Mental Health Disorder

700. Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior.

Answer: - Communicate expected behavior to the client - Assist the client in developing means of setting limits on personal behavior - Follow through about the consequence of behavior in a non punitive manner - Be clear with the client regarding the consequences for exceeding limits set regarding behavior

catatonic stupor

Catatonic schizophrenia is a type (or subtype) of schizophrenia that includes extremes of behavior. At one end of the extreme the patient cannot speak, move or respond - there is a dramatic reduction in activity where virtually all movement stops, as in a catatonic stupor. v

Conversion disorder

Conversion disorder, also called functional neurological symptom disorder, is a condition in which you show psychological stress in physical ways. The condition was so named to describe a health problem that starts as a mental or emotional crisis — a scary or stressful incident of some kind — and converts to a physical problem. For example, in conversion disorder, your leg may become paralyzed after you fall from a horse, even though you weren't physically injured. Conversion disorder signs and symptoms appear with no underlying physical cause, and you can't control them.

Electroconvulsive Therapy (ECT)

Electroconvulsive therapy (ECT) is a procedure, done under general anesthesia, in which small electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It often works when other treatments are unsuccessful. Much of the stigma attached to ECT is based on early treatments in which high doses of electricity were administered without anesthesia, leading to memory loss, fractured bones and other serious side effects.

Crying Spell

a crying spell is any length of time a person spends crying unable to control themselves. They see it or hear it and break into tears unable to stop. Rather like a child or a sensitive person. when i remember my dead wife, i have panic attacks and crying spell.

MANIA

mental illness marked by periods of great excitement, euphoria, delusions, and overactivity.

Manic

showing wild and apparently deranged excitement and energy.

691. A nurse is preparing for the hospital discharge of a client with a history of command hallucinations to harm self or other. The nurse instruct the client about intervention for hallucination and anxiety and determines that the client understands the intervention when the client states:

Answer: "I can call my therapist when I'm hallucination so that I can talk about my feelings and plans and not hurt anyone" Rationale: There may be an increased risk for impulsive and/ adhesive behavior if a client is receiving command hallucination to harm self or others. Talking about the auditory hallucination can interfere with the subvocal muscular activity associated with a hallucination

695. A client is unwilling to go out of the house for fear of doing something crazy in public "Because of this fear, the client remains homebound except when accompanied outside by the spouse. The nurse determines that the client has

Answer: Agoraphobia Rationale: Agoraphobia is a fear of being alone in open or public area where escape might be difficult. Agoraphobia includes experiencing fear or a sense of helplessness or embarrassment if a phobic attack occurs. Avoidance of such situational usually result in the reduction of social and professional interaction

698. A manic client announces to everyone in the day room that a stripper is coming to perform that evening. When psychiatric nurse aide firmly states that the clients behavior is not appropriate the manic client becomes verbally abusive and threatens physical violence to the nurse aide. Based on the analysis of this situation, the nurse determines that the appropriate action would be to:

Answer: Escort the manic client to his or her room Rationale: The client is at risk for injury to self and others and therefore should be escorted out of the dayroom.

689. A client is admitted to the in patient unit and is being considered for electroconvulsive therapy (ECT). The client appears calm, but the family is hyper-vigilant and anxious. The client mother begins to cry and states, "My chills brain will be destroyed. How can the doctor do this? The nurse makes which therapeutic response?

Answer: It sounds as though you have some concerns about the ECT procedure. Why don't we sit down together and discuss my concerns you may have? Rationale: The nurse needs to encourage the family and client to verbalize their fears and concerns.

692. A nurse observes that a client is psychotic, pacing and agitated and is making aggressive gesture affect is belligerent(hostile and Agressive). Base on these observation the nurse immediate priority care is to:

Answer: Provide safety for the client and other clients on the units rationale: Safety of the client is the priority

688. A nurse is caring for a client with a diagnosis of depression. The nurse monitors for signs of constipation and urinary retention, knowing that these problems are likely caused by:

Answer: Psychomotor retardation and side effects of medication Rationale: Constipation can be related to inadequate food intake, lack of exercise, and poor diet. In this situation is most likely cause by medication

687. A nurse is collecting data on a client who is actively hallucinating, Which nursing statement would be therapeutic at this time?

Answer: Sometimes people hear things or voices others can't hear. Rationale: It is important for the nurse to reinforce reality with the client

686. A client with delirium becomes agitated and confused at night. The best initial intervention by the nurse is to:

Answer: Use a nightlight and turn off the television Rationale: It is important to provide a consistent daily routine and a low stimulation environment when the client is agitated and confused. Noise levels including a radio and a television may add to the confusion and disorientation. Moving the client next to the nurses station is not the initial intervention

694. A mother of a teenage client with an anxiety disorder is concerned about her daughter progress on discharge. She states that her daughter "stashes food, eats all the wrong things that make her hyperactive," In helping the mother prepare for her daughter discharge, the nurse suggest that the mother:

Answer: Restrict the amount of chocolate and caffeine products in the home Rationale: Client with anxiety disorder should abstain from or limit their intake of caffeine, chocolate, and alcohol. These products have the potential on increasing anxiety. in the

693. A nurse is caring for a client diagnosed with catatonic stupor. The client is lying on the bed, with the body pulled into a fetal position. The appropriate nursing intervention is which of the following?

Answer: Sit beside the client in silence and verbalize occasional open ended-questions. Rationale: Client with Catatonic Stupor may be immobile and mute and may require consistent, repeated approaches. The nurse facilities communication with the client by sitting in silence, asking an open-ended-questions and pausing to provide opportunities for the client to respond. The nurse would not leave the client alone. Fortunately, with pharmacotherapy and improved individual management, severe catatonic symptoms rarely occur.

699. A nurse notes documentation in a clients record that the client is experiencing delusions of persecution. The nurse understands that these types of delusion are characteristic of which of the following

Answer: The false belief that one is a very powerful person. Rationale: A delusion is a false belief held to be true even when there is evidence to the contrary. A delusion of persecution is the thought that one is being singled out for harm by others

697. A client was admitted to a medical unit with acute blindness. Many tests are performed and there seems to be no organic reason why this client cannot see. The nurse later learns that the client became blind after witnessing a hit-and-run car crash, in which family of three was killed. The nurse suspects that the client may be experiencing a:

Answer: Conversion disorder Rationale: A conversion disorder is the alteration or loss of a physical function that cannot be explained by any known pathophysiological mechanism. It is thought to be an expression of psychological need or conflict. In this situation, the client witnessed an accident that was so psychologically painful that the client became blind.

696. A client has reported that crying spells have been a major problem over the past several weeks, and that the doctor said that depression is probably the reason. The nurse observes that the client is sitting slumped in the chair and the clothes that the client is wearing do not fit well. The nurse interprets that further data collection should focus on.

Answer: Weight Loss Rationale: All the options are possible issue to address however, the weight loss is the first item that needs further data collection because ill-fitting clothing could indicate a problem with nutritions. The client has already told the nurse that the crying spells have been a problem. Medication or sleep patterns are not mentioned or addressed in the question

690. A client who is diagnosed with pedophilia and has been recently paroled as a sex offender says, "I'm in treatment and i have served my time. Now this group has posters of me all over the neighborhood telling about me with my picture on it. "Which of the following is an appropriate response by the nurse."

Answer: You understand that people fear for their children, but you're feeling unfairly treated Rationale: Focusing and verbalizing the implied concern is the therapeutic. Response because it assists the client to clarify thinking and re-examine what the client is really saying.