NSG 357 EXAM 2 Readings!

Depression is so common, in fact, that it has been referred to as the...

"common cold of psychiatric disorders."

How does the batterer act in the honeymoon phase?

- the batterer becomes extremely loving, kind, and contrite - he promises her that the abuse will never recur and begs her forgiveness - he is afraid that she will leave him and uses every bit of charm that he has - he plays on her feelings of guilt, and she desperately wants to believe him

What happens in the tension-building phase?

- the woman senses that the man's tolerance for frustration is declining - minor battering incidents may occur during this phase, and in a desperate effort to avoid more serious confrontations, the woman accepts the abuse as legitimately directed towards her; she assumes the guilt for the abuse, even reasoning that perhaps she did deserve the abuse - the minor battering incidents continue, and the tension mounts as the woman waits for the impending explosion - the abuser begins to fear that his partner will leave him, which leads to increased jealousy and possessiveness. - she then withdraws from him, which he takes as rejection and that angers him more

Lithium range for maintenance

0.6 to 1.2 mEq/L

Severe postpartum depression occurs in...

1-2 women out of 1000

What are the stages of the cycle of battering in order?

1. tension building 2. acute battering incident 3. honeymoon phase

Lithium range for acute mania

1.0 to 1.5 mEq/L

Symptoms of lithium toxicity appear at blood levels greater than...

1.5 mEq/L

The lithium dosage should be withheld if levels reach...

1.5 mEq/L

The incidence of postpartum moderate depression is...

10-20%

Blood samples should be taken for lithium...

12 hours after the last dose

Suicide is the second leading cause of death in the...

15 to 24-year-old age group

While the elderly makes up 13% of the population, they account for ___ of all suicide in the US.

15%

The highest risk age group for rape is...

16 to 34 years old

Although the elderly only makes up 13% of the US population, they make up ____ of the suicides in the US

16%

The instance of bipolar disorder is relatively equal in women and men

1:2 to 1

Agoraphobia onset is usually in the...

20s and 30s and persists for many years

The nurse is prioritizing nursing diagnoses in the plan of care for a client experiencing a manic episode. Number the diagnoses in order of the appropriate priority. ____ a. Disturbed sleep pattern evidenced by sleeping only 4-5 hours per night. ____ b. Risk for injury related to manic hyperactivity ____ c. Impaired social interaction evidenced by manipulation of others ____ d. Imbalanced nutrition: less than body requirements evidenced by loss of weight and poor skin turgor

3, 1, 4, 2

Monozygotic twins have a ___ chance of heritability of recurrent depressive disorders.

37%

Divorced, widowed, and separated people have rates that are ___ than those that are married.

4-5x greater

Risk for suicide rises in adolescence, peak between...

40 to 50 and level off until age 65, when the rates rise again for the remaining years

Suicide risk is highest in clients over the age of...

50

Approximately ____ moms experience the baby blues after delivery

50-85%

What is the best distinguisher between a mood disorder and normal teenage behavior?

A visible manifestation of behavioral change that lasts for several weeks

A nurse is caring for four clients. Which of the following clients should the nurse identify as likely to experience difficulty in being assertive? Select all that apply. A. A 20-year-old woman who is completing college homework assignments for several peers. B. A 69-year-old widow who is socially isolated C. A 17-year-old boy with conduct disorder D. A 45-year-old successful executive E. A 50-year-old diagnosed with narcissistic personality disorder

A. A 20-year-old woman who is completing college homework assignments for several peers. B. A 69-year-old widow who is socially isolated C. A 17-year-old boy with conduct disorder

A psychiatrist who embraces the Psychological Recovery Model tells the nurse that a client is in the Growth stage. What should the nurse expect to find when assessing this client? A. A client feeling confident about achieving goals in life. B. A client who is aware of the need to set goals in life. C. A client who has mobilized personal and external resources. D. A client who begins to actively take control of his or her life.

A. A client feeling confident about achieving goals in life.

A client is admitted to the psychiatric unit with a diagnosis of major depressive disorder. The client is unable to concentrate, has no appetite, and is experiencing insomnia. Which should be included in this clients plan of care? A. A simple, structured daily schedule with limited choices of activities B. A daily schedule filled with activities to promote socialization C. A flexible schedule that allows the client opportunities for decision making D. A schedule that includes mandatory activities to decrease social isolation

A. A simple, structured daily schedule with limited choices of activities

A nurse notices a client clenching fists periodically and pacing the hallway. Which of the following nursing interventions would best assist the client at this time? Select all that apply. A. Acknowledge the clients behavior. B. Initiate forced medication protocol. C. Assist the client to a quiet area. D. Initiate confinement measures. E. Speak with a soft and calming voice.

A. Acknowledge the clients behavior. C. Assist the client to a quiet area. E. Speak with a soft and calming voice.

A client has a history of excessive fear of water. What is the term that a nurse should use to describe this specific phobia, and under what subtype is this phobia identified? A. Aquaphobia, a natural environment type of phobia B. Aquaphobia, a situational type of phobia C. Acrophobia, a natural environment type of phobia D. Acrophobia, a situational type of phobia

A. Aquaphobia, a natural environment type of phobia

Which nursing intervention strategy is most appropriate to implement initially with a suicidal client? A. Ask a direct question such as, Do you ever think about killing yourself? B. Ask client, Please rate your mood on a scale from 1 to 10. C. Establish a trusting nurseclient relationship. D. Apply the nursing process to the planning of client care.

A. Ask a direct question such as, Do you ever think about killing yourself?

A client diagnosed with bipolar disorder states, I hate oatmeal. Lets get everybody together to do exercises. Im thirsty and Im burning up. Get out of my way; I have to see that guy. What should be the priority nursing action? A. Assess the clients vital signs. B. Offer to have the dietitian discuss food preferences. C. Encourage the client to lead the exercise program in the community meeting. D. Acknowledge the client briefly and then walk away.

A. Assess the clients vital signs.

A client has been brought to the emergency department for signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD). The client has a history of a suicide attempt 1 year ago. Which nursing intervention would take priority in this situation? A. Assessing the clients pulse oximetry and vital signs B. Developing a plan for safety for the client C. Assessing the client for suicidal ideations D. Establishing a trusting nurseclient relationship

A. Assessing the clients pulse oximetry and vital signs

Which of the following instructions regarding lithium therapy should be included in a nurses discharge teaching? Select all that apply. A. Avoid excessive use of beverages containing caffeine. B. Maintain a consistent sodium intake. C. Consume at least 2,500 to 3,000 mL of fluid per day. D. Restrict sodium content. E. Restrict fluids to 1,500 mL per day.

A. Avoid excessive use of beverages containing caffeine. B. Maintain a consistent sodium intake. C. Consume at least 2,500 to 3,000 mL of fluid per day.

Which of the following explanations should a nurse include when teaching parents why is it difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? Select all that apply. A. Bipolar symptoms are similar to attention deficit-hyperactivity disorder symptoms. B. Children are naturally active, energetic, and spontaneous. C. Neurotransmitter levels vary considerably in accordance with age. D. The diagnosis of bipolar disorder cannot be assigned prior to the age of 18. E. Genetic predisposition is not a reliable diagnostic determinant.

A. Bipolar symptoms are similar to attention deficit-hyperactivity disorder symptoms. B. Children are naturally active, energetic, and spontaneous.

A client begins to smash furniture, cannot be talked down, and refuses medications. Which is the most appropriate nursing intervention? A. Call a violence code. B. Ask the ward clerk to put in a call for the physician. C. Place the client in seclusion. D. Place the client in four-point restraints.

A. Call a violence code.

Two clients are roommates on an inpatient psychiatric unit. At breakfast, client A, who had been missing her gold locket, notices client B wearing it. Which should a nurse recognize as a nonassertive or passive behavioral response from client A? A. Client A ignores the situation. B. Client A discusses the situation with her nurse and develops a plan of action. C. Client A immediately approaches client B and pulls the necklace off her neck. D. Client A offers to wash client Bs clothes and accidentally spills bleach in the water.

A. Client A ignores the situation.

A nursing instructor is teaching about the medications used to treat panic disorder. Which student statement indicates that learning has occurred? A. Clonazepam (Klonopin) is particularly effective in the treatment of panic disorder. B. Clozapine (Clozaril) is used off-label in long-term treatment of panic disorder. C. Doxepin (Sinequan) can be used in low doses to relieve symptoms of panic attacks. D. Buspirone (BuSpar) is used for its immediate effect to lower anxiety during panic attacks.

A. Clonazepam (Klonopin) is particularly effective in the treatment of panic disorder.

Two clients get into a heated argument regarding TV program selections. The nurse turns off the TV and asks the clients to go to their rooms to cool off, after which they will discuss and attempt to resolve the problem. The nurses action is promoting which assertive technique? A. Defusing B. Clouding or fogging C. Responding as a broken record D. Shifting from content to process

A. Defusing

A client diagnosed with major depressive disorder was raised in a strongly religious family where bad behavior was equated with sins against God. Which nursing intervention would be most appropriate to help the client address spirituality as it relates to his illness? A. Encourage the client to bring into awareness underlying sources of guilt. B. Teach the client that religious beliefs should be put into perspective throughout the life span. C. Confront the client with the irrational nature of the belief system. D. Assist the client to modify his or her belief system in order to improve coping skills.

A. Encourage the client to bring into awareness underlying sources of guilt.

A nurse has been caring for a client diagnosed with generalized anxiety disorder (GAD). Which of the following nursing interventions would address this clients symptoms? Select all that apply. A. Encourage the client to recognize the signs of escalating anxiety. B. Encourage the client to avoid any situation that causes stress. C. Encourage the client to employ newly learned relaxation techniques. D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety. E. Encourage the client to avoid caffeinated products.

A. Encourage the client to recognize the signs of escalating anxiety. C. Encourage the client to employ newly learned relaxation techniques. D. Encourage the client to cognitively reframe thoughts about situations that generate anxiety. E. Encourage the client to avoid caffeinated products.

A college student has been diagnosed with generalized anxiety disorder (GAD). Which of the following symptoms should a campus nurse expect this client to exhibit? Select all that apply. A. Fatigue B. Anorexia C. Hyperventilation D. Insomnia E. Irritability

A. Fatigue D. Insomnia E. Irritability

Some biological factors may be associated with the predisposition to suicide. Which of the following biological factors have been implicated? A. Genetics and decreased levels of serotonin B. Heredity and increased levels of norepinepherine C. Temporal lobe atrophy and decreased levels of acetylcholine D. Structural alterations of the brain and increased levels of dopamine.

A. Genetics and decreased levels of serotonin

Which of the following has the SAMHSA described, as major dimensions of support for a life of recovery? Select all that apply. A. Health B. Community C. Home D. Religious affiliation E. Purpose

A. Health B. Community C. Home E. Purpose

A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order? A. History of alcohol dependence B. History of personality disorder C. History of schizophrenia D. History of hypertension

A. History of alcohol dependence

A client is admitted with a diagnosis of persistent depressive disorder. Which client statement would describe a symptom consistent with this diagnosis? A. I am sad most of the time and Ive felt this way for the last several years. B. I find myself preoccupied with death. C. Sometimes I hear voices telling me to kill myself. D. Im afraid to leave the house.

A. I am sad most of the time and Ive felt this way for the last several years.

After a teenager reveals that he is gay, the father responds by beating him. The next morning, the teenager is found hanging in his closet. Which paternal grief responses should a nurse anticipate? Select all that apply. A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me! D. Im just going to have to accept that he was gay. E. Well, that was a selfish thing to do.

A. I cant believe this is happening. B. If only I had been more understanding. C. How dare he do this to me!

A client diagnosed with panic disorder states, When an attack happens, I feel like I am going to die. Which is the most appropriate nursing reply? A. I know its frightening, but try to remind yourself that this will only last a short time. B. Death from a panic attack happens so infrequently that there is no need to worry. C. Most people who experience panic attacks have feelings of impending doom. D. Tell me why you think you are going to die every time you have a panic attack.

A. I know its frightening, but try to remind yourself that this will only last a short time.

A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling this situation in a healthy manner? A. I know that it was not my fault. B. My boyfriend has trouble controlling his sexual urges. C. If I dont put myself in a dating situation, I wont be at risk. D. Next time I will think twice about wearing a sexy dress.

A. I know that it was not my fault.

Which client statement demonstrates improvement in anger/aggression management? A. I realize I have a problem expressing my anger appropriately. B. I know I cant use physical force anymore, but I can intimidate someone with my words. C. Its bad to feel as angry as I feel. Im working on eliminating this poisonous emotion entirely. D. Because my wife seems to be the one to set me off, Ive decided to remain separated from her.

A. I realize I have a problem expressing my anger appropriately.

A nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement would indicate a need for further follow-up instructions? A. I will need scheduled bloodwork in order to monitor for toxic levels of this drug. B. I wont stop taking this medication abruptly, because there could be serious complications. C. I will not drink alcohol while taking this medication. D. I wont take extra doses of this drug because I can become addicted.

A. I will need scheduled bloodwork in order to monitor for toxic levels of this drug.

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? Select all that apply. A. Ill have to let my surgeon know about this medication before I have my cholecystectomy. B. Guess I will have to give up my glass of red wine with dinner. C. Ill have to be very careful about reading food and medication labels. D. Im going to miss my caffeinated coffee in the morning. E. Ill be sure not to stop this medication abruptly.

A. Ill have to let my surgeon know about this medication before I have my cholecystectomy. B. Guess I will have to give up my glass of red wine with dinner. C. Ill have to be very careful about reading food and medication labels. E. Ill be sure not to stop this medication abruptly.

A nursing student is developing a study guide related to historical facts about suicide. Which of the following facts should the student include? Select all that apply. A. In the Middle Ages, suicide was viewed as a selfish and criminal act. B. During the Roman Empire, suicide was followed by incineration of the body. C. Suicide was an offense in ancient Greece, and a common-site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically. E. Old Norse traditionally set a person who committed suicide adrift in the North Sea.

A. In the Middle Ages, suicide was viewed as a selfish and criminal act. C. Suicide was an offense in ancient Greece, and a common-site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically.

When planning care for women in abusive relationships, which of the following information is important for the nurse to consider? Select all that apply. A. It often takes several attempts before a woman leaves an abusive situation. B. Substance abuse is a common factor in abusive relationships. C. Until children reach school age, they are usually not affected by parental discord. D. Women in abusive relationships usually feel isolated and unsupported. E. Economic factors rarely play a role in the decision to stay in abusive relationships.

A. It often takes several attempts before a woman leaves an abusive situation. B. Substance abuse is a common factor in abusive relationships. D. Women in abusive relationships usually feel isolated and unsupported.

Which of the following are behavioral components of assertive communication? A. Listening B. You statements C. Closed posture D. Continuous direct eye contact

A. Listening

A client who has been diagnosed with bipolar I disorder states, God has taught me how to decode the Bible. A nurse should anticipate that which combination of medications would be ordered to address this clients symptoms? A. Lithium carbonate (Lithobid) and risperidone (Risperdal) B. Lithium carbonate (Lithobid) and carbamazepine (Tegretol) C. Valproic acid (Depakote) and sertraline (Zoloft) D. Valproic acid (Depakote) and lamotrigine (Lamictal)

A. Lithium carbonate (Lithobid) and risperidone (Risperdal)

Which of the following nursing diagnoses would be expected for an adult survivor of incest? Select all that apply. A. Low self-esteem B. Powerlessness C. Disturbed personal identity D. Knowledge deficit E. Noncompliance

A. Low self-esteem B. Powerlessness

A client states, My illness is so devastating, I feel like my life is on hold. The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andersen and associates? A. Moratorium B. Awareness C. Preparation D. Rebuilding

A. Moratorium

Although historically lithium has been the medication of choice for mania, several others have been used with good results. Which of the following are used in the treatment of bipolar disorder? Select all that apply. A. Olanzepine (Zyprexa) B. Paroxetine (Paxil) C. Carbamazepine (Tegretol) D. Gabapentin (Neurontin) E. Tranylcypromine (Parnate)

A. Olanzepine (Zyprexa) C. Carbamazepine (Tegretol) D. Gabapentin (Neurontin)

Arthur, who is diagnosed with obsessive-compulsive disorder, reports to the nurse that he cant stop thinking about all the potentially life threatening germs in the environment. What is the most accurate way for the nurse to document this symptom? A. Patient is expressing an obsession with germs. B. Patient is manifesting compulsive thinking. C. Patient is expressing delusional thinking about germs. D. Patient is manifesting arachnophobia of germs.

A. Patient is expressing an obsession with germs.

A psychiatrist prescribes a monoamine oxidase inhibitor (MAOI) for a client. Which foods should the nurse teach the client to avoid? A. Pepperoni pizza and red wine B. Bagels with cream cheese and tea C. Apple pie and coffee D. Potato chips and diet cola

A. Pepperoni pizza and red wine

Which statement made by an emergency department nurse indicates accurate knowledge of domestic violence? A. Power and control are central to the dynamic of domestic violence. B. Poor communication and social isolation are central to the dynamic of domestic violence. C. Erratic relationships and vulnerability are central to the dynamic of domestic violence. D. Emotional injury and learned helplessness are central to the dynamic of domestic violence.

A. Power and control are central to the dynamic of domestic violence.

A client is diagnosed with bipolar I disorder: manic episode. Which nursing intervention would be implemented to achieve the outcome of Client will gain 2 pounds by the end of the week? A. Provide client with high-calorie finger foods throughout the day. B. Accompany client to cafeteria to encourage adequate dietary consumption. C. Initiate total parenteral nutrition to meet dietary needs. D. Teach the importance of a varied diet to meet nutritional needs.

A. Provide client with high-calorie finger foods throughout the day.

A client diagnosed with obsessive-compulsive disorder states, I really think my future will improve because of my successful treatment choices. Im going to make my life better. Which guiding principle of recovery has assisted this client? A. Recovery emerges from hope. B. Recovery is person-driven. C. Recovery occurs via many pathways. D. Recovery is holistic.

A. Recovery emerges from hope.

A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent job loss. What should be the priority nursing diagnosis for this client? A. Risk for suicide R/T hopelessness B. Anxiety: severe R/T hyperactivity C. Imbalanced nutrition: less than body requirements R/T refusal to eat D. Dysfunctional grieving R/T loss of employment

A. Risk for suicide R/T hopelessness

A client who has been diagnosed with a phobic disorder asks the nurse if there are any medications that would be beneficial in treating phobic disorders. Which of the following would be accurate responses by the nurse? Select all that apply. A. Some antianxiety agents have been successful in treating social phobias. B. Some antidepressant agents have been successful in diminishing symptoms of agoraphobia and social anxiety disorder (social phobia). C. Specific phobias are generally not treated with medication unless accompanied by panic attacks. D. Beta-blockers have been used successfully to treat phobic responses to public performance.

A. Some antianxiety agents have been successful in treating social phobias. B. Some antidepressant agents have been successful in diminishing symptoms of agoraphobia and social anxiety disorder (social phobia). C. Specific phobias are generally not treated with medication unless accompanied by panic attacks. D. Beta-blockers have been used successfully to treat phobic responses to public performance.

A 20-year-old female has a diagnosis of premenstrual dysphoric disorder. Which of the following should a nurse identify as consistent with this diagnosis? Select all that apply. A. Symptoms are causing significant interference with work, school, and social relationships. B. Patient-rated mood is 2/10 for the past 6 months C. Mood swings occur the week before onset of menses D. Patient reports subjective difficulty concentrating E. Patient manifests pressured speech when communicating

A. Symptoms are causing significant interference with work, school, and social relationships. C. Mood swings occur the week before onset of menses D. Patient reports subjective difficulty concentrating

Which assessment data should a school nurse recognize as signs of physical neglect? A. The child is often absent from school and seems apathetic and tired. B. The child is very insecure and has poor self-esteem. C. The child has multiple bruises on various body parts. D. The child has sophisticated knowledge of sexual behaviors.

A. The child is often absent from school and seems apathetic and tired.

A kindergarten student is frequently violent toward other children. A school nurse notices bruises and burns on the childs face and arms. What other symptom should indicate to the nurse that the child might have been physically abused? A. The child shrinks at the approach of adults. B. The child begs or steals food or money. C. The child is frequently absent from school. D. The child is delayed in physical and emotional development.

A. The child shrinks at the approach of adults.

A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, Im going to use a knotted shower curtain when no one is around. Which information would determine the nurses plan of care for this client? A. The more specific the plan is, the more likely the client will attempt suicide. B. Clients who talk about suicide never actually commit it. C. Clients who threaten suicide should be observed every 15 minutes. D. After a brief assessment, the nurse should avoid the topic of suicide.

A. The more specific the plan is, the more likely the client will attempt suicide.

A nurse uses the commitments of the Tidal Model of Recovery in psychiatric nursing practice. Which of the following nursing actions reflect the use of the Develop Genuine Curiosity commitment? Select all that apply. A. The nurse expresses interest in the clients story. B. The nurse asks for clarification of certain points. C. The nurse encourages the client to speak his own words in his own unique way. D. The nurse assists the client to unfold the story at his or her own rate. E. The nurse provides the clients with copies of all documents relevant to care.

A. The nurse expresses interest in the clients story. B. The nurse asks for clarification of certain points. D. The nurse assists the client to unfold the story at his or her own rate.

A nurse reviews the laboratory data of a 29-year-old client suspected of having major depressive disorder. Which laboratory value would potentially rule out this diagnosis? A. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL B. Potassium (K+) level of 4.2 mEq/L C. Sodium (Na+) level of 140 mEq/L D. Calcium (Ca2+) level of 9.5 mg/dL

A. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL

A nurse begins the intake assessment of a client diagnosed with bipolar I disorder. The client shouts, You cant do this to me. Do you know who I am? Which is the priority nursing action in this situation? A. To provide self and client with a safe environment B. To redirect the client to the needed assessment information C. To provide high-calorie finger foods to meet nutritional needs D. To reorient the client to person, place, time, and situation

A. To provide self and client with a safe environment

A client is admitted in a manic episode of bipolar I disorder. Which nursing intervention should be most therapeutic for this client? A. Using a calm, unemotional approach during client interactions B. Focusing primarily on enforcing limits C. Limiting interactions to decrease external stimuli D. Encouraging the client to establish social relationships with peers

A. Using a calm, unemotional approach during client interactions

During an assertiveness training group, a nurse suggests using I statements. The group questions the usefulness of this communication technique. Which explanation by the nurse is most appropriate? A. When I statements are used, opinions are communicated without blaming others. B. When I statements are used, anger is displaced by using indirect means. C. When I statements are used, responsibility for ones behavior is attributed to another. D. When I statements are used, eye contact is promoted.

A. When I statements are used, opinions are communicated without blaming others.

One nurse confronts another and says, You are always so talkative in the meetings. I dont know why you cant stay quiet sometimes. Which reply by the other nurse reflects the technique of clouding/fogging? A. Youre right. I do speak up a lot. B. Sounds to me like youre agitated and we need to talk. What are you truly angry about? C. Are you offended that I speak up, or because my thoughts are in opposition to yours? D. I have the right to express my opinion.

A. Youre right. I do speak up a lot.

Annie has trichotillomania. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? (Select all that apply) A. awareness training B. competing response training C. social support D. hypnotherapy E. aversive therapy

A. awareness training B. competing response training C. social support

What has been identified as the most common comorbid disorder in children and adolescents with bipolar disorder?

ADHD

Stage II

Acute mania

Depression is associated with dysfunction of the adrenal cortex and is observed in...

Addison's disease and Cushing's syndrome

What is a behavior intended to threaten or injure the victim's security or self-esteem. It means "to go against," "to assault," or "to attack." It is a response that aims at inflicting pain or injury on objects or people; whether the damage is caused by words, fists, or weapons, the behavior is virtually always designed to punish; it is frequently accompanied by bitterness, meanness, and ridicule?

Aggression

What is a negative function or destructive use of anger?

Aggression

Who maintains their own rights while violating the rights of others?

Aggressive individuals

What can be used in the treatment of dysthymia, MDD with melancholia or psychotic symptoms, depression associated with organic disease, alcoholism, schizophrenia, or intellectual developmental disorder, and depression accompanied by anxiety?

Antidepressants

Who stands up for their own rights while protecting the rights of others?

Assertive individuals

Janet has a diagnosis of generalized anxiety disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? A. "xanax is not effective for generalized anxiety disorder" B. "buspirone must be taken daily in order to be effective" C. "i will ask the doctor if he will change your dose of Buspirone to PRN so that you don't have to take it every day" D. "your friend really should be taking the Xanax every day"

B. "buspirone must be taken daily in order to be effective"

A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. The nurse should correlate these symptoms with which lithium level? A. 1.3 mEq/L B. 1.7 mEq/L C. 2.3 mEq/L D. 3.7 mEq/L

B. 1.7 mEq/L

A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, I heard about something called a monoamine oxidase inhibitor (MAOI). Cant my doctor add that to my medications? Which is an appropriate nursing reply? A. This combination of drugs can lead to delirium tremens. B. A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis. C. Thats a good idea. There have been good results with the combination of these two drugs. D. The only disadvantage would be the exorbitant cost of the MAOI.

B. A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis.

Once the nurse initiates restraint for an out-of-control 45-year-old patient, what must occur within 1 hour, according to JCAHO standards? A. The patient must be let out of restraint. B. A physician or other licensed independent practitioner must conduct an in-person evaluation. C. The patient must be bathed and fed. D. The patient must be included in debriefing.

B. A physician or other licensed independent practitioner must conduct an in-person evaluation.

A client diagnosed with bipolar I disorder is distraught over insomnia experienced over the last 3 nights and a 12-pound weight loss over the past 2 weeks. Which should be this clients priority nursing diagnosis? A. Knowledge deficit R/T bipolar disorder AEB concern about symptoms B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss C. Risk for suicide R/T powerlessness AEB insomnia and anorexia D. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights

B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss

A nursing instructor is teaching about suicide in the elderly population. Which information should the instructor include? A. Elderly people use less lethal means to commit suicide. B. Although the elderly make up less than 13% of the population, they account for 16% of all suicides. C. Suicide is the second leading cause of death among the elderly. D. It is normal for elderly individuals to express a desire to die, because they have come to terms with their mortality.

B. Although the elderly make up less than 13% of the population, they account for 16% of all suicides.

A nursing instructor is teaching about the concept of anger. Which student statement indicates the need for further instruction? A. Anger is physiological arousal. B. Anger and aggression are essentially the same. C. Anger expression is a learned response. D. Anger is not a primary emotion.

B. Anger and aggression are essentially the same.

A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member states, Should I seek psychiatric help for my mother? Which is an appropriate nursing reply? A. My mother also worries unnecessarily. I think it is part of the aging process. B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning. C. From what you have told me, you should get her to a psychiatrist as soon as possible. D. Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications.

B. Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning.

A client continually waits more than an hour before being seen at the mental health clinic. The client approaches the nurse and states, When I have to wait for more than an hour to be seen, I feel like my time is not important. The nurse recognizes this as what type of behavior? A. Aggressive behavior B. Assertive behavior C. Passiveaggressive behavior D. Passive behavior

B. Assertive behavior

A client states, I have come to the conclusion that this disease has not paralyzed me. The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andersen and associates? A. Moratorium B. Awareness C. Preparation D. Rebuilding

B. Awareness

A nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder. The client states, Im feeling a lot better, so you can stop watching me. I have taken up too much of your time already. Which is the best nursing reply? A. I really appreciate your concern but I have been ordered to continue to watch you. B. Because we are concerned about your safety, we will continue to observe you. C. I am glad you are feeling better. The treatment team will consider your request. D. I will forward you request to your psychiatrist because it is his decision.

B. Because we are concerned about your safety, we will continue to observe you.

During a psychoeducational group on assertiveness training, a client asks, Why do we need to learn about this stuff? Which is the most appropriate nursing reply? A. Because your doctor requires you to attend this group. B. Being assertive is the ability to stand up for yourself while respecting the rights of others. C. Assertiveness training teaches you how to ask for what you want, when you want it. D. Assertive people place the needs and rights of others before their own.

B. Being assertive is the ability to stand up for yourself while respecting the rights of others.

A newly admitted client diagnosed with major depressive disorder states, I have never considered suicide. Later the client confides to the nurse about plans to end it all by medication overdose. What is the most helpful nursing reply? A. There is nothing to worry about. We will handle it together. B. Bringing this up is a very positive action on your part. C. We need to talk about the things you have to live for. D. I think you should consider all your options prior to taking this action.

B. Bringing this up is a very positive action on your part.

A client presents in the emergency department with complaints of overwhelming anxiety. Which of the following is a priority for the nurse to assess? A. Risk for suicide B. Cardiac status C. Current stressors D. Substance use history

B. Cardiac status

A newly admitted client is diagnosed with major depressive disorder with suicidal ideations. Which would be the priority nursing intervention for this client? A. Teach about the effect of suicide on family dynamics. B. Carefully and unobtrusively observe on the basis of assessed data, at varied intervals around the clock. C. Encourage the client to spend a portion of each day interacting within the milieu. D. Set realistic achievable goals to increase self-esteem.

B. Carefully and unobtrusively observe on the basis of assessed data, at varied intervals around the clock.

A student nurse has just entered a psychiatric rotation. The student asks a nursing instructor, How will we know if someone may get violent? Which is the most appropriate reply by the nursing instructor? A. You cant really say for sure. There are limited indicators of potential violence. B. Certain behaviors indicate a potential for violence. They are labeled as a prodromal syndrome and include rigid posture, clenched fists, and raised voice. C. Any client can become violent, so it is best to be aware of your surroundings at all times. D. When a client suddenly becomes quiet, is withdrawn, and maintains a flat affect, this is an indicator of potential violence.

B. Certain behaviors indicate a potential for violence. They are labeled as a prodromal syndrome and include rigid posture, clenched fists, and raised voice.

Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is the most appropriate in this instance? A. Obtain an order from the physician to place Theresa in restraints to prevent any attempts to harm herself. B. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis. C. Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. D. Do not allow Theresa to participate in any unit activities while she is on suicide precautions.

B. Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis.

For select clients, physical restraint is considered to be a beneficial intervention. This is based on which premise? A. Clients with poor boundaries do not respond to verbal redirection, and they need firm and consistent limit setting. B. Clients with limited internal control over their behavior need external controls to prevent harm to themselves and others. C. Clients with antisocial tendencies need to submit to authority. D. Clients with behavioral dysfunction need behavioral interventions.

B. Clients with limited internal control over their behavior need external controls to prevent harm to themselves and others.

What is the priority reason for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder? A. The attention during the assessment is beneficial in decreasing social isolation. B. Depression is a symptom of several medical conditions. C. Physical health complications are likely to arise from antidepressant therapy. D. Depressed clients avoid addressing physical health and ignore medical problems.

B. Depression is a symptom of several medical conditions.

A client has the following symptoms: preoccupation with imagined defect, verbalizations that are out of proportion to actual physical abnormalities, and numerous visits to plastic surgeons to seek relief. Which nursing diagnosis would best describe the problems evidenced by these symptoms? A. Ineffective coping B. Disturbed body image C. Complicated grieving D. Panic anxiety

B. Disturbed body image

An individual experiences sadness and melancholia in September continuing through November. Which of the following factors should a nurse identify as most likely to contribute to the etiology of these symptoms? Select all that apply. A. Gender differences in social opportunities that occur with age B. Drastic temperature and barometric pressure changes C. Increased levels of melatonin D. Variations in serotonergic functioning E. Inaccessibility of resources for dealing with life stressors

B. Drastic temperature and barometric pressure changes C. Increased levels of melatonin D. Variations in serotonergic functioning

Which is the priority focus of recovery models? A. Empowerment of the health-care team to bring their expertise to decision-making B. Empowerment of the client to make decisions related to individual health care C. Empowerment of the family system to provide supportive care D. Empowerment of the physician to provide appropriate treatments

B. Empowerment of the client to make decisions related to individual health care

What tool should a nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? A. Risky Activity tool B. FIND tool C. Consensus Committee tool D. Monotherapy tool

B. FIND tool

A newly admitted client is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to assess? A. Pacing B. Flight of ideas C. Lability of mood D. Irritability

B. Flight of ideas

A clients spouse asks, What evidence supports the possibility of genetic transmission of bipolar disorder? Which is the best nursing reply? A. Clients diagnosed with bipolar disorders have alterations in neurochemicals that affect behaviors. B. Higher rates of relatives diagnosed with bipolar disorder are found in families of clients diagnosed with this disorder. C. Higher rates of relatives of clients diagnosed with bipolar disorder respond in an exaggerated way to daily stress. D. More individuals diagnosed with bipolar disorder come from higher socioeconomic and educational backgrounds.

B. Higher rates of relatives diagnosed with bipolar disorder are found in families of clients diagnosed with this disorder.

Which risk factor should a nurse recognize as the most reliable indicator of potential client violence? A. A diagnosis of schizotypal personality disorder B. History of assaultive behavior C. Family history of violence D. Recent eviction from a homeless shelter

B. History of assaultive behavior

A client diagnosed with alcohol abuse disorder is referred to a residential care facility after discharge. According to the SAMHSA, which dimension of recovery is supporting this client? A. Health B. Home C. Purpose D. Community

B. Home

After years of dialysis, an 84-year-old states, Im exhausted, depressed, and done with these attempts to keep me alive. Which question should the nurse ask the spouse when preparing a discharge plan of care? A. Have there been any changes in appetite or sleep? B. How often is your spouse left alone? C. Has your spouse been following a diet and exercise program consistently? D. How would you characterize your relationship with your spouse?

B. How often is your spouse left alone?

Which client statement would the nurse recognize as indicating that the client understands dietary teaching related to lithium carbonate (Lithobid) treatment? A. I will limit my intake of fluids daily. B. I will maintain normal salt intake. C. I will take Lithobid on an empty stomach. D. I will increase my caloric intake to prevent weight loss.

B. I will maintain normal salt intake.

A nursing instructor is teaching about components present in the recovery process, as described by Andresen and associates, which led to the development of the Psychological Recovery Model. Which student statement indicates that further teaching is needed? A. A client has a better chance of recovery if he or she truly believes that recovery can occur. B. If a client is willing to give the responsibility of treatment to the health-care team, he or she is likely to recover. C. A client who has a positive sense of self and a positive identity is likely to recover. D. A client has a better chance of recovery if he or she has purpose and meaning in life.

B. If a client is willing to give the responsibility of treatment to the health-care team, he or she is likely to recover.

After teaching a client about lithium carbonate (Lithane), a nurse would consider the teaching successful on the basis of which client statement? A. I should expect to feel better in a couple of days. B. Ill call my doctor immediately if I experience any diarrhea or ringing in my ears. C. If I forget a dose, I can double the dose the next time I take this drug. D. I need to restrict my intake of any food containing salt.

B. Ill call my doctor immediately if I experience any diarrhea or ringing in my ears.

An isolative client was admitted 4 days ago with a diagnosis of major depressive disorder. Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu? A. Well go to the day room when you are ready for group. B. Ill walk with you to the day room. Group is about to start. C. It must be difficult for you to attend group when you feel so bad. D. Let me tell you about the benefits of attending this group.

B. Ill walk with you to the day room. Group is about to start.

A nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions. The nurse should recognize that which client statement would provide supportive evidence of this symptom? A. I cant stop my sexual urges. They have led me to numerous affairs. B. Im the worlds most perceptive attorney. C. My wife is distraught about my overspending. D. The FBI is out to get me.

B. Im the worlds most perceptive attorney.

A client who has been taking buspirone (BuSpar) as prescribed for 2 days is close to discharge. Which statement indicates to the nurse that the client has an understanding of important discharge teaching? A. I cannot drink any alcohol with this medication. B. It is going to take 2 to 3 weeks in order for me to begin to feel better. C. This drug causes physical dependence, and I need to strictly follow doctors orders. D. I cant take this medication with food. It needs to be taken on an empty stomach.

B. It is going to take 2 to 3 weeks in order for me to begin to feel better.

A client admitted to the psychiatric unit following a suicide attempt is diagnosed with major depressive disorder. Which behavioral symptoms should the nurse expect to assess? A. Anxiety and unconscious anger B. Lack of attention to grooming and hygiene C. Guilt and indecisiveness D. Low self-esteem

B. Lack of attention to grooming and hygiene

Which statement indicates that the nurse is acting as an advocate for a client who was hospitalized after a suicide attempt and is now nearing discharge? A. I must observe you continually for 1 hour in order to keep you safe. B. Lets confer with the treatment team about the resources that you may need after discharge. C. You must have been very upset to do what you did today. D. Are you currently thinking about harming yourself?

B. Lets confer with the treatment team about the resources that you may need after discharge.

An adult client assaults another client and is placed in restraints. Which statement from the client while in restraints should alert a nurse that further assessment is necessary? A. I hate all of you! B. My fingers are tingly. C. You wait until I tell my lawyer. D. I have a sinus headache.

B. My fingers are tingly.

At 3 a.m., when less restrictive methods fail, a physician orders restraints for an angry, aggressive client. To meet Joint Commission standards, at what time and by whom should a nurse expect an in-person client evaluation? A. No later than 8 a.m., by a licensed independent practitioner or a clinical nurse specialist B. No later than 4 a.m., by a physician or a licensed independent practitioner (LIP) C. No later than 3:30 a.m., by a physician or the clients case manager D. No later than 6 a.m., by the psychiatrist or a clinical nurse specialist

B. No later than 4 a.m., by a physician or a licensed independent practitioner (LIP)

An emergency department nurse, who has worked 10 straight days, is pulled to the psychiatric unit. Which represents a passiveaggressive statement by the emergency department nurse? A. Get someone else to work 3 to 11! Ive been working 10 days straight, and I need a break! B. Okay. Ill do it, then purposefully leaves paperwork undone when leaving the unit at 11 p.m. C. I have worked 10 days straight, and I cannot work tonight. I will work for you tomorrow if you need me. D. Yes, Ill do it. Anything to keep peace with the hospital administration is a good thing.

B. Okay. Ill do it, then purposefully leaves paperwork undone when leaving the unit at 11 p.m.

An anorexic client states to a nurse, My father has recently moved back to town. Since that time the client has experienced insomnia, nightmares, and panic attacks that occur nightly. She has never married or dated and lives alone. What should the nurse suspect? A. Possible major depressive disorder B. Possible history of childhood incest C. Possible histrionic personality disorder D. Possible history of childhood bulimia

B. Possible history of childhood incest

A nurse recently admitted a client to an inpatient unit after a suicide attempt. A health-care provider orders amitriptyline (Elavil) for the client. Which intervention related to this medication should be initiated to maintain this clients safety upon discharge? A. Provide a 6-month supply of Elavil to ensure long-term compliance. B. Provide a 1-week supply of Elavil with refills contingent on follow-up appointments. C. Provide a pill dispenser as a memory aid. D. Provide education regarding the avoidance of foods containing tyramine.

B. Provide a 1-week supply of Elavil with refills contingent on follow-up appointments.

A nursing instructor is teaching about the guiding principles of the recovery model, as described by the SAMHSA. Which student statement indicates that further teaching is needed? A. Recovery occurs via many pathways. B. Recovery emerges from strong religious affiliations. C. Recovery is supported by peers and allies. D. Recovery is culturally based and influenced.

B. Recovery emerges from strong religious affiliations.

A nurse maintains a clients confidentiality, addresses the client appropriately, and does not discriminate on the basis of gender, age, race, or religion. Which guiding principle of recovery has this nurse employed? A. Recovery is culturally based and influenced. B. Recovery is based on respect. C. Recovery involves individual, family, and community strengths and responsibility. D. Recovery is person-driven.

B. Recovery is based on respect.

A client is brought to an emergency department after being violently raped. Which nursing action is appropriate? A. Discourage the client from discussing the event, as this may lead to further emotional trauma. B. Remain nonjudgmental and actively listen to the clients description of the event. C. Meet the clients self-care needs by assisting with showering and perineal care. D. Provide cues, based on police information, to encourage further description of the event.

B. Remain nonjudgmental and actively listen to the clients description of the event.

The nurse observes a clients escalating anger. The client begins to pace the hall and shouts, You all better watch out. Im going to hurt anyone who gets in my way. Which should be the priority nursing intervention? A. Calmly tell the client, Staff will help you to control your impulse to hurt others. B. Remove other clients from the area and maintain milieu safety. C. Gather a show of force by contacting security for assistance. D. Calmly tell the client, You will need to be medicated and secluded.

B. Remove other clients from the area and maintain milieu safety.

A nursing student questions an instructor regarding the order for fluvoxamine (Luvox), 300 mg daily, for a client diagnosed with obsessive-compulsive disorder (OCD). Which instructor reply is most accurate? A. High doses of tricyclic medications will be required for effective treatment of OCD. B. Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD. C. The dose of Luvox is low due to the side effect of daytime drowsiness and nighttime insomnia. D. The dosage of Luvox is outside the therapeutic range and needs to be questioned.

B. Selective serotonin reuptake inhibitor (SSRI) doses, in excess of what is effective for treating depression, may be required for OCD.

A teenager gets a C in algebra. The mother angrily states, All you ever do is listen to music and text your friends. The teenager replies, What is it that youre really upset about, mom? Which response pattern is the teenager expressing? A. Clouding and fogging B. Shifting from content to process C. Delaying assertively D. Assuming responsibility for ones own statements

B. Shifting from content to process

Which nursing approach is likely to be most therapeutic when dealing with a newly admitted, hostile, suspicious client? A. Place a hand on the clients shoulder and state, I will help you to your room. B. Slowly and matter-of-factly state, I am your nurse and I will show you to your room. C. Firmly set limits by stating, If your behavior does not improve you will be secluded. D. Smile and state, I am your nurse. When do you want to go to your room?

B. Slowly and matter-of-factly state, I am your nurse and I will show you to your room.

A client is diagnosed with major depressive disorder. Which nursing diagnosis should a nurse assign to this client to address a behavioral symptom of this disorder? A. Altered communication R/T feelings of worthlessness AEB anhedonia B. Social isolation R/T poor self-esteem AEB secluding self in room C. Altered thought processes R/T hopelessness AEB persecutory delusions D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

B. Social isolation R/T poor self-esteem AEB secluding self in room

A nursing instructor is teaching about violence-intervention protocols. Which student statement would indicate the need for further instruction? A. Administering psychotropic medications can be a part of violence-intervention protocols. B. Soothing the client by stroking an arm or shoulder can be a part of violence-intervention protocols. C. Applying leather restraints can be a part of violence-intervention protocols. D. Calling for assistance is a part of violence-intervention protocols.

B. Soothing the client by stroking an arm or shoulder can be a part of violence-intervention protocols.

A stockbroker commits suicide after being convicted of insider trading. In speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? A. Your grieving will subside within 1 year; until then I recommend antidepressants. B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area. C. The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them. D. Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone.

B. Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area.

A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia. The nurse would expect which of the following behavioral therapies to be most commonly used in the treatment of phobias? Select all that apply. A. Benzodiazepine therapy B. Systematic desensitization C. Imploding (flooding) D. Assertiveness training E. Aversion therapy

B. Systematic desensitization C. Imploding (flooding)

A client is diagnosed with cyclothymic disorder. What client behaviors should the nurse expect to assess? A. The client expresses feeling blue most of the time. B. The client has endured periods of elation and dysphoria lasting for more than 2 years. C. The client fixates on hopelessness and thoughts of suicide continually. D. The client has labile moods with periods of acute mania.

B. The client has endured periods of elation and dysphoria lasting for more than 2 years.

Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self? A. The client will not physically harm self. B. The client will express three positive self-attributes by day 4. C. The client will reveal a suicide plan. D. The client will establish a trusting relationship.

B. The client will express three positive self-attributes by day 4.

A client diagnosed with obsessive-compulsive disorder is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which would be an appropriate initial client outcome during the first week of hospitalization? A. The client will refrain from ritualistic behaviors during daylight hours. B. The client will wake early enough to complete rituals prior to breakfast. C. The client will participate in three unit activities by day 3. D. The client will substitute a productive activity for rituals by day 1.

B. The client will wake early enough to complete rituals prior to breakfast.

A client who is diagnosed with major depressive disorder asks the nurse what causes depression. Which of these is the most accurate response? A. Depression is caused by a deficiency in neurotransmitters, including serotonin and norepinephrine. B. The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role. C. Depression is a learned state of helplessness cause by ineffective parenting. D. Depression is caused by intrapersonal conflict between the id and the ego.

B. The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role.

A nursing instructor is teaching about recovery as it applies to mental illness. Which student statement indicates that further teaching is needed? A. The goal of recovery is improved health and wellness. B. The goal of recovery is expedient, comprehensive behavioral change. C. The goal of recovery is the ability to live a self-directed life. D. The goal of recovery is the ability to reach full potential.

B. The goal of recovery is expedient, comprehensive behavioral change.

Success of long-term psychotherapy with Theresa (Who attempted suicide following a break up with her boyfriend) could be measured by which of the following behaviors? A. Theresa has a new boyfriend B. Theresa has an increased sense of self-worth C. Theresa does not take antidepressants anymore D. Theresa told her old boyfriend how angry she was with him for breaking up with her

B. Theresa has an increased sense of self-worth

A nursing instructor is teaching about specific phobias. Which student statement should indicate that learning has occurred? A. These clients do not recognize that their fear is excessive, and they rarely seek treatment. B. These clients have overwhelming symptoms of panic when exposed to the phobic stimulus. C. These clients experience symptoms that mirror a cerebrovascular accident (CVA). D. These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis.

B. These clients have overwhelming symptoms of panic when exposed to the phobic stimulus.

A nursing instructor is teaching about the prevalence of bipolar disorder. Which student statement indicates that learning has occurred? A. This disorder is more prevalent in the lower socioeconomic groups. B. This disorder is more prevalent in the higher socioeconomic groups. C. This disorder is equally prevalent in all socioeconomic groups. D. This disorders prevalence cannot be evaluated on the basis of socioeconomic groups.

B. This disorder is more prevalent in the higher socioeconomic groups.

A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because he complains that it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders? A. Sertraline (Zoloft) B. Valproic acid (Depakote) C. Trazodone (Desyrel) D. Paroxetine (Paxil)

B. Valproic acid (Depakote)

A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose? A. When the client has a knowledge deficit related to the effects of the drug B. When the client combines the drug with alcohol C. When the client takes the drug on an empty stomach D. When the client fails to follow dietary restrictions

B. When the client combines the drug with alcohol

On an inpatient psychiatric unit, a restrained 16-year-old client continues to verbally lash out and threatens to abuse staff and kill self when released. To meet Joint Commission standards, at what time should a nurse expect the physician to renew the clients restraint order? A. Within 1 hour of the original restraint order B. Within 2 hours of the original restraint order C. Within 3 hours of the original restraint order D. Within 4 hours of the original restraint order

B. Within 2 hours of the original restraint order

A client refuses to go on a cruise to the Bahamas with his spouse because of fearing that the cruise ship will sink and all will drown. Using a cognitive theory perspective, the nurse should use which of these statements to explain to the spouse the etiology of this fear? A. Your spouse may be unable to resolve internal conflicts, which result in projected anxiety. B. Your spouse may be experiencing a distorted and unrealistic appraisal of the situation. C. Your spouse may have a genetic predisposition to overreacting to potential danger. D. Your spouse may have high levels of brain chemicals that may distort thinking.

B. Your spouse may be experiencing a distorted and unrealistic appraisal of the situation.

Passive-aggressive individuals behavior:

Behavior is indirect, covert, and takes form in passive, non-confrontative action. These people are devious, manipulative, sly, and they undermine others with behavior that expresses the opposite of what they are feeling. They are highly critical and sarcastic. They allow others to make decisions for them and then resist by using passive behaviors. Their goal is domination through retaliation. They possess extremely low self-confidence

An individual who is experiencing a manic episode or has a history of one or more manic episodes; the client may also have experienced periods of depression

Bipolar I Disorder

Characterized by recurrent bouts of major depression with episodic occurrence of hypomania; the client may have never experienced a full manic episode

Bipolar II Disorder

What has been suggested as a first line-treatment for winter blues and as an adjunct in chronic MDD or dysthymia with seasonal exacerbations?

Bright light therapy

What happens by the end of the acute battering incident?

By the end of the incident he cannot understand what has happened, only that in his rage he lost control

A nurse is planning care for a client diagnosed with bipolar disorder: manic episode. In which order should the nurse prioritize the listed client outcomes? Client Outcomes: 1. Maintains nutritional status. 2. Interacts appropriately with peers. 3. Remains free from injury. 4. Sleeps 6 to 8 hours a night. A. 2, 1, 3, 4 B. 4, 1, 2, 3 C. 3, 1, 4, 2 D. 1, 4, 2, 3

C. 3, 1, 4, 2

A nursing student asks an emergency department nurse, Why does a rapist use a weapon during the act of rape? Which nursing reply is most accurate? A. A weapon is used to increase the victimizers security. B. A weapon is used to inflict physical harm. C. A weapon is used to terrorize and subdue the victim. D. A weapon is used to mirror learned family behavior patterns.

C. A weapon is used to terrorize and subdue the victim.

A college student is unable to take a final examination because of severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which priority nursing diagnosis should a campus nurse assign for this client? A. Noncompliance R/T test taking B. Ineffective role performance R/T helplessness C. Altered coping R/T anxiety D. Powerlessness R/T fear

C. Altered coping R/T anxiety

A client on an inpatient unit is diagnosed with bipolar disorder: manic episode. During a discussion in the dayroom about weekend activities, the client raises his voice, becomes irritable, and insists that plans change. What should be the nurses initial intervention? A. Ask the group to take a vote on alternative weekend events. B. Remind the client to quiet down or leave the dayroom. C. Assist the client to move to a calmer location. D. Discuss with the client impulse control problems.

C. Assist the client to move to a calmer location.

A nurse is caring for four clients diagnosed with major depressive disorder. When considering each clients belief system, the nurse should conclude which client would potentially be at highest risk for suicide? A. Roman Catholic B. Protestant C. Atheist D. Muslim

C. Atheist

A nurse on an inpatient unit helps a client understand the significance of treatments and provides the client with copies of all documents related to the plan of care. This nurse is employing which commitment in the Tidal Model of Recovery? A. Know that Change Is Constant B. Reveal Personal Wisdom C. Be Transparent D. Give the Gift of Time

C. Be Transparent

How would a nurse differentiate a client diagnosed with a social phobia from a client diagnosed with a schizoid personality disorder (SPD)? A. Clients diagnosed with social phobia can manage anxiety without medications, whereas clients diagnosed with SPD can manage anxiety only with medications. B. Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social phobia are not. C. Clients diagnosed with social phobia avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life. D. Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social phobias tend to avoid interactions in all areas of life.

C. Clients diagnosed with social phobia avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life.

How should a nurse best describe the major maladaptive client response to panic disorder? A. Clients overuse medical care because of physical symptoms. B. Clients use illegal drugs to ease symptoms. C. Clients perceive having no control over life situations. D. Clients develop compulsions to deal with anxiety.

C. Clients perceive having no control over life situations.

The nurse is providing counseling to clients diagnosed with major depressive disorder. The nurse chooses to help the clients alter their mood by learning how to change the way they think. The nurse is functioning under which theoretical framework? A. Psychoanalytic theory B. Interpersonal theory C. Cognitive theory D. Behavioral theory

C. Cognitive theory

A nurse should assign which nursing diagnosis to a client needing assistance with assertiveness? A. Disturbed personal identity B. Disturbed thought processes C. Defensive coping D. Impaired verbal communication

C. Defensive coping

A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. According to learning theory, what is the cause of this clients symptoms? A. Depression is a result of anger turned inward. B. Depression is a result of abandonment. C. Depression is a result of repeated failures. D. Depression is a result of negative thinking.

C. Depression is a result of repeated failures.

Which client data indicate that a suicidal client is participating in a plan for safety? A. Compliance with antidepressant therapy B. A mood rating of 9/10 C. Disclosing a plan for suicide to staff D. Expressing feelings of hopelessness to nurse

C. Disclosing a plan for suicide to staff

A client who has been raped is crying, pacing, and cursing her attacker in an emergency department. Which behavioral defense should a nurse recognize? A. Controlled response pattern B. Compounded rape reaction C. Expressed response pattern D. Silent rape reaction

C. Expressed response pattern

Joanie is a new patient at the mental health clinic. She has been diagnosed with body dysmorphic disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? A. Alprazolam (Xanax) B. Diazepam (Valium) C. Fluoxetine (Prozac) D. Olanzapine (Zyprexa)

C. Fluoxetine (Prozac)

In determining the degree of suicidal risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as: A. Low B. Moderate C. High D. Unable to determine

C. High

While trying to control aggressive behavior, a client asks an assertiveness training nurse to give an example of an I statement. Which of the following statements is the best example of this assertive communication technique? A. I would like to know why you came home late without calling me. B. I hate it when you think you can just come home late without calling anyone to let them know where you are. C. I feel angry when you come home late without calling. D. I think you dont care about me, because if you did, youd call me if you were planning on coming home late.

C. I feel angry when you come home late without calling.

A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, rates mood at 9/10, and is much more communicative. Which action should be the nurses priority at this time? A. Give the client off-unit privileges as positive reinforcement. B. Encourage the client to share mood improvement in group. C. Increase frequency of client observation. D. Request that the psychiatrist reevaluate the current medication protocol.

C. Increase frequency of client observation.

The dean of nursing criticizes a faculty member about views on academic freedom. The faculty member states, Are you upset because I believe in academic freedom or because you dont? The faculty member is using which technique to promote assertive behavior? A. Standing up for ones basic human rights B. Delaying assertively C. Inquiring assertively D. Responding assertively with irony

C. Inquiring assertively

The client states, I get into trouble because I respond violently without thinking. That usually gets me into a mess. Which nursing reply would be most therapeutic to address this clients problem? A. Everybody loses their temper. Its good that you know that about yourself. B. Ill bet you have some interesting stories to share about overreacting. C. Lets explore methods to help you stop and think before taking action. D. Its good that you are showing readiness for behavioral change.

C. Lets explore methods to help you stop and think before taking action.

A woman comes to an emergency department with a broken nose and multiple bruises after being beaten by her husband. She states, The beatings have been getting worse, and Im afraid that next time he might kill me. Which is the appropriate nursing reply? A. Leopards dont change their spots, and neither will he. B. There are things you can do to prevent him from losing control. C. Lets talk about your options so that you dont have to go home. D. Why dont we call the police so that they can confront your husband with his behavior?

C. Lets talk about your options so that you dont have to go home.

Which treatment should a nurse identify as most appropriate for clients diagnosed with generalized anxiety disorder (GAD)? A. Long-term treatment with diazepam (Valium) B. Acute symptom control with citalopram (Celexa) C. Long-term treatment with buspirone (BuSpar) D. Acute symptom control with ziprasidone (Geodon)

C. Long-term treatment with buspirone (BuSpar)

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this clients risk for suicide? A. Encouraging participation in the milieu to promote hope B. Developing a strong personal relationship with the client C. Observing the client at intervals determined by assessed data D. Encouraging and redirecting the client to concentrate on happier times

C. Observing the client at intervals determined by assessed data

A nurse has identified the following nursing diagnosis: ineffective communication R/T lack of assertiveness skills AEB inability to state needs. Which statement encourages the client to acknowledge the priority of this problem? A. Are you having thoughts of harming yourself or others? B. With whom are you least assertive? C. On a scale of 1 to 10, rank the importance of being assertive. D. When are you available to attend the assertiveness training class?

C. On a scale of 1 to 10, rank the importance of being assertive.

When questioned about bruises, a woman states, It was an accident. My husband just had a bad day at work. Hes being so gentle now and even brought me flowers. Hes going to get a new job, so it wont happen again. This client is in which phase of the cycle of battering? A. Phase I: The tension-building phase B. Phase II: The acute battering incident phase C. Phase III: The honeymoon phase D. Phase IV: The resolution and reorganization phase

C. Phase III: The honeymoon phase

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. What should be the nurses priority intervention at this time? A. Obtaining an order for locked seclusion until client is no longer suicidal B. Conducting 15-minute checks to ensure safety C. Placing the client on one-to-one observation while monitoring suicidal ideations D. Encouraging client to express feelings related to suicide

C. Placing the client on one-to-one observation while monitoring suicidal ideations

A nurse discovers a clients suicide note that details the time, place, and means to commit suicide. What should be the priority nursing intervention and the rationale for this action? A. Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note B. Establishing room restrictions, because the clients threat is an attempt to manipulate the staff C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide D. Calling an emergency treatment team meeting, because the clients threat must be addressed

C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide

Which initial nursing approach makes limit-setting better accepted by clients who are aggressively acting out? A. Confronting clients with their needs for secondary gains B. Teaching relaxation techniques C. Reflecting back to the client empathy about the clients distress D. Presenting appropriate values that need to be modified

C. Reflecting back to the client empathy about the clients distress

A nursing supervisor is scheduling holiday hours. When the supervisor tells the staff nurse that she needs to work Christmas day, the staff nurse calmly states, I worked last Christmas and will not work this Christmas. When the supervisor says But I need you to work, the nurse repeats I worked last Christmas and will not work this Christmas. This is an example of which assertive behavior technique? A. Shifting from content to process B. Standing up for ones basic rights C. Responding as a broken record D. Defusing

C. Responding as a broken record

A 75-year-old client with a long history of depression is currently on doxepin (Sinequan), 100 mg daily. The client takes a daily diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign highest priority? A. Risk for ineffective thermoregulation R/T anhidrosis B. Risk for constipation R/T excessive fluid loss C. Risk for injury R/T orthostatic hypotension D. Risk for infection R/T suppressed white blood cell count

C. Risk for injury R/T orthostatic hypotension

A newly admitted client is experiencing a manic episode of bipolar I disorder and presents as very agitated. The nurse should assign which priority nursing diagnosis to this client? A. Ineffective individual coping R/T hospitalization AEB alcohol abuse B. Altered nutrition: less than body requirements R/T mania AEB 10-pound weight loss C. Risk for violence: directed toward others R/T agitation and hyperactivity D. Sleep pattern disturbance R/T flight of ideas AEB sleeps 1 to 2 hours per night

C. Risk for violence: directed toward others R/T agitation and hyperactivity

Warrens college roommate actively resists going out with friends whenever they invite him. He says he cant stand to be around other people and confides to Warren They wouldnt like me anyway. Which disorder is Warrens roommate likely suffering from? A. Agoraphobia B. Mysophobia C. Social anxiety disorder (social phobia) D. Panic disorder

C. Social anxiety disorder (social phobia)

A client is experiencing a severe panic attack. Which nursing intervention would meet this clients immediate need? A. Teach deep breathing relaxation exercises B. Place the client in a Trendelenburg position C. Stay with the client and offer reassurance of safety D. Administer the ordered prn buspirone (BuSpar)

C. Stay with the client and offer reassurance of safety

A new nursing graduate asks the psychiatric nurse manager how to best classify suicide. Which is the nurse managers best reply? A. Suicide is a DSM-5 diagnosis. B. Suicide is a mental disorder. C. Suicide is a behavior. D. Suicide is an antisocial affliction.

C. Suicide is a behavior.

A client diagnosed with generalized anxiety states, I know the best thing for me to do now is to just forget my worries. How should the nurse evaluate this statement? A. The client is developing insight. B. The clients coping skills are improving. C. The client has a distorted perception of problem resolution. D. The client is meeting outcomes and moving toward discharge.

C. The client has a distorted perception of problem resolution.

In the emergency department, a raped client appears calm and exhibits a blunt affect. The client answers a nurses questions in a monotone using single words. How should the nurse interpret this clients responses? A. The client may be lying about the incident. B. The client may be experiencing a silent rape reaction. C. The client may be demonstrating a controlled response pattern. D. The client may be having a compounded rape reaction.

C. The client may be demonstrating a controlled response pattern.

A client diagnosed with paranoid schizophrenia has a history of aggravated assault. A nurse assigns Risk for other-directed violence as the clients priority nursing diagnosis. Based on this diagnosis, which would be an appropriate, correctly written outcome for this client? A. The client will not verbalize anger or hit anyone. B. The client will verbalize anger rather than hit others. C. The client will not inflict harm on others during this shift. D. The client will be restrained if verbal or physical abuse is observed during this shift.

C. The client will not inflict harm on others during this shift.

A client is diagnosed with bipolar disorder and admitted to an inpatient psychiatric unit. Which is the priority outcome for this client? A. The client will accomplish activities of daily living independently by discharge. B. The client will verbalize feelings during group sessions by discharge. C. The client will remain safe throughout hospitalization. D. The client will use problem-solving to cope adequately after discharge.

C. The client will remain safe throughout hospitalization.

What client information does a nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)? A. The clients understanding of the need for regular bloodwork B. The clients mood and affect score, according to the facilitys mood scale C. The clients cognitive ability to understand information about the medication D. The clients access to a support network willing to participate in treatment

C. The clients cognitive ability to understand information about the medication

A client is newly admitted to an inpatient psychiatric unit. Which of the following is most critical to assess when determining risk for suicide? A. Family history of depression B. The clients orientation to reality C. The clients history of suicide attempts D. Family support systems

C. The clients history of suicide attempts

An adult client diagnosed with bipolar I disorder is prescribed lamotrigine (Lamictal), 400 mg three times a day, for mood stabilization. Which is a true statement about this medication order? A. This dosage is within the recommended dosage range. B. This dosage is lower than the recommended dosage range. C. This dosage is more than twice the recommended dosage range. D. This dosage is four times higher than the recommended dosage range.

C. This dosage is more than twice the recommended dosage range.

A client living on the beachfront seeks help with an extreme fear of crossing bridges, which interferes with daily life. A psychiatric nurse practitioner decides to try systematic desensitization. Which explanation of this therapy should the nurse convey to the client? A. Using your imagination, we will attempt to achieve a state of relaxation that you can replicate when faced with crossing a bridge. B. Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response. C. Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety. D. In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate.

C. Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety.

A nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a mini-mental status exam? A. To rule out bipolar disorder B. To rule out schizophrenia C. To rule out neurocognitive disorder D. To rule out a personality disorder

C. To rule out neurocognitive disorder

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago. The client asks if it is normal to have gained 12 pounds in this time frame. Which is the appropriate nursing reply? A. Thats strange. Weight loss is the typical pattern. B. What have you been eating? Weight gain is not usually associated with lithium. C. Weight gain is a common but troubling side effect. D. Weight gain occurs only during the first month of treatment with this drug.

C. Weight gain is a common but troubling side effect.

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? A. You are safe here. We will make sure nothing happens to you. B. You're just lucky your roommate came home when she did. C. What exactly do you plan to do? D. I don't understand. You have so much to live for.

C. What exactly do you plan to do?

A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not at ill-at-ease with the staff or other pts anymore." In light of this change, which nursing intervention is most appropriate? A. give attention the to ritualistic behaviors each time they occur and point out their inappropriateness. B. ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. C. set limits on the amount of time Sandy may engage in the ritualistic behavior. D. continue to allow Sandy all the time she wants to carry out the ritualistic behavior.

C. set limits on the amount of time Sandy may engage in the ritualistic behavior.

Action of barbiturates:

CNS depression, also produce effects in the hepatic and cardiovascular systems

Violent behavior may be associated with hormonal dysfunction caused by...

Cushing's disease or hyperthyroidism

After less restrictive means have been attempted, an order for client restraints has been obtained for a hostile, aggressive 30- year-old client. If client aggression continues, how long will the nurse expect the client to remain in restraints without a physician order renewal? A. 1 hour B. 2 hours C. 3 hours D. 4 hours

D. 4 hours

Which situation presents an example of the basic concept of a recovery model? A. The clients family is encouraged to make decisions in order to facilitate discharge. B. A social worker, discovering the clients income, changes the clients discharge placement. C. A psychiatrist prescribes an antipsychotic drug on the basis of observed symptoms. D. A client diagnosed with schizophrenia schedules follow-up appointments and group therapy.

D. A client diagnosed with schizophrenia schedules follow-up appointments and group therapy.

The treatment team is making a discharge decision regarding a previously suicidal client. Which client assessment information should a nurse recognize as contributing to the teams decision? A. No previous admissions for major depressive disorder B. Vital signs stable; no psychosis noted C. Able to comply with medication regimen; able to problem-solve life issues D. Able to participate in a plan for safety; family agrees to constant observation

D. Able to participate in a plan for safety; family agrees to constant observation

A highly agitated client paces the unit and states, I could buy and sell this place. The clients mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this clients behavior? A. Rates mood 8/10. Exhibiting looseness of association. Euphoric. B. Mood euthymic. Exhibiting magical thinking. Restless. C. Mood labile. Exhibiting delusions of reference. Hyperactive. D. Agitated and pacing. Exhibiting grandiosity. Mood labile.

D. Agitated and pacing. Exhibiting grandiosity. Mood labile.

A nurse is caring for four clients. Which client should the nurse identify as least prone to developing problems with anger and aggression? A. A child raised by a physically abusive parent B. An adult with a history of epilepsy C. A young adult living in the ghetto of an inner city D. An adolescent raised by Scandinavian immigrant parents

D. An adolescent raised by Scandinavian immigrant parents

A nursing student is developing a plan of care for a suicidal client. Which documented intervention should the student implement first? A. Communicate therapeutically. B. Observe the client. C. Provide a hazard-free environment. D. Assess suicide risk.

D. Assess suicide risk.

The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? A. Address only serious suicide threats to avoid the possibility of secondary gain. B. Promote trust by verbalizing a promise to keep suicide attempt information within the family. C. Offer a private environment to provide needed time alone at least once a day. D. Be available to actively listen, support, and accept feelings.

D. Be available to actively listen, support, and accept feelings.

A client on an inpatient unit is angry with a peer. During lunch, when the peer is not looking, the client spits into his soup. How would the nurse document this interaction? A. Client is displaying assertive behaviors. B. Client is displaying aggressive behaviors. C. Client is displaying passive behaviors. D. Client is displaying passiveaggressive behaviors.

D. Client is displaying passiveaggressive behaviors.

After restraints are removed from a client, the staff discusses the incident and establishes guidelines for the clients return to the therapeutic milieu. Which unit procedure is the staff implementing? A. Milieu reenactment B. Treatment planning C. Crisis intervention D. Debriefing

D. Debriefing

How would a nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? A. GAD is acute in nature, and panic disorder is chronic. B. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. C. Hyperventilation is a common symptom in GAD and rare in panic disorder. D. Depersonalization is commonly seen in panic disorder and absent in GAD.

D. Depersonalization is commonly seen in panic disorder and absent in GAD.

A client is newly diagnosed with obsessive-compulsive disorder and spends 45 minutes folding clothes and rearranging them in drawers. Which nursing intervention would best address this clients problem? A. Distract the client with other activities whenever ritual behaviors begin. B. Report the behavior to the psychiatrist to obtain an order for medication dosage increase. C. Lock the room to discourage ritualistic behavior. D. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

D. Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors.

A client diagnosed with brief psychotic disorder is pacing the milieu and occasionally punches the wall. Which should be the initial nursing action? A. Assertively instruct the client to stop punching the wall. B. Encourage the client to write down feelings in a journal. C. With the help of staff, initiate seclusion protocol. D. Ensure adequate physical space between the nurse and the client.

D. Ensure adequate physical space between the nurse and the client.

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? A. Suicidal threats and gestures should be considered manipulative and/or attention-seeking. B. Suicide is the act of a psychotic person. C. All suicidal individuals are mentally ill. D. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt.

D. Fifty to eighty percent of all people who kill themselves have a history of a previous attempt.

A nurse is planning care for a child who is experiencing depression. Which medication is approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children and adolescents? A. Paroxetine (Paxil) B. Sertraline (Zoloft) C. Citalopram (Celexa) D. Fluoxetine (Prozac)

D. Fluoxetine (Prozac)

A client is diagnosed with persistent depressive (dysthymia) disorder. Which should a nurse classify as an affective symptom of this disorder? A. Social isolation with a focus on self B. Low energy level C. Difficulty concentrating D. Gloomy and pessimistic outlook on life

D. Gloomy and pessimistic outlook on life

Which teaching should the nurse in an employee assistance program provide to an employee who exhibits symptoms of domestic physical abuse? A. Have ready access to a gun and learn how to use it B. Research lawyers who can aid in divorce proceedings C. File charges of assault and battery D. Have ready access to the number of a safe house for battered women

D. Have ready access to the number of a safe house for battered women

A client diagnosed with major depressive disorder states, Ive been feeling down for 3 months. Will I ever feel like myself again? Which reply by the nurse will best assess this clients affective symptoms? A. Have you been diagnosed with any physical disorder within the last 3 months? B. Have you ever felt this way before? C. People who have mood changes often feel better when spring comes. D. Help me understand what you mean when you say, feeling down?

D. Help me understand what you mean when you say, feeling down?

During a one-to-one session with a client, the client states, Nothing will ever get better, and Nobody can help me. Which nursing diagnosis is most appropriate for a nurse to assign to this client at this time? A. Powerlessness R/T altered mood AEB client statements B. Risk for injury R/T altered mood AEB client statements C. Risk for suicide R/T altered mood AEB client statements D. Hopelessness R/T altered mood AEB client statements

D. Hopelessness R/T altered mood AEB client statements

An aggressive nurse manager tells a staff nurse she has no business rallying staff to change the schedule. What would be an example of a technique that the staff nurse could use to stand up for her basic human rights? A. What is the real reason that you dont want the schedule changed? B. Sounds to me like youre threatened by this change. C. Are you upset because you dont want to redo the schedule? D. I have the right to express my opinion about the schedule.

D. I have the right to express my opinion about the schedule.

A client diagnosed with an obsessive-compulsive disorder spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify? A. Sublimation B. Dissociation C. Rationalization D. Intellectualization

D. Intellectualization

Which is the most appropriate nursing reply when a client asks what the goal and benefit are of assertive skills training? A. It protects the client from others who express aggressive feelings. B. It gives reliable, expert information so that clients may correct faulty behaviors. C. It clarifies misperceptions that have caused clients to distort reality. D. It improves communication skills in order to improve interpersonal relationships.

D. It improves communication skills in order to improve interpersonal relationships.

A suicidal client says to a nurse, Theres nothing to live for anymore. Which is the most appropriate nursing reply? A. Why dont you consider doing volunteer work in a homeless shelter? B. Lets discuss the negative aspects of your life. C. Things will look better in the morning. D. It sounds like you are feeling pretty hopeless.

D. It sounds like you are feeling pretty hopeless.

Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder? A. Its just a matter of time and I will be well. B. If I ignore these feelings, they will go away. C. I can fight these feelings and overcome this disorder. D. Nothing will help me feel better.

D. Nothing will help me feel better.

A cab driver stuck in traffic is suddenly lightheaded, tremulous, and diaphoretic and experiences tachycardia and dyspnea. An extensive workup in an emergency department reveals no pathology. Which medical diagnosis is suspected, and what nursing diagnosis takes priority? A. Generalized anxiety disorder and a nursing diagnosis of fear B. Altered sensory perception and a nursing diagnosis of panic disorder C. Pain disorder and a nursing diagnosis of altered role performance D. Panic disorder and a nursing diagnosis of panic anxiety

D. Panic disorder and a nursing diagnosis of panic anxiety

A nurse is caring for four clients taking various medications, including imipramine (Tofranil), doxepine (Sinequan), ziprasidone (Geodon), and tranylcypromine (Parnate). The nurse orders a special diet for the client receiving which medication? A. Tofranil B. Senequan C. Geodon D. Parnate

D. Parnate

After vying for a nurse management position, nurse A is chosen over nurse B. When nurse manager A calls for staff meetings, nurse B is chronically late or absent. Nurse B is exhibiting which type of behavior? A. Passive B. Assertive C. Aggressive D. Passiveaggressive

D. Passiveaggressive

The inpatient psychiatric unit is being redecorated. At a unit meeting, staff discusses bedroom dcor for clients experiencing mania. The nurse manager evaluates which suggestion as most appropriate? A. Rooms should contain extra-large windows with views of the street. B. Rooms should contain brightly colored walls with printed drapes. C. Rooms should be painted deep colors and located close to the nurses station. D. Rooms should be painted with neutral colors and contain pale-colored accessories.

D. Rooms should be painted with neutral colors and contain pale-colored accessories.

A confused client has recently been prescribed sertraline (Zoloft). The clients spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect, and what could be its possible cause? A. Neuroleptic malignant syndrome caused by ingestion of two different serotonin reuptake inhibitors (SSRIs) B. Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) C. Serotonin syndrome caused by ingestion of an SSRI and an MAOI D. Serotonin syndrome caused by ingestion of two different SSRIs

D. Serotonin syndrome caused by ingestion of two different SSRIs

A client experiences an exacerbation of psychiatric symptoms to the point of threatening self-harm. Which action step of the Wellness Recovery Action Plan (WRAP) model should be employed, and what action reflects this step? A. Step 3: Triggers that cause distress or discomfort are listed. B. Step 4: Signs indicating relapse are identified and plans for responding are developed. C. Step 5: A specific plan to help with symptoms is formulated. D. Step 6: Following client-designed plan, caregivers now become decision-makers.

D. Step 6: Following client-designed plan, caregivers now become decision-makers.

A client diagnosed with bipolar disorder, who has taken lithium carbonate (Lithane) for 1 year, presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. How should the nurse interpret these symptoms? A. Symptoms indicate consumption of foods high in tyramine. B. Symptoms indicate lithium carbonate discontinuation syndrome. C. Symptoms indicate the development of lithium carbonate tolerance. D. Symptoms indicate lithium carbonate toxicity.

D. Symptoms indicate lithium carbonate toxicity.

A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis? A. The client is disheveled and malodorous. B. The client refuses to interact with others. C. The client is unable to feel any pleasure. D. The client has maxed-out charge cards and exhibits promiscuous behaviors.

D. The client has maxed-out charge cards and exhibits promiscuous behaviors.

During the planning of care for a suicidal client, which correctly written outcome should be a nurses first priority? A. The client will not physically harm self. B. The client will express hope for the future by day 3. C. The client will establish a trusting relationship with the nurse. D. The client will remain safe during the hospital stay.

D. The client will remain safe during the hospital stay.

A client is served divorce papers while on the inpatient psychiatric unit. When a nurse tells the client the unit telephone cannot be used after hours, the client raises his fists, swears, and spits at the nurse. Which negative coping mechanism has the client exhibited? A. The defense mechanism of projection B. The defense mechanism of reaction formation C. The defense mechanism of sublimation D. The defense mechanism of displacement

D. The defense mechanism of displacement

An instructor is teaching about assertive rights. Which student statement indicates a need for further instruction? A. The right to be treated with respect is an assertive right. B. The right to say no without feeling guilty is an assertive right. C. The right to change your mind is an assertive right. D. The right to always put oneself first is an assertive right.

D. The right to always put oneself first is an assertive right.

A woman describes a history of physical and emotional abuse in intimate relationships. Which additional factor should a nurse suspect? A. The woman may be exhibiting a controlled response pattern. B. The woman may have a history of childhood neglect. C. The woman may be exhibiting codependent characteristics. D. The woman might be a victim of incest.

D. The woman might be a victim of incest.

During an assertiveness training group, a client admits to aggressive behaviors. The client asks for suggestions for how to become more assertive and less aggressive. Which is the most appropriate nursing reply? A. Several techniques, including meditation and progressive muscle relaxation, appear helpful. B. Theres not much that can be done about aggressive behavior because of biological responses. C. Certain types of medications have been proven effective in promoting assertive communication. D. There are several techniques, including I statements, role playing, and thought stopping, that can help promote assertive behaviors and decrease aggressive behaviors.

D. There are several techniques, including I statements, role playing, and thought stopping, that can help promote assertive behaviors and decrease aggressive behaviors.

A client who is in a severely abusive relationship is admitted to a psychiatric inpatient unit. The client fears for her life. A staff nurse asks, Why doesnt she just leave him? Which is the nursing supervisors most appropriate reply? A. These clients dont know life any other way, and change is not an option until they have improved insight. B. These clients have limited skills and few vocational abilities to be able to make it on their own. C. These clients often have a lack of financial independence to support themselves and their children, and most have religious beliefs prohibiting divorce and separation. D. These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness.

D. These clients are paralyzed into inaction by a combination of physical threats and a sense of powerlessness.

A client is experiencing high stress. The client states, My boss treats me like a doormat and thinks nothing of demanding frequent overtime. Which nursing intervention would be appropriate? A. To incorporate the family support system into the clients plan of care B. To teach thought-reframing techniques C. To encourage the client to seek other employment D. To teach the client how to use I statements

D. To teach the client how to use I statements

A nursing instructor is discussing various challenges in the treatment of clients diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these clients? A. Treatment is compromised when clients cant sleep. B. Treatment is compromised when irritability interferes with social interactions. C. Treatment is compromised when clients have no insight into their problems. D. Treatment is compromised when clients choose not to take their medications.

D. Treatment is compromised when clients choose not to take their medications.

Which best describes a nurses use of assertive behavior? A. When a nurse attempts to please others and apologizes for awkwardness in a new role B. When a nurse becomes defensive and angry when peers offer suggestions for improvement C. When a nurse has problems making decisions and has a tendency to procrastinate D. When a nurse is open and direct when asked by the nurse manager to complete assignments

D. When a nurse is open and direct when asked by the nurse manager to complete assignments

A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The clients spouse questions the Zyprexa order. Which is the appropriate nursing reply? A. Zyprexa in combination with Eskalith cures manic symptoms. B. Zyprexa prevents extrapyramidal side effects. C. Zyprexa ensures a good nights sleep. D. Zyprexa calms hyperactivity until the Eskalith takes effect.

D. Zyprexa calms hyperactivity until the Eskalith takes effect.

Lithium is pregnancy class __ and the half-life is...

D; 24 hours

Stage III

Delirious mania

What may or may not be a part of the clinical picture in BD?

Delusions or hallucinations

What is common in the elderly?

Depression

______ is a major cause of suicide among teens.

Depression

What is characterized by symptoms associated with a major depressive disorder that are the direct physiological consequence of another medical condition, which causes distress OR impairment of functioning?

Depressive disorder due to another medical condition

What is stating what one wants with clarity and candor?

Direct communication

Episodes of acute mania can be treated with...

ECT

What is also one of the safest and most effective treatments for MDD in the elderly?

Electroconvulsive therapy

What does FIND stand for?

F: Frequency - symptoms occur most days in a week. I: Intensity - symptoms are severe enough to cause extreme disturbances in one domain or moderate disturbance in two or more domains. N: Number - symptoms occur three or four times a day. D: duration - symptoms occur 4 or more hours in a day.

Using the ____ can help diagnosis bipolar disorder in children.

FIND strategy

Behaviors of aggressive individuals:

Feelings are expressed dishonestly and inappropriately. They say what is on their mind at the expense of others. This behavior results in put-downs, leaving the receiver hurt and humiliated. They act superior, are loud, demanding, angry, and cold. Eye contact includes staring people down to intimidate them. Aggressive behavior hinders interpersonal relationships

Behaviors of Assertive individuals:

Feelings are expressed openly and honestly. They assume responsibility of their actions and allow others to choose for themselves. They maintain self-respect and respect and dignity for all. They use a lot of "I" statements, their voices are warm, and eye contact is intermittent but direct. These people are self-confident and experience satisfactory relationships with others

What can be used in adolescents and children?

Fluoxetine

Stage I -

Hypomania

How do clients feel in the growth phase?

Individuals exhibit confidence in managing their illnesses and are resilient when relapses occur; the individual in the growth stage has developed a strong, positive sense of self and identity; those who reach this phase report a more profound sense of meaning

Who is more likely to behave in an abusive manner as adults?

Individuals who were abused as a child

How does the acute battering incident begin?

It most often begins with the batterer justifying his behavior to himself

Phobias may be acquired by direct learning or imitation (modeling)?

Learning theory

Negative self-evaluating/feelings about self or self-capabilities

Low self-esteem

What is depressed mood or loss of interest or pleasure in usual activities, can be a single episode or recurrent, ranges from mild-severe, whether there are psychotic, catatonic, or melancholic features, and if there is a presence of anxiety and the severity of suicide risk?

MDD

What is one of the leading causes of unemployment in the united states?

MDD

The most common of these medications are the steroids used to treat...

MS and SLE

What was determined to be the first line treatment for BD?

Monotherapy with traditional mood stabilizers or atypical antipsychotics

What are the most common disorders that precede suicide?

Mood disorders

How many people report having been raped at some time in their lives?

Nearly 1 in 5 women and 1 in 71 men

What is the presence of obsessions, compulsions, or both, the severity of which is significant enough to cause distress or impairment in social, occupational, or other important areas of functioning; the individual recognizes that the behavior is excessive or unreasonable but, because of the feeling of relief from discomfort that it promotes, is compelled to continue the act?

OCD

What occurs when a specific behavior is reinforced?

Operant conditioning

Who defends their own rights by expressing resistance and general obstructiveness in response to the expectations of others?

Passive-aggressive individuals

The lived experience of lack of control over a situation, including a perception of one's actions do not significantly affect an outcome

Powerlessness

Who are at highest risk?

Professional healthcare personnel and business executives

Suicide rates among Roman Catholic populations have been lower than rates among...

Protestants and Jews

What is one of the strongest forms of learning?

Role modeling

The first line therapy for children and adolescents with mania is a..

SGA

What occurs in response to other physiological disorders?

Secondary depression

Impaired ability to perform or complete ADLs for self

Self-care deficits

What are thought to be decreased in anxiety disorders?

Serotonin and GABA

What seasons are associated with mood disorders?

Spring and Fall

What is the first phase of battering?

The Tension-Building Phase

What is a structured system for monitoring uncomfortable and distressing symptoms and, through planned responses, reducing, modifying or eliminating those symptoms; that includes plans for responses from others when a person's symptoms have made it impossible to continue to make decisions, take care of him/herself and keep him/herself safe?

The Wellness Recovery Action Plan (WRAP) Model

Behaviors of nonassertive individuals:

Their eyes are usually downcast, feel anxious and hurt because they let others choose for them, feel uncomfortable in social interactions, and they just want to be liked by others but frequently harbor anger and resentment

What are intended to eliminate intrusive, unwanted thoughts?

Thought-stopping techniques

What is a procedure that is used to treat depression by targeting certain cells in the brain?

Transcranial magnetic stimulation

Who are at the greatest risk for suicide?

White males over 80

Who are at the highest risk for suicide?

White people

Freud believed that phobias developed when...

a child experiences normal incestuous feeling toward the opposite gender parent and fear aggression from the same gender parent

For the majority of BD clients, the most effective treatment seems to be...

a combination of psychotropic medication and psychosocial therapy

Severe depression symptoms at the physiological level:

a general slowdown of the entire body, reflected in sluggish digestion, constipation, urinary retention, amenorrhea, impotence, diminished libido, anorexia, weight loss, difficulty falling asleep and awakening very early in the morning, feeling worse in the morning and somewhat better as the day progresses

Children can become depressed for many reasons, but most usually have...

a genetic predisposition and then a precipitating event occurs

The incestuous relationship may become...

a love-hate relationship from the daughter, she continues to strive for the ideal father-daughter relationship but is fearful and hateful of the sexual demands he places on her.

More than 90% of people who kill themselves have...

a mental disorder, most commonly a mood disorder or a substance abuse disorder

Acute mania may be...

a progression in intensification of hypomania or can be manifested directly and most experience marked impairment and require hospitalization

In the growth stage, the individual feels...

a sense of optimism and hope of a rewarding future

Most religions consider suicide as...

a sin against God

You are having company for dinner and they are due to arrive in 20 minutes. You are about to finish cooking and still have to shower and dress. The doorbell rings and it is a man selling a new product for cleaning windows. Which of the following is an example of an aggressive response? a. "I don't do windows!" and slam the door in his face. b. "I'll take a case," and write him a check. c. "Sure, I'll take three bottles." Then to yourself you think: "I'm calling this company tomorrow and complaining to the manager about their salespeople coming around at dinnertime!" d. "I'm very busy at the moment. I don't wish to purchase any of your product. Thank you."

a. "I don't do windows!" and slam the door in his face.

You're on your way to the laundry room when you encounter a fellow dorm tenant who often asks you to "throw a few of my things in with yours." You view this as an imposition. He asks you where you're going. Which of the following is an example of a passive-aggressive response? a. "I'm on my way to the Celtics game. Where do you think I'm going?" b. "I'm on my way to do some laundry. Do you have anything you want me to wash with mine?" c. "It's none of your damn business!" d. "I'm going to the laundry room. Please don't ask me to do some of yours. I resent being taken advantage of in that way."

a. "I'm on my way to the Celtics game. Where do you think I'm going?"

You have been studying for a nursing exam all afternoon and lost track of time. Your husband expects dinner on the table when he gets home from work. You have not started cooking yet when he walks in the door and shouts, "Why the heck isn't dinner ready?" Which of the following is an example of a passive-aggressive response? a. "I'm sorry. I'll have it done in no time, honey." Bu then you move very slowly and take a long time to cook the meal. b. "I'm tired from studying all afternoon. Make your own dinner, you bum! I'm tired of being your slave!" c. "I haven't started dinner yet. I'd like some help from you." d. "I'm so sorry. I know you're tired and hungry. It's all my fault. I'm a terrible wife!"

a. "I'm sorry. I'll have it done in no time, honey." Bu then you move very slowly and take a long time to cook the meal.

You and your best friend, Jill, have had plans for 6 months to go on vacation together in Hawaii. You have saved your money and have plane tickets to leave in 3 weeks. She has just called you and reported that she is not going. She has a new boyfriend, they are moving in together, and she doesn't want to leave him. You are very angry with Jill for changing your plans. Which of the following is an example of an assertive response? a. "I'm very disappointed and angry. I'd like to talk to you about this later. I'll call you." b. "I'm very happy for you, Jill. I think it's wonderful that you and Jack are moving in together." c. You tell Jill that you are really happy for her, but then say to another friend, "Well, that's the end of my friendship with Jill!" d. "What? You can't do that to me! We've had plans! You're acting like a real slut!"

a. "I'm very disappointed and angry. I'd like to talk to you about this later. I'll call you."

The physician orders lithium carbonate 600 mg tid for a newly diagnosed client with Bipolar I Disorder. There is a narrow margin between the therapeutic and toxic levels of lithium. Therapeutic range for acute mania is: a. 1.0 to 1.5 mEq/L b. 10 to 15 mEq/L c. 0.5 to 1.0 mEq/L d. 5 to 10 mEq/L

a. 1.0 to 1.5 mEq/L

A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?" Which of the following is the correct response by the nurse? a. Blue cheese, red wine, raisins b. Black beans, garlic, pears c. Pork, shellfish, egg yolks d. Milk, peanuts, tomatoes

a. Blue cheese, red wine, raisins

The nurse hears John, a client with a history of violence, yelling in the dayroom. The nurse observes his increased agitation, clenched fists, and loud, demanding voice. He is challenging and threatening staff and the other clients. The nurse's priority intervention would be to: a. Call for assistance. b. Draw up a syringe of prn haloperidol. c. Ask John if he would like to talk about his anger. d. Tell John if he does not calm down he will have to be restrained.

a. Call for assistance.

John, a client with a history of violence, has been hospitalized on the psychiatric unit. He becomes agitated and begins to threaten the staff and other clients. When all other interventions fail, John is placed in restraints in the seclusion room for his and others' protection. Which of the following are interventions for the client in restraints? (Select all that apply.) a. Check temperature and pulse of extremities. b. Document all observations. c. Explain to the client that restraint is his punishment for violent behavior d. Provide ongoing assessment and observation. e. Withhold food and fluid until client is calm and can be released from restraints.

a. Check temperature and pulse of extremities. b. Document all observations. d. Provide ongoing assessment and observation.

Examining the ABC's: antecedents, behavior, and consequences of one's thoughts is a form of Cognitive Behavioral Therapy called: a. Cognitive Restructuring b. Flooding c. Systematic Desensitization d. Exposure

a. Cognitive Restructuring

Which of these procedures is important in following up an episode of violence on the unit? (Select all that apply.) a. Document all observations and occurrences. b. Conduct a debriefing with the staff. c. Discuss what occurred with other clients who witnessed the incident. d. Warn the client that it could happen again if he become violent.

a. Document all observations and occurrences. b. Conduct a debriefing with the staff. c. Discuss what occurred with other clients who witnessed the incident.

A school nurse notices bruises and scars on a child's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. as a health-care worker, report the suspicion to the department of health and human services b. check Jana again in a week and see if there are any new bruises c. meet with Jana's parents and ask them how Jana got the bruises d. initiate paperwork to have Jana placed in foster care

a. as a health-care worker, report the suspicion to the department of health and human services

The goal of cognitive therapy with depressed clients is to: a. identify and change the dysfunctional patterns of thinking b. resolve the symptoms and initiate or restore adaptive family functioning c. alter the neurotransmitters that are creating the depressed mood d. provide feedback from peers who are having similar experiences

a. identify and change the dysfunctional patterns of thinking

Which of the following is true about aggression? (Select all that apply.) a. it is goal directed. b. its aim is to do harm to a person or object. c. it has requisite of intent. d. it energizes and mobilizes the body for self-defense.

a. it is goal directed. b. its aim is to do harm to a person or object. c. it has requisite of intent.

A client with OCD spends many hours each day washing his hands. The most likely reason he washes his hands so much is that: a. relieves his anxiety b. reduces the probability of infection c. gives him a feeling of control over his life d. increases his self-concept

a. relieves his anxiety

Which of following interventions are appropriate for a client on suicide precautions? (Select all that apply) a. remove sharp objects, belts, and other potentially dangerous articles from the client's environment b. accompany the client to off-unit activities c. obtain a promise from the client that she will not do anything to harm herself for the next 12 hours d. put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions

a. remove sharp objects, belts, and other potentially dangerous articles from the client's environment b. accompany the client to off-unit activities c. obtain a promise from the client that she will not do anything to harm herself for the next 12 hours

A client has just been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which of the following behavioral manifestations might the nurse expect to assess? (select all that apply) a. slumped posture b. delusional thinking c. feelings of despair d. feels best early in morning and worse as the day progresses e. anorexia

a. slumped posture b. delusional thinking c. feelings of despair e. anorexia

A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client? a. stay with client and reassure of safety b. administer a dose of diazepam c. leave the client alone in a quiet room so that she can calm down d. encourage the client to talk about what triggered the attack

a. stay with client and reassure of safety

A nurse is who helping a client in the preparation stage of the psychological recovery model might include which of the following interventions? a. teach about effects of the illness and how to recognize, monitor, and manage symptoms b. help the client identify "triggers" that cause distress or discomfort c. help the client establish a daily maintenance list d. listen actively while the client composes his or her personal story

a. teach about effects of the illness and how to recognize, monitor, and manage symptoms

A battered woman present to the ED with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. The priority nursing intervention is: a. tending to the immediate care of her wounds b. providing her with information about a safe place to stay c. administering the PRN tranquilizer ordered by the physician d. explaining how she may go about bringing charges against her husband

a. tending to the immediate care of her wounds

The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis? a. the client as experienced no physical harm to herself b. the client sets realistic goals for herself c. the client expresses some optimism and hope for the future d. the client has reached a stage of acceptance in the loss of the relationship with her boyfriend

a. the client as experienced no physical harm to herself

Negative thinking can sometimes interfere with one's...

ability to respond assertively

What have been noted in clients with panic disorders?

abnormal elevations of blood lactate

What is the the maltreatment of one person by another?

abuse

Who experience a stressful life situation; having few, if any, support systems, commonly isolated from others; lacking understanding of child development or care needs; lacking adaptive coping strategies, angers easily, has difficulty trusting others; and expecting the child to be perfect, may exaggerate any mild difference the child manifests from the usual?

abusive parents

Signs of depression from ages 3 to 5:

accident proneness, phobias, aggressiveness, and excessive self-reproach for minor infractions

situations in which the rapist is acquainted with the victim

acquaintance rape

What is described as the emotional reaction associated with an experience?

affect

Symptoms of depression can be described as alterations in the four spheres of human functioning:

affective, behavioral, cognitive, and physical

Freud believed that melancholia occurs...

after someone has lost a loved object, either actually by death or emotionally by rejection, or the loss of some other abstraction of value

The overall suicide risk falls for females after...

age 65

The following demographics are assessed in the suicidal client:

age, gender, ethnicity, marital status, socioeconomic status, occupation, method, religion, and family history

Tumors in the brain, particularly in the areas of the limbic system and the temporal lobes; trauma to the brain, resulting in cerebral changes; and diseases, such as encephalitis, have all been implicated in the predisposition to...

aggression and violent behavior

Rape is an act of...

aggression, not passion

Organic brain syndromes associated with various cerebral disorders have been implicated in the predisposition to...

aggressive and violent behavior

Alzheimer's, Parkinson's, and Huntington's disease can all have...

agitated depression

Panic disorder may or may not be accompanied by...

agoraphobia

Basic human rights have equal representation for...

all individuals

The focus of therapy with depressed children is to...

alleviate the child's symptoms and strengthen the child's coping and adaptive skills, with the hope of possibly preventing future psychological problems

What is the opposite of egoistic suicide; the individual who is prone to this is excessively integrated into the group; the group allegiance is so strong that the individual would sacrifice his life for the group?

altruistic suicide

fear, particularly important in panic and phobic disorders

amygdala

The areas of the brain affected by anxiety disorders and the symptoms that they mediate include:

amygdala, hippocampus, locus ceruleus, brainstem, hypothalamus, frontal cortex, thalamus, and basal ganglia

Assertive honesty is not an outspoken declaration of everything that is on one's mind, it is...

an accurate representation of feelings, opinions, or preferences expressed in a manner that promotes self-respect and respect for others

Freud believes that suicide occurs as a result of...

an earlier repressed desire to kill someone else

Unmet needs for satisfaction and security result in...

an undeveloped ego and a weak superego

The precursor to violence is...

anger

What is viewed as the emotional response to one's perception of a situation?

anger

Positive functions or constructive uses of anger:

anger energizes and mobilizes the body for self-defense; communicated assertively, anger can promote conflict resolution; anger arousal is a personal signal or threat or injustice against oneself, the signal elicits coping responses to deal with the distress; anger is constructive when it provides a feeling of control over a situation and the individual is able to assertively take charge of the situation; and anger is constructive when it is expressed assertively, serves to increase self-esteem, and leads to mutual understanding and forgiveness

What is the use of various techniques and strategies to control responses to anger-provoking situations; the goal is to reduce both the emotional feelings and the physiological arousal that anger endangers?

anger management

Aggression can arise from...

anger, anxiety, guilt, frustration, or suspiciousness

What occurs in response to changes that occur in an individual's life that disrupts feelings of relatedness to the group?

anomic suicide

Mild depression symptoms: at the physiological level:

anorexia or overeating, insomnia or hypersomnia, headache, backache, chest pain, or other symptoms associated with the loss of a significant other

Moderate depression symptoms at the physiological level:

anorexia or overeating, insomnia or hypersomnia, sleep disturbances, amenorrhea, decreased libido, headaches, backaches, chest pain, abdominal pain, low energy level, fatigue and listlessness, feeling best in the morning and continually worse as the day progresses

Treatment of psychotic PPD may be treated with...

antidepressants, supportive psychotherapy, group therapy, and possibly family therapy

What is a necessary force for survival and has been experienced by humanity throughout the ages?

anxiety

What is apprehension, tension, or uneasiness from anticipation of danger, the source of which is largely unknown or unrecognized; may be regarded as pathological when it interferes with social and occupational functioning, achievement of desired goals, or emotional comfort?

anxiety

What is considered a normal reaction to a realistic danger or threat to biological integrity or self-concept?

anxiety

What is the subjective emotional response to a stressor?

anxiety

What are vague uneasy feeling of discomfort or dread accompanied by an autonomic response; a feeling of apprehension caused by anticipation of danger?

anxiety (panic)

What are the most common of all psychiatric illnesses and result in considerable functional impairment and distress?

anxiety disorders

Phobias can begin at...

any age

The possibility of neglect may be considered when the parent or other adult caregiver:

appears to be indifferent to the child; seems apathetic or depressed; behaves irrationally or in a bizarre manner; and is abusing alcohol or other drugs

Norepinephrine is known to mediate...

arousal and can cause hyperarousal and anxiety

What promotes equality in human relationships, enabling us to act in our own best interests, to stand up for ourselves without undue anxiety, to express honest feelings comfortably, to exercise personal rights without denying the rights of others?

assertive behavior

Nurses can assist individuals to learn and practice...

assertiveness techniques

Those who consider themselves religiously affiliated are less likely to..

attempt suicide than their nonreligious counterparts

In what stage, is there a dawn of hope that life is not over?

awareness stage

Margaret, a 68 year old widow experiencing a manic episode, is admitted to the psychiatric unit after being brought to the emergency department by her sister in law. Margaret yells, "My sister in law is just jealous of me! She's trying to make it look like I'm insane!" This behavior is an example of? a) delusion of grandeur b) delusion of persecution c) delusion of reference d) delusion of control or influence

b) delusion of persecution

A fellow worker often borrows small amounts of money from you with the promise that she will pay you back "tomorrow." She currently owes you $15, and has not yet paid back any that she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is an example of a nonassertive response? a. "I've decided not to loan you any more money until you pay me back what you already borrowed." b. "I'm so sorry. I only have enough to pay for my own lunch today." c. "Get a life, will you? I'm tired of you sponging off me all the time!" d. "Sure, here's two dollars." Then to the other workers in the office: "Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!"

b. "I'm so sorry. I only have enough to pay for my own lunch today."

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is: a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

b. "It is not your fault. You did the right thing by coming here."

You are in a movie theater that prohibits smoking. The person in the seat next to you just lit a cigarette and the smoke is very irritating. Which of the following is an example of an assertive response? a. You say nothing. b. "Please put your cigarette out. Smoking is prohibited." c. You say nothing, but begin to frantically fan the air in front of you and cough loudly and convulsively. d. "Put your cigarette out, you slob! Can't you read the 'no smoking' sign?"

b. "Please put your cigarette out. Smoking is prohibited."

Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." The nurse's best response is: a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."

The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68-year-old woman with major depressive disorder. After 3 days of taking the medication, Margaret says to the nurse, "I don't think this medicine is doing any good. I don't feel a bit better." What is the most appropriate response by the nurse? a. "cheer up Margaret. you have so much to be happy about." b. "sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "i'll report that to the physician, margaret. maybe he will order something different." d. "try not to dwell on your symptoms, margaret. why don't you join the others down in the dayroom?"

b. "sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms."

Which of the following assessment data would the nurse consider as risk factors for possible violence in a client? (Select all that apply.) a. A diagnosis of somatization disorder b. A diagnosis of bipolar disorder c. Substance intoxication d. Argumentative and demanding behavior e. Past history of violence

b. A diagnosis of bipolar disorder c. Substance intoxication d. Argumentative and demanding behavior e. Past history of violence

Which of the following statements describes battering? a. Violence is that of a physical or sexual nature. b. Battering is a complex pattern related to power and control over another person. c. The batterer takes responsibility for his/her actions. d. Violence usually stops when the victim gives enough power to the abuser.

b. Battering is a complex pattern related to power and control over another person.

The third phase of the behavioral patterns that are repeated over time in abusive relationships is called the ___________. a. Tension building phase. b. Honeymoon phase. c. Acute Battering Incident. d. Triggering event phase.

b. Honeymoon phase.

Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso, in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

b. Jana is experiencing physical abuse and neglect.

Which of the following individuals is at the highest risk for suicide? a. Nancy, age 33, Asian American, Catholic, middle socioeconomic group, alcoholic b. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer in the pancreas c. Carol, age 15, African American, Baptist, high socioeconomic group, no physical or mental health problems d. Mike, age 55

b. John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer in the pancreas

A child with bipolar disorder also has attention-deficit/hyperactivity disorder (ADHD). How would these comorbid conditions most likely be treated? a. No medication would be given for either condition b. Medication would be given for both conditions simultaneously c. The bipolar condition would be stabilized first before medication for the ADHD would be given d. The ADHD would be treated before consideration of the bipolar disorder

b. Medication would be given for both conditions simultaneously

Margaret, a 68-year-old widow, is brought to the emergency department by her sister-in-law. Margaret has a history of bipolar disorder and has been maintained on medication for many years. Her sister-in-law reports that Margaret quit taking her medication a few months ago, thinking she didn't need it anymore. She is agitated, pacing, demanding, and speaking very loudly. Her sister-in-law reports that Margaret eats little, is losing weight, and almost never sleeps: "I'm afraid she's going to just collapse!" Margaret is admitted to the psychiatric unit. The priority nursing diagnosis for Margaret is: a. Imbalance nutrition: less than body requirement related to not eating b. Risk for injury related to hyperactivity c. Disturbed sleep pattern related to agitation d. Ineffective coping related to denial of depression

b. Risk for injury related to hyperactivity

John, age 27, was brought to the emergency department by two police officers. He smelled strongly of alcohol and was combative. His blood alcohol level was measured at 293 mg/dL. His girlfriend reports that he drinks excessively every day and is verbally and physically abusive. The nurses give John the nursing diagnosis of Risk for Other-Directed Violence. What would be appropriate outcome objectives for this diagnosis? (Select all that apply.) a. The client will not verbalize anger or hit anyone. b. The client will verbalize anger rather than hit others. c. The client will not harm self or others. d. The client will be restrained if he becomes verbally or physically abusive.

b. The client will verbalize anger rather than hit others. c. The client will not harm self or others.

John and his girlfriend had an argument during her visit. Which behavior by John would indicate he is learning to adaptively problem-solve his frustrations? a. John says to the nurse, "Give me some of that medication before I end up in restraints!" b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag. c. John says to the nurse, "I guess I'm going to have to dump that broad!" d. John says to his girlfriend, "You'd better leave before I do something I'm sorry for."

b. When his girlfriend leaves, John goes to the exercise room and punches on the punching bag.

Cognitive therapy assists the client to reduce their anxiety response by: a. understanding the hypothesized unconscious meaning of the anxiety. b. altering cognitive distortions. c. based on education. d. providing homework assignments. e. all of the above.

b. altering cognitive distortions. c. based on education. d. providing homework assignments.

In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include? (select all that apply) a. don't eat chocolate while taking this medication b. keep taking this medication, even if you don't feel it is helping. it sometimes takes a while to take effect. c. don't take this medication with the migraine drugs triptans. d. go to the lab each week to have your blood drawn for therapeutic level of this drug e. this drug causes a high degree of sedation, so take it just before bedtime

b. keep taking this medication, even if you don't feel it is helping. it sometimes takes a while to take effect. c. don't take this medication with the migraine drugs triptans.

A newly admitted depressed client isolates herself in her room and just sits and stares into space. How best might the nurse begin an initial therapeutic relationship with this client? a. say "come with me. I will go with you to group therapy." b. make frequent short visits to her room and sit with her. c. offer to introduce her to the other clients d. help her identify stressors in her life that precipitates crises

b. make frequent short visits to her room and sit with her.

Which of the following is a true statement about mental health recovery? (Select all that apply) a. mental health recovery applies only to severe and persistent mental illness b. mental health recovery serves to provide empowerment to the client c. mental health recovery is based on the medical model d. mental health recovery is a collaborative process

b. mental health recovery serves to provide empowerment to the client d. mental health recovery is a collaborative process

A young woman who has just undergone a sexual assault is brought into the ED by a friend. The priority nursing intervention would be: a. help her to bathe and clean herself up b. provide physical and emotional support during evidence collection c. provide her with a written list of community resources for survivors of rape d. discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases

b. provide physical and emotional support during evidence collection

The initial care plan for a client with OCD who washes her hands obsessively would include which nursing interventions? a. keep the client's bathroom locked so she cannot wash her hands all the time. b. structure the client's schedule so that she has plenty of time for washing her hands c. place the client in isolation until she promises to stop washing her hands so much d. explain the client's behavior to her, since she is probably unaware that it is maladaptive

b. structure the client's schedule so that she has plenty of time for washing her hands

A nurse is educating a patient about his lithium therapy. She is explaining signs and symptoms of lithium toxicity. Which of the following would she instruct the client to be alert for? a. fever, sore throat, malaise b. tinnitus, severe diarrhea, ataxia c. occipital headache, palpitations, chest pain d. skin rash, marked rise in blood pressure, bradycardia

b. tinnitus, severe diarrhea, ataxia

tremor

basal ganglia

The phenomenon of learned helplessness may be applied to the...

battered woman's progressing inability to act on her own behalf

What is a pattern of coercive control founded on and supported by physical and/or sexual violence or threat of violence of an intimate partner?

battering

Transparency is important in the teambuilding process between the individual and the professional helper

be transparent

The individual is the expert in their life and they must be the leader in deciding what needs to be done

become the apprentice

In bipolar disorder, recovery is a continuous process. Some the strategies to help an individual take control of bipolar disorder include:

becoming an expert on the disorder, take medications regularly, become aware of the earliest symptoms, develop a plan for emergencies, identify and reduce sources of stress, know when to seek help, and develop a personal support system.

Suicide is not a diagnosis or a disorder, it is a...

behavior

What are the behaviors of fear?

behavior directed toward avoidance of a feared object or situation (phobic disorder)

Examples of emotional injury include....

belittling or rejecting the child, ignoring the child, blaming the child for thing over which he or she has no control, isolating the child from normal social experiences, and using harsh and inconsistent discipline

Most rapists are...

between the ages of 25 and 44, and 54% are white, 32% are black, and the remainder are a mix of other races

What are mood swing cycles of extreme elation and euphoria and profound depression?

bipolar disorder

What abnormally and persistently elevated, expansive, or irritable mood and excessive activity or energy that is judged to be the result of direct physiological consequence of another medical condition?

bipolar disorder due to another medical condition

Action of SSRIs:

block reuptake of serotonin into the presynaptic nerve terminal, increasing synaptic concentration of serotonin

Action of noradrenergic agents: propranolol - clonidine -

blocks beta adrenergic receptor activity; stimulates alpha-adrenergic receptors

Symptoms at serum lithium levels of 1.5 to 2.0 mEq/L:

blurred vision, ataxia, tinnitus, persistent nausea and vomiting, severe diarrhea

Symptoms of depression and characteristics of OCD are common in individuals with...

body dysmorphic disorder

What is the exaggerated belief that the body is deformed or defective in some specific way?

body dysmorphic disorder

Side effects of noradrenergic agents: propranolol -

bradycardia, hypotension, weakness, fatigue, impotence, GI upset, bronchospasm

respiratory activation; heart rate

brainstem

What did Hippocrates believe caused melancholia?

by excessive black bile, a heavily toxic substance produced in the spleen or intestine, which affected the brain

A client whose husband died 6 months ago is diagnosed with major depressive disorder. She says to the nurse, "I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? a. "Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer." b. "I can understand how you must feel." c. "Those feelings are a normal part of the grief response." d. "Just think about the good times that you had while he was alive."

c) "Those feelings are a normal part of the grief response."

At a hospital committee meeting, a fellow nurse who is the chairperson has interrupted you each time you have tried to make a statement. The next time it happens, you intend to respond assertively. Which of the following is an example of an assertive response? a. "You make a lousy leader! You won't even let me finish what I'm trying to say!" b. You say nothing. c. "Excuse me. I would like to finish my statement." d. You say nothing, but you fail to complete your assignment and do not show up for the next meeting.

c. "Excuse me. I would like to finish my statement."

A client who has been in restraints is now calm. He apologizes to the nurse and says, "I hope I didn't hurt anyone." The nurse's best response is: a. "This is our job. We know how to handle violent clients." b. "We understand you were out of control and didn't really mean to hurt anyone." c. "It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control you behavior." d. "It is an unpleasant situation to have to restrain someone, but we have to think of the other clients. We can't have you causing injury to others. I just hope it doesn't happen again."

c. "It is fortunate that no one was hurt. You will not be placed in restraints as long as you can control you behavior."

Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? a. "You'll get over him in time, Theresa." b. "Forget him. There are other fish in the sea." c. "You must be feeling very sad about your loss." d. "Why do you think he broke up with you, Theresa?"

c. "You must be feeling very sad about your loss."

Your husband says, "You're crazy to think about going to college! You're not smart enough to handle the studies and the housework, too." Which of the following is an example of a nonassertive response? a. "I will do what I can, and the best that I can." b. (Thinking to yourself): "We'll see how he likes cooking dinner for a change." c. "You're probably right. Maybe I should reconsider." d. "I'm going to do what I want to do, when I want to do it, and you can't stop me!"

c. "You're probably right. Maybe I should reconsider."

A typewritten report for your psychiatric nursing class is due tomorrow at 8 a.m. The assignment was made 4 weeks ago, and yours is ready to turn in. Your roommate says, "I finally finished writing my report, but now I have to go to work, and I don't have time to type it. Please be a dear and type it for me, otherwise I'll fail!" You have a date with your boyfriend. Which of the following is an example of an aggressive response? a. "Okay, I'll call Ken and cancel our date." b. "I don't want to stay here and type your report. I'm going out with Ken." c. "You've got to be kidding! What kind of a fool do you take me for, anyway?" d. "Okay, I'll do it." However, when your roommate returns from work at midnight, you are asleep and the report has not been typed.

c. "You've got to be kidding! What kind of a fool do you take me for, anyway?"

Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium b. Group therapy with other agoraphobics c. Facing her fear in gradual step progression d. Hypnosis

c. Facing her fear in gradual step progression

John, who was hospitalized with alcohol intoxication and violent behavior, is sitting in the dayroom watching TV with the other clients when the nurse approaches with his 5 p.m. dose of haloperidol. John says, "I feel in control now. I don't need any drugs." The nurse's best response is based on which of the following statements? a. John must have the medication, or he will become violent. b. John knows that if he will not take the medication orally, he will be restrained and given an intramuscular injection. c. John has the right to refuse the medication provided there is no immediate danger to self or others. d. John must take the medication at this time in order to maintain adequate blood levels.

c. John has the right to refuse the medication provided there is no immediate danger to self or others.

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that Sharon provoked with her threat to leave. d. Phase III. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

c. Phase II. The acute battering incident that Sharon provoked with her threat to leave.

The fear of social or performance situations in which embarrassment may occur and when experienced produces an immediate response refers to: a. Agoraphobia b. Specific Phobia c. Social Phobia d. Panic Disorder

c. Social Phobia

When it has been assessed that a client is in control and no longer requires restraining, how does the nurse proceed? a. The nurse removes the restraints. b. The nurse calls for assistance to remove the restraints. c. With assistance, the nurse removes one restraint. d. The nurse tells the client he will have to wait until the doctor comes in.

c. With assistance, the nurse removes one restraint.

A nurse who is helping a client with mental illness recovery using the WRAP Model says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following? a. a list of words that describe how the individual feels when he or she is feeling well b. a list of things the client needs to do every day to maintain wellness c. a list of strategies the client has used in the past that help relieve disturbing symptoms d. a list of the client's favorite health-care providers and phone numbers

c. a list of strategies the client has used in the past that help relieve disturbing symptoms

Margaret, age 68, is diagnosed with Bipolar I Disorder, current episode manic. She is extremely hyperactive and has lost weight. One way to promote adequate nutritional intake for Margaret is to? a. sit with her during meals to ensure that she eats everything on her tray b. have her sister in law bring all her food from home because she knows Margaret's likes and dislikes c. provide high calorie, nutritious finger foods and snacks that Margaret can eat "on the run" d. tell Margaret that she will be on room restriction until she starts gaining weight

c. provide high calorie, nutritious finger foods and snacks that Margaret can eat "on the run"

A client experiencing a manic episode enters the milieu area dressed in a provocative and physically revealing outfit. Which of the following is the most appropriate intervention by the nurse? a. tell the client that she cannot wear this outfit while she is in the hospital b. do nothing and allow her to learn from the responses of her peers c. quietly walk with her back to her room and help her change into something more appropriate d. explain to her that if she wears this outfit she must remain in her room

c. quietly walk with her back to her room and help her change into something more appropriate

Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized with Major Depressive Disorder. The priority nursing diagnosis for Margaret would be: a. imbalanced nutrition; less than body requirements b. complicated grieving c. risk for suicide d. social isolation

c. risk for suicide

A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? a. the wellness toolbox b. the daily maintenance c. the individual's personal story d. triggers

c. the individual's personal story

Phase III can last between the times of Phase I or II but...

can be so short that it can go undetected

Anxiety was first described as a physiological disorder and identified by its physical symptoms, particularly the...

cardiac symptoms

Hypomania mood:

cheerful and expansive, underlying irritability that surfaces rapidly if something goes wrong

What is the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing any visual depiction of such conduct; or the rape, and in cases of caretaker of inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children?

child sexual abuse

OCD may begin in...

childhood but is more common to begin in adolescence or early adulthood

Generalized anxiety disorder may begin in...

childhood or adolescence, but onset is not uncommon after age 20

The disorder occurs in all developmental levels, including...

childhood, adolescence, senescence, and during the puerperium

Most rapes happen...

close to the victim's own neighborhood

Delirious mania cognition and perception:

clouding of consciousness, with accompanying confusion, disorientation, and sometimes stupor. Religiosity, delusions of grandeur or persecution, and auditory or visual hallucinations. Extremely distractible and incoherent.

The most effective treatment for depression in the elderly is a...

combination of psychosocial and behavioral approaches

Relationships and social network that provide support, friendship, love, and hope

community

Symptoms of bipolar disorder may be hard to assess in children, and they may also present with...

comorbid conduct disorders or ADHD

What is a disorder that occurs after death of a significant other, in which the experience of distress accompanying bereavement fails to follow normative expectations and manifests in functional impairment?

complicated grieving

Some survivors develop a...

compounded rape reaction, in which additional symptoms such as depression and suicide, substance abuse, and even psychotic behaviors

What are repetitive ritualistic behavior or thoughts, the purpose of which is to prevent or reduce distress or to prevent some dreaded event or situation; the person feels driven to perform such actions in response to an obsession or according to rules that must be applied rigidly, even though the behaviors or thoughts are recognized to be excessive or unreasonable?

compulsions

Symptoms of depression in the elderly are not much different than in younger people, but they are often...

confused with other illnesses associated with the aging process

Emotional abuse may be suspected when the parent or other adult caregiver:

constantly blames, belittles, or berates the child; is concerned about the child and refuses to consider offers of help for the child's problems; and overtly rejects the child

In cognitive therapy, the individual is taught to...

control thought distortions that are considered to be a factor in the development and maintenance of mood disorders

The following manifestations may be evident after the attack:

contusions and abrasions about various parts of the body; headaches, fatigue, sleep pattern disturbances; stomach pains, nausea and vomiting; vaginal discharge and itching, burning upon urination, rectal bleeding and pain; rage, humiliation, embarrassment, desire for revenge, and self-blame; and fear of physical violence and death

The individual and the practitioner decide together what needs to be done immediately

craft the step beyond

When developing a wellness toolbox, the individual...

creates a list of skills, tools, and skills that they have used in the past to assist in relieving disturbing symptoms

Treatment modalities for survivors of abuse include...

crisis intervention with the sexual assault victim, safe shelter for battered women, and therapy for families who use violence

What stage is identifying symptoms that indicate that the patient can no longer care for themselves, make independent decisions, or keep themselves safe?

crisis planning stage

What is a chronic mood disturbance of at least 2 years' duration, involving numerous periods of elevated mood that do not meet the criteria for a hypomanic episode and numerous periods of depressed mood of insufficient severity or duration to meet the criteria for major depressive episode, never without symptoms for more than 2 months?

cyclothymic disorder

A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

d. "I hope you have made the right decision. Call this number if you need help."

You are asked to serve on a committee on which you do not wish to serve. Which of the following is an example of a nonassertive response? a. "Thank you, but I don't wish to be a member of that committee." b. "I'll be happy to serve." But then you don't show up for any of the meetings. c. "I'd rather have my teeth pulled!" d. "Okay, if I'm really needed, I'll serve."

d. "Okay, if I'm really needed, I'll serve."

Which of the following is true about childhood sexual abuse? a. The abuse helps children to learn to trust their own feelings. b. Peer relationships develop without delay. c. Women who were abused as children do not commonly enter into relationships with men who abuse them. d. Childhood sexual abuse commonly distorts development of normal associations of pleasure with sexual activity.

d. Childhood sexual abuse commonly distorts development of normal associations of pleasure with sexual activity.

Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T experiences panic anxiety when she encounters snakes. b. Ms. T refuses to fly in an airplane. c. Ms. T will not eat in a public place. d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

This disorder is characterized by recurrent, unexplained panic attacks followed by at least one month of persistent concern about having another attack. a. Obsessive Compulsive Disorder b. Generalized Anxiety Disorder c. Specific Phobia d. Panic Disorder

d. Panic Disorder

Pairing relaxation techniques with imagined scenes of situations that cause an anxiety response is a form of cognitive behavioral therapy called: a. Exposure b. Cognitive Restructuring c. Biofeedback d. Systematic Desensitization

d. Systematic Desensitization

Education for the client who is taking MAOIs should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity. b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks. c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment. d. Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification.

d. Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification.

The most common comorbid condition in children with bipolar is: a. schizophrenia b. substance disorders c. oppositional defiant disorder d. attention-deficit/hyperactivity disorder

d. attention-deficit/hyperactivity disorder

John is a client at the mental health clinic. He is depressed, has been expressing suicidal ideations, and has been seeing the psychiatric nurse every 3 days. He has been taking 100 mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. Today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. How might the nurse assess this behavioral change? a. the sertraline is finally taking effect b. he is no longer in need of antidepressant medication c. he has completed the grief response over the loss of his wife d. he may have decided to carry out his suicide plan

d. he may have decided to carry out his suicide plan

A woman who was sexually assaulted six months ago by a man with whom she was acquainted that has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason that the man raped her was: a. because he had been drinking, he was not in control of his actions b. he had not had sexual relations with a girl in many months c. he was predisposed to become a rapist by virtue of the poverty conditions under which he was reared d. he was expressing power and dominance by means of sexual aggression and violence

d. he was expressing power and dominance by means of sexual aggression and violence

With implosion therapy, a client with phobic anxiety would be: a. taught relaxation exercises b. subjected to graded intensities of the fear c. instructed to stop the therapeutic session as soon as anxiety is experienced d. presented with massive exposure to a variety of stimuli associated with the phobic object/situation

d. presented with massive exposure to a variety of stimuli associated with the phobic object/situation

Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways? a. she feels hopeless about her future without her boyfriend b. without her boyfriend, she feels like an outsider with her peers c. she is feeling intense guilt about her boyfriend broke up with her d. she is angry at her boyfriend for breaking up with her and has turned the anger inward toward herself

d. she is angry at her boyfriend for breaking up with her and has turned the anger inward toward herself

A nurse is assisting an individual with mental illness recovery using the psychological recovery model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the psychological recovery model would the nurse assess this individual to be? a. the awareness stage b. the preparation stage c. the rebuilding stage d. the moratorium stage

d. the moratorium stage

A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. Another way in which the nurse can get information from the child is to: a. have her evaluated by the school psychologist b. tell her she may select a "treat" from the treat box of she answers the nurse's questions c. explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class d. use a family of dolls to role-play the child's family with her

d. use a family of dolls to role-play the child's family with her

GABA is ____ in anxiety disorders.

decreased

Serotonin is ____ in anxiety disorders.

decreased

The abusing man wages a continuous campaign of...

degradation against his female partner

Mild depression symptoms: at the affective level

denial of feelings, anger, anxiety, guilt, helplessness, hopelessness, sadness, despondency

Severe depression symptoms: at the affective level:

denial of feelings, anger, anxiety, guilt, helplessness, hopelessness, sadness, despondency

Anger is a stage in the grieving process, and individuals who become fixed in this stage may become...

depressed

Symptoms of postpartum melancholia:

depressed mood, agitation, indecision, lack of concentration, guilt, and an abnormal attitude toward bodily functions. There could be a lack of interest in or rejection of their baby. Risks of suicide and infanticide should not be overlooked

Being single is a predisposing factor to...

depression

What is an alteration in mood that is expressed as feelings of sadness, despair, and pessimism; there is a loss of interest in usual activities, and somatic symptoms may be evident, changes in appetite and sleep patterns are common?

depression

What is one of the oldest and most frequently diagnosed psychiatric illnesses?

depression

What is one of the oldest recognized psychiatric illnesses that is still prevalent today?

depression

When anger is turned inward on oneself, it can result in...

depression and low self-esteem

Brain tumors esp. in the temporal lobe can cause...

depression symptoms

Examples of mood include...

depression, joy, elation, anger, and anxiety

Once the crisis intervention is complete, the individual may require long-term psychotherapy, during which he or she works to:

develop and maintain a more positive self-concept, learn more effective ways to express feelings, improve interpersonal relationships, and achieve a sense of belonging and a measure of hope for living

Nurses need to express genuine interest in the story so that they can better understand the storyteller and their story

develop genuine curiosity

The steps of the WRAP model.

developing a wellness toolbox, daily maintenance list, triggers, early warning signs, things are breaking down or getting worse, and crisis planning

What is the confusion in mental picture of one's physical self?

disturbed body image

Side effects of antipsychotics:

dizziness, drowsiness, dry mouth, constipation, increased appetite, weight gain, ECG changes, extrapyramidal symptoms, and hyperglycemia and diabetes

Side effects of buspirone:

dizziness, drowsiness, dry mouth, headache, nervousness, nausea, insomnia

A meteorological factor associated _____ to human mental instability. (2)

drastic temperature and barometric pressure changes

Side effects of lithium:

drowsiness, dizziness, headache, dry mouth, thirst, GI upset, nausea and vomiting, fine hand tremors, hypotension, arrhythmias, pulse irregularities, polyuria, dehydration, and weight gain

Side effects of calcium channel blockers:

drowsiness, dizziness, hypotension, bradycardia, nausea, and constipation

Side effects of noradrenergic agents: clonidine -

dry mouth, sedation, fatigue, hypotension.

What is similar but milder than MDD, chronically depressed mood for most of the day, more days than not, for at least 2 years; can be early or late onset and there is no evidence of psychotic symptoms?

dysthymia (persistent DD)

Which of the following describe the common reasons a battered woman stays with an intimate partner? a. Fear of retaliation. b. For the sake of her children. c. Lack of a support network. d. Hopelessness. e. All of the above.

e. All of the above.

The average onset for bipolar disorder is the...

early 20s

What is the response of the individual who feels separate and apart from the mainstream if society; integration is lacking, and the individual doesn't feel like a part of any cohesive group?

egoistic suicide

During a manic episode, the mood is...

elevated, expansive, and irritable

What is a pattern of behavior on the part of the parent or caretaker that results in serious impairment of the child's social, emotional, or intellectual functioning?

emotional abuse

What is chronic failure by the parent or caretaker to provide the child with the hope, love, and support necessary for the development of a sound, healthy personality?

emotional neglect of a child

Anxiety involves the...

emotional response to the intellectual appraisal of a threatening stimulus

Anxiety is an _____ process, while fear is a _____ process.

emotional; cognitive

The basic concept of a recovery model is...

empowerment of the consumer

There is evidence to suggest that the addition of psychosocial therapy...

enhances the effectiveness of psychopharmacological therapy in the maintenance of bipolar disorder in children and adolescents

Epilepsy of temporal and frontal lobes origin in...

episodic aggression and violent behavior

Is OCD more common in men or women?

equally common in men and women

Acute mania mood:

euphoria and elation, a continuous high, but it is subject to frequent variation by changing to irritability and anger or sadness and crying

Symptoms associated in children and adolescents with BD:

euphoric/expansive mood, irritable mood, grandiosity, decreased need for sleep, pressured speech, racing thoughts, distractibility, increase in goal-directed activity/psychomotor agitation, excessive involvement in pleasurable or risky activities, psychosis, and suicidality

Motor activity in manic episodes is...

excessive and frenzied while, psychotic features may also be present

The person knows that his or her fear is...

excessive or unreasonable, but is powerless to change, even though the individual may occasionally endure the phobic stimulus when experiencing intense anxiety

Symptoms at serum lithium levels of 2.0 to 3.5 mEq/L:

excessive output of dilute urine, increasing tremors, muscular irritability, psychomotor retardation, mental confusion, and giddiness

Acute mania activity and behavior:

excessive, sexual interest is increased, poor impulse control, may become social and sexually uninhibited, excessive spending is common. They have the ability to make others carry out their wishes and project failure onto those people. Energy seems inexhaustible and sleep need is diminished. Hygiene is neglected, dress may be disorganized or bizarre, and makeup may be excessive

Assertive behaviors characteristics:

eye contact, body posture like sitting and leaning toward the person in conversation, distance/physical contact, gestures, facial expressions, voice, fluency, timing, listening, thoughts, content, and persistence

True or false: Most rapists have a history of mental illness.

false

Studies of familial patterns suggest that a ____ to anxiety disorders exists.

familial predisposition

Victims may be isolated from...

family and support systems

Cognitive theorists think that anxiety is a product of...

faulty cognitions or anxiety-inducing self-instructions

The main thesis of the cognitive view is that...

faulty, distorted, or counterproductive thinking patterns accompany or precede maladaptive behaviors and emotional disorders

What is the response to perceived threat that is consciously recognized as a danger?

fear

zoophobia

fear of animals

taphophobia

fear of being buried alive

ailurophobia

fear of cats

nyctophobia

fear of darkness

thanatophobia

fear of death

mysophobia

fear of dirt, germs, and contamination

cynophobia

fear of dogs

claustrophobia

fear of enclosed spaces

pyrophobia

fear of fire

anthophobia

fear of flowers

trichophobia

fear of hair

acrophobia

fear of heights

homophobia

fear of homosexuality

equinophobia

fear of horses

dementophobia

fear of insanity

astraphobia

fear of lightning

herpetophobia

fear of lizards, reptiles

gamophobia

fear of marriage

murophobia

fear of mice

belonephobia

fear of needles

numerophobia

fear of numbers

algophobia

fear of pain

anthropophobia

fear of people

siderodromophobia

fear of railroads or train travel

A child may experience many years of abuse without reporting it because of...

fear of retaliation by the abuser

Other reasons women stay in abusive relationships include:

fear of retaliation, for the children, for financial reasons, lack of a support network, religious reasons, and hopefulness

ochophobia

fear of riding in a car

ophidiophobia

fear of snakes

Specific phobia is identified by...

fear of specific objects or situations that could cause harm, but the person's reaction to them is excessive, unreasonable, and inappropriate

arachnophobia

fear of spiders

xenophobia

fear of strangers

triskaidekaphobia

fear of the number 13

aquaphobia

fear of water

scoleciphobia

fear of worms

Signs of depression up to age three:

feeding problems, tantrums, lack of playfulness, and emotional expressiveness, failure to thrive, or delays in speech and gross motor development

Assertive behavior helps us...

feel good about ourselves, increases our self-esteem, helps us feel good about others, and increases our ability to develop satisfying relationships with others

Assertive behavior promotes a...

feeling of personal power and self-confidence, which are commonly lacking in clients with emotional disorders

Transient depression symptoms physiological level:

feeling tired and listless

In the expressed response pattern, the survivor expresses...

feelings of fear, anger, and anxiety through such behaviors as crying, sobbing, restlessness, and tension

What feelings are common in the victim?

feelings of guilt, anger, fear, and shame

Anger is physiological arousal, it instills...

feelings of power and generates preparedness

Moderate depression symptoms: at the affective level:

feelings of sadness, dejection, helplessness, powerlessness, hopelessness, gloomy and pessimistic outlook, low self-esteem, difficulty experiencing pleasure in activities

Severe depression symptoms at the behavioral level:

feelings of total despair, hopelessness and worthlessness, flat affect, appearing devoid of emotional tone, prevalent feeling is nothingness and emptiness, apathy, loneliness, sadness, and inability to feel pleasure

How does the client feel in the moratorium stage?

feels hopeless, out of control and powerless to change, like they don't know who they are as a person and being diagnosed with a mental illness can be traumatic and create a loss of meaning in life

While men use ___ more often.

firearms

MDD is more common among...

first-degree relatives of people with the disorder than among the general population

Rape is a traumatic experience, and many women experience...

flashbacks, nightmares, rage, physical symptoms, depression, and thoughts of suicide for many years after the occurrence

Acute mania cognition and perception:

fragmented and often psychotic, racing and disjointed thinking that may be manifested by a continuous flow of accelerated, pressured speech, with abrupt changes from topic to topic, SO easily distracted, and hallucination and delusions are common

Delirious mania activity and behavior:

frenzied and characterized by agitated, purposeless movements, safety is at stake. Exhaustion, injury to self or others, and eventually death can occur without intervention in delirious mania

cognitive interpretations

frontal cortex

Anger can be associated with a number of typical behaviors, including:

frowning facial expression, clenched fists, low-pitched verbalizations forced through clenched teeth, yelling and shouting, intense eye contact or avoidance of eye contact, easily offended, defensive response to criticism, passive-aggressive behaviors, emotional overcontrol with flushing of the face, intense discomfort, and continuous state of tension

Societal influences, such as ____, also have been implicated

general acceptance of violence as a means of solving problems

What is persistent, unrealistic, and excessive anxiety and worry, which have occurred more days than not for at least 6 months, and cannot be attributed to specific organic factors, such as caffeine intoxication or hyperthyroidism?

generalized anxiety disorder

Panic disorders have a strong ______ element.

genetic

Aggressiveness may have a...

genetic link and the genetic karyotype XYY may be connected as well

Bipolar disorder seems to have a...

genetic vulnerability

Change happens when the individual and practitioner spend quality time in therapeutic relationship

give the gift of time

Aggression is always...

goal-directed and has the aim of harm to a specific person or object

In systematic desensitization, the client is...

gradually exposed to the phobic stimulus, either in a real or imagined situation

Many rapists report ...

growing up in abusive homes, and some theorists relate the predisposition to rape to a "seductive, but rejecting, mother.

The outcome of the psychological recovery process is...

growth

Depression in adolescence can be _____ to diagnose than in a young child.

harder

Child sexual abuse may be considered a possibility when the child:

has difficulty walking or sitting; suddenly refuses to change for gym or to participate in physical activities; reports nightmares or bedwetting; experiences a sudden change in appetite; demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior; becomes pregnant or contracts a venereal disease, particularly of under the age 14; runs away; and reports sexual abuse by a parent or another adult caregiver

Side effects of SNRIs:

headache, dry mouth, nausea, somnolence, dizziness, insomnia, asthenia, constipation, diarrhea

Overcoming and managing one's disease as well as living in a physically and emotionally healthy way

health

Recovery is supported by four major dimensions:

health, home, purpose, and community

Cognitive therapy for depression focuses on...

helping the individual to alter mood by changing the way he or she thinks

Women usually feel that their only safe place is to...

hide from the batterer

Bipolar disorder is more common in...

higher socioeconomic classes

Those in the highest and lowest socioeconomic classes have ____ than those in the middle classes.

higher suicide rates

associated with memory related to fear responses

hippocampus

What are persistent difficulties discarding or parting with possessions, regardless of their actual value?

hoarding disorders

A stable and safe place to live

home

Some fathers who participate in incestuous relationships may have...

homosexual tendencies and have difficulty achieving a stable heterosexual orientation

What is basic to assertive behavior?

honesty

Recovery emerges from...

hope

What is the catalyst of the recovery process?

hope

finding and maintaining hope that recovery can occur

hope

There are four components that were consistently evident in the recovery process:

hope, responsibility, self and identity, and meaning and purpose

What may be a central underlying factor in the predisposition to suicide?

hopelessness

PPD can be associated with...

hormonal changes, tryptophan metabolism, or alterations in membrane transport during the early postpartum period

SAD is thought to be related to the presence of the...

hormone melatonin

In the Tidal Model, the metaphor of water is used to describe...

how individuals in distress can become emotionally, physically, and spiritually shipwrecked

Other symptoms of childhood depression include:

hyperactivity, delinquency, school problems, psychosomatic complaints, sleeping and eating disturbances, social isolation, delusional thinking, and suicidal thoughts or actions

Lithium is contraindicated in those with...

hypersensitivity, cardiac or renal disease, dehydration, sodium depletion, brain damage, pregnancy and lactation. Use with caution in those with thyroid disorder, diabetes, urinary retention, history of seizures, and with the elderly

What is not severe enough to cause marked impairment in social or occupational functioning or to require hospitalization, and it does not include psychotic features?

hypomania

Symptoms of manic states can be described according to three stages:

hypomania, acute mania, and delirious mania

activation of stress response

hypothalamus

The early warnings sign is divided into two parts: part 1 involves...

identification of the subtle signs that indicate a possible worsening of the situation

The ___ cannot prevent dominant id behavior from occurring.

immature ego

Symptoms at serum lithium levels above 3.5 mEq/L:

impaired consciousness, nystagmus, seizures, coma, oliguria/anuria, arrhythmias, myocardial infarction, and cardiovascular collapse

Group therapy forms an...

important dimension of multimodal treatment for the depressed client

Recovery from mental health disorders and substance use disorders is a process of change through which individuals...

improve their health and wellness, live a self-directed life, and strive to reach their full potential

Several factors put adolescents at risk for suicide, including...

impulsive and high risk behaviors, untreated mood disorders, access to lethal means, and substance abuse

Some women who are in violent relationships grew up...

in abusive homes and may have left those homes, even gotten married, at a very young age to escape the abuse

The things are breaking down and getting worse stage is divided into two parts:

in part one, the individual lists symptoms that are occurring that indicate that the situation has worsened and in part two, the individual makes a plan that he or she thinks will help when the symptoms have worsened

What are the behaviors of ineffective role performance?

inability to fulfill usual patterns of responsibility because of need to perform rituals (OCD)

Common symptoms of depression in the adolescent are...

inappropriately expressed anger, aggressiveness, running away, delinquency, social withdrawal, sexual acting out, substance abuse, restless, and apathy, loss of self-esteem, sleeping and eating disturbances, and psychosomatic complaints are also common

What is the occurrence of sexual contacts or interaction between, or sexual exploitation of, close relatives, or between participants who are related to each other by a kinship bod that is regarded as a prohibition to sexual relations?

incest

Antidepressants work to ___, which is accomplished by blocking the reuptake of these neurotransmitters by the neurons.

increase the concentration of norepinephrine, serotonin, and/or dopamine

Norepinephrine is _____ in anxiety disorders.

increased

Hypomania activity and behavior:

increased motor activity, very extroverted and sociable, lack the depth of personality and warmth to formulate close friendships, talk and laugh a lot (even when it is inappropriate), increased libido, and some have weight loss and anorexia

Various long-term effects include...

increased restlessness, dreams and nightmares, and phobias

Severe insomnia is associated with an...

increased risk for suicide

Action of benzodiazepines:

increases the affinity of the GABAA receptor for GABA

Treatment of bipolar disorders includes...

individual therapy, group and family therapy, cognitive therapy, ECT, and psychopharmacology

Treatment of depression includes...

individual therapy, group and family therapy, light therapy, transcranial magnetic stimulation, and psychopharmacology

ECT is the...

induction of a grand mal (generalized) seizure through the application of electrical current to the brain

What is the inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources?

ineffective coping

What is a pattern of performing rapid, unplanned reactions to internal or external stimuli without regard for the negative consequences of these reactions to the impulsive individual or to others?

ineffective impulse control

Action of SNRIs:

inhibit reuptake of neuronal serotonin and norepinephrine; mild reuptake of dopamine

Freud believed that suicide is a response to the...

intense self-hatred that an individual possessed; the anger originated toward a love object but was ultimately turned inward against the self

What is the requisite in the definition of aggression?

intent

The Tidal Model is a mental health nursing recovery model that can be used as the basis for...

interdisciplinary mental health care

Predisposing factors include...

internalized anger, hopelessness, desperation and guilt, history of aggression and violence, shame and humiliation, developmental stressors, sociological influences, genetics, and neurochemical factors

The possibility of neglect may be considered when the child:

is frequently absent from school; begs or steals food or money; lacks or needed medical or dental care, immunizations, or glasses; is consistently dirty and has severe body odor; lacks sufficient clothing for the weather; abuses alcohol or other drugs; and states that there is no one at home to provide care

Sexual abuse may be considered a possibility when the parent or other adult caregiver:

is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex; is secretive and isolated; and is jealous or controlling with family members

When is anxiety considered to be abnormal or pathological?

it is out of proportion to the situation that's creating it and the anxiety interferes with social, occupational, or other important areas of functioning

If incest is reported with one daughter then...

it should be suspected with all of the other daughters

Sometimes the woman may provoke the incident...

just to get it over with.

The average age of onset of panic disorder is the...

late 20s

Social anxiety disorder often begins in...

late childhood or early adolescence and runs a chronic, sometimes lifelong course

The expression of anger is...

learned

The suicidal client should not be...

left alone

The more cohesive the society, the more an individual feels integrated into society, and the...

less likely he or she was to commit suicide

Men succeed more because of the...

lethality of the means that they choose

Transient depression

life's everyday disappointments

The drug of choice for bipolar mania was...

lithium carbonate, but now other drugs are satisfactory alone or in combination with lithium

Part of being assertive includes...

living up to these responsibilities

arousal

locus ceruleus

A fundamental lack of trust resulting from an unsatisfactory parent-child relationship causes...

low self-esteem and a poor sense of identity is a basic characteristic of an adult survivor of incest

Many women who are battered have...

low self-esteem and assume the female sex-role stereotypes, and often accept the blame for the batterer's action

Depression and personality disorders are more common in...

lower socioeconomic classes

Deficits in _____ can cause depressive symptoms.

magnesium and sodium

84% of elderly suicides are...

male and firearms are the most common means of committing suicide

The battered woman views her relationship as...

male dominant

What is an alteration in mood that is expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, and accelerated thinking and speaking; can occur as a biological or psychological disorder, or as a response to substance use or a general medical condition?

mania

Amphetamines, antidepressants, and high doses of anticonvulsants, and narcotics have the potential for initiating a...

manic episode

Certain medications used to treat somatic illnesses have been known to trigger a...

manic response

a spouse may be held liable for sexual abuse directed at a marital partner against that person's will

marital rape

In the controlled response pattern, the feelings are...

masked or hidden, and a calm, composed, or subdued affect is seen

finding purpose and meaning in life

meaning and purpose

What is a severe form of depression in which symptoms are exaggerated and interest or pleasure of all activities is lost?

melancholia

When anger is buried, it can precipitate a number of physical problems, such as...

migraine headaches, ulcers, colitis, and even coronary artery disease

Aggression can be classified as...

mild, moderate, severe, or extreme

Panic attacks usually last...

minutes

Hope is manifested in the...

mobilization of personal and external resources to foster self-care and find pathways to goals

Dysthymia is an example of...

moderate depression

Severe depression is an intensification of the symptoms associated with the...

moderate level, but they may lose contact with reality

Augmentation with a second medication is indicated when....

monotherapy fails

Twin studies have shown a much higher concordance rate for...

monozygotic twins than for dizygotic twins

What also called affect, a pervasive and sustained emotion that may have a major influence on a person's perception of the world?

mood

Psychiatric disorders that predispose individuals to suicide include...

mood disorders, substance use disorders, schizophrenia, personality disorders, and anxiety disorders

A bipolar disorder is characterized by...

mood swings from profound depression to extreme euphoria, with intervening periods of normalcy

The Psychological Recovery Model has five stages, including:

moratorium, awareness, preparation, rebuilding, and growth

Signs of depression from ages 9 to 12:

morbid thoughts and excessive worrying

Symptoms of moderate postpartum depression:

more bad days than good, tending to be worse toward evening and associated with fatigue, irritability, loss of appetite, sleep disturbances, loss of libido, and feelings of inability to care for their baby

Anxiety provides the...

motivation for achievement and is a necessary force for survival

Side effects of anticonvulsants:

nausea and vomiting, drowsiness, dizziness, blood dyscrasias, prolonged bleeding time, risk of severe rash, decreased efficacy with oral contraceptives, and risk of suicide with all antiepileptic drugs

Side effects of SSRIs:

nausea, diarrhea, headache, insomnia, somnolence, sexual dysfunction

How many people in the US report having been the victim of intimate partner violence?

nearly 3 in 10 women and 1 in 10 men

What are the three cognitive distortions that are believed to be the basis for depression?

negative expectations of the environment, negative expectations of the self, and negative expectations of the future

Thought stopping techniques help individuals remove...

negative, unwanted thoughts from awareness and promote the development of a more assertive attitude

Recovery involves the development of...

new meaning and purpose in one's life as one grows beyond the catastrophic effects of mental illness

Battered women commonly see...

no way out of their present situation and may be encouraged by their social support network to remain in the abusive relationship

The four response patterns we need to know:

nonassertive, assertive, aggressive, and passive-aggressive

Recovery occurs via many pathways: recovery is...

nonlinear and is characterized by continual growth and improved functioning that may involve setbacks

What may play a role in aggressive impulses?

norepinephrine, dopamine, and serotonin

Depression may be related to a deficient level of...

norepinephrine, serotonin, and dopamine

Mild depression

normal grief response

Anxiety is usually considered a...

normal reaction to a realistic danger or threat to biological integrity or self-concept

What are recurrent and persistent thoughts, impulses, or images experienced as intrusive and stressful; recognized as being excessive and unreasonable even though they are a product of one's mind; the thought, impulse, or image cannot be expunged by logic or reasoning?

obsessions

Research provides support for recovery as an...

obtainable goal for individuals with bipolar disorder

There is a smaller peak in suicides in...

october

Physical abuse may be suspected when the parent or other adult caregiver:

offers conflicting, unconvincing, or no explanation for the child's injury; describes the child as "evil," or in some other very negative way; uses harsh physical discipline with the child; has a history of abuse as a child; and has a history of abusing animals or pets

Lithium levels should be monitored...

once or twice a week after initial treatment is started until levels are stable and then monthly during maintenance therapy

Aggressive behavior could be primarily a product of...

one's culture and social structure

Anger responses can be learned through...

operant conditioning

Treatment of the depressed child and adolescent is usually done in an...

outpatient fashion, except if they are actively suicidal, home environment precludes adherence to a treatment regimen, or if the patient needs to be separated from the home because of psychosocial development, or if the patient has indicated possible harm to self or others

Women usually choose...

overdose

Exposure to the phobic stimulus produces...

overwhelming symptoms of panic, including palpitations, sweating, dizziness, and difficulty breathing

Aggression can be associated with:

pacing, restlessness, tense facial expression and body language, verbal or physical threats, loud voice, shouting, use of obscenities, argumentative, threats of homicide or suicide, increase in agitation, with overreaction to environmental stimuli, panic anxiety, leading to misinterpretation of the environment, disturbed thought processes, suspiciousness, and angry mood, often disproportionate to the situation

At least four symptoms must be present to identify the presence of a panic attack:

palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feelings of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, light-headed, or faint; chills or heat sensations; paresthesia; derealization or depersonalization; fear of losing control or going crazy; or fear of dying

What are the behaviors of severe/panic anxiety?

palpitations, trembling, sweating, chest pain, shortness of breath, fear of going crazy, fear of dying (panic disorder). Excessive worry, difficulty concentrating, sleep disturbance (generalized anxiety disorder)

What is a sudden overwhelming feeling of terror or impending doom. This most severe form of emotional anxiety is usually accompanied by behavioral, cognitive, and physiological signs and symptoms considered to be outside the expected range of normalcy?

panic

Genetics, neuroanatomical, biochemical, and neurochemical aspects may contribute to...

panic and GAD

What are recurrent panic attacks, the onset of which is unpredictable, and manifested by intense apprehension, fear, or terror, often associated with feelings of impending doom and accompanied by intense physical discomfort?

panic disorder

Action of buspirone:

partial agonist of 5-HT1A receptor

Three factors that have been identified as important considerations in assessing for potential violence include:

past history of violence, client diagnosis, and current behavior

Violence occurs when...

people lose control of their anger

Hypomania cognition and perception:

perceptions of self are exalted (ideas of great worth and ability), thinking is flighty, and perception of the environment is heightened, but they are so easily distracted

Men who batter are usually characterized as...

persons with low self-esteem and high stress without the ability to cope with it; they could be pathologically jealous and present a dual-personality, which is one to the partner and another one to the rest of the world

What is fear cued by the presence of anticipation of a specific object or situation, exposure to which invariability provokes an immediate anxiety response or panic attack even though the subject recognizes that the fear is excessive or unreasonable?

phobia

Certain life experiences may set the stage for...

phobic reactions later in life

What includes any nonaccidental physical injury (ranging from minor bruises to severe fractures or death) as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting, burning, or any other method that is inflicted by a parent, caregiver, or other person who has responsibility for the child?

physical abuse of a child

What is refusal of or delay in seeking health care, abandonment, expulsion from the home or refusal to allow a runaway to return home, and inadequate supervision?

physical neglect of a child

Precipitating events include...

physical or emotional detachment by the primary caregiver, parental separation or divorce, death of a loved one, a move, academic failure, or physical illness

The symptoms associated with substance/medication-induced depressive disorder are considered to be the direct result of...

physiological effects of a substance and they cause distress and impairment in several areas of functioning; the depressed mood is associated with withdrawal and intoxication from substances

Nonassertive individuals seek to...

please others at the expense of denying their own basic rights

Suicide risk and age are...

positively correlated, especially with men

What is a depressed mood, excessive anxiety, mood swings, and decreased interest in activities during the week prior to menses, improving shortly after the onset of menstruation, and lessening in the week postmenses?

premenstrual dysphoric disorder (PDD)

What are the behaviors of disturbed body image?

preoccupation with imagined defect; verbalizations that are out of proportion to any actual physical abnormality that may exist; numerous visits to plastic surgeons or dermatologists seeking relief (body dysmorphic disorders)

Mild depression symptoms: at the cognitive level:

preoccupation with the loss, self-blame, ambivalence, blaming others

Anger creates a state of ____ by arousing the sympathetic nervous system.

preparedness

Severe depression symptoms at the at the cognitive level:

prevalent delusional thinking, with delusions of persecution and somatic delusions being most common, confusion, indecisiveness, and an inability to concentrate, hallucinations reflecting misinterpretations of the environment, excessive self-deprecation, self-blame, and thoughts of suicide

What is the key issue in the management of aggressive or violent behavior?

prevention

The indications for lithium:

prevention and treatment of manic episodes of bipolar disorder, neutropenia, cluster headaches, alcohol dependence, bulimia, postpartum affective psychosis, and corticosteroid-induced psychosis

Anger is not a_____ emotion, but it is typically experienced as an almost automatic inner response to hurt, frustration, or fear.

primary

What is anxiety and tension, verbal abuse and profanity, and increasing hyperactivity?

prodromal syndrome

Moderate depression occurs when grief is...

prolonged or exaggerated

Becoming more assertive empowers individuals by...

promoting self-esteem, without diminishing the esteem of others

Aggression can be physical or verbal but is virtually always designed to...

punish

Meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society

purpose

Studies haven't shown a relationship between...

race and affective disorder

What is the expression of power and dominance by means of sexual violence, most commonly by men over women, although men may also be rape victims?

rape

What is underreported in the US?

rape

Some children report incest experiences to their mother only to be...

rebuffed by her and told to remain secretive about the abuse

The hard work of recovery takes place in the...

rebuilding stage

What stage is where the person takes the necessary steps to work towards his or her goals in rebuilding a meaningful life?

rebuilding stage

What is described as a deeply personal, unique process of changing one's attitudes, values, feelings, goals, skills, and/or roles?

recovery

There are ten guiding principles of recovery, which include: (10)

recovery emerges from hope, recovery is person-driven, recovery occurs via many pathways, recovery is holistic, recovery is supported by peers and allies, recovery is supported through relationships and social networks, recovery is culturally-based and influenced, recovery is supported by addressing trauma, recovery involves individual, family, and community strengths and responsibility, and recovery is based on respect

The client on anticonvulsants should:

refrain from discontinuing the drug abruptly; report symptoms (skin rash, unusual bleeding, spontaneous bruising, sore throat, fever, malaise, dark urine, and yellow skin or eyes) to physician; not drive or operate dangerous machinery until reaction to the medication has been established; avoid consuming alcoholic beverages and nonprescription medication without approval from the physician; carry card at all times identifying the name of medications being taken

When anger is expressed inappropriately, it can interfere with...

relationships

What are the behaviors of ineffective impulse control?

repetitive and impulsive pulling out of one's hair (trichotillomania)

When anger is suppressed it can turn into...

resentment

The ultimate objective of working with families of clients with mood disorders is to...

resolve the symptoms and initiate or restore adaptive family functioning

Individuals are encouraged to speak their own words in their own unique way

respect the language

Along with rights comes an equal amount of...

responsibilities

taking responsibility for one's life and well-being

responsibility

Nurses should help the person reveal and come to value that wisdom, so it might be used to sustain the person throughout the voyage of recovery

reveal personal wisdom

The client taking lithium should consume a diet...

rich in sodium as well as 2,500 to 3,000 mL of fluid per day

Abuse is on the ___ in this society.

rise

Being bullied increases the...

risk of depression and suicidal behavior in youth

What are the behaviors of ineffective coping?

ritualistic behavior; obsessive thoughts, inability to meet basic needs; severe level of anxiety (OCD)

Individuals develop patterns of responding in various ways, such as...

role modeling, by receiving positive or negative reinforcement, or by conscious choice

Transient depression symptoms at the affective level:

sadness, dejection, feeling downhearted, having the blues

Higher risk is associated with a family history of suicide, especially in a...

same-gender parent

Recovery is a way of living a...

satisfying, hopeful, and contributing life even with limitations caused by illness

The most common sites for trichotillomania are the...

scalp, eyebrows, and eyelashes

Onset of symptoms may reflect a...

seasonal pattern

Depressive symptoms that occur as a consequence of a non-mood disorder or as an adverse effect of certain medications are called....

secondary depression

Right-sided lesions in the limbic system, temporobasal areas, basal ganglia, and thalamus have been shown to induce...

secondary mania

Side effects of benzodiazepines:

sedation, dizziness, weakness, ataxia, decreased motor performance, dependence, and withdrawal

renewing the sense of self and building a positive identity

self and identity

Some have viewed suicide as a...

self-saving mechanism to prevent public humiliation

Some changes in the noradrenergic system and a decrease in ____ have been noted in suicidal clients.

serotonin

Disturbances in .... appear to be the most significant in anxiety disorders. (3)

serotonin, norepinephrine, and GABA

Delirious mania is characterized by...

severe clouding of consciousness and an intensification of the symptoms associated with acute mania

MDD is an example of...

severe depression

Behavioral indicators of emotional injury may include:

shows extreme in behavior; is either inappropriately adult or infantile; is delayed in physical or emotional development; has attempted suicide; and reports a lack attachment to the parent

Anger and aggression are...

significantly different

Bipolar disorder tends to be more common in...

single people than in married people

Most sexual assault victims are...

single women

Moderate depression symptoms at the cognitive level:

slowed thinking processes, difficulty concentrating and directing attention, obsessive and repetitive thoughts, generally portraying pessimism and negativism, verbalizations and behavior reflecting suicidal ideations

Moderate depression symptoms: at the behavioral level:

sluggish physical movements, slumped posture, slowed speech, limited verbalizations, possibly consisting of ruminations about life's failures or regrets, social isolation with a focus on the self, increased use of substances possible, self-destructive behavior possible, and decreased interest in personal hygiene and grooming

What is an excessive fear of situations in which a person might do something embarrassing or be evaluated negatively by others?

social anxiety disorder

Normality of the anxiety experienced in response to a stressor is defined by...

societal and cultural standards

Excessive levels of ____ can cause depressive symptoms.

sodium bicarbonate or calcium

The basis for a meaningful life lies in...

solid core values

Transient depression symptoms at the behavioral level:

some crying possible

Transient depression symptoms at the cognitive level:

some difficulty getting mind off of one's disappointment

Side effects of barbiturates:

somnolence, agitation, confusion, ataxia, dizziness, bradycardia, hypotension, constipation

What is a marked, persistent, and excessive or unreasonable fear when in the presence of, or when anticipating an encounter with, a specific object or situation?

specific phobia

There is a large peak in suicides in the...

spring

Techniques that promote assertive behavior:

standing up for one's basic rights, assuming responsibility for one's own statements, responding as a "broken record," agreeing assertively, inquiring assertively, shifting from content to process, clouding/fogging, defusing, delaying assertively, responding assertively with irony, and using "I" statements

Since ADHD has been identified as the most common comorbid disorder in children and adolescents with bipolar disorder, medications for ADHD must be...

started after mood stabilizers have controlled the symptoms of bipolar disorder

unlawful intercourse between a person who is over the age of consent and a person who is under the age of consent

statutory rape

What are the behaviors of social isolation?

stays at home alone, afraid to venture out alone (agoraphobia)

Medications that can cause a depressed mood:

steroids (prednisone and cortisone), hormones (estrogen and progesterone), sedatives (barbiturates and benzodiazepines), antibacterial and antifungal drugs (ampicillin, cycloserine, tetracycline, and sulfonamides), antineoplastics (vincristine and zidovudine), analgesics and anti-inflammatory drugs (opiates, ibuprofen, and phenylbutazone), and antiulcer drugs (cimetidine)

High rates of violence exist within the...

subculture of poverty in the US

What is associated with this disorder is considered to be the direct result of physiological effects of a substance; may include elevated expansive, or irritable mood, with inflated self-esteem, decreased need for sleep, and distractibility, may cause significant distress or impairment in social, occupational, or other important areas of functioning?

substance/medication-induced bipolar disorder

Women attempt suicide more often, but men...

succeed more

Violent behavior often goes hand in hand with...

suicidal behavior

Must assess for suicide risk...

suicidal ideas and acts (the seriousness, if they have a plan and the means, how lethal the means are, suicide attempts), the interpersonal support system, the analysis of the suicidal crisis, including: precipitating stressor, relevant history, and life-stage issues, and psych/medical/family history and coping strategies.

Alcohol use, barbiturate use, and psychosis can increase the risk of...

suicide

Desperation and guilt are other factors in...

suicide

LGBT youth has a higher risk for...

suicide

Loss of a loved one through death or separation and lack of employment or increased financial burden also increase risk of...

suicide

People who have attempted suicide are at a higher risk for...

suicide

Maternity blues usually doesn't need treatment, just...

support and comfort

Treatment for moderate PPD may be relieved with...

supportive psychotherapy and continuing assistance with home management until the symptoms subside

Deficiencies in thiamine, vitamin b6, vitamin b12, niacin, vitamin C, iron, folic acid, zinc, calcium, and potassium can produce...

symptoms of depression

Women who are battered often...

take blame for their situation; they may have been reared in abusive families and have come to expect this type of behavior

The client on lithium should:

take medication on a regular basis, even when they feel good; not drive or operate dangerous machinery until lithium levels are stabilized; not skimp on dietary sodium intake; notify the physician if nausea and vomiting occur; carry card or other identification noting that he or she is taking lithium, be aware of appropriate diet if weight gain does occur; be aware of risks of becoming pregnant while on lithium; be aware of side effects and symptoms associated with toxicity; and refer to written material furnished by health-care providers while receiving self-administered maintenance

The client on a calcium channel blocker should:

take medication with meals if GI upset occurs; use caution when driving or when operating dangerous machinery; refrain from discontinuing the drug abruptly; report occurrence of symptoms (irregular heartbeat, SOB, swelling of hands and feet, pronounced dizziness, chest pain, profound mood swings, severe and persistent headaches) to physician; rise slowly from a sitting or lying position to prevent a sudden drop in blood pressure; avoid taking other medication without physician's approval; and carry card at all times describing medications being taken

What happens in the preparation stage?

taking responsibility involves learning about the effects of the illness and how to recognize, monitor, and manage symptoms; the person is willing to take risks and try new activities to reestablish a sense of self

The abuser may use threats of...

taking the children away as a tactic of emotional abuse

Mild depression symptoms: at the behavioral level:

tearfulness, regression, restlessness, agitation, withdrawal

integration of sensory stimuli

thalamus

What is the most common reason battered women give for staying?

that they fear for their life and/or the lives of their children

What is usually the shortest and most violent phase of battering, usually lasting up to 24 hours?

the acute battering incident

What phase is when the individual realizes that a possibility for recovery exists?

the awareness level

Maltreatment is considered whether or not...

the caretaker intended to cause harm, or even if the injury resulted from over-discipline or physical punishment

During the first phase of interpersonal psychotherapy:

the client is assessed to determine the extent of the illness and then vital information is passed on to the client to enhance their understanding of the illness

Implosion therapy, or flooding, is a therapeutic process in which...

the client must imagine situations or participate in real-life situations that they find frightening for a prolonged period of time

Normal anxiety dissipates when...

the danger is no longer a threat is no longer present

Onset of incestuous relationships usually occur when...

the daughter is 8-10 years old and commonly begin with genital touching and fondling

The psychological implications for the anxiety symptoms were not recognized until...

the early 1900s

Help is usually sought only in...

the event of severe injury or if the woman fears for her life or those of her children

Mild depressive episodes occur when...

the grief process is triggered in response to the loss of a valued object

The early warnings sign is divided into two parts: in part 2...

the individual develops a plan for responding to the early warning signs that result in relief or in preventing them from escalating

The daily maintenance list is developed into three parts: In part 3...

the individual keeps a list of things that need to be done and reads it daily as a reminder

The triggers step is divided into two parts: in part one...

the individual lists events or circumstances that would cause distress and discomfort

The triggers step is divided into two parts: in part two...

the individual uses items from the wellness toolbox to develop a plan for what to do if triggers interfere with wellness

The daily maintenance list is developed into three parts: in part one...

the individual writes a description of how they would like to feel when experiencing wellness

The long-term effects of sexual assault depend largely on...

the individual's ego strength, social support system and the way he or she was treated as a victim

The preparation stage begins with...

the individual's resolve to begin the work of recovery

What stage is dark despair and confusion?

the moratorium

Who is usually most vulnerable to incest?

the oldest daughter

How does the patient feel in the awareness stage?

the patient develops an awareness of the need to take control of his or her life. Feelings of control and responsibility lead to a sense of personal empowerment that paves the way for recovery. The individual realizes that they are a person independent of their illness. The individual strives for a personal comprehension of the illness, why it occurred, and what the implications of the illness are for his or her future.

The psychological recovery model focuses on...

the person's self-determination in the course of his or her recovery process.

What theory focuses on the inability of the ego to intervene when conflict occurs between the id and superego, producing anxiety?

the psychodynamic theory

How does the patient feel in the rebuilding stage?

the pt has hope for and looks forward to a more fulfilling life; the person begins to actively take control of his or her life, by enlisting social support, improvement of self-image, handling social pressures, and building social competence; the pt elaborates and enhances their sense of identity by having succeeded in previous stages in developing a positive self-confidence by succeeding at new activities; having realistic goals and a positive sense of identity provides a sense of purpose in life

Reciprocal inhibition is described as...

the restriction of anxiety prior to the effort of reducing avoidance behavior

Silent rape reaction is when...

the survivor tells no one about the assault

Areas of the brain that may be involved in aggressive behavior include... (3)

the temporal lobe, the limbic system, and the amygdaloid nucleus

What is a person-centered approach to help people deal with their problems of human living; focus is on their personal story?

the tidal model

During the third phase of interpersonal psychotherapy, the...

therapeutic alliance is terminated

The daily maintenance list is developed into three parts: In part two...

they make a list of things that they need to do every day to maintain wellness while using the wellness toolbox as a reference

Small children are usually ignored by the abuser, but as they grow older...

they may have become targets of abuse

How long does the tension building phase last?

this phase can last from weeks to many months or years

What are the ten basic human rights?

to be treated with respect, to express feelings, opinions, and beliefs, to say "no" without feeling guilty, to make mistakes and accept responsibility for them, to be listened to and taken seriously, to change your mind, to ask for what you want, to put yourself first sometimes, to set your own priorities, to refuse justification for your feelings or behaviors

The general goals of cognitive therapy are... (3)

to obtain symptom relief as quick as possible, to assist the client in identifying dysfunctional patterns of thinking and behaving, and to guide the client in evidence and logic that effectively tests the validity of the dysfunctional thinking

Systematic desensitization with reciprocal inhibition involves two main elements:

training in relaxation techniques and progressive exposure to a hierarchy of fear stimuli while in the relaxed state

Symptoms of depression occur along a continuum according to the degree of severity from...

transient to severe

What is the recurrent pulling out of one's hair that results in hair loss?

trichotillomania

The suicidal rate for single people is...

twice that of married people

Affective illness has been the subject of considerable research on the relevance of hereditary factors through...

twin, family, and adoption studies

The construction of gender stereotypes (gender socialization) enforces...

typical female characteristics, such as helplessness, passivity, and emotionality, which are associated with depression

The expression of anger can come...

under personal control

Symptoms of a panic disorder come on...

unexpectedly and are not triggered by situations in which the person is the focus of others' attention

Signs of physical abuse of a child include:

unexplained burns, bites, bruises, broken bones, or black eyes; has fading bruises or other marks noticeable after an absence from school; seems frightened of the parents and protests or cries when it is time to go home; shrinks at the approach of adults; reports injury by a parent of another adult caregiver; and abuses animals or pets

The client on antipsychotics should:

use caution when driving or when operating dangerous machinery; refrain from discontinuing the drug abruptly; use sunblock lotion and wear protective clothing when spending time outdoors; report the occurrence of symptoms (sore throat, fever, malaise, unusual bleeding, easy bruising, persistent nausea and vomiting, severe headache, rapid heart rate, difficulty urinating, muscle twitching, tremors, darkly colored urine, excessive urination, excessive thirst, excessive hunger, weakness, pale stools, yellow skin or eyes, muscular, incoordination, or skin rash) to physician; rise slowly from a sitting or lying position to prevent a sudden drop in blood pressure; take a frequent sip of water, chew sugarless gum, or suck on hard candy if dry mouth is an issue; good oral care is very important; consult the physician about smoking on antipsychotics; dress warmly in cold weather and avoid extended exposure to very high or low temperatures; avoid drinking alcohol while on antipsychotics; avoid taking other medications without approval; be aware of possible risks if pregnancy on these medications; be aware of side effects of antipsychotics; continue to take this medication, even if one is feeling okay; and carry a card or other identification at all times describing medications being taken

Concentrate on the individual's strengths, which are the major tools in the recovery process

use the available toolkit

Signs of depression from ages 6 to 8:

vague physical complaints and aggressive behavior, clinging to parents and avoiding new people and challenges, and lagging behind their classmates in social skills and academic competence

The person is encouraged to tell his or her story

value the voice

What are the 10 Tidal Commitments?

value the voice, respect the language, develop genuine curiosity, become the apprentice, use the available toolkit, craft the step beyond, give the gift of time, reveal personal wisdom, know that change is constant, and be transparent

Frequency and severity of the panic attacks...

vary widely

What are the behaviors of powerlessness?

verbal expressions of having no control over life situation; nonparticipation in decision making related to own care or life situation; expressions of doubt regarding role performance

Delirious mania mood:

very labile, alternate between feelings of despair and unrestrained merriment and ecstasy to irritability. May be indifferent to the environment and panic anxiety may be evident

The nature of the hypomanic person is...

very volatile and fluctuating

Statistics show that___ is rampant in the US.

violence

Physical crowding may be related to...

violence through increased contact and decreased defensible space

The acute battering incident may begin with the batterer...

wanting to "just teach her a lesson."

During the second phase of interpersonal psychotherapy:

we focus on helping the client resolve complicated grief reactions

The _____ is unable to produce feelings of guilt.

weak superego

Intimate partner violence, child abuse, and sexual assault are...

widespread, and all populations are equally affected

This loving phase focuses on the...

woman's perception of the relationship

Agoraphobia is more commonly diagnosed in...

women

From 65+, ____ are also more commonly affected by depression.

women

From age 10 to midlife, ____ are more commonly affected by depression

women

Social anxiety disorder is more common in...

women

Anxiety disorders are more common in...

women than men

Depression is more common in...

women than men by 2:1