Mental Health Final
A healthcare team is planning care for a pt hospitalized following a suicide attempt. Which statement by a team member should serve as a basis for planning?
"A pt who has made a recent suicide attempt requires ongoing assessment to determine the level of risk."
A pt is being assessed for a bing-eating-associated eating disorder. Which assessment question is directed towards collecting data on the most commonly abused substance among this pt population?
"How much alcohol do you drink on a weekly basis?"
A nurse talks with a pt who is engaged in an arts and crafts activity. The pt says, "I've never been artistic. I shouldn't even come to these silly groups." The pt also attends cognitive behavioral therapy sessions two times a week. Which comment by the nurse would be supportive of the cognitive behavioral therapy?
"I noticed that you made interesting color combinations and encouraged others"
Which complaint is representative of anxiety in a 6-yr old child?
"I worry that my dad will get hurt at work."
Which response demonstrates both empathy and understanding of the relationships genetics has on the development of schizophrenia in twins?
"In fraternal twins the chance of the other twin developing the disorder is quite small"
A pt with GAD receives a new prescription for Paroxetine (Paxil) 10mg at bedtime. The pt finds information on the internet that states that the drug is an antidepressant. The pt calls the nurse saying, "The doctor gave me the wrong drug. I have anxiety, not depress." Select the nurse's best response
"Its not a mistake. Some antidepressant medications also work well for managing anxiety."
Which pt statement made by a spouse is representative of those seen in Phase 3 of the -- response regarding the death of a loved one?
"Maybe going and spending time with my daughter will help."
A pt who is hospitalized with anorexia nervosa states during a one-to-one session with the nurse, "Im freaking out. Im loosing it." Which nurse response would be most therapeutic at this time?
"Please tell me what thoughts are going through your head right now."
What information concerning amitriptyline (Elavil) 50mg tie would the nurse give the pt regarding the expected outcome of this medication therapy?
"This medication is expected to improve brain chemical imbalance"
Which response is most therapeutic when a parent whose child is diagnosed with Tourette's disorder voiced concerns that their child's facial contortions are merely acts of defiance?
"Your sons behavior is likely due to a neurological dysfunction that causes those involuntary facial tics."
The individual who displays the history and symptoms most consistent with a medical diagnosis of seasonal affective disorder (SAD) is:
26 yrs of age and complains of 3 consecutive years of depressed mood beginning in November and remaining until April.
Which behavior is observed in the honeymoon stage of a community's adjustment to a severe flood?
A community rally is held to show support for the rebuilding of the town.
Behavior models are?
A learned theory
The nurse has been working with a pt who has adjustment disorder with depressed mood. Which finding would permit the nurse to accurately evaluate that the crisis has been resolved?
Absence of presenting symptoms
Which pt response demonstrates that the pt whose home was destroyed by a fire is coping with the disaster?
Addressing the details regarding the rebuilding of the house
Which of the following meets the DSM-IV-TR criteria for moderate mental retardation?
Advanced as far as the second grade and provides her own personal are with supervision
A 16yr old pt has anorexia nervosa. Which term use to describe the menstrual history is characteristic of this disorder?
Amenorrhea
Which intervention will best help a child manage hyperactive behavior?
Arranging for the child to play basketball 4 times a week
What is a side effect from Haldol?
Athkanesia
What will a pt receiving an ECT receive approx. 30 min before the procedure?
Atropine 0.5mg IM
What type of medication improves tar dive dyskinesia?
Atypical Antipsychotics
A client is admitted tot he mental health unit with a dx of schizophrenia. A nursing dx that is formulated for the client is disturbed thought processes related to paranoia. In formulating nursing interventions with the members of the health care team, a nurse provides instructions to:
Avoid laughing or whispering in front of the client.
A suicidal pt agreed on day to of hospitalization to write and sign a "no self-harm contract" As a result of this contract the health care team should plan to:
Base the level of observation on staff assessment
A pt admitted with a dx of schizophreniform disorder R/O organic pathology. -- this information, the nurse can expect that the pt will:
Be scheduled for a MRI test
Effects on a teenager when they huff inhalants:
CNS damage, hearing loss, memory loss are permanent. Kidney damage can be reversed.
Which behavior best supports the dx of attention-deficit/hyperactivity disorder in an 8-yr old child?
Can concentrate on school work for only very short periods of time.
Excessive guilt and shame is indicative of what?
Chronic low self esteem
The use of movement to express emotions, work out tensions, development an improved body image and achieve body awareness and social interactions in mental pt's
Dance Therapy
What is the first thin you will do with a pt with impulse control and poor coping skills?
Discuss space and boundaries, the need for boundaries and set the boundries
When the nurse got in trouble by her supervisor and took it out on the family. This is an example of:
Displacement
A sudden travel away from home or work with an inability to recall ones past or where one has been. Expresses confusion about personal identity
Dissociative Fugue
Which nursing dx is appropriate for a pt who insists on being called "Your Highness" and demonstrates loosely associated thoughts?
Disturbed thought processes
When a pt is diagnosed with borderline personality disorder experiences the death of a beloved parent, which characteristic response will the nurse anticipate?
Expresses extreme anger and rage by burning parents clothes.
What is the difference between Atypical Antipsychotics and Typical Antipsychotics?
Extrapyramidal effects
A woman gets a report of abnormal cells found on a pap smear. She calls her attorney to prepare a will and tells her family, "I won't be around much longer." Which nursing dx and etiology best apply to this situation?
Fear related to misinterpretation and misinformation regarding Pap tests
Which observation is supportive of a diagnosis of avoid ant personality disorder?
Fears criticism from others, including staff
Father of psychoanalytic theory?
Feud
What is the primary symptom of Neuroleptic Malignant Syndrome?
High fever (104.0 or higher)
A pt reports fears of having breast cancer and says to the nurse, "I've missed so much work having three mammograms in the past 6 months. No problems showed up but Im sure thats because the radiologic technicians were not qualified to correctly perform mammograms." which disorder would the nurse suspect?
Hypochondriasis
Which statement by the young adult would alert the nurse that the suicide risk has increased?
I have a necktie in my room that I can use to hang myself
By discharge, which outcome is appropriate for a pt who hears voices telling them that he is --
Identify events that increase anxiety and promote hallucinations
Which measure consistent with the use of cognitive therapy could the nurse incorporate into the tx plan of a chronically depressed pt?
Identify negative evaluations and challenge pessimistic beliefs
The awkward child is ridiculed by his father for his poor skills at baseball. The adult begins to have panic attacks when asked to play baseball on his work's team.
Im short and not an athlete
A pt exhibiting auditory hallucinations in addition to being forgetful and easily confused. Which dx does the nurse base the pt's interventions on?
Impaired cognitive functioning
The nursing dx that would be universally applicable for children with autistic -- would be?
Impaired social interaction related to inability to relate to others
A 5yr old girl on a behavior modification program is admitted to the unit. The nurse would expect to participate in which activity based on this approach?
Include the child in the creation of a behavioral contract
CNS stimulants, if given late in the day, may cause what?
Insomnia
What should the nurse tell the client about Lithium who believes they are having an adverse response?
Instruct the pt not to take it until the physician orders and draws a blood level.
A client with Loneliness related to social isolation as a nursing dx would have what outcome?
Interact with peers daily
Something that an individual is required to do by law
Legal Duty
Which intervention wild qualify as primary prevention of violent behaviors in children and adolescents?
Limiting exposure to violence on TV, video, and computer games
If someone was taking MAOI's what foods would you tell them not to eat?
Liver and onions & Sauerkraut
The nurse is leading a support group for women who have experienced interpersonal violence. A pt asks about the characteristics of the perpetrators of interpersonal violence. The nurse accurately responds that they are:
Most often someone the victim knows.
What is more important that verbal communication?
Non verbal communication
A nurse assesses a client with the admitting diagnosis of bipolar affective disorder and mania. The primary symptom presented by the client that requires the nurse's immediate intervention is the client's:
Nonstop physical activity and poor nutritional intake
A nurse in the emergency department is caring for a young females victim of sexual assault. The client's physical assessment is complete, and physical evidence has been collected. The nurse notes that the client is withdrawn, confused, and at times physically immobile. These behaviors are interpreted by the nurse as:
Normal reactions to a devastating event.
A pt with borderline personality disorder is having difficulty with memories of sexual abuse and reports vague, generalized pains, menstural problems and headaches that severely impact her ability to function independently. Which collaborative consult will have the greatest impact on their health and wellness?
Occupational therapist exploring ways to reduce stress
An emergency department nurse is caring for an adult client who attempted suicide. Which of the following priority nursing interventions would the nurse include in the plan of care?
One-to-one suicide precautions
What do you do for GI distress caused by taking Valproate?
Pepcid
Pain in one or more anatomic sites
Physical pain
A pt who is a policewoman tells the nurse she is depressed and has lots of stress with her job. She mentions that employee assistance counseling failed to change her attitude. She states that she will use her police revolver to shoot herself during the day when no one is at home and the home is locked. What would the nurse think of this plan?
Plan explicit. Imminence high. Method highly lethal and accessible. Rescue potential low.
Different from confidentiality. An enacted statute to designated professionals to allow certain information given to professionals by pt to remain secret during any litigation
Privileged Communication
When a young married nurse was attracted to a male nurse this is an example of:
Projection
Why give Atropine before an ECT?
Protects against vagal bradycardia
The exacerbation of physical pain may be a result of what kind of pain?
Psychologic factors
In a person with alcohol abuse what response will you most likely see?
Rehab generally involves several relapses before true sobriety is achieved
The nurse is assessing a child with autism. Which of the following behaviors would the nurse expect to observe?
Repeating "milk, milk, milk, milk" until given a drink
There are several suicidal pt's on the psychiatric unit. When meal trays are returned to the kitchen a serrated-edged knife is missing. The nurse to whom the aid reports this too should:
Report the information to the charge nurse and suggest a unit search.
A nurse counsels a pt who has been dx with BDD. Which nursing dx would be a priority for the plan of care?
Risk for self-directed violence
what is an example of Altruism?
Self reflecting on why I work with these pt's who won't get well
What is the basis for a 1-month crisis intervention follow-up for individuals who have survived a major hurricane?
Symptomology of acute stress disorder can occur within a month of experiencing the trauma.
A client arrives in the emergency department in a crisis state. The client shows signs of profound anxiety and is unable to focus on anything but the object of the crisis and the impact on self. The initial nursing assessment would focus on:
The client's coping mechanisms
The major rationale for careful ongoing assessment of a pt with adjustment disorder is:
The disorder may be a precursor to a more serious mental health problem
To plan effectively for an individual who is in crisis, the nurse must have an understanding of:
The meaning of the crisis event to the individual.
The nurse conducts milieu therapy based on the understanding that:
The milieu provides realistic community interactions
A pt's plan of care is being managed by an interdisciplinary team familiar with the etiology of pt's with eating disorders Which team principle is most important to the successful tx of this patient population?
The plan of care must demonstrate collaboration and consistency by the team.
Which statement correctly describes the schizotypal personality disorder?
There may be misinterpretation of events but not psychosis
the nurse is careful to provide a quiet, comfortable, safe environment when conducting an assessment interview. What is the reason this is particularly important when working with a pt believed to be exhibiting characteristics of a personality disorder?
This disorder produces defensive ,guarded and impulsive behavior that is easily provoked into anger when the pt feels threatened
What is the most important thing to do for a pt with Conversion disorder?
To educate the pt and family
What is it called when a pt wants the same nurse to take care of him every time expressing attachment?
Transference
What increases serotonin and norepinephrine?
Trricyclic Antidepressants (TCA's)
A pt with severe weight loss as a result of anorexia nervosa has refused meal trays and supplemental feedings for 3 days since being admitted to the hospital and so referring has been ordered. Which intervention will initiate this tx?
Tube feedings until the pt eats 90% of all meals for one day
What type of medications reduce positive symptoms
Typical Antipsychotics
Therapeutic interactions between the nurse and a manic pt will be facilitated when the nurse--
Uses a lam matter-of-fact approach to structuring
Research shows that what demographic is now recognized to abuse alcohol?
Women
A pt has been displaying advanced thoughts of suicide. Which action reflects this?
Wrists are bleeding from cuts with a butter knife
What med has a rapid effect?
Xanax
SSRI's are often used to treat:
panic attacks
