Mental Health Exam 3
A patient diagnosed with schizophrenia is experiencing catatonia. The patient has little spontaneous movement and waxy flexibility. Which of the following is the appropriate pharmacological intervention? A- Ativan IM B- Haldol C- Tylenol D- Buspar
A
What nursing diagnosis is most likely to be associated with a client having schizophrenia experiencing auditory hallucinations?
Disturbed sensory perception
During a tr team meeting a point is made that a patient with schizophrenia has recovered from acute psychosis, but continues to demonstrate apathy, avolution, and flat affect. What are those called? The nurse who relates the symptoms to serotonin excess, too much dopamine, will suggest that the patient receive which medication? A- Haldol B- Metoprolol C- Seroquel D- Olanzapine (Zyprexa)
Olanzapine (Zyprexa)
A client is exhibiting schizophrenia and has mania and major depressive disorder. What is the client's diagnosis?
Schizoaffective disorder
The client diagnosed with borderline personality disorder tends to label certain persons on the staff and being either good or bad. This behavior is an example of?
Splitting
the most app nursing action for clients with panic attack is to? (select all that apply)
Stay with them Use short simple sentences
A male client with a diagnosis of schizophrenia tells you that people are able to read his mind. What is this called?
Thought broadcasting
Which economic factors are most critical to the success of discharge planning for a patient diagnosed with severe and persistent mental illness? (select all that apply)
access to housing income to meet basic needs availability to health insurance
Priority for a patient taking clozaril (clozapine) should include what?
Agranulocytosis
When working with a patient newly emigrated from Asia who has been assessed as having xenophobia, the nurse could anticipate making the assessment that the individual: A- Resists sharing food with others B- Would be reluctant to ride an elevator C- Is unlikely to talk with non-family members D- Fears the consequences of going out of doors
C
Which patient statement bests supports the diagnosis of somatic disorder? A- "I want to fly a plane." B- "I feel great today." C- "I can't do much because of the severe pain." D- "I want to eat ice cream."
C
A newly admitted patient with schizophrenia says, "The voices are bothering me. They yell and tell me I'm bad. I have to get away from them." What is the best reply from the nurse? A- "Try to ignore the voices." B- "Do you believe what the voices are telling you." C- "Do you talk back to the voice?" D- "What are the voices telling you?"
D
A nurse assess the four children below, Which assessment finding should prompt the nurse to refer the child for further evaluation? A- A 4 year old who stuttered for the first 3 weeks after the birth of their younger brother B- A 9 month old who does not like to eat vegetables and likes to be rocked C- A 3 month old who cries after feeding until being burped and sucks his thumb D- A 3 year old who is mute and passive toward adults who is repetitive
D
A nurse would assess for which of the following characteristics in the behaviors of any clients diagnosed with a personality disorder?
Disruption with something in the patient's life ie: splitting, fear of abandonment
The nurse determines that a client who is described as a loner and who does not express a desire for close interpersonal relationships reflects a behavioral pattern associated with what personality disorder?
Schizoid personality disorder (Cluster A)
A healthcare provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has negative symptoms such as apathy, avolution, anadonia, and flat affect?
Vraylar
A patient diagnosed with schizophrenia states, "My co-workers are out to get me. I know doctors are plotting to overdose me." What term identifies what type of delusion is the patient experiencing? A- Persecution B- Auditory C- Dangerous D- Disorganized
A
Which of the following are possible interventions for patients experiencing NMS? (Neuroleptic malignant syndrome) (select all that apply)
stop medication administer Ativan 2 mg IV fluids for hydration administer dantrolene administer bromocriptine
When assessing a 2 year old diagnosed with autism spectrum disorder, what should the nurse expect?
underdeveloped communication and social skills. The child avoids eye contact The child becomes upset with minor changes in routine The child does not relate to the parents
Which response by the nurse would best assist a patient in de-escalating aggressive behavior? A- "Tell me what's going on." B- "Why are you getting so upset?" C- "If you throw something, you will be restrained." D- "It's time for group therapy. You can talk there."
A
A healthcare provider considers which antipsychotic medication to prescribe for a patient diagnosed with schizophrenia who has auditory hallucinations and poor social functioning. This patient is also overweight. Which drug should the nurse advocate. Which of the following medications has a low side effect profile?
Apiprazole (Abilify)
A newly admitted patient diagnosed with schizophrenia is restless and constantly scans the environments. The patient states, "Someone is whispering in my ears. The voices are telling me to escape from this hospital." the nurse may correctly assess this as what classic symptom? A- Auditory hallucination B- ADHD C- Visual hallucination D- ODD
Auditory hallucination
A child diagnosed with ADHD is going to begin med therapy. The nurse should plan to teach the family about which classification of medications? A- Anti-inflammatories B- CNS stimulants and non stimulants C- Antiemetics D-Analgesics
B
A client diagnosed with antisocial personality disorder tells Nurse A, "You're a much better nurse than Nurse B said you were." The client then tells Nurse B, "Nurse A is upset with you for some reason." To Nurse C, the client states, "I think you're great, but Nurse A said she saw you make three mistakes this morning." The nurse should conclude that these behaviors are intended to have which effect? A- Create guilt in the staff B- Manipulate the staff C- Gain acceptance D- Gain attention
B
A nursing assessment indicates a client is experiencing a panic attack. The client is unable to understand direction and is preoccupied with thoughts of danger. Which of the following would be the appropriate nursing diagnosis? A. Ineffective health maintenance B. Altered thought processes C. Risk for noncompliance D. Impaired communication.
B
A patient diagnosed with liver failure has been on the transplant waiting list 8 months. The patient says, "Why is it taking so long to have the surgery? Maybe I'm meant to die for all the bad things I've done." The nurse should document the patient comment in which section of the assessment? A- Physical B- Spiritual C- Financial D- Psychological
B
A patient has taken Haloperidol for 3 years. The nurse notes that the patient grimaces and constantly smacks both lips. The patient's neck and shoulders twist in a low snake like motion. Whats the problem. A- Agranulocytosis B- Tardive dyskinesia C- Tourette's syndrome D- Anticholinergic effects
B
A patient reports fears of having cervical cancer and says to the nurse, "I've had Pap smears by six different doctors. The results were normal, but I'm sure that's because of errors in the laboratory." Which disorder would the nurse suspect? A- Conversion (functional neurological) disorder B- Illness anxiety disorder (hypochondriasis) C- Somatic symptom disorder D- Factitious disorder
B
What is the basis for the reduction in disturbed thought processes when a patient is administered haloperidol (Haldol)? A- Reduction in the number of brain cells that crave dopamine B- Dopamine receptors are blocked, making dopamine less available C- Dopamine receptors are enhanced, making more dopamine available D- Medication causes an increased cellular production of dopamine
B
Which nursing action best addresses the needs of a paranoid patient who believes the food is poisoned? A- Explaining that others eat the food and are not harmed B- Offer the patient to receive packaged food C- Encouraging the patient to discuss why someone would poison the food D- Taking steps to prevent the patient from verbalizing the delusional thoughts
B
Which patient diagnosed with schizophrenia would be expected to have the lowest level of overall functioning? A- A 5 year old patient playing on the monkey bars at the local playground B- A 40 year old person who has been experiencing relapses since they were 18 and often doesn't take their meds as prescribed C- A 70 year old patient reading a book while laying on the beach D- A 20 year old persona eating cake and ice cream at a birthday party
B
A 12 year old child does not follow rules and has trouble with authority figures. The child awakens before the parents every morning. The child attends kindergarten, but the teacher reports child being unruly and intrusive. What is this child's most likely problem? A- CD (Conduct disorder) B- ADHD C- ODD (Opposition defiant disorder) D- Bipolar
C
A client arrives for her mental health appointment wearing a cocktail dress and theatrical makeup. She announces loudly, dramatically, and in a flirtatious manner that she needs to be seen immediately because she is experiencing overwhelming psychological distress. The nurse should recognize behaviors suggestive of which personality disorder? A- Borderline B- Narcissistic C- Histrionic D- Antisocial
C
What is the focus of outcome identification for the treatment plan of a patient presenting with grandiose thinking associated with acute mania? A- Maintaining an interest in the environment B- Developing an optimistic outlook C- Self-control of distorted thinking D- Stabilizing the sleep pattern
C
A nurse plans the care for an individual diagnosed with antisocial personality disorder. Which characteristic behaviors would the nurse expect? (select all that apply)
Callous attitude Aggression
Which nursing outcome would indicate that a client with a nursing dx of risk for self mutilation due to feelings of abandonment related to the end of a close relationship has improved.
Client verbalized fear of abandonment in a realistic way.
A 15-year-old ran away from home six times and was arrested for prostitution. The parents told the Court, "We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the father. The adolescents problem is most consistent with what criteria for which disorder? A- Attention deficit hyperactivity disorder (ADHD) B- Post-traumatic stress disorder (PTSD) C- Intermittent explosive disorder D- Conduct disorder
D
A newly admitted patient has the diagnosis of catatonic schizophrenia. Which behavior observed in the patient supports that diagnosis? A- Uses a rhyming form of speech B- Refuses to eat any unwrapped foods C- Laughs when watching a sad movie D- Maintains an immobilized state for hours
D
A nurse sits with a patient diagnosed with schizophrenia. The patient starts to laugh uncontrollably, although the nurse has not said anything funny. Select the nurse's best response. A- "Why are you laughing?" B- "Please share the joke with me." C- "I don't think I said anything funny." D- "You're laughing. Tell me what's happening."
D
A patient diagnosed with schizophrenia tells the nurse, "I eat skiller, tent in Easter that blows away. Get it? (word salad) What is the nurses best response? A- "What language are you speaking?" B- "Oh, that sounds interesting. Tell me more." C- "I don't think you know what you're saying. Can you say it again?" D- "I'm having difficulty understanding what you're saying to me."
D
A patient prescribed an antipsychotic medication develops a high fever, unstable blood pressure, and muscle rigidity. Her next dose of medication is due. The nurse should: A- Administer the medication and monitor the vital signs every 4 hours. B- Give a lower dose of the medication for 24 hours and monitor the blood pressure. C- Prepare to administer a prn dose of the anticholinergic drug benztropine (Cogentin). D- Hold the medication and immediately describe the patient's symptoms to the doctor.
D
A soldier returned 1 year ago from Afghanistan and was diagnosed with post-traumatic stress disorder (PTSD). Which social event would most likely be disturbing for this soldier? A- Halloween festival with neighborhood children B- Singing carols around a Christmas tree. C- Family outing to the seashore D- Fireworks display on July 4th
D
Which initial short-term outcome would be appropriate for a patient who was admitted expressing delusional thoughts? A- Accept that delusion is illogical. B- Distinguish external boundaries. C- Explain the basis for the delusions. D- Engage in reality-oriented conversation.
D
A patient begins therapy with Haldol for Schizophrenia. Based on your understanding of the side effects related to Haldol, what teaching should the nurse provide?
EPS
When a patient is diagnosed with schizophrenia and taking Haldol 5 mg nightly. The patient states, "I want to stop taking these pills. I feel restless and have muscle spasms." What side effect is that?
EPS
Personality disorder: Weird Wild worried A- Paranoid, schizotypal B- Histrionic C- avoidance/dependent personality
Know this info
A nurse worked with a patient diagnosed with schizophrenia. Regarding the importance of medication management, the patient repeatedly says, "I don't like taking pills." Which treatment strategies should the nurse discuss with the patient and the healthcare provider?
Long acting injectable (antipsychotic)
What are the primary distinguishing factors between the children with Oppositional defiant disorder (ODD) and those diagnosed with conduct disorder Conduct disorder (CD). (select all that apply)
ODD tests limits and disobeys authority figures CD often violates the rights of others
A pt diagnosed with schizophrenia is hospitalized after arguing with co-working and threatening to harm them. The patient is suspicious and says 2 staff members I saw talking and plotting to assault me. Based on that which nursing dx relates? (select all that apply)
Risk for other directed violence Disturbed thought process