NUR 214 (Mental Health - Test 3) NCLEX Style Practice Questions

A nurse is interviewing a client who recently attempted suicide. Which question is appropriate for the nurse to ask the client? A) "Do you currently have a plan for killing yourself?" B) "Why would you think about harming yourself?" C) "Did you feel unsafe?" D) "Do you ever think about hurting yourself?" **P-28**

A ("Do you currently have a plan for killing yourself?")

The nurse instructs the client about phenelzine sulfate. Which client statement indicates to the nurse that further teaching is necessary? A) "I can't wait to eat a hot dog with sauerkraut" B) "I'm going to have to get some polycarbophil when I get home" C) "I will be playing double tennis with my neighbors" D) "When I get home, I am going to take my car out for a road trip" **K**

A ("I can't wait to eat a hot dog with sauerkraut")

The nurse interacts with the client diagnosed with depression. The nurse expects the client to express which thought? A) "I'm embarrassed that everyone has to take care of me" B) "Once my depression is over, I'll be able to get on with life" C) "I like being taken care of from time to time" D) "I'm glad that I came for help in time" **K**

A ("I'm embarrassed that everyone has to take care of me")

A nurse at a psychiatrist's office is reviewing the medication prescribed to several new clients for mood disorders. Which order would the nurse question? A) A prescription for paroxetine for a 15-year-old boy with depression B) A prescription for fluoxetine for a 14-year-old girl with depression C) A prescription for sertraline for a 10-year-old boy with obsessive-compulsive disorder D) A prescription for sertraline for an 11-year-old girl with depression **P-28**

A (A prescription for paroxetine for a 15-year-old boy with depression)

Which condition is associated with the highest rate of comorbidity with depression? A) Alcohol abuse B) Obesity C) Back problems D) Hypertension **P-28**

A (Alcohol abuse)

The nurse observes a client being treated for depression sitting with the head down and avoiding conversation with peers. Which nursing intervention is most appropriate for this client? A) Ask open-ended questions about the client's feelings B) Ask the client closed-ended questions C) Encourage a peer to sit with the client and the nurse D) Tell the client that lack of involvement leads to more depression **P-28**

A (Ask open-ended questions about the client's feelings)

A client receiving pain medication for abdominal discomfort reports no relief of pain and continues to describe multiple somatic complaints. The client also describes feelings of discouragement and hopelessness related to the pain, because the healthcare team has not yet found a cause for the pain. Which action by the nurse is appropriate? A) Assessing the client for depression B) Obtaining an order for different pain medication C) Contacting the family to talk to the client D) Reviewing of the client's lab values **P-28**

A (Assessing the client for depression)

A client prescribed an antidepressant tells the nurse that the pill causes dizziness upon standing or changing position too quickly. This is a common side effect of which antidepressant medication? A) Atypical antidepressant B) Monoamine oxidase inhibitor (MAOI) C) Selective serotonin reuptake inhibitor (SSRI) D) Lithium **P-28**

A (Atypical antidepressants)

Which client observation indicates that interventions provided to a client in the manic phase of bipolar disorder have improved self-care activities? A) Completed morning bath and changed clothes B) Washes hands after using the toilet when reminded C) Cleaned liquid spilled on floor but did not change clothes D) Brushes own teeth every time when reminded **P-28**

A (Completed morning bath and changed clothes)

The health care provider prescribes lithium carbonate for the client. The nurse understands which other medication is contraindicated for this client? A) Diuretic B) Monoamine oxidase inhibitor C) Tricyclic antidepressant D) Antibiotic **K**

A (Diuretic)

A patient who is taking lithium carbonate is being discharged. Which information should the nurse teach? A) Drink fluid and use salt regularly B) Have serum lithium levels checked every 6 months C) Limit fluid intake to 1,000 ml of fluid per day D) Adjust the dose if you feel out of control **Kahoot - Bipolar**

A (Drink fluid and use salt regularly)

A client who has attempted to commit suicide in the past tells the nurse about feeling better since being prescribed an antidepressant medication. Which conclusion by the nurse is appropriate based on the assessment data? A) Improved mood B) Improved sleep C) Improved feelings of guilt D) Improved appetite **P-28**

A (Improved mood)

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client? A) Monitor closely for harm to self or others B) Assist in completing an application for admission C) Supply the client with written information about her or his mental health problem D) Provide an opportunity for the family to discuss why the felt the admission was needed **Rationale: Review Book pg. 930**

A (Monitor closely for harm to self or others)

The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care? A) One-to-one suicide precautions B) Suicide precautions with 30 minute checks C) Checking the whereabouts of the client every 15 minutes D) Asking the client to report suicidal thoughts immediately **Rationale: Review Book pg. 976**

A (One-to-one suicide precautions)

A patient is psychotic, pacing, agitated, and using aggressive gestures. What is the priority intervention for this patient? A) Provide safety for the client and other clients on the unit B) Offer the patient a less stimulated area in which to calm down C) Assist in caring in controlled environment, like quiet room D) Provide the other clients with sense of comfort and safety **Kahoot - Bipolar**

A (Provide safety for the client and other clients on the unit)

A client tells the nurse about rarely going outdoors in the winter because of a lack of energy or desire. Based on this data, which does the nurse suspect the client is experiencing? A) Seasonal affective disorder B) Side effect of medication C) Situational depression D) Anxiety **P-28**

A (Seasonal affective disorder)

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement? A) Setting limits on the client's behaviors B) Asking the client to leave the group session C) Asking another nurse to escort the client out of the group session D) Telling the client that they will not be able to attend any future group sessions **Rationale: Review Book pg. 950**

A (Setting limits on the client's behaviors)

Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal? A) The adolescent give away a DVD and a cherished autographed picture of a performer B) The adolescent runs out of the therapy group, swearing at the group leader, and to her room C) The adolescent becomes angry while speaking on the telephone and slams down the receiver D) The adolescent gets angry with her roommate when the roommate borrows the client's clothes without asking **Rationale: Review Book pg. 975**

A (The adolescent give away a DVD and a cherished autographed picture of a performer)

A client diagnosed with depression is scheduled to begin electroconvulsive therapy (ECT) treatments. It is most important for the nurse to notify the health care provider about which information? A) The client is being treated for glaucoma B) The client's parent had seizures with meningitis C) The client has worn dentures for ten years D) The client is allergic to shellfish **K**

A (The client is being treated for glaucoma)

The nurse is providing care for a client who is experiencing situational depression after the death of her mother. During the assessment, the nurse learns that the client has returned to work, is caring for her family, and spends quiet time reflecting on her life and future. Which conclusion by the nurse is most appropriate? A) The client is working through the grief process B) The client is experiencing denial regarding the death of a parent C) The client is exhibiting ineffective coping D) The client is experiencing anxiety **P-28**

A (The client is working through the grief process)

The nurse is providing teaching to a 71-year-old client who was prescribed escitalopram (Lexapro) for depression. The client is also taking medication for type II diabetes, hypertension, and heart disease. What should the nurse include in her teaching? A) The client will need to come in for more frequent monitoring B) The client may experience an increase in memory problems C) The client will not be able to drive D) The client will no longer need to take medication for hypertension **P-28**

A (The client will need to come in for more frequent monitoring)

A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L. The nurse plans care based on which representation of this level? A) Toxic B) Normal C) Slightly above normal D) Excessively below normal **Rationale: Review Book pg. 990**

A (Toxic)

A client with depression is receiving electroconvulsive therapy (ECT). Which interventions should the nurse plan when caring for this client? (Select all that apply) A) Maintain nothing-by-mouth status until fully awake B) Administer intravenous fluids for 8 hours postprocedure C) Place in the lateral recumbent position D) Provide oral fluids immediately after the procedure E) Place in the supine position with the head flat **P-28**

A & C (Maintain nothing-by-mouth status until fully awake) (Place in the lateral recumbent position)

Which assessment findings indicate that a client is at increased risk for suicide? (Select all that apply) A) Substance abuse B) Age 59 C) Plays golf twice a week D) Widowed for 6 months E) Recently started a new job **P-28**

A & D (Substance abuse) (Widowed for 6 months)

The nurse is in the mental health clinic understands which foods must be avoided by client taking phenelzine sulfate? (Select all that apply) A) Aged cheese B) Lunch meats C) Nuts D) Leafy vegetables E) Tofu F) Chocolate **K**

A, B, E & F (Aged cheese) (Lunch meats) (Tofu) (Chocolate)

A nurse educator is teaching a group of student nurses regarding depression, its pathophysiology, and the theories related to the disorder. What statements will the nurse instructor include about the theories of depression? (Select all that apply) A) Sociocultural theory emphasizes the role that social stressors play in the development of depression B) The sociocultural factor theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences C) The learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences D) The sociocultural factor theory suggests that all people have an inborn need for interpersonal relationships. E) The learning theory states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents **P-28**

A, C, & E (Sociocultural theory emphasizes the role that social stressors play in the development of depression) (The learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences) (The learning theory states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents)

A student nurse is assisting in the care of a client with bipolar disorder. The student nurse researches the disorder further, focusing on the pathophysiology and etiology of the disorder. Which are true regarding the pathophysiology and etiology of bipolar disorder? (Select all that apply) A) No definitive cause or specific pathophysiology has been identified for bipolar spectrum disorders B) Bipolar disorders, anxiety disorders, and personality disorders share biological susceptibility and inheritance patterns C) Immunologic abnormalities may contribute to the pathophysiology of mania and bipolar disorder D) Children of parents with bipolar disorder have an increased risk of developing the disorder E) Stressful life events and an emotionally overinvolved, hostile, and critical communication pattern are factors associated with heritability of the disorder **P-28**

A, C, D, & E (No definitive cause or specific pathophysiology has been identified for bipolar spectrum disorders) (Immunologic abnormalities may contribute to the pathophysiology of mania and bipolar disorder) (Children of parents with bipolar disorder have an increased risk of developing the disorder) (Stressful life events and an emotionally overinvolved, hostile, and critical communication pattern are factors associated with heritability of the disorder)

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? (Select all that apply) A) Communicate expected behaviors to the client B) Ensure that the client knows that they are not in charge of the nursing unit C) Assist the client in identifying ways of setting limits on personal behaviors D) Follow through about the consequences of behavior in a nonpunitive manner E) Enforce rules by informing the client that he/she will not be allowed to attend therapy groups F) Have the client state the consequences for behaving in ways that are viewed as unacceptable **Rationale: Review Book pg. 951**

A, C, D, & F (Communicate expected behaviors to the client) (Assist the client in identifying ways of setting limits on personal behaviors) (Follow through about the consequences of behavior in a nonpunitive manner) (Have the client state the consequences for behaving in ways that are viewed as unacceptable)

A client is scheduled for electroconvulsive therapy (ECT) for the treatment of depression. Which instructions should the nurse include regarding this therapy? (Select all that apply) A) You will need to remove all jewelry before beginning the therapy session B) These treatments will cure the depression C) Long-term memory loss often occurs after receiving ECT D) The treatments are known to help some but not all people with depression E) You will need to stop eating and drinking 4 hours prior to the therapy session **P-28**

A, D, & E (You will need to remove all jewelry before beginning the therapy session) (The treatments are known to help some but not all people with depression) (You will need to stop eating and drinking 4 hours prior to the therapy session)

The nurse is providing care to a client diagnosed with bipolar disorder. The client's family asks the nurse what this is. Which response by the nurse is appropriate? A) "Bipolar disorder is a type of depression that includes attention deficit disorder symptoms." B) "Bipolar disorder means there are cycles of depression as well as extreme elevations in mood, or mania." C) "Bipolar disorder just means that the mood alternates with the seasons, and it becomes worse in the winter." D) "Bipolar disorder is just another type of depression, except depression occurs in cycles." **P-28*8

B ("Bipolar disorder means there are cycles of depression as well as extreme elevations in mood, or mania.")

Which statement indicates the patient understands education regarding lithium therapy? A) "I can stop my lithium when I feel better" B) "I will probably need to take lithium for the rest of my life" C) "I will taper lithium when therapeutic level is achieved" D) "I can continue with my diuretic and cardiac medications" **Kahoot - Bipolar**

B ("I will probably need to take lithium for the rest of my life")

Manic patient is demonstrating grandiosity. Which statement would be consistent with this symptom? A) "I can't do anything anymore" B) "I'm the world's most astute financier" C) "I can understand why my wife is upset that I overspend" D) "I can't understand where all the money in our family goes." **Kahoot - Bipolar**

B ("I'm the world's most astute financier")

The police arrive at the emergency department with a client who has lacerated both wrists. Which is the initial nursing action? A) Administer an antianxiety agent B) Assess and treat the wound sites C) Secure and record a detailed history D) Encourage and assist the client to ventilate feelings **Rationale: Review Book pg. 975**

B (Assess and treat the wound sites)

A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose? A) On an empty stomach B) At the same time each evening C) Evenly spaced around the clock D) As needed when the client complains of depression **Rationale: Review Book pg. 988**

B (At the same time each evening)

The client is diagnosed with bipolar disorder. During the period of elation, which approach does the nurse plan to use frequently? A) Point out the effect a client's behavior has on others B) Attempt to distract and redirect the client C) Encourage the client to express self D) Provide opportunities for the client to socialize **K**

B (Attempt to distract and redirect the client)

A patient is admitted with bipolar and mania. Which symptoms require immediate action? A) Grandiose delusions of being a czar of Russia B) Constant physical activity and poor oral intake C) Constant, incessant talking, with sexual innuendos D) Outlandish behaviors and wearing odd and eccentric clothing **Kahoot - Bipolar**

B (Constant physical activity and poor oral intake)

Which neurotransmitter change is frequently associated with suicide? A) Increase in serotonin B) Decrease in serotonin C) Increase in dopamine D) Decrease in dopamine **P-28**

B (Decrease in serotonin)

A client who was widowed 3 years ago states, "I don't have many friends. The only people I visit with are some acquaintances at the local bar." Which health problem does the nurse realize the client is at risk for based on this statement? A) Bipolar disorder B) Depression C) Suicide D) Extended grief **P-28**

B (Depression)

The client is placed on escitalopram 10 mg daily. For which adverse effect does the nurse instruct the family to observe? A) Photophobia B) Dizziness C) Epistaxis D) Hypertensive crisis **K**

B (Dizziness)

Which molecule has been implicated in the pathophysiology of depression? A) Brain natriuretic peptide B) Dopamine C) Epinephrine D) Calcitonin **P-28**

B (Dopamine)

A client in the manic phase of bipolar disorder is prescribed lithium and has a current lithium blood level of 0.4 mEq/L. Which clinical manifestation does the nurse anticipate when assessing this client? A) A decrease in manic behavior B) Hyperactivity and pressured speech C) A return to baseline behavior, calm and rational D) Signs and symptoms of depression **P-28**

B (Hyperactivity and pressured speech)

The nurse is teaching a client who is being started on imipramine about the medication. The nurse should inform the client to expert maximum desired effects at which time period following initiation of the medications? A) In 2 months B) In 2 to 3 weeks C) During the first week D) During the sixth week of administration **Rationale: Review Book pg. 989**

B (In 2 to 3 weeks)

Which intervention is a primary prevention strategy for depression? A) Regular screening for depression B) Provide education about stress management C) Counseling clients about their risk for mood disorders D) Developing community-based mental health programs **P-28**

B (Provide education about stress management)

A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse determines that which is an adverse effect, indicating that the client is taking an excessive amount of the medication? A) Constipation B) Seizure activity C) Increased weight D) Dizziness when getting upright **Rationale: Review Book pg. 990**

B (Seizure activity)

The nurse provides care for a client who has been taking a tricyclic antidepressant for the last 12 days. Which behavior does the nurse assess for? A) Angry behavior B) Suicidal behavior C) Withdrawal from reality D) Early morning waking **K**

B (Suicidal behavior)

The client is brought to the hospital by the spouse. The client is boisterous, quarrelsome, and unusually energetic. The spouse reports that in the past week the client has not slept more than three hours a night, and has been buying extravagant items they cannot afford. Which understanding is basic to the care of the client with episodes of elation and depression? A) The client has nonspecific fears B) The client is easily stimulated by the surroundings C) The client has recurring unwanted thoughts D) The client has a well-organized delusional system **K**

B (The client is easily stimulated by the surroundings)

The nurse is caring for several clients who have plans to commit suicide. Which plan does the nurse identify as being most lethal? A) The individual who plans to use a mild overdose of pharmaceuticals B) The individual who plans to jump off a tall building C) The individual who plans to jump off a bridge into a river D) The individual who plans to slit across one wrist **P-28**

B (The individual who plans to jump off a tall building)

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? A) Chess B) Writing C) Board games D) Group exercise **Rationale: Review Book pg. 952**

B (Writing)

A client with a 2-month-old child is experiencing insomnia, mood swings, and crying. Which interventions does the nurse anticipate being incorporated into a collaborative plan of care for the client experiencing postpartum depression? (Select all that apply) A) Electroconvulsive therapy B) Psychosocial interventions C) Antidepressants D) Time management and exercise therapy E) Cognitive-behavioral therapy **P-28**

B & C (Psychosocial interventions) (Antidepressants)

A client in the manic phase of bipolar disorder will not sit down to eat. Which can the nurse do to ensure adequate nutrition and improved self-care of this client? (Select all that apply) A) Provide a sedative before meals B) Discuss finger-food options with the dietitian C) Use a jacket restraint at meal times D) Ask the healthcare provider if intravenous feedings would be applicable E) Provide nutritious liquids **P-28**

B & E (Discuss finger-food options with the dietitian) (Provide nutritious liquids)

The nurse is providing care to a client who is exhibiting manifestations of a mood disorder. Which assessment findings indicate that the client may be at an increased risk for bipolar disorder? (Select all that apply) A) Blood pressure 120/80 mmHg B) Recent major life-altering event C) Works out at the gym every week D) Currently employed E) Mother diagnosed with bipolar disorder **P-28**

B & E (Recent major life-altering event) (Mother diagnosed with bipolar disorder)

A nurse working in a psychiatric hospital is performing a suicide assessment on a client diagnosed with major depressive disorder (MDD). Which actions by the nurse are appropriate when conducting a suicide assessment? (Select all that apply) A) Assess all clients for suicide risk by using indirect questioning B) Ask if the client has any thought of suicide C) Avoid asking about suicide to avoid "planting the idea" in the client's mind D) Assess the lethality of the suicide plan, if one exists E) If the client has suicidal thoughts, assess whether or not the client would act on them **P-28**

B, D, & E (Ask if the client has any thought of suicide) (Assess the lethality of the suicide plan, if one exists) (If the client has suicidal thoughts, assess whether or not the client would act on them)

A client is brought to the emergency department by family members after taking an overdose of diazepam. The family reports the client has become increasingly depressed and withdrawn during the previous month. Which question is most important for the nurse to ask during the initial interview? A) "Why did you do this to yourself?" B) "Can you elaborate on what is bothering you?" C) "Exactly how much and when did you take the medication?" D) "Did you seriously think of killing yourself?" **K**

C ("Exactly how much and when did you take the medication?")

A client diagnosed with depression is on psychiatric unit. The client continually reports to the nurse, "My stomach is missing." Which response by the nurse is most appropriate? A) "That is not possible. You wouldn't be able to eat anything." B) "I am here to help you with this problem." C) "It sounds as if you feel very empty and alone." D) "This is a common response to depression." **K**

C ("It sounds as if you feel very empty and alone.")

Divalproex sodium is prescribed for patient with bipolar. What is best rationale for this prescription? A) Divalproex sodium helps stimulate appetite of bipolar patients B) Patients with bipolar are at high risk of seizures C) Anticonvulsant medications stabilize mood of persons with bipolar D) Divalproex is an antidepressant that reduces suicidal ideation **Kahoot - Bipolar**

C (Anticonvulsant medications stabilize mood of persons with bipolar)

An adolescent client hospitalized with asphyxiation following a suicide attempt tells the nurse, "I know other kids have the same problems I do, but I just wanted to make it stop." Which action by the nurse is the most appropriate? A) Discuss the client's attendance at school and what activities are enjoyed B) Suggest the client listen to music and read a light novel to reduce stress C) Ask if the client would like to talk about stressors and problems D) Ask what is so devastating that the client needed to commit suicide **P-28**

C (Ask if the client would like to talk about stressors and problems)

A client is admitted to the mental health unit after an attempted suicide by hanging. The nurse can best ensure client safety by which action? A) Requesting that a peer remain with the client at all times B) Removing the client's clothing and placing the client in a hospital gown C) Assigning to the client a staff member who will remain with the client at all times D) Admitting the client to a seclusion room where all potentially dangerous articles are removed **Rationale: Review Book pg. 976**

C (Assigning to the client a staff member who will remain with the client at all times)

The nurse is planning care for an adult client demonstrating symptoms of depression. Which assessment technique is most appropriate? A) More time talking with the client B) Ask family members about the client's demeanor C) Beck Depression Inventory D) Mood Disorder Questionnaire **P-28**

C (Beck Depression Inventory)

A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly? A) Client reports not going to work for the past week B) Client complains of not being able to "do anything" anymore C) Client arrives at the clinic neat and appropriate in appearance D) Client reports sleeping 12 hours per night and 3 to 4 hours during the day **Rationale: Review Book pg. 990**

C (Client arrives at the clinic neat and appropriate in appearance)

The nurse is performing an assessment on an 8-year-old child who the mother is concerned has depression. Which symptoms of depression are consistent with a child of this age? A) Regression in toilet training B) Self-destructive play themes C) Decrease in academic performance D) Poor self-care **P-28**

C (Decrease in academic performance)

A manic client begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement? A) Place the client in seclusion for 30 minutes B) Tell the client that the behavior is inappropriate C) Escort the client to their room, with the assistance of other staff D) Tell the client that their telephone privileges are revoked for 24 hours **Rationale: Review Book pg. 951**

C (Escort the client to their room, with the assistance of other staff)

A woman with bipolar disorder is taking lithium. She continues to take lithium until she realizes she is pregnant, which is 6 weeks into the pregnancy. Which potential adverse effect might the nurse tell the client about when she asks about lithium and pregnancy? A) Craniofacial defects B) Neural tube defects C) Heart defects D) Gastrointestinal defects **P-28**

C (Heart defects)

A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse, "I'm finally cured." Based on the client's behavior and statement, which intervention should the nurse include in the plan? A) Suggesting a reduction of medication B) Allowing increased "in-room" activities C) Increasing the level of suicide precautions D) Allowing the client off-unit privileges as needed **Rationale: Review Book pg. 976**

C (Increasing the level of suicide precautions)

The home care nurse hears the spouse of a client say "With you being so sick lately, I can't maintain this home by myself, so I never invite family over anymore. I can't stand to have them see our house in this rundown state." The client engages in an argument with the spouse, and the spouse begins to cry. Which does the home care nurse identify as occurring with this couple? A) Evidence of low blood glucose levels B) Financial struggles within the family C) Possible situational depression D) Spousal abuse **P-28**

C (Possible situational depression)

A nurse working on a psychiatric unit is caring for a client who has been diagnosed with major depressive disorder (MDD). Upon assessment of the client, which clinical manifestations does the nurse recognize as consistent with this diagnosis? A) Depressed mood or loss of interest occasionally for at least 1 week B) Depressed mood sporadically for at least 2 years C) Restlessness, fatigue, suicidal ideation, feelings of guilt D) Anxiety, change in appetite, grief, altered nutrition **P-28**

C (Restlessness, fatigue, suicidal ideation, feelings of guilt)

The nurse is caring for a client with bipolar disorder who has expressed the desire to harm self. What is the priority nursing diagnosis for this client? A) Powerlessness B) Impaired Social Interaction C) Risk for Suicide D) Social Isolation **P-28*8

C (Risk for Suicide)

Which statement about bipolar disorder is true? A) The client will exhibit functional impairment at work during remission periods B) Episodes associated with bipolar disorder tend to decrease in frequency with age C) Some clients with bipolar disorder do not experience remission periods D) Bipolar disorders typically appear between the ages of 25 and 50 **P-28**

C (Some clients with bipolar disorder do not experience remission periods)

The nurse cares for the client with depression who attempts suicide. The nurse understands which is the most likely reason the client attempts suicide? A) The client is suspicious and mistrustful B) The client consciously wishes to manipulate others C) The client feels overwhelmed and helpless D) The client wants to gain attention **K**

C (The client feels overwhelmed and helpless)

A client is experiencing symptoms of depression. Which laboratory or diagnostic test would be the priority to determine if depression is being caused by another health problem? A) Electrocardiogram B) MRI of the brain C) Thyroid function tests D) Cerebral angiogram **P-28**

C (Thyroid function tests)

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? (Select all that apply) A) Figs B) Yogurt C) Crackers D) Aged cheese E) Tossed salad F) Oatmeal raisin cookies **Rationale: Review Book pg. 989**

C & E (Crackers) (Tossed salad)

A nurse is conducting an admission assessment on a client admitted for thoughts of suicide. Which assessment findings would indicate that the client is at a high level risk of suicide? (Select all that apply) A) Displays mild depression B) Shows curiosity about death C) Has access to a gun at home D) Admits planning to end his or her life E) Discusses a plan to end his or her life in detail **P-28**

C, D, & E (Has access to a gun at home) (Admits planning to end his or her life) (Discusses a plan to end his or her life in detail)

During group therapy on the unit, one client seldom speaks. One morning, the quiet client listens intensely and maintains eye contact with another client who speaks about depression, but the quiet client still does not speak. Which response by the nurse is most appropriate? A) "You are both sad now, but it is better to have a positive view to share." B) "Why are you looking that way? You seem very upset? C) "Express yourself verbally, so the group understands you." D) "Do you have some feelings about what's being said?" **K**

D ("Do you have some feelings about what's being said?")

The nurse is caring for a client recovering from a suicide attempt. Which client statement indicates to the nurse that the risk of suicide has diminished? A) "I am not looking forward to going home with my parents." B) "I now know that threatening suicide will help me get what I want from my parents." C) "Even though I failed this time, I lived to think about it again." D) "I am looking forward to going to school and seeing my friends." **P-28**

D ("I am looking forward to going to school and seeing my friends.")

A nursing instructor is evaluating a nursing student's knowledge regarding a client with suicidal thoughts. Which statement made by the student demonstrates an understanding regarding assessing a client with suicidal thoughts? A) "I should attempt to make light of the circumstances." B) "I should be indirect and respectful." C) "I should not talk about suicide directly." D) "I should directly acknowledge the situation." **P-28**

D ("I should directly acknowledge the situation.")

The nurse instructs a client diagnosed with bipolar disorder receiving lithium 300 mg three times a day. The nurse determines that teaching is effective if the client makes which statement? A) "I can still have my coffee" B) "I should increase my level of exercise" C) "I can sit in a hot tub" D) "I will eat a moderate amount of sodium" **K**

D ("I will eat a moderate amount of sodium")

The nurse cares for a client receiving sertraline. Which statement is most important for the nurse to make? A) "It will not have any effect on your sleeping patterns." B) "You don't have to worry about interactions with other medications." C) "You can drink beer and wine, but not mixed drinks, while taking the medication." D) "It might take four weeks for you to reach full therapeutic effect." **K**

D ("It might take four weeks for you to reach full therapeutic effect.")

A depressed client on an inpatient unit says to the nurse, "My family would be better off without." Which is the nurse's best response? A) "Have you talked to your family about this?" B) "Everyone feels this way when they are depressed." C) "You will feel better once your medication begins to work." D) "You sound very upset. Are you thinking of hurting yourself?" **Rationale: Review Book pg. 975**

D ("You sound very upset. Are you thinking of hurting yourself?")

A client with a diagnosis of depression who has attempted suicide says to the nurse, "I should have died. I've always been a failure. Nothing ever goes right for me." Which response by the nurse demonstrates therapeutic communication? A) "You have every to live for." B) "Why do you see yourself as a failure?" C) "Feeling like this is al part of being depressed." D) "You've been feeling like a failure for a while?" **Rationale: Review Book pg. 929**

D ("You've been feeling like a failure for a while?")

Which individual has the most risk factors for depression? A) A 43-year-old man who was fired from his job 8 months ago and has been unable to find employment B) A 38-year-old woman who recently moved away from all her family to go to graduate school C) A 68-year-old man who lost his wife in a car accident and lives close to two of their three children D) A 19-year-old woman who was emotionally and physically abused as a child and dropped out of school at the age of 16 when she became pregnant **P-28**

D (A 19-year-old woman who was emotionally and physically abused as a child and dropped out of school at the age of 16 when she became pregnant)

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention? A) Encouraging quiet reading and writing for the first few days B) Identification of physical activities that will provide exercise C) No socializing activities until the client asks to participate in milieu D) A structured program of activities in which the client can participate **Rationale: Review Book pg. 950**

D (A structured program of activities in which the client can participate)

A client is slumped on the floor with a razor blade in hand and blood pours from the wrist. The nurse finds the client. Which action is the most important for the nurse to take? A) Find out why the client tried to commit suicide B) Telephone the health care provider to explain the situation C) Ask the unlicensed assistive personnel to hold the wrist while the nurse calls the health care provider D) Apply pressure to the wrist and call another nurse to help **K**

D (Apply pressure to the wrist and call another nurse to help)

A client in a hypomanic state is dressed sexually and making sexual remarks. What nursing action should be completed? A) Insist that the client leave the common room B) Confront the client regarding dress and mannerisms C) Tell the other clients to ignore the behavior D) Approach the client calmly and escort back to client's room **Kahoot - Bipolar**

D (Approach the client calmly and escort back to client's room)

A patient has increased restlessness, pressured speech that is worsening a week after lithium prescribed. The nurse should: A) Explain to client the proper ways to apply makeup B) Continue to monitor the client's sleeping patterns C) Discourage the client from attending group therapy D) Consider the need to obtain a lithium level **Kahoot - Bipolar**

D (Consider the need to obtain a lithium level)

The nurse is caring for a client with a chronic health condition. Which condition should the nurse identify as a common complication associated with reduced role function? A) Osteoporosis B) Congestive heart failure C) Diabetes D) Depression **P-28**

D (Depression)

A manic patient states, "Where is my daughter? I love Louis. Rain go away. Dogs eat dirt." What is this? A) Echolalia B) Neologism C) Clang associations D) Flight of ideas **Kahoot - Bipolar**

D (Flight of ideas)

A client gives the home health nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication? A) Complaints of insomnia B) Complaints of hunger and fatigue C) A pulse rate less than 60 beat per minute D) Frequent hand washing with hot, soapy **Rationale: Review Book pg. 990**

D (Frequent hand washing with hot, soapy)

The nurse cares for the client diagnosed with depression and encourages the client to join an activity. Which approach by the nurse is best? A) Offer several appealing choices to the client B) Tell the client it is part of the healthcare provider's orders C) Describe the activity in detail to the client D) Invite the client to join in **K**

D (Invite the client to join in)

The nurse understands that bipolar disorders affect clients differently across the lifespan. Which is true regarding bipolar disorder and lifespan considerations? A) Children with bipolar disorders present with mood changes only B) Children with bipolar disorders rarely exhibit violent tempers C) Suicide risk does not increase in adolescents and teenagers who are diagnosed with bipolar disorders D) Lifetime prevalence of bipolar disorders in adolescents is 0-3% **P-28**

D (Lifetime prevalence of bipolar disorders in adolescents is 0-3%)

A client being treated for severe depression reports feeling better and having more energy. Which is a priority nursing diagnosis for the client at this time? A) Social Isolation B) Hopelessness C) Situational Low Self-Esteem D) Risk for Self-Directed Violence **P-28**

D (Risk for Self-Directed Violence)

A 76-year-old man was recently diagnosed with Alzheimer disease. His wife passed away 6 months ago due to metastatic breast cancer. The client states that he doesn't sleep well, often forgets to eat because he doesn't feel hungry, and he just doesn't get involved in social functions anymore because his kids don't want him to drive. He states that he feels isolated and lonely. What diagnosis should the nurse include as the highest priority in this client's plan of care? A) Ineffective Activity Planning B) Grieving C) Risk for Loneliness D) Risk for Suicide **P-28**

D (Risk for Suicide)

A nurse is caring for a client who displays symptoms associated with seasonal affective disorder (SAD). Which treatment would the nurse question as inappropriate for this client? A) Cognitive-behavioral therapy B) Light therapy C) Bupropion extended-release D) Selective serotonin reuptake inhibitor (SSRI) **P-28**

D (Selective serotonin reuptake inhibitor (SSRI))

A client states that he often wonders if everyone would be better off if he were dead. What does the nurse identify this as? A) A suicide attempt B) Suicide planning C) A suicide threat D) Suicidal ideation **P-28**

D (Suicidal ideation)

The client diagnosed with bipolar depression is hospitalized in the elation phase of the illness. The client says to the nurse, "I just bought myself a home computer and a large screen TV for the family." Which interpretation by the nurse is most accurate? A) The client wants to impress the nurse with the level of generosity toward the family B) The client is insecure about self-worth and needs to manipulate electronic devices C) The client has completely lost contact with reality and thought patterns are disturbed D) The client has a mood disturbances and the judgement is poor at this time **K**

D (The client has a mood disturbances and the judgement is poor at this time)

A client in the manic phase of bipolar disorder is unable to sleep during the night. Which interventions could be helpful to this client? (Select all that apply) A) Engage in conversation B) Extend daytime naps C) Encourage the client to watch television D) Assist the client with a warm bath and provide a light snack E) Encourage the client to listen to soothing music **P-28**

D & E (Assist the client with a warm bath and provide a light snack) (Encourage the client to listen to soothing music)