Mental health Nursing Videbeck 22-24

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Amnestic Disorder

Characterized by a disturbance in memory that results directly from the physiologic effects of a general medical condition or from the persisting effects of a substance such as alcohol or other drugs

A nurse is teaching a family how to best help their child who has been recently diagnosed with a neurodevelopmental disorder. Which statement indicates to the nurse that teaching has been effective?

"We will be able to enjoy more structure in our home."

A nurse is giving instructions to a client diagnosed with delirium. What might the nurse repeat the instructions frequently? ~select all that apply~

- The client may have impaired attention - The client may have impaired recent and immediate memory

Vascular Dementia

Has symptoms similar to those of Alzheimer's disease, but onset is typically abrupt and followed by rapid changes in functioning, a plateau or leveling-off period, more abrupt changes, another leveling-off period, and so on

A nurse is assessing a Caucasian child with attention deficit hyperactivity disorder (ADHD). On asking the parents for their opinion regarding the treatment for their child, what response is the nurse likely to get?

"We would prefer that you give our child medication instead of any behavioral therapy.".

Which statement, made by a client diagnosed with an anxiety disorder, should trigger the nurse's concern about the client's understanding of the use of defense mechanisms?

"When I have a problem, I just deny it until it goes away"

The nurse is caring for a client undergoing cognitive behavior therapy for OCD. How does the cognitive model describe the client's thought process? ~select all that apply~

- The client wants to control own thoughts - The client has intolerance for uncertainty - The client overestimates the threats caused by the thoughts

A nurse is caring for a client with PTSD who is treated with cognitive-behavioral therapy. What changes in behavior should the nurse expect in the client during the first week of therapy? ~select all that apply~

- The client will have decreased anxiety and fear - The client will be able to identify the traumatic event

A nurse is seeing an adolescent with a diagnosis of conduct disorder for the first time to establish goals for treatment. During the first meeting, the adolescent yells a profanity at the nurse and states, "This is pointless." What is the nurse's best response?

"I want to continue to work with you but I don't accept the language you have chosen."

A client with PTSD has undergone cognitive restructuring therapy. What statement by the client would most clearly suggest that therapy has had its intended effect?

"I'm no longer blaming myself for what happened"

The mental health nurse assesses for the most common mental health disorder found in children when asking which of the following questions?

"Do you ever get scolded at school for not sitting still?

What question by the nurse is focused on identifying oniomaniac tendencies in a client diagnosed with depression?

"Do you get enjoyment out of all the clothes you buy?"

The nurse is assessing a client who recently experienced her first panic attack while at the grocery store. To identify complications of the disorder, the nurse should ask:

"Do you have any problems going out alone to public places?"

The geriatrician has prescribed an 80-year-old client donepezil in order to treat the client's dementia, Alzheimer's type. Which teaching points should the nurse provide to the client's spouse about the new medication?

"Donepezil won't cure your spouse's dementia of Alzheimer's type, but it has the potential to slow down the progression of the disease."

A nurse is caring for a client diagnosed with delirium who has been brought for treatment by the client's adult child. While taking the client's history, which question would be most appropriate for the nurse to ask the client's adult child?

"Has your parent taken any medications recently?"

A psychiatric nurse is assessing a client with PTSD. During the psychosocial component of the assessment, what assessment question should the nurse include?

"How are your symptoms affecting your day-to-day routines?"

Which of the following statements made by a client diagnosed with PTSD leads the nurse to believe the client is experiencing dissociative symptoms?

"I describe my feelings like I'm having an out-of-body experience"

A 73-year-old client has been brought to the emergency department by the client's adult children due to abrupt and uncharacteristic changes in behavior, including impairments of memory and judgment. The subsequent history and diagnostic testing have resulted in a diagnosis of delirium. Which teaching point about the client's diagnosis should the nurse provide to the family?

"If the underlying cause of delirium is identified and treated, most people return to their previous level of functioning."

Which statement made by the nurse to the family of a client diagnosed with OCD demonstrates the best general understanding of the chronic nature of the disorder and its management?

"It's important to know that the symptoms will intensify during periods of stress"

Jeremy, a 9-year-old with ADHD, has been placed on the stimulant methylphenidate (Ritalin, Concerta). The nurse knows that the teaching has been effective when his parents state which of the following?

"Jeremy may have some side effects, like insomnia, headache, or stomach ache, but they are rare"

Which statement by the nurse providing care for a client diagnosed with OCD indicates a need for additional education regarding the client's ritualistic hand washing?

"Let me help you find something less time consuming to do to manage your anxiety"

A nurse observes that a client with PTSD is experiencing dissociative symptoms. What instruction should the nurse give to the client to prevent being stuck in a daze?

"Look around the room"

After completing a series of parent training sessions with parents of an 8-year-old client with oppositional defiant disorder, the child's mother calls the nurse with concerns. The mother states, "What you taught us isn't working, can you please talk to my child about his behavior?" Which is the nurse's most effective response?

"Please tell me more about what you are having difficulty with."

"Please tell me more about what you are having difficulty with." Exploring in depth what the client's mother is having difficulty with can help the nurse build the parental capacity to address the behavioral difficulties they are having on their own. Identifying specific pitfalls can promote problem solving. Meeting with the child individually at the school counseling office takes the child out of the environment where the behavior is most problematic (in the home). Working with the child individually is ineffective as the best treatment for oppositional defiant disorder is to work with the parents in building their capacity for behavior management. Telling the mother to bring the client to the nurse's office for another session communicates that the parents do not already have the tools to manage the child's behaviors independently. (less)

The nurse is dialoguing with a client who has been referred after witnessing a workplace accident several weeks ago that resulted in a coworker's death. What assessment finding would support a diagnosis of PTSD?

"The client states that she is often "awake for hours and hours each night"

Which statement by the nurse demonstrates an understanding of the role automatisms have in a panic attack?

"The client taps her fingers very rapidly when she is feeling anxious"

The nurse is assessing a client who has received a tentative diagnosis of delirium. The nurse is explaining to the family about the major cause of the client's condition. Which statement by the nurse would be most appropriate?

"The client's diagnosis is primarily based on the rapid onset of the change in consciousness."

An 80-year-old client with Alzheimer's disease is prescribed donepezil. Which teaching points should the nurse provide to the client's spouse about the new medication?

"The drug won't cure the client's Alzheimer's, but it has the potential to slow down the progression of the disease."

A nurse works in a psychiatric clinic. During a counseling session, the nurse finds that the client who has PTSD is unable to identify the intensity of his emotions. The client states that extreme emotions appear out of nowhere and with no warning. What suggestion should the nurse provide to help the client get in touch with his emotions?

"Use a journal or a log to write down your feelings"

After educating the parents of a child diagnosed with ADHD on the disorder and its treatment, the nurse determines that the education has been effective when the parents state which of the following?

"We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention."

A client diagnosed with Alzheimer's disease says, "I'm so afraid. Where am I? Where is my family?" How should the nurse respond?

"You are in the hospital and you are safe here. Your family will return at 10 o'clock, which is in 1 hour from now"

A 35-year-old client is delirious after being lost in the woods for several days and becoming severely dehydrated. At 9 p.m. the client tells the nurse to get the client's clothes because the client has to get home to the client's family. Which response by the nurse is most therapeutic?

"You're in the hospital. You did not drink for several days, but you're getting better now."

A child age 3 years has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized?

"Your child may seem unduly anxious in the presence of strangers."

The nurse is assessing a client who lost his family and all material possessions in an earthquake. After reviewing the history, the nurse suspects that the client has PTSD. Which statements of the client lead the nurse to make this interpretation? ~select all that apply~

- "I am not able to sleep at night" - I prefer being along, all by myself" - "I often have nightmares about the earthquake"

Which of the following individuals is exhibiting signs or symptoms that are characteristic of PTSD? ~select all that apply~

- A man who has frequent nightmares about the time a fellow soldier died from an improvised explosive device - A woman who is unable to relax without first barricading her home after a violent home invasion and assault - A woman who has quit her job so that she no longer has to go to her old office where she was attacked and robbed - A police officer who experiences panic attacks when he thinks about the time he was forced to shoot a violent suspect

The nurse is assessing the practical skills diagnosed with intellectual disability. Which of the following would the nurse assess? ~select all that apply~

- Activities of daily living - Occupational skills - Use of money

A nurse finds that a client diagnosed with PTSD is curled up in a defensive posture. The nurse concludes that the client may be experiencing a flashback. What interventions would be helpful in eliminating the flashback experience? ~select all that apply~

- Ask the client to stand up - Ask the client to focus on the movement of the feet and arms

The nurse is assessing an older client with late onset OCD. What assessment does the nurse perform for this client? ~select all that apply~

- Assess for degenerative disorders - Obtain history of recent infections - Assess for possible brain injury

The nurse is assessing a client who has been referred for care following a violent assault. What assessment findings should the nurse document as being diagnostic criteria for PTSD? ~select all that apply~

- The client describes herself as being constantly "on edge" - The client states, "All I can think about these days is the attack" - The client states that she completely avoids the neighborhood where the attack occurred

A nurse is providing care to a client with dementia who is hyperactive. A diet high in which of the following would be most appropriate to include in the nutritional plan for this client? ~select all that apply~

- Carbohydrates - Protein

A client demonstrates an understanding about the risk factors for developing dementia when engaging in which health promotion activities? ~select all that apply~

- Eating a diet that provides sufficient amounts of B vitamins - Regularly reads fictional novels for entertainment - Does the daily newspaper crossword puzzle - Exercises at the gym 3 times a week

A nurse is assessing a child diagnosed with autism spectrum disorder. When assessing the child's communication, which of the following would the nurse expect to find? ~select all that apply~

- Echolatia - Pronoun reversals

What intervention does the nurse perform when caring for a client with OCD? ~select all that apply~

- Encourage the client to perform activities of daily living within a fixed time - Teach the client social skills such as appropriate conversation topics - Teach the client to avoid trigger situations

The nurse is planning to give health-related education to adolescents with PTSD. What topics should the nurse discuss specifically for these clients? ~select all that apply~

- Healthy balanced diet - Setting small, specific, achievable goals - Ill effects of alcoholism and drug abuse

A nurse is assessing a client with anxiety. Which of the following signs and symptoms would the nurse attribute to sympathetic nervous stimulation? ~select all that apply~

- Heart racing - Hypertension

A client performs ritualistic washing of the hands and dishes, along with rearranging the table before settling down to a meal. What intervention does the nurse implement to help this client complete this daily routine? ~select all that apply~

- Include the time taken for the ritual in the day's timetable - Come to an agreement with the client on a time to stop the ritual - Encourage a gradual decrease in the time allotted for the ritual

A nurse is assessing a child with attention deficit hyperactivity disorder. Which assessing finding is the nurse likely to see in this child? ~select all that apply~

- Overactivity - Impulsiveness

Which of the following are cognitive-behavioral therapy techniques that may be used effectively with anxious clients? ~select all that apply~

- Positive reframing - Decatastrophizing - Assertiveness training - Unlearning

When a client is experiencing a panic attack while in the recreation room, what interventions are the nurse's first priorities? ~select all that apply~

- Provide a safe environment - Ensure the client's privacy

A client is diagnosed with PTSD. The client is a survivor of a bomb blast. Which symptom of PTSD is the nurse likely to find in the client? ~select all that apply~

- Reexperiencing the trauma through dreams - Feeling detached from others - Showing irritability and outbursts of anger - Losing a sense of control over one's life

Assessment of a child with autism spectrum disorder reveals stereotypic behavior. Which of the following would the child demonstrate? ~select all that apply~

- Rocking - Hand flapping - Head banging

The nurse is caring for a client with delirium. Which interventions may help manage this client? ~select all that apply~

- Speak in simple sentences - Provide orienting verbal cues when talking with the client - Allow adequate time for the client to comprehend and respond

The care plan for a 6-year-old child diagnosed with attention deficit hyperactive disorder (ADHD) includes interventions to help manage which of the following behaviors seen in the child? ~select all that apply~

- Temper tantrums when asked to clean up his room - Refusal to acknowledge others' right to select group activities - Frequent acting out during class "quiet time" - Thoughtless habit of not waiting him to turn

A nurse is assessing a 2-year-old child diagnosed with autism spectrum disorder. Which findings does the nurse expect to find on assessment? ~select all that apply~

- The child avoids eye contact - The child does not relate to parents - The child becomes upset with minor changes in routine

A child is diagnosed with reactive attachment disorder. What findings in the child would help to determine the treatment? ~select all that apply~

- The child is a victim of abuse - The child withdraws from any social contact - The child treats strangers and caregivers alike

The nurse is caring for an adolescent with dermatillomania. What does the nurse tell the client's parent about this disorder? ~select all that apply~

- The client finds comfort in skin picking - It can lead to loss of occupational functioning - It can lead to medical complications

A psychiatric nurse has assessed a client with PTSD. Before referring the client to psychotherapy, the nurse refers the client to a substance dependence treatment program. Why does the nurse refer the client to an addiction treatment program before referring for psychotherapy? ~select all that apply~

- The nurse believes that addiction can decrease the effectiveness of the psychotherapy - The nurse believes that the client is not expressing feelings because of the effect of the addiction

A nurse is preparing a plan of care for a client with anxiety. Which of the following would the nurse most likely include? ~select all that apply~

- Using appropriate coping skill - Identifying treatment modalities - Involving family for support, if appropriate - Providing supportive feedback

IN PTSD, which of the following signs/symptoms could be classified as intrusive? ~select all that apply~

- When the client reexperiences a traumatic image - Have feelings that the event is reoccurring

A nurse's aide has rung the call light for assistance while providing a client's twice-weekly bath because the client became agitated and aggressive while being undressed. Knowing that the client has a diagnosis of Alzheimer's disease and is prone to agitation, which measure may help in preventing this client's agitation?

Reminding the client multiple times that he or she will be soon having a bath

The nurse is assessing a client who is diagnosed with delirium. Which presenting sign in the client indicates to the nurse that the client may may have a diagnosis of dementia?

Remote memory loss

A nurse is counseling the parents of an adolescent client with oppositional defiant disorder (ODD). The parents state, "We've tried everything, what else are we supposed to do?"What is the most likely reason for the parent's voiced loss of hope?

The adolescent may have limited sensitivity to reward and punishment.

The nurse is assessing a client who spends several hours arranging and rearranging items around the house. What does the nurse anticipate is the cause of this compulsive behavior?

The client is preoccupied with perfection

Delirium can be differentiated from many other cognitive disorders in which way?

It has a rapid onset and is highly treatable if diagnosed quickly.

The nurse is assessing the physiological effects of severe OCD in a client. What does the nurse expect to find during assessment?

The client is unable to maintain adequate personal hygiene

A patient with OCD states that she is making a concerted effort to reduce the frequency and duration of her rituals. What intervention should the nurse include to assist in these efforts?

Teach the patient non-pharmacologic relaxation techniques

A group of nursing students are reviewing signs and symptoms of anxiety. The students demonstrate a need for additional review when they identify which of the following?

Tearfulness

DOPAMINE positive

1st generation antipsychotics:(TYPICAL ANTIPSYCHOTICS) BLOCK ______________ Target the________ signs of schizophrenia such as: Delusions Hallucinations Disturbed thinking And other psychotic symptoms.

Going Along

Technique used with clients with dementia; providing emotional reassurance to clients without correcting their misperceptions or delusions

Which nursing intervention is focused on the primary goal of anxiety management and treatment?

Assessing the client's ability to implement stress management techniques effectively

The psychiatric mental health nurse is working with a client who has been diagnosed with PTSD. Assessment reveals that the client is experiencing frequent episodes of intrusion. The nurse should consequently prioritize what assessment?

Assessing the quantity and quality of the client's sleep

What intervention does the nurse perform to assist the client in decreasing the frequency of repetitive behaviors?

Assist the client to keep a record of when time is used in performing activities

The nurse understands that numerous comorbidities can contribute to the development of dementia. Which client may be at risk for dementia?

A 49-year-old client whose human immunodeficiency virus (HIV) has progressed to acquired immunodeficiency syndrome (AIDS)

The nurse understands that numerous comorbidities can contribute to the development of dementia. Which of the following clients may be at risk for dementia?

A 49-year-old man whose HIV has progressed to AIDS

Which of the following IQs correlates with severe mental retardation?

20 to 35

Nearly which percentage of adults is affected by anxiety disorders?

25%

The mother of a child with ADHD tells the school nurse that her child's teacher has called a conference. Of which of the following statements is true regarding evaluation of treatments for the child with ADHD?

often the parents or teacher notice positive outcomes of treatment

Which of the following IQs correlates with moderate retardation?

35 to 50

Agranulocytosis=

= failure of the bone marrow to produce adequate WBCs. • Clozapine has the potentially fatal side effect of agranulocytosis. • Develops suddenly and is characterized by: fever, malaise, ulcerative sore throat, and leukopenia. Clients taking this antipsychotic must have weekly WBC counts for the first 6 months of clozapine therapy and every 2 weeks thereafter.

Hallucinations

= false sensory perceptions, or perceptual experiences that do not exist in reality

Blunted affect

= few observable facial expressions.

Delusions

= fixed false beliefs with no basis in reality, in the psychotic phase of illness.

associative looseness

= fragmented or poorly related thoughts and ideas

Pseudoparkinsonism

= includes a shuffling gait, mask- like facies, muscle stiffness (continuous) or cogwheeling rigidity (ratchet like movements of joints)

Flat affect

= no facial expression

Delusional disorder

= occurs later in life, unshakeable belief in something not true but non-bizarre and could occur in real life (being followed, poisoned, deceived, conspired against, or loved from a distance); different types of disorder based on theme of main delusion

Thought insertion

= others are placing thoughts in their mind against their will.

Though withdrawal

= others are taking their thoughts.

preservation

= persistant adhérence to a single idea or topic; verbal repetition of a sentence, word, or phrase resisting attempts to change the topic.

Echolalia

= repetition or imitation of what someone else says.

Abnormal involuntary movement scale (AIMS)

= scale used to screen for symptoms of movement disorders.

Thought blocking

= the client may suddenly stop mid sentence and remain silent for several seconds to one minute.

Thought broadcasting

= they state that the believe others can hear there thoughts.

Dystonic reaction

= to antipsychotic medications appear ear in the course of treatment and are characterized by spasms in discrete muscle groups such as the neck muscles or eye muscles. Can be painful.

Depersonalization

= when the client feels detached from his or her behavior.

Waxy flexibility

= when the client maintains any position in which they are placed, even if the postiton is awkward or uncomfortable.

Schizotypal

=Involves odd, eccentric behaviors, including transient psychotic symptoms. Approximately 20% of people with this disorder will eventually be diagnosed with schizophrenia.

Polydipsia

=abnormally great thirst as a symptom of disease (such as diabetes) or psychological disturbance.

abolition or lack of volition

=absence of will, ambition, or drive to take action and accomplish tasks.

apathy

=feelings of indifference toward people, activities, and events.

Word salad

=jumbled words and phrases that are disconnected or incoherent and make no sense to the listener.

Alogia

=the inability to speak because of mental defect, mental confusion, or aphasia.

Cognitive behavior therapy

=to adjust thoughts and reactions to them

Anxiety disorder is considered chronic and generalized when excessive anxiety and worry about two or more life circumstances exist for at least

6 months

Below average intellectual functioning is initially diagnosed when an IQ is below which level?

Approximately what percentage of children with pervasive development disorders has mental retardation?

75%

Brief psychotic disorder

= Client experiences sudden onset of at least one psychotic symptom such as: Delusions, hallucinations, or disorganized speech or behavior. Lasts from 1 day to 1 month. The episode may not have an identifiable stressor or may follow childbirth. Seen a lot in substance abuse.

Delusional disorder:

= Client has one or more non bizarre delusions. This means the focus of the delusions are believable. Psychosocial functioning is not really impaired because behavior is not obviously odd or bizarre.

Anhedonia

= Client may be feeling depressed and having no pleasure or joy in life

ambivalence

= Holding seemingly contradictory beliefs or feels about the same person, event, or situation.

Schizophreniform

= The client exhibits an acute, reactive psychosis for less than 6 months necessary to meet diagnostic criteria of schizophrenia.

Shared psychotic disorder

= Two people share a similar delusion. ○ The person who develops this disorder has a close relationship with someone who has delusions. The more submissive or suggestable person may rapidly improve when removed from the dominating person.

Psychomotor retardation

= a general slowing of all movements

Tardive dyskinesia

= a late appearing side effect of antipsychotic medications, is characterized by abnormal, involuntary movements such as lip smacking

Neuroleptic malignant syndrome (NMS)

= a serious and frequently fatal condition seen in those being treated with antipsychotic medications.

Neuroleptic Malignant Syndrome NMS

= a serious and frequently fatal condition seen in those being treated with antipsychotic medications. • Characterized by: ○ muscle rigidity, high fever, increased muscle enzymes ○ autonomic instability (BP, diaphoresis, pallor) ○ elevated creatine phosphokinase (CPK) ○ Confusion ○ agitation or stupor Treated by discontinuing the medication.

Extrapyramidal side effects

= acute dystonic reactions, akathisia, and parkinsonism, tardive dyskinesia, seizures, and neuroleptic malignant syndrome.

Extrapyramidal side effects (EPS)

= acute dystonic reactions, akathisia, and parkinsonism, tardive dyskinesia, seizures, and neuroleptic malignant syndrome. • EEPS are reversible movement disorders induced by neuroleptic medication. • Treatment: ○ Discontinue drug ○ Lower dose ○ Give anticholinergics ○ dopamine agonist ○ Beta blockers Benzodiazepines

Neuroleptics

= aka antipsychotic medications

Command hallucinations

= are voices demanding that the client the client take action, often to harm self or others . And are considered dangerous.

Residual-type

= characterized by a past history of at least one episode of schizophrenia, but currently has no positive symptoms

Akathisia

= characterized by restless movement, pacing, inability to remain still.

Psychosis

= displaying actively the positive symptoms of delusions, hallucinations, and disordered thinking.

The nurse is counseling a family with a child who has been abused by an adult family friend in the past. When explaining the child's needs to the family, which of the following would be most important for the nurse to stress?

A supportive relationship with an adult

Which of the following is the most common disorder of childhood?

ADHD

Executive Functioning

Ability to think abstractly and to plan, initiate, sequence, monitor, and stop complex behavior

In clients with Alzheimer's disease, neurotransmission is reduced, neurons are lost, and the hippocampal neurons degenerate. Which neurotransmitter is most involved in cognitive functioning?

Acetylcholine

After teaching a group of nursing students about dementia, the instructor determines a need for additional teaching when the students identify which as a primary goal of nursing care?

Achievement of self-esteem needs

Which of the following would not be considered a primary goal of nursing care for a client with delirium?

Achievement of self-esteem needs

Which would not be considered a primary goal of nursing care for a client with delirium?

Achievement of self-esteem needs

Cheryl was physically assaulted 1 week ago. She has been having trouble remembering the event and feels as if she is walking around in a dreamlike state. From what condition is Cheryl suffering?

Acute stress disorder

In a discussion with a group of high school teachers about oppositional defiant disorder (ODD), the nurse says that behavior modification of the parents and teachers toward such children forms the basis of therapy. What is the most appropriate rationale that the nurse gives when asked about this strategy?

Adolescents with ODD learn maladaptive behavior at home and can be perpetuated at school

Adolescents with ODD learn maladaptive behavior at home and can be perpetuated at school The treatment of ODD is based on parental behavioral interventions. It is believed that problem behaviors in ODD are learned and reinforced in the home and at school, hence the approach of the parents and teachers toward the child may help to eliminate this disorder at earlier ages. In adolescents, behavioral therapy may also be required along with parental management. It may not be true that these children are closest to their parents. Such clients are usually very aggressive and lack a sense of fear of anybody. (less)

A client is diagnosed with Alzheimer's disease. While assessing the client, the nurse notes that the client has trouble identifying objects such as a key and spoon. The nurse would document this as what?

Agnosia

A nurse is assessing a client diagnosed with Alzheimer's disease. As part of the assessment, the nurse asks the client to identify common objects. The nurse is assessing for what?

Agnosia

The nurse is caring for a client with dementia. The client's brain images show atrophy of cerebral neurons and enlargement of the third and fourth ventricles. What is the cause of dementia in this client?

Alzheimer's disease

Which of the following children is most likely to be diagnosed with oppositional defiant disorder or conduct disorder?

An 11-year-old boy who was caught breaking into a home to steal money

Which of the following children is most likely to be diagnosed with oppositional defiant disorder or conduct disorder?

An 11-year-old boy who was caught breaking into a home to steal money Crime is a common manifestation of oppositional defiant disorder and conduct disorder. High-risk sexual behavior may accompany the disorders but is not diagnostic. Tics and verbal outbursts are characteristic of Tourette's syndrome. Difficulty in relating to others is characteristic of autism spectrum disorders. (less)

What is the primary sign of delirium?

An altered level of consciousness

Which term is used to describe the inability to execute motor functioning, despite intact motor abilities?

Apraxia

Panic disorder is treated with cognitive-behavioral techniques, deep breathing, and relaxation, in addition to which of the following?

Antianxiety medications

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

neuroleptics

Antipsychotic medications are aka ___________.

Which of the following medication classifications is used in the treatment of tic disorders?

Antipsychotics

A client diagnosed with Alzheimer's disease has an alteration in language ability. This alteration would be documented as what?

Aphasia

A client with dementia is having difficulty finding the words that he wants to use. When he could not remember the name of his shoes, he referred to them as, "the things you put on your feet." What is the name for this condition?

Aphasia

Which of the following terms is used to describe the inability to execute motor functioning, despite intact motor abilities?

Apraxia

When conducting a nursing assessment of a client experiencing moderate cognitive dysfunction, the nurse can best prepare for an effective interview by ensuring what?

Asking a family member to be present during the assessment

Which nursing assessment is most appropriate for an older client presenting with reports of generalized anxiety?

Assess for depression

Which of the following is an antidepressant used to treat ADHD?

Atomexetine (Strattera)

The history of a child newly diagnosed with attention deficit hyperactivity disorder reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?

Atomoxetine

The child psychiatric assessment differs from that of adults in which of the following ways?

Attention to developmental milestones

A child is diagnosed with autism spectrum disorder and is experiencing aggression and irritability. Which medication would the nurse expect to be prescribed to address these issues?

Atypical antipsychotics

When giving tacrine (Cognex) to an elderly client, the nurse must be aware of what information?

Because the liver is most vulnerable to tacrine, liver function tests must be done periodically

When giving tacrine to an elderly client, the nurse must be aware of what information?

Because the liver is most vulnerable to tacrine, liver function tests must be done periodically.

A nurse is providing community education regarding adolescents with oppositional defiance disorder (ODD). Which point should the nurse include in the educational session?

Behavior problems can develop when parental figures pay attention to a child's maladaptive behaviors

A nurse is assessing a girl age 8 years with a mood disorder. Which of the following would the nurse most likely expect to assess?

Behavioral problems

A client has vascular neurocognitive disorder. When teaching the family about the cause of this disorder, which would the nurse expect to integrate into the explanation?

Blood flow in the vessels to the brain are blocked.

The nurse is assessing a child diagnosed with expressive language disorder. During the assessment, the parents tell the nurse the child had normal speech development until around 3 years of age when the child was involved in a serious car accident. Which part of the body may be affected in the child?

Brain

Risperdal zyprexa seroquel geodon abilify invenga

COMMNLY USED ATYPICAL ANTIPSYCHOTICS: • Risperidone (______) • Olanzapine (_______) • Quetiapine (_________) • Ziprasidone (________) • Aripiprazole (________) Paliperidone (_______)

Creutzfeldt-Jakob Disease

Central nervous system disorder that typically develops in adults 40 to 60 years of age and involves altered vision, loss of coordination or abnormal movements, and dementia

thorazine

Chlorpromazine (_______) was developed in 1952 and since then all other treatment methods became obsolete.

A client with PTSD tells the nurse, "I deserve to be abused that way. I feel I am the one responsible for that incident. I don't have any hopes in lfe. I no longer mean anything to anyone." Based on these statements, which is the most appropriate nursing diagnosis?

Chronic low self-esteem

Confabulation

Clients may make up answers to fill in memory gaps; usually associated with organic brain problems

When assessing children, the nurse needs to ask more of which type of question compared with assessment of adults?

Closed ended

When assessing children, the nurse needs to ask more of which type of question compared with assessment of adults?

Closed ended Children think in more concrete terms; thus, the nurse needs to ask more specific and fewer open-ended questions than would typically be asked of adults.

Reframing

Cognitive-behavioral technique in which alternative points of view are examined to explain events

A client spends hours stacking and unstacking towels. She is repeatedly checking to make sure that the towels are in order of color. What term is used to identify this behavior?

Compulsion

A 16 year old male client is highly disruptive in class and has been in trouble at home. His mother recently found him torturing a cat. When she questioned him about how he could hurt an animal, he laughed at her. Which of the following conditions will the client most likely be diagnosed with?

Conduct disorder

A nurse is assessing a child who had an episode of passing feces in the classroom. The child has no other disabilities. The nurse concludes that the child had intentional encopresis. Which other condition is the child likely to have?

Conduct disorder

Which of the following childhood disorders is characterized by serious violations of social norms, such as destruction of property?

Conduct disorder

Which of the following childhood disorders is characterized by serious violations of social norms, such as destruction of property?

Conduct disorder Conduct disorder is characterized by serious violations of social norms, including aggressive behavior, destruction of property, and cruelty of animals. ODD is characterized by a persistent pattern of disobedience, argumentativeness, angry outbursts, low frustration tolerance, and tendency to blame others for misfortunes. OCD is characterized by intrusive thoughts that are difficult to dislodge (obsessions) or ritualized behaviors that the child feels driven to perform (compulsions). ADHD is a persistent pattern of inattention, hyperactivity, and impulsiveness that is pervasive and inappropriate for developmental level. (less)

The nurse is caring for a client with OCD. What are the expected outcomes for the client who has been stabilized by medication and behavior therapy?

Continue follow-up therapy as needed

Which of the following terms describes the use of socially unacceptable words, which are frequently obscene?

Coprolalia

Which of the following is a parasympathetic effect of anxiety?

Hyperactive bowel sounds

Pick's Disease

Degenerative brain disease that particularly affects the frontal and temporal lobes and results in a clinical picture similar to that of Alzheimer's disease

An 80-year-old is brought to the clinic by the client's spouse. The client has a history of peripheral vascular disease and type 2 diabetes. The spouse states that the client hasn't seemed to be normal for the preceding few days, noting that the client has been lethargic and mildly confused at times and has been incontinent of urine. The spouse reports that the client's blood glucose levels have been elevated. The nurse considers which as the most likely explanation for the client's change in mental status?

Delirium related to underlying medical problem

A client is diagnosed with early-onset OCD. Which assessment data supports this diagnosis?

Demonstrates body dysmorphic tendencies

Which term describes feelings of being disconnected from oneself as seen in a panic attack?

Depersonalization

Aphasia

Deterioration of language function

Nurses who work in a pediatric psychiatric-mental health facility should do which of the following?

Develop self awareness of issues that remind them of their own childhood and adolescence.

A nurse is assessing an 8-year-old child. The child is unable to dress herself and is not able to manipulate toys, such as building blocks. The child stutters while talking. The child does not have impaired motor coordination. What is the most likely diagnosis of the child?

Developmental coordination disorder

The nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is

Diarrhea

The wife caregiver of a client with dementia tells the nurse that her husband has been agitated lately. She states, "I don't know how to handle this. He was always such a gentle person!" Which of the following interventions should the nurse suggest?

Distract the client with family photos and discuss the events pictured

The spouse caregiver of a client with dementia tells the nurse that the client has been agitated lately. The spouse states, "I don't know how to handle this. The client was always such a gentle person!" Which interventions should the nurse suggest?

Distract the client with family photos and discuss the events pictured.

A nurse is preparing a care plan for a child with autism spectrum disorder. Which of the following would be an appropriate nursing diagnosis for this client?

Disturbed Sensory Perception related to diminished awareness of stimuli

After teaching a class about the biochemical theories associated with panic disorder, the instructor determines a need for additional education when the students identify which neurotransmitter as being implicated?

Dopamine

The nurse is assessing a client recently diagnosed with OCD. What does the nurse tell the client about the onset of the disorder?

Early onset may indicate family history of OCD

A physician in an outpatient clinic has prescribed fluoxetine (Prozac) to a client with intermittent explosive disorder. What should the nurse include in teaching about this medication?

Emphasize the need to seek medical help if suicidal thoughts arise.

Which is a metabolic cause of delirium?

Hypoglycemia

Which of the following is a metabolic cause of delirium?

Hypoglycemia

Time Away

Involves leaving clients for a short period and then returning to them to reengage in interaction; used in dementia care

When developing the plan of care for the family of a child with a neurodevelopmental disorder, which of the following would be least appropriate to include?

Excluding the parents from being included in the plan of care

A teenager and her parents visits the clinic to discuss the teen's skin picking. There are many bleeding wounds and various stages of scabs located up and down both arms. The parents are very upset about this behavior and want it to stop. Which of the following would the health care provider document?

Excoriation disorder

The nurse is planning a counseling session with a group of "at-risk" adolescents on the topic of drug abuse. Which education strategy would be most effective?

Involving peers in teaching the effective group problem-solving skills.

What interventions does the nurse use to promote therapeutic communication with the client diagnosed with OCD?

Explore the thoughts and feelings that trouble the client

When lecturing about dissociative disorders to a group of nursing students, a nurse states that an essential feature of their disorder involves which of the following?

Failure to integrate identity, memory, and consciousness

A client with PTSD has been referred for cognitive processing therapy. What would be the predominant symptom in a client for whom this therapy would be useful?

Feeling of guilt and self-blame

The client is an 84-year-old suffering from delirium. The client has been in a nursing home for the past 2 years but recently is becoming combative and has become a threat to staff. Which medication would the client most likely receive for these symptoms?

Haloperidol

Which of the following is the drug of choice for Tourette's disorder?

Haloperidol (Haldol)

Which of the following medications has been found to be effective as a treatment in autism?

Haloperidol (Haldol)

The nurse is assessing a child with autism spectrum disorder. After reading the medical history, the nurse finds that the child engages in stereotypical motor behavior. Which observation of the child made by the nurse might be indicative of stereotypical motor behavior?

Flapping hands repeatedly

Which medication does the nurse anticipate the health care provider will prescribe for a client who is beginning treatment for OCD?

Fluvoxamine

Which of the following is the hallmark of beginning mild dementia?

Forgetfulness

A nurse is studying the brain images of children with attention deficit hyperactivity disorder (ADHD). In these images, the nurse would find abnormalities related to which area of the brain?

Frontal lobe

A nurse is providing education to the care provider of a cognitively impaired client who is prescribed a cholinesterase inhibitor. Which information about medication side effects should the nurse be sure to include?

Gastrointestinal (GI) symptoms

After teaching a group of nursing students about intellectual disability, the instructor determines that the teaching was successful when the students identify which of the following as the most common etiology?

Genetic syndromes

A child is taking methylphenidate (Ritalin) for treatment of ADHD. Which of the following side effects much be monitored in this child?

Growth delays

A child is taking methylphenidate (Ritalin) for treatment of ADHD. Which of the following side effects must be monitored in this child?

Growth delays

A nurse is working with a child undergoing behavioral modification therapy for his attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation?

He cannot sit through meals.

A 6-year-old boy who has been diagnosed with autism spectrum disorder would be expected to display which of the following behaviors?

He spends time alone and shows little interest in making friends.

Which of the following educational techniques is helpful in the special education classroom?

High degree of structure

The nurse is caring for clients with OCD. Which progressive and debilitating disorder is most commonly seen with a late onset?

Hoarding

Which of the following is the primary treatment for delirium?

Identify and treat any casual or contributing medical conditions

A nurse is caring for a client with delirium. The client sees a thermometer on the nurse's table and shouts, "Don't stab me!" and then cowers. Which feature of delirium is this client exhibiting?

Illusion

A 15-year-old client with intermittent explosive disorder gives no history of childhood abuse, neglect, or maltreatment. What could be the cause of the disorder in this client?

Imbalance in the production of serotonin

A nurse is caring for a child with enuresis. The child does not have an abnormalities associated with development or behavior. Which drug would the child be prescribed to treat the condition?

Imipramine (Tofranil)

Apraxia

Impaired ability to execute motor functions despite intact motor abilities

While planning care for a child who has excoriation disorder, which of the following would be the priority NANDA?

Impaired skin integrity

The nurse who provides care under the auspices of a group home is planning the care of a 12-year-old boy who has been referred to the home by the court system. Knowing that the boy has a documented history of conduct disorder, which of the following nursing diagnoses should the nurse prioritize during the boy's transition into the group home?

Impaired social interaction due to aggressive behavior

Impaired social interaction due to aggressive behavior The aggression, acting out, and antisocial behavior associated with conduct disorder create the potential for social alienation in a group setting. Such individuals are less likely to withdraw, injure themselves, or experience hopelessness. (less)

Which of the following is considered a hyperactive/impulsive behavior seen in ADHD?

Inability to play quietly

Agnosia

Inability to recognize or name objects despite intact sensory abilities

Huntington's Disease

Inherited, dominant gene disease that primarily involves cerebral atrophy, demyelination, and enlargement of the brain ventricles

A nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when educating the parent on this disorder?

Initiating conversations with the child frequently

A client was admitted to an inpatient unit with a diagnosis of dementia. A nursing assessment and interview of the client would include what?

Intellectual ability, health history, and self-care ability

About half of children diagnosed with autism also have which of the following?

Intellectual disability

A client with dementia is having difficulty clearly communicating about physical needs. When teaching the caregiver about ways to assist the client in meeting physical needs, which instruction would the nurse most likely include?

Keep a record of bowel movements.

A nurse is assessing a child's adaptive behavior. Which of the following would the nurse assess when evaluating the child's conceptual skills?

Language

Profound mental retardation is diagnosed as being which of the following IQs?

Less than 20

Which of the following would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors?

Limit setting

Which of the following would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors?

Limit setting Limit setting involves three steps: informing the client of the rule or limit, explaining the consequences if the client exceeds the limit, and stating the expected behavior.

Thorazine haldol trilafon prolix

List the commonly used typical antipsychotics: • Chlorpromazine (_________) • Haloperidol (_________) • Perphenazine (Etrafon, ______) Fluphenazine (__________)

• Phase 1: • Patient notices some changes (not psychosis) then those close to patient notice the changes: (Moody, irritable, anxious, strange activity (no obvious psychosis) • Phase 2: • Patient notices psychotic changes (hears voices or has false beliefs) then those close to patient notice psychotic changes (patient accuses others of reading his mind or claims to have great powers) • Phase 3: Psychiatric intervention with a decrease in symptom severity Phase 4: Remission and residual effects

List the phases of schizophrenia and their discription::

Which of the following medications is not known to cause delirium?

Loop diuretics

The nurse is planning an initial therapy session with a client age 20 years whose parents had alcoholism. The nurse anticipates that the client would most likely exhibit symptoms of which of the following?

Low self-concept

externalizing behaviors

Lying Cheating at school Swearing Truancy Vandalism Setting fires Bragging Screaming Arguing Threatening Demanding Relentless teasing Anger outbursts

Which of the following is the priority intervention for a client diagnosed with delirium?

Maintenance of safety

After teaching a group of nursing students about drugs used to treat Alzheimer's disease, the instructor determines that additional teaching is needed when the group identifies which as a N-methyl-D-aspartic acid (NMDA) receptor antagonist?

Memantine

Dementia

Mental disorder that involves multiple cognitive deficits, initially involving memory impairment with progressive deterioration that includes all cognitive functioning

Which medication is the most effective for ADHD?

Methylphenidate (Ritalin)

Which medication is the most effective treatment for ADHD?

Methylphenidate (Ritalin)

Which level of anxiety helps the client focus attention to learn, problem solve, think, act, feel, and protect himself or herself?

Mild

According to which of the following is an inattentive behavior seen in ADHD?

Missing details

The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and is concerned only with stating that he is about to die. The nurse would classify this level of anxiety as which of the following?

Moderate

The mental health nurse is gathering a health history on a new client. The client is constantly pacing the floor and stating that he is about to die. The nurse would classify this level of anxiety as which of the following?

Moderate

A client with a medical diagnosis of dementia of Alzheimer's type has been increasingly agitated in recent days. As a result, the nurse has identified the nursing diagnosis of "risk for injury related to agitation and confusion" and an outcome of "the client will remain free from injury." What intervention should the nurse use in order to facilitate this outcome?

Monitor amount of environmental stimulation and adjust as needed.

The nurse is caring for a client who performs ritualistic hand washing and cleaning for about 30 minutes several times a day. What does the nurse tell the client's partner about caring for this client?

Monitor own health and anxiety levels

While reviewing the medical record of a client with moderate dementia of the Alzheimer type, a nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?

N-methyl-D-aspartate (NMDA) receptor antagonist

While reviewing the medical record of a client with moderate dementia of Alzheimer type, a nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?

NMDA receptor antagonist

atypical

New antipsychotic medications called second generation or "_______" antipsychotics were developed in the 1990's

What is the initial intervention the nurse should implement when helping a client diagnosed with dementia deal with paranoid delusions?

Observe the client in order to identify the triggers for the delusions

A older adult client develops delirium secondary to an infection. Which would be the most likely cause?

Pneumonia

Which is an infection-related cause of delirium?

Pneumonia

Which of the following is an infection-related cause of delirium?

Pneumonia

A group of nursing students is reviewing information about delirium and its causes. The students demonstrate a need for additional review when they identify which as a cause of this medical condition?

Oxidative stress

A client has experienced a gradual flattening of affect, confusion, and withdrawal and has been diagnosed with Alzheimer's disease. Which additional findings would the nurse most likely assess?

Personality change, wandering, and inability to perform purposeful movements

A client with dementia becomes extremely agitated shortly after being admitted to the psychiatric unit. The nurse is reluctant to use physical restraints to control the client. What is a likely reason the nurse has this reluctance?

Physical restraints may increase the client's agitation.

The nurse is teaching a client's parents about managing the child's tic disorder. The nurse explains that it is extremely important for the child to get plenty of rest. What is the primary reason for the nurse to provide this education? Choose the best answer.

Physical stress and fatigue can increase symptoms in tic disorder.

internalizing behaviors

Prefers to be alone Withdraws Sulks Won't talk Is secretive Overly shy Stares in lieu of verbal response Physically underactive Somatic aches and pains Dizziness Nausea, vomiting, stomach problems Fatigue, lethargy Lonely Guilt feelings Nervous Crying spells Feels worthless, unloved

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications?

Presence of comorbid psychiatric disorders

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications?

Presence of comorbid psychiatric disorders Clients with ODD are likely to have comorbid psychiatric symptoms related to conditions like attention deficit hyperactivity disorder (ADHD). Pharmacological therapy for these comorbid conditions can be helpful in reducing the severity of ODD symptoms. Children less than 3 years of age are expected to exhibit behavior similar to ODD, but this is considered normal and does not require any therapy. Use of abusive language and hostile behavior toward parents are signs consistent with ODD and do not require pharmacological therapy. (less)

Alzheimer's Disease

Progressive brain disorder that has a gradual onset but causes an increasing decline in functioning, including loss of speech, loss of motor function, and profound personality and behavioral changes such as those involving paranoia, delusions, hallucinations, inattention to hygiene, and belligerence

The nurse is assisting a client with behavior therapy for OCD. What nursing intervention may help enhance self-esteem?

Provide opportunities for the client to accomplish an activity

The client has advanced Alzheimer's disease and becomes confused at mealtimes. The client has agnosia, apraxia, and disturbed executive functioning. Which is the most appropriate nursing intervention?

Provide the client with a tray, opening containers for the client.

What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia?

Provides interaction with those with similar concerns

Which of the following approaches is included in milieu therapy for the child with autism spectrum disorder?

Providing a routine and predictive environment

A client is in the mild stage of dementia due to Alzheimer's disease. Which intervention would be most appropriate?

Providing emotional support and gentle reminders

A client with PTSD has been prescribed lorazepam 1 mg SL q6h PRN. What assessment finding indicates that treatment is having the desired effect?

Reduced anxiety

A care aide has rung the call light for assistance while providing a client's twice-weekly bath because the client became agitated and aggressive while being undressed. Knowing that the client has a diagnosis of dementia of Alzheimer's type and is prone to agitation, which measure may help in preventing this client's agitation?

Reminding the client multiple times that he or she will be soon having a bath

A client with Alzheimer's disease has a nursing diagnosis of risk for injury related to memory loss, wandering, and disorientation. Which nursing intervention should appear in this clients care plan to prevent injury?

Remove hazards from the environment

Palilalia

Repeating words or sounds over and over

Echolalia

Repetition or imitation of what someone else says; echoing what is heard

Which of the following should be included in a teaching plan for a client prescribed a benzodiazepine?

Rise slowly from a lying or sitting position

The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, "He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum." Based on this information, the nurse identifies which nursing diagnosis as the priority?

Risk for Social Isolation related to poor social skills of the child

Which nursing diagnosis would be the priority for the client experiencing acute delirium?

Risk for injury related to confusion and cognitive deficits

Which of the following is the drug of choice for a Tic disorder?

Risperidone (Risperdal)

Which of the following is the primary concern for a client with panic-level anxiety?

Safety

A 13-year-old boy who has been diagnosed with oppositional defiant disorder has taunted the nurse when she bent over to pick something up and mocked her weight. How should then nurse respond?

Say, "That's not an acceptable thing to say."

A client is diagnosed with panic disorder. Which of the following would the nurse expect to administer as the drug of choice initially?

Selective serotonin reuptake inhibitors

A 15-year-old boy being treated for depression will most likely be given which of the following first-line pharmacologic treatments?

Serotonin reuptake inhibitors

A nurse determines that a client who is experiencing anxiety is using relief or primitive survival behaviors. The nurse determines that the client is experiencing which degree of anxiety?

Severe

Which can be identified as a hallmark symptom of dementia?

Short-term memory loss

The nurse receives a report that a 75-year-old client is recovering from surgery. During the shift, the nurse notes that the client is forgetful and restless. Several times, the client calls the nurse the name of the client's daughter. The nurse interprets this behavior as what?

Signs of delirium

The client is 42 years old, married, and has two children, ages 16 and 18. The client is also caring for the client's parent, who is in the late stages of Alzheimer's disease. The nurse would want to assess the client for what?

Signs of stress

callous and unemotional behavior

Similar to that seen in adults with antisocial personality disorder. They have little empathy for others, do not feel "bad" or guilty or show remorse for their behavior, have shallow or superficial emotions, and are unconcerned about poor performance at school or home.

A client is diagnosed with dementia related to Parkinson's disease. While at a clinic visit, a cholinesterase inhibitor is prescribed for the client. The nurse knows that this type of medication would be prescribed for the client to achieve which goal?

Slow deterioration of memory and function

Parkinson's Disease

Slowly progressive neurologic condition characterized by tremor, rigidity, bradykinesia, and postural instability

Which of the following would be an appropriate intervention of a client experiencing an anxiety attack?

Staying with the client and speaking in short sentences

Which of the following is a disturbance of the normal fluency and tie patterning of speech?

Stuttering

Which of the following is a disturbance of the normal fluency and time patterning of speech?

Stuttering

Delirium

Syndrome that involves a disturbance of consciousness accompanied by a change in cognition

Which of the following is a cardiovascular response of the sympathetic nervous system?

Tachycardia

Which of the following medications, used to treat dementia, requires a liver function test every 1 to 2 weeks?

Tacrine (Cognex)

A 7-year-old boy experiences tics, which have become increasingly frequent in recent months. How should the nurse educate the boy's teacher to respond to his tics?

Teach the boy's classmates that his tics are not something that he can control

A 7-year-old boy experiences tics, which have become increasingly frequent in recent months. How should the nurse educate the boy's teacher to respond to his tics?

Teach the boy's classmates that his tics are not something that he can control.

A nurse is caring for a client with conduct disorder. The nurse needs to help the client understand the relationship between aberrant behavior and the consequences when the behavior is problematic. Which nursing intervention is most appropriate to help this client?

Teach the client about limit setting and the need for limits.

Teach the client about limit setting and the need for limits. Clients with conduct disorder may have no knowledge of the concept of limits and how they can be beneficial. The nurse should teach about limit setting and the need for limits, to help clients understand the relationship between aberrant behavior and the consequences when the behavior is problematic. The problem-solving process should be taught to clients, as they may not know how to solve problems constructively. Appropriate conversation and social skills should be taught to clients to assist them in socializing with others. Clients should be encouraged to discuss their thoughts and feelings, as this is the first step in dealing with clients with conduct disorder. (less)

A nurse is assessing a 15-year-old adolescent with conduct disorder. Which appearance might the nurse see in the adolescent?

The adolescent has lots of tattoos and body piercings.

A nurse is assessing a 15-year-old adolescent with conduct disorder. Which appearance might the nurse see in the adolescent?

The adolescent has lots of tattoos and body piercings. Adolescents with conduct disorder appear normal for their age group but may have an extreme appearance, such as having tattoos and body piercings. They appear normal in terms of personal hygiene. These adolescents have no guilt associated with their behavior, thus they probably will not look terrified. The nurse is unlikely to observe changes associated with self-harm. (less)

The adolescent may have limited sensitivity to reward and punishment. The most likely reason for the parent's sense of loss of control and hope with their adolescents child who has a diagnosis of ODD is that the client has a limited ability to make associations between a behavior and the consequences of that behavior—-both negative and positive. The parents likely did not neglect to teach the client appropriate behavior. Childhood abuse may be a predisposing factor for ODD. The parents likely did not pamper the client; however, problem behaviors may have inadvertently reinforced in the home. (less)

A nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent has been prescribed risperidone (Risperdol) by the primary healthcare provider. What would be the most likely reason for the healthcare provider to prescribe this drug to the client?

The adolescent's behavior poses a danger to others.

The adolescent's behavior poses a danger to others. Risperidone (Risperdol) is given to those clients with conduct disorder whose behavior poses a threat to others. Poor social behavior and disturbances in concentration need not be treated with drugs. Unlike in intermittent explosive disorder, the client with conduct disorder has no remorse, guilt, or depression after behaving violently. (less)

The nurse is assessing a child with tic disorder. The nurse documents in the assessment sheet that the child exhibits coprolalia. What might be be interpreted from this?

The child continuously repeats socially unacceptable words.

The nurse expects the child with expressive language disorder is likely to present with which nursing assessment finding?

The child has difficulty forming complete sentences.

mild

The child has some conduct problems that cause relatively minor harm to others. Examples include repeated lying, truancy, minor shoplifting, and staying out late without permission.

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The child is given medication and behavioral modification therapy to treat the condition. Which outcome achieved within 3 days would indicate successful therapy?

The child is able to complete assignment or tasks with assistance

The child is able to complete assignments or tasks with assistance.

A nurse is assessing a child with attention deficit hyperactivity disorder (ADHD). For every question asked by the nurse, the child answers, "I don't know." What is the most likely reason for the child to respond in this way?

The child is not paying attention to the nurse's questions.

The nurse is teaching the parents of a child with involuntary enuresis about methods to manage the condition. Which interventions does the nurse recommend to the parents?

The child should use pads with a warning bell

The nurse is teaching the parents of a child with involuntary enuresis about methods to manage the condition. Which intervention does the nurse recommend to the parents?

The child should use pads with a warning bell.

What signs of stabilization does the nurse recognize during the follow-up visit of a client undergoing behavior therapy for obsessive-compulsive disorder (OCD)?

The client completes daily routine within a specified time

When assessing the insight and self-concept of a client with OCD, what does the nurse note?

The client has a fear of "going crazy"

An older client comes to the clinic for a yearly physical exam. During the assessment the client tells the nurse that he sometimes has begun feeling anxious about his forgetfulness. The nurse notes the client may have mild dementia. Which finding would lead the nurse to conclude this?

The client has difficulty finding words

An older client comes to the clinic for a yearly physical exam. During the assessment, the client tells the nurse that the client sometimes has begun feeling anxious about the client's forgetfulness. The nurse notes the client may have mild dementia. Which finding would lead the nurse to conclude this?

The client has difficulty finding words

A nurse is performing a follow-up assessment of a male client who had been treated for PTSD a year ago. The client tells the nurse that he is not able to maintain relationships with women and that his relationships last for a very short time. What is the most likely reason for this problem?

The client has issues with developing trust

The client has early Alzheimer's disease. When asked about family history, the client relates that the client has two children who are both grown and who visit the client around the holidays each year. The nurse subsequently discovers that the client has one child who is currently assigned overseas and who has not been home for 2 years. Which would best describe the client's behavior?

The client is confabulating, most likely to cover for memory deficit.

The nurse is interviewing a client who has been diagnosed with PTSD after being randomly attacked with a gun. The client describes a recent event where she panicked and jumped for cover when a care backfired on the street. How should the nurse best interpret this event?

The client is experiencing hyperarousal

A client with a diagnosis of PTSD tells the nurse, "When things get really bad, it sometimes feels like I'm not even in my body, like I'm floating around and watching myself." How should the nurse best interpret this client's statement?

The client is likely experiencing derealization as a result of PTSD

What assessment finding would suggest to the nurse that the client with PTSD is experiencing dissociation?

The client is often "staring into space" and has no idea how much time has passed

The nurse is assessing a client with aphasia and notes the client may be exhibiting echolalia during their conversation. What signs does the nurse observe that leads to this conclusion?

The client may echo whatever is heard.

The nurse asks a client to pretend the client is brushing the client's teeth. The client is unable to perform the action. Upon examination, the nurse finds that the client possesses intact motor abilities. What can this problem be documented as?

The client may have apraxia.

The nurse is documenting clinical observations after a therapeutic session with an adolescent client with a disruptive behavior disorder. What should the nurse identify is an internalizing behavior?

The client only stares at the nurse when asked how the client is doing today.

The nurse is documenting clinical observations after a therapeutic session with an adolescent client with a disruptive behavior disorder. What should the nurse identify is an internalizing behavior?

The client only stares at the nurse when asked how the client is doing today. An example of an internalizing behavior that can be observed in clients with disruptive behavior disorders is refraining from talking. The client who just stares at the nurse when asked a question is demonstrating internalizing behaviors common in disruptive behavior disorders. Not showing up for multiple appointments is an example of truancy, an externalizing behavior common in disruptive behavior disorders. Telling the nurse that her grandmother passed away when, in fact, this is not true, indicates that the client is lying. Lying is one example of an externalizing behavior in disruptive behavior disorders. Pushing a chair over during the therapeutic session is an example of an angry outburst with aggression. This is an externalizing behavior. (less)

The nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent is not interested in seeking summer employment. What is the most likely reason for the client's disinterest in getting a job?

The client prefers stealing money over working for it.

The client prefers stealing money over working for it. The adolescent with conduct disorder is most likely to steal money for survival instead of earning it through employment. Feeling too disturbed to be able to work and feeling that he would be inefficient at work are not behaviors related to clients with conduct disorder. Depression and anxiety are not present in clients with conduct disorder. (less)

A 65-year-old has been admitted to the intensive care unit following surgical resection of the bowel. The client has developed a fever. Which additional signs indicate the client has developed delirium?

The client removes the client's surgical bandage and begins picking at the sheets.

The psychiatric mental health nurse is assessing a client who was diagnosed with PTSD after the death of his child from a medical error. What assessment finding would most warrant interventions aimed at addressing the client's dissociation?

The client reports large gaps in her memory of the traumatic event

Major goals for the nursing care of clients with dementia should include what?

The client will be safe, be physiologically stable, and have infrequent episodes of agitation.

Which goal is appropriate for the client being treated for OCD with response prevention therapy?

The client will experience notably less anxiety when engaged in delaying the ritual within 3 months

An 82-year-old client with a diagnosis of vascular dementia has been admitted to the geriatric psychiatry unit of the hospital. In planning the care of this client, which outcome should the nurse prioritize?

The client will remain free from injury.

The diagnosis of delirium is supported when the nurse notes which in the client?

The is convinced that the client sees "hundreds" of bugs and is not always oriented to time and place

Tardive Dyskinesia

________ ________= a late appearing side effect of antipsychotic medications. After long term dopamine antagonist use. • characterized by abnormal, involuntary movements such as: • grimacing, tongue protrusion, lip smacking, puckering and pursing, and rapid eye blinking • Rapid movements of the arms, legs, and trunk • Involuntary movements of the fingers It is irreversible once it appears. But discontinuing or reducing meds can arrest progression.

moderate

The number of conduct problems increases as does the amount of harm to others. Examples include vandalism, conning others, running away from home, verbal bullying and intimidation, drinking alcohol, and sexual promiscuity.

A client has developed PTSD after a violent sexual assault committed by a close family member. When planning this client's care, the nurse should follow what guideline?

The nurse should avoid touching the client during interactions unless necessary

Paranoid

________-type: has delusions (persecution or being famous) and auditory hallucinations with relatively normal intellectual functioning and expression of affect; angry, aloof, anxious and argumentative

Undifferentiated

________-type: shares some symptoms of all types but not enough of any one of them

Disorganized

________-type: speech and behavior lack cohesion (difficult to understand) flat affect or inappropriate emotions (laugh inappropriately at something not funny); disruption in normal activities of daily living.

A group of friends have arrived at the hospital to visit a client recently diagnosed with delirium. The nurse tells the friends they can visit with the client one at a time. What is the likely reason for the nurse to give this instruction?

The nurse wants to prevent increasing the client's confusion.

The nurse preparing an educational program on dementia should include which information?

The onset of symptoms of dementia is gradual

Schizophrenia

__________ causes distorted and bizarre thoughts perceptions, emotions, movements, and behavior. Chronic, severe, diabling, brain disorder 1.1% of Americans.

Schizoaffective

____________ disorder is diagnosed when the severely ill client has a mixture of psychotic and mood symptoms. Signs/Symptoms: Include those of both schizophrenia and a mood disorder such as bipolar disorder or depression.

A nurse is counseling the parents of a child with oppositional defiant disorder (ODD). What does the nurse advise the parents for dealing with the maladaptive behavior of their child?

The parents should ignore the child's behavior.

Severe

The person has many conduct problems that cause considerable harm to others. Examples include forced sex, cruelty to animals, physical fights, cruelty to peers, use of a weapon, burglary, robbery, and violation of previous parole or probation requirements

Noneurologic

______________ side effects include weight gain, sedation, photosensitivity, and anticholinergic symptoms such as dry mouth, blurred vision, constipation, urinary retention, and orthostatic hypotension.

Pseudoparkinsonism

_________________ or neuroleptic-induced parkinsonism = includes a shuffling gait, mask- like facies, muscle stiffness (continuous) or cogwheeling rigidity (ratchet like movements of joints)

A nurse is assessing an adolescent with conduct disorder. Which statement by the nurse about the adolescent is most likely to be true?

The sibling of the client has conduct disorder.

A nurse is assessing an adolescent with conduct disorder. Which statement by the nurse about the adolescent is most likely to be true?

The sibling of the client has conduct disorder. Most children with conduct disorder have siblings with the same psychiatric disorder. Although it is possible to develop CD if a sibling has a mood disorder, the likelihood is higher that the client would also develop a mood disorder. Clients with conduct disorder will show cruelty to animals. A client with a chronic medical condition is more likely to be able to experience and convey empathy, eliminating the presence of conduct disorder. (less)

Reminiscence Therapy

Thinking about or relating personally significant past experiences in a purposeful manner to benefit the client

The nurse uses the technique of timeout for a client with conduct disorder. Which problem demonstrated by the client would have led the nurse to use this intervention?

Threatening the nurse

A nurse is caring for a client with delirium. The nurse assesses the client's activities of daily living on a daily basis. What is the most likely reason for assessing these so frequently?

To assess for fluctuation in the client's capabilities

A nurse is studying the medical chart of a client with delirium. The nurse finds that the client was given haloperidol. What would be the most likely reason for administering this drug to the client?

To decrease agitation

For which of the following reasons would a nurse ask an adolescent client with conduct disorder to maintain a diary?

To help identify her feelings.

Which of the following would not be an initial intervention for the client with acute anxiety?

Touching the client in an attempt to comfort him

Which of the following would not be included in the plan of care for a client diagnosed with acute anxiety?

Touching the client in an attempt to comfort him

Which of the following conditions is characterized by multiple motor tics and one or more vocal tics many times throughout the day for 1 year or more?

Tourette syndrome

A client's older mother has been diagnosed with hoarding disorder. What does the nurse instruct the client about the mother's hoarding disorder?

Treatment may involve community agencies

The nurse is assessing a teenage client with onychophagia. What does the nurse teach the parent about the disorder?

Treatment with SSRI antidepressant is effective

antipsychotic medications psychosocial

Treatments of schizophrenia focus on eliminating symptoms by using ___________ __________ and _______ treatments

Korsakoff's Syndrome

Type of dementia caused by long-term, excessive alcohol intake that results in a chronic thiamine or vitamin B deficiency

Which of the following statements reflects accurately the effects of childhood mental illness?

Untreated mental illness in childhood often results in long-term mental illness in adults.

When providing education to the parents of a client with conduct disorder, which is a valid teaching point?

Use 'I' language and express an emotion when setting limits.

When providing education to the parents of a client with conduct disorder, which is a valid teaching point?

Use 'I' language and express an emotion when setting limits. With clients diagnosed with conduct disorder, parents need to replace old patterns of communicating such as yelling, hitting, or simply ignoring with more effective communication strategies such as assertive limit setting. Using 'I' language and identifying an emotion can help the parents set limits in a healthy way. Consequences will only be effective if something of value is taken from the client. Many adolescents prefer time alone in their rooms. This would not be the most effective information to provide to the parents. Some parents need to let the client experience the consequences of their actions rather than rescuing them. Advocating for the adolescent when the client is disruptive in school will only perpetuate the negative behavior. Adolescents with conduct disorder are prone to thrill-seeking, risky behavior including frequent sexual activity. This should not be normalized as part of the education provided to the parents. (less)

To manage voiding issues, such as incontinence, male clients diagnosed with dementia would best be managed by what?

Use of disposable, adult diapers

Supportive Therapy

Use of physical touch to convey support, interest, caring; may not be welcome or effective with all clients

A woman in her fifties has contacted her HCP because of concerns for her husband, who has suddenly begun behaving uncharacteristically in recent days. Most recently, he became lost while driving to his home of 30 years and temporarily forgot his son's name. Diagnostic testing has ruled out delirium and he has been previously healthy. What is the most likely cause of the husband's cognitive changes?

Vascular dementia

The nurse is assessing a child diagnosed with conduct disorder. Based on which behavior would this client be described as exhibiting the disorder at moderate intensity?

Verbal bullying

The nurse is assessing a child diagnosed with conduct disorder. Based on which behavior would this client be described as exhibiting the disorder at moderate intensity?

Verbal bullying Verbal bullying is an example of a behavior seen clients exhibiting a moderate intensity form of conduct disorder. Truancy is described as a behavior seen in a mild intensity form of the disorder. Cruelty to animals and attempted robbery are described as a behavior seen in a severe intensity form of conduct disorder. (less)

When assessing a client with dementia, a nurse identifies that the client is experiencing hallucinations. Based on the nurse's understanding of this disorder, which type of hallucination would the nurse expect as most common?

Visual

Which type of hallucination is most commonly seen in clients diagnosed with delirium?

Visual

Which type of hallucination most commonly occurs in clients diagnosed with dementia?

Visual

The nurse is teaching relaxation techniques to a client with OCD. When does the nurse teach relaxation techniques to the client?

When the client is experiencing low anxiety levels

An older adult with no significant medical history is admitted to the hospital through the emergency department after hitting the client's head during a fall and fracturing the humerus. The client does not require surgery and will probably be discharged the following day. Should the nurse be concerned about delirium?

Yes, because of the head injury and medication

Catatonic

________ -type: disturbances of movement (none or can't stop); may remain mute or may repeat anything others say or do senselessly (echolalia); lack capacity for self-care

The nurse is assessing the orientation of a client who belongs to the religious group Jehovah's Witnesses. Which questions should the nurse ask this client? Select all that apply.

Where is your residence located? What is your mother's name? Where is your workplace located?

When discussing a school-aged child's behavioral contract with the school staff, how should the nurse most effectively explain a time-out?

a retreat away to regain self-control

When discussing a school-aged child's behavioral contract with the school staff, how should the nurse most effectively explain a time-out?

a retreat away to regain self-control A time-out is a retreat to a neutral place so clients can regain self-control. It is not a punishment, therefore it would be inaccurate to describe this technique as a consequence for unacceptable behavior. A time-out should not signal the end of the school day for the child. Instead, it should be an opportunity to practice emotional regulation in order to progressively gain the ability to tolerate the school environment in a nondisruptive way. A time-out is not moving the child to sit with a different group of peers. In order for this technique to be effective, there must be little or no external stimulus as this may prevent the child's ability to regain self-control. (less)

Which of the following is normal adolescent behavior? a. being critical of self and others b. defiant, negative, and depressed behavior c. frequent hypochondriacal complaints d. unwillingness to assume greater autonomy

a. being critical of self and others

Catatonia

abnormality of movement and behavior arising from a disturbed mental state (typically schizophrenia). It may involve repetitive or purposeless overactivity, or catalepsy, resistance to passive movement, and negativism.

Which client, presenting with a report of vague physical symptoms, should be assessed for possible anxiety by the nurse?

an Asian American client

A nurse is assessing a 10-year-old child who is displaying behaviors that are consistent with oppositional defiance disorder. When conducting the assessment, the nurse should also assess for which co-morbidity?

attention deficit hyperactivity disorder

attention deficit hyperactivity disorder Oppositional defiance disorder is often co-morbid with other psychiatric disorders that need to be treated as well. It is possible that the oppositional defiance disorder is superimposed on the attention deficit hyperactivity disorder because this problem is the underlying cause of the child's maladaptive behaviors. (less)

The nurse has completed teaching sessions for parents about conduct disorder. Which of the following statements indicates a need for further teaching? a. Being consistent with rules at home will probably be a real challenge for me and my child. b. It helps to know that these problems will get better as my child gets older. c. Real progress for our child is likely to take several weeks or even months d. We need to set up a system of rewards and consequences for our child's behaviors

b. It helps to know that these problems will get better as my child gets older.

The nurse understands that effective limit setting for children includes (select all that apply): a. allowing the child to participate in defining limits b. consistent enforcement of limit by entire team c. explaining the consequences of exceeding limits d. informing the child of the rule or limit e. negotiation of reasonable requests for change in limits f. providing 3 or 4 cues or prompts to follow the established limit

b. consistent enforcement of limit by entire team c. explaining the consequences of exceeding limits d. informing the child of the rule or limit

An effective nursing intervention for the impulsive and aggressive behaviors that accompany conduct disorder is: a. assertiveness training b. consistent limit setting c. negotiation of rules d. open expression of feelings

b. consistent limit setting

A nurse assessing a client with IED would expect which of the following? A. blaming others for provoking angry outbursts b. difficulty coping with ordinary life stressors c. lack of remorse for aggressive behavior d. premeditated aggressive outbursts to get what the client wants

b. difficulty coping with ordinary life stressors

A 16 year old with ODD is most likely to have difficulty in relationships with (select all that apply): a. family friends b. law enforcement c. parents - mother, father, or both d. peers of the same age group e. school superintendent f. store manager at work

b. law enforcement c. parents - mother, father, or both e. school superintendent f. store manager at work

conduct disorder

characterized by persistent behavior that violates societal norms, rules, laws, and the rights of others. These children and adolescents have significantly impaired abilities to function in social, academic, or occupational areas.

A pre-teen client has been considered a neighborhood bully for several years. Peers avoid him, and the mother says she cannot believe a thing he tells her. Recently, the client was observed shooting at several dogs with a pellet gun and setting fire to a vacant lot for the first time. A nurse would assess these behaviors as being most consistent with which disorder?

conduct disorder

conduct disorder Conduct disorder is characterized by persistent behavior that violates societal norms, rules, laws, and the rights of others. These clients have significantly impaired abilities to function in social, academic, or occupational areas. Symptoms are clustered in four areas: aggression to people and animals, destruction of property, deceitfulness and theft, and serious violation of rules. This is an example of moderate conduct. Moderate: The number of conduct problems increases as does the amount of harm to others. Examples include vandalism, conning others, running away from home, verbal bullying and intimidation, drinking alcohol, and sexual promiscuity. Oppositional defiant disorder consists of an enduring pattern of uncooperative, defiant, disobedient, and hostile behavior toward authority figures without major antisocial violations. The behaviors are more pervasive than defiance of authority. To suffer from pyromania is more than one incidence of setting a fire. (less)

Oppositional Defiant Disorder

consists of an enduring pattern of uncooperative, defiant, disobedient, and hostile behavior toward authority figures without major antisocial violations

Parents of a child with ODD are referred to a parent management training program. The parents ask the nurse what to expect from these sessions. The best response by the nurse is: a. This is a method of parenting that involves negotiation of responsibilities with your child. b. This is a support group for parents to discuss the difficulties they are having with their children. c. You will have a chance to learn how to manage all your child's negative behaviors d. You will learn behavior management techniques to use at home with your child

d. You will learn behavior management techniques to use at home with your child

The nurse is developing a care plan for a client diagnosed with ADHD. The nurse teaches the client to take the last dose of dextroamphetamine (Dexedrine)

early in the afternoon

The nurse documents that a client diagnosed with dementia of the Alzheimer's type is exhibiting agnosia when the client is observed being unable to ...

identify a picture of a car.

A client with PTSD has just completed a session of eye movement, desensitization, and reprocessing (EMDR) therapy. The client states that she is exhausted because she has been:

imagining the details of the traumatic event with the therapist

A nurse is working with an adolescent client with a diagnosis of conduct disorder. The nurse is helping the client reflect on a situation in which the client became aggressive and asks how the client could have handled it differently. The nurse is employing which intervention?

improving coping skills and self-esteem

The nurse is conducting a health history of a 35-year-old male client with a history of intermittent explosive disorder, diagnosed in adolescence. The nurse should include an assessment of which health issue?

increased blood pressure

A nurse is discussing a client's condition with the client's family. A family member states that the client has a long history of mental retardation. The nurse corrects the family member by explaining that which is the correct term for this condition?

intellectual disability

Intermittent Explosive Disorder

involves repeated episodes of impulsive, aggressive, violent behavior and angry verbal outbursts, usually lasting less than 30 minutes. During these episodes, there may be physical injury to others, destruction of property, and injury to the individual as well.

Distraction

involves shifting the client's attention and energy to a different topic

Parents of a child who is exhibiting OCD may notice the child:

is failing classes due to lack of concentration

A nurse is seeing a female client who has been mandated to counseling sessions after shoplifting numerous times. Which disruptive behavior disorder is the client most likely experiencing?

kleptomania

A nurse is seeing a female client who has been mandated to counseling sessions after shoplifting numerous times. Which disruptive behavior disorder is the client most likely experiencing?

kleptomania Kleptomania is characterized by the impulsive, repetitive theft of items not needed by the person, either for personal use or monetary gain. This problem is more common in females. Pyromania is characterized by repeated, intentional fire-setting. Intermittent explosive disorder involves repeated episodes of impulsive, aggressive, violent behavior and angry verbal outbursts. Children who respond to pressures by internalizing emotions can see that result in somatic complaints, withdrawal, isolative behavior and problems with anxiety and depression. In this case, the client is engaging in externalizing behaviors. (less)

An adolescent client says he has become bored with the video game that has been used as a reward for positive behavior. Which of the following is the most effective intervention for this client?

let the client choose another reward that would be more fun.

Poor "executive functioning" (the ability to understand information and use it to make decisions) Trouble focusing or paying attention Problems with "working memory" (the ability to use information immediately after learning it)

list some cognitive symptoms of schizophrenia

alogia anhedonia apathy asociality blunted affect catatonia flat affect abolition or lack of volition inattention

list some negative symptoms of schizophrenia

ambivalence associative looseness delusions echopraxia flight of ideas preservation bizarre behavior

list some positive symptoms of schizophrenia

paranoid disorganized catatonic undifferentiated residual

list the types of schizophrenia: 5 of them

What is the initial intervention the nurse should implement when helping a client diagnosed with dementia deal with paranoid delusions?

observe the client in order to identify the triggers for the delusions

What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia?

provides interaction with those with similar concerns

Which client behavior should the nurse attempt to change when managing a client's tendency to wander and pace at night?

take a nap mid afternoon and before dinner

The nurse should consider the intervention referred to as "going along with" when managing the care of which client?

the older widower who is worried about his wife not being able to visit because of the snow

15-25

the peak age of onset for men is

25-35

the peak age on onset for women is

Dystonic reactions

to antipsychotic medications appear ear in the course of treatment and are characterized by spasms in discrete muscle groups such as the neck muscles or eye muscles. Can be painful.

Which type of hallucination most commonly occurs in clients diagnosed with dementia?

visual

positive/hard negative/soft cognitive

what are the three major categories of schizophrenia symptoms?

dopamine SEROTONIN

• 2nd generation antipsychotics (ATYPICAL ANTIPSYCHOTIC): ○ BLOCK _________AND INHIBIT THE REUPTAKE OF _________ Inhibiting reuptake improves the depressive components.

A nurse is performing a general assessment of adolescents in a school to identify students with conduct disorder. Which students are likely to be identified with the condition, based on the nurse's assessment? Select all that apply.

• A student who repeatedly bullies younger students • A student who is constantly involved in activities resulting in damage to school property • A student who always uses abusive language while speaking to teachers

Which nursing interventions are focused on promoting safety and compliance when working with a child diagnosed with a conduct disorder? Select all that apply.

• All staff consult the care plan when determining interventions. • The agreed upon routine is adhered to by all staff members • Time-out is implemented when limits are not respected.

A nurse suspects that a child has oppositional defiant disorder. When reviewing the child's history, which of the following would support this suspicion? Select all that apply.

• Blaming others for problems • Angry outbursts • Disobedience

A nurse suspects that a child has oppositional defiant disorder. When reviewing the child's history, which of the following would support this suspicion? Select all that apply.

• Blaming others for problems • Angry outbursts • Disobedience Oppositional defiant disorder is characterized by a persistent pattern of disobedience, argumentativeness, angry outbursts, low tolerance for frustration, and tendency to blame others for misfortunes, large and small. Children with oppositional defiant disorder have trouble making friends and often find themselves in conflict with adults. Conduct disorder is characterized by more serious violations of social norms, including aggressive behavior, destruction of property, and cruelty to animals. (less)

clozaril

• Clozapine (________) - than can cause agranulocytosis (loss of the white blood cells) • sore throat, fever, malaise, leukopenia • White blood cell counts are checked every week or two • Clozapine used when patients do not respond to other antipsychotic medications

A 14-year-old client's behavior meets the criteria for a conduct disorder when the nursing assessment documents that the child has (Select all that apply.)

• Confessed to hurting the neighbor's dog • Served after-school detention for repeatedly disobeying the teaching staff • Been regularly accused by family members of "stealing their stuff" • Been caught lying on a regular basis A 14-year-old client's behavior meets the criteria for a conduct disorder when the nursing assessment documents that the child has done the following: confessed to hurting the neighbor's dog, served detention, been accused of stealing, and been caught lying. (less)

Fluphenazine Haloperidol risperdal consta paliperidone

• Depot injection refers to injections once or twice a month of slowly absorbed drugs (not for acute problems): • _________ (Prolixin) (sesame oil) • __________(Haldol) (sesame oil) • __________ (microspheres) ______________(Invega Sustenna) (microspheres)

A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session? Select all that apply.

• Effective parenting skills • Skills to improve peer relationships • Skills to improve academic performance

A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session? Select all that apply.

• Effective parenting skills • Skills to improve peer relationships • Skills to improve academic performance Family therapy is most desirable to treat school-aged children with conduct disorder. While teaching parents about strategies to treat this disorder, the nurse should talk about good parenting, skills to improve peer relationships, and skills to improve academic performance. Legal procedures for criminal behavior and medications for conduct and antisocial personality disorder need not be addressed in this teaching. (less)

days few weeks 6 weeks

• Expected effects of antipsychotics on symptoms: • within _______feeling agitated and having hallucinations, usually modify; • within a _____ ______delusions usually modify; after about _____ _____ see major improvement

A nurse is meeting the parents of an 8-year-old child with oppositional defiant disorder. Which strategies can the nurse offer the parents to promote the use of positive reinforcement? (Select all that apply.)

• Give high-fives for following through on a request the first time. • Offer the child a toy or a game after a week of good behavior at school. • Take the child out for ice cream after a weekend free of arguing or questioning.

The nurse is assessing an adolescent client who was diagnosed with autism spectrum disorder as a child. On current assessment the nurse finds that the client's behavior has deteriorated. What may be the possible causes of this change? Select all that apply.

• Increased parental and peer pressure • Inability to perform well in school • Hormonal changes

A child with attention deficit hyperactivity disorder has been prescribed Dextroamphetamine (Dexedrine). For what effects should the nurse tell the parents to monitor the child? Select all that apply.

• Insomnia • Weight loss • Appetite suppression

An adolescent was expelled from school for being extremely verbally abusive to female students in the classroom. What other behavioral abnormalities does the nurse expect to find in this adolescent? Select all that apply.

• Low self-esteem • Emotional instablity • Frequent temper outbursts

• Low self-esteem • Emotional instablity • Frequent temper outbursts Abusing female students in class is indicative of conduct disorder. Children with conduct disorder have low self-esteem and frequently lose their temper. Such children show no guilt or remorse for their behavior. Therefore, they are unlikely to have anxiety or depression. Children with conduct disorder are known to be unemotional, thus they cannot behave in an emotionally unstable way. (less)

The nurse is assessing a 7-year-old child whose achievement in math is below that expected for his age, formal education, and intelligence. The nurse suspects he may be at risk for:

• Poor social skills. • Low self-esteem. • Dropping out of school.

Which behaviors should the nurse anticipate in children with mild conduct disorder? Select all that apply.

• Repeated lying • Minor shoplifting

When assisting the parents of a child diagnosed with ADHD, which of the following would the nurse suggest? Select all that apply.

• Set clear limits with consequences • Keep to regular routines • Maintain a calm environment

When the nurse is conducting a biopsychosocial assessment of a child, which of the following techniques can be used to establish rapport with family members? Select all that apply.

• Speak slowly. • Maintain eye contact. • Show acceptance.

A nurse is planning to educate a client who is diagnosed with intermittent explosive disorder about self-management strategies for the condition. What topics should the nurse address while teaching this client? Select all that apply.

• Strategies for anger management • Strategies to avoid alcohol and substance use • Relaxation techniques

• Strategies for anger management • Strategies to avoid alcohol and substance use • Relaxation techniques The education imparted by the nurse should focus on helping the client manage the symptoms associated with intermittent explosive disorder. The nurse should teach the client relaxation techniques, anger management strategies, and strategies to prevent the use of alcohol and drugs. Clients with IED are unlikely to have pain or diet-related problems, therefore, these need not be taught to the client. (less)

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply.

• Temperament of the adolescent • Peer group of the adolescent • Behavior of parents

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply.

• Temperament of the adolescent • Peer group of the adolescent • Behavior of parents It is believed that interaction of genes, temperament, and adverse social conditions cause oppositional defiant disorder (ODD). Behavior of the parents suggests genetic linkage. Characteristics of the peer group is indicative of the adversity of the social conditions around the adolescent. Eating habits and academic performance are affected due to ODD, but are not known to be a cause of ODD. (less)

A nurse is assessing an adolescent with conduct disorder. Which should the nurse expect to find in this adolescent? Select all that apply.

• The adolescent may be unwilling to speak to the nurse. • The adolescent may behave disrespectfully to the nurse. • The adolescent may make derogatory comments about his parents and teachers.

A nurse is assessing an adolescent with conduct disorder. Which should the nurse expect to find in this adolescent? Select all that apply.

• The adolescent may be unwilling to speak to the nurse. • The adolescent may behave disrespectfully to the nurse. • The adolescent may make derogatory comments about his parents and teachers. Adolescents with conduct disorder may act lazy and be unwilling to be interviewed. They may be disrespectful to the nurse and other personnel in the healthcare facility. They may also make derogatory comments about their parents and teachers. People with conduct disorder are very unlikely to express grief. They show no guilt or remorse associated with their acts. These adolescent are unlikely to be stressed. Clients with conduct disorder are very unlikely to behave like a hypochondriac and give false complaints of having a physical illness. (less)

A nurse is reassessing a 6-year-old client with oppositional defiant disorder (ODD). Which findings would suggest that the patient is at a high risk of developing conduct disorder? Select all that apply.

• The client has developed new psychiatric symptoms. • The client has become more aggressive since the last assessment. • The client has developed symptoms of ODD at a very young age.

A nurse is developing a plan of care for a client with conduct disorder. Which of the following would be treatment outcomes for this client? Select all that apply.

• The client will not hurt others or damage property. • The client will engage in socially acceptable behavior. • The client will learn effective problem-solving skills.

A nurse is developing a plan of care for a client with conduct disorder. Which of the following would be treatment outcomes for this client? Select all that apply.

• The client will not hurt others or damage property. • The client will engage in socially acceptable behavior. • The client will learn effective problem-solving skills. If a client undergoes successful treatment, he or she should be able to behave in a socially acceptable manner, display appropriate problem-solving skills, no longer hurt others or damage property. Clients with conduct disorder usually do not have issues related to personal hygiene. Such clients do require relief from anxiety or depression, as they are considered unemotional and do not show regret or feel any remorse after inappropriate behavior. (less)

Mental health Nursing Videbeck 22-24

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