Psych Final Study
Name the defense mechanism: demonstrating an inability to reconcile negative and positive attributes of self or other
splitting
Name the defense mechanism: a person who has feelings of anger and hostility toward his work supervisor addresses those feelings by working out vigorously at the gym during his lunch period
sublimation
Name the defense mechanism: dealing with unacceptable feelings or impulses by unconsciously substituting acceptable forms of expression
sublimation
Name the defense mechanism: a person who has lost his job states he will worry about paying his bills next week
suppression
Name the defense mechanism: voluntarily denying unpleasant thoughts and feelings
suppression
What is this an example of? A client may see a nurse as being like his mother, and thus may demonstrate some of the same behaviors with the nurse as he demonstrated with his mother.
transference
________________________ are used to treat mainly positive psychotic symptoms.
typical antipsychotics
Name the defense mechanism: an adolescent completes his chores without being prompted after having an argument with his parents
undoing
Name the defense mechanism: performing an act to make up for prior behavior
undoing
Which patient behavior is a criterion for mechanical restraint? Select one: a. Refusing a medication dose. b. Screaming profanities. c. Assaulting a staff person. d. Throwing a pillow at another patient. e. Spitting at a family member during visiting hours.
c
blaming, scapegoating, thinking prejudicially, and stigmatizing others
projection
Match the nursing approach for the emotional response: agitated (1)
provide short and concise instructions
Seroquel
quetiapine
Name the defense mechanism: overcompensating or demonstrating the opposite behavior of what is felt
reaction formation
Abilify
aripiprazole
Tegretol
carbamazepine
Name the defense mechanism: a school-age child begins wetting the bed after learning his parents are separating
regression
Geodon
ziprasidone
Name the defense mechanism: a person who has a fear of the dentist's drill continually "forgets" his dental appointments
repression
Name the defense mechanism: putting unacceptable ideas, thoughts, and emotions out of conscious awareness
repression
Risperdal
risperidone
Name the defense mechanism: a client tells a nurse that she is the only one who cares about her, yet the following day, the same client refuses to talk to the nurse
splitting
__________ occurs when the client views a member of the health care team as having characteristics of another person who has been significant to the client's personal life.
transference
__________________ are current medications of choice for psychotic disorders, and they generally treat both positive and negative symptoms.
atypical antipsychotics
A charge nurse is discussing the care of a client who has MDD w/ a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates a need for further teaching? a. Care during the continuation phase focuses on treating continued manifestation of MDD. b. Medication and psychotherapy are used to prevent a relapse of MDD. C. The goal of treatment during the maintenance phase is prevention of future episodes of MDD. d. The client is at greatest risk for suicide during the first weeks of an MDD episode.
a
A nurse is caring for a client who smokes and has lung cancer. The client reports, "I'm coughing because I have that cold that everyone is getting." Which of the following defense mechanisms is the client using? a. denial b. displacement c. reaction formation d. sublimation
a
A pt is started on a regimen of lamotrigine (Lamictal) 50 mg daily for bipolar depression. The pt shows the nurse a red and purple rash on his arm that is blistering and peeling. What is the most likely explanation? a. The rash is a rare adverse effect which causes a toxic epidermal necrolysis. b. The pt is experiencing a benign rash to the medication which can be treated with diphenhydramine (Benadryl). c. The med increases the pt's sensitivity to sunlight resulting in a sunburn from not using protection. d. The rash is a common side effect which resolves after the medication reaches therapeutic range.
a
A pt is taking a monoamine oxidase inhibitor (MAOI). The RN assesses the client closely because: a. Headache, hypertension, and nausea and vomiting may indicate toxicity. b. Hypotensive crisis may be precipitated by foods rich in tyramine and typtophan. c. Hypotension may indicate toxicity d. These medications increase the amount of MAOI in the liver.
a
A supervisor assigns a worker a new project. The worker initially agrees but feels resentful. The next day when asked about the project, the worker says, "I've been working on other things." When asked 4 hours later, the worker says, "Someone else was using the copier, so I couldn't finish it." The worker's behavior demonstrates: Select one: a. Passive aggression b. Acting out c. Rationalization d. Projection
a
During the termination phase of the nurse-client relationship, the clinic nurse observes that the client continuously demonstrates bursts of anger. The most appropriate interpretation of the behavior is that the client... Select one: a. Is displaying typical behaviors that can occur during termination. b. Requires further treatment and is not ready to be discharged. c. Needs to be referred to the psychiatrist as soon as possible. d. Needs to be admitted to the hospital.
a
In the majority of the culture of the US, which person is at greatest risk of be incorrectly labeled mentally ill? a. person who is Pentecostal and describes hearing God's voice b. person who is usually pessimistic but strives to meet personal goals c. wealth person who gives $20 bills to needy individuals d. person who believes in the "law of attraction" and the one's mental disposition attracts similar external circumstances and events to get the individual's needs met
a
Pt on tranylcypromine (Parnate) requests info on foods that are acceptable to eat while taking the med. RN tells the pt that it is safe to eat: a. Oranges b. Smoked fish c. Cheddar cheese d. Raisins
a
Two staff nurses applied for a charge nurse position. After the promotion was announced, the nurse who was not promoted said, "The nurse manager had a headache the day I was interviewed." Which defense mechanism is evident? Select one: a. Projection b. Splitting c. Introjection d. Conversion
a
A 22-year old college student presented to the EC with HTN (BP 200/110), tachycardia, cramping, hyperreflexia, and myoclonus. He was taking phenelzine (Nardil) and had been out to a restaurant with friends. What is the most likely food/drink that could have interacted with the med? a. Grapefruit juice b. Red wine c. Cucumbers d. Eggs
b
A client is admitted for psychiatric observation after being arrested for breaking windows in the home of his former girlfriend, who had refused to see him. His history reveals abuse as a child by a punitive father, torturing family pets, and one arrest for disorderly conduct. The nursing diagnosis that should be considered for development is: Select one: a. Post-traumatic syndrome b. Risk for other-directed violence c. Risk for injury d. Disturbed thought processes
b
An aggressive client was placed in four-point restraints and given an intramuscular dose of anxiolytic medication. Systematic assessment to guide interventions during the period of restraint should include: Choose all that apply Select one or more: a. Vital signs b. Nutritional needs c. Level of awareness d. Hydration e. Elimination needs f. Range of Motion and comfort needs
abcdef
The nurse directs the intervention team who must take an aggressive client to seclusion. Other clients have been removed from the area. Before approaching the client, the nurse should ensure that staff: Choose all that apply Select one or more: a. Appoint a person to clear a pat and open, close or lock doors. b. Move behind the client to use the element of surprise. c. Select the person who will communicate with the client. d. Quickly approach the client and take hold of the closest arm or leg. e. Remove jewelry, glasses, and harmful items from their persons.
ace
Match the nursing approach for the emotional response: anxious (4)
active listening, allowing patient to vent, be supportive and informative, address immediate concerns, offer alternatives
Name the defense mechanism: a nurse who lost a family member in a fire is a volunteer firefighter
altruism
Name the defense mechanism: dealing with anxiety by reaching out to others
altruism
examples of atypical antipsychotics (6, generic names, alphabetical order):
aripiprazole, clozapine, olanzapine, quetiapine, risperidone, ziprasidone
A patient is undergoing diagnostic tests. the patient says, "Nothing is wrong with me except a stubborn chest cold." the spouse reports that the patient smokes, coughs daily, and has lost 15 pounds and is easily fatigued. Which defense mechanism is the patient using? Select one: a. Projection b. Denial c. Regression d. Displacement
b
A person who feels unattractive repeatedly says, "Although I'm not beautiful, I am smart." This is an example of: Select one: a. Devaluation b. Compensation c. Identification d. Repression
b
An RN is caring for a pt in acute mania who is being treated with carbamazepine (Tegretol). The RN reviews the lab results of the drug plasma level and determines that the plasma level is in a therapeutic range if which of the following is noted? a. 18 mcg/ml b. 10 mcg/ml c. 1 mcg/ml d. 20 mcg/ml
b
An older patient is given a prescription of haloperidol (Haldol). NRS instructs pt and family to report signs of pseudoparkinsonism and tells family to monitor for: a. tremors and hyperpyrexia b. stooped posture and shuffling goat c. muscle weakness and decreased salivation d. motor restlessness and apahsia
b
Health maintenance and promotion efforts for patients with sever and persistent mental illness should include education about the importance of regular: a. home safety inspections b. screening for cancer, HTN, DM c. monitoring self-care abilities d. determination of adequacy of patient's support system
b
The RN notes that a pt receiving lithium therapy is drowsy, has slurred speech, and is experiencing muscle twitching and impaired coordination. The RN takes which of the following actions? a. Increase fluids to 2000 ml per day b. Calls the physician c. Doubles the next lithium dose d. Holds one dose of lithium
b
The client on the mental health unit who should be assessed as being at highest risk for directing violent behavior towards others is... Select one: a. The client who has severe depression with delusions of worthlessness. b. The client who has paranoid delusions that she is being followed by members of the mafia. c. The client who has obsessive-compulsive disorder and performs many rituals. d. The client who has completed alcohol withdrawal and is beginning a rehabilitation program.
b
The client says to the nurse "I am going to die, I wish my family would stop hoping for a cure! I get so angry when they carry on like this! After all, I'm the one who's dying." The most therapeutic response is: Select one: a. "I think we should talk more about your anger with your family." b. Have you shared your feelings with your family?" c. "You're feeling angry that your family continues to hope for you to be cured." d. "Well, it sounds like you're being pessimistic. After all, years ago people died of pneumonia."
b
The nurse is preparing the client for the termination phase of the nurse-client relationship. The nurse prepares to implement which nursing task is most appropriate for this phase? Select one: a. Identifying expected outcomes. b. Making appropriate referrals. c. Developing realistic solutions. d. Planning short term goals.
b
"Dry as a bone, red as a beat, hot as a hare, blind as a bat, and mad as a hatter" describes the symptoms of: a. Neurleptic melignant syndrome b. Lithium toxicity c. Anticholinergic toxicity d. Serotonin Syndrome
c
1. A nurse is talking with a client who is at risk for suicide following the death of his spouse. Which of the following statements by the nurse is appropriate? A. "I feel very sorry for the loneliness you must be experiencing." B. "Suicide is not the appropriate way to cope with loss." C. "Losing someone close to you must be very upsetting." D. "I know how difficult it is to lose a loved one."
c
A client is pacing the hall near the nurses' station, swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and say... Select one: a. "Please quiet down" b. "You need to go to your room to get control of yourself." c. "You seem upset. Tell me about it." d. "Hey, what's up?"
c
A nurse is making a home visit to a client who is in the late stages of alzheimer's. The client's spouse, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and stress of providing care. Which action is appropriate? a. instruct the client's spouse to offer finger foods to increase oral intake b. schedule the client for placement of feeding tube c. provide info on resources for respite care d. verify that a current power of attorney document is on file
c
NRS is obtaining consent for a client who has just learned she must have a breast biopsy. Client is perspiring, pale, RR 30/min and says "I don't quite understand what you're telling me." Anxiety is which level? a. mild b. severe c. moderate d. panic
c
The first task in assessing violent behavior should be Select one: a. Establishing a treatment plan. b. Obtaining information from observers. c. Determination of the cause. d. Admission to the hospital. e. Ascertaining degree of injuries.
c
The nurse is caring for a Native American client who says, "I don't want you to touch me. I'll take care of myself." Which nursing response is most therapeutic? Select one: a. "Okay, if that's what you want. I'll just leave this cup for you to collect your urine." b. "Why are you being so difficult? I only want to help you." c. "It sounds as though you want to take care of yourself. Let's work together so you can do things for yourself." d. "If you don't want our care, why did you come here?"
c
The nurse is meeting a new client on the unit. Which action, by the nurse, is most effective in initiating the nurse-client relationship? Select one: a. Describe the nurse's family and ask the client to describe his/her family. b. Wait until the client indicates a readiness to establish a relationship. c. Introduce self and explain the purpose and the plan for the relationship. d. Ask the client why he/she was brought to the hospital.
c
Which of the following is false regarding depression seen in persons with schizophrenia? a. 50% of pt. w/ acute schizophrenia have depressive symptoms b. depression may be a side effect of antipsychotic meds c. schizophrenic males are more likely to experience depressive symptoms compared to their female counterparts d. depressive symptoms may be a response to recovery of insight e. depression might be an integral part of schizophrenia
c
Clozaril
clozapine
What is this an example of? A nurse may feel defensive and angry with a client for no apparent reason if the client reminds her of a friend who often elicited those feelings.
countertransference
___________________ occurs when a health care team member displaces characteristics of people in her past onto a client.
countertransference
A client has, in the past, had a nursing diagnosis of ineffective coping related to impulsively acting out anger as evidenced by striking others. An appropriate plan for forestalling such incidents would be: Select one: a. Offer one-on-one supervision to help the client maintain control. b. Request that the client receive lorazapam (Ativan) every 4 hours to reduce anxiety. c. Explaining that restrain and seclusion will be used if violence occurs. d. Helping a client identify incidents that trigger impulsive acting out.
d
A client looks at a mirror and cries out, "I look like a bird. This is not my face." The nurse responds therapeutically by saying: Select one: a. "What kind of a bird do you think you are?" b. "Maybe the light is playing tricks on you." c. "Why do you think that you look like a bird?" d. "That must be very distressing to you, your face does not look different to me."
d
A home care RN visits a pt at home. Clonazepam (Klonopin) has been prescribed for the pt, and the RN teaches the pt about the med. Which statement by the pt indicates that further teaching is necessary? a. "I can take my medication at bedtime if it tends to make me feel drowsy." b. "My drowsiness will decrease over time with continued treatment." c. "I should take my medication with food to decrease stomach problems." d. "If I experience slurred speech, it will disappear in about 8 weeks."
d
A nurse assesses a confused older adult. The nurse experiences sadness and reflects, "the pt is like one of my grandparents... so helpless." What feeling does the nurse describe? a. catastrophic reaction b. defensive coping reaction c. transference d. countertransference
d
A patient who is experiencing moderate anxiety says, "I feel undone." An appropriate response for the nurse would be: Select one: a. What would you like me to do to help you? b. "Why do you suppose you are feeling anxious?" c. "You must get your feelings under control before we can continue." d. "I'm not sure I understand. Give me an example."
d
An effective nursing intervention for helping angry clients learn to manage anger without violence would be: Select one: a. Administering antianxiety medications. b. Administering antipsychotic medications c. Providing negative reinforcement such as restraint or seclusion in response to angry outbursts, whether or not violence is present. d. Using cognitive strategies to identify a thought that increases anger, find proof for or against the belief, and substitute reality-based thinking.
d
Hrs interviewing 25 y/o w/ dx of dysthymia. Which of the finding should the nurse expect? a. Report of a minimum of five clinical findings of depression. b. wide fluctuations in mood c. inflated sense of self-esteem d. presence of manifestations for at least 2 years
d
Lorazepam (Ativan) is prescribed for a pt to manage anxiety. Which of the following, if noted on the pt's record, would indicate the need to consult with the physician before administering the med? a. History of hypothyroidism b. History of diabetes mellitus c. History of coronary artery disease d. Positive pregnancy test
d
Name the defense mechanism: a young adult explains he had to drive home from a party after drinking alcohol because he had to feed his dog
rationalization
Name the defense mechanism: creating reasonable and acceptable explanations for unacceptable behavior
rationalization
Mrs. F. has remained close to the nurse all day. When the nurse talked with other clients during dinner, Mrs. F. tried to regain the nurse's attention and began to shout, "You're just like my mother. You pay attention to everyone but me!" The best interpretation of this behavior is that... Select one: a. Mrs. F. has been spoiled by her family. b. The nurse has failed to meet Mrs. F's needs. c. Mrs. F. is exhibiting resistance. d. Mrs. F. is demonstrating transference.
d
The most therapeutic response a nurse could make to a student who begins to cry upon learning that a failing grade was received on a final exam is: Select one: a. "It won't seem so important 5 years from now." b. "You'll make it next time." c. "How close were you to passing?" d. "Failing an exam is an upsetting thing to happen."
d
Which statement about aggression would serve as the rational for care planning using behavioral techniques? Aggression... Select one: a. runs in families and is manifested as early as infancy. b. results from low levels of the neurotransmitter serotonin. c. results from abnormalities in the temporal lobe of the brain. d. is motivated by rewards received for previous aggression.
d
With conventional (typical) antipsychotics, the higher the potency, a. the higher the risk for sedation. b. The lower the risk for dystonia. c. The lower the risk for EPS. d. The higher the risk of EPS.
d
Name the defense mechanism: a person who dislikes her sister's daughter offers to babysit so that her sister can go out of town
reaction formation
Match the nursing approach for the emotional response: tension reduction following physical intervention (2)
reestablish therapeutic rapport, initiate debriefing
Name the defense mechanism: demonstrating behavior from an earlier developmental level, often exhibited as childlike or immature
regression
Name the defense mechanism: a parent who is informed that his son was killed in combat tells everyone he is coming home for the holidays
denial
Name the defense mechanism: pretending the truth is not reality to manage the anxiety of acknowledging what is real
denial
Name the defense mechanism: a person who is angry about losing his job destroys his child's favorite toy
displacement
Name the defense mechanism: shifting feelings related to an object, person, or situation to another less threatening object, person, or situation
displacement
Name the defense mechanism: an adolescent witnesses a shooting and is unable to recall any details of the event
dissociation
Name the defense mechanism: temporarily blocking memories and perceptions from concsciousness
dissociation
Name the type of aggression. attacks others in an effort to avoid getting hurt themselves; protecting self
fear driven
Haldol
haloperidol
How to plan interventions that reduce irritation and frustration in a patient w/ ineffective coping who impulsively acts out in anger?
identify triggers
Name the type of aggression. learned from past experience that aggression helps person achieve what they want, manipulation
instrumental
Name the type of aggression. chronically angry at the world, constantly looking to get upset and have something set him/her off
irritable
Lamictal
lamotrigine
Match the nursing approach for the emotional response: aggression (3)
maintain physical distance, know escape routes, come up with physical intervention plan with team
Zyprexa
olanzapine
Match the nursing approach for the emotional response: calm (3)
professional, helpful, available
Name the defense mechanism: a young adult blames his substance use disorder on his parents' refusal to buy him a new car
projection
Name the defense mechanism: blaming others for unacceptable thoughts and feelings
projection
