Psych Final Exam

Which therapy is most effective in decreasing depression in elderly clients? a) Crisis intervention b) Group therapy c) Orientation therapy d) Reminiscence therapy

d) Reminiscence therapy Reminiscence therapy encourages clients to think about and reflect on the past. Studies have shown that clients who participate in this therapy have increased self-esteem and are less likely to suffer from depression. Reminiscence therapy helps older adults to work through their losses and maintain self-esteem.

What causes an increased risk for suicide in patients with depression?

>> Family or personal history of suicide attempts >> Comorbid anxiety disorder or panic attacks >> Comorbid substance use disorder or psychosis >> Poor self-esteem >> A lack of social support >> A chronic medical condition

A charge nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "Care during the continuation phase focuses on treating continued manifestations of MDD." B. "The goal of treatment during the maintenance phase is prevention of future episodes of MDD." C. "The client is at greatest risk for suicide during the first weeks of an MDD episode." D. "Medication and psychotherapy are used to prevent a relapse of MDD."

A. "Care during the continuation phase focuses on treating continued manifestations of MDD." The focus of the continuation phase is relapse prevention. Treatment of manifestations occurs during the acute phase of MDD.

A nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statements by the nurse is appropriate? A. "Tell me about how you are feeling right now." B. "You should focus on the positive things in your life to decrease your anxiety." C. "Why do you believe you are experiencing this anxiety?" D. "Let's discuss the medications your provider is prescribing to decrease your anxiety."

A. "Tell me about how you are feeling right now." Asking an open-ended question is therapeutic and assists the client in identifying anxiety.

A nurse working in an acute mental health facility is caring for a 35-year-old female client who has clinical findings of depression. The client lives at home with her husband and two young children. She currently smokes and has a history of chronic asthma. The nurse should identify which of the following as risk factors for depression for this client? (Select all that apply.) A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes E. Being married

A. Age of 35 years old B. Female gender C. History of chronic asthma D. Currently smokes Nicotine is considered a substance abuse disorder**

A nurse is caring for a client who has a new prescription for disulfiram (Antabuse) for the treatment of his alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. This form of treatment is an example of which of the following? A. Aversion therapy B. Flooding C. Biofeedback D. Dialectical behavior therapy

A. Aversion therapy Aversion therapy pairs a maladaptive behavior with unpleasant stimuli to promote a change in behavior.

A nurse is planning care for the termination phase of a nurse-client relationship. Which of the following actions is appropriate to include in the plan of care? A. Discussing ways to use new behaviors B. Practicing new problem-solving skills C. Developing goals D. Establishing boundaries

A. Discussing ways to use new behaviors

A nurse is working in a community mental health facility. Which of the following services are appropriate for clients to receive? (Select all that apply). A. Educational groups B. Medication dispensing programs C. Individual counseling programs D. Detoxification programs E. Crisis intervention

A. Educational groups B. Medication dispensing programs C. Individual counseling programs Detox programs are provided in partial hospitalization programs Crisis intervention is offered in an ACT program

A nurse observes a client who is pacing and wringing his hands. The client states, "I don't know why, but I've worried every day for over a year that my son will die a horrible death." The nurse identifies that this finding is consistent with which of the following disorders? A. Generalized anxiety disorder B. Panic disorder C. Posttraumatic stress disorder D. Acute stress disorder

A. Generalized anxiety disorder Generalized anxiety disorder is characterized by uncontrollable, excessive worry for more than 3 months.

A nurse working on an acute mental health unit is caring for a client who has post-traumatic stress disorder (PTSD). Which of the following is an expected finding? (Select all that apply.) A. Hallucinations B. Obsessive need to talk about the traumatic event C. Exaggerated displays of emotion D. Recurring nightmares E. Diminished reflexes

A. Hallucinations D. Recurring nightmares Patients with PTSD will avoid stimuli associated with the traumatic event, be unable to show feelings or emotions, and experience increased arousal.

A nurse is making a home visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following are appropriate suggestions to decrease the client's risk for injury? (Select all that apply) A. Install childproof door locks. B. Place rugs over electrical cords. C. Mark cleaning supplies with colored tape. D. Place the client's mattress on the floor. E. Install light fixtures above stairs.

A. Install childproof door locks. Door locks that are difficult to open are appropriate to reduce the risk of the client wandering outside without supervision. D. Place the client's mattress on the floor. Placing the client's mattress on the floor reduces the risk for falls out of bed. E. Install light fixtures above stairs. Stairs should have adequate lighting to reduce the risk for falls. - Rugs create a fall risk hazard and should be removed. Electrical cords should be secured to baseboards rather than covered. - Cleaning supplies should be placed in locked cupboards. Marking with colored tape does not prevent the client's access to hazardous materials.

A nurse is communicating with a newly admitted client. Which of the following is a barrier to therapeutic communication? A. Offering advice B. Reflecting meaning C. Listening attentively D. Giving information

A. Offering advice Offering advice to a client is a barrier to therapeutic communication and should be avoided. Advice tends to interfere with the client's ability to make personal decisions and choices

A nurse working on an acute mental health unit is admitting a client who has major depressive disorder and co-morbid anxiety disorder. Which of the following is the highest priority action by the nurse? A. Placing the client on one-to-one observation B. Assisting the client to perform ADLs C. Encouraging the client to participate in counseling D. Teaching the client about medication adverse effects

A. Placing the client on one-to-one observation The greatest risk for a client who has MDD and co-morbid anxiety is injury due to self-harm. Therefore, the highest priority intervention is placing the client on one-to-one observation.

A nurse is preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following are appropriate to include in the plan of care? (Select all that apply.) A. Priority restructuring B. Monitoring thoughts C. Diaphragmatic breathing D. Journal keeping E. Meditation

A. Priority restructuring B. Monitoring thoughts D. Journal keeping Diaphragmatic breathing and meditation are forms of behavioral therapies.

A patient with major depression walks and moves slowly. Which term should the nurse use to document this finding? A. Psychomotor retardation B. Psychomotor agitation C. Vegetative sign D. Anhedonia

A. Psychomotor retardation

A nurse is planning a peer group discussion about the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). Which of the following is appropriate to include in the discussion? (Select all that apply.) A. The DSM-5 is used to identify mental health disorders. B. The DSM-5 establishes diagnostic criteria. C. The DSM-5 indicates recommended pharmacological treatment. D. The DSM-5 assists nurses in planning care. E. The DSM-5 indicates expected assessment findings.

A. The DSM-5 is used to identify mental health disorders. B. The DSM-5 establishes diagnostic criteria. D. The DSM-5 assists nurses in planning care. E. The DSM-5 indicates expected assessment findings.

A nurse is told during change-of-shift report that a client is stuporous. When assessing the client, which of the following is an expected finding? A. The client arouses briefly in response to a sternal rub. B. The client has a Glasgow Coma Scale score less than 7. C. The client exhibits decorticate rigidity. D. The client is alert but disoriented to time and place.

A. The client arouses briefly in response to a sternal rub. A client who is stuporous requires vigorous or painful stimuli to elicit a response.

A nurse is planning care for a client following surgical implantation of a vagus nerve stimulation (VNS) device. The nurse should plan to monitor for which of the following adverse effects? (Select all that apply.) A. Voice changes B. Seizure activity C. Disorientation D. Dysphagia E. Neck pain

A. Voice changes D. Dysphagia E. Neck pain

A nurse is obtaining informed consent for a client who has just learned she must have a breast biopsy. The client is perspiring and pale, has a respiratory rate 30/min, and says, "I don't quite understand what you're trying to tell me." The nurse should assess the client's anxiety as which of the following? A. Mild B. Moderate C. Severe D. Panic

B. Moderate Moderate anxiety decreases problem-solving and may hamper one's ability to understand information. Vital signs may increase somewhat, and the person is visibly anxious.

Which disorder is co-morbid in approximately 70% of clients who have a depressive disorder?

Anxiety disorders This combination makes a client's prognosis poorer, with a higher risk for suicide and disability.

A nurse is caring for a client in restraints. Which of the following statements are appropriate documentation? (Select all that apply.) A. "Client ate most of his breakfast." B. "Client was offered 8 oz of water every hr." C. "Client shouted at assistive personnel." D. "Client received chlorpromazine (Thorazine) 15 mg by mouth at 1000." E. "Client acted out after lunch."

B. "Client was offered 8 oz of water every hr." C. "Client shouted at assistive personnel." D. "Client received chlorpromazine (Thorazine) 15 mg by mouth at 1000." How much water was offered and how often it was offered is objective data that should be documented when a nurse is caring for a client in restraints. A description of the client's verbal communication is objective data and should be documented. The dosage and time of medication administration is objective data and should be documented when caring for a client in restraints.

A charge nurse is discussing transcranial magnetic stimulation (TMS) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "TMS is indicated for clients whose depression is not relieved by medication." B. "I will provide post-anesthesia care following TMS." C. "TMS is usually performed as an outpatient procedure." D. "I will schedule the client for daily TMS treatments for the first several weeks."

B. "I will provide post-anesthesia care following TMS." Post-anesthesia care is not necessary after TMS because the client does not receive anesthesia and is alert during the procedure.

A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy? A. "Even if my anxiety improves, I will need to continue this therapy for 6 weeks." B. "The therapist will focus on my past relationships during our sessions." C. "Psychoanalysis will help me reduce my anxiety by changing my behaviors." D. "This therapy will address my conscious feelings about stressful experiences."

B. "The therapist will focus on my past relationships during our sessions." Classical psychoanalysis places a common focus on past relationships to identify the cause of the anxiety disorder.

A nurse is caring for a client who has Alzheimer's disease and is beginning to experience noticeable short-term memory loss. When discussing a new prescription for donepezil (Aricept), the nurse should include which of the following in the teaching? A. "You should avoid taking over-the-counter acetaminophen while on donepezil." B. "You can expect the progression of cognitive decline to slow with donepezil." C. "You will be screened for underlying kidney disease prior to starting donepezil." D. "You should stop taking donepezil if you experience nausea or diarrhea."

B. "You can expect the progression of cognitive decline to slow with donepezil." - Should avoid NSAIDs, rather than acetaminophen, due to risk for GI bleeding - Should be screened for underlying heart and pulmonary disease, rather than kidney disease, prior to treatment - GI adverse effects are common and may result in a dosage reduction. However, the client should not abruptly stop the medication.

A nurse is caring for a group of clients. Which of the following clients should a nurse consider for referral to an assertive community treatment (ACT) group? A. A client in an acute care mental health facility who has fallen several times while running down the hallway B. A client who lives at home and keeps "forgetting" to come in for his monthly antipsychotic injection for schizophrenia C. A client in a day treatment program who says he is becoming more anxious during group therapy D. A client in a weekly grief support group who says she still misses her deceased husband who has been dead for 3 months

B. A client who lives at home and keeps "forgetting" to come in for his monthly antipsychotic injection for schizophrenia An ACT group works with clients who are non-adherent with traditional therapy, such as the client in a home setting who keeps "forgetting" his injection.

A nurse is planning group therapy for clients dealing with bereavement. Which of the following should the nurse include in the initial phase? (Select all that apply.) A. Encourage the group to work toward goals. B. Define the purpose of the group. C. Discuss termination of the group. D. Identify informal roles of members within the group. E. Establish an expectation of confidentiality within the group.

B. Define the purpose of the group. C. Discuss termination of the group. E. Establish an expectation of confidentiality within the group. During the working phase, the group works toward goals and informal roles are identified.

A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone has been getting." Which of the following defense mechanisms is the client using? A. Reaction formation B. Denial C. Displacement D. Sublimation

B. Denial This is an example of denial, which is pretending the truth is not reality to manage the anxiety of acknowledging what is real.

A nurse is performing an admission assessment for a client who has delirium related to an acute urinary tract infection. Which of the following are expected findings? (Select all that apply.) A. History of gradual memory loss B. Family report of personality changes C. Hallucinations D. Unaltered level of consciousness E. Restlessness

B. Family report of personality changes C. Hallucinations E. Restlessness

Which assessment finding in a patient with major depression represents a vegetative sign? A. Restlessness B. Hypersomnia C. Feelings of guilt D. Frequent crying

B. Hypersomnia

A nurse in an outpatient mental health clinic is preparing to conduct an initial client interview. When conducting the interview, which of the following is the highest priority action? A. Respect the client's need for personal space. B. Identify the client's perception of her mental health status. C. Include the client's family in the interview. D. Teach the client about her current mental health disorder.

B. Identify the client's perception of her mental health status. Assessment is the priority action when taking the nursing process approach to client care. Identifying the client's perception of her mental health status provides important information about the client's psychosocial history.

A nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans ways to make his sister look bad so his parents will think he's the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following? A. Placation B. Manipulation C. Blaming D. Distraction

B. Manipulation Manipulation is the dysfunctional behavior of using dishonesty to support an individual agenda.

A nurse hears a newly licensed nurse discussing a client's hallucinations in the hallway with another nurse. Which of the following actions should the nurse take first? A. Notify the nurse manager. B. Tell the nurse to stop discussing the behavior. C. Provide an in-service program about confidentiality. D. Complete an incident report.

B. Tell the nurse to stop discussing the behavior. The nurse should tell the newly licensed nurse to stop discussing the client's hallucinations in a public location. This is the priority action.

A nurse is in the working phase of a therapeutic relationship with a client who has methamphetamine use disorder. Which of the following indicates transference behavior? A. The client asks the nurse whether she will go out to dinner with him. B. The client accuses the nurse of telling him what to do just like his ex-girlfriend. C. The client reminds the nurse of a friend who died from a substance overdose. D. The client becomes angry and threatens harm to himself.

B. The client accuses the nurse of telling him what to do just like his ex-girlfriend. When a client views the nurse as having characteristics of another person who has been significant to his personal life, such as his ex-girlfriend, this indicates transference.

A nurse decides to put a client who has a psychosis in seclusion overnight because the unit is very short-staffed, and the client frequently fights with other clients. This is an example of A. beneficence. B. a tort. C. a facility policy. D. justice.

B. a tort. A civil wrong that violates a client's civil rights is a tort. In this case, it is false imprisonment.

A nurse working in an outpatient clinic is providing teaching to a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? A. "I can expect my problems with PMDD to be worst when I'm menstruating." B. "I will use light therapy 30 min a day to prevent further recurrences of PMDD." C. "I am aware that my PMDD causes me to have rapid mood swings." D. "I should increase my caloric intake with a nutritional supplement when my PMDD is active."

C. "I am aware that my PMDD causes me to have rapid mood swings." A clinical finding is emotional lability (rapid mood swings). PMDD findings are present during the luteal phase (just prior to menses).

A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements by the nurse is appropriate? A. "I feel very sorry for the loneliness you must be experiencing." B. "Suicide is not the appropriate way to cope with loss." C. "Losing someone close to you must be very upsetting." D. "I know how difficult it is to lose a loved one."

C. "Losing someone close to you must be very upsetting."

A nurse is orienting a new client to a mental health unit. When explaining the unit's community meetings, which of the following statements by the nurse is appropriate? A. "You and a group of other clients will meet to discuss your treatment plans." B. "Community meetings have a specific agenda that is established by staff." C. "You and the other clients will meet with staff to discuss common problems." D. "Community meetings are an excellent opportunity to explore your personal mental health issues."

C. "You and the other clients will meet with staff to discuss common problems."

A nurse is caring for several clients who are attending community-based mental health programs. Which of the following clients should the nurse plan to visit first? A. A client who recently burned her arm while using a hot iron at home B. A client who requests that her antipsychotic medication be changed due to some new side effects C. A client who says he is hearing a voice that tells him he is not worthy of living anymore D. A client who tells the nurse he experienced symptoms of severe anxiety before and during a job interview

C. A client who says he is hearing a voice that tells him he is not worthy of living anymore Greatest risk for self-harm

Which of the following is an example of a client who requires emergency admission to a mental health facility? A. A client with schizophrenia who has frequent hallucinations B. A client with symptoms of depression who attempted suicide a year ago C. A client with borderline personality disorder who assaulted a homeless man with a metal rod D. A client with bipolar disorder who paces quickly down the sidewalk while talking to himself

C. A client with borderline personality disorder who assaulted a homeless man with a metal rod. A client who is a current danger to self or others is a candidate for emergency admission.

A nurse is interviewing a 25-year-old client who has a new diagnosis of dysthymia. Which of the following findings should the nurse expect? A. There are wide fluctuations in mood. B. The report of a minimum of five clinical findings of depression. C. The presence of manifestations for at least 2 years. D. There is an inflated sense of self-esteem.

C. The presence of manifestations for at least 2 years. 2 years in adults; 1 year in children.

A nurse is working with an established group and identifies various member roles. Which of the following should the nurse identify as an individual role? A. A member who praises input from other members B. A member who follows the direction of other members C. A member who brags about accomplishments D. A member who evaluates the group's performance toward a standard

C. A member who brags about accomplishments An individual who brags about accomplishments is acting in an individual role that does not promote the progression of the group toward meeting goals. A. An individual who praises the input of others is acting in a maintenance role. B. An individual who is a follower is acting in a maintenance role. D. An individual who evaluates the group's performance is acting in a task role.

A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions? A. Observes group techniques without interfering with the group process B. Discusses a technique and then directs members to practice the technique C. Asks for group suggestions of techniques and then supports discussion D. Suggests techniques and asks group members to reflect on their use

C. Asks for group suggestions of techniques and then supports discussion Democratic leadership supports group interaction and decision making to solve problems.

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse identifies that repetitive behavior in a client who has OCD is due to which of the following? A. Narcissistic behavior B. Fear of rejection from staff C. Attempt to reduce anxiety D. Adverse effect of antidepressant medication

C. Attempt to reduce anxiety Clients who have OCD demonstrate repetitive behavior in an attempt to suppress persistent thoughts or urges.

A nurse in an acute mental health facility is caring for a client who has a severe mental illness and soon will be ready for discharge but still requires supervision much of the time. The client's wife works all day but is home by late afternoon. Which of the following should the nurse suggest as appropriate follow-up care? A. Receiving daily care from a home health aide B. Having a weekly visit from a nurse case worker C. Attending a partial hospitalization program D. Visiting a community mental health center on a daily basis

C. Attending a partial hospitalization program A partial hospitalization program can provide treatment during the day while allowing the client to spend nights at home, as long as a responsible family member is present.

A nurse is leading a peer group discussion about the indications for electroconvulsive therapy (ECT). Which of the following is appropriate to include in the discussion? A. Borderline personality disorder B. Acute withdrawal related to a substance use disorder C. Bipolar disorder with rapid cycling D. Dysthymic disorder

C. Bipolar disorder with rapid cycling

A nurse is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following is appropriate when implementing this form of therapy? A. Demonstrate riding in an elevator, and then ask the client to imitate the behavior. B. Advise the client to say "stop" out loud every time he begins to feel an anxiety response related to an elevator. C. Gradually expose the client to an elevator while practicing relaxation techniques. D. Stay with the client in an elevator until his anxiety response diminishes.

C. Gradually expose the client to an elevator while practicing relaxation techniques. Systematic desensitization is the planned, progressive exposure to anxiety-provoking stimuli. During this exposure, relaxation techniques suppress the anxiety response.

A charge nurse is discussing the characteristics of a nurse-client relationship with a newly licensed nurse. Which of the following are appropriate to include in the discussion? (Select all that apply.) A. The needs of both participants are met. B. An emotional commitment exists between the participants. C. It is goal-directed. D. Behavioral change is encouraged. E. A termination date is established.

C. It is goal-directed. D. Behavioral change is encouraged. E. A termination date is established. It only focuses on the needs of the client. Emotional commitments between participants is a characteristic of intimate/social relationships.

A nurse is assessing a client immediately following an electroconvulsive therapy (ECT) procedure. Which of the following are expected findings? (Select all that apply.) A. Hypotension B. Paralytic ileus C. Memory loss D. Nausea E. Tachycardia

C. Memory loss D. Nausea E. Tachycardia

A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's spouse, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following is an appropriate action by the nurse? A. Verify that a current power of attorney document is on file. B. Instruct the client's spouse to offer finger foods to increase oral intake. C. Provide information on resources for respite care. D. Schedule the client for placement of an enteral feeding tube.

C. Provide information on resources for respite care. - Clients in late-stage Alzheimer's disease are at risk for choking and are unable to eat without assistance. Therefore, offering finger foods is not an appropriate action.

A client tells a student nurse, "Don't tell anyone, but I hid a sharp knife under my mattress in order to protect myself from my roommate, who is always yelling at me and threatening me." Which of the following actions should the nurse take? A. Keep the client's communication confidential, but talk to the client daily, using therapeutic communication to convince him to admit to hiding the knife. B. Keep the client's communication confidential, but watch the client and his roommate closely. C. Tell the client that this must be reported to healthcare staff because it concerns the health and safety of the client and others. D. Report the incident, but do not inform the client of the intention to do so.

C. Tell the client that this must be reported to healthcare staff because it concerns the health and safety of the client and others. This is a serious safety issue that must be reported to the staff. Using the principle of veracity, the student tells this client truthfully what must be done regarding the issue.

A nurse is working on promotion of healthy coping skills with older adult clients who had all previously been hospitalized for severe depression and are now in a residential care facility. The nurse should recognize that this is an example of which of the following? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Mental status examination

C. Tertiary prevention

A nurse is conducting therapy with a several clients and their families. Effective communication with clients and families is based on A. discussing in-depth topics with which the client feels comfortable. B. using silence to avoid unpleasant or difficult topics. C. attending to verbal and nonverbal behaviors. D. requiring the client and family to ask for feedback.

C. attending to verbal and nonverbal behaviors.

A nurse in a long-term care facility is caring for a resident who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following is an appropriate response by the nurse? A. "You have forgotten that this is your home." B. "You cannot go outside without a staff member." C. "Why would you want to leave? Aren't you happy with your care?" D. "I am your nurse. Let's walk together to your room."

D. "I am your nurse. Let's walk together to your room." It is appropriate for the nurse to introduce herself with each new interaction and to promote reality in a calm, reassuring manner.

A nurse is discussing free association as a therapeutic tool with a client who has major depressive disorder. Which of the following client statements indicates understanding of this technique? A. "I will write down my dreams as soon as I wake up." B. "I may begin to associate my therapist with important people in my life." C. "I can learn to express myself in a nonaggressive manner." D. "I should say the first thing that comes to my mind."

D. "I should say the first thing that comes to my mind." Free association is the spontaneous, uncensored verbalization of whatever comes to a client's mind.

When a family asks a nurse for reassurance about a client's condition, which of the following is an appropriate response? A. "I think your son is getting better. What have you noticed?" B. "I'm sure everything will be okay. It just takes time to heal." C. "I'm not sure what's wrong. Have you asked the doctor about your concerns?" D. "I understand you're concerned. Let's discuss what concerns you specifically."

D. "I understand you're concerned. Let's discuss what concerns you specifically." A therapeutic response reflects upon, and accepts, the family's feelings, and it allows the members to clarify what they are feeling.

A nurse is providing teaching for a client who is scheduled to receive electroconvulsive therapy (ECT) for the treatment of major depressive disorder. Which of the following client statements indicates understanding of the teaching? A. "It is common to treat depression with ECT before trying medications." B. "I can have my depression cured if I receive a series of ECT treatments." C. "I will have seizures lasting 1½ to 2 min during ECT." D. "I will receive a muscle relaxant to protect me from injury during ECT."

D. "I will receive a muscle relaxant to protect me from injury during ECT." A muscle relaxant, such as succinylcholine (Anectine), is administered to reduce the risk for injury during induced seizure activity. ECT is indicated for patients who have major depressive disorder that is unresponsive to medications. Induced seizures during ECT typically last only 25-60 seconds.

A charge nurse is discussing mental status examinations with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "To assess cognitive ability, I should ask the client to count backward by 7." B. "To assess affect, I should observe the client's facial expression." C. "To assess language ability, I should instruct the client to write a sentence." D. "To assess remote memory, I should have the client repeat a list of objects."

D. "To assess remote memory, I should have the client repeat a list of objects." Asking the client to repeat a list of objects is appropriate to assess immediate, rather than remote, memory.

A nurse is caring for a client who is experiencing moderate anxiety. Which of the following is an appropriate nursing intervention when trying to give necessary information to the client? A. Reassure the client that everything will be okay. B. Use a low-pitched voice and speak slowly. C. Ignore the client's anxiety so that she will not be embarrassed. D. Demonstrate a calm manner while using simple and clear language.

D. Demonstrate a calm manner while using simple and clear language. Giving information simply and calmly will help the client grasp essential facts.

A nurse working on an acute mental health unit forms a group to focus on self-management of medications. At each of the meetings, two of the members use the opportunity to discuss their common interest in gambling on sports. This is an example of which of the following? A. Triangulation B. Group process C. Subgroup D. Hidden agenda

D. Hidden agenda A hidden agenda is when some group members have a different goal than the stated group goals. The hidden agenda is often disruptive to the effective functioning of the group.

A charge nurse is conducting a class on therapeutic communication to a group of newly licensed nurses. Which of the following responses by the newly licensed nurse requires additional teaching regarding nonverbal communication? A. Personal space B. Posture C. Eye contact D. Intonation

D. Intonation Intonation is the tone of one's voice and can communicate a variety of feelings.

A nurse is planning care for a client who has a mental health disorder. Which of the following is appropriate to include as a psychobiological intervention? A. Assist the client with systematic desensitization therapy. B. Teach the client appropriate coping mechanisms. C. Assess the client for comorbid health conditions. D. Monitor the client for adverse effects of medications.

D. Monitor the client for adverse effects of medications.

A nurse is communicating with a client on the acute mental health facility. The client states, "I can't sleep. I stay up all night." The nurse responds, "You are having difficulty sleeping?" Which of the following therapeutic communication techniques is the nurse demonstrating? A. Offering general leads B. Summarizing C. Focusing D. Restating

D. Restating Restating allows the nurse to repeat the main idea expressed.

A nurse is caring for a client who is experiencing a panic attack. Which of the following is an appropriate nursing intervention? A. Discuss new relaxation techniques. B. Show the client how to change his behavior. C. Distract the client with a television show. D. Stay with the client, and remain quiet.

D. Stay with the client, and remain quiet. During a panic attack, the nurse should quietly remain with the client. This promotes safety and reassurance without additional stimuli. Do not try to teach new techniques, show them how to change their behavior, or ask a lot of questions because the patient is unable to concentrate on new information.

Who is most likely to be diagnosed with a depressive disorder?

Twice as common in females between the ages of 15 and 40 than in males. Also, very common in patients older than 65 years old, but more difficult to recognize. >> Often mistaken for dementia. Similar clinical findings between depression and dementia are - memory loss, confusion, and behavioral problems (social isolation or agitation).

An elderly client, newly admitted to a nursing home, refuses to participate in activities of daily living (ADLs). Which nursing intervention would best help the client to be as independent as possible in meeting self-care needs? a) Assign a variety of caregivers so that one person does not do everything for the client. b) Establish a specified amount of time for ADL completion. c) Set client expectations at the beginning of each day. d) Structure the activities of daily living to mirror previous home routines.

d) Structure the activities of daily living to mirror previous home routines. Structuring the activities of daily living to mirror previous home routines can help foster independence in activities of daily living. Maintaining familiar routines will ease the transition to residential care and increase client compliance in meeting self-care needs.

Client teaching for all antidepressants

☐ Do not discontinue medication suddenly. ☐ Therapeutic effects are not immediate, and it may take several weeks or more to reach full therapeutic benefits. ☐ Avoid hazardous activities, such as driving or operating heavy equipment/machinery, due to the potential adverse effect of sedation. ☐ Notify the provider of any thoughts of suicide. ☐ Avoid alcohol while taking an antidepressant.