MH final study guide
In order for a client to be diagnosed with an anxiety disorder, the client must have had symptoms for longer than which time frame?
1 month
Mood-stabilizing treatment would be contraindicated for which clients? (Select all that apply.)
20-year-old client who is hypernatremic. 45-year-old with a history of chronic renal failure. 35-year-old client who is pregnant
How many hours can a client be held under an emergency protective custody order
48 to 72
To be diagnosed with generalized anxiety disorder, the client experiences an increased level of anxiety and worry on most days over which time frame?
6 months
A client becomes very anxious when riding in an elevator, which is going to the 12th floor. This would be documented as which of the following types of phobia?
Acrophobia
When reviewing a care plan of a client diagnosed with obsessive-compulsive disorder, the nurse would expect to see which of the following nursing interventions early in treatment?
Allow time for the client to perform the ritual.
Which of the following treatment approaches has been proven to be the most beneficial for the client diagnosed with an anxiety disorder?
Antianxiety medications combined with psychotherapy
A client is dreading speaking in front of others during a group therapy session. This behavior is consistent with which type of anxiety?
Anticipatory
least restrictive restraint orders
Antipsychotic and sedating med
Which medication classification would the nurse expect to be used in the treatment of a client diagnosed with an anxiety disorder?
Anxiolytics
A client prescribed phenelzine (Nardil) has spent the afternoon away from the unit with family. Which intervention should the nurse initiate immediately upon learning that the client had pizza for lunch at an Italian restaurant?
Assess and document the client's blood pressure
A client is being discharged on a tricyclic antidepressant (TCA). The nurse should include which of the following in the discharge teaching?
Avoid consuming alcohol
the nurse uses which therapeutic communication techniques to establish an understanding of the client's message?
Clarification. Validation
A patient diagnosed with obsessive-compulsive disorder avoids touching all doorknobs when entering the health clinic. This type of obsessive thought content would be documented as which of the following?
Contamination
Which mood disorder is less severe than major depressive disorder but tends to be more chronic?
Dysthymic
When the nurse suggests to a client that, "You and I need to take a walk" the client responds with "walk, walk, walk...." This is an example of which speech pattern?
Echolalia
A client diagnosed with agoraphobia associated with panic disorder has been scared to leave her home for 3 months, unable to go to the grocery store. In reviewing the care plan, the nurse would expect to find which goal for this client?
Function effectively within the environment
When the nurse shows concern for a client's well-being, which characteristic of the nurse-client relationship is being demonstrated?
Genuineness
Which clients present the nurse with the obligation to disclose what might be considered confidential client information?
HIV, physically assaulted 69, various stage bruise 6
A client is diagnosed with depression. When reviewing the chart of the client, the nurse notes that the client has anhedonia. The nurse would expect to note which of the following sign or symptom related to anhedonia?
Inability to experience pleasure
A client is laughing when talking about a brother's death. This type of affect would be accurately documented as which of the following?
Incongruent
The nurse is caring for a severely depressed client. The nurse should be aware of suicide warning signs. Which of the following would be be inconsistent as a warning sign?
Increase appetite
Which of the following would be a sympathetic nervous system response to panic anxiety?
Increased heart rate
A client has been diagnosed with agoraphobia. Which of the following is a manifestation of phobias?
Irrational fear
What term is used to identify the technique the nurse is employing when using hand gestures and facial expressions when communicating with a client?
Kinesics
Changing the dressing on the wrist wound the client created during his or her suicide attempt Providing documentation about a rash noted after the client began a new antidepressant Administering a PRN antidiarrheal medication as prescribed Providing one-on-one observation of the client
LPN duties
The nurse is caring for a client who has just undergone electroconvulsive therapy (ECT). Which of the following is an expected postprocedure manifestation of ECT?
Memory deficits
Which of the neurotransmitters has been implicated in mania?
Norepinephrine
When a medication was prescribed when none of the other interventions to control the hallucinations were successful. demonstrates understanding of _______'s rules for psychotropic drugs
OBRA
The nurse is caring for a client whose serum lithium carbonate level is 1.5 mEq/L. The nurse would expect the physician to :
Order the next dose of the drug to be held
A client diagnosed with obsessive-compulsive disorder is constantly checking the oven to make sure it is off. This is an example of which type of obsessive thought content?
Repeated doubts
A client is being assessed following a suicide attempt. She continues to have suicidal thoughts. Which of the following nursing diagnoses would take priority at this time?
Risk for violence, self-directed, related to suicidal thoughts
The nurse misinterprets the meaning of a client's statement regarding her feelings about her recent divorce. To correct the miscommunication and restore the benefits of active listening between the client and nurse, which should be the nurse's initial intervention?
Role model for the client by apologizing for the misunderstanding
The nurse is preparing information for a community-focused presentation and is using the Americans with Disabilities Act (ADA) as a primary reference. Which is the likely focus of the nurse's presentation regarding patient rights of the mentally ill?
Use and availability of public transportation
The nurse states to the client, "It is time for your dinner." The client responds with "For your dinner, for your dinner, for your dinner...." The nurse would document this as which type of speech pattern?
Verbigeration
Which nursing statement demonstrates an understanding of the barriers presented to the delivery of nursing care in correctional facilities?
aware of rules and meds at 3
intervention for client who repeatedly fails to abide by the unit's rules, the nurse says that he has lost tv as the _________ for failing to follow the rules.
consequence
educate client expected outcome that is associated with electroconvulsive therapy treatment
controlled seizure restores balance
Which nonverbal communication technique would be a barrier to openness
crossed legs and arms
Two mandatory in-services on the delivery of __________ __________ care are scheduled yearly. shows importance of minority
culturally competent
Nurse hears a client shouting at other clients in the hallway. client hx aggressiveness, nurse should
de-escalate and redirect
A nurse is overheard responding to a client by stating, "Why would you think that was acceptable?" Nurse manager explains this makes client _________- _________ and __________
defensive, embarrassed, and ashamed
client makes sexually inappropriate remark. Nurse should be _________- and (explain) -__________
direct and unacceptable
(HIPAA) of 1996 holds mental health care professionals legally and ethically responsible for
disclosure of info, who gets info, privacy, client access
What tx of severe depression and suicidal ideations can be assigned to LPN?
document rash, one on one, dressing change, PRN meds
During the termination phase, which event is a nursing focus?
encourage independence
goal of therapeutic communication example Has the client talked with you about how he _____ about _____
feels about hospitalization
Which individual meets the criteria for an involuntary psychiatric admission?
hurt self or others
delegated to a LPN on a mental health unit
inappropriate behavior
for a 45-year-old who lives in a group home for the cognitively impaired, the nrse should anticipate ________ __________ when needing informed consent
informed consent
The primary principle to determine how MH treatment can be received __________ ____________ care in safe environment
least restrictive
I respect your right to disagree with your roommate but let's talk about doing that without offending them
nurse as counselor
where do you find scope and minimum standard of practice for the care she provides?
nurse practice act
The nurse is reinforcing rules and boundaries to a newly admitted client. which phase?
orientation
a milieu where clients are accepted regardless of their mental illness is where it is possible for every client with ________ or __________ ______________ can take part in a holiday program
physical or mental limitations
primary legal obligation to mod to severe alz client
protect rights
intervention for a client wihes to register complain
provide info on how to file
Ask the client to use their own words to describe their illness to show they understand their ________ _________
psychiatric condition
treatment for acute depression
psychotherapy and medication
primary reason client is evaluated for the existence of anxiety and depression ( acute physical health)
recovery delayed by mental illness
A client with anxiety, hx of abuse "What's the goal of my tx?
reduce symptoms
psychotropic drugs among the older client population is decrease in ______ ________ and ___________ as as increased body fat, loss of muscle, and dehydration risk
renal function and albumin
Which characteristic provides insight into how people respond to their environment and how others react to their behavior?
self awareness
My nurse and I have discussed what changes I need to make in my life demonstrates ________ relationship
therapeutic
How does the nurse use communication to best affect mental health care for a client diagnosed with a mental illness
therapeutic communication to build trust
A safe place that provides the clients with the opportunity to work on their problems with members of their health care team
therapeutic milieu
Which nursing characteristic is vital to the nurse-client relationship?
trustworthy
to minimize the barriers to MH care that exists for the Hispanic and Asian immigrants
understand belief and values
Which statement by the nurse demonstrates an understanding of the impact of personal space on a conversation? client _________ to ______ sit across table
willing to talk
Which statement made by a nurse indicates a need for future instructions on maintaining professional boundaries?
"I promised to call the client's mother and tell her he's sorry for hurting her."
Which statement demonstrates the nurse's use of focusing when communicating with a client about relationships with family members?
"Let's get back to how you feel about your son's decision to leave school."
Which statement made by a mental health nurse demonstrates a need for additional education regarding the importance of maintaining professional boundaries?
"The best part of this job is knowing that the clients really need me."
A client who is experiencing a panic attack states, "I am going to die. I feel like I am suffocating." What is the nurse's best response?
"You are having a panic attack. I will not leave you alone."
When educating a client who is prescribed lithium, the nurse should reinforce which statement regarding the client's diet?
"You can't eat a little of salt one day and a lot the next
When assessing a client diagnosed with an anxiety disorder, the nurse should use which type of questioning?
Direct
pioneers that secured legislation to help construct mental hospitals with standards for care
Dorothea Dix
When the client states, "I am hungry. Will you buy me a car? I like walking in the park. Do you like to play cards? Can we go to the movie?"
Flight of ideas
A nurse who is unfamiliar with barriers to therapeutic communication would
Give advice
Which interventions would be consistent with the implementation of active listening? (Select all that apply.)
Giving critical attention to verbal comments. Allowing the nurse to model appropriate behaviors such as apologizing. Attempting to understand the client's perception of the situation. Reviewing client comments and behaviors before responding
Which type of individual therapy is nondirective and focuses on helping the client to clarify his or her own feelings
Humanistic
demonstrate empathy and objectivity for client with anger management issues? "_____ _____ but throwing the chair is ____ _____
I see, not accetable
A client has been diagnosed with generalized anxiety disorder. In order to establish a nurse-client relationship, which of the following steps is most important?
Lower the clients anxiety level
A physiologic response to generalized anxiety includes which of the following?
Muscle tension
A client has been diagnosed with obsessive-compulsive anxiety disorder. The nurse would expect to find which of the following clinical manifestations?
Persistent unwanted thoughts
A client is being admitted to an inpatient clinical unit for treatment of obsessive-compulsive anxiety disorder. The nurse understands that this anxiety disorder is associated with which of the following?
Persistent unwanted thoughts and ritualistic behaviors
A client diagnosed with mania is pacing back and forth. To ensure adequate nutrition for this client, which would be most appropriate?
Pieces of fruit and grilled chicken leg
A soldier has been back from Iraq for four weeks. He is being seen in the outpatient mental health clinic due to complaints of inability to sleep, nightmares, and flashbacks. The nurse would expect the client to be diagnosed with which of the following?
Post traumatic stress disorder
Which would be consistent with the characteristics of a therapeutic relationship? (Select all that apply.)
Promotes a return to independent living within societal norms. Focuses on identifying client problems. Develops goals for improvement of existing problems. Dependent on the situation and needs of the client
The nurse intends to implement limit setting for a manipulative client. Which intervention should be applied initially?
Recognizing what the client is attempting to do as being controlling
The nurse must use extreme caution when using touch to convey caring with a client who is:
Sexually preoccupied
The client for whom a MAOI is prescribed should be taught to avoid which of the following dietary items?
Smoked or processed meat
Which of the following levels of risk of suicide entails a thought that indicates the person's desire to do self harm?
Suicidal ideation
The nurse understands that which antidepressant can result in a fatal cardiac arrhythmia in overdose situations? TCAs
TCAs
The nurse is teaching a client receiving lithium carbonate, a mood-stabilizing agent. Which of the following should be included in the plan of care?
Take the medication with food to prevent GI upset.
Which statement is true regarding therapeutic communication?
The focus is on the client.
The nurse is developing a teaching plan for a client receiving an antidepressant. Which of the following should be included in the teaching plan?
There is a delayed therapeutic effect
A client is being discharged on a tricyclic antidepressant (TCA). The nurse should reinforce which statement from the discharge teaching?
This medication should not be taken while pregnant
The nurse should avoid which of the following interventions when dealing with a client having a panic attack?
Touching the client
nurse helps client to overcome the fear of public places. is what phase?
Working
A client has had five mood shifts within 1 year, alternating between mania and depression. The nurse would correctly document this assessment finding as: rapid cycling
rapid cycling
