PN HESI PHYCHIATIRC

While reviewing the side effects of a newly prescribed medication, a 72-year-old client notes that one of the side effects is a reduction in sexual drive. What is the best response by the practical nurse (PN)?

"How will this affect your present sexual activity?"

A client who is experiencing paralysis of the left arm curses at the practical nurse (PN) and, using the right arm, throws a hairbrush against the wall. How should the PN respond?

"I can see you are upset. I want you to know I am a good listener."

A client is admitted with extensive burns and is crying during dressing change treatment. The client tells the nurse, "Please let me die. Why are you all torturing me like this? I just want to die." Which response by the PN is best?

"I know these treatments must seem like torture to you, but we want to help you recover."

A 62-year-old man has been grieving about his daughter's death. A drunk driver killed her 6 months earlier. Which statement by the client would indicate to the nurse that he is improving?

"I slept well last night."

When the nurse begins to assist an elderly client diagnosed with dementia to get out of bed, the client becomes angry and yells at the nurse, "Get out of here! I'll get up when I'm ready." Which response should the nurse provide?

"I'll be back in 30 minutes to help you get out of bed and walk around the room."

A client with Alzheimer's disease is wandering the busy halls of the extended care facility and asks the practical nurse (PN), "Where should I stand for the parade?" Which response is best for the nurse to provide?

"Let's go back to the activity room and see what is going on in there."

A male client with schizophrenia reports hearing voices that tell him to walk in the middle of the street. Which statement indicates to the practical nurse (PN) that the client needs continued hospitalization?

"No matter what I do, I can't make the voices go away."

A client is admitted to the mental health unit with a chief complaint of crying, depressed mood, and sleeping difficulties. While talking about the death of a friend, the client states, "I can't believe this happened." Which statement by the practical nurse (PN) is most therapeutic?

"Tell me more about how you're feeling."

During an admission interview, a male client states that he has been using alcohol and other illegal drugs every day for the last 3 years. What question is most important for the practical nurse (PN) to ask this client?

"When did you last use alcohol or any other drug?"

The nurse notes that a client receiving phenytoin (Dilantin) daily has a serum phenytoin level of 14 mcg/mL. What intervention should the nurse implement?

Make sure that the client is performing thorough oral care.

An older adult with a 30-year history of bipolar disease presents at the psychiatric outpatient clinic with diarrhea and confusion. What information is most important for the practical nurse to obtain?

Medications taken during the last week

The practical nurse (PN) is monitoring a client with alcohol dependency who is admitted for detoxification. The client complains of a headache, and the vital signs are as follows: blood pressure, 129/76 mm Hg, pulse, 88 beats/min, and temperature, 98.9° F. What action should the PN implement?

Offer the client ibuprofen 200 mg.

A client who is receiving phenytoin (Dilantin) begins to exhibit nystagmus and diplopia. Which physiologic manifestation is consistent with these findings?

Phenytoin toxicity

A female client diagnosed with major depression was admitted to the psychiatric unit yesterday. Today she refuses to take a bath, dress, or eat, and she wants to sleep during the day. Which intervention has the highest priority for this client?

Provide and maintain a safe, structured, daily routine.

A male client on the mental health unit becomes very agitated and begins pulling pictures off the wall. The practical nurse (PN) asks for assistance to intervene and take the client to a quiet room away from other clients. What is the most important reason for removing the client to a quiet area away from others?

Provide protection for the client and others in the milieu.

When explaining the meaning of hospice care to a client, the nurse should include which information? (Select all that apply.)

Provides specialized bereavement programs Uses Kubler-Ross's work on the stages of grieving

On admission, a highly anxious client is described as delusional. The practical nurse (PN) understands that this client is out of contact with reality and is experiencing which type of disorder?

Psychotic disorder

A female client tells the practical nurse (PN) that she wants to talk about some recent stresses. While sitting at a table talking to the PN, the client leans over, puts her head down, and states, "I feel like I'm having an anxiety attack." The client begins to hyperventilate. How should the PN respond?

Reassure the client that she will be okay.

A 53-year-old client with a known history of heavy alcohol abuse is admitted for emergency surgery following a motor vehicle collision. The practical nurse (PN) should observe for which symptoms that are early indications of alcohol withdrawal?

Restlessness, tremors, anxiety, elevated blood pressure, and transient hallucinations

Which assessment findings indicate to the practical nurse that a client is experiencing stress? (Select all that apply.)

Tapping foot and chewing on fingernail Stating a recent lack of sexual desire Reporting a feeling of always being thirsty.

A male client with an antisocial personality is complimenting the female nurse about her hair, soft skin, and beautiful eyes in a group meeting. What action should the practical nurse (PN) take?

Tell the client that he is being inappropriate and to please stop.

An elderly female client diagnosed with advanced dementia is admitted to the hospital with a fractured hip. The client repeatedly tells the staff, "Take me home. I want my Mommy." Which response is best for the practical nurse (PN) to provide?

Tell the client that the nurse is there and will help her.

The daughter of a female client diagnosed with Alzheimer's disease reports to the nurse that her mother has recently lost her appetite and refuses to eat. The client recently started taking rivastigmine tartrate (Exelon). What instructions are important for the nurse to provide the client's daughter?

The prescriber should be notified about this adverse effect of the medication right away.

The practical nurse (PN) is interviewing a client who denies hearing voices or having suicidal ideas. However, the client reports having angry outbursts and difficulty controlling mood changes. What information is most important for the nurse to obtain?

Use of psychotropic medications

An adult male client who is withdrawing from alcohol is in his room talking to himself and looking under the bed trying to find his neighbor. In the order of priority, what interventions should the practical nurse (PN) implement? (Arrange the items in order, with first on top and last on bottom.)

1.Take the client's vital signs 2.Review the last medications administered. 3.Report the client's behavior to the charge nurse. 4.Sit quietly with the client.

The health care provider prescribes clonazepam (Klonopin) 1.25 mg. The medication is available in 0.50-mg tablets. What should the nurse administer?

2.5 tablets

The daughter of an older adult who is confused asks the practical nurse (PN) for guidance regarding the use of alternative dietary supplements to treat Alzheimer's disease. Which information should the PN provide?

Advise carefully reviewing information regarding research findings.

The practical nurse (PN) is collaborating with the nursing staff about the plan of care for a client who is very depressed. What is the most important intervention to implement during the first 48 hours after the client's admission to the inpatient unit?

Maintain safety in the client's milieu.

Clients receiving disulfiram (Antabuse) for the treatment of alcoholism should be cautioned about the importance of avoiding alcohol, particularly during concurrent treatment with cephalosporin antibiotics, because an Antabuse reaction may be initiated. Which symptom would indicate that the client is experiencing a reaction to disulfiram (Antabuse)?

Headache

A female client who became agitated an hour previously is now pacing the hallway and asking to leave the mental health unit. What action should the practical nurse (PN) take first?

Allow the client to continue pacing.

Several days after hospitalization, a client is repeatedly washing the top of the same table. Which intervention is best for the practical nurse (PN) to implement first to help the client cope with anxiety related to this behavior?

Allow time for the ritualistic behavior, and then redirect the client to other activities.

The spouse of a female client who has been physically abused refuses to leave the client's room during the admission interview. Which action should the practical nurse (PN) implement?

Assist the client to walk to a treatment room on the unit.

Which client requires the most immediate intervention by the nurse

Client experiencing sudden onset of confusion and disorientation

An elderly client is transferred from the critical care unit and suddenly becomes disoriented and fearful and is hallucinating. The practical nurse (PN) should expect to implement which intervention based on the nursing diagnosis of "Confusion related to ICU psychosis?"

Cluster care to maximize rest periods during the day.

A client diagnosed with schizophrenia has been taking the antipsychotic agent clozapine (Clozaril) for the past 3 weeks. Which nursing assessment finding would have the greatest implications for this client's care?

Low-grade fever

A family has just learned that a member of the family has been given a terminal diagnosis. They are very upset and are loudly expressing their anger in the hall. Which action should the nurse take first?

Guide the family to an empty room for privacy.

A client diagnosed with chronic schizophrenia was discharged from a mental health unit 6 weeks earlier and returns to the clinic for a follow-up visit. Which behavior best indicates that the client will be able to maintain independent community living? The client:

Has taken his medications as prescribed since discharge.

A caregiver wishes to discuss end-of-life issues with the nurse. The caregiver asks the nurse to explain what DNR means. What information is most important for the nurse to provide?

DNR means that no attempts to perform cardiopulmonary resuscitation will be done.

A female client is admitted to the psychiatric inpatient unit with a diagnosis of major depression after her retirement. The initial nursing care plan includes the goal, "Assist client to express feelings of guilt." What is true about the goal statement referring to the client's depression?

Depressed clients are often unaware of underlying feelings and should be encouraged to explore self-awareness.

A female client who is tearful and experiencing suicidal thoughts related to memories of childhood abuse is admitted to the mental health unit. She reports having nightmares, difficulty sleeping, and an inability to cope at work. Which nursing diagnosis should the practical nurse (PN) address as the priority when implementing the plan of care?

Depression with suicidal thoughts

A female client tells the nurse, "Sometimes I wish I could go to sleep and not wake up." When the practical nurse (PN) asks if she has thoughts of killing herself, she says, "Yes." Which action is most important for the PN to take?

Determine if the client has a plan for committing suicide.

The nurse is caring for a client diagnosed with a bipolar disorder who is currently in the manic phase and is acting aggressively toward others. Which activity should the nurse consider for the client?

Finger painting

A client is admitted to the hospital with the diagnosis of schizophrenia. Which finding should the practical nurse (PN) recognize as most characteristic of the mental status of a client diagnosed with schizophrenia?

Flat affect

A male client tells the practical nurse (PN) that he wants to leave the hospital 1 day after admission. The client is depressed and has disorganized thoughts, with poor judgment. Which documentation in the client medical record suggests that the client is unable to safely care for basic needs? The client:

Forgot to turn off the stove several times in the last month.

The practical nurse (PN) is caring for a client with bipolar disorder who is in the manic phase. Which intervention in the client's plan of care should the PN implement?

Give short, simple, and direct explanations to the client.

In evaluating a client's response to an antidepressant medication, which statement should the practical nurse (PN) expect to hear from a client who has been taking the medication for 10 days?

I have been sleeping better for the past few days."

The police accompany a male client to the emergency department after he tried to jump off a bridge. Which question is most important for the practical nurse (PN) to ask when the client is admitted to the mental health unit?

Is the client having command hallucinations?

A client becomes angry while waiting for a supervised break to smoke a cigarette outside and states, "I want to go outside now and smoke. It takes forever to get anything done here!" Which intervention is best for the practical nurse to implement?

Review the schedule of outdoor breaks with the client.

The practical nurse (PN) observes a male client who is sitting alone and mumbling to himself. How should the PN document this finding?

Sits alone and mumbles to self

The nurse working in the community health clinic is assessing risk factors that can decrease medication effectiveness for clients diagnosed with schizophrenia. Which client behavior is likely to decrease the effectiveness of psychotropic medications?

Smokes at least 20 cigarettes daily