psych exam 2

A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The clients spouse asked the nurse about the possible side effects of ECT. Which of the following responses should the nurse make?

"The main side effects are temporary and may include mild confusion, headache, and short-term memory loss."

A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurses station at 0300 demanding the nurse call the provider immediately. Which of the following responses from the nurse is appropriate?

"You must be very upset about something"

A nurse is preparing to teach a client about his prescription of lithium for the treatment of bipolar disorder. Which of the following statements should the nurse include in the teaching?

"You will need to stop this medication if you are experiencing diarrhea"

A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse "I should have died, because I am totally worthless." Which of the following responses should the nurse make?

"You've been feeling that you life has no meaning"

What classes of drugs treat depression?

-Selective Serotonin reuptake inhibitors (SSRIs):first line therapy, -Serotonin norepinephrine reuptake inhibitors (SNRIs) -Tricyclic antidepressants -Monoamine oxidase inhibitors (MAOIs)

A adolescent that has been breaking the law and hits on his parents and is known as a bully. What diagnosis would support this type of behavior?

Conduct Disorder

A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take?

Determine the client's need for assistance with grooming.

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity?

Experiencing diarrhea

A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase one week ago. The client reports having an improved appetite, but still feels very depressed and is having trouble sleeping. Which of the following actions should the nurse take?

Explain that the antidepressants often take several weeks to be fully effective.

Dialectical behavioral therapy (DBT) is given by a registered nurse. True or False

False

A 14 year old male that has been arrested for stealing and has been suspended from school tells say "I hate my family, my parents like my brother better because he never does anything wrong". Which type of therapy would be most beneficial for this 14 year old male and family?

Family therapy

SSRI side effects & teaching

First line treatment: insomnia, serotonin syndrome, GI bleed, weight gain, sexual disfunction, headache, teeth clenching Teaching: very little risk of overdose

What are the signs & symptoms of bipolar?

Hyperactivity, poor judgement, excessive talking, etc

SNRI side effects & teaching

Hypertension

A nurse is caring for an adolescent who is experiencing indications of depression. Which of the following findings should the nurse expect?

Irritability Insomnia Low self-esteem Chronic Pain

A nurse is reviewing medication records for several clients who have bipolar disorder. The nurse should recognize that which of the following medications are used to treat clients who have bipolar disorder?

Paroxetine Lithium Valproate Carbamazepine

An adolescent diagnosed with CD has aggression, impulsivity, hyperactivity, and mood symptoms. The treatment team believes this adolescent may benefit from medication. The nurse anticipates the health care provider will prescribe which type of medication?

Second-generation antipsychotic

Clonzaepam

Sedative, It can treat seizures, panic disorder, and anxiety.

What are the 3 main neurotransmitters with a role in psychological disease processes?

Seretonin, GABA, & Dopamine

Which neurotransmitters are important in depression?

Seretonin, GABA, & Dopamine

Time out

Sit on the Outside of the group or on the edge until they can gain control

A nurse is planning a unit orientation for a newly admitted client who has severe depression. Which of the following should be the nurses approach?

Sit with the patient and offer simple, direct information.

A nurse is caring for a client who has major depressive disorder. Which of the following findings should the nurse expect?

Sleep disturbances

A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the clients plan of care?

Spending time sitting with the client

A nurse is providing discharge teaching to a client who has bipolar disorder ad will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity?

The clients runs 4 miles outdoors every afternoon.

Suicide nursing interventions

Therapy, medication, thought doesn't mean anything

A parent of a child with oppositional defiant disorder as the nurse what medication is given for ODD? Medication is not recommended, therapies to focus on adaptive coping mechanisms are the first to be utilized. True or False?

True

A universal nursing diagnosis for autism spectrum disorders is Impaired social interaction related to difficulty maintaining relationships. True or False

True

Risperiodone

It can treat schizophrenia, bipolar disorder, and irritability caused by autism.

Lamotrigine

It can treat seizures and bipolar disorder.

What are neurotransmitters?

It is a type of chemical messenger which transmits signals across a chemical synapse

Suicide populations at risk

LGTBQ, minorities

Anergia

Lack of energy; passivity, lack of persistence at work or school

MAOIs side effects

Last resort: "so many side effects", agitation, anxiety, mania

Classes that are mood stabilizers

Lithium carbamazepine

A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication?

Liver function test must be monitored

Which assessment findings present familial risks for a child to develop a psychiatric disorder? (Select all that apply.)

Living with an alcoholic parent Having a mother diagnosed with schizophrenia

Which assessment findings support a diagnosis of ODD?

Negative, hostile, and spiteful toward parents. Blames others for misbehavior and is vindictive getting revenge.

Amitriptyline

Nerve pain medication, antidepressant: treats depression

Adverse effects of methylphenidate (Ritalin) include :insomnia, appetite suppression (weight loss) headache, abdominal pain, lethargy, urinary retention. True or False

True

Resiliency enables a child to handle the stresses of a difficult childhood. Resilient children can adapt to changes in the environment, take advantage of nurturing relationships with adults other than parents, distance themselves from emotional chaos occurring within the family, learn, and use problem-solving skills. True or False

True

Major depressive disorder pt teachings

teaching coping skills (long-term)

A client who has major depressive disorder states to the nurse that he and his family would be better off if he were gone. Which of the following is the nurse's priority response?

"Are you thinking of harming yourself?"

A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed, wearing clean clothes, and combed and styled hair. which of the following responses by the nurse is therapeutic?

"I can see you have done some grooming today"

A client becomes very dejected and states, "No one really cares what happens to me. Life isn't worth living anymore." Which of the following responses should the nurse make?

"I care about you, and I am concerned that you feel so sad"

A nurse is caring for a client who is depressed and refuses to participate in group therapy or perform activities of daily living. Which of the following statements should the nurse make to the client?

"I will assist you in getting out of bed and getting dressed"

A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches the client states "Im feeling really down, and dont want to talk to anyone right now" which of the following responses should the nurse make?

"I'll just sit here with you for a few minutes then"

A nurse on a crisis hotline is speaking to a client who says "I just took an entire bootle of Amitriptyline" which of the following responses should the nurse make?

"I'm glad you called, and I want to send an ambulance to help you"

What classes of drugs treat bipolar?

1st gene: 2nd gene:

Restructuring

A disruptive child on a residential behavioral unit is yelling, The nurse takes him to the bowling alley for an activity.

A charge nurse is admitting a client who has bipolar disorder and who is in the manic phase. Which of the following room assignments should the nurse give the client?

A private room in a quiet location on the unit

A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

A private room in a quiet location on the unit

A nurse in an acute care mental health facility is preparing to administer morning medications for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following action should the nurse take?

Administer the morning dose of lithium

Phenytoin (Phenytek)

Anticonvulsant, slowing down impulses in the brain that cause seizures

Paroxetine (Paxil)

Antidepressant, SSRI

Aripiprozole

Antipsychotic, It can treat schizophrenia, bipolar disorder, depression, and Tourette syndrome. It can also treat irritability associated with autism.

A nurse asks a client who is sducidal to make a safety contract, but the client declines. Which of the following actions should the nurse identify as the priority?

Assign a staff member to stay with the client at all times

What is bipolar?

Bipolar 1: most severe form, at least 1 manic episode, highest mortality rate of the three Bipolar 2: At least 1 hypomanic episode, at least 1 major depressive disorder Cyclothymic disorder: Alternate with symptoms of mild to moderate depression for at least 2 years (adults), Rapid cycling possible

Major depressive disorder nursing interventions

Caring for injuries, establishing therapeutic alliance, promoting reflective dialogue

Restraining

Chemical or mechanical

Tricyclics side effects & teaching

Orthostatic hypotension, dry mouth, blurred vision, photophobia, urinary retention, constipation, tachy, sedation teaching: watch for seizures, very toxic, cardiac arrhythmia, no more than a week supply at one time (suicide risk)

Parents of an adolescent diagnosed with a CD say, "We don't know how to respond when our child breaks the rules in our house. Is there any treatment that might help us?" Which therapy is likely to be helpful for these parents?

Parent-child interaction therapy (PCIT)

Behavioral contract

Parents and child/adolescent agrees to rules, rewards and consequences

Suicide warning signs

Plan, giving their important belongs away, saying/not saying, worried about other things (bills, exams, family), eye contact while talking?

Quiet room

Put in a separate area such as a seclusion room with an unlocked door

What behaviors are identified with conduct disorder Select all that Apply.

Pyromania Stealing Bully Risk taking behaviors Hurting animals

Bipolar priority nursing diagnosis (intervention)?

Risk of injury, Risk of violence (other directed, self directed), ineffective coping

Fluoxetine

SSRI, It can treat depression, obsessive-compulsive disorder (OCD), bulimia nervosa, and panic disorder.

** Lithium **

Used to reduce symptoms of mania and hypomania Keep a normal salt and fluid intake Levels should be monitored at least 5 days after therapy begins, after each dosage change, and until therapeutic level is reached Checked monthly until stable for 6-12 months Then, check blood level every 3 months 0.8-1.4 Toxic level could cause N/V, weakness, and diarrhea 2.0-2.5: can lead to seizures, vision changes

Limit setting

Using clear, sharp statements about prohibited behavior and guidance for performing a behavior that is expected

A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?

Walking with the nurse in the courtyard

Carbamazepine

anticonvulsant, can be used for bipolar disorder

Euphoria

describes an elevated mood and intense feelings of happiness and well-being that are not brought on by situational influences

Anhedonia

inability to feel pleasure

Dysthymia

persistent mild depression

Major depressive disorder vegetative signs

slowly over time (sleep, sex, hygiene) Vegetative symptoms are disturbances of a person's functions necessary to maintain life