Psych Mental Health Practice 5

True or False The most common obsession is the fear of contamination.

True

Another cognitive dysfunction common in BPD is __________, or times when thinking, feeling, or behaviors occur outside a person's awareness

dissocociation

The diagnostic criteria of somatic symptom disorder include one or more symptoms that cause persistent __________ or significant disruption in daily lives for at least 6 months.

distress

Anorexia age on onset

14-16 abnormal menstrual

Which of the following clients being treated for anorexia displays assessment values that warrant hospitalization? A. A 25-year-old whose weight is 70% of ideal and who has a serum magnesium level 1.2 mg/dL B. A 32-year-old with a temperature of 98°F and a pulse rate of 54 C. A 16-year-old with serum potassium of 3.8 mEq/L and a BP of 98/66 mmHg D. A 10-year-old whose weight has remained unchanged in spite of a 3-inch growth spurt

A. A 25-year-old whose weight is 70% of ideal and who has a serum magnesium level 1.2 mg/dL

The nurse is interviewing a client with diagnoses of obsessive-compulsive disorder (OCD) and depression. The client has scored high on the Yale-Brown Obsessive Compulsive Scale and acknowledges that his rituals cause him great distress. What is the nurse's best initial action? A. Assess the client's risk for self-harm B. Educate the client about the high rates of recovery from OCD C. Assess the client's insight into his diagnoses D. Administer the Mini Mental Status Examination (MMSE)

A. Assess the client's risk for self-harm

When a client with obsessive-compulsive disorder (OCD) has developed self-harming thoughts and actions, the emergency department nurse should expect to administer which medication to assist with the client's anxiety/panic? A. Benzodiazepines such as lorazepam B. Antipsychotics such as lithium carbonate C. Analgesics such as morphine sulfate D. Tricyclic antidepressants such as amoxapine

A. Benzodiazepines such as lorazepam

A nurse has reviewed various theories related to the etiology of obsessive-compulsive disorders (OCD). Which client(s) diagnosed with OCD demonstrate the biologic theories? Select all that apply. A. a client whose symptoms were related to imbalances of chemicals in the brain B. a client whose symptoms improved with behavioral treatment C. a client who understands the errors in their behavior but has no inhibitory control D. a client who has a first-degree relative with the disorder E. a client who feels less anxious after their compulsions and continues the behavior

A. C. D.

A client with obsessive-compulsive disorder has been prescribed clomipramine. What action should the nurse encourage so the client can prevent adverse effects? A. Ensure adequate fluid intake throughout the day B. Limit sodium intake to 1500 mg per day C. Avoid grapefruit juice and fresh grapefruit D. Eat four to five small meals daily for the first two weeks of treatment

A. Ensure adequate fluid intake throughout the day

The most severe form of factitious disorder includes which of the following? A. Munchausen's syndrome B. Malingering C. Alexithymia D. Hypochondriasis

A. Munchausen's syndrome

When the nurse is not informed of developmental and cultural issues related to the client's background, which of the following may be expected? A. Normal patterns of behavior may be labeled as deviant, immoral, or insane. B. The meaning of the client's behavior can be derived from conventional wisdom. C. The nurse should rely on personal values and standards. D. The nurse should request a change of assignment.

A. Normal patterns of behavior may be labeled as deviant, immoral, or insane.

The psychiatric mental health nurse has received a referral from a community health nurse regarding a client who appears to have hoarding disorder. When planning this client's care, the nurse should prioritize what consideration? A. Promoting the client's safety in the home environment B. Teaching the client to differentiate between necessary and unnecessary items C. Educating the client about the use of relaxation techniques D. Collaborating with law enforcement while maintaining the client's autonomy

A. Promoting the client's safety in the home environment

Fluoxetine includes a black box warning concerning which of the following? A. Suicidality in children and adolescents B. Myocardial infarction C. Renal failure D. Stroke

A. Suicidality in children and adolescents

A nurse is seeing a female client who has been mandated to counseling sessions after shoplifting numerous times. Which disruptive behavior disorder is the client most likely experiencing? A. kleptomania B. pyromania C. intermittent explosive disorder D. internalizing behavior

A. kleptomania

A patient's mental health disorder is characterized by the patient's excessive cleaning of her surroundings. How can the nurse best address the biochemical aspects of the patient's disorder? A. Dialogue with the patient about isolation, undoing, and reaction forming B. Administer sustained serotonin reuptake inhibitors (SSRIs) as prescribed C. Educate the patient about the relationship between cerebral glucose metabolism and mental health D. Administer anticonvulsants as prescribed

B. Administer sustained serotonin reuptake inhibitors (SSRIs) as prescribed

Violence and insensitivity are associated with which personality disorder? A. Schizoid personality disorder B. Antisocial personality disorder C. Histrionic personality disorder D. Borderline personality disorder

B. Antisocial personality disorder

Which of the following characteristics differentiates functional neurologic symptom disorder from malingering disorder? A. Functional neurologic symptom disorder is normally permanent, while malingering disorder is transient in response to stress. B. Functional neurologic symptom disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms. C. Functional neurologic symptom disorder produces reward, while malingering disorder normally results in punishment or difficulty. D. Functional neurologic symptom disorder has no pathophysiological cause, while malingering disorder has a neurological or endocrine basis.

B. Functional neurologic symptom disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms.

A client is prescribed phenelzine. The nurse is educating the client on avoiding foods containing tyramine to prevent which of the following? A. Seizures B. Hypertensive crisis C. Hypoglycemia D. Oversedation

B. Hypertensive crisis

The nurse is asked to assess an adult for Antisocial Personality Disorder (ASPD). Which details occurring prior to the age of 15 support the diagnosis? Select all that apply. A. Attempting suicide B. Killing a neighbor's cat C. Experiencing psychosis D. Initiating frequent physical fights E. Stealing a purse from a woman in a store

B. Killing a neighbor's cat D. Initiating frequent physical fights E. Stealing a purse from a woman in a store

A client with a diagnosis of obsessive-compulsive disorder (OCD) has been admitted to the psychiatric unit prior to undergoing psychosurgery. The nurse who is caring for this client should understand that: A. the client has recently been diagnosed with OCD. B. behavioral therapy and drug treatment have failed. C. the client likely has a comorbid diagnosis of depression. D. the client likely has a psychiatric advance directive (PAD) in place.

B. behavioral therapy and drug treatment have failed.

A 36-year-old client demonstrates a pattern of overexpressiveness with emotions. The client has a relationship history in which the client is attention seeking. The client has recently been experiencing difficulty maintaining appropriate boundaries with colleagues at a new job. The nurse would most likely suspect which disorder? A. Schizoid personality disorder B. Narcissistic personality disorder C. Schizotypal personality disorder D. Histrionic personality disorder

D. Histrionic personality disorder

The nurse is talking with a client that is diagnosed with histrionic personality disorder. Which statement made by the client does the nurse identify correlates with this diagnosis? A. "All of the other clients on this unit must follow the rules of the unit." B. "Why do you think others on the unit are being friendly to me." C. "No one is paying attention to me and I am so angry!" D. "I am just not sure what activity to do, will you tell me?"

C. "No one is paying attention to me and I am so angry!"

For a person to be diagnosed with antisocial personality disorder, the individual must be a minimum of what age? A. 7 years B. 13 years C. 18 years D. 21 years

C. 18 years

Which occurs when thinking, feeling, or behaviors occur outside a person's awareness? A .Affective instability B. Impulsivity C. Dissociation D. Dichotomous thinking

C. Dissociation

When assessing a client with narcissistic personality disorder, the nurse would expect the client to demonstrate which of the following? A. Genuine concern for others B. Mistrust of others C. Grandiose and superior self-concept D. Dependence on others for decision making

C. Grandiose and superior self-concept

When describing the major difference between somatic symptom disorder and factitious disorders, which would the nurse include? A. In somatic symptom disorder, clients consciously seek attention. B. In factitious disorders, clients are unaware that their symptoms are not real. C. In somatic symptom disorder, clients are not consciously aware that needs are being met through physical complaints. D. Factitious disorders respond much more readily to psychopharmacologic treatment than does somatic symptom disorder.

C. In somatic symptom disorder, clients are not consciously aware that needs are being met through physical complaints.

The nurse is involved in the care of a client with antisocial personality disorder. Which purpose does the nurse identify as a priority when participating in a periodic team meeting when caring for this client? A. Updating treatment recommendations as the client improves. B. Rotating team members need to be apprised of the care planned for the client. C. Staff frustrations in caring for the client need to be processed. D. Team consistency is important to prevent manipulation by the client.

D. Team consistency is important to prevent manipulation by the client

The nurse is providing education to a client prescribed clomipramine to help with obsessive-compulsive disorder. Which statement by the client indicates the teaching was effective? A. "I should be feeling better in a week once I am on the medication." B. "I will not feel sleepy as a side effect of the medication." C. "I should take the medication on an empty stomach. D. "I may have a risk of suicidal thoughts with the medication."

D. "I may have a risk of suicidal thoughts with the medication."

A client with a diagnosis of antisocial personality disorder would exhibit a history of conduct disorder before which age? A. 7 years B. 10 years C. 12 years D. 15 years

D. 15 years

Treatment of eating disorders often combines psychotherapy and psychopharmacology. Which classes of medications can be used to treat eating disorders? A. Antipsychotics B. Stimulants C. Mood stabilizers D. Antidepressants

D. Antidepressants

The client presents to the emergency department with reports of chest pain. The nurse performs an assessment for this client, who has a history of a somatic symptom illness. Which outcome does the nurse achieve by performing a physical assessment? A. Ease the client's mind that the nurse is looking for physical illness. B. Physical disorders underlie somatic disorders. C. Physical examinations are reimbursed by third-party payers. D. Any underlying pathology should be ruled out first.

D. Any underlying pathology should be ruled out first.

__________ is a sexual pain disorder characterized by genital pain in men or women associated with sexual intercourse.

Dyspareunia

True or False persons with excoriation disorder only pick at their skin with their fingers.

False

True or False Antidepressants given to treat OCD are usually given in lower doses than those to treat depression.

False

True or False Patients with OCD generally describe their compulsions as pleasurable

False

Affective__________ is evidenced by erratic emotional responses to situations and intense sensitivity to criticism or perceived slights.

Instability

In the sexual response cycle, _________ is the gradual return of the organs and body systems to the nonaroused state.

Resolution

True or False Hoarding disorder can begin in childhood and last a lifetime.

True

True or False Somatic symptom disorder can involve a lifelong pattern of symptoms that persists into old age.

True

True or False The drive for thinness is an intense physical and emotional process that overrides all physiologic body cues.

True

Research has shown a link between sexual ______________ and somatization.

abuse

The age of onset for bulimia is late _________________.

adolescent 15-24

Emerging evidence shows that _________________, or difficulty in identifying and expressing emotions, is seen in people with somatic symptoms.

alexithymia

The most widely accepted psychoanalytic theory of anorexia centers around the key tasks of separation-individuation and _______________, which are interrupted.

autonomy

Nearly all physiologic and psychological functions fluctuate according to ______________ rhythm, which is regulated by the biologic clock located in the hypothalamus.

circadian

Dialectical behavior therapy (DBT) combines __________ and behavioral therapy strategies.

cognitive

_________________ restructuring is a method of teaching the person to restructure dysfunctional thought processes by defining and testing them..

cognitive

In _________________ disorder, patients often present with pseudoneurologic symptoms, vision problems, deafness, hallucinations, or seizures.

conversion

_________ cards contain statements that are positively oriented and pertain to the person's specific obsessions and compulsions.

cue

What is a common adverse effect of bulimia nervosa

decreased tooth enamel

In __________ thinking, persons with BPD evaluate experiences, people, and objects in terms of mutually exclusive categories such as good or bad, success or failure, or extremely positive or extremely negative.

dichotomous

_______________ is approved by the FDA for treating bulimia nervosa.

fluoxetine

Sleep ________________________ is an internal biochemical system that operates as a timer or counter that generates pressure to sleep and regulates sleep intensity.

homeostasis

The hallmark symptom of primary __________________ is the patient's intense focus and anxiety regarding the inability to fall asleep or maintain sleep.

insomnia

The ______________, the fashion industry, and peer pressure are significant social influences in the causes of eating disorders.

media

8 ________________ is a hormone released from the pineal gland that aids in the regulation of the sleep-wake cycle.

melotonin

The essential characteristic of ____________ disorder is the repeated occurrence of frightening dreams that fully awaken an individual.

nightmare

________________ are unwanted, intrusive, and persistent thoughts or impulses that cause anxiety and distress.

obsessions

Sexual __________ is part of individual identity that refers to the physical and emotional attraction to another person.

orientation

_________________________ is the most important intervention during the hospital or initial stage of treatment of anorexia nervosa.

refeeding

The term __________________ describes the experience and expression of unexplained physical symptoms through bodily sensations, functional changes, or somatic descriptions.

somatization

When the patient categorizes the nurse as all good or all bad, he or she is using the primitive defense of __________.

splitting

The __________ nervous system largely controls orgasmic discharge.

sympathetic

___________________ is chronic self-destructive hair pulling that results in noticeable hair loss.

trichotillomania