sedatives.

Which physical characteristic is a nurse most likely to assess in a patient diagnosed with anorexia nervosa?

VERY LOW WEIGHT

A client with schizophrenia (SCPT) has been started on medication therapy with clozapine. The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication?

White blood cell count

A client is pacing in the hall near the nurses' station and swearing loudly. What response is best for the nurse to provide?

You seem pretty upset. Tell me about it.

A community mental health nurse has worked with a patient for 2 years but now she is moving out of the city and terminates the relationship. A new nurse who begins work with this patient will

begin at the orientation phase

A patient says, "I feel detached and weird all the time, like I'm looking at life through a cloudy window. Everything seems unreal. These feelings really interfere with my work and study." Which term should the nurse use to document this complaint?

a. Depersonalization

The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications?

alprazolam (Xanax)

Alprazolam (Xanax) is prescribed for a patient experiencing acute anxiety. Most important teaching should include instructions to:

avoid alcoholic beverages.

Clonazepam (Klonopin) is prescribed for a patient who is experiencing acute anxiety. Health teaching should include instructions to:

avoid alcoholic beverages.

A community mental health nurse has worked with a patient for 2 years but now she is moving out of the city and terminates the relationship. A new nurse who begins work with this patient will:

begin at the orientation phase.

The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications?

clonazepam (Klonopin)

A patient with paranoid schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. The psychiatrist notifies the local minister. The psychiatrist has:

demonstrated the duty to warn and protect

A patient tells the mental health nurse, "I wanted my health care provider to prescribe alprazolam (Xanax) for my anxiety disorder, but buspirone (Buspar) was prescribed instead. Why? I want my Xanax, it is good for me" The nurse's reply should be based on the knowledge that buspirone:

does not cause dependence and benzodiazepines cause dependence.

A patient tells the nurse, "I wanted my health care provider to prescribe clonazepam (Klonopin) for my anxiety disorder, but buspirone (Buspar) was prescribed instead. Why?" The nurse's reply should be based on the knowledge that buspirone:

does not cause dependence and benzodiazepines cause dependence.

A nurse can anticipate anticholinergic side effects will be likely when a patient is taking:

haloperidol, typical antipsychotic medication

A nurse cares for an older adult patient admitted for the treatment of depression. The health care provider prescribes an antianxiety medication, but the dose is more than the usual adult dose. The nurse should:

hold the medication and consult the health care provider

A patient experiences an episode of severe acute anxiety. Of these medications in the patient's medical record, which is most appropriate to administer as an as-needed (PRN) anxiolytic

lorazepam (Ativan)

A patient experiences an episode of severe acute anxiety. Of these medications in the patient's medical record, which is most appropriate to administer as an as-needed (PRN) anxiolytic medication?

lorazepam (Ativan)

A student says, "Before taking a test, I feel a heightened sense of awareness and restlessness." The nurse can correctly assess the student's experience as:

mild anxiety

While talking with a patient diagnosed with major depressive disorder, a nurse notices the patient is unable to maintain eye contact. The patient's chin lowers to the chest while the patient looks at the floor all the time. Which aspect of communication has the nurse assessed?

nonverbal communication

A nurse should assess a patient taking a medication with anticholinergic properties for inhibited the function of the:

parasympathetic nervous system.

A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day, when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copy machine, so I couldn't finish it." The worker's behavior demonstrates:

passive aggression.

On the basis of current knowledge of neurotransmitter effects, a nurse anticipates that the treatment plan for a patient with memory difficulties may include medications designed to:

prevent destruction of acetylcholine

What is the desirable outcome for the orientation phase of a nurse-patient relationship? The patient will demonstrate behaviors that indicate:

rapport and trust with the nurse.

Which individual with a mental illness may need emergency involuntary hospitalization for mental illness? The individual who:

refuses eating during last 2 weeks to weight lost and patient's weight is 80 pounds , blood pressure is 66/40 mm Hg, and heart rate is 38 per minute

A nurse uses Maslow's hierarchy of needs to plan care for a psychotic patient. Which problem will receive higher priority? The patient who:

refuses to eat or bathe.

The nurse is developing a comprehensive care plan for a young woman with an eating disorder. The nurse refers this client to assertiveness skills classes. The nurse knows that this is an appropriate intervention because this client may have problems with

self-identity and self-esteem

The most challenging nursing intervention for patients diagnosed with Cluster B personality disorders, especially borderline personality disorder (BPD), who use manipulation to get their needs met is:

setting limits.

To assist a patient with a somatic system disorder, a nursing intervention of high priority is to:

shift the focus from somatic symptoms to feelings

A nurse wants to enhance the growth of a patient by showing positive regard. The action consistent with this wish is:

staying with a tearful and very anxious patient

The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications?

temazepam (Restoril)

A patient should be considered for involuntary commitment for psychiatric care when he or she:

threatens to harm self

A patient should be considered for involuntary hospitalization for psychiatric care when he or she:

threatens to harm self.