QUIZ # 5 PSYCHIATRIC NURSING EAQ

Which statement made by a depressed client would provide insight into a common feeling associated with depression?

"I still feel bad about my sister dying of cancer. I should have done more for her!"

Which statement is true of the relationship between bipolar disorder and suicide?

Suicide is a serious risk, because nearly 20% of those diagnosed with bipolar disorder commit suicide.

A client who exhibits concrete thinking is unable to communicate in what manner?

Abstractly Rationale Concrete thinking refers to an over emphasis on specific details and impairment in the ability to use abstract thinking.

A client says to the nurse, "I once enjoyed going to parks and museums with my family but that is not fun anymore." How would the nurse document this complaint?

Anhedonia Rationale Anhedonia means that there is no pleasure or joy in life. It is a common finding with depression. Anergia refers to a lack of energy or physical passivity. Euthymia refers to a mood state that is normal and moderate, with neither depression nor mania. Self-deprecation refers to negative statements about self.

A client diagnosed with schizophrenia is most likely to experience which type of hallucination?

Auditory Rationale Clients diagnosed with schizophrenia may experience hallucinations arising out of any of the senses; however, 60 percent of people with schizophrenia experience auditory hallucinations at some time during their lives. Visual hallucinations are more commonly associated with substance abuse and withdrawal. Tactile and olfactory hallucinations are rare.

Which assessment finding regarding communication is likely in a client experiencing acute mania?

Clang associations Rationale Clang associations are the stringing together of words because of their rhyming sounds, without regard to their meaning.

Which antianxiety medication should the nurse expect will be prescribed to clients with acute mania?

Clonazepam Rationale Antianxiety medications are prescribed to clients with acute mania who are resistant to lithium therapy to reduce psychomotor agitation in the clients.

The nurse can most expect a client demonstrating typical manic behavior to be attired in what type of clothing?

Colorful and outlandish Rationale Manic patients often manage to dress and apply makeup in ways that create a colorful, sometimes bizarre, appearance.

A client has recently been prescribed an antipsychotropic medication. Which assessment data should the nurse identify as a risk factor for the development of autonomic dysfunction?

Comorbid diagnosis of depression Rationale Risk factors for the development of autonomic dysfunction include older age, female gender (3:2), and presence of a mood disorder.

Which nursing diagnosis would be most useful for a depressed client who shows psychomotor retardation?

Constipation Rationale A client with psychomotor retardation has vegetative signs of depression and often is constipated.

Individuals diagnosed with schizophrenia display varying degrees of neurocognitive impairments that are evidenced by what factors? Select all that apply. <p>Individuals diagnosed with schizophrenia display varying degrees of neurocognitive impairments that are evidenced by what factors? <b> Select all that apply.</b> </p>

Disorganized thinking Disorganized speech Rationale Individuals diagnosed with schizophrenia display varying degrees of neurocognitive impairments, including disorganized thinking and disorganized speech.

Which side effects of lithium can be expected when the medication is at therapeutic levels?

Fine hand tremors and polyuria

Which complaint regarding sleep would the nurse expect from a client diagnosed with major depression?

I wake up about 4 AM and cannot go back to sleep. I feel tired all the time."

What information concerning electroconvulsive therapy (ECT) treatment and its effectiveness for clients diagnosed with bipolar disorder is true?

It is promising for clients with a history of rapid cycling.

Which is considered the first-line drug used to treat mania?

Lithium Rationale Lithium, a mood stabilizer, is the first-line drug used in treating bipolar disorder.

Identify the major groups of schizophrenic symptoms. Select all that apply.

Positive Cognitive Mood Negative

What negative system phenomenon is a client who responds to questions briefly or with one-word answers displaying?

Poverty of speech Rationale The client who responds to questions briefly or with one-word answers is displaying poverty of speech. Anergia is the lack of energy, passivity, or lack of persistence at work or school.

What is the sequence of phases in the course of the schizophrenia?

Prodromal, acute, stabilization, maintenance Rationale Prodromal, acute, stabilization, and maintenance are the sequence of phases in the course of the disease.

A depressed client is noted to pace very often, pull at his or her clothes, and wring his or her hands. What do these behaviors indicate?

Psychomotor agitation Rationale These behaviors describe the psychomotor agitation sometimes seen in clients with the agitated type of depression.

A depressed client is noted to pace very often, pull at his or her clothes, and wring his or her hands. What do these behaviors indicate?

Psychomotor agitation Rationale These behaviors describe the psychomotor agitation sometimes seen in clients with the agitated type of depression. Senile dementia is a loss of cognitive function seen in older adults.

A client experiencing an inability to recognize reality is exhibiting which symptom?

Psychosis Rationale A client who is experiencing an inability to recognize reality is exhibiting psychosis.

When a client experiences four or more mood episodes in a 12-month period, what term does the nurse document?

Rapid cycling Rationale "Rapid cycling" implies four or more mood episodes in a 12-month period, as well as more severe symptomatology.

A client diagnosed with major depressive disorder has vegetative symptoms. Which nursing diagnosis is most applicable to these symptoms?

Self-care deficit Rationale Vegetative signs of depression include grooming and hygiene deficiencies, significantly reduced appetite, and changes in sleeping, eating, elimination, and sexual patterns.

When is a client diagnosed with seasonal affective disorder likely to begin experiencing fewer symptoms? <p>When is a client diagnosed with seasonal affective disorder likely to begin experiencing fewer symptoms?</p>

Spring Rationale Seasonal affective disorder occurs during the months when sunlight diminishes. Clients may begin to feel effects in the late fall and will be affected throughout the winter. They improve during the spring and feel well during the summer.

A client remains motionless for long periods of time and at times appears to be in a coma. How can this state be described?

Stupor Rationale Stupor refers to a state in which the catatonic client is motionless for long periods and may even appear to be in a coma.

Which side effect of antipsychotic medication therapy is generally irreversible?

Tardive dyskinesia Rationale Tardive dyskinesia is not always reversible with discontinuation of the medication and has no proven cure.

When preparing a client for electroconvulsive therapy (ECT), what does the nurse discuss with the client?

The initial course of therapy requires 6 to 12 treatments. Rationale A usual course of ECT is 6 to 12 treatments. Maintenance ECT usually involves weekly treatments for the first month after remission, with gradual tapering to monthly ECT treatments.

To plan care for a client who is manic, the nurse must consider that lithium cannot be started until what takes place? <p>To plan care for a client who is manic, the nurse must consider that lithium cannot be started until what takes place?</p>

The physical examination and laboratory tests are analyzed.

A client admitted with a diagnosis of depression has been having angry outbursts with staff and peers on the unit since being admitted. Based on the client's behavior, what is the nurse's primary concern?

This type of behavior places a depressed client at high risk for self-harm.

Which approach should the nurse use when communicating with a client experiencing an elated mood and euphoria?

Use a calm, firm approach.