Mental Health Dynamic Questions

A nurse is assessing a client who is experiencing post traumatic stress disorder (PTSD) following a traumatic event. which of the following medication should the nurse expect the provider to prescribe? A. Bupropion B. Phenelzine C. Mirtazapine D. Paroxetine

A. Bupropion (an aminoketone antidepressant that is prescribed for smoking cessation, depression, and treatment of ADHD. it is not prescribed for the treatment for PTSD) B. Phenelzine (an MAOI antidepressant that can be prescribed for PTSD. however, SSRIs such as paroxetine are the first choice for PTSD) C. Mirtazapine (is a tricyclic antidepressant that can be prescribed for PTSD. however SSRIs such as paroxetine are the first choice for PTSD) D. Paroxetine (CORRECT ANSWER) - the nurse should expect the provider to prescribe paroxetine, an SSRI that is considered the first line treatment for PTSD

A nurse is assessing a newly admitted client who has generalized anxiety disorder and states, "I drink alcohol to forget the pain." the client is exhibiting a maladaptive response to which of the following defense mechanism? A. Compensation B. Conversion C. Projection D. Suppression

A. Compensation - compensation is a defense mechanism by which a person covers a real or perceived problem or weakness. this client is temperorarily attempting to block the constant worry of generalized anxiety disorder by drinking alcohol, which is a maladaptive method of increasing self-esteem. an example of an adaptive use of compensation would be if a person who had an anxiety disorder worked hard to excel in some way to avoid being defined by the anxiety disorder. - Conversion is the unconscious transformation of anxiety into physical manifestations with no organic cause. - Projection is the unknowing rejection of emotionally unacceptable feelings by attributing those feelings to others. - Suppression is the conscious blocking of disturbing feelings by suppressing conscious thoughts to avoid worrying about a stressor.

A nurse is caring for a client who was brought to the clinic by her adult son, who states that his father recently died. the client repeatedly yells at her son stating, "quit lying about your father!" the nurse should recognize that the client is demonstrating which of the following defense mechanisms? A. Denial B. Identification C. Introjection D. Sublimation

A. Denial - demonstrating denial through the belief that her son is lying about her partner's death. (CORRECT) * Identification is taking on the characteristics of another person *Introjection is adopting the values and beliefs of another person *Sublimation is the conversion of unacceptable drives into socially sanctioned activities

A nurse in a mental health facility is admitting a client who has antisocial personality disorder. which of the following behaviors should the nurse expect the client to exhibit? A. Lack of remorse B. self- mutilation C. delusional behavior D. Splitting

A. Lack of remorse - a client who has antisocial personality disorder lacks empathy for others and shows no remorse or guilt for callous behavior

A nurse is caring for a client who has schizophrenia and started taking a first generation antipsychotic medication 3 weeks ago. the client reports a feelings of inner restlessness, rocks back and forth when sitting down, and paces frequently. the nurse should identify that the client is experiencing which of the following adverse effects of antipsychotic medications? A. Neuroleptic malignant syndrome B. Akathisisa C. Anticholinergic toxcitiy D. Opisthotonos

A. Neuroleptic malignant syndrome - neuroleptic malignant syndrome is a rare and serious adverse effect of antipschotic medications. manifestations of this disorder include a high fever, hypertension, tachycardia, and muscle rigidity. B. Akathisia (CORRECT ANSWER) - Akathisia is an extrapyramidal effect that can occur in a client within the first 2 months of beginning a first generation antipsychotic medication. the client might be unable to rest due to a feeling of inner restlessness. rocking back and forth and pacing the floor can also be manifestations of akathisia. the nurse should report this finding to the provider. several medications, such as propranolol, can be used to treat akathisia. C. Anticholinergic toxicity - can occur when a client takes medications that cause anticholinergic effects, such as antipsychotic medications. manifestations of anticholinergic toxicity include delirium, unstable vital signs, and decreased bowel sounds. D. Opisthotonos - position demonstrated by extreme arching of the head and spine during a severe muscle spasms called acute dystonia, which is an adverse effect of some antipsychotic medications.

A nurse is caring for a client who reminds her of a negative person in her past. These memories cause the nurse to unconsciously displace negative feelings on the client. The nurse should recognize that she is demonstrating which of the following behaviors. A. Suppression B. Countertransference C. Transference D. Assertiveness

A. Suppression: occurs through the conscious denial of a disturbing feelings B. Countertransference: occurs through the unconscious displacement of feelings towards the nurse (CORRECT ANSWER) C. Transference: occurs through the unconscious displacement of feelings towards the nurse. D. Assertiveness: occurs through the expression of feelings without denying those of others.

A nurse is observing a client who has histrionic personality disorder. which of the following behaviors should the nurse expect? A. The client whispers in the provider's ear B. The client refuses to provide her telephone number C. The client has diminished facial expressions D. The client asks if if she is doing the right think 3 times during the appointment.

A. The client whispers in the provider's ear (CORRECT ANSWER) - acting provocatively and seductively is an expected behavior of an individual with histrionic personality disorder B. The client refuses to provide her telephone number (A client who has paranoid personality disorder will manifest behaviors that indicate distrust and suspiciousness of others due to the false belief that others seek to cause the client harm) C. The client has diminished facial expressions (A client who has schizoid personality disorder will manifest an expressionless demeanor and exhibit social withdrawal.) D. The client asks if if she is doing the right think 3 times during the appointment. (A client who has dependent personality disorder will seek constant reassurance due to a lack of self confident and an excessive need to be care for)

A nurse is caring for a client who is undergoing electroconvulsive therapy (ECT) to treat major depression. following the procedure, which of the following actions should the nurse take? A. administer oxygen B. administer an anticonvulsant C. administer an opioid antagnosit D. Administer IV fluids

A. administer oxygen - in prepration for ECT, the anesthesiologist administers succinylcholine, which paralyzes respiratory muscles. client require oxygen administration until their respiratory status is stable.

A nurse is assessing a client who takes phenelzine for the treatment of depression. which of the following findings Is the priority for the nurse to report to the provider? A. elevated blood pressure B. weight gain C. Muscle twitching D. +2 peripheral edema

A. elevated blood pressure - the greatest risk for this client is an elevated blood pressure, which increases the risk of a hypertensive crisis that can result from taking an MAOI like phenelzine.

a nurse is planning care for a client who has dissociative disorder and is experiencing flashbacks while in public. which of the following interventions should the nurse include in the plan to help the client recognize and counter the flashbacks? A. encourage reality testing B. provide opportunities for socialization C. consistently remind the client of past traumatic events D> discourage client expressions of negative feelings

A. encourage reality testing - reality testing involves scanning the surrounding to see if other are afraid and reorientation to time and place. this can help clients recognize that the flashbacks are not real.

A nurse in an acute care mental health facility observes a client who has bipolar disorder begin to shout and use offensive language toward a visitor. which of the following actions should the nurse take? A. give the client 2 options for ending the situation B. move quickly to stand directly in from of the client before speaking C.direct other clients to move toward the client as a show of force D. tell the client that the conversation will be ended if the shouting continues

A. give the client 2 options for ending the situation - giving the client several options (e.g.2 different location in which to be away from visitors and other clients) prevents the client from feeling powerless and gives the client some responsibility for making choices.

A nurse is performing an assessment of a newly admitted client. to establish trust, which of the following actions should the nurse perform in the orientation phase of the nurse- client relationship? A. inform the client that the admission is confidential B. Introduce the client to other clients in the day room C. assist the client in facilitating a behavioral change D. determine which coping strategies the client used in the past

A. inform the client that the admission is confidential - according to evidence based practice, the nurse should inform the client about confidentiality during the orientation phase of the nurse client relationship. this action helps establish trust between the nurse and the client.

A nurse is working in a retirement community is assessing an older adult client. which of the following manifestations should the nurse identify as an expected age related change? A. making occasional errors when balancing a checkbook B. confusion with time or place C. poor judgement D. changes in mood

A. making occasional errors when balancing a checkbook - the nurse should identify that making occasional errors when balancing a checkbook is an expected age related change in an older adult. other manifestations can include needing occasional assistance with operating appliances, forgetting a name or an appointment and then remembering it later, difficulty finding the correct use of a word, and becoming tired after social activities

A nurse communicating with a client at an inpatient mental health facility. which of the following actions by the nurse demonstrates the proper use of active listening? A. offering self B. using silence C. paying attention to body language D. reflecting feelings

A. offering self B. using silence C. paying attention to body language (CORRECT ANSWER) - active listening involves identifying verbal and nonverbal communication by the client, which includes paying attention to body language. D. reflecting feelings

A nurse is planning a staff education session about the administration of antidepressant medications to older adult client. which of the following pieces of information should the nurse include in the teaching? A. older adult client require lower initial dose of antidepressant medication that adult clients. B. older adult client should not receive antidepressant medication C. older adult client achieve the therapeutic effects of antidepressant medications more quickly than adult clients D. older adult client have a decreased risk of experiencing adverse effects from antidepressant medication.

A. older adult client require lower initial dose of antidepressant medication that adult clients. - older adult clients should start at half of the adult dose for antidepressant medications. this is due to altered rates of absorption and the increased risk for adverse effect.

A nurse is teaching a parent who has admitted to verbally abusing his children about stress management techniques. which of the following strategies is the nurse providing? A. tertiary prevention B. individual psychotherapy C. Family psychotherapy D. Primary prevention

A. tertiary prevention - the nurse is providing tertiary prevention methods by offering stress management techniques to the abuser after the abuse has occurred. tertiary prevention methods facilitate the rehabilitative process for both victims of violence and those who perpetuate it. - Primary prevention is taken before abuse actually occurs. primary prevention methods include identifying clients at risk of committing child violence and providing support services to prevent the occurrence of abuse.

A nurse is caring for a client with schizophrenia who has been taking chlorpromazine for the past 2 months. which of the following findings demonstrates that the chlorpromazine has been effective? A. the client reports hallucination occur less frequently B. the client sleeps uninterrupted for 6 hr each night C. the client reports that she is the "most important person on the unit" D. the client demonstrates stereotypes behaviors.

A. the client reports hallucination occur less frequently - the nurse should identify the chlorpromazine, when used to treat schizophrenia, reduces hallucinations. chlorpromazine is a first generation conventional antipsychotic medication and use effective in decreasing delusions, hallucinations, and agitation. it can also treat manic behavior in client who have bipolar disorder.

A nurse is admitting a client who has a hip fracture to the medical surgical care unit. the client states, "I've never been in the hospital before, and I feel like I have a lot of anxiety". which of the following responses should the nurse offer? A: "you're feeling anxious about being in the hospital for the first time" B. "anxiety while in the hospital is a feeling many people experience" C. "why do you think you feel anxious about being in the hospital" D. "What activities do you enjoy when you're not in the hospital"

A: "you're feeling anxious about being in the hospital for the first time" - the nurse should use therapeutic communication when discussing the client's concerns. this statement by the nurse is an example of restating, which is a therapeutic communication technique that encourages the client to continue talking and clarify any misunderstandings if necessary.

A nurse is assessing a client who has major depressive disorder for suicide risk factors and protective factors. which of the following client statement should the nurse identify as a protective factor that decreases the client's risk for suicide? A. "I am a college graduate and make a lot of money at my profession" B. "I consider myself a good problem- solver" C. "My family lives out of state, and I spend my spare time at home" D. "I enjoy restoring antique weapons and have a nice collection."

B. "I consider myself a good problem- solver" - the ability to problem-solve and to think critically is a protective factor against suicide. feelings of low self esteem or hopelessness are risk factors for suicide.

A nurse is assessing a client who has schizophrenia. which of the following statements by the client should the nurse recognize as an erotomaniac delusion? A. "My coworker is trying to poison me because he is afraid i'll take his job" B. "I have only met Jenny twice, but I know she loves me" C. "I am selling my house before the earthquake hits in May " D. "The foil on my walls prevents the government from controlling me"

B. "I have only met Jenny twice, but I know she loves me" - the nurse should recognize that a client who believes another person desires him or her romantically after meeting only a few times is demonstrating an erotomaniac delusion.

A nurse in an acute care mental health facility is evaluating the plan of care for a client who has major depressive disorder and was admitted 1 week ago following a suicide attempt. Which of the following client statement should indicate to the nurse the treatment plan has been effective? A. "I just don't want to talk about anything that happened before my admission" B. "I was feeling completely hopeless when I tried to kill myself" C. "I am feeling really great today, and.I think I am ready to go home" D. "I want to punch the doctors who put me in this hospital"

B. "I was feeling completely hopeless when I tried to kill myself" - this statement should indicate to the nurse that the client is meeting a short term goal of being willing to discuss painful feelings that occurred at the time of the suicide attempt. the nurse should also evaluate whether the client is now willing to seek help when feelings of self harm occur.

A nurse on a psychiatric unit is talking with a client when the client makes a sexual advance toward the nurse. which of the following responses should the nurse make? A. "It's normal for you to have sexual feeling toward the staff" B. "You need to stop any type of sexual advances" C. "This behavior is unacceptable while I am your nurse" D. "What would your family think of this type of behavior"

B. "You need to stop any type of sexual advances"

A nurse in a community mental health facility is caring for 4 clients. which of the following clients should the nurse identify as experiencing an adventitious crisis? A. a client who has a new diagnosis of severe bipolar disorder B. A client who is depressed following a devastating fire in her home C. a client who is experiencing acute grief following his father's death D. a client who is experiencing postpartum depression following the birth of her first child.

B. A client who is depressed following a devastating fire in her home - a client who is depressed following a devastating fire in her home

A nurse is caring for a client who has schizophrenia and started taking a first generation antipsychotic medication 3 weeks ago. the client reports a feeling of inner restlessness, rocks back and forth when sitting down, and paces frequently. the nurses should identify that the client is experiencing which of the following adverse effects of antipsychotic medications? A. Neuroleptic malignant syndrome B. Akathisia C. Anticholinergic toxicity D. Opisthotonos

B. Akathisia (inability to remain still) - akathisia is an extrapyramidal adverse effect than can occur in a client within the first 2 months of beginning a first generation antipsychotic medication. the client might be unable to rest due to a feeling of inner restlessness. rocking back and forth and pacing the floor can also be manifestations of akathisia. the nurse should report this finding to the provider. several medications, such as propranolol, can be used to treat akathisia.

A nurse is updating the plan of care for a client who has a major depression and a new prescription for amitriptyline. the nurse should plan to monitor the client for which of the following adverse effects? A. Hypertension B. Drowsiness C. Panic attacks D. Diarrhea

B. Drowsiness - drowsiness is an expected side effect of amitriptyline and other tricyclic antidepressants. sedation is most likely to be present during the first weeks of treatment with amitriptyline and can increase the risk of falls.

A nurse is assessing a client who is experiencing alcohol withdrawal. for which of the following findings should the nurse anticipate the administration of lorazepam? A. Decreased pulse rate B. Increased blood pressure C. Decreased urinary output D. Increased nausea

B. Increased blood pressure - lorazepam is a benzodiazepine that is administered to a client who is experiencing alcohol withdrawal for stabilizing vital signs, preventing seizures, and treating delirium tremens. the nurse should anticipate the provider to prescribe lorazepam for increasing blood pressure.

A nurse is planning care for a client who has completed detoxification from opioid abuse disorder. the nurse should plan to teach about which of the following medications? A. Methadone B. Naltrexone C. Buprenorphine D. Disulfiram

B. Naltrexone - the nurse should plan to educate the client on the medication naltrexone, an opioid antagonist that is used for the Long term maintenance of opioid use disorder. Naltrexone is the usual medication choice following detoxification from opioids.

A nurse in a substance use disorder treatment facility is reviewing the medication records of a group of clients. the nurse should expect to administer methadone for a client who has a substance use disorder for which of the following substances? A. Amphetamines B. Opiates C. Barbiturates D. Hallucinogens

B. Opiates - the administration of methadone is indicated for the treatment of opiate use disorder. opiates include opium, morphine, codeine, methadone, and heroin. methadone is given as a substitute to prevent cravings and severe manifestations of opiate withdrawal.

A nurse is providing teaching to a client who has panic disorder and a new prescription for clomipramine. which of the following adverse effects should the nurse include in the teaching? A. diarrhea B. sedation C. hypertension D. urinary frequency

B. Sedation - the nurse should inform the client that adverse effects of clomipramine include sedation, orthostatic hypotension, and anticholinergic effects such as dry mouth, blurred vision, urinary retention, constipation, and tachycardia.

A nurse is teaching a client who has depression and is scheduled for transcranial magnetic stimulation (TMS). the nurse should inform the client that TMS can cause which of the following adverse effects? A. Retrograde Amnesia B. Seizures C. Confusion D. Suicidal Ideation

B. Seizures - although uncommon, seizures are a potential adverse effects of TMS - Retrograde amnesia is a potential adverse effects of ECT - Confusion is a potential adverse effect ECT - Suicial Ideation is a manifestation of depression. TMS is prescribed as a treatment for depression and is intended to decrease suicidal ideation and the manifestations of depression such as guilt, hopelessness, sadness, and excessive crying.

A nurse in an acute substance disorder unit is assessing a client who received treatment in the emergency department for a heroin overdose. which of the following findings should the nurse anticipate during heroin withdrawal? A. excessive sleeping B. muscle aches C. pupillary constriction D. absent bowel sounds

B. muscle aches - the nurse should expect manifestation of withdrawal to begin within 6 to 8 hours following the last dose of heroin. Some other symptoms are insomnia, pupillary dilation , and diarrhea

A nurse in an acute substance disorder unit is assessing a client who received treatment in the emergency department for a heron overdose. which of the following findings should the nurse anticipate during heroin withdrawal? A. excessive sleeping B. muscle aches C. pupillary constriction D. absent bowel sounds

B. muscle aches - the nurse should expect the client to have muscle aches during heroin withdrawal. the nurse should expect manifestations of withdrawal to begin within 6 to 8 hours following the last does of heroin.

A nurse in a provider's office is reviewing the medical history of a client who asks about the use of varenicline for smoking cessation. which of the following items in the client's medical history indicates a precaution for the use of varenicline? A. the client has type 1 diabetes mellitus B. the client has a history of depression C. the client has rheumatoid arthritis D. the client has a history of GERD

B. the client has a history of depression - the nurse should recognize that varenicline can cause mood changes and thoughts of suicide. precautions should be taken when prescribing this medication to clients who have a history of psychiatric disease such as depression

A nurse is assessing a newly admitted client who has schizophrenia. the client suddenly looks at an empty chair and appears to be listening to something. which of the following responses should the nurse make? A."I thought I heard something too" B. "Is someone telling you something?" C. "What are you hearing?" D. "There is nobody in that chair for you to listen to"

C. "What are you hearing?" - this open ended question allows the nurse to find out what the client is hearing without validating the hallucination as real. the nurse should watch the client for anxiety or fear and ensure that the hallucination is not commanding the client to hurt self or other. after an assessment of the client's hallucinations is complete, the nurse can develop a plan to decrease the hallucinations.

A client who has cognitive impairment tells the nurse. "Im leaving now. I have to be home by 5:00pm because dinner will be ready." which of the following responses by the nurse demonstrates the use of validation therapy? A. "it is 5:30pm right now. you are in the hospital, and we will bring you dinner soon" B. "dont worry about dinner. your father is bringing dinner to you here tonight" C. "at home, you had dinner at 5pm. was your father a good cook?" D. "your father was born in the year 1920. can you tell me what year it is now?"

C. "at home, you had dinner at 5pm. was your father a good cook?" - this response validates the client's feelings and redirects the conversation to another topic so that the client can talk about memories. validation therapy does not attempt to orient the client to reality but instead validates the underlying feelings expressed by the client and redirects the conversation

A nurse is teaching a client who's schizophrenia about involuntary commitment. which of the following statement should the nurse identify as an indication that the client understand the teaching? A. "my family cannot commit me because I am homeless" B. "even when Im calm, I'll be forced to take psychotropic medication" C. "at least 2 doctors must support the commitment application" D. "I am afraid the doctors will make me have surgery"

C. "at least 2 doctors must support the commitment application" -involuntary commitment is a court ordered mandate requiring admission of client to receive mental health services either at an outpatient or at an inpatient mental health facility. at least 2 doctors or other mental health professionals must agree that the client should be involuntary committed to ensure due process and avoid accidentally committing the client.

A nurse is providing teaching to the partner of a client who has conversion disorder. which of the following statement by the partner shows an understanding of the teaching? A. "my partner is pretending to be ill to get attention" B. "my partner is purposefully making our child sick" C. "the stress of losing our child caused my partner to go blind" D. "my partner is worried that he has cancer, even though his tests are normal"

C. "the stress of losing our child caused my partner to go blind" - the nurse should explain to the partner that conversion disorder manifests as deficits in motor or sensory functions. emotional conflict or stress is reflected in physical manifestations that can include paralysis, blindness, movement disorder, numbness, paresthesia, loss of hearing, or episodes resembling epilepsy.

A nurse is providing teaching to a client who has generalized anxiety disorder and a new prescription for bus-irons. which of the following manifestations is a common adverse effect of this medication? A. Confusion B. Bradycardia C. Dizziness D. Insomnia

C. Dizziness - the nurse should inform the client that dizziness is a common adverse effect of bus-irons. the nurse should instruct client to avoid driving and operating heavy machinery until presence of adverse effect has been determined.

A nurse is reviewing the medical record of a client who has a new prescription for a benzodiazepine. for which of the following findings should the nurse question the provider's prescription? A. Skeletal muscle injury B. History of status epileptics C. Hypotension D. Insomnia

C. Hypotension - the nurse should question the provider's prescription for a benzodiazepine for a client who has hypotension. benzodiazepines can cause severe hypotension and increase the client's risk of cardiac arrest.

A nurse is caring for a client who is receiving treatment at an inpatient alcohol treatment facility. which of the following actions should the nurse identify as an example of an intentional tort? A. administering an incorrect dose of benzodiazepines B. informing the client's family member of the admission without the client's knowledge C. Informing the client that an injection will be administered if the client remains agitated D. failing to recognize suicide risk, resulting in the client's death

C. Informing the client that an injection will be administered if the client remains agitated (CORRECT) - this is an example of assault. assault is an intentional tort that is characterized by a threat toward a client that makes the client fearful of harm or unwanted touching. (CORRECT) A. administering an incorrect dose of benzodiazepines (example of negligence, which is the failure to use expected care in any situation when there is a duty to do so) B. informing the client's family member of the admission without the client's knowledge ((example of invasion of privacy, which is a quasi intentional tort and a violation of the health information portability and accountability act HIPAA). ) D. failing to recognize suicide risk, resulting in the client's death (this is an example of negligence, even if negligence resulted in the client's death, this is still considered an unintentional tort)

A nurse on an inpatient rehabilitation unit is assessing a client who has a opioid use disorder and is experiencing withdrawal. which of the following manifestations should the nurse expect? A. Hyperactivity B. Headache C. Rhinorrhea D. Tremulousness

C. Rhinorrhea - Rhinorrhea, lacrimation, pupillary dilation, yawning, and piloerection are classic manifestations of opioid withdrawal. - Hyperactivity is a manifestations of sedative, hypnotic, and anti anxiety medication withdrawal - Headache is a manifestation of cannabis withdrawal and caffeine withdrawal. - Tremulousness is a manifestation of alcohol withdrawal

A nurse is caring for a client who has obsessive compulsive disorder. which of the following actions should the nurse take first? A. encourage the client to verbalize her feelings B. teach the client relaxation techniques C. determine the client's anxiety level D. role play problem solving behaviors with the client.

C. determine the client's anxiety level - the nurse should apply the nursing process priority setting framework to plan client care and prioritize the nursing actions. each step of the nursing process builds on the previous step, beginning with an assessment or data collection. before the nurse can formulate a plan of action, implement a nursing intervention, for notify a provider of change in the client's status, he/she must first collect adequate data from the client. Assessing the client's anxiety level is vital in order to plan appropriate actions, as nursing interventions vary depending on the level of anxiety experienced by the client.

A nurse is providing discharge teaching for a client who has a new prescription for doxepin. which of the following adverse effects is associated with this medication? A. weight loss B. diarrhea C. drowsiness D. bradycardia

C. drowsiness (weight gain, constipation, and tachycardia are adverse effect of doxepin)

A nurse is caring a plan of care for a client who has borderline personality disorder and exhibits manipulative behaviors. which of the following interventions should the nurse include to address limit-setting? A. teach the client to use reaction formation for behavior control B. recommend the client attend assertiveness training. C. establish and explain consequences for the client's behavior D. encourage the client to increase socialization

C. establish and explain consequences for the client's behavior - the nurse should communication desired behavior and expectations to the client, as well as the detailed consequences of not meeting them. when addressing limit setting with the client, these expectations and consequences should be included in the plan of care.

A nurse is assessing a client who has ADHD and reports abruptly discontinuing his amphetamine treatment. which of the following assessments indicates that the client is physically dependent on the amphetamines? A. the client exhibits paranoia B. the client reports having insomnia C. the client reports eating excessively D. the client has an increased heart rate

C. the client reports eating excessively - when amphetamine is taken at a therapeutic dose, it causes appetite suppression. abrupt withdrawal of amphetamine can result in abstinence syndrome in a client who is physically dependent on the medication. indications of physical dependence include excessive eating, exhaustion, depression, prolonged sleep, and a craving for more amphetamine.

A nurse in a mental. health facility is meeting with a client who has a diagnosis of major depression. during the conversation, the client stops speaking, and the nurse sits silently next to the client for several minutes. the nurse should identify that the therapeutic communication technique of silence is used for which of the following purposes? A. to show approval of the client's desire to not talk B. to give the client time to evaluate the nurse C. to encourage the client to express feelings or concerns D. to prevent the nurse from making a non therapeutic response

C. to encourage the client to express feelings or concerns - silence during the therapeutic communication has many functions, including providing the client with time to formulate thoughts and express feelings or concerns. during the silence, the client can also consider alternatives and think about what has been said.

A nurse is caring for a client who has schizophrenia. the client states, "Aliens came into my room last night and took a sample of my blood." Which of the following responses should the nurse make? A. "Aliens do not exist" B. "Has your daughter had her baby?" C. "Do you mean to say a laboratory technician drew your blood last night?" D "That does not sound real"

D "That does not sound real" - the nurse is voicing doubt with response, which expresses uncertainty regarding the reality of the client's conclusion of the hallucination. this is a therapeutic response because the statement allows the client to expand upon the earlier statement, which allows exploration of the client's thought processes.

A nurse is admitting a client who has alcohol use disorder. which of the following statement indicates that the client is using denial as a coping mechanism? A. "I put in extra hours at work so I dont think about drinking" B. "I know that wine is good for my heart, so that's why I drink some each evening" C. "I make up for my drinking by taking my partner on nice vacations" D. "I am able to go to work every day so I don't have a problem"

D. "I am able to go to work every day so I don't have a problem" - Insisting that drinking is not a problem because the client can go to work every day involves the defense mechanism of denial. this allows the client to ignore the existence of an alcohol use disorder.

A nurse is talking with a client who has an anxiety disorder. the client states, "I have something important to tell you, but you have to promise to keep it a secret". which of the following responses should the nurse make? A. "anything you tell me is kept private between the two of us" B. "I feel uncomfortable being asked to keep a secret for you" C. "Why do you feel that this information needs to be kept private?" D. "I might have to share this information with your provider."

D. "I might have to share this information with your provider." - the nurse should be honest with the client so that the client can decide whether to share the information. the information the client shares can be vital for the treatment plan and can present a safety risk for the client or others. therefore, the nurse may be legally obligated to share the information with the client's provider and health care team..

A nurse is providing teaching to a client who has a new prescription for buspirone. which of the following statement by the client indicates an understanding of the teaching? A. "I need to watch for signs of dehydration" B. "I need to have my kidney function monitored while taking this medication" C. "I should take this medication on an empty stomach" D. "I might not notice the effects of this medication for several weeks"

D. "I might not notice the effects of this medication for several weeks" - the effects of buspirone develop slowly. the initial response takes at least a week, and a peak response takes several weeks. because of the delayed action, buspirone should not be takes asa PRN medication for the relief of anxiety.

A nurse is talking with a client who has major depressive disorder. which of the following client statement should the nurse identify as a covert statement of suicidal ideation? A. "I don't want to be alive any longer" B. "I think every day about killing myself" C. "my parents will be happier when Im dead" D. "I won't have to deal with things mung longer"

D. "I won't have to deal with things mung longer" - the nurse should listen closely for overt and covert statement that indicate a client's intent to commit suicide. covert statements, such as this example, can implicate a client's plan for suicide or wish not to be alive. covert statement are more difficult to identify because they do openly express the client's suicidal thoughts. the nurse should assess the client further suicidal ideation and implement interventions to recuse the risk of a suicide attempt.

A nurse is providing teaching to a client about cannabis use disorder. which of the following client statement indicated an understating of the teaching? A. "withdrawal of cannabis occurs 3 days after cessation" B. "there are no physical manifestations of withdrawal from cannabis" C. "drug screens can detect cannabis for up to 8 weeks after use" D. "cannabis use can produce effects resembling the effects of alcohol use"

D. "cannabis use can produce effects resembling the effects of alcohol use" - the nurse should explain to the client, when used moderately, cannabis produces effects same as the alcohol effects and other CNS depressants.

A nurse is providing teaching to the family of a client who has schizophrenia. which of the following statements by a family member indicates an understanding of the teaching? A. "we will not set time limits for discussing her delusions" B. "we will avoid reacting to her command hallucinations" C. "she might lose weight due to her medications" D. "she might be having a relapse if she stops attending social events"

D. "she might be having a relapse if she stops attending social events" - signs of relapse includes avoiding other people, sleep disturbances, difficulty concentrating, and being unable to tell reality from non reality - antipsychotics medications adverse effect is weight gain

A nurse is providing teaching to the family of a client who is scheduled for electroconvulsive therapy (ECT). which of the following statements made by the family indicated an understanding of ECT? A. "we are so glad there are no physical side effects of shock treatment" B. "thank goodness there is not permanent memory loss" C. "Cardiac dysrhythmias can persist for several weeks" D. "we won't be alarmed if there is some confusion after the treatment"

D. "we won't be alarmed if there is some confusion after the treatment" - it is common following ECT for a client to experience confusion and disorientation. Confusion and disorientation often occur following ECT.

A nurse is caring for a client who has anorexia nervosa. the client states "if I gain weight, I'll never get a boyfriend." which of the following cognitive distortions is the client displaying? A. overgeneralization B. Personalization C. Emotional reasoning D. Catasrophizing

D. Catasrophizing - a client displays the cognitive distortion of catastrophizing by assuming the worst possible outcomes will occur. (CORRECT) - overgeneralization: a client who displays the cognitive distortion of overgeneralization when he uses one, or a few, unfortunate events as proof that things will never go right again. - Personalization: a client displays the cognitive distortion of personalization by assuming responsibility for a situation that was not within the client's control. - Emotional reasoning: a client displays the cognitive distortion of emotional reasoning by making decisions based on the client's emotional state.

A nurse is caring for a client with alcohol use disorder who has undergone detoxification. which of the following medication should the nurse expect the provider to prescribe to assist the client with maintaining sobriety? A. verenicline B. Clonidine C. Buprenorphine D. Disulfiram

D. Disulfiram - Disulfiram is a type of aversion therapy that helps clients abstain from alcohol. drinking alcohol while taking this medication produces a toxic reaction that causes vomiting, confusion, heartaches, breathing difficulties, and other manifestations - Varenicline reduces nicotine cravings - Clonidine treats heroin withdrawal - Buprenorphine treats opioid withdrawal

A nurse is assessing a client who has a history of alcohol use disorder and is experiencing alcohol withdrawal. which of the following findings should the nurse identity as a manifestation of severe alcohol withdrawal? A. decreased appetite B. slurred speech C. Insomnia D. Hallucinations

D. Hallucinations - manifestation of severe alcohol withdrawal, along with diaphoresis, hyperthermia, and tachycardia

A nurse is assessing a client who is at risk for cognitive impairment. which of the following findings should the nurse identify as an early indication of cognitive decline? A. Disorientation to time B. problems handling finances C. social withdrawal D. Impaired recent memory

D. Impaired recent memory - short term memory loss is generally an early indication of mild cognitive decline. other indication of early or mild dementia include misplacing household items and demonstrating subtle changes in personality.

A nurse is assessing a client who is at risk for cognitive impairment. which of the following findings should the nurse identify as an early indication of cognitive decline? A. Disorientation to time B. Problems handling finances C. Social Withdrawal D. Impaired recent memory

D. Impaired recent memory - short term memory loss is generally an early indication of mild cognitive decline. other indications of early or mild dementia include misplacing household items and demonstrating subtle changes in personality. (CORRECT) - client who have moderate cognitive decline become disoriented to time, places, and events - client who have moderate cognitive decline lose their ability to handle money and finances. they also begin to have difficult using language - client who have moderate cognitive decline withdraw from socializing and become self absorbed

A nurse is assessing a client who is experiencing post traumatic stress disorder (PTSD) following a traumatic event. which of the following medications should the nurse expect the provider to prescribe? A. Bupropion B. Phenelzin C. Mitrazapine D. Paroxetine

D. Paroxetine - Paroxetine is an SSRI that is considered the first line of treatment for PTSD (CORRECT) - Bupropion: an aminoketone antidepressant that prescribed for smoking cessation, depression, and treatment of ADHD. it is not prescribed for the treatment of pTSD - Phenelzine is an MAOI antidepressant that can be prescribed for PTSD. However SSRIs such as paroxetine are the first choice for PTSD - Mirtazapine is a tricycle antidepressant that can be prescribed for PTSD. However, SSRIs such as paroxetine are the first choice for PTSD

A nurse in an emergency department is assessing a client who reports recent cocaine use. which of the following manifestations should the nurse expect? A. Hypertension B. Drowsiness C. Bradycardia D. Pinpoint Pupils

D. Pinpoint Pupils - cocaine is a central nervous system stimulant. therefore, hypertension is an expected finding in a client who has recently used cocaine.

A community mental health nurse is planning strategies to address substance use by adolescents. which of the following interventions should the nurse include as a method of primary prevention? A. offer substance use treatment options for adolescents from low income households B. encourage random testing for substance use for adolescents participating in extracurricular activities C. educate high school teachers about detecting the manifestations of substance use D. Provide a presentation at local high school on resisting peer pressure for substance use

D. Provide a presentation at local high school on resisting peer pressure for substance use - planning prevention that prevent the onset of substance use is an example of primary prevention. by providing information to adolescents on methods to resist peer pressure for substance use, the nurse can help prevent the substance use from occurring (CORRECT) - Secondary Prevention: planning interventions that promote early detection of substance use is an example of secondary prevention. encouraging the use of random testing for substance use allows early detection and enables the nurse to refer adolescents for treatment. **educating teachers about manifestations of substance use allows early detection and enables the nurse to refer adolescents for treatment. - Tertiary Prevention: planning interventions that stop or decrease substance use is an example of tertiary prevention. ensuring that adolescents, regardless of income, have treatment options can decrease the overall incidence of substance abuse.

A nurse is providing teaching to a client who has a new prescription for amitriptyline. the nurse should teach the client that which of the following over the counter medications can cause cardiac dysrhythmias when taken concurrently with amitriptyline? A. Acetaminophen B. Famotidine C. Naproxen D. Pseudoephedrine

D. Pseudoephedrine - Pseudoephedrine interacts with tricyclic medications and is therefore contraindicated. ingesting products containing ephedrine along with amitriptyline can cause cardiac dysrhythmias.

A nurse is planning care for a client who is scheduled to undergo electroconvulsive treatment (ECT). which of the following interventions should the nurse include? A. Maintain a clear liquid diet for 6 to 8 hr prior to ECT. B. Allow the client to sleep for 3 to 4 hr following ECT. C. Administer IM epinephrine to the client prior to ECT. D. Reorient the client to the environment after ECT.

D. Reorient the client to the environment after ECT. - Due to a transient period of confusion after ECT, the nurse should plan to reorient the client following ECT.

A nurse is working with a client who exhbitis extreme superstition, elaborate speech patterns, and eccentric behavior. the nurse should identify these features as which of the following personality disorders? A. paranoid B. Histrionic C. Antisocial D. Schizotypal

D. Schizotypal - findings of schizotypal personality disorder include a pattern of social impairments and cognitive alterations, including superstitious actions that are not congruent with the client's cultural norms and speech changes

A nurse is assessing a client who has been taking thioridazine hydrochloride for several days. the client reports hand tremors, drooling, and rigid extremities. which of the following actions should the nurse take? A. reassure the client that these effects are expected B. administer diazepam C. encourage deep breathing and relaxation D. administer benztropine

D. administer benztropine - client is experiencing extrapyramidal effects of thioridazine, which includes pseuodparkinsonism. benztropine is a medication that counteracts these adverse effects. the nurse should notify the provider if extrapyramidal effects occur and obtain a prescription to alleviate the manifestations.

A nurse in an acute mental health facility is leading a nursing staff discussion about the legal aspects of involuntary admissions. which of the following pieces of information should the nurse include? A. a client who is involuntary admitted must take prescribed medications. B. an involuntary admission of a client is limited to 2 weeks. C. a client who is involuntarily admitted can leave the facility against medical advice. D. an involuntary admission is justified if the client is a danger to others.

D. an involuntary admission is justified if the client is a danger to others. - a client who is danger to self or to others qualifies for an involuntary admission. the ability to meet basic needs due to the need for mental health treatment is also a justification for an involuntary admission.

A nurse is assessing a client who is taking lithium to treat bipolar disorder and has a lithium level of 2.2 mEq/L. which of the following findings should the nurse expect? A. muscle weakness B. Oliguria C. vomiting D. blurry vision

D. blurry vision - manifestations of lithium toxicity with levels between 2-2.5mEq/L include blurry vision, ataxia, clonic twitching, severe hypotension, and polyuria.

A nurse is preparing to apply wrist restraints on a client who is threatening to harm others and has not responded to less invasive interventions. which of the following actions should the nurse plan to take? A. obtain a PRN prescription for restraints from the client's provider. B. visually observe the client every 10 min until restraints are removed C. ensure 3 fingers can fit between the restraint and the client's wrist. D. document the client's behavior every 15 min while restraints are in place.

D. document the client's behavior every 15 min while restraints are in place. - the nurse should plan to document the client's behavior every 15 min while restraints are in place to meet the legal requirement for use of restraints. this documentation allows prompt identification of complication related to restraint use and helps ensure that restraints are removed as soon as possible, depending on the client's behavior.

A nurse is determining the total score for a client's Alcohol Use Disorders Identification Test (AUDIT) by assigning a score of 0 to 4 for each answer. For which of the following self- reported findings should the nurse assign the client a score of 4? A. the frequency of alcohol intake is typically 3 times per week B. the client misses work once a month becuase of alcohol intake. C. alcohol intake does not cause the client to have feelings of guilt D. last month, the provider suggested the client should reduce alcohol intake.

D. last month, the provider suggested the client should reduce alcohol intake. - when determining a client's total score for the AUDIT self-reported version, the nurse should assign a score of 4 in the client indicates that a friend, relative, or health care provider has recommended decreasing alcohol consumption at least once during the last 12 months.

A nurse is planning for a client who has vegetative signs of depression. which of the following actions should the nurse include in the plan? A. limit snacking between meals B. Schedule regular nap times during the day C. weigh the client monthly D. provide decaffeinated beverages

D. provide decaffeinated beverages - a client who has vegetative signs of depression is at high risk for altered sleep. because caffeinated beverages can interrupt restful sleep, the nurse should plan to offer the client decaffeinated beverages.

A nurse is planning care for a client who has vegetative signs of depression. which of the following actions should the nurse include in the plan? A. limit snacking between meals B. schedule regular nap times during the day C. weight the client monthly D. provide decaffeinated beverages

D. provide decaffeinated beverages - a client who has vegetative signs of depression is at high risk for altered sleep. because caffeinated beverages can interrupt restful sleep, the nurse should plan to offer the client decaffeinated beverages. (Correct) **a client who has vegetative signs of depression is at risk for appetite changes that can lead to malnutrition. the nurse should offer the client high protein, high calories snacks throughout the day and evening to support nutritional stability.

A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode. which of the following interventions should the nurse include in the plan? A. discourage the client from taking naps during the day. B. allow the client to choose which item of clothing to wear each day. C. encourage the client to participate in group therapy. D. provide the client frequently with high calorie finger foods

D. provide the client frequently with high calorie finger foods - the nurse should provide the client with high calorie snacks and meals during a manic episode to provide the calorie replacement needed due to excessive physical energy and activity. providing finger foods increases the client's intake by making eating easier when mania creates difficulties with sitting down and concentrating on a meal.

A nurse is caring for a client who has post traumatic stress disorder (PTSD) and who is undergoing eye movement desensitization and reprocessing (EMDR) therapy. the nurse should identify that EMDR includes which of the following strategies? A. exposes the client to circumstances that trigger the PTSD B. Assists the client with behavioral modification C. encourages the client to visualize a relaxing scene when traumatic memories occur D. uses stimuli to change how the client processes

D. uses stimuli to change how the client processes - EMDR uses stimuli such as tapping, eye movements, or audio sounds combines with verbalization of the traumatic event by the client. while the client recalls the traumatic event, these stimuli create a neurological and physiological changes in how the client integrates the memories. EMDR. is a type of psychotherapy carried out during several sessions by a therapist who is trained in the method.