TEST 2 FINAL REVIEW
A client is being discharged on disulfiram. Which instruction for disulfiram should the client receive? a. Read product labels carefully to avoid all products containing alcohol. b. Disulfiram will prevent the desire to drink alcoholic beverages. c. Skip the daily dose of disulfiram on days when consumption of alcoholic beverages is likely. d. Take disulfiram with food to avoid stomach upset.c.
a
A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordination B) Stupor C) Emotional lability D) Ataxia
a
A client is brought to the emergency department following a car accident. The client's blood alcohol level (BAL) is 0.10%. Which of the following would the client likely exhibit? a. Impaired coordination b. Ataxia c. Giddiness d. Emotional lability
a
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The nurse assesses the client and finds the client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which is typical of these symptoms? a. Alcohol withdrawal syndrome b. Continuing intoxication c. Wernicke-Korsakoff syndrome d. Delirium tremens
a
A client is to receive lithium therapy as part of the treatment plan for bipolar disorder. When reviewing the clients medication history, which agents would alert the nurse to the possibility that a decrease in lithium dosage may be needed? Select all that apply. A) Lisinopril B) Hydrochlorothiazide C) Indomethacin D) Caffeine E) Aspirin
a, b, c
A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis
a, b, c
. The nurse is caring for a client who was diagnosed with schizoaffective disorder. Based on the nurses understanding of this disorder, the nurse develops a plan of care to address which issue as the top priority? A) Suicide B) Aggression C) Substance abuse D) Eating disorder
a
A client has experienced a first episode of major depression and has received medication and treatment, which has led to a complete remission of the symptoms. The client asks the nurse, "How much longer will I need to take the medication?" Which response by the nurse would be most appropriate? a. "You'll need to continue the medication for about 6 to 12 months to see how things go." b. "Since you have no more symptoms, you can stop taking the medications tomorrow." "c. It's probably best to continue the medication for another month, gradually decreasing the dosage over that time." d. "The medication has eliminated your symptoms so you'll need to keep taking it for the rest of your life."
a
A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when they identify which of the following as possible risk factors? Select all that apply. A) History of substance abuse as a teenager B) Little social support C) Inadequate coping skills D) Prior episode of anxiety disorder E) Concomitant medical illnesses
b, c, e
A nursing instructor is preparing a class discussion about major depression. Which of the following would the instructor expect to include? (select all that apply) A) Depression in children is manifested in the same manner as in adults. B) The risk for suicide is especially high during the mid-adolescent years. C) Response to treatment in older adults is slower than that for younger adults. D) People older than age 65 years have the lowest suicide rates of any age group. E) Episodes of depression tend to occur more frequently over time. F) Depressive disorders are most often treated in the primary care setting.
b, c, e and f
After assessing a client with schizophrenia, the nurse suspects that the client is experiencing an anticholinergic crisis. Which of the following would the nurse most likely have assessed? Select all that apply. A) Dilated reactive pupils B) Blurred vision C) Ataxia D) Coherent speech E) Facial pallor F) Disorientation
b, c, f
A group of nursing students is reviewing information about other psychotic disorders. The students demonstrate understanding of this information when they identify which disorder as involving an inducer? A) Brief psychotic disorder B) Schizophreniform disorder C) Shared psychotic disorder D) Psychotic disorder attributable to a substance
c
A nurse is assessing a patient and the patients social networks. When evaluating this area, the nurse integrates knowledge that which of the following is an important component? A) Blood relationships B) Bonding with one another C) Reciprocity D) Emotional support
c
A nurse is caring for a client diagnosed with schizophreniform disorder. The nurse demonstrates understanding of this disorder when identifying that the client is at risk for developing what? a. Substance abuse b. Personality disorder c. Schizophrenia d. Major depression
c
The nurse is working with a client who has schizophrenia, disorganized type. It is time for the client to get up and eat breakfast. Which statement by the nurse would be most effective in helping the client prepare for breakfast? a. "Why don't you stay here and I'll get your tray for you." b. "I'll expect you in the dining room in 20 minutes." c. "Stay right there and I'll get your clothes for you." d. "Its time to put your clothes on now."
d
To integrate feedback about the effects of coping, and to allow for continual processing of new information refers to ... a. Stressors b. Allostasis c. Social functioning d. Reappraisal
d
The nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which of the following would the nurse expect to find? A) History of chronic major depression B) Consistently disrupting behavior patterns C) Verbalization of bizarre delusions D) Living with one or more delusions for a period of time
d
The nurse is caring for a client who was just admitted with a diagnosis of schizoaffective disorder with depression. Which agent would the nurse anticipate as being prescribed for this client? A) Lithium B) Haloperidol C) Chlorpromazine D) Clozapine
d
The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, identifying this agent as which type? A) Selective serotonin reuptake inhibitor B) Cyclic antidepressant C) Norepinephrine dopamine reuptake inhibitor D) Alpha-2 antagonist
d
The nurse is reviewing the medical records of several patients diagnosed with major depression. The nurse identifies which patient as least likely to commit suicide? A) Divorced man B) Widowed woman C) Single woman D) Married man
d
A client has entered the manic phase of bipolar disorder. To maintain the client's nutrition, which of the following should be offered?
finger foods!
A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy?
liver function test
you should not take what drug if you have glaucoma?
the SNRI venlafaxine
t/f: Dysregulation of the body's autonomic responses is the result of prolonged exposure to cortisol.
true
what are the two main side effects with MAO's?
- hypertensive crisis - serotonin syndrome
brief psychotic disorder - how long - does it show symptoms of positive or negative schizophrenia
- is at least 1 day but less than 1 month - positive
dysthymic disorder is characterized as Feelings of depression for at least how long?
2 years
A nurse is reviewing information about the drug, lithium carbonate. The nurse demonstrates understanding of the information by identifying which situation as a potential cause of lithium toxicity? Select all that apply. a. Hot climate b. Diarrhea c. Vomiting d. Hypernatremia e. Strenuous exercise
A, b, c, and e
what foods can you not eat with MAO
Aged cheeses. Yogurt. Cured meats and certain other meat products. Fermented sausages such as pepperoni, salami, and bologna. Beef or chicken liver. Anchovies. Caviar. Herring.
What is nystagmus?
Involuntary rapid eye movements
A client with bipolar disorder having experienced a depressive episode is prescribed lamotrigine. After teaching the client about this medication, the nurse determines that the teaching was successful when the client states which of the following? A) I need to notify my physician if I develop a skin rash. B) I need to have my blood tested about once a month. C) I have to watch how much salt I use every day. D) This drug can affect my liver function.
a
A client with bipolar disorder is receiving divalproex sodium as part of the treatment plan. When monitoring the clients blood level for this drug, which level would alert the nurse to the need to change the dosage? A) 30 ng/mL B) 55 ng/mL C) 75 ng/mL D) 115 ng/mL
a
A hospitalized client with schizophrenia is receiving antipsychotic medications. While assessing the client, the nurse identifies signs and symptoms of a dystonic reaction. Which agent would the nurse expect to administer? A) Diphenhydramine (Benadryl) B) Propranolol (Inderal) C) Risperidone (Risperdal) D) Aripiprazole (Abilify)
a
A nurse has just completed a suicide risk assessment of a 76-year-old widowed man. In addition to documenting the presence or absence of suicidal thoughts, plan, and means, the nurse would also document which of the following? A) Use of substances 6 hours before the assessment B) Speech patterns C) Availability of support resources D) Amount of sleep in past 24 hours
a
A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan)
a
A nursing instructor is developing a class lecture that compares and contrasts schizoaffective disorder with schizophrenia. When describing one of the differences between these two diagnoses, which of the following would the instructor include as reflecting schizoaffective disorder? A) It is episodic in nature. B) It involves difficulties with self-care. C) It has less severe hallucinations. D) It is associated with a lower suicide risk.
a
A nursing instructor is preparing a class lecture about schizophrenia and outcomes focusing on recovery. Which of the following would the instructor include as a major goal? A) Continuity of care B) Shorter in-patient stays C) Immediate crisis stabilization D) Social engagement
a
A patient visits the clinic and tells the nurse about being under a great deal of stress on the job for the past month. Applying the factors that determine the stress response, which question would be most appropriate for the nurse to ask? A) What effect is the stress having on your job performance? B) How would you describe the social network within your family? C) What is the specific event that you find most stressful? D) When did you first become aware of experiencing this stress?
a
Both valproate and carbamazepine may be lethal if high doses are ingested. Toxic symptoms appear in 1 to 3 hours and include what? a. Neuromuscular disturbances b. Urinary frequency c. Bradycardia d. Tinnitus
a
During an interview, a patient states, I feel so guilty, and Im so ashamed of what I did. The nurse interprets this as which of the following? A) Negative emotion B) Positive emotion C) Borderline emotion D) Nonemotion
a
The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important? A) Suicide B) Hypersomnia C) Cardiac arrhythmia D) Erectile dysfunction
a
The nurse is caring for a patient who has been under severe stress while caring for her elderly mother who is in the advanced stages of Alzheimers disease. The nurse explains that the patient is adapting to the stress is she is experiencing because of which of the following? A) Ability to survive in the midst of severe stress B) Acceptance of others help in caring for her mother C) Success at being able to solve problems D) Capability in setting reasonable personal goals
a
The nurse is caring for a patient with chronic stress for the past month because of job loss and financial difficulties. When evaluating the patients assessment findings, the nurse would anticipate finding an elevated antibody titer to which of the following? A) Herpes simplex viruses B) Herpes zoster viruses C) Acquired immune deficiency viruses D) Influenza viruses
a
The nurse is caring for an elderly client who has been taking an antipsychotic medication for 1 week. The nurse notifies the physician when he observes that the client has muscle rigidity that resembles Parkinsons disease. Which agent would the nurse expect the physician to prescribe? A) Anticholinergic B) Anxiolytic C) Benzodiazepine D) Beta-blocker
a
The nurse is reviewing the medical record of a client with bipolar disorder. The nurse would most likely expect to find a history of which of the following? A) Panic disorder B) Schizophrenia C) Delusional disorder D) Posttraumatic stress disorder
a
The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess? A) Low energy B) Intense concentration C) Agitation D) Normal appetite
a
client asks the nurse if he needs to alter any of his activities because he is taking lithium carbonate. Which of the following responses would be most appropriate? A) Increase your salt intake if an activity causes you to perspire heavily. B) Wear sunscreen when you are going to be outdoors in the summer time. C) Drink less fluid than usual now because you are taking this drug. D) No changes are necessary for strenuous activities you do outdoors.
a
. When assessing a client with delusional disorder, the nurse would most likely expect to find impairment in which of the following? Select all that apply. A) Social functioning B) Marital functioning C) Intellectual functioning D) Occupational functioning E) Mental status functioning
a and b
The nurse is developing a teaching plan for a client who is prescribed escitalopram (SSRI). Which of the following side effects would the nurse include in this plan? Select all that apply. A) Weight gain B) Decreased sexual interest C) Sedation D) Blurred vision E) Urinary retention F) Dry mouth
a and b
A client is being diagnosed with major depressive disorder based on reports of depressed mood, insomnia, loss of pleasure, extreme fatigue, and poor concentration. To confirm this diagnosis, which condition related to the client's report of symptoms must be present? Select all that apply. a. Issues must be among the recognized symptoms for this disorder b. The client's symptoms are unrelated to an underlying medical condition c. Symptoms cause a noticeable negative effect on the client's ability to function d. Symptoms interfere with the client's ability to maintain social and employment relationships e. monitoring symptoms for 4 weeks
a, b, c, d
A nurse is conducting an assessment of a patients social network. Which of the following would the nurse assess? Select all that apply. A) How big is your network of contacts? B) What benefits do you receive from these people? C) Who is responsible for providing the support? D) Do any of the members know one another? E) What services do you think might be helpful?
a, b, c, d
After educating a group of nurses about caffeine, the group leader determines that the education was successful when the group identifies which finding as indicating intoxication? Select all that apply. a. Restlessness b. Nervousness c. Urinary retention d. Insomnia e. Excitement f. Pale face
a, b, c, d, e
The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure
a, b, e
A nurse is assessing a client who is brought to the emergency department. The nurse suspects that the client is experiencing mania. Which finding would support the nurse's suspicion? Select all that apply. a. Easily distractible b. Slowness of speech c. Statements of self-importance d. Flight of ideas e. Sleepiness
a, c, d
A patient comes to the clinic for an evaluation of headache, fatigue, and an overall feelings of being down. When assessing the patient, which statement by the patient would alert the nurse to suspect possible suicide? Select all that apply. A) Ive been drinking about three or four more beers every night. B) Ive been going out with my friends about once or twice a week. C) Im so tired that all I ever want to do is sleep all the time. D) Most times, I feel like Im trapped with no way out. E) Im looking for a new job because my job is so stressful.
a, c, d
A client with bipolar disorder has a lithium drug level of 1.2 mEq/L. Which of the following would the nurse expect to assess? Select all that apply. A) Metallic taste B) Ataxia C) Diarrhea D) Slurred speech E) Fasciculations F) Muscle weakness
a, c, f
A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline (MAO). Which question by the nurse would be most important to ask at this time? A) When did you last have blood drawn to check your drug level? B) What have you had to eat or drink today? C) Are you having any chest pain? D) Do you use any herbal remedies?
b
A client diagnosed with bipolar disorder and experiencing mania is admitted to the inpatient psychiatric setting. During the acute phase of mania, which medication would the nurse expect to most likely administer? A) Lithium carbonate (Lithium) B) Haloperidol lactate (Haldol) C) Fluoxetine (Prozac) D) Paroxetine (Paxil)
b
A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur? a. Difficulty driving b. Impaired judgment c. Coma d. Stupor
b
A client is prescribed carbamazepine as part of the treatment plan for bipolar disorder. The nurse obtains a complete blood count and differential before initiating therapy. The nurse would instruct the client to return to the outpatient facility for repeat blood testing at which time? a. 3 months b. 1 month c. 12 months
b
A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) I can have a glass of wine with dinner if I choose. B) I should eat small frequent meals if I get nauseated. C) I should take the drug on an empty stomach. D) I might experience diarrhea with this drug.
b
A client was abandoned by the parents at age 3, resulting in the client's perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of what? a. A biological explanation for the client's depressive disorder. b. A psychodynamic interpretation of the client's major depressive disorder. c. a social explanation for the clients depressive disorder
b
A client with schizophrenia is prescribed clozapine because other prescribed medications have been ineffective. After teaching the client and family about the drug, the nurse determines that the teaching was successful when they state which of the following? A) He needs to have an electrocardiogram periodically when taking this drug. B) Well need to make sure that he has his blood count checked at least weekly. C) He might develop toxic levels of the drug if he smokes cigarettes. D) We need to watch to make sure that he doesnt lose too much weight.
b
A client with schizophrenia reads the advice column in the newspaper daily. When asked why the client is so interested in the advice column, the client replies, "This person is my guide and tells me what I must do every day." The nurse would best describe this type of thinking as what? a. Personalization b. Referential delusion c. Grandiose delusion d. Thought insertion
b
A client with schizophrenia tells the nurse, Im being watched constantly by the FBI because of my job. Which response by the nurse would be most appropriate? A) Tell me more about how you are being watched. B) It must be frightening to feel like youre always been watched. C) Youre not being watched; its all in your mind. D) You are experiencing a delusion because of your illness.
b
A family member of a client diagnosed with schizoaffective disorder asks a nurse what causes the disorder. Which response by the nurse would be most appropriate? A) Dysfunctional family dynamics has been identified as a strong link. B) Research has suggested that the cause is predominately genetic. C) Dopamine, a substance in the brain, appears to be underactive. D) Studies have indicated that birth order is strongly associated with this disorder.
b
A nurse is developing a teaching plan for a client with schizophrenia. Which method would the nurse use to be most effective? A) Engaging the client the trial and error learning B) Having the client write down information after directly being given the correct information C) Asking the client questions that encourage the client to guess at the correct answer D) Using visual aids that are very colorful and full of descriptive graphic images
b
A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation
b
A nurse is reviewing the medical record of a patient who has attempted suicide. Which of the following would the nurse identify as relating to a psychological cause? A) History of childhood trauma B) Cluster B personality disorder C) Social isolation D) Suicide contagion
b
A patient is talking to the nurse about her friendship with another person. She comments, That person is always there for me, and I am always there for her. We help each other out; sometimes shes helping me, and sometimes I am helping her. The nurse interprets the patients statements about her social network as reflecting which of the following? A) Denseness B) Reciprocity C) Social support D) Constraints
b
After teaching a group of students about the epidemiology of schizoaffective disorder, the instructor determines that the teaching was successful when the students state which of the following? A) The disorder occurs often in children. B) It is more likely to occur in women. C) Most persons are African Americans. D) The disorder is rare in family relatives.
b
Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is ... a. assisting Carrie with her activities of daily living, including a shower and clean clothing. b. assessing Carrie's current suicidal ideation and putting her on suicide precautions. c. ask her if she wants to go get some rest
b
Clients diagnosed with schizophrenia may experience disordered water balance that may lead to water intoxication. Which may occur as a result of water intoxication? a. Hypernatremia b. Hyponatremia c. Dehydration
b
what depressive disorder is this? Outside the norm of temper tantrums-irritability, verbally and physically aggressive, destructive to property. Behavior is frequent (2-3 times per week)
disruptive mode dysregualtion disorder
The mental health nurse appropriately provides education on light therapy to which client? a. 45-year-old lawyer whose medication therapy needs an additional treatment b. 20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term c. 50-year-old farmer whose major depression has not responded to any treatment modality d. 58-year-old showing signs of early Alzheimer's disease
b
The nurse is caring for a client with major depression. The client tells the nurse that she just isnt sure that life is worth living. The nurse documents which nursing diagnosis as the priority? A) Self-esteem, Low, related to depressive episode B) Hopelessness related to symptoms of depression C) Anxiety related to lack of energy for self-care activities D) Thought Processes, Disturbed, related to memory loss and depression
b
The nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the clients eyes are fixed on the ceiling. The nurse interprets this finding as which of the following? A) Akathisia B) Oculogyric crisis C) Retrocollis D) Tardive dyskinesia
b
The nurse is preparing to document information obtained from a client diagnosed with a delusional disorder who is experiencing somatic delusions. Which of the following would the nurse most likely document? A) Disorientation B) Reduced attention span C) Above average intelligence D) Body complaints
b
The nurse is preparing to interview a client who has a delusional disorder. Which of the following would the nurse expect? A) Cognitive impairment B) Normal behavior C) Labile affect D) Evidence of motor symptoms
b
The nurse is seeing a 26-year-old client and the client's family. The client's family describes the client as being "very, very different." The family describes a history of periods of unpredictable behavior and disregard for consequences occurring a few times each year. The client has recently been diagnosed with bipolar I disorder, a condition that is characterized by what? a. Failure to respond to conventional pharmacological treatments for mood disorders b. An elevated mood that lasts for at least 1 week c. The presence of objective signs of depression without the presence of anhedonia d. The client's admission of a mood disorder
b
To confirm that a client is experiencing a manic episode, the nurse must eliminate the possibility that the client's symptoms are related to which problem? a. Insomnia b. Substance use c. Overexcitment d. Inflated self-esteem or grandiosity
b
When describing the concept of allostatic load to a group of students, which of the following would the instructor identify as abnormalities of which of the following as indicative of the overall changes? A) Nuclear imaging studies B) Laboratory test results C) Bone radiographs D) Cardiac studies
b
When it is noted in the medical record that the client is diagnosed as parasuicidal, which of the following is the most effective nursing intervention? a. Assume that the client had expressed suicidal ideations in the past b. Assess the client for indications of self-induced injuries c. Ask the client to sign a no-suicide contract d. Assume that the client had attempted suicide in the past
b
Which of the following side effects is characterized by spasms in discrete muscle groups, such as the neck muscles or eye muscles? a. Tardive dyskinesia b. Dystonic reactions c. Pseudoparkinsonism d. Akathisia
b
a client is prescribed phenelzine (Nardil) to treat her depression. She is at a local caf for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order? A) Roast beef, mashed potatoes, and gravy B) A Cobb salad with blue cheese and Roquefort salad dressing C) Scrambled eggs, toast, and grape jelly D) Medium-well steak, French fries, and broccoli
b - MAO
A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils
b and c
The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When teaching the client about this procedure, which of the following would the nurse include? Select all that apply. A) You will receive a short-acting anesthetic to relax you. B) You will be awake and alert during the procedure. C) You can resume your normal activities right after the treatment. D) We will need to shave your scalp at the area where the magnet is placed. E) You might feel a moderate amount of stinging at the site.
b and c
A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine
b and d
A nurse is providing an in-service presentation on coping and adaptation. Which of the following would the nurse most likely include? Select all that apply. A) Most coping strategies are similar in their approach. B) Coping when effective leads to adaptation. C) Reappraisal occurs simultaneously with coping. D) The same coping strategy is used in each situation. E) Coping is a deliberate and planned effort to mange stress.
b and e
A client taking an antidepressant has experienced a 12-pound weight gain in 1 month as a side effect of the medication. Which of the following are nursing interventions to help this patient with this problem? Select all that apply. a. Remind the patient that weight gain is better than feeling depressed. b. Recommend daily exercise. c. Recommend a nutritionally balanced diet. d. Advocate with the physician to consider changing the medication. e. Reassure the patient that the weight gain is not that significant.
b, c, d
A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking
b, c, d
A client with bipolar disorder has a plasma lithium concentration of 2.7 mE/L. Which finding would a nurse most likely assess in this client? Select all that apply. a. Tinnitus b. Seizures c. Fasciculations d. Incoordination e. Nystagmus
b, c, e
what depressive disorder is this? Deficits in recognition of emotion through facial expression, decision making, and control
disruptive modo dysregulation disorder
A client admitted to the inpatient psychiatric unit changes clothes eight or nine times a day, wears heavy eye makeup, is intrusive with other clients, and makes inappropriate sexual advances toward staff members. Which goal would be most appropriate for this client? a. The client will record the number of clothing changes per day. b. The client will verbalize feelings of low self-esteem with nursing staff. c. The client will refrain from being intrusive with others and change clothing only twice per day. d. The client will identify two trusted staff members of the opposite sex to help choose appropriate dress.
c
A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drugs purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status
c
A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse? a. "I know what my strengths are" b. "I'm not very comfortable with being alone yet." c. "I can still hang out with my old friends. I am just not going to use."
c
A client is hospitalized on a psychiatric unit secondary to a suicide attempt. He has been diagnosed with depression. He has been consistently depressed. When assessing the client, which of the following would alert the nurse that the clients suicidal risk has worsened? A) He tells the nurse that he feels more depressed than ever. B) He is lethargic, remaining isolated from other clients. C) He says he feels better as he interacts more with other clients. D) His energy level and degree of depression remain the same.
c
A client who is receiving lithium comes to the clinic for an evaluation. During the visit, the client reports a fine hand tremor. Which action by the nurse would be most appropriate? A) Immediately obtain a specimen to determine the clients blood drug level. B) Suggest that the client take the medication with meals or snacks. C) Assist the client in minimizing exposure to stressors. D) Encourage the client to elevate the affected hand on a pillow.
c
A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria
c
A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. Johns wort to feel better. The nurse assesses the client for which of the following? A) Water intoxication B) Increased depressive symptoms C) Serotonin syndrome D) Hypertensive crisis
c
A client with schizoaffective disorder is prescribed clozapine to treat her symptoms. Which of the following instructions would the nurse provide? A) Keep a record of how often and how long you experience the side effect of dry mouth. B) Monitor your urinary output and notify your doctor if your urine changes color. C) Keep an eye on your weight, and if you gain weight rapidly, notify your doctor. D) If you experience any drowsiness, discontinue taking this medication.
c
A family member of an adolescent who has expressed a desire to commit suicide asks the nurse, What might predict the possibility of future suicide attempts? Which of the following would the nurse include in the response? A) Unemployment B) Death of a spouse C) Previous suicide attempt D) Polydrug use
c
A nurse is developing a presentation for families who have members that have been diagnosed with bipolar disorders. When describing this condition to the group, which of the following would the nurse most likely include? A) As the person ages, the episodes tend to decrease over time. B) Environmental stressors are a key cause of these disorders. C) The risk for suicide is high with either depression or mania. D) Risk-taking behaviors are more common with a depressive episode.
c
A nurse is performing an assessment of a patient with suicidal ideation. Which question would the nurse most likely ask to determine the degree of planning? A) How seriously do you want to die? B) Have you attempted suicide before? C) Could you stop yourself from killing yourself? D) How much do the thoughts distress you?
c
A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so shed remember to get well. The nurse suspects that the client may be experiencing which of the following? A) Wernickes syndrome B) Delirium tremens C) Korsakoffs psychosis D) Malignant hyperthermia
c
A nurse is working with a group of clients diagnosed with schizophrenia in a community setting. Which of the following would least likely be a priority? A) Improving the quality of life B) Instilling hope C) Managing psychosis D) Preventing relapse
c
Assessment of a client with schizophrenia reveals that he is hearing voices that tell him that people are staring at him and illusions. When developing the plan of care for this client, which nursing diagnosis would be most appropriate? A) Disturbed thought processes B) Risk for self-directed violence C) Disturbed sensory perception D) Ineffective coping
c
The nurse determines that a patient is at imminent risk for suicide. Which of the following would be least appropriate to include in the patients plan of care? A) Listening intently and nonjudgmentally B) Validating the patients feelings and experience C) Instituting strict restriction on the patients activity D) Using cognitive interventions to foster hope
c
The plan of care for a client diagnosed with depression includes cognitive interventions. The nurse would expect to assist with which of the following? A) Social skills training B) Activity scheduling C) Thought stopping D) Interpersonal therapy
c
The police bring a client to the hospital. They found the client in a hospital gown, swimming in a local creek. The client states that the client was "being baptized by Mother Nature, who loves and worships me." How would the nurse describe the client's current alterations in mental status? a. Visual hallucinations b. Neologisms c. Grandiose delusions d. Dysphoria
c
The policies and procedures at a community psychiatric-mental health center include an emphasis on case finding. How can a nurse at the center best perform case finding? a. Encouraging clients not to be ashamed of previous suicide attempts or suicidal thoughts b. Modifying the center's environment to maximize client safety c. Assessing all clients carefully to identify those at risk for suicide d. Organizing the layout of the center to allow observation of clients
c
Which of the following would be most important for the nurse to keep in mind when establishing the nursepatient relationship with a client with schizophrenia to promote recovery? A) The relationship typically develops over a short period of time. B) Decisions about care are the responsibility of interdisciplinary team. C) Short, time-limited interactions are best for the client experiencing psychosis. D) Typically, clients with schizophrenia readily engage in a therapeutic relationship
c
After educating a client with bipolar disorder on his prescribed lithium therapy, the nurse determines that additional education is needed when the client states which of the following? a. "I need to avoid drinking any alcohol." b. "I need to report any problems with severe diarrhea or slurred speech." c. "I need to cut back on my salt intake when it's really hot outside." d. "I can use sugarless candies to help with any metallic taste."
c - need to cut back on salt always
While assessing a client with schizophrenia, the client states, Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies. The nurse interprets this statement as indicating which type of delusion? A) Grandiose B) Nihilistic C) Persecutory D) Somatic
c - these delusions are which the affected persons believe they are being persecuted, despite a lack of evidence.
A client is brought to the emergency department by his brother. The client has a history of bipolar disorder for which he is taking divalproex. The brother reports that he watched his brother take the medication about 2 hours ago. He stated, A little while ago, he got very disoriented and agitated. The nurse suspects toxicity based on assessment of which of the following? Select all that apply. A) Tachypnea B) Bradycardia C) Hypotension D) Nystagmus E) Vomiting
c, d, e
the nurse is preparing a teaching plan for the family of a client who has been diagnosed with bipolar disorder. After teaching them about potential indicators for relapse, the nurse determines that the teaching was effective when they identify which of the following as suggesting mania? Select all that apply. A) Avoiding people B) Sleeping more than usual C) Talking faster than usual D) Being hungry all the time E) Reading several books at once
c, d, e
in stage 2 of stress what is released to maintain resistance against the stress?
cortisol
A client has been diagnosed with schizophrenia. Assessment reveals that the client lives alone. His clothing is disheveled, his hair is uncombed and matted, and his body has a strange odor. During an interview, the clients family voices a desire for the client to live with them when he is discharged. Based on the assessment findings, which nursing diagnosis would be the priority? A) Ineffective Role Performance related to symptoms of schizophrenia. B) Social Isolation related to auditory hallucinations. C) Dysfunctional Family Processes related to psychosis. D) Bathing Self-Care Deficit related to symptoms of schizophrenia
d
A client hospitalized for treatment of schizophrenia has been receiving olanzapine (Zyprexa) for the past 2 months. The nurse would be especially alert for which of the following? A) Weight loss B) Hypertension C) Diarrhea D) Diabetes
d
A client who has a major depressive episode tells the nurse that for the past 2 weeks, he has been hearing voices and at times thinks that someone is following him. History reveals that he had these alternating symptoms before along with times when he has experienced neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which of the following? A) Paranoid schizophrenia B) Undifferentiated schizophrenia C) Brief psychotic disorder D) Schizoaffective disorder
d
A group of nursing students is reviewing information about suicide and associated concepts. The group demonstrates understanding of the information when they identify which of the following as the probability that a person will successfully complete suicide? A) Parasuicide B) Suicidal ideation C) Suicidality D) Lethality
d
A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you cant make me stop drinking. Which response by the nurse would be most appropriate? A) You have to stop drinking and driving; you could kill someone. B) Youre right; youre not an alcoholic. C) You should consider what you are doing to your marital relationship. D) Youre the only one who can make yourself stop drinking.
d
After teaching a group of students about appraisal and the stress response, the instructor determines that additional teaching is needed when the students identify which of the following as part of the primary appraisal? A) Relevance of the goal B) Consistency of goal with values C) Personal commitment D) Outcome explanation
d
An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities
d
An unconscious client is admitted to the emergency department after a motor vehicle accident. The client's blood alcohol level upon admission was .17. The client's family soon arrives, reporting that the client is an extended family member who is visiting from out of town. They cannot give much more history other than that the client is a "social drinker." After being transported to the unit, the client starts sweating and has elevated vital signs. What information should the nurse request of the family? a. Who is the next of kin? b. For what occasion is the client visiting from out of town? c. Does the client have a history of any sort of anxiety disorder? d. Are there other indications that the client may be a heavy drinker?
d
Disulfiram should not be administered until a client has abstained from alcohol for at least how long? a. 8 hours b. 16 hours c. 4 hours d. 12 hours
d
When obtaining a clients history, the nurse determines that the client has been experiencing delusions and hallucinations for the past 3 months, which has caused some problems in his ability to function on a daily basis at work. He also is exhibiting catatonic excitement, echopraxia, loose associations, and pressured speech. The nurse suspects which of the following? A) Schizophrenia B) Schizoaffective disorder C) Brief Psychotic disorder D) Schizophreniform disorder
d
When reviewing the diagnostic criteria for schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), which would be most accurate? a. Schizophrenia can be diagnosed as soon as an individual states he or she is hallucinating and delusional. b. Schizophrenia lasts at least 1 month and must include the symptom of hallucinations. c. Schizophrenia can be diagnosed as soon as an individual states he or she is hearing voices. d. Schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms.
d
Which assessment findings in a client who is suspected of having a delusional disorder would be suggestive of a diagnosis of schizophrenia? a. The client responds to group psychotherapy. b. The client's beliefs are considered delusional but nonbizarre. c. The client does not have insight into his or her delusions. d. The client experiences frequent and sustained hallucinations.
d
Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder? a. Insulting, provocative behavior directed at staff b. Grandiose thinking and poor concentration c. Bizarre, colorful, inappropriate dress d. Hyperactivity, dismissing meals, and sleep disturbance
d
Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension? a. Eat a nutritionally balanced diet b. Take medication with food c. Get daily exercise d. Increase hydration
d
While leading a student class presentation about general adaptation syndrome and its stages, which of the following would the student describe as the final stage? A) Perception of a threat B) Use of coping mechanisms C) Physiologic response D) Exhaustion
d
nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include? a. Methadone will produce a high similar to heroin. b. Unlike heroin, methadone is nonaddicting. c. People taking methadone run the same risks associated with intravenous drug use as those taking heroin. d. Methadone will meet the physical need for opiates without producing cravings for more.
d
A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time? A) 6:00 AM B) 7:00 AM C) 8:00 AM D) 9:00 AM
d - it is a TCA, take levels 12 hours later