Mental Health Midterm ch 1-10

Which of the following clients meets the criteria for an involuntary admission to a psychiatric mental health unit?

A 26-year-old kindergarten teacher who is not in touch with reality and was found wandering in and out of traffic on a busy road

The nurse planning care for a mentally ill client bases interventions on which concept?

Every client has a certain degree of resilience.

How can a nurse best differentiate whether an Asian client is demonstrating a mental illness after having attempted suicide?

Identify the client's culture's view regarding suicide.

Which antidepressant requires special dietary restrictions to prevent the possible development of hypertensive crisis?

Phenelzine

According to Maslow's hierarchy of needs, the most basic needs category for nurses to address is:

Physiological

Which theorist is associated with behavioral therapy?

Skinner

Which function is classified as a circadian rhythm?

Sleep cycle

Which of the following activities would be considered nursing care and appropriate to be performed by a basic level nurse for a patient suffering from mental illness?

Teaching coping skills for a specific family dynamic

An individual is found to consistently wear only a bathrobe and neglect the cleanliness of his apartment. When neighbors ask him to stop his frequent outbursts of operatic arias, he acts outraged and tells them he must sing daily and will not promise to be quieter. This behavior supports what conclusion about this client?

The client is not conforming with social norms.

A male patient reports to the nurse, "I'm told I have memories of childhood abuse stored in my unconscious mind. I want to work on this." Based on this statement, what information should the nurse provide the patient?

To seek the help of a trained therapist to help uncover and deal with the trauma associated with those memories.

Which medication increases blood levels of lamotrigine, increasing Stevens-Johnson syndrome risk?

Valproate

Which neurotransmitter is potentiated by benzodiazepines?

γ-aminobutyric acid

A registered nurse has accepted a position as staff nurse on a psychiatric unit. Which statement made by the nurse requires additional instructions regarding the therapies provided on the unit?

"You will attend a psychotherapy group that I lead that will help you care for yourself."

Which question should the nurse ask when assessing for what Sullivan's Interpersonal Theory identifies as the most painful human condition?

"Do you think of yourself as being lonely?"

Which nursing statement illustrates the concept of client advocacy?

"Dr. Raye, during the admission interview, the client stated they will refuse fluoxetine because of adverse effects they experienced previously."

When providing respectful, appropriate nursing care, how should the nurse identify the patient and his or her observable characteristics?

The patient in room 234 is displaying manic behavior

Which assessment should the nurse perform to evaluate the pharmacokinetic effect of a monoamine oxidase inhibitors (MAOIs) antidepressant medication?

The results of the liver function test

When discussing therapy options, the nurse should provide information about interpersonal therapy to which patient? Select all that apply.

The teenager who is the focus of bullying at school The older woman who has just lost her life partner to cancer The middle-aged adult who recently discovered her partner has been unfaithful

In an outpatient psychiatric clinic, a nurse notices that a newly admitted young male patient smiles when he sees her. One day the young man tells the nurse, "You are pretty like my mother." The nurse recognizes that the male is exhibiting:

Transference

When considering mental illness, recovery is best described to a client by which statement?

Working, living, and participating in the community

The World Health Organization describes health as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Which statement is true in regard to overall health? Select all that apply.

Poor physical health can lead to mental distress and disorders. There is a strong relationship between physical health and mental health.

The mental health status of a particular client can best be assessed by considering which factor?

Position placement on a continuum from health to illness

A newly divorced 36-year-old mother of three has difficulty sleeping. When she shares this information to her gynecologist, she suggests which of the following services as appropriate for her patient's needs?

Primary care provider

Recognizing the frequency of depression among the American population, the nurse should advocate for which mental health promotion intervention?

Providing regular depression screening for adolescent and teenage students

A client tells the mental health nurse "I am terribly frightened! I hear whispering in my head that someone is going to kill me." Which criteria of mental health can the nurse assess as lacking?

Rational thinking

When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage in to ensure that the patient stays the focus of all therapeutic conversations?

Reflecting on personal behaviors and personal needs

The incoherent thought and speech patterns of the client diagnosed with schizophrenia are related to the brain's inability to perform which function?

Regulate conscious mental activity.

A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept?

Schema

Emma is a 40-year-old married female who has found it increasingly difficult to leave her home due to agoraphobia. Emma's family is appropriately concerned and suggests that she seek psychiatric care. After investigating her options, Emma decides to try:

Telepsychiatry

Homeostasis is promoted by interaction between the brain and internal organs and is mediated by component of the nervous system?

The autonomic nervous system

Antagonism of which receptor contributes to orthostatic hypotension observed with trazodone therapy?

Alpha-1

When treating mental illnesses with psychotropic drugs what is the focus of the treatment?

Altering brain neurochemistry.

Which second-generation antipsychotic requires routine absolute neutrophil count monitoring?

Clozapine

What is the basic functional unit of the nervous system called?

neuron

Role-playing is associated with which type of psychotherapy?

Modeling

Which imaging technique can provide information about brain function?

Positron emission tomography (PET) scan

Which nursing intervention demonstrates the theory behind operant conditioning?

Rewarding the client with a token for avoiding an argument with another client

A patient has been voluntarily admitted to a mental health facility after an unsuccessful attempt to harm himself. Which statement demonstrates a need to better educate the patient on his patient's rights?

"I can hurt myself if I want to. It's none of your business."

Which statement made by a patient demonstrates a healthy degree of resilience? Select all that apply.

"I try to remember not to take other people's bad moods personally." "I've learned to calm down before trying to defend my opinions." "I know that discussing issues with my boss would help me get my point across."

Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met?

"I'm experiencing much less anxiety about school now."

Which statement demonstrates the nurse's understanding of the effect of environmental factors on a patient's mental health?

"I'm not familiar with the patient's cultural view on suicide."

The nurse being aware that certain mental illness have a prevalence among a specific gender, will suspect which statement was made by a female client (Select all that apply.)

"I've been arrested 6 times in the last 15 years." "I've been depressed most of my adult life."

The mental health team is determining treatment options for a male patient who is experiencing psychotic symptoms. Which question(s) should the team answer to determine whether a community outpatient or inpatient setting is most appropriate? Select all that apply.

"Is the patient expressing suicidal thoughts?" "Does the patient have intact judgment and insight into his situation?" "Does the patient require a therapeutic environment to support the management of psychotic symptoms?" "Does the patient require the regular involvement of their family/significant other in planning and executing the plan of care?"

A patient is telling a tearful story. The nurse listens empathically and responds therapeutically with:

"Let's devise a plan on how you will react next time in a similar situation."

Which client statement demonstrates the mental health concept of resilience?

"Losing my job was hard but my skills will help me get another one."

When considering stigmatization, which statement made by the nurse demonstrates a need for immediate intervention by the nurse manager?

"My experience has been that the Irish have a problem with alcohol use."

A 38-year-old client diagnosed with major depression states, "my provider said something about the medicine I've been prescribed will affect my neurotransmitters. What exactly are neurotransmitters?" What is the nurse's best response to the client's question?

"Neurotransmitters are chemical messengers in the brain that help regulate specific functions such as depression."

A nurse's identification badge includes the term, "Psychiatric Mental Health Nurse." A client with a history of paranoia asks, "What does that title mean?" Keeping in mind the diagnosis of the client, how should the nurse respond to this question?

"We have the specialized skills needed to care for those with mental illnesses."

A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement?

"What I did was stupid."

A patient needs supportive care for the maintenance treatment of bipolar disorder. The new nurse demonstrates an understanding of the services provided by the various members of the patient's mental healthcare team when he makes which statement:

"Your counselor asked me to remind you of the group session on critical thinking at 2:00 today."

Which of the following clients would be appropriate to refer to a partial hospitalization program (PHP)?

A client being discharged from an inpatient alcohol rehabilitation unit

The primary goal and benefit of assertive community treatment (ACT) is demonstrated by which situation?

A client diagnosed with schizophrenia has avoided being rehospitalization for 16 months.

What client assessment data demonstrates parity related to mental health care?

A client's mental health coverage is equal to his/her medical/surgical coverage.

How does Harry Stack Sullivan's Interpersonal Theory view anxiety?

A painful emotion arising from social insecurity

Which action reflects therapeutic practices associated with operant conditioning?

Acknowledging a patient who is often verbally aggressive for complimenting a picture another patient drew

According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory?

All memories

Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority?

Assessing the client for strengths upon which a nurse-client relationship can be based

What is the premise underlying behavioral therapy?

Behavior is learned and can be modified

According to current information what factor is associated with the most disabling mental disorders?

Biological influences

The nurse caring for a client prescribed an antidepressant medication that produces anticholinergic side effects should assess for which possible side effects? (Select all that apply.)

Blurred vision Dry mouth Constipation

Which of the following structural safety precautions is most important when attempting to prevent a common type of inpatient suicide?

Break-away closet bars to prevent hanging

Which antidepressant is FDA approved for the treatment of postpartum depression?

Brexanolone

Which antidepressant is contraindicated in a patient diagnosed with a seizure disorder?

Bupropion

A nurse, active in local consumer mental health groups and in local and state mental health associations, keeps aware of state and national legislation affecting mental illness treatment. How can this nurse positively affect the climate for effective, mental health treatment?

By educating the public on the effects that stigmatizing has on mental health clients.

A nurse is assessing a patient who graduated at the top of his class but now obsesses about being incompetent in his new job. The nurse recognizes that this patient may benefit from the following type of psychotherapy:

Cognitive behavioral

Which statement best describes the Diagnostic and Statistical Manual, fifth edition (DSM-5) DSM-5?

It is a medical psychiatric assessment system.

An Afghanistan Conflict veteran has been homeless since being discharged from military service. He is now diagnosed with schizophrenia. The nurse practitioner recognizes that assertive community treatment (ACT) is a good option for this patient since ACT provides:

Care for hard-to-engage, seriously ill patients

Which part of the brain regulates voluntary motor movements?

Cerebellum

An adolescent female is readmitted for inpatient care after a suicide attempt. What is the most important nursing intervention to accomplish upon admission?

Checking the patient's belongings for dangerous items

Which branch of epidemiology is the nurse involved in when seeking outcomes for clients whose depression was treated with electroconvulsive therapy (ECT)?

Clinical

A nursing student new to psychiatric-mental health nursing asks a peer what resources he can use to figure out which symptoms are present in a specific psychiatric disorder. The best answer would be:

DSM

The nurse caring for a client prescribed risperidone observes the client carefully for which possible side effects? (Select all that apply.)

Daytime sleepiness Sexual dysfunction A weight gain

Freud believed that individuals cope with anxiety by implementing which mechanism?

Defense mechanisms

Based on the current understanding of brain physiology, which neurotransmitter would be the expected target of medication prescribed to manage depression? (Select all that apply.)

Dopamine Serotonin Norepinephrine

Which client problem would be most suited to the use of interpersonal therapy?

Dysfunctional grieving

The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience?

Encouraging them to talk about their school plans to help achieve identity

What is the primary advantage of using a case manager when considering the planning and implementation of client care?

Enhances resource management.

A nursing diagnosis for a client with a psychiatric disorder serves what purpose with considering the plan of care?

Establishing a framework for selecting appropriate interventions.

Linda is terrified of spiders and cannot explain why. Because she lives in a wooded area, she would like to overcome this overwhelming fear. Her nurse practitioner suggests which therapy?

Exposure and response prevention therapy

The nurse frequently includes daily sessions involving relaxation techniques. Which assessment data would most indicate a need for this intervention to be included in the initial plan of care for a patient?

Family history of anxiety and symptoms of anxiety

Pablo is a homeless adult who has no family connection. Pablo passed out on the street and emergency medical services took him to the hospital, where he expresses a wish to die. The physician recognizes evidence of substance use problems and mental health issues and recommends inpatient treatment for Pablo. What is the rationale for this treatment choice? Select all that apply.

He requires stabilization of multiple symptoms. He has nutritional and self-care needs. He is in imminent danger of harming himself.

Which organ secretes hormones that are a normal component of the body's general response to stress? (Select all that apply.)

Hypothalamus Pituitary gland Adrenal glands

Which intervention demonstrates an attempt by nursing staff to meet the goals identified by The Joint Commission as National Patient Safety Goals? Select all that apply.

Identifying patients using both name and date of birth before drawing blood. Administering the Beck Scale on each patient at the time of admission. Performing a medication history assessment on each new patient. Using appropriate hand washing technique at all times.

Epidemiological studies contribute to improvements in care for individuals with mental disorders by:

Identifying risk factors that contribute to the development of a disorder.

The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention?

Ignoring the tantrum and giving attention when the child acts appropriately

When a tumor of the cerebellum is present, the nurse should expect that the client would initially demonstrate which sign/symptom?

Impaired balance

A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement?

In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of the "id" and the ability to function as an adult?

It is the source of one's survival instincts

A nurse is providing care to a 28-year-old client diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which client symptom as having priority?

Lack of sleep

The medication prescribed for a client acts by blocking reuptake of both serotonin and norepinephrine. The nurse evaluates the treatment as successful when observing which client behavior?

Laughing at a joke

The nurse responsible for the care of a client prescribed clonazepam should evaluate treatment as being successful when the client demonstrates which behavior?

Less anxiety

A prescription for which medication would require the nurse to monitor the client for potential development of the side effect of hypothyroidism?

Lithium

Which mood stabilizer most commonly causes hypothyroidism with long-term use?

Lithium

Which severe mental illness has a prevalence of over 6% among the populace of the United States? (Select all that apply.)

Major depressive disorder Bipolar disorder

The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority?

Making the client feel physically and emotionally safe

Which statement about mental illness is true?

Mental illness changes with culture, time in history, political systems, and the groups defining it.

A 49-year-old client diagnosed with schizophrenia at 22 years old is prescribed risperidone. Which nursing assessment is the priority for this client?

Monitoring for abnormal involuntary movements

Which pathway is involved in the development of extrapyramidal symptoms secondary to antipsychotic-induced dopamine receptor blockade?

Nigrostriatal

What term is used to identify the quantitative study of the distribution of mental disorders in human populations?

epidemiology

Cells that respond to stimuli, conduct electrical impulses, and release neurotransmitters are called

neurons