Psych final exam 1-3

A healthcare provider prescribes clozapine (Clozaril) to a client with schizophrenia. Which parameters should be assessed before initiating the drug? Select all that apply a.Prolactin levels b.Body mass index c.White blood cell count d.Serum potassium levels e.Absolute neutrophil count

B,C,E

A nurse in a psychiatric unit is caring for several patients. Which of the following clients should the nurse recommend for group therapy?: A. a client who has been taking Amitriptyline for 3 months for depression B. a client exhibiting psychotic behavior C. a client admitted 12 hours ago for acute mania D. a client who is experiencing alcohol intoxication

A

The nurse would recognize which of the following drugs as central nervous system depressants? select all that apply a. Cannabis b. Diazepam (Valium) c. Heroin d. Meperidine (Demerol) e. Phenobarbital f. Whisky

B,E,F

Which of the following statements about aggression has been found to be true?

Being part of a group can increase a person's aggressive tendencies.

A client is pacing in the hall when the nurse overhears the client say, "Leave me alone. I am not a member of the secret service." How should the nurse initially respond?

"Tell me what you are hearing right now."

A patient expresses sadness, stating "being all alone with no one to share my life." Which response by the nurse demonstrates the existence of a therapeutic relationship? a. "Loneliness can be a very painful and difficult emotion." b. "Let's talk and see if you and I have any interests in common." c. "I use Facebook to find people who share my love of cooking." d. "Loneliness is managed by getting involved with people."

A

Clonidine is prescribed for symptoms of opioid withdrawal. Which of the following nursing assessments are essential before giving a dose of this medication? a. Assessing the client's blood pressure b. Determining when the client last used an piate c. Monitoring the client for tremors d. Completing a thorough physical assessment

A

which of the following is true about benzodiazepines such as Valium and Ativan?

Benzodiazepines (sometimes called "benzos") work to calm or sedate a person, by raising the level of the inhibitory neurotransmitter GABA in the brain. Common benzodiazepines include diazepam (Valium), alprazolam (Xanax), and clonazepam (Klonopin), among

The nurse is sitting in the day area with a patient who has been experiencing a major depressive episode. The patient appears flat, makes little eye contact, and nods their head yes or no in response to questions. Which statement by the nurse aligns with what is known about strategies for communicating with a depressed individual?

-be patient and understanding. -offer encouragement and acknowledge gains, no matter how small. -ask if there is anything you can do to help, instead of asking what's wrong. -acknowledge that the mental health condition isn't their fault. -speak clearly and at a pace that they understand.

Which nursing action(s) are appropriate when providing care to a client who is in four-point restraints? select all that apply

-patient behavior that indicates the continued need for restraints. -patient's mental status, including orientation. -number and type of restraints used and where they're placed. -condition of extremities, including circulation and sensation. -extremity range of motion. -patient's vital signs. -skin care provided.

Which medication does a nurse anticipat will be prescribed to a patient to prevent life-threatening symptoms of alcohol withdrawal?

Diazepam, Lorazepam, Thiamine

What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient? a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c. Considering the patient's history, there is little chance that the comment will do any actual harm. d. Most people with a mentally illness have by necessity developed a high tolerance of forgiveness.

A

The wife of a client who is taking doxepin (Sinequan) calls the nurse and reports that her husband has become more hopeless and disconnected with life. What is the nurse's best response?

?

A 46-year-old female arrives to the ED brought in by law-enforcement after starting a fight with another woman at a local bar and threatening to kill herself. Her blood alcohol level is 120. Which question would be most important for the nurse to ask?

?

A client states, "I stopped taking my fluvoxamine (Luvox) yesterday because I never have the desire to have sex with my wife anymore." Which response by the nurse is most therapeutic?

?

A client who has a history of a short temper and physically abusive behavior becomes violent and is admitted to the psychiatric service. At the time the client is extremely anxious. What is the priority nursing action?

?

A client who is depressed states "I think my family would be better off without me. They don't need to worry about me anymore." What would be the appropriate first response by the nurse?

?

A husband is upset that his wife alcohol withdrawal delirium has persisted for a second day what is the most appropriate and its response by the nurse?

?

A novice nurse on an inpatient psychiatic unit is caring for a patient diagnosed with bipolar disorder, under the supervision of her preceptor. The patient is experiencing a manic episode. Which statement made by the novice nurse indicates further guidence is needed by the preceptor?

?

A sexual assault victim on the behavioral health unit is staring blankly at the wall and not responding to their name or other verbal cues. What action by the nursing assistant warrants further education?

?

Which nursing intervention is particularly well-chosen for addressing a population at high risk for developing schizophrenia: A) Screening a group of males between the ages of 15 - 25 for early symptoms. B) Forming a support group for females aged 25 - 35 who are diagnosed with substance use issues. C) Providing a group for patients between the ages of 45 - 55 with information on coping skills that have proven to be effective. D) Educating the parents of a group of developmentally delayed 5 - 6 year olds on the importance of early intervention.

A

Kyle, a patient with schizophrenia, began to take the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is ok he seems unable to respond verbally. His vital signs are: BP- 170/100, HR-110, T- 104.2F. What are the priority nursing interventions. Select all that apply a. Begin to wipe him with a washcloth wet with cold water or alcohol. b. Hold his medication, and contact his provider stat. c. Administer a medication such as benztropine IM to correct his dystonic reaction. d. Reassure him that although there is no treatment for his tar dive dyskinesia, it will pass. e. Explain that he has anticholinergic toxicity, hold his meds, and give IM physostigmine. f. Hold his medication tonight, and

A, B

Based on Maslow's hierarchy of needs, physiological needs for a restrained patient include:Select all that apply. a. Private toileting, oral hydration b. Checking the tightness of the restraints c. Therapeutic communication d. Maintaining a patent airway

A,B,D

A client is brought to the emergency department after a friend noticed fresh blood on the client's sleeves. During the body check, the nurse visualizes several open, horizontal slash marks on both of their forearms. Which response is appropriate at this time?

Address the marks, ask how she got them.

Three days after admission to the ICU following an alcohol-related auto accident, a client begins to sweat, have tremors, and scream that they are bugs crawling on him and shadowy figures in his room. A few hours later the client has a grand Mal seizure. What condition does the nurse suspect?

Alcohol withdraw

The nurse is caring for a new patient admitted yesterday morning with suicidal ideation and a plan to hang themselves. The patient is complaining of chronic sleep disturbances.Which medication might the provider order to be taken at bedtime because of its dual purpose?

Ambien, trazodone

The nurse is reading the provider's admission and sees "Ms. Smith reports significant anhedonia over the last six months since her husband died." Which statement by the patient during the nursing assessment matches the provider's documentation?

Anhedonia is the inability to feel pleasure

A newly admitted male patient has a long history of aggressive behavior toward staff. Which statement by the nruse demonstrates the need for more information about the use of restraint? A. "If his behavior warrants restraints, someone wills tay with him the entire time he's restrained." B. "I'll call the primary provider and get an as needed (prn) seclusion/restraint order." C. "If he's restrained, be sure he is offered food and fluids regularly." D. "Remember that physical restraints are our last resort."

B

Substance abuse is often present in people diagnosed with bipolar disorder. Laura, a 28-year-old with a diagnosis of bipolar disorder, drinks alcohol instead of taking her medications. The nurse caring for this patient recognizes that: A. Anxiety may be present. B. Alcohol ingestion is a form of self-medication. C. The patient is lacking a sufficient number of neurotransmitters. D. The patient is using alcohol because she is depressed.

B

The nurse has completed medication education for the anxious patient who is receiving buspirone (BuSpar). The nurse determines that the patient needs additional instruction when the patient makes which statement? a. "Side effects I might experience include dizziness, headache, and drowsiness." b. "I can take this medication when I feel anxious and it will relax me." c. "I have to take this medicine on a regular basis for it to help me." d. "I don't need to worry about becoming dependent on this medication."

B

The nurse is caring for a patient who is making obscene gestures to other staff members and is raising his voice in protest of an ordered test. What is the nurse's best action? a. Determine the patient's level of anxiety. b. Determine what basic patient needs are not being met. c. Review the patient's chart for previous violent episodes. d. Contact the health care provider regarding the patient's actions.

B

Which of the following statements about anger is true? a. Expressing anger openly and directly usually leads to arguments b. Anger results from being frustrated, hurt, or afraid c. Suppressing anger is a sign of maturity d. Angry feelings are a negative response to a situation.

B

Which statement made by the nurse demonstrates the best understanding of nonverbal communication? Terms in this set (10) OriginalAlphabetical a. "The patient's verbal and nonverbal communication is often different." b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response." c. "If a patient is slumped in the chair, I can be sure he's angry or depressed." d. "It's easier to understand verbal communication that nonverbal communication."

B

Which student behavior is consistent with therapeutic communication? a. Offering your opinion when asked in order to convey support. b. Summarizing the essence of the patient's comments in your own words. c. Interrupting periods of silence before they become awkward for the patient. d. Telling the patient he did well when you approve of his statements or actions.

B

A client diagnosed with generalized anxiety disorder is placed on clonazepam (Klonopin) and buspirone (BuSpar). Which client statement indicates teaching has been effective? a. The client verbalizes that the clonazepam (Klonopin) is to be used for long-term therapy in conjunction with buspirone (BuSpar). b. The client verbalizes that buspirone (BuSpar) can cause sedation and should be taken at night. c. The client verbalizes that clonazepam (Klonopin) is to be used short-term until the buspirone (BuSpar) takes full effect. d. The client verbalizes that tolerance can result with long-term use of buspirone (BuSpar).

C

A client with a history of alcoholism is diagnosed with Wernicke encephalopathy associated with Korsakoff syndrome. What does the nurse anticipate will be prescribed? A. Traditional phenothiazine B. Judicious use of antipsychotics C. Intramuscular injections of thyamine D. Oral administration of chlorpromazine

C

An effective method of preventing escalation in an environment with violent offenders is to develop a level of trust through: A. A causual authoritative demeanour B. Keeping patients busy C. Brief, frequent, nonthreathening encounters D. Threats of seclusion or punishment

C

Client "I had an accident" Nurse "Tell me about your accident" This is an example of which therapeutic communication technique? A. Making observations B. Offering self C. General lead D. Reflection

C

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, "Las sight, demons came into my room and tried to rape me." Which response would be most therapeutic? a. "There are no such things as demons. What you saw were hallucinations." b. "It is not possible for anyone to enter your room at night. You are safe here." c. "You seem very upset. Please tell me more about what you experienced last night." d. "That must have been very frightening, but we'll check on you at night and you'll be safe."

C

The client tells the nurse that she takes a drink every morning to calm her nerves and stop her tremors. The nurse realizes the client is at risk for: A. An anxiety disorder B. A neurologic disorder C. Physical dependence D. Psychologic addiction

C

A patient is receiving 3mg of risperidone (Risperdal) daily as part of their treatment for schizophrenia. During the morning assessment, the nurse notes that the patient has developed tremors and a temperature of 104 degrees. What should the nurse do next?

Call the physician

Discharge teaching is complete on a patient who was admitted with schizophrenia. The home medications that he is being discharged on include Clozapine (Clozaril). Which statement made by the patient indicates to the nurse that the teaching has been effective in regards to his medications?

Can cause agranulocytosis so CBC should be drawn regularly, weight gain, diabetes, and dyslipidemia

The nurse is reviewing the data below of four clients with psychiatric disorders. Which client would require monitoring of serum sodium levels based on the given data? Client Condition Drug Therapy А Panic disorder Escitalopram (Lexapro) B Bipolar depression Paroxetine (Paxil) C Schizophrenia Asenapine (Saphris) D Bipolar 1 disorder Lithium (Lithobid)

D

What question by the nurse leader is helpful in managing a monopolizing member of a group? a. "You seem angry. Is there something you want to discuss with the group?" b. "Would it be helpful if you had time to think about the question?" c. "Would you tell us about experiences that have frightened you?" d. "Who else would like to share feelings about this issue?"

D

A nurse is caring for a client who has been prescribed disulfiram (Antabuse) as a deterrent to alcohol relapse. Which information should the nurse include when teaching the client about this medication? A. "Only oral ingestion of alcohol will cause a reaction when taking this drug." B. "It is safe to drink beverages that have only 12% alcohol content." C. "This medication will decrease your cravings for alcohol." D. "Reactions to combining Antabuse with alcohol can occur 2 weeks after stopping the drug."

D Using alcohol, even a small amount, while taking this medication can lead to a reaction that may include flushing, throbbing headache, breathing problems (e.g., shortness of breath, fast breathing), nausea, vomiting, dizziness, extreme tiredness, fainting, fast/irregular heartbeat, or blurred vision.

Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic? a. Restating b. Encouraging description of perception c. Summarizing d. Asking "why" questions

D therapeutic communication techniques such as active listening, silence, focusing, using open ended questions, clarification, exploring, paraphrasing, reflecting, restating, providing leads, summarizing, acknowledgment, and the offering of self, will be described below.

The nurse is providing medication education to a patient who has been prescribed lithium to stabilize mood. Which early signs and symptoms of toxicity should the nurse stress to the patient. Select all that apply. A. Increased attentiveness B. Getting up at night to urinate C. Improved vision D. An upset stomach for no apparent reason E. Shaky hands that make holding a cup difficult

D, E

signs of stimulant abuse

Dilated pupils Restlessness Hyperactivity Loss of appetite Weight loss Sweating Deceptive behavior, such as lying or stealing Doctor shopping, or meeting with multiple doctors to get prescriptions Using prescriptions more than prescribed Using stimulant drugs without a prescription Using illicit stimulant drugs Exhibiting excessive energy or motivation Aggressive behavior or anger outbursts Mood-swings Risky or impulsive behaviors Jitteriness Rapid heartbeat Elevated blood pressure Hyper-focus Flight of ideas Racing thoughts Anxiety or nervousness Increased sense of well-being or confidence

A client with depression has been taking escitalopram (Lexapro) for the last 3 months and has noticed improvement of symptoms. The nurse asks the client about any side effects they have experienced. What would the nurse expect the client to report?

Headache, nausea, diarrhea, dry mouth, increased sweating, feeling nervous, restless, fatigue, or having trouble sleeping (insomnia)

A client has been undergoing lithium (Lithobid) therapy since bipolar disorder was diagnosed. The client teaches back the following instructions to the nurse regarding pharmacological managment of his mental illness. In light of the client's statements, what will the nurse do? Client Statement: Drink 2-3L of water every day Eat a low-sodium diet Have blood drawn prior to each follow up appointment to include lithium level, blood urea nitrogen (BUN), and thyroid stimulating hormone (TSH)

Instruct to have adequate sodium in diet

The nurse is caring for a patient with bipolar 1 disorder who takes lithium (Eskalith). A lab draw for a lithium level reveals a serum value of 0.3 mmol/L. What behaviors would the nurse expect to see in the client?

Lithium serum levels normally range from approximately 0.6 to 1.2 mEq/L. low lithium side effects- -frequent urination. -thirst. -hand tremors. -dry mouth. -weight gain or loss. -gas or indigestion. -restlessness. -constipation.

A 23-year-old woman presents to the outpatient psychiatric clinic and is diagnosed with bipolar 2 disorder. She is prescribed valproic acid (Depakote). Which statement by the patient indicates the nurse's teaching about the medication has been effective?

Monitor Depakote levels, liver function tests, and CBC with diff every 3-6 months. Take with food.

Citalopram (Celexa) is prescribed for a client with generalized anxiety disorder and depression. What information does the nurse include when teaching the client about this drug?

Monitor for hyponatremia. Administer with food. Administer dose at 6 PM or later. Promote balanced nutrition and exercise.

Narcan Administration

NARCAN (naloxone) may be administered intravenously, intramuscularly, or subcutaneously. The most rapid onset of action is achieved by intravenous administration, which is recommended in emergency situations.

A patient is being admitted for bipolar disorder, type 1. Which of the following statements made by the patient is an example of grandiose delusion?

People experiencing grandiose delusions often describe larger-than-life feelings of superiority and invulnerability. Grandiosity is an exaggerated sense of one's importance, power, knowledge, or identity, even if there is little evidence to support the beliefs.

What is the nurse's priority concem when caring for a bipolar manic patient?

Providing safety

A client with a family history of diabetes is concerned about the effects of psychiatric medication. Which medication is most likely to cause problems with glucose regulation?

SGA such as zyprexa and clozaril

For what reason would a patient with bipolar 2 disorder be most likely admitted to an inpatient psychiatric unit?

SI

A patient presents to the emergency room with a sore throat, body aches, and a temperature of 100.8F. Upon examination of the list of home medications, which drug would prompt further assessment by the nurse?

SJS - so look for anticonvulsants such as lamictal

A client with borderline personality disorder is admitted for major depression and non-compliance with medications. On the second night of hospitalization, the client awakens from a nightmare and is yelling at her roommate for "coming at me with that knife you've got hidden." What should the nurse do first to ensure safety?

Safety for the roommate

A new patient arrives to the inpatient psychiatric unit after using methamphetamine and making suicidal statements. Which action by the nurse should take priority?

Safety then ABC's

The serum lithium level of a client admitted during a manic episode is 2.7 mEq/L. What does the nurse expect to find when assessing this client?

Seizures Nystagmus Fasciculations

The nurse is caring for a patient with panic disorder on the inpatient unit. What primary characteristic of this disorder does the nurse know the patient likely struggles with?

Sense of impending doom or danger. Fear of loss of control or death. Rapid, pounding heart rate. Sweating. Trembling or shaking. Shortness of breath or tightness in your throat. Chills. Hot flashes.

The nurse knows that which statement is true about stress?

Stress is the wear and tear that life causes on the body.

Which of the following would the nurse recognize as signs of alcohol withdrawal? Select all that apply

Symptoms may occur from two hours to four days after stopping alcohol. They may include headaches, nausea, tremors, anxiety, hallucinations, and seizures.

Which behaviors would the nurse expect to observe in a patient experiencing an acute manic episode. Select all that apply

The defining characteristics of mania include increased talkativeness, rapid speech, a decreased need for sleep, racing thoughts, distractibility, increase in goal-directed activity, and psychomotor agitation

What are the following reasons that nurses lead groups? select all that apply

The nurse-led group therapy focuses on recovery concepts such as identifying and modifying maladaptive thinking, developing assertiveness skills, and learning new coping skills. Group therapy creates an environment where the patient tries out and develops new ways to manage emotions and behaviors.

Rights of Psychiatric Patients

The right to be informed of one's own condition, of proposed or current services, treatment or therapies, and of the alternatives; The right to consent to or refuse any service, treatment or therapy upon full explanation of the expected consequences of such consent or refusal.

Which of the following statements indicate that the nurse understands the stages of alcohol withdrawal? select all that apply

The signs and symptoms of early withdrawal usually occur within 48 hours of the last drink. The initial indication is an elevation of vital signs: heart rate, blood pressure, and temperature. Tremors develop next—first a fine tremor of the hands and fasciculation of the tongue, then gross tremors of the extremities.

A client with major depressive disorder is being considered for electroconvulsive therapy (ECT). Which client teaching should the nurse make a priority for informed decision-making?

They will be lathargic or confused after ECT

Which admission interview question would be most effective in identifying potential risk factors for borderline personality disorder?

Were you ever sexually, physically, or emotionally abused as a child?

A 40-year-old patient with Bipolar I disorder would benefit the most from which medication? a Carbamazepine (Tegretol) b Olanzapine (Zyprexa) c Paliperidone (Invega) d Sertraline (Zoloft)

a

A client calls the nurse and reports feeling anxious. What is the appropriate initial response? a.Sit and talk with the client about the feelings. b.Ask the unlicensed assistive personnel to check on the client. c.Administer the prescribed as-needed antianxiety medication. d.Call the client's health care provider to report the client's anxiety.

a

A client has just been admitted with a diagnosis of schizophrenia, paranoid type. Which is an example of a negative symptom of schizophrenia? a Anhedonia b Delusions that President Donald trump is sending aluminum bugs to eat at my face while I sleep c Auditory hallucinations telling the patient to take cover under the tables in the milieu of the unit d The patient's belief that his medications are being contaminated with ricin poison

a

The nurse is providing care to a client taking fluphenazine (Prolixin) for chronic schizophrenia. Which drug does the nurse anticipate will be prescribed to the client for routine use to manage neuromuscular side effects of treatment? a Benztropine (Cogentin) b Lorazepam (Ativan) c Lurasidone (Latuda) d Thioridazine (Thorazine)

a

A few hours after the nurse administers the morning dose of paroxetine (Paxil), the patient becomes hostile, confused, shivering and screaming that he is going to die. The patient's vital signs are as follows: Blood Pressure: 158/92 Pulse: 118 Respirations: 22 SpO2: 99% Temperature: 102.6 F The nurse prepares to call the psychiatrist to report this change in condition. What pharmacological orders might the nurse receive? Select all that apply a. cyproheptadine (periactin) b. dantrolene (dantrium) c. flumazenil (romazicon) d. lorazepam (Ativan) e. sertraline (Zoloft)

a, b, d

The nurse has just completed an admission interview and physical assessment. Which findings would be consistent with a diagnosis of borderline personality disorder? Select all that apply a. history of mood swings b. fine scarring noted on both wrists c. poor personal hygiene habits d. report of a suicide attempt 6 months ago e. currently prescribed an antianxiety medicine

a, b, d, e

A client brings himself to the emergency room in a state of panic because he is currently taking isocarboxazid (Marplan) and attended a cookout a few hours ago where he consumed a large amount of beer and alcohol. What symptoms will the nurse monitor the client for during the remainder of the shift. Select all that apply a.chest pain b. clonic jerking of the extremities c. hostile mood swing d. hypertension e. severe headache f. hypothermia

a, d, e

A confused hallucinating client says. "My arms are turning to stone." What is the most therapeutic response?

assure her they are not

A hospitalized, depressed client has been taking nortriptyline (Aventyl) for 1 week. They have become more social and no longer talk about suicide. What should the nurse do in response to the client's behavior? A.arrange for the client to have more visitors b. keep the client under close supervision c. observe the client for side effects of the medication d. have the client perform a daily self-reflection

b

A patient experiencing extrapyramidal side effects is not able to sit still in their chair or stop tapping their feet on the floor. What would the nurse record this observation as in their medical record? a Acute dystonia b Akathisia c Pseudo parkinsonism d Tardive dyskinesia

b

Which of the following statements would indicate that teaching about naltrexone(Re Via) has been effective? a."I'll get sick if I use heroin while taking this medication." b."This medication will block the effects of any opioid substance I take." c."If I use opioids while taking naltrexone, I'll become extremely ill." d."Using naltrexone may make me dizzy."

b. This medication will block the effects of any opioid substance I take

A client with a history of traumatic brain injury is admitted for severe anxiety related to intrusive thought about having sexual encounters with animals. Upon review of the client's home medication list, which medication causes the most concern for the nurse and needs brought to the provider's attention?

bupropion

A patient is receving lurasidone (Latuda) for schizophrenia and tells the nurse they have not had a bowel movement for two days. What is the best initial action by the nurse? a Contact the physician for an order for a fleet's enema b Contact the physician for an order for an abdominal x-ray c Have the patient drink prune juice and additional fluids d Hold the medication until the patient has a bowel movement

c

After performing a SADPERSONS risk assessment, which finding would the nurse consider to be a risk factor for carrying out a suicide plan? .drinks wine in the evenings b. occasionally takes sleeping pills c. recently separated from spouse d. has five biological children

c

What is the priority action for a client who is experiencing a flashback? A.teaching the client ways to decrease anxiety b. explaining the cause of anxiety to the patient c. reassuring and protecting the client until the episode subsides d. providing a physical activity to redirect client focus

c

Which chronic medical condition would need to be investigated before a diagnosis of major depressive disorder was made? a.asthma b. crohn's disease c. hypothyroidism d. migraine headache

c

Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient is experiencing auditory hallucinations? a "I know you say you hear voices, but I cannot hear them" b "Stop listening to the voices, they are not real" c "you say that you are hearing voices. What are they telling you?" d "Please tell the voices to leave you alone for now"

c

Which statement by the client would indicate to the nurse the education about clonazepam (klonopin) has been effective? A."I will probably always need to take this medication for my depression" b. "my anxiety will be eliminated if I take this medication as prescribed" c. "this medication will quickly relax me so that I can focus on problem solving"

c.

"I like to skate like a freight, don't hate" is an example of what type of speech exhibited by a bipolar patient?

clang association

The nurse is caring for a client in an outpatient clinic who has selected and obtained lethal measures to follow through with suicide completion. What is the priority action for this client? a.schedule a follow up appointment in the clinic in 1-3 weeks b. referral to an outpatient psychotherapy service c. encourage use of coping skills to reduce stress d. arrange for admission to the inpatient behavioral health unit

d

Which medication would the nurse be hesitant to call in a prescription for they knew the patient has a history of repeated attempts of suicide by overdose? a. mirtazapine (remeron) b. hydroxyzine (atarax) c. fluoxetine (prozac) d. clomipramine(anafranil)

d.

A client with depression was prescribed fluoxetine (Prozac). After two days, the client arrives at the hospital and reports restlessness, confusion, and muscle spasms. Upon assessment, the nurse finds an elevated body temperature. Which intervention by the healthcare provider would be the first to occur?

fluids, no reversal for prozac

Which statement made by the patient would the nurse identify as a risk factor for suicide?

giving things away saying goodbye being more social

The patient has been receiving olanzapine (Zyprexa) for chronic, recurrent psychosis. the nurse assesses that the patient has developed tardive dyskinesia. What findings support this conclusion?

tardive dyskinesia- involuntary and abnormal movements of the jaw, lips and tongue. Typical symptoms include facial grimacing, sticking out the tongue, sucking or fish-like movements of the mouth.

A patient with schizoaffective disorder is taking clozaril (Clozapine). Which laboratory finding would require immediate intervention by the nurse?

labs to monitor- Baseline blood tests should check white cell count, troponins, CRP and possibly BNP3. Patients with a history of cardiac disease or abnormal cardiac findings on examination (such as QT prolongation) should be referred to a cardiologist

After taking apriprazole (Abilify) for one month, a client reports, "I feel stiff and my hands shake now." The picture below illustrates the client's posture observed by the nurse in the clinic. What extrapyrimidal side effect does the nurse conclude the client has developed?

parkinsonism

A client has been receiving oxycodone with acetaminophen for moderate pain associated with a serious back injury sustained in a motor vehicle accident. The client has returned three times in the last month for refills of the prescription. Which assessment findings in addition to slurred speech leads the nurses suspect opioid intoxication?

pinpoint pupils, euphoria, drowsiness, slurred speech, impaired memory, hypotension, bradycardia, bradypnea, hypothermia

A nurse detects that a client is experiencing severe-level anxiety. Which nursing intervention should be implemented first?

provide calm, brief, directive communication

A client with obsessive-compulsive disorder washes their hands three times for three minutes, then uses three paper towels to open the door to avoid touching the dirty doorknob. How should the nurse respond initially to this behavior?

short answer

Which side effects of quetiapine (Seroquel) would the nurse include in the discharge instructions that are important for the client to monitor at home?

side effects of Seroquel- -speech problems; -dizziness, drowsiness, -tiredness; -lack of energy; -fast heartbeats; -stuffy nose; -increased appetite, -weight gain; -upset stomach, -vomiting, -constipation; -dry mouth

A client is receiving imipramine (Tofranil) for depression. Which adverse effect specific to this drug class requires further assessment?

side effects- nausea. drowsiness. weakness or tiredness. excitement or anxiety. nightmares. dry mouth. skin more sensitive to sunlight than usual. changes in appetite or weight.

A nurse is caring for a client who is diagnosed with bipolar 1 disorder. Which assessment finding supports the diagnosis?

symptoms -feeling sad, hopeless or irritable most of the time. -lacking energy. -difficulty concentrating and remembering things. -loss of interest in everyday activities. -feelings of emptiness or worthlessness. -feelings of guilt and despair. -feeling pessimistic about everything. -self-doubt.

During an inpatient assessment, the nurse determines the patient is demonstrating symptoms of psychosis. What did the patient say that led the nurse to this conclusion. Select all that apply.

symptoms of psychosis- -A drop in grades or job performance. -Trouble thinking clearly or concentrating. -Suspiciousness or unease around others. -Lack of self-care or hygiene. -Spending more time alone than usual. -Stronger emotions than situations call for. -No emotions at all.

Confidentiality means respecting the client's right to keep his or her information private. When can the nurse share information about the client?

the client threatens to harm a family memberthe client gives written permission the client's legal guardian asks for information