Psych Questions

A client with schizophrenia tells the nurse "I eat skiller. Tend to end. Easter. It blows away. Get it?" The best response for the nurse to make would be:

"I am having difficulty understanding what you are saying."

A client, recently admitted to the behavioral unit, quickly paces about the dayroom while pounding his fist together. The client's speech pattern is rapid, and his affect appears animated and angry. Based on these observations, which intervention should be the nurse's immediate priority?

Provide a safe, therapeutic milieu

A client, aged 16 years, comes to the crisis clinic with several superficial cuts on her left wrist. She paces around the room and cries with convulsive sobs. She cowers when approached and response to the nurse's question with shrugs or monosyllables. The most therapeutic response by the nurse would be:

"I can see you are feeling anxious. I am going to stay and talk with you to help you feel better"

When working with a client who is on phenelzine (Nardil), the nurse teaches the client about the medication. Which of the following statements by the client best indicates that the client understood the lessons of the nurse?

"I realize that I must stay on a special diet."

A nurse is giving instructions to a client receiving lithium. The nurse tells the client to do which of the following to prevent lithium toxicity:

Avoid becoming dehydrated during exercise

The most appropriate response by the nurse when a despondent client says, "nothing matters anymore" would be

"Are you having thoughts of suicide?"

A disheveled client with severe depression and psychomotor retardation has not showered for several days. The nurse should:

Firmly and neutrally assist the client with showering

A client is hospitalized for severe depression. The nurse can expect to provide the client with a teaching plan about:

Fluoxetine (Prozac)

Which of the following statements by a client on Ventafaxine (Effexor) best indicates that the client understood the lessons taught by the nurse about this medication?

"I won't stop the medication suddenly but will reduce it gradually if it is discontinued"

. A newly admitted client with schizophrenia approaches the unit nurse and says "The voices are bothering me. They are yelling and telling me I am bad. I have got to get away from them" The most helpful reply for the nurse to make would be:

"I'll stay with you. Focus on what we are talking about, not the voices"

A nurse is caring for an elderly client who husband died approximately 6 weeks ago. The client says, there's no one left to care about me. Everyone that I have loved is now gone. The nurse would make which appropriate response?

"It sounds as though you are feeling all alone right now"

A client who has been diagnosed with depression is preparing for discharge. The nurse determine that the client has an understanding of the disorder if the client makes which statement?

"It's important for me to eat well, and to take my medication. If I begin to feel bad again, I'll see my doctor"

A client with depression tells the nurse, "Bad things that happen are always my fault." To assist the client in refraining this overgeneralization, the nurse should respond:

"Let's look at one bad thing that happened to see if another explanation exists"

During the maintenance phase of treatment, a client with bipolar disorder asks the nurse, "Do I have to keep taking this lithium even though my mood is stable now?" Which is the most appropriate response?

"Taking the medication every day helps prevent relapse and recurrences"

Which comment by a patient diagnosed with bipolar disorder best indicates the patient is experiencing mania?

"Yesterday I made 487 posts on my social network page"

A client, age 19, is highly dependent on her parents and fears leaving home to go away for college. Shortly before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. The client asks the nurse, "why has this happened to me?" What is the nurse's best response?

"Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."

A nurse is having a conversation with a depressed client in an inpatient psychiatric unit. The client says to the nurse, "things would be so much better for everyone if I just weren't around." Which response by the nurse would be appropriate at this time?

"you sound very unhappy. Are you thinking of harming yourself"?

In discussing the effects of ECT with the patient, you should relate that the most likely side effect may be which of the following?

Amnesia

A newly admitted client diagnosed with paranoid schizophrenia is hypervigilant and constantly scans the environment. He states that he saw two doctors talking in the hall and knows they were plotting to kill him. The nurse may correctly assess this behavior as:

An idea of reference

A woman has just received the news that her husband died. She approaches the nurse who cared for him during his last hours and says angrily "if you had given him your undivided attention instead of running off to care for others, he would still be alive." The nurse's response should consider that:

Anger is a normal phenomenon that is experienced during grieving

Your assigned client is experiencing a depressive mood disorder which is suspected to be due to one of several medications the client is taking. The client is taking a multipurpose vitamin, low dose aspirin and antihypertensive, and levothyroxine (synthroid). Which of these medication is one the most frequent examples of medications causing depression?

Anti-hypertensive

In additional to anti-depressants and mood stabilizers, what other major category of medications will the psychiatric nurse most often be administering to clients diagnosed with a diagnosis of bipolar disorder?

Anti-psychotics

The statement that provides the best rationale for closely monitoring the severely depressed client during antidepressant therapy is:

As depression improves, physical energy becomes available to carry out a suicide plan

a 28- year old woman demonstrates a pervasive pattern of unstable relationships, poor self-image, impulsiveness, and irritability. Which of the following is the most appropriate diagnosis to consider?

Borderline personality disorder

Which dinner menu is best suited for a bipolar client with acute mania?

Broiled chicken breast sandwich, and ear of corn and an apple

The nursing care plan indicates that a client is at risk for self-harm. A priority outcome of care is that the client performs which action?

Denies suicidal ideation and identifies options to deal with stressors

A pregnant 33-year-old woman with bipolar disorder had stopped taking her mood stabilizers. Two months into her pregnancy, she presented to your clinic with pressured speech and belief that her baby is Jesus Christ. Her husband is concerned because she has also stopped talking her prenatal vitamins and is acting bizarrely, which of the following is the safest intervention to consider treating her symptoms?

Electroconvulsive therapy (ECT)

The nurse teaches the family of a client with major depression disorder. Which of the following information should be included in the teaching?

Encourage a person with depression to keep a regular routine of activity and rest

A new client with mania is admitted to the unit. This client is loud and disruptive of the ward milieu. The nursing staff remain calm and patient. During the arts and crafts activity when this client's attempts to run the group are ignored, the client begins to curse at the leader. The best nursing intervention is to:

Escort this client to a quiet private room

After seeking help at an outpatient mental health clinic, a client who was raped while walking her dog is diagnosed with post traumatic stress disorder and MDD. Three months later, the client returns to the clinic, complaining of fear, loss of control and helpless feelings. Which nursing interventions is most appropriate for this client?

Exploring the meaning of the traumatic event

The nurse is working with a client who has a diagnosis of Bipolar disorder and is taking lithium. The client is in a manic phase and is not eating or drinking much water. The nurse is concerned when the client develops a fever of 101, degrees, seems confused, and has blood pressure of 100/64 (baseline 132/84). It is time for the client to receive her next dose of lithium. The client has a prn order for Tylenol 650 for fever above 100 degrees Fahrenheit. The nurse would:

Hold the lithium, and call the health care provider immediately

A client on lithium suffered from diarrhea and vomiting. Which of the following is the priority nursing intervention of the nurse in charge?

Hold the next dose and obtain an order for a stat serum lithium level

Police bring in a client to the crisis center. She had been directing traffic and shouting rhymes at the intersection of a busy street. Her husband reported that she stopped taking her lithium 3 weeks ago and had not slept or eating in 3 days. Which behaviors will be of priority for the nurse?

Hyperactivity; ignoring eating and sleeping

In the treatment of depression associated with bipolar disorder, newer antidepressants such as selective serotonin reuptake inhibitors (SSRIs):

Improve the effectiveness of treatment

A nurse is caring for a male client with manic depression. The plan of care for a client in a manic state would include:

Listening attentively with a non-judgmental attitude and avoiding power Struggles

. You are a nurse at the community mental health crisis center and one evening you received a call from an unidentified male who tells you that he "just needed someone to talk to." You notice that his voice was sad and flat. Further history reveals that his wife died one year ago today. You proceeded to complete a suicide risk assessment. Which of the following Is a risk factor for suicide?

Male gender

A nurse teaching a client about atyramine-restricted diet would approve which meal?

Mashed potatoes, ground beef patty, corn, green beans, apple pie

While entering the building, an elementary school nurse observes a person in the distance merging from a first and approaching the school. The person is dressed in black from head to toe, wearing a backpack and carrying a long, narrow, dark object. Which action should the nurse take first?

Move to a secure location

.High fever, tachycardia, increased muscle tone, stupor, and unstable blood pressure are side effects of antipsychotics associated with:

Neuroleptic Malignant Syndrome

The nurse observes a client prescribed haloperidol (Haldol) who has his head rotated to one side in a stiff, fixed position with his lower jaw thrust forward and drool coming from his mouth should intervene by:

Obtaining an order to administer diphenhydramine (Benadryl) 50 mg IM

An elderly client returned from the hospital after surgery in which he was diagnosed with liver cancer. At home, he became increasingly depressed. He was readmitted to the hospital when his wife found him unconscious after taking sleeping pills and alcohol. Which of the following client outcomes should the nurse establish for him as a priority? The client will:

Remain safe while in the hospital

The nurse is working with a young adult female client who has bipolar disorder. Her psychiatrist has ordered lithobid 300mg, three times a day. Which of the following things is most important for the nurse to do or check before administering this medication?

Results of a pregnancy test and birth control methods

The nurse is working with a hospitalized client who is taking neuroleptic medication that has recently been changed and increased. The nurse notices that the client has high fever (104 degrees F), is confused and has extreme muscle rigidity. The nurse would:

Suspect neuroleptic malignant syndrome, hold the neuroleptic medication and call the health care provider

While working in the outpatient community health clinic, in partnership with the newly admitted client diagnosed with schizophrenia, the nurse formulates which of the following goals directed at maintaining optimal functioning? SELECT ALL THAT APPLY

Take medication as directed Maintain a regular sleep pattern Participate in social skills meeting as scheduled

A client received maintenance doses of trifluoperazine (Stelazine) 30mg po daily for 1.5 years. The clinic nurse notes the client is grimacing and seems to be constantly smacking her lips. Her neck and shoulders twist in a slow, snakelike motion. The nurse should suspect the presence of:

Tardive dyskinesia

A patient has been taking Escitalopram (Lexapro) 10mg daily for four weeks. Initially, the patient reported depression and suicidal thoughts. The patient's sleep, appetite, energy, and appearance have now begun to move. Which statement applies to this patient?

The patient's suicide potential is increased

A client newly prescribed an antidepressant reports experiencing dry mouth, constipation and a feeling of lightheadedness when standing. What teaching is needed for the client?

These are side effects of the anti-depressant and can be lessened by taking sips of water, increasing dietary fiber, and moving slowly when standing.

The nurse working with depressed clients taking tricyclic antidepressants must keep in mind which of the following in planning and implementing care?

These medications are dangerous in overdoes, and clients must be monitored for suicidal ideation

The community nurse is speaking to a group of new mothers as part of a primary prevention program. Which self-measures would be most helpful as a strategy to decrease the occurrence of mood disorders?

Verbalizing rather than internalizing feelings

The nurse plans care for a client hospitalized during the manic phase of bipolar disorder. Which activity is most appropriate for this client?

Walk around the outside activity area with the mental health technician