NURS 6005 (Mental Health) Final Exam Study Set

Mild mania is also called...

hypomania (think Tigger to dysthymia's Eeyore)

A client who is a known susbtance user arrives at the ED. When asked the reason for their visit, they say they "needed to stop". They appear restless, and are experiencing regular leg movements. They complain of muscle and bone pain, trouble sleeping, diarrhea, and cold flashes. They are vomiting, and have visible goose bumps on their skin during their cold flashes. Which class of drugs do you suspect they are withdrawing from? A. Opioids B. Stimulants C. Hallucinogens D. Alcohol

A. Opioids

1. Bipolar disorder is characterized by episodes of both _____________ and _______________. 2. What are the three types of bipolar disorder?

1. Bipolar disorder is characterized by episodes of both depression and mania. 2. Cyclothymia (mild), Bipolar II (severe depression w/hypomania), Bipolar I (most severe swings)

A nurse is planning discharge for a client who has schizophrenia and reports "I don't have a place to live." Which of the following referrals should the nurse request from the provider? A. Social Worker B. Spiritual advisor C. Employment assistance D. Psychiatrist

A. Social Worker -A social worker is a professional who can coordinate specialty care and community assistance for clients who have a mental health disorder diagnosis and have social issues such as homelessness.

The nurse is reviewing the labs for a client with bipolar disorder who was recently placed on Lithium. Which of the following Serum Lithium levels would be a cause for concern? (SATA) A. 2.0 mEq/L B. 1.2 mEq/L C. 0.6 mEq/L D. 0.2 mEq/L

A and D are concerning. -A is much too high; early symptoms of toxicity can be seen at levels greater than 1.5 mEq/L. -D is too low. We generally want Lithium levels to be above 0.5 mEq/L in order to see therapeutic benefits. -Therapeutic range for lithium is between 0.5-1.5 mEq/L

A nurse is caring for a client who states that they are entitled to a single room on the mental health unit and that the nurse is not educated enough to care for them. The nurse should identify that this finding is consistent with which of the following personality disorders? A. Narcissistic personality disorder B. Histrionic personality disorder C. Dependent personality disorder D. Paranoid personality disorder

A is correct: Narcissistic personality disorder -Clients who have narcissistic personality disorder feel a sense of grandiosity and entitlement and often will either devalue or idealize their caregivers.

A nurse has been confronted about stealing and taking drugs from the narcotics cart in the med room. The nurse has been reported to the board of nursing in their state. What is the likely initial outcome? A. The nurse will be assisted into drug treatment. B. The nurse will need to transfer to a different unit. C. The nurse will be fired immediately D. The nurse will lose their nursing license immediately.

A. The nurse will be assisted into drug treatment.

A nurse is caring for a client who has schizophrenia. Which of the following findings indicates that the client is in the prodromal phase? A. Withdrawn Behavior B. Incoherent Speech C. Severe Delusions D. Frequent Hallucinations

A. Withdrawn Behavior -Uncharacteristically withdrawn behavior is a symptom of the prodromal phase, which is the initial phase of the disorder and is marked by less severe symptoms of delusions and hallucinations. -Completely incoherent speech is a characteristic of the active phase of schizophrenia when symptoms of disorganized speech are most severe. -Severe delusions would be exhibited by a client in the active phase of schizophrenia. -Frequent hallucinations are characteristic of the active phase of schizophrenia when symptoms occur more often and with regularity.

Overactivity, overeating, overspending, not sleeping, and talking quickly are all manifestations of... A. Mania B. Depression C. Abeel D. Suicidal Ideation

A (Mania) is correct. Abeel is also correct, but will not be on the exam.

A patient is a high suicide risk. What is the priority action by the nurse? A. Arrange for one-on-one supervision. B. Administer antidepressants. C. Reassure client that everything will be fine. D. Arrange for the client to be in seclusion.

A (arrange for one-on-one supervision) is correct. -B: Administering antidepressants may be helpful, but most antidepressants do not work over the short term. -C is false reassurance. -D: Patients who are a high suicide risk should not be left alone. If possible, encourage patients to be in a community space during group activities.

The onset of a manic episode is often preceded by...

Increased Sleep Disturbances

persistent depressive disorder (dysthymia) may also be described as...

Mild depression Major depression = Severe Depression

Depression which occurs through the first year after giving birth is known as...

Postpartum depression

A client presents with bleeding gums, bloody diarrhea, nosebleeds, and seizures. A tox scan reveals that they have consumed rat poison. Upon investigation, it's found that they consumed the rat poison deliberately in order to become sick. This client would likely be diagnosed with what disorder?

This client most likely has Factitious Disorder. -Clients who have factitious disorder assume the sick role by misrepresenting their manifestations or deliberately injuring or infecting themselves in an attempt to have their emotional needs met. -Be careful to distinguish factitious disorder from malingering. With malingering, individuals induce sickness or injury in return for a clear external reward (ie. drinking 5 bottles of Miralax so you don't have to go to work). Clients with factitious disorder also induce sickness or injury, but without a clear external reward.

Mild Bipolar disorder, which manifests as cycling between mania and depression for at least two years (to meet clinical diagnosis requirements) is also called...

Cyclothymia

What is the leading cause of intellectual disability in the United States?

Fetal Alcohol Syndrome

What are some treatment options for schizophrenia?

-Antipsychotic medications. -Psychotherapy. -Cognitive behavioral therapy. -Support and education for both the client and family.

Alcohol withdrawal is typically treated with what class of medications?

-Benzodiazepines -Diazepam and chlordiazepoxide are the first-line choice. -Barbiturates (phenobarbital) are only considered if the client has contraindications for benzos. -Carbamazepine may be used to control seizure activity

What is the treatment of choice for Antisocial Personality Disorder?

-Cognitive behavioral therapy is usually the treatment of choice for this personality disorder. -Medications do not change the disorder but can help with some of the aggression. -Antidepressants, antipsychotics, and mood stabilizers might be prescribed as well to treat depression, psychosis, and mania, respectively.

What are some non-pharmacological treatments for depression?

-Cognitive-Behavioral Therapy (CBT) -Electroconvulsive Therapy (for refractive depression) -Transcranial Magnetic Stimulation: Uses magnetic pulses to stimulate focal areas of the cerebral cortex. Not done under anesthesia, unlike ECT. -Vagal Nerve Stimulation: Stimulator implanted in the chest wall. -Deep Brain Stimulation: Surgically implanted electrodes. -Light Therapy (for seasonal depression/SAD) -St. John's wort (not with SSRIs)

What treatment modalities are used for Borderline Personality Disorder?

-Dialectical Behavior Therapy (DBT): Provides coping strategies for impulse control and affective lability. -Cognitive Behavioral Therapy (CBT). -Narrative therapy, which deconstructs and reauthors personal stories. -Medications such as benzodiazepines, antidepressants, or mood stabilizers to treat the anxiety, emotional dysregulation, and psychotic features that often are present in both adults and youths with this disorder.

A nurse is reviewing a client's risk for substance use disorder. Which of the following information about ingestion routes accurately describes substance addiction potential? A. Smoking or injecting a substance increases the potential for addiction. B. The route does not make a difference, but the specific drug consumed is the factor. C. Taking pills orally increases risk for addiction because pills are easy to access and use. D. Some routes of substance use give the addict slower, more drawn-out pleasure from the drug.

A is correct -When a drug is smoked or injected, it travels faster to the brain. This raises addiction potential.

Which of the following are manifestations of Major Depressive Disorder? (SATA) A. Anhedonia B. Significant, unintentional weight loss or gain. C. Insomnia D. Talkativeness

A, B, C are all correct. -Anhedonia is a loss of interest or pleasure in activities -Pts may experience wt loss or gain and a decrease or increase in appetite (appetite changes) -Patients may present with insomnia or hypersomnia -Talkativeness is a manifestation of mania, not depression.

Which of the following are warning signs that a person may attempt suicide? (SATA) A. Withdrawing from family and friends. B. Stating that they feel like they have a solution to their problems. C. Engaging in risky, impulsive behavior. D. Stating that they feel like a burden to others.

A, C, and D are all warning signs of suicide. B is incorrect. People who are considering suicide are more likely to express a feeling of being trapped, without any solutions to their problems.

Positive Manifestations of schizophrenia are defined as feelings, beliefs, or behaviors that are not present in most other people (not normally present). These positive manifestations include which of the following? (SATA) A. Hallucinations. B. Alogia C. Delusions D. Disorganized speech

A,C,D are correct. Hallucinations, delusions, and disorganized speech are positive manifestations. -Alogia is a slowness in thinking observed by a person's speech patterns and language skills. it may also be called "poverty of speech".

"Anosognosia" is a wonderful term which means...

Anosognosia is a lack of insight when someone is either unaware or cannot perceive accurately their own mental health.

A patient who has been feeling depressed for some time experiences a sudden, extreme mood swing and now seems cheerful and exuberant. Why might the nurse find this concerning? A. This patient must have Bipolar disorder. B. Sudden, extreme mood swings are a warning sign of suicide. C. This is a warning sign of delirium. D. This patient is in the behavioral health unit and should not be happy.

B is correct. Sudden, extreme mood swings are a warning sign of suicide.

A nurse on an inpatient mental health unit is evaluating a client who was admitted for suicidal ideation for readiness for discharge. Which of the following statements by the client indicates they may be ready for discharge? A. "I plan to go hunting when I get home." B. "When I get home, I will reach out to my friends if I start feeling down." C. "I am going to make a will as soon as I get home." D. "When I get home, I will get even with my boss for firing me from my job."

B. "When I get home, I will reach out to my friends if I start feeling down." -This statement by the client indicates future planning and a solution to problems. Clients who are experiencing suicidal ideation do not make future plans and feel trapped without solutions to problems. -A and B are sus as hell. -C is pretty ominous.

A nurse is working with a provider to determine which laboratory tests should be ordered for a client who is suspected of chronic alcohol use. The nurse should identify that which of the following sets of laboratory data might indicate chronic alcohol use? A. Brain natriuretic peptide, cardiac enzymes, alkaline phosphatase B. CBC, WBC, neutrophils, platelets C. Liver panel, comprehensive metabolic panel, BAL/BAC, magnesium D. Blood glucose level, T3, T4, thyroid-stimulating hormone

C. Liver panel, comprehensive metabolic panel, BAL/BAC, magnesium. -Expect elevated AST/ALT for liver enzymes.

A nurse is discussing common misconceptions regarding patients who have substance use disorder. The nurse should include which of the following as a possible consequence of a client being labeled by providers as drug-seeking? A. The client may realize that their behavior is inappropriate. B. The client will ask to see what is written in their chart and sue the provider. C. The client may be discharged without getting needed treatment. D. The provider may be reprimanded and lose their job.

C. The client may be discharged without getting needed treatment. -Many times, patients with addiction are labeled as drug seeking and may be discharged without getting the treatment needed.

What are some other conditions or illnesses that may manifest with symptoms of depression? (Hint, think HH: Head and Hormones).

Cognitive Disorders: -Parkinson's -Huntington's -TBI Hormonal Imbalances: -Hypothyroidism -Premenstrual Dysphoria -Postpartum Depression

Which of the following lab/diagnostic tests can help diagnose schizophrenia? A. CBC B. Lumbar Puncture C. SHZ D. None of the above

D is correct. There are no lab tests to diagnose schizophrenia.

The prevalence of bipolar disorder is... A. 8.7% B. 5.3% C. 7.1% D. 2.8%

D. (2.8%) is correct. All the other answers describe prevalence rates of depression (8.7% females, 5.3% males, 7.1% general prevalence)

A nurse on a mental health unit is using the SAD PERSONS scale to assess the risk of suicide among several clients. Which of the following clients should the nurse identify as having the highest risk? A. A 43-year-old female client B. A 21-year-old female client C. A 35-year-old male client D. A 15-year-old male client

D. A 15-year-old male client Rationale: clients who are less than 19 years of age and older than 45 years of age have an increased risk of suicide. Clients who are male also have an increased risk of suicide.

A nurse is caring for a client who has schizophrenia. Which of the following findings should the nurse identify as a comorbidity to this condition? A. Osteoarthritis B. Cancer C. Alzheimer's disease D. Diabetes mellitus

D. Diabetes mellitus -Medical conditions such as weight gain, diabetes, metabolic syndrome, cardiovascular disease and pulmonary disease are more common in persons with schizophrenia than the general population. -Recall that many antipsychotic medications can cause metabolic problems as a side-effect, including T2D.

A nurse is caring for a client who has schizophrenia. In which of the following phases of the nurse-client relationship should the nurse suggest a guided therapy session? A. Orientation Phase B. Resolution phase C. Identification phase D. Exploitation phase

D. Exploitation phase -The exploitation phase is when the nurse seeks to get the client to reveal deep-rooted feelings and concerns. This can frequently be addressed through nonpharmacological interventions such as education or guided therapy sessions.

A nurse is providing care to a client who is experiencing a loss of motor strength with no identifiable physical cause. The nurse would suspect the client to be diagnosed with which of the following disorders? A. Somatic symptom disorder B. Illness anxiety disorder C. Factitious disorder D. Functional neurological symptom disorder

D. Functional neurological symptom disorder

A nurse is caring for a client who has been diagnosed with schizophrenia and is experiencing delusions of being the Quizlet King. Which of the following delusion types describes this client's behavior? A. Persecutory B. Control C. Thought Insertion D. Grandiose

D. Grandiose Delusions -Grandiose delusions are firmly held beliefs by a person that they are someone other than who they are - often a person of wealth, fame, or a deity.

A nurse is caring for a client who recently gave birth. The nurse notices the newborn is displaying manifestations of opioid withdrawal. The nurse should recognize the newborn's manifestations as signs of which of the following conditions? A. Substance use disorder B. Tolerance C. Fetal alcohol syndrome D. Neonatal abstinence syndrome

D. Neonatal abstinence syndrome -Opioid withdrawal in a newborn whose mother used opioids in pregnancy is known as neonatal abstinence syndrome.

Mild depressive disorder may also be called...

Dysthymia (don't call them Eeyores please, but it is a helpful reference point).

True or False: People with Depression are always sad.

False. Depression is a disorder characterized by extremely low energy. Sadness may be involved, but disinterest and fatigue are the most common manifestations.

Delusions are best described as...

Fixed, false beliefs.

A nurse is caring for a client who has been diagnosed with dissociative identity disorder. The client develops an alter personality when discussing the trauma. How should the nurse respond when this occurs? A. Inform the client that the nurse will not work with them until they return from their alter state. B. Flood the client with data from the previous trauma. C. Encourage the client not to switch to their alter personality. D. Display empathetic listening and keep the client comfortable and safe.

Obviously the answer is D, but you probably chose B you sick weirdo.

How can Bipolar I be differentiated from Bipolar II?

Patients with Bipolar I experience extremely high levels of mania (higher highs) whereas patients with Bipolar II have hypomania, but often suffer from more profound depression (Lower Lows). If it helps, think of the "II" in "Bipolar II" as standing for "lower lows".

SAD PERSONS is a mnemonic scale for assessing suicide risk. What does each letter stand for?

Sex (Male=higher lethality) Ages < 19 0r > 45 are the highest risk Depression Previous attempt Ethanol Rational thinking loss Social supports lacking Organized plan No partner Sickness (major or chronic)

A client newly diagnosed with Illness Anxiety Disorder asks the nurse about possible treatment options. What are some treatments for Illness Anxiety Disorder that the nurse can mention to the client?

The following treatments are useful for Illness Anxiety Disorder: -SSRIs such as Fluoxetine (Prozac) -Psychotherapy -Cognitive Behavioral Therapy

True or False: Individuals diagnosed with Somatic Symptom Disorder are subconsciously faking their symptoms to relieve psychological pain associated with past traumas.

This is false. People with SSDs are not faking their symptoms.

Within what age range do people with a psychotic-related disorder typically first experience manifestations? -Within what age range are they typically first diagnosed?

-First manifestations in late teens to mid-twenties. -Diagnosed most often between ages 16-30

What are some safety concerns with a client who is currently under the influence of alcohol?

-May aspirate their own vomit -Severe dehydration and peripheral vascular collapse -Respiratory arrest -Bleeding risk (alcohol is a blood thinner) -At risk for accident if driving

A nurse working in a detoxification unit is reviewing the process of addiction. The nurse should identify that which of the following parts of the brain are implicated in the reward pathway leading to addiction? A. Basal ganglia, extended amygdala, and prefrontal cortex B. Midbrain, cerebrum, and temporal lobe C. Prefrontal cortex, brain stem, and frontal cortex D. Cerebellum, pons, and medulla oblongata

A. Basal ganglia, extended amygdala, and prefrontal cortex. -The basal ganglia rewards you for taking a hit, the amygdala makes you anxious when you don't, and the prefrontal cortex is involved in judgment.

A nurse is caring for a client who reports an extensive history of physical and sexual abuse as a child. The client states, "Sometimes I do things that I'm not aware of. I see pictures of myself on social media and I am wearing things that I would never wear, and I am in locations where I would never go. It makes me feel so frustrated." The client is exhibiting manifestations of which of the following disorders? A. Dissociative identity disorder B. Dissociative amnesia C. Depersonalization/derealization disorder D. Somatic symptom disorder

A. Dissociative identity disorder is characterized by two or more separate personalities that each have their own patterns of behavior and memories

Which drug class dramatically increases the risk for cardiac toxicity if combined with alcohol? A. Opioids (Fentanyl, Morphine) B. Hallucinogens (PCP, LSD) C. Stimulants (Adderall, Methylphenidate) D. Sedatives

C (stimulants) is correct.

A nurse on an inpatient mental health unit is teaching a newly licensed nurse about suicide prevention. Which of the following statements made by the newly licensed nurse indicates an understanding of the information presented? A. "The client can eat their meal alone in their room." B. "The blinds in the client's room will need to stay closed to prevent overstimulation." C. "All sharp objects should be removed from the client's room." D. "Family members should be encouraged to look up the warning signs of suicide."

C. "All sharp objects should be removed from the client's room." -The nurse should identify that all items, including sharp objects or potential weapons, that could be potentially dangerous and used to complete a suicide attempt should be removed from the client's room. -A and B are wrong because clients on suicide watch should not be left out of site, especially with utensils. -D sounds correct, but this education should be provided by the nurse, not the internet.

A nurse is reviewing the medical record of a client who recently has been diagnosed with schizophrenia. Which of the following finding is a genetic risk factor associated with the development of schizophrenia? A. Biologic sibling with Down syndrome. B. Biologic grandparent with fragile x syndrome C. Biologic uncle with Rett syndrome D. Biologic parent with schizophrenia

D. Biologic parent with schizophrenia -A client with a biological parent who is diagnosed with schizophrenia is six times more likely to develop the disorder. -All of the other syndromes are risk factors for Autism Spectrum Disorder. People with schizophrenia may display autistic traits, but this is different from the disorder.

A nurse is caring for a client who seeks care frequently due to fear of having a serious illness. After learning that the laboratory results showed no abnormalities, the client begins to hyperventilate. The client is exhibiting manifestations of which of the following disorders? A. Functional neurological symptom disorder B. Factitious disorder C. Somatic symptom disorder D. Illness anxiety disorder

D. Illness anxiety disorder -Illness anxiety disorder is when a client experiences constant thoughts about having a significant illness related to misinterpreted bodily symptoms.

A nurse is caring for a client who was hospitalized with a high blood alcohol content level. The client's manifestations included anxiety, tremors, BP 166/100 mm Hg, and tachypnea about 1 hr ago. Now the client begins yelling out that they are seeing spiders crawling all over the walls. They believe they are at home and begin calling for their mother. The nurse should recognize that the client is experiencing which of the following stages of alcohol withdrawal? A. Stage 1 (mild) B. The client's manifestations indicate a psychotic disorder, not alcohol withdrawal. C. Stage 2 (moderate) D. Stage 3 (severe)

D. Stage 3 (severe) -Disorientation, hallucinations, and seizures are manifestations of Stage 3 withdrawal.

Is depression more common in men or women?

Depression is more common in women (8.7% of women vs. 5.3% of men).

Children who exhibit extreme irritability, tantrums, and trouble functioning in school and with peers may be diagnosed with...

Disruptive Mood Dysregulation Disorder

What classes of medication may be used to treat depression?

-SSRIs (Fluoxetine/Prozac) -SNRIs (venlafaxine) -TCAs (Imipramine) -MAOIs (Phenelzine) -SGAs (Clozapine) -Mood stabilizers (lithium) -Anticonvulsants (Carbamezapine/Tegretol and Valproic acid/Depakote).

The prodromal phase of a psychotic episode is manifested by...

-Disruption in sleep patterns -Decreased motivation, concentration, daily functioning -Increased suspicion of others or situations -Increased isolation (often the first sign of impending psychosis) -Increased anxiety -Negative manifestations begin to emerge

Splitting (devaluing or idealizing others) is a key characteristic of which two personality disorders?

-Narcissist Personality Disorder -Borderline Personality Disorder

Suicide rates are highest among which groups?

-Native Americans and non-Hispanic Whites. -Veterans -People living in Rural areas -People who work in industries such as mining and construction.

Delusions are defined as firmly held beliefs without evidence. There are several different subcategories of delusions. What are they?

-Persecution: Something or someone (actual or imaginary) is going to harm them -Grandiose: Believing they have exceptional fame, abilities, or wealth, including believing they are of royalty or a deity -Thought insertion/Withdrawal: Someone or something is giving or taking away thoughts or ideas -Control: An outside force is controlling their mind or parts of their body

In general, have suicide rates been increasing or decreasing?

-Suicide rates have increased 33% between 1999 and 2019. -There is roughly 1 death from suicide every 11 minutes (U.S.)

A public health nurse is preparing a suicide prevention program for patrons of the local library. The nurse should inform the attendees that suicide is the second leading cause of death in which of the following age groups? A. 10 to 34 years of age B. 35 to 44 years of age C. 45 to 54 years of age D. Over 65 years of age

A. 10 to 34 years of age -According to the CDC, suicide is the second leading cause of death for people 10 to 34 years of age. (probably because this group has generally good health).

Negative manifestations of schizophrenia are defined as feelings and behaviors that are usually present, but absent in the person with schizophrenia. These include which of the following? (SATA) A. Alogia B. Autism C. Blunted Affect D. Disinterest in previously enjoyed activities.

A-D are all correct. -Alogia is a slowness in thinking observed by a person's speech patterns and language skills. -Autism is defined as a lack of ability in communication and social interaction as well as behavior that displays repetitive or restrictive patterns. -Blunted affect refers to a lessened ability to express emotions. -Ambivalence of feelings is another manifestation.

A nurse is discussing findings of depression with a group of clients. Which of the following client statements indicates an understanding of the information? A. "Thyroid problems can cause depression." B. "Staying awake for days can be a finding of depression." C. "Hyperactivity is a finding associated with depression." D. "Impulsiveness is a finding that is commonly associated with depression."

A. "Thyroid problems can cause depression." -Depression can be induced by medical conditions, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and hypothyroidism. -Some clients with depression may suffer from insomnia, but staying awake for days at a time is more characteristic of mania. -Hyperactivity and impulsive behavior are associated with mania, not depression.

A school nurse is preparing a presentation for high school students on the relationship between substances and depression. Which of the following substances should the nurse plan to include as a contributing factor in the development of substance-induced depressive disorder? A. Amphetamines B. Selective serotonin reuptake inhibitors C. Nonsteroidal anti-inflammatory drugs D. Monoamine oxidase inhibitors

A. Amphetamines -Substance/medication-induced depressive disorder occurs soon after a client begins taking or withdrawing from a substance, with the most common occurrences when the client is using alcohol, phencyclidine, hallucinogens, inhalants, opioids, and amphetamines. -You can also solve this question by process of elimination. SSRIs and MAOis treat depression, so are unlikely candidates for causing depression. NSAIDs do not have an effect on mood.

A nurse is caring for a client who states, "I have no close friends. I do not go to parties. I can't talk in front of people, and I fear rejection." The nurse should identify that these findings are manifestations of which of the following personality disorders? A. Avoidant personality disorder B. Antisocial personality disorder C. Dependent personality disorder D. Obsessive-compulsive personality disorder

A. Avoidant personality disorder -A client who has avoidant personality disorder will typically lack close friends, avoid social activities for fear of criticism, and feel anxiety or embarrassment when speaking in front of other people.

A nurse is creating a presentation about depression for a community health fair. The nurse should plan to report that depression is more prevalent among which of the following demographics? A. Adult males B. Adult females C. Adolescents between the ages of 15 and 17 D. Children ages 10 to 14

B. Adult females -The prevalence of depression in U. S. adults aged 18 or older in 2017 was estimated at 17.3 million, with higher prevalence among females.

A nurse in an outpatient clinic is caring for a client who has major depressive disorder and has reported suicidal thoughts. Which of the following is the first information the nurse should try to obtain from the client? A. How lethal are the client's thoughts of self-harm? B. Does the client have access to committing self-harm? C. Does the client have a suicide plan? D. Does the client have someone to call when they are feeling suicidal?

C. Does the client have a suicide plan? -Using the safety/risk reduction priority framework, the first information the nurse should try to obtain is whether the client has a definite suicide plan.

A nurse is caring for a client who is hospitalized for gallbladder removal surgery. On their first postoperative day, the client has agitation, a high temperature, increased respirations, irritability, and confusion. The nurse should recognize that the client may be experiencing withdrawal from which of the following substances? A. Hallucinogens B. Alcohol C. Heroin D. Stimulants

B. Alcohol -Withdrawal from hallucinogens produces manifestations such as headaches, increased appetite, sleepiness, and depression. -Heroin (opioid) withdrawal produces manifestations such as restlessness, muscle and bone pain, insomnia, diarrhea, and vomiting. -Stimulant withdrawal produces manifestations such as depression, fatigue, increased appetite, insomnia, vivid unpleasant dreams, slowed thinking and movement, and restlessness.

A nurse is caring for a client who has borderline personality disorder. The nurse should identify that which of the following factors may have contributed to the development of this disorder? A. Gender predisposition B. Childhood rejection C. Lower socioeconomic status D. Second-generation relative with schizophrenia

B. Childhood rejection -exposure to traumatic events during childhood, such as fear of rejection and/or abandonment, are contributing factors for the development of borderline personality disorder.

A nurse is caring for a client who regularly uses methamphetamine and is experiencing blood vessel constriction and spasming. The nurse should identify that the client is at high risk for developing which of the following conditions? A. Liver and pancreatic disease B. Heart disease and stroke C. Brain trauma and injury D. Bone loss and osteoporosis

B. Heart disease and stroke -Fun fact: severe vasospasm from stimulants such as cocaine can result in a type of angina called "Prinzmetal's Angina" which is pretty metal. It's also called variant angina, but that's hella boring.

A nurse is caring for a client who is diagnosed with schizophrenia. Which of the following manifestations should the nurse identify as a negative symptom? A. Paranoia B. Lack of emotions C. Confusion D. Distorted beliefs

B. Lack of emotions -Negative symptoms are the absence of something normally present (such as emotions). -Other negative symptoms can include lack of motivation, lack of interest, lack of energy, withdrawal from others, and absence of speech.

A nurse is caring for a client who has been brought to the emergency department and is experiencing acute fentanyl toxicity. The nurse should expect to observe which of the following adverse effects in this client? A. Tachypnea B. Pupillary dilation C. Hypertension D. Elevated heart rate

B. Pupillary dilation -Acute toxicity of opioids can result in hypoxia, which is a condition that results when too little oxygen reaches the brain. Hypoxia can have short- and long-term psychological and neurological effects, including coma, permanent brain damage, and death. -TLDR: Hypoxia for longer than about 3 minutes causes brain damage and coma, with dilated pupils unresponsive to light.

A nurse is caring for a client who was hospitalized with a high blood alcohol content level. The client's manifestations now include anxiety, tremors, BP 166/100 mm Hg, and tachypnea. The nurse should recognize that the client is experiencing which of the following stages of withdrawal from alcohol? A. Stage 1 (mild) B. Stage 2 (moderate) C. Stage 0 (pre-withdrawal) D. Stage 3 (severe)

B. Stage 2 (moderate) -Stage 1 withdrawal does not include increased blood pressure or increased respirations. Therefore, A is incorrect. -There is no stage 0 for withdrawal. C is incorrect. -Stage 3 withdrawal includes hallucinations, disorientation, and seizures in addition to the listed manifestations. D is incorrect.

After finals week, a student arrives at the emergency department with complaints of vivid, unpleasant dreams, slowed cognition and movement, depressed mood, and insomnia. They appear restless and claim to feel "ravenous" all the time. When asked by the nurse, they confess to using some "study buddies" to enhance their school performance over the past several semesters, but have stopped after their last final. Given their symptom picture and subjective report, which class of medications do you suspect they are withdrawing from? A. Opioids B. Stimulants C. Hallucinogens D. Alcohol

B. Stimulants -Stimulant withdrawal manifestations include: Depression, tiredness, increased appetite, insomnia, vivid unpleasant dreams, slowed thinking and movement, restlessness. -Adderall (Amphetamine/Dextroamphetamine) has several street names. "Study Buddies" is one of these.

A nurse is assessing a client who has a diagnosis of mania related to bipolar disorder. Which of the following behaviors should the nurse expect the client to exhibit? A. The client is giving away their possessions. B. The client is demonstrating risky behavior. C. The client is sleeping excessively. D. The client states they feel worthless.

B. The client is demonstrating risky behavior. -Expect a client who is experiencing mania to exhibit risky behavior. Other behaviors of mania include impulsivity, overactivity, pacing, sleeplessness, fast speech, and being overconfident.

A nurse is educating a group of clients about addiction. The nurse should include that which of the following factors increases the potential for addiction? A. The brain already has cognitive deficits that causes it to be vulnerable to addiction. B. The developing brain is exposed to substances at an early age. C. Initial use of substances began in adulthood. D. Medical insurance availability for substance use disorder treatment.

B. The developing brain is exposed to substances at an early age. -The risk for addiction is heightened when the developing brain is exposed to substances.

A patient arrives at the emergency department complaining of headaches, increased appetite, sleepiness, and depressed mood. They tell the nurse that they recently quit using drugs after having one too many bad trips. Which class of drugs do you suspect they are withdrawing from? A. Opioids B. Stimulants C. Hallucinogens D. Alcohol

C. Hallucinogens -Hallucinogens cause fairly mild withdrawal symptoms when compared to most other drug classes.

A nurse is caring for a client who is moving the furniture in the day room into straight rows and complaining about the different colors of clothes the other clients are wearing. The nurse should identify that these findings are consistent with which of the following personality disorders? A. Paranoid personality disorder B. Histrionic personality disorder C. Obsessive-compulsive personality disorder D. Schizoid personality disorder

C is correct. -Clients who have obsessive-compulsive personality disorder are preoccupied with order and strict adherence to moral rules. -Clients who have paranoid personality disorder might want to sit where they can observe others and the door opening, but they are unlikely to care if chairs are in a straight line. -Clients who have histrionic personality disorder are more prone to dramatic behaviors and might wear outrageous or flashy clothing. -Clients who have schizoid personality disorder usually do not care where others sit or what they wear as they often prefer to be alone.

Which of the following statements by a patient with Bipolar I disorder regarding their new lithium prescription indicates that teaching has been successful? A. "I will need to decrease my sodium intake while I'm on this medication" B. "Lithium will help with my manic symptoms, but not my depressive symptoms" C. "I will need to get my blood drawn regularly while I'm on this medication to ensure therapeutic levels". D. "I only need to take this medication until I feel better".

C is correct. "I will need to get my blood drawn regularly while I'm on this medication to ensure therapeutic levels". -Clients newly placed on lithium therapy should have their blood levels drawn weekly or every fortnight until levels stabilize. Thereafter, they should be checked every 3 months. -A is incorrect because clients on lithium should NOT decrease sodium intake because this can cause lithium levels to increase. -B is incorrect because lithium helps with both manic and depressive symptoms. -D is incorrect; patients taking lithium for bipolar disorder will need to be on this medication continuously, and should not quit when they feel better.

A nurse is discussing schizophrenia spectrum disorders with a client. The client states, "My friend says that before I started hearing voices, I stopped hanging out with them. Why is that?" Which of the following responses should the nurse make? A. "That is very interesting, We are not sure why people start to isolate themselves." B. "Were you avoiding your friend so that you could hear the voices more clearly?" C. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." D. "Do you think of yourself as more of an introvert? That makes a difference with how you socialize."

C. "Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning." -Social isolation has been identified as an early manifestation of psychosis. During this isolation the person often experiences negative thoughts, which may lead to other symptoms of psychosis, such as hearing voices.

A nurse is caring for a client who has a substance use disorder. Which of the following statements by the nurse is an example of patient-centered care? A. "I would like to focus on what I believe are the best goals for you to work on." B. "I am going to have to change our meeting time because I need to go get lunch." C. "Let's review the goals you set today and see what your priority is this week." D. "Although you have mentioned wanting to talk today about your past abuse, let's discuss this handout I have with new coping skills."

C. "Let's review the goals you set today and see what your priority is this week."

A nurse is caring for a client who is scheduled for transcranial magnetic stimulation. When preparing the client for the procedure, which of the following statements should the nurse make? A. "The procedure will last about 1 hour." B. "During the procedure, you may notice slight relaxation of the jaw." C. "This procedure is effective when combined with psychotherapy." D. "The treatments will take about 6 months."

C. "This procedure is effective when combined with psychotherapy." -Transcranial magnetic stimulation has been proven to be very effective in the treatment of depression when coupled with psychotherapy.

A nurse is teaching a client at a prenatal clinic. The client shares that they have family members diagnosed with schizophrenia and wants to know how they can reduce their baby's risk of developing schizophrenia. Which of the following information should the nurse include? A. Abstain from getting pregnant as a teenager. B. Limit iron intake. C. Avoid contracting a viral infection. D. Restrict calories to maintain weight.

C. Avoid contracting a viral infection. Viral infections are a complication that can occur during pregnancy that places a child at risk for developing schizophrenia. The client should be instructed to avoid contracting a viral infection.

A nurse is caring for an adult client who was recently involved in a motor vehicle accident. The client states, "I feel strange, like I am outside of my body watching myself talk." Which of the following is the client likely experiencing? A. Factitious disorder B. Dissociative identity disorder C. Depersonalization/derealization D. Dissociative amnesia

C. Depersonalization/derealization -With depersonalization/derealization, the client would describe dissociative symptoms such as having an out-of-body experience.