mental health quiz 3 (chp: 11, 12, 20, 21, 10, 13, 22, 30, 16, & 19 + pharm chp: 7 & 8)

a nurse is caring for a client who is taking phenelzine. for which of the following adverse effects should the nurse monitor? (select all that apply)

orthostatic hypotension headache

a nurse working on an acute mental health unit is admitting a client who major depressive disorder and comorbid anxiety disorder. which of the following actions is the nurse's priority?

placing the client on one-to-one observation

a nurse is interviewing a 25 year old who has a new diagnosis of dysthymic disorder. which of the following findings should the nurse expect?

presence of manifestations for at least 2 years

a charge nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

the client is at greatest risk for suicide during the first weeks of an MDD episode

a nurse is caring for a client who has derealization disorder. which of the following findings should the nurse identify as an indication of derealization?

the client states that the furniture in the room seems to be small and far away

a charge nurse is discussing mirtazapine with a newly licensed nurse. which of the following statements by the newly licensed nurse indicates understanding?

the medication increases the release of serotonin and norepinephrine

a nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. which of the following information should the nurse include?

this medication has a low risk for dependency

a nurse is planning care for a client following surgical implantation of a VNS device. the nurse should plan to monitor for which of the following adverse effects? (select all that apply)

voice changes dysphagia neck pain

a nurse is conducting a class for a group of newly licensed nurses on caring for clients who are at risk for suicide. which of the following information should the nurse include in the teaching?

a no-suicide contract decreases the client's risk for suicide.

a nurse is assessing a client who has major depressive disorder. the nurse should identify with of the following client statements as an overt comment about suicide? (select all that apply)

"my family will be better of if im dead" "I wish my life was over" "if I kill myself then my problems will go away"

a nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. which of the following statements actions should the the nurse make?

"tell me about how you are feeling right now"

a nurse manager is discussing the care of a client who has personality disorder with a newly licensed nurse. which of the following statements by the newly nurse indicates an understanding of the teaching?

I should practice limit-setting to help prevent client manipulation

a nurse is caring for a client who has bulimia nervosa and has stopped purging behavior. the client tells the nurse that she is afraid she is going to gain weight. which of the following responses should the nurse make?

I understand you have concerns about your weight, but first, lets talk about your recent accomplishmetns

a nurse is caring for a client who is to begin taking fluoxetine for treatment of GAD. which of the following statements indicates the client understands the use of this medication?

I will need to discontinue this medication slowly

a nurse is providing teaching for a client who is scheduled to receive ECT for the treatment of major depressive disorder. which of the following client statements indicates understanding of the teaching?

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

a charge nurse is discussing TMS with a newly licensed nurse. which of the following statements by the newly licensed nurse indicates an understanding of the teaching?

I will schedule the client for daily TMS treatment for the first several weeks

a nurse is caring for a client who has avoidant personality disorder. which of the following statements is expected from a client who has this type of personality disorder?

I'm scared that you're going to leave me

a nurse working in an acute mental health facility is caring for a 35 year old female client who has manifestations of depression. the client lives at home with her partner and two young children. she currently smokes and has a history of chronic asthma. which of the following factors put the client at risk for depression?

age gender history of chronic asthma smoking

a nurse is discussing the risk factors for somatic symptom disorder with a newly licensed nurse. which of the following risk factors should the nurse include? (select all that apply)

anxiety disorder female gender

a nurse is planning care for a client who has body dysmorphic disorder. which of the following actions should the nurse plan to take first?

assessing the client's risk for self-harm

a nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. the nurse identifies that repetitive behavior in a client who has OCDE is due to which of the following underlying reasons?

attempt to reduce anxiety

a nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. which of the following findings should the nurse expect? (select all that apply)

attempts to convince other clients to give him their belongings blames others for his past and current problems

a nurse is leading a peer group discussion about the indications for ECT. which of the following indications should the nurse include in the discussion?

bipolar disorder with rapid cycling

a nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. which of the following should the nurse include in the teaching? (select all that apply)

change positions slowly to minimize dizziness chew sugarless gum to prevent dry mouth

a nurse is caring for a client who takes paroxetine to treat post traumatic stress disorder. the client states that he grinds his teeth during the night, which causes pain in his mouth. the nurse should identify which of the following interventions as possible measures to manage the client's bruxism? (select all that apply)

concurrent administration of buspirone use of a mouth guard changing to a different class of antianxiety medication

a nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. which of the following interventions should the nurse include as a primary intervention? (select all that apply)

conducting a suicide risk screening on all clients educating high school teens about suicide prevention teaching middle-school educators about warning indicators of suicide

a nurse is caring for a client who has depression and a new prescription for venlafaxine. for which of the following adverse effects should the nurse monitor this client? (select all that apply)

cough dizziness decreased libido

a nurse is reviewing the medical record of a client who has conversion disorder. which of the following findings should the nurse identify as placing the client at risk for conversion disorder?

death of a child 2 months ago

a nurse working on an acute mental health unit is caring for a client who has PTSD. which of the following findings should the nurse expect? (select all that apply)

difficulty concentrating on tasks negative self image recurring nightmares

a charge nurse is preparing a staff education session on personality disorders. which of the following personality characteristics associated with all of the personality disorders should the nurse include in the teaching? (select all that apply)

difficulty in getting along with other members of a group display of defense mechanisms when routines are changed difficulty understanding why it is inappropriate to have a personal relationship with staff

a nurse is developing a plan of care for a client who has conversion disorder. which of the following actions should the nurse include?

discuss alternate coping strategies with the client

a nurse is caring for a client who is on suicide precautions. which of the following interventions should the nurse include in the plan of care?

ensure that the client swallows medications

a nurse is assessing a client who has generalized anxiety disorder. which of the following findings should the nurse expect? (select all that apply)

excessive worry for 6 months restlessness need for reassurance

a nurse is caring for a client who has been taking sertaline for the past 2 days. which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?

fever

a nurse is assessing a client 4 hours after receiving an initial dose of fluoxetine. which of the following findings should the nurse report to the provider as indications of serotonin syndrome? (select all that apply)

hallucinations diaphoresis agitation

a nurse is performing an admission assessment of a client who has bulimia nervosa with purging behavior. which of the following is an expected finding? (select all that apply)

hypokalemia slightly elevated body weight

a nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. which of the following actions is the nurses priority?

identify the client's level of orientation

a nurse is assessing a client immediately following an ECT procedure. which of the following findings should the nurse expect? (select all that apply)

memory loss nausea confusion

a nurse working in a mental health clinic is providing teaching to a client who has a new prescription for diazepam for GAD. which of the following information should the nurse provide?

report confusion as a potential indication of toxicity

a nurse is caring for a client who has borderline personality disorder. the client says, "the nurse on the evening shift is always nice! you are the meanest nurse ever!" the nurse should recognize the client's statement as an example of which of the following defense mechanisms?

splitting

a nurse is caring for a client who is experiencing a panic attack. which of the following actions should the nurse take first?

stay with the client and remain calm

a nurse is involved in a serious and prolonged mass casualty in the ER. which of the following strategies should the nurse use to help prevent developing a trauma related disorder? (select all that apply)

take breaks during the incident for food and water debrief with others following the incident take advantage of offered counseling

a nurse is collecting an admission history for a client who has acute stress disorder. which of the following information should the nurse expect to collect?

the client expresses a sense of unreality about the traumatic incident

a nurse is reviewing the medical record of a client who has a new prescription for bupropion for depression. which of the following findings is the priority for the nurse to report to the provider?

the client had a motor vehicle crash last year and sustained a head injury

a nurse is teaching a client who has a new prescription for imipramine how to minimize the anticholinergic effects. which of the following instructions should the nurse include in the teaching? (select all that apply)

void just before taking the medication wear sunglasses when outside chew sugarless gum

a nurse is preparing to obtain a nursing history from a client who has new diagnosis of anorexia nervosa. which of the following questions should the nurse include in the assessment? (select all that apply)

what is your relationship like with your family? would you describe your current eating habits? can you discuss your feelings about your appearance?

a nurse is counseling a client who has factitious disorder imposed on another. which of the following client statements should the nurse expect?

"I needed to make my son sick so that someone else would take care of him for awhile"

a nurse in an acute mental health facility is planning care for a client who has dissociative fugue. which of the following interventions should the nurse add to the plan of care?

work with the client on grounding techniques

a nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for PTSD. which of the following statements should the nurse include in the teaching?

you may have a decreased desire for intimacy while taking this medication

a nurse working in an outpatient clinic is providing teaching to a client who has new diagnosis of premenstural dysphoric disorder (PMDD). which of the following statements by the client indicates understanding of the teaching?

I am aware that my PMDD causes me to have rapid mood swings

a nurse is providing teaching to a client who has a new prescription for amitriptyline. which of the following statements by the client indicates an understanding of the teaching?

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

a nurse is teaching a client who has a new prescription for escitalopram for treatment of GAD. which of the following statements by the client indicates understanding of the teaching?

I need to discontinue this medication slowly

A nurse on an acute care unit is planning care for a client who has anorexia nervosa with binge-eating and purging behavior. Which of the following nursing actions is appropriate to include in the client's plan of care?

implement one-to-one observation during meal times

a nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for paroxetine. which of the following instructions should the nurse include?

it can take several weeks before you feel like the medication is helping

a nurse is caring for a client who states, "I plan to commit suicide". which of the following assessments should the nurse identify as the priority?

lethality of the method and availability of means

a nurse is caring for an adolescent client who has anorexia nervosa with recent rapid weight loss and a current weight of 90 lbs. which of the following statements indicates the client is experiencing the cognitive distortion of catastrophizing?

life isn't worth living if I gain weight

a nurse is assessing a client who has illness anxiety disorder. which of the following findings should the nurse expect? (select all that apply)

obsessive thoughts about disease history of childhood abuse avoidance of health care providers depressive disorder

a nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. which of the following indicates that the client has developed an adverse effect of this medication?

orthostatic hypotension