Mental Health- Exam 2

A nurse is teaching a client who has a new prescription for imipramine (Tofranil) how to minimize anticholinergic effects. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Void just before taking the medication. B. Increase the dietary intake of potassium. C. Wear sunglasses when outside. D. Change positions slowly when getting up. E. Chew sugarless gum.

A C E

A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (select all that apply) A. Methadone is a replacement for physical dependence to opioids B. Methadone reduces the unpleasant effect associated with abstinence syndrome C. Methadone can be used during opioid withdrawal and to maintain abstinence D. Methadone increases the risk for acetaldehyde syndrome E. Methadone must be prescribed and dispensed by an approved treatment center

A, B, C, E

A nurse is preparing to implement cognitive reframing techniques for a client who has an anxiety disorder. Which of the following are appropriate to include in the plan of care? (Select all that apply.) A. Priority restructuring B. Monitoring thoughts C. Diaphragmatic breathing D. Journal keeping E. Meditation F. Assertiveness Training

A, B, D, F

A nurse is teaching the guardians of a child who has autism spectrum disorder about indications of imipramine toxicity. Which of the following should the nurse include in teaching? (Select all that apply) A. Seizures B. Agitation C. Photophobia D. Dry mouth E. Irregular pulse

A, B, E

A charge nurse is discussing manifestations of schizophrenia with a newly licensed nurse. Which of the following should the charge nurse identify as being effectively treated by conventional antipsychotics? (Select all that apply.) A. Auditory hallucinations B. Withdrawal from social situations C. Delusions of grandeur D. Severe agitation E. Anhedonia

A, C, D

A nurse is caring for a client who takes paroxetone to treat post traumatic stress disorder. The client states that he grinds his teeth at night, which causes pain in his mouth. The nurse should identify which of the following interventions as possible measures to manage the clients bruxism (select all that apply) a. concurrent administration of buspirone b. administraion of a different ssri c. use of amouth guard d. changing to a different class of antianxiety medications e. increasing the dose of paroxetine

A, C, D

A nurse is caring for a client who takes ziprasidone (Geodon). The client reports difficulty swallowing the oral medication and becomes extremely agitated with injectable administration. The nurse should contact the provider to discuss a change to which of the following medications? (Select all that apply.) A. Olanzapine (Zyprexa) B. Quetiapine (Seroquel) C. Aripiprazole (Abilify) D. Clozapine (Clozaril) E. Asenapine

A, C, D, E

A nurse is planning care for a client following surgical implantation of a vagus nerve stimulation (VNS) device. The nurse should plan to monitor for which of the following adverse effects? (Select all that apply.) A. Voice changes B. Seizure activity C. Disorientation D. Dysphagia E. Neck pain

A, D, E

A charge nurse is discussing mirtazapine (Remeron) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding? A. "This medication increases the release of serotonin and norepinephrine." B. "I will need to monitor the client for hyponatremia while taking this medication." C. "This medication is contraindicated for clients who have an eating disorder." D. "Sexual dysfunction is a common adverse effect of this medication."

A. "This medication increases the release of serotonin and norepinephrine."

Nurse is discussing routine follow‑up needs with a client who has a new prescription for valproate. the nurse should inform the client of the need for routine monitoring of which of the following? A. AST/ALT & LDH B. Creatinine & BUN C. WBC & Granulocyte counts D. Serum sodium & potassium

A. AST/ALT & LDH

A nurse is caring for a client who is experiencing extreme mania due to bipolar disorder. Prior to administration of lithium blood level is 1.2 mEq/L. Which of the following actions should the nurse take? A. Administer the next dose of lithium carbonate as scheduled B. Prepare for administration of aminophyline C. Notify the provider for possible increase in the dosage of lithium carbonate D. Request a stat repeat of the client's lithium blood level

A. Administer the next dose of lithium carbonate as scheduled

A nurse is caring for a client who has a new prescription for disulfiram (Antabuse) for the treatment of his alcohol use disorder. The nurse informs the client that this medication can cause nausea and vomiting if he drinks alcohol. This form of treatment is an example of which of the following? A. Aversion therapy B. Flooding C. Biofeedback D. Dialectical behavior therapy

A. Aversion therapy

A nurse is teaching a client about stress-reduction techniques. Which of the following client statements indicate understanding of the teaching? A. Cognitive reframing while help me change my irrational thoughts to something positive B. Progressive muscle relaxation uses a mechanical device to hep me gain control over my pulse rate C. Biofeedback causes my body to release endorphins so that I feel less stress and anxiety D. mindfulness allows me to prioritize the stressors in my life so that I have less anxiety

A. Cognitive reframing while help me change my irrational thoughts to something positive

A nurse is providing teaching to an adolescent client who has a new prescription for clomipramine for OCD. Which of the following information should then nurse provide? A. Eat a diet high in fiber B. Check temperature daily C. Take medication first thing in the morning before eating D. Add extra calories to the diet as between meal snacks

A. Eat a diet high in fiber

A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? A. This medication will help prevent seizures during alcohol withdrawal B. Taking this medication will decrease our cravings for alcohol C. This medication maintains your blood pressure at a normal level during alcohol withdrawal D. Taking this medication will improve your ability to maintain abstinence from alcohol

A. This medication will help prevent seizures during alcohol withdrawal

A nurse is preparing to provide an educational seminar on stress to other nursing staff. Which of the following information should the nurse include in the discussion? A. excessive stressors cause the client to experience stress B. The body's initial adaptive reposes to stress is denial C. Absence of stressors results in homeostasis D. Negative, rather than positive stressors create a biological response

A. excessive stressors cause the client to experience stress

A nurse is caring for a client who is taking phenelzine (Nardil). For which of the following adverse effects should the nurse observe? (Select all that apply.) A. Elevated blood glucose level B. Orthostatic hypotension C. Priapism D. Hypomania E. Bruxism

B and D

Nurse is discussing early indications of toxicity with a client who has a new prescription for lithium carbonate for bipolar disorder. the nurse should include which of the following manifestations in the teaching? (select all that apply.) A. Constipation B. Polyuria C. Rash D. Muscle weakness E. Tinnitus

B and D

A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EPS)? (Select all that apply.) A. Decreased level of consciousness B. Drooling C. Involuntary arm movements D. Urinary retention E. Continual pacing

B, C, E

A nurse is discussing acute versus prolonged stress with a client. Which of the following effects should the nurse identify as an acute stress response? A. Chronic pain B. Depressed immune system C. Increased blood pressure D. Panic Attacks E. unhappiness

B, C, E

A nurse is teaching a child who has intermittent explosive disorder about a new prescription for fluoxetine. Which of the following information should the nurse provide? (select all that apply). A. An adverse effect of this medication is CNS depression B. Administer the medication in the morning C. Monitor weight loss while taking this medication D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop E. This medication blocks the synaptic reuptake of serotonin in the brain

B, C, E

A nurse is planning group therapy for clients dealing with bereavement. Which of the following shouldthe nurse include in the initial phase? (Select all that apply.) A. Encourage the group to work toward goals. B. Define the purpose of the group. C. Discuss termination of the group. D. Identify informal roles of members within the group. E. Establish an expectation of confidentiality, respect, trust within the group. F. Members get to know each other

B, C, E, F

A nurse is assessing a client 4 hr after receiving an initial dose of fluoxetine which of the following findings should the nurse report to the provider as indications of serotonin syndrome (select all that apply) a. hypothermia b. hallucinations c. muscular flaccidity d. diaphoresis e. agitation

B, D, E

A nurse is providing teaching to an adolescent client who is to begin taking atomoxetine for ADHD. The nurse should in trust the client to monitor for which of the following adverse effects? (Select all that apply). A. Somnolence B. Yellowing skin C. Increased appetite D. Fever E. Malaise

B, D, E

A nurse is providing teaching to a client who has a new prescription for amitriptyline (Elavil). Which of the following client statements indicates understanding of the teaching? A. "While taking this medication, I'll need to stay out of the sun to avoid a skin rash." B. "I may feel drowsy for a few weeks after starting this medication." C. "I cannot eat my favorite pizza with pepperoni while taking this medication." D. "This medication will help me lose the weight that I have gained over the last year."

B. "I may feel drowsy for a few weeks after starting this medication."

Nurse is caring for a client who is prescribed lithium therapy. the client states that he wants to take ibuprofen for osteoarthritis pain relief. Which of the following statements should the nurse make? A. "That is a good choice. ibuprofen does not interact with lithium." B. "Regular aspirin would be a better choice than ibuprofen." C. "Lithium decreases the effectiveness of ibuprofen." D. "The ibuprofen will make your lithium level fall too low."

B. "Regular aspirin would be a better choice than ibuprofen."

A nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans ways to make his sister look bad so his parents will think he's the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following? A. Placation B. Manipulation C. Blaming D. Distraction

B. Manipulation

A client says that she is experiencing increased stress because her significant other is "pressuring me and my kids to go live with him. I love him, but I'm not ready to do that." Which of the following recommendations should the nurse make to promote a change in the client's situation? A. Learn to practice mindfulness B. Use assertiveness techniques C. Exercise regularly D. Rely on the support of a close friend

B. Use assertiveness techniques

A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which of the following statements by the client indicates an understanding of teaching? A. Taking this medication will help reduce my craving for heroin B. While taking this medication, I should keep a pack of sugarless gum C. I can expect some diarrhea from taking medicine D. Each dose of this medication should be placed under my tongue to dissolve

B. While taking this medication, I should keep a pack of sugarless gum

A nurse working in an ED is caring for a clinet who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? A. administer flumazenil B. identify the clients LOC C. influse IV fluids D. Prepare the client for gastric lavage

B. identify the clients LOC

A nurse is teaching a client who has an anxiety disorder and is scheduled to begin classical psychoanalysis. Which of the following client statements indicates an understanding of this form of therapy? A."Even if my anxiety improves, I will need to continue this therapy for 6 weeks." B."The therapist will focus on my past relationships during our sessions." C."Psychoanalysis will help me reduce my anxiety by changing my behaviors." D."This therapy will address my conscious feelings about stressful experiences."

B."The therapist will focus on my past relationships during our sessions."

A nurse is assessing a client immediately following an electroconvulsive therapy (ECT) procedure. Whichof the following are expected findings? (Select all that apply.) A. Hypotension B. Paralytic ileus C. Memory loss D. Polyuria E. Tachycardia

C and E

A nurse is assisting in the discharge planning for a client following alcohol detoxification. The nurse should expect prescriptions for which of the following medications to promote long term abstinence from alcohol? (select all that apply) A. Lorazepam B. Diazepam C. Disulfiram D. Naltrexone E. Acamprostate

C, D, E

A nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for iloperidone (Fanapt). Which of the following client statements indicates understanding of the teaching? A. "I will be able to stop taking this medication as soon as I feel better." B. "If I feel drowsy during the day, I will stop taking this medication and call my provider." C. "I will be careful not to gain too much weight while taking this medication." D. "This medication is highly addictive and must be withdrawn slowly."

C. "I will be careful not to gain too much weight while taking this medication."

A nurse is working with an established group and identifies various member roles. Which of the following should the nurse identify as an individual role? A. A member who praises input from other members B. A member who follows the direction of other members C. A member who brags about accomplishments D. A member who evaluates the group's performance toward a standard

C. A member who brags about accomplishments

A nurse wants to use democratic leadership with a group whose purpose is to learn appropriate conflict resolution techniques. The nurse is correct in implementing this form of group leadership when she demonstrates which of the following actions? A. Observes group techniques without interfering with the group process B. Discusses a technique and then directs members to practice the technique C. Asks for group suggestions of techniques and then supports discussion D. Suggests techniques and asks group members to reflect on their use

C. Asks for group suggestions of techniques and then supports discussion

A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? A. Chew the gum for no more than 10 minutes B. Rinse out the mouth immediately before chewing the gum C. Avoid eating 15 min prior to chewing the gum D. Use of the gum is limited to 90 days

C. Avoid eating 15 min prior to chewing the gum

A nurse is leading a peer group discussion about the indications for electroconvulsive therapy (ECT). Which of the following is appropriate to include in the discussion? A. Borderline personality disorder B. Acute withdrawal related to a substance use disorder C. Bipolar disorder with rapid cycling D. Dysthymic disorder

C. Bipolar disorder with rapid cycling

A nurse is assisting with systematic desensitization for a client who has an extreme fear of elevators. Which of the following is appropriate when implementing this form of therapy? A. Demonstrate riding in an elevator, and then ask the client to imitate the behavior. B. Advise the client to say "stop" out loud every time he begins to feel an anxiety response related to an elevator. C. Gradually expose the client to an elevator while practicing relaxation techniques. D. Stay with the client in an elevator until his anxiety response diminishes.

C. Gradually expose the client to an elevator while practicing relaxation techniques.

A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should anticipate a prescription of which of the following medications? A. Chlorpromazine (Thorazine) B. Thiothixene (Navane) C. Risperidone (Risperdal) D. Haloperidol (Haldol)

C. Risperidone (Risperdal)

A nurse working on an acute mental health unit forms a group to focus on self-management of medications. At each of the meetings, two of the members use the opportunity to discuss their common interest in gambling on sports. This is an example of which of the following? A. Triangulation B. Group process C. Subgroup D. Hidden agenda

C. Subgroup

A nurse is reviewing the medical record of a client who has a new prescription for bupropion (Wellbutrin) for depression. Which of the following findings is the highest priority for the nurse to report to the provider? A. The client has a family history of seasonal pattern depression. B. The client currently smokes 1.5 packs of cigarettes per day. C. The client had a motor vehicle crash last year and sustained a head injury. D. The client has a BMI of 25 and has gained 10 lb over the last year.

C. The client had a motor vehicle crash last year and sustained a head injury.

A charge nurse is discussing transcranial magnetic stimulation (TMS) with a newly licensed nurse.Which of the following statements by the newly licensed nurse indicates a need for further teaching? A. "TMS is indicated for clients whose have schizophrenia disorder" B. "I will provide postanesthesia care following TMS." C. "TMS is usually lasts 5 to 10 minutes" D. "I will schedule the client for daily TMS treatments 3-5 times a week for the first several weeks"

D. "I will schedule the client for daily TMS treatments 3-5 times a week for the first several weeks"

Nurse is admitting a client who has a new diagnosis of bipolar disorder and is scheduled to begin lithium therapy. When collecting a medical history from the client's adult daughter, which of the following statements is the priority to report to the provider? A. "My mother has diabetes that is controlled by her diet." B. "My mother recently completed a course of prednisone for acute bronchitis." C. "My mother received her flu vaccine last month." D. "My mother is currently on furosemide for her congestive heart failure."

D. "My mother is currently on furosemide for her congestive heart failure."

A nurse is caring for a school age child who has conduct disorder and a new prescription for methylphenidate transdermal patches. Which of the following information should the nurse provide about the medication? A. Apply the patch once daily at bedtime B. Place the patch carefully in a trash can after removal C. Apply the transdermal patch to the anterior waist area. D. Remove the patch each day after 9 hr

D. Remove the patch each day after 9 hr

A nurse working in a mental health clinic is providing teaching to a client who has a new prescription for diazepam for generalized anxiety disorder. Which of the following information should the nurse provide A. three to six weeks of treatment is required to achieve a therapeutic benefit B. combining alcohol with diazepam will produce a paradoxical response C. diazepam has a lower risk for dependence than other anti-anxiety medications D. report confusion as a potential indication for toxicity

D. report confusion as a potential indication for toxicity

A nurse is discussing free association as a therapeutic tool with a client who has major depressive disorder. Which of the following client statements indicates understanding of this technique? A. "I will write down my dreams as soon as I wake up." B. "I may begin to associate my therapist with important people in my life." C. "I can learn to express myself in a non aggressive manner." D."I should say the first thing that comes to my mind."

D."I should say the first thing that comes to my mind."

A nurse is providing teaching for a client who is scheduled to receive electroconvulsive therapy (ECT) for the treatment of major depressive disorder. Which of the following client statements indicatesunderstanding of the teaching? A. "It is common to treat depression with ECT before trying medications." B. "I can have my depression cured if I receive a series of ECT treatments." C. "I will have seizures lasting 1½ to 2 min during ECT." D."I will receive a muscle relaxant to protect me from injury during ECT."

D."I will receive a muscle relaxant to protect me from injury during ECT."

A nurse is caring for a client who is to begin taking fluoxetine for treatment of GAD. Which of the following statments indicates the client understands the use of this medication? a. i will take the medication at bedtime b. i will follow a low sodium diet c. i will need to discontinue this medication slowly d. I will be at risk for weight loss with long term use of this medication

c. i will need to discontinue this medication slowly