psych midterm moodle questions

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. "Failing an exam is an upsetting thing to happen." b. "You'll make it next time." c. "How close were you to passing?" d. "It won't seem so important 5 years from now."

a. "Failing an exam is an upsetting thing to happen."

A client with a potential for violence is exhibiting aggressive gestures, making belligerent comments to the other clients, and is continuously pacing in the hallway. Which of the following comments by the nurse would be therapeutic at this time? Select one: a. "What is causing you to become agitated?" b. "Why are you intent on upsetting the other clients?" c. "You are going to be restrained if you do not change your behavior." d. "Please stop so I don't have to put you in seclusion."

a. "What is causing you to become agitated?" The appropriate response is to ask the client what is causing the anger. This helps make the client aware of the behavior and may assist the nurse in planning appropriate interventions. "Please stop so I don't have to put you in seclusion." and "You are going to be restrained if you do not change your behavior." constitute threats to the client, which are inappropriate. "Why are you intent on upsetting the other clients?" is confrontational and could further escalate the client's behavior.

An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic. Which defense mechanism is evident? Select one: a. Rationalization b. Introjection c. Regression d. Compensation

a. Rationalization

The goal for a patient is to increase resiliency. Which outcome should a nurse add to the plan of care? Within 3 days, the patient will: Select one: a. identify healthy coping behaviors in response to stressful events. b. meet own needs without considering the rights of others. c. allow others to assume responsibility for major areas of own life. d. describe feelings associated with loss and stress.

a. identify healthy coping behaviors in response to stressful events. The patient's ability to identify healthy coping behaviors indicates adaptive, healthy behavior and demonstrates an increased ability to recover from severe stress. Describing feelings associated with loss and stress does not move the patient towards adaptation. The remaining options are maladaptive behaviors.

A patient who has been diagnosed with Schizoaffective Disorder, Bipolar Type has an order to receive valproicacid (Depakene) 500mg once daily.To maximize the patient's safety, the nurse schedules administration of the medication: Select one: a. Before breakfast b. At bedtime c. With lunch d. With breakfast

b. At bedtime Valproic acid is a mood stabilizer and anticonvulsant that causes central nervous system (CNS) depression.For this reason, the side effects include sedation, dizziness, ataxia, and confusion.When the patient is taking this medication as a single daily dose, administering it at bedtime negates the risk of injury from sedation and enhances patient safety.Otherwise, it may be given after meals to avoid gastrointestinal upset.

When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented? Select one: a. Sit with the client in the day room to provide comfort b. Communicate with simple words and brief message c. Instruct the client regarding unit rules and regulations. d. Leave the client alone to maintain privacy.

b. Communicate with simple words and brief message When communicating with a client experiencing a panic attack, the nurse needs to use simple words and brief messages, spoken calmly and clearly. Any communication that is loud and demanding would only escalate anxiety.

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. Compensation

The nurse is describing medication side effects to a client who is taking a benzodiazepine. The nurse tells the client to take the medication only as prescribed because of the most serious risk of: Select one: a. Headache b. Dependence c. Skin rashes d. Gastrointestinal side effects

b. Dependence A benzodiazepine carries with it a high risk for abuse and physical and psychological dependence. For this reason, limited amounts of these medications are given to a client at one time. The other symptoms may be side effects of some benzodiazepines but are not as serious as the risk of dependence.

Larazepam (Ativan) is prescribed for a client to manage anxiety.Which of the following, if noted on the client's record, would indicate the need to consult with the physician before administering the medication? Select one: a. History of diabetes millitus b. Positive pregnancy test c. History of hypothyroidism d. History of coronary artery disease

b. Positive pregnancy test Larazepam is contraindicated in clients who are pregnant or breastfeeding because this drug crosses the placenta and breast milk posing potential danger to the fetus or newborn infant in view of their pharmacologic effects, side effects, or complications. It is also not prescribed for clients who haarehave a hypersensitivity or cross-sensitivity with other benzodiazepines.It is contraindicated in clients who are comatose, with preexisting central nervous system (CNS) depression, those with uncontrolled severe pain, and those with narrow-angle glaucoma.

A nurse is caring for a hospitalized patient who has been taking clozapine (Clozaril) for the treatment of a schizophrenic disorder, and the nurse reviews the laboratory studies that have been prescribed for the patient. Which laboratory study will the nurse specifically review to monitor for an adverse effect associated with the use of this medication? Select one: a. Blood urea nitrogen b. White blood cell count c. Hemoglobin level d. Cholesterol level

b. White blood cell count Hematological reactions can occur in the patient taking clozapine and include agranulocytosis and mild leukopenia.The white blood cell count should be assessed before initiating treatment and should be monitored closely during the use of this medication.The client should also be monitored for signs indicating anranulocytosis, which may include sore throat, malaise, and fever.Options 2, 3, and 4 are unrelated to the use of this medication.

The nurse has been caring for a client with a diagnosis of depression. The client says to the nurse, "I wish you would just be my friend." The appropriate response by the nurse is: Select one: a. "I am your friend." b. "I can't be your friend. I'm the nurse, and you're the client." c. "Our relationship is a therapeutic and helping one." Nurses may struggle with requests by clients to "be my friend." d. "You have plenty of friends. You don't need me to be your friend, too."

c. "Our relationship is a therapeutic and helping one." Nurses may struggle with requests by clients to "be my friend." When this occurs, the nurse should make it clear that the relationship is a therapeutic and helping one. This does not mean that the nurse is not friendly toward the client at times. It does mean, however, that the nurse follows the stated guidelines regarding a therapeutic relationship. "I am your friend." "I can't be your friend. I'm the nurse, and you're the client." and "You have plenty of friends. You don't need me to be your friend, too." are inappropriate.

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. "Why do you think that you look like a bird?" b. "What kind of a bird do you think you are?" c. "That must be very distressing to you, your face does not look different to me." d. "Maybe the light is playing tricks on you."

c. "That must be very distressing to you, your face does not look different to me."

In preparing for the orientation phase of the therapeutic relationship, the nurse suggests addressing which of the following subjects? Select one: a. Facilitating behavioral change b. Promoting problem solving skills in the client c. Establishing the parameters of the relationship d. Promoting self-esteem in the client

c. Establishing the parameters of the relationship During the orientation phase of the therapeutic nurse-client relationship, four subjects need to be addressed. These subjects include the parameters of the relationship, the formal or informal contract, confidentiality, and termination of the relationship. Promoting problem-solving skills and self-esteem and facilitating behavioral change are subjects of the working phase of the nurse-client relationship.

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. Introjection b. Conversion c. Projection d. Splitting

c. Projection

The client who is diagnosed with a borderline personality is admitted to the psychiatric unit. Based on a thorough understanding of personality disorders, the nurse would select which nursing diagnosis as the priority? Select one: a. Social isolation b. Chronic low self-esteem c. Risk for self-mutilation d. Ineffective coping

c. Risk for self-mutilation Clients with borderline personality disorder are most often hospitalized because of impulsive attempts at self-mutilation or suicide. The nursing intervention of constant close observation is usually initiated to protect the client from impulsive behavior. Therefore, "risk for self-mutilation" is the priority.

What type of reaction is John having and what is it called?

dystonia

What type of reaction is Stewart having?

Akathisia

A client has been admitted to the inpatient psychiatric unit because the client has displayed violent behavior and is at risk for potentially harming others. Which of the following should the nurse avoid doing when caring for this client? Select one: a. Arranging for a security officer to be available in the general area b. Facing the client while speaking and providing nursing care c. Admitting the client to a room near the nurses' station d. Closing the door to the client's room when giving care to the client

D. The nurse should not isolate herself or himself with a potentially violent client. The door to the client's room should remain open when giving care. The client should be placed in a room near the nurses' station and not at the distant end of a corridor. The nurse should never turn away from the client. A security officer or male aide should be readily available if there is a possibility of imminent violence.

An acutely depressed client is receiving cognitive-behavioral therapy. The nurse is developing a plan of care for the client and includes interventions that focus on this type of therapy. Which of the following interventions would the nurse include? Select all that apply. Select one or more: a. Assisting the client's family to participate in group therapy on a regular basis b. Assisting the client to rehearse new cognitive and behavioral responses c. Assisting the client to participate in the treatment process d. Assisting the client with the administration of antidepressant medications e. Assisting the client to develop alternative thinking patterns f. Assisting the client to identify and test negative cognition

The correct answers are: Assisting the client to identify and test negative cognition, Assisting the client to develop alternative thinking patterns, Assisting the client to participate in the treatment process, Assisting the client to rehearse new cognitive and behavioral responses b, c, e, f

A home care nurse visits a client at home. Clonazepam (Klonopin) has been prescribed for the client, and the nurse teaches the client about the medication. Which statement by the client indicates that further teaching is necessary? Select one: a. "If I experience slurred speech, it will disappear in about 8 weeks." b. "I should take my medication with food to decrease stomach problems." c. "My drowsiness will decrease over time with continued treatment." d. "I can take my medication at bedtime if it tends to make me feel drowsy."

a. "If I experience slurred speech, it will disappear in about 8 weeks." Clients who are experiencing signs and symptoms of toxicity with the administration of clonazepam exhibit slurred speech, sedation, confusion, respiratory depression, hypotension, and eventually coma.Some drowsiness may occur but will decrease with continued use.The medication may be taken with food to decrease gastrointestinal irritation. The other options are correct and represent an accurate understanding of the medication.

In the shift-change report, an off-going nurse criticizes a patient who wears heavy makeup. Which comment by the nurse who receives the report best demonstrates advocacy? Select one: a. "Our patients need our help to learn behaviors that will help them get along in society." b. "Let's all show acceptance of this patient by wearing lots of makeup too." c. "This is a psychiatric hospital. Craziness is what we are all about." d. "Your comments are inconsiderate and inappropriate. Keep the report objective."

a. "Our patients need our help to learn behaviors that will help them get along in society." Accepting patients' needs for self-expression and seeking to teach skills that will contribute to their well0being demonstrates respect and are important parts of advocacy. The on-coming nurse needs to take action to ensure that others are not prejudiced against the patient. Humor can be appropriate within the privacy of a shift report but not at the expense of respect for patients. Judging the off-going nurse in a critical way will create conflict. Nurses must show compassion for each other.

Cognitive therapy was provided for a patient who frequently said, "I'm stupid." Which statement by the patient indicates the therapy was effective? Select one: a. "Sometimes I do stupid things. b. "I always fail when I try new things." c. "Things always go wrong for me." d. "I'm disappointed in my lack of ability."

a. "Sometimes I do stupid things." "I'm stupid" is an irrational thought. A more rational thought is, "Sometimes I do stupid things." The latter thinking promotes emotional self-control. The incorrect options reflect irrational thinking."

The nurse is developing a care plan that will include goals that will help the client achieve an optimal level of functioning and appropriate resource utilization. When the nurse enters the client's room, the client asks the nurse, "Could you ask the physician to let me have a pass for the weekend?" The nursing response that assists the client in achieving these goals is: Select one: a. "When the physician arrives on the unit, I will let him or her know that you have a question." b. "When your doctor comes in, I will ask for a pass for the weekend." c. "I will call the doctor and find out if you can have a pass so that you can make your arrangements." d. "You can't have a pass for the weekend. You are not ready, and I'm sure that your doctor will say no."

a. "When the physician arrives on the unit, I will let him or her know that you have a question." The nurse should become aware of the client's strengths and encourage the client to work at the optimal level of functioning. In "When the physician arrives on the unit, I will let him or her know that you have a question." the nurse is helping the client develop resources. The nurse does not act for clients unless absolutely necessary and then only as a step toward helping clients act on their own. Consistently encouraging clients to use their own resources helps minimize clients' feelings of helplessness and dependency and also validates their potential for change.

A nurse is caring for a patient in acute mania who is being treated with carbamazepine (Tegretol).The nurse reviews the laboratory report for the results of the drug plasma level and determines that the plasma level is in a therapeutic range if which of the following is noted? Select one: a. 10 mcg/ml b. 18 mcg/ml c. 20 mcg/ml d. 1 mcg/ml

a. 10 mcg/ml When carbamazepine is administered, plasma levels of the medication need to be monitored periodically to check for absorption of the medication.The amount of the medication prescribed is based on the results of this laboratory test.The therapeutic plasma level of carbamazepine is 3 to 14 mcg/ml.

Two staff nurses applied for promotion to nurse manager. The nurse not promoted initially had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others. Which term best describes this nurse's response? Select one: a. Altruism b. Suppression c. Sublimation d. Passive aggression

a. Altruism

What other medications can be used on a long-term basis to prevent this type of reaction? CIRCLE ALL THAT APPLY: Select one or more: a. Clonidine (Catapres) b. Benzotropine (Cogentin) c. Propranolol (Inderal) d. Lorazapam (Ativan) e. Trihexyphenidyl (Artane)

a. Clonidine (Catapres) b. Benzotropine (Cogentin) c. Propranolol (Inderal) d. Lorazapam (Ativan) e. Trihexyphenidyl (Artane)

The nurse is working with a client who shows signs of benzodiazepine withdrawal. The nurse suspects that the client has suddenly discontinued taking which of the following prescribed medications? Select one: a. Diazepam (Valium) b. Fluoxetine (Prozac) c. Sertraline (Zoloft) d. Haloperidol (Haldol)

a. Diazepam (Valium) The only benzodiazepine presented in the options is diazepam (Valium). Benzodiazepines are effective only when used for short-term therapy. Short-acting benzodiazepines can produce withdrawal symptoms within 1 to 2 days, whereas long-acting benzodiazepines take 5 to 10 days for withdrawal symptoms to occur following discontinuation. Manifestations include insomnia, agitation, anxiety, irritability, nausea, and diaphoresis. The other options list an antipsychotic ("sertraline (Zoloft)") and antidepressants ("haloperidol (Haldol)" and "fluoxetine (Prozac)").

For the last year, a college student continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia.This behavior is associated with which diagnosis? Select one: a. Generalized Anxiety Disorder (GAD) b. Agoraphobia c. Obsessive-Compulsive Disorder (OCD) d. Social Phobia Disorder

a. Generalized Anxiety Disorder (GAD) GAD may be diagnosed when excessive, unrealistic worry and anxiety become chronic and last for at least 6 months. The anxiety experienced is generalized rather than specific.The anxiety is not associated with a specific object as in phobia, or event as in PTSD.

A client is taking a monoamine oxidase inhibitor (MAOI). The nurse assesses the client closely because: Select one: a. Headache, hypertension, and nausea and vomiting may indicate toxicity. b. Hypotension may indicate toxicity c. These medications increase the amount of MAOI in the liver. d. Hypotensive crisis may be precipitated by foods rich in tyramine and typtophan.

a. Headache, hypertension, and nausea and vomiting may indicate toxicity. Headache, hypertension, tachycardia, nausea, and vomiting are precursors to hypertensive crisis brought about by the ingestion of foods rich in tyramine and tryptophan while the client is taking an MAOI. These medications act by decreasing the amount of MAOI in the liver, which is necessary for the breakdown and utilization of tyramine, and tryptophan. Hypertensive crisis may lead to circulatory collapse, intracranial hemorrhage, and death.

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. Introduce self and explain the purpose and the plan for the relationship. b. Ask the client why he/she was brought to the hospital. c. Wait until the client indicates a readiness to establish a relationship. d. Describe the nurse's family and ask the client to describe his/her family.

a. Introduce self and explain the purpose and the plan for the relationship.

Stewart is a 64 year old man who is undergoing inpatient psychiatric treatment with haloperidol (Haldol). After several days of therapy, the patient complains that he feels very restless and agitated and he cannot stop moving his legs. He paces constantly, sits and then stands, and is unable to sit still. Which of the following medication can be given initially to remove this distressing reaction? Select one: a. Lorazepam (Ativan) Lorazepam (Ativan) b. Cholorpromazine (Thorazine) c. Paroxitine (Paxil) d. Sertraline (Zoloft)

a. Lorazepam (Ativan) Lorazepam (Ativan)

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. Making appropriate referrals. b. Identifying expected outcomes. c. Developing realistic solutions. d. Planning short term goals.

a. Making appropriate referrals.

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. is demonstrating transference. b. Mrs. F. is exhibiting resistance. c. Mrs. F. has been spoiled by her family. d. The nurse has failed to meet Mrs. F's needs.

a. Mrs. F. is demonstrating transference.

A patient on tranylcypromine (Parnate) requests information on foods that are acceptable to eat while taking the medication.The nurse tells the patient that it is safe to eat: Select one: a. Oranges b. Smoked fish c. Cheddar cheese d. Raisins

a. Oranges; Tranylcypromine is classified as a monoamine oxidase inhibitor (MAOI) and, as such, tyramine-containing food should be avoided. Types of food to be avoided include, but are not limited to, those items identified except for oranges which are permissible. Additionally, beer, wine, caffeinated beverages, picked meats, yeast preparations, avocados, bananas, and plums are to be avoided.

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. Rationalization c. Projection d. Acting out

a. Passive aggression

A 22-year old college student presented to the ER with hypertension (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 medication? Select one: a. Red wine b. Grapefruit juice c. Eggs d. Cucumbers

a. Red wine Monoamine inhibitors (MAOIs) inhibit the enzyme (MAO) that breaks down monoamine neurotransmitters (i.e., dopamine, norephinephrine, serotonin) once they have been pumped back into the presynaptic cell. While taking MAOIs, certain foods and alcohol that are high in the amino acid tyramine (aged, pickled, processed) can cause a severe hypertensive crisis and should be avoided. Alcohol (specifically beer and red wine) should be avoided or should be limited to only 4 ounces per day.

A nurse in the emergency department is preparing to care for a female client who has just been sexually assaulted. Which of the following client behaviors would demonstrate denial? Select one: a. The client is calm and quiet. b. The client is verbalizing generalizations about the incident. c. The client is justifying unacceptable self-behaviors. d. The client is blaming her sister for the incident.

a. The client is calm and quiet. Denial is a response by a victim of sexual abuse. It is described as an adaptive and protective reaction and may be identified by a calm and quiet behavior in the client. Projection is blaming, or "scapegoating." Rationalization is justifying the unacceptable attributes about self. Intellectualization is the excessive use of abstract thinking or generalizations to decrease painful thinking.

The nurse is assisting in developing a plan of care for a client with a psychotic disorder who is experiencing altered thought processes that include the belief that the food is being poisoned. The nurse develops strategies that will encourage the client to discuss feelings and plans to: Select one: a. Use open-ended questions and silence. b. Focus on the components of adequate nutrition. c. Focus on the fact that the client's beliefs are untrue. d. Instruct the client about the need for adequate nutrition.

a. Use open-ended questions and silence. Open-ended questions and silence are strategies used to encourage clients to discuss their feelings. "Focus on the components of adequate nutrition" and "instruct the client about the need for adequate nutrition" are not helpful to the client because they do not encourage the client to express feelings. "Focus on the fact that the client's beliefs are untrue" will block the nurse-client relationship.

Two students fail their introductory nursing course. One student plans to seek tutoring and retake the course next fall. The second student attempts suicide. Which of the following factors would have been influential in the development of the second student's crisis? Select one: a. The individual's family birth order b. A lack of adequate coping mechanisms c. The time of year in which the event occurred d. The presence of support systems

b. A lack of adequate coping mechanisms Adequate coping mechanisms can influence how an individual responds to the development of a crisis. Resilience is key; if a person can draw on past successful coping strategies, a crisis may be diverted. The second student had a lack of adequate coping mechanisms.

The nurse is talking with a male client who is actively hallucinating. The client is fearful that the voices he hears will direct him to kill himself or will hurt him directly. Which of the following nursing statements would be therapeutic at this time? Select one: a. "I know you believe they are going to cause you harm, but it's not true." b. "I don't hear them, but it must be frightening to hear voices that others can't hear." c. "I know whose voices you are hearing and told them not to hurt you." d. "I can hear the voices too, but they are telling you to go to bed now."

b. "I don't hear them, but it must be frightening to hear voices that others can't hear." It is important for the nurse to let the client know that what the client is hearing is not heard by the nurse and to avoid reinforcing the client's altered reality. The nurse avoids confronting the client but rather says supportive things such as, "This must be very frightening to you" or "It's difficult to understand all that you are experiencing right now." "I can hear the voices too, but they are telling you to go to bed now." "I know whose voices you are hearing and told them not to hurt you." and "I know you believe they are going to cause you harm, but it's not true." reinforce the client's altered reality.

The nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which of the following statements prior to discharge? Select one: a. "I know now that I can't be all things to all people all the time." b. "I know that I won't become depressed again after the treatment I received here." c. "It is important for me to take my medications just as prescribed." d. "It's been good to learn better ways to deal with the stresses in my life."

b. "I know that I won't become depressed again after the treatment I received here." Depression is a mood disorder that can be a recurrent illness. The client must learn to recognize symptoms of the disorder and to know who and when to call to resume more active treatment. Each of the incorrect options indicates a successful coping mechanism or health-promoting behavior.

A nurse is having a conversation with a depressed client on an inpatient psychiatric unit. The client says to the nurse, "Things would be so much better for everyone if I just weren't around." Which of the following responses by the nurse would be appropriate at this time? Select one: a. "I know what you mean; everyone gets that way when they are depressed." b. "You sound very unhappy. Are you thinking of harming yourself?" c. "Have you talked to anyone specifically about what is bothering you?" d. "Those feelings will go away when your medication really takes effect."

b. "You sound very unhappy. Are you thinking of harming yourself?" Clients who are depressed may be at higher risk for suicide. When clients make statements such as the one in the question, it is critical for the nurse specifically to assess suicidal ideation and plan. The best method is to ask the client directly about whether a specific plan has been formed.

What medication can be prescribed to alleviate symptoms that Joni is going through? CIRCLE ALL THAT APPLY Select one or more: a. Benzotropine (Cogentin) b. Deutetrabenazine (Austedo) c. Diphenhydramine (Benadryl) d. Valbenazine (Ingrezza)

b. Deutetrabenazine (Austedo) d. Valbenazine (Ingrezza)

The nurse is assigned to a client who is psychotic, pacing, agitated, and using aggressive gestures and rapid speech. The nurse determines that the priority of care at this time is which of the following? Select one: a. Offering the client a less stimulated area in which to calm down and gain control b. Providing safety for the client and other clients on the unit c. Providing the other clients on the unit with a sense of comfort and safety by isolating the client d. Assisting in caring for the client in a controlled environment, such as a quiet room

b. Providing safety for the client and other clients on the unit Safety for the client and other clients is the priority. "Providing safety for the client and other clients on the unit" is the only option that addresses the client's and other clients' safety needs. "Offering the client a less stimulated area in which to calm down and gain control" and "assisting in caring for the client in a controlled environment, such as a quiet room" address only the client's needs. "Providing the other clients on the unit with a sense of comfort and safety by isolating the client" addresses only the needs of the other clients on the unit.

Laura is a 54 year old woman who recently was treated for a treatment resistant Strephylococcus infection and is currently finishing a prescription for Linezolid (Zyvox) is brought to the emergency room by her life partner after complaining that her heart is racing and she has a headache along with a fever of 102.4. Vitals are checking in the Emergency department and her blood pressure is 160/105mg Hg, pulse of 125/min and respiratory rate is 20/min. She also complains of recent diarrhea. Upon examination, the physician finds hyperreflexic clonus of a +3. She also admits to taking Sertraline (Zoloft) for years to treat Generalize Anxiety Disorder. Which of the following is the most likely diagnosis? Select one: a. Lethal catatonia b. Serotonin Syndrome c. Neuroleptic Malignant Syndrome d. Acute dystonic reaction e. Malignant hyperthermia

b. Serotonin Syndrome

A patient is started on a regimen of lamotrigine (Lamictal) 50 mg daily for bipolar depression. The client shows the nurse a red and purple rash on his arm that is blistering and peeling. What is the most likely explanation? Select one: a. The patient is experiencing a benign rash to the medication which can be treated with diphenhydramine (Benadryl). b. The rash is a rare adverse effect which causes a toxic epidermal necrolysis. c. The medication increases the patient'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.

b. The rash is a rare adverse effect which causes a toxic epidermal necrolysis. Stevens-Johnson syndrome is a serious rash requiring hospitalization and discontinuation of treatment. The incidence of this rash is approximately 0.08% in patients being prescribed Lamictal for mental health issues (higher for those being prescribed it for seizure disorders). The rash develops during in the first few months of the medication being titrated especially if the medication is increased too quickly. The potential to develop Steven-Johnson syndrome increase when Lamictal is used as adjunct therapy with Valproic Acid (Depakote).

Psychotherapy involves all below except: Select one: a. positive expectancy b. appropriate medications c. neural plasticity d. a therapeutic relationship e. none of the above

b. appropriate medications Medication is not used in psychotherapy.

A client hates her mother because of childhood neglect.The nurse determines which client statement represents the use of the use of the defense mechanism of reaction formation? Select one: a. "My mom always loved my sister more than she loved me." b. "I don't like to talk about my relationship with my mother." c. "I have a very wonderful mother whom I love very much." d. "My mother hates me."

c. "I have a very wonderful mother whom I love very much. "The client hides her negative unacceptable feelings by the exaggerated expression of positive feelings. This is an example of the defense mechanism of reaction formation.

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. "If you don't want our care, why did you come here?" c. "It sounds as though you want to take care of yourself. Let's work together so you can do things for yourself." d. "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."

A client receiving long-term therapy with lithium carbonate (Lithobid) exhibits muscle tremors, confusion, vomiting, and diarrhea. The nurse anticipates that the results of the latest test of the serum lithium level will be between: Select one: a. 0 and 0.5 mEq/L b. 1.0 and 1.3 mEq/L c. 1.5 and 2.0 mEq/L d. 0.6 and 1.0 mEq/L

c. 1.5 and 2.0 mEq/L The therapeutic serum level of lithium is 0.6 to 1.2 mEq/L.. Serum lithium concentrations of 1.5 to 2.0 mEq/L may produce a variety of symptoms, including vomiting, diarrhea, drowsiness, incoordination, coarse hand tremors, muscle tremors, and mental confusion.

The nurse in the pediatric unit is admitting a 2-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development? Select one: a. Initiative versus guilt b. Industry versus inferiority c. Autonomy versus shame and doubt d. Trust versus mistrust

c. Autonomy versus shame and doubt A 2-year-old child, a toddler, is in the autonomy versus shame and doubt stage. In this stage, the toddler develops a sense of control over the self and bodily functions and exerts himself or herself. Trust versus mistrust characterizes the stage of infancy. Initiative versus guilt characterizes the preschool age. Industry versus inferiority characterizes the school-age child.

A client is admitted to the psychiatric unit with a diagnosis of bipolar affective disorder and mania. The nurse would prioritize that which of the following symptoms or behaviors requires immediate intervention? Select one: a. Grandiose delusions of being a czar of Russia b. Outlandish behaviors and wearing odd and eccentric clothing c. Constant physical activity and poor oral intake d. Constant, incessant talking, with sexual innuendoes

c. Constant physical activity and poor oral intake Mania is a period when the mood is predominantly elevated, expansive, or irritable. The client's mood may be characterized by excitement, euphoria, hyperactivity, excessive energy, decreased need for sleep, and impaired ability to concentrate or complete a single train of thought. Each of the options is reflective of possible symptoms. Using Maslow's Hierarchy of Needs theory, however, you would select as a priority an option that clearly presents a nursing problem at the most fundamental level (physiological integrity).

The nurse is told that the result of a serum carbamazepine (Tegretol) level for a client who is receiving the medication for the control his mood swings is 10mcg/mL. Based on this laboratory result, the nurse anticipates that the physician will prescribe: Select one: a. An increase of the dosage of the medication b. A decrease of the dosage of the medication c. Continuation of the presently prescribed dosage d. Discontinuation of the medication

c. Continuation of the presently prescribed dosage When carbamazepine is administered, blood levels need to be monitored periodically to check for the client's absorption of the medication. The amount of the medication prescribed is based on the blood level achieved. The therapeutic serum range of carbamazepine is 4 to 12 mcg/mL. The nurse would anticipate that the physician will continue the presently prescribed dosage.

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. Regression b. Displacement c. Denial d. Projection

c. Denial

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. "You're feeling angry that your family continues to hope for you to be cured." c. Have you shared your feelings with your family?" d. "Well, it sounds like you're being pessimistic. After all, years ago people died of pneumonia."

c. Have you shared your feelings with your family?"

A patient tells a nurse, "My new friend is the most perfect person one could imagine; kind, considerate, and good looking. I can't find a single flaw." This patient is demonstrating: Select one: a. Denial b. Compensation c. Idealization d. Projection

c. Idealization

Which nursing diagnosis is written correctly? Select one: a. Risk for social isolation related to low self-esteem evidenced by staying in room during the day. b. Low self-esteem related to major depressive disorder evidenced by childhood abuse. c. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss. d. Conduct disorder related to childhood sexual abuse evidenced by hostile and aggressive behaviors.

c. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss. Imbalanced nutrition: less than body requirements related to suspiciousness evidenced by 20 lbs. weight loss is a correctly written nursing diagnosis. Evidence of a nutritional problem is documented and the cause of the problem, suspiciousness, is identified. "Imbalanced nutrition: less than body requirements" is an approved NANDA diagnostic stem.

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. Needs to be admitted to the hospital. b. Needs to be referred to the psychiatrist as soon as possible. c. Is displaying typical behaviors that can occur during termination. d. Requires further treatment and is not ready to be discharged.

c. Is displaying typical behaviors that can occur during termination.

Donna is a 56 year old woman who lives alone in an apartment and functions quiet independently. She attends church on a weekly basis and stops at the senior center to play cards and do craft several times a week. In the past week Donna has not been out of her apartment due to catching the flu bug. One of her friends from the senior center stops by to visit and finds her to be in her underwear and the house in disarray. Donna appears confused and she states she has not been able to keep anything down and is having severe bouts of diarrhea and stomach cramps. She has a slight hand tremor but she is still able to carry things and offer her friend coffee. Her friend notes that she appears weak and drowsy, and has slurred speech. She convinces Donna to go to let her drive her to the Emergency Room. Donna informs the ER nurses that although she has not been able to hold much of her food down, she has continued to take her prescription medications including Inderal and Lithium without fail. Which of the following is the most likely diagnosis? Select one: a. Serotonin Syndrome b. Influenza c. Lithium toxicity d. Extrapryamidal Symptom e. Bipolar Disorder

c. Lithium toxicity

The nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. The most likely focus of therapy of this residential center is: Select one: a. Systematic desensitization b. Aversion conditioning c. Milieu therapy d. Cognitive-behavioral therapy

c. Milieu therapy Milieu therapy, or "therapeutic community," has as its focus a living, learning, or working environment. Such therapy may be based on any number of therapeutic modalities, from structured behavioral therapy to spontaneous, humanistically oriented approaches. Its characteristics include an emphasis on group and social interaction, and rules and expectations that are mediated by peer pressure. Systematic desensitization is a form of behavior modification therapy that involves increased exposure to an object or situation that causes anxiety. Exposure to the object increases until the anxiety about the object ceases. Cognitive-behavioral therapy is used to help clients identify and examine dysfunctional thoughts, as well as identify and examine values and beliefs that maintain these thoughts. In aversion conditioning, a stimulus attractive to the client is paired with an unpleasant event in an attempt to endow it with negative properties.

Joey 27 year old male with a history of paranoid schizophrenia is brought by a friend to the hospital. The woman had been an inpatient on a psychiatric hospital; for several months after being discharged. She had been maintained on haldoperidal decanoate shots. For the past couple of days , after the last injection, she has appeared "strange". She is stiff, cannot swallow or talk, and appears tremulous. The friend is concerned that she has some kind of infection, since she has a fever. On examination, her temperature is 101.7 F, blood pressure is 157/104mg Hg, pulse is 122/min, and respirations are 24/min. She has increased tone in her neck and extremities, and appears tremulous, diaphoretic, and confused. Her leukocytes count is 19,600/mm3 and the serum creatine phosphokinase is markedly elevated along with an elevated CK level of 1400 IU/L. A workup for infection is negative. Which of the following is the most likely diagnosis? Select one: a. Lethal catatonia b. Serotonin Syndrome c. Neuroleptic Malignant Syndrome d. Malignant hyperthermia e. Acute dystonic reaction

c. Neuroleptic Malignant Syndrome

A mental health nurse is assigned to care for a client with a diagnosis of undifferentiated schizophrenia with acute exacerbation. The nurse uses which of the following approaches when planning care for this client? Select one: a. Allow the client to set the goals for the plan of care. b. Repeatedly point out inconsistencies in the client's communication during initial treatment. c. Provide assistance with grooming and nutrition until the client's thinking has cleared. d. Let the client act out initially, and use the quiet room and restraints as needed.

c. Provide assistance with grooming and nutrition until the client's thinking has cleared. In the acute phase, the nurse must assume responsibility for planning for the client's basic human needs, such as nutrition, hygiene, sleep, and activities of daily living (ADLs). As the nurse plans care for the schizophrenic client, it is important to understand the client's developmental stage and ability to accept the disease. The client lacks insight and may not be aware of the illness because of the severe decompensation in thinking. "Allow the client to set the goals for the plan of care" and "let the client act out initially, and use the quiet room and restraints as needed" are incorrect because these actions do not provide a structured routine. "Repeatedly point out inconsistencies in the client's communication during initial treatment" is a nontherapeutic communication technique.

The client admitted to the mental health unit with major depression 3 days ago could hardly get out of bed without coaxing and needed constant encouragement to get dressed and participate in unit activities. Today, the client appears in the dayroom dressed and well-groomed, without any guidance from the staff. The client appears to be calm and relaxed, yet more energetic than before. The nurse should take which initial action after noting this client's behavior? Select one: a. Notify the staff of these observations at the team meeting, which will begin in 3 hours. b. Continue to monitor the client's behavior from a distance. c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide. d. Document that the client is adapting to the unit and is feeling safe.

c. Speak to the client personally about the nurse's observations, and ask if the client is thinking about suicide. A sudden improvement in a depressed client's mood may indicate that the client has decided to commit suicide. The most direct way to validate the nurse's impression is to ask the client directly about suicidal ideation or plans. The other options are not the most appropriate initially.

A client relates angrily to the nurse that his wife says he is selfish. Which response by the nurse would be most helpful? Select one: a. "Everyone is a little bit selfish." b. "That's just her opinion." c. "I don't think that you are selfish." d. "You sound angry - tell me more about what went on."

d. "You sound angry - tell me more about what went on."

The following patients are seen in the emergency department. Which of the following patients meets the severity of illness and intensity of care required for the admitting officer to recommend admission to the psychiatric unit? The patient who: Select one: a. experiencing anxiety and a sad mood after a separation from a spouse of 10 years. b. who self inflicted a superficial cut on the forearm after a family argument. c. who is a single parent and hears voices saying, "Smother your infant." d. experiencing dry mouth and tremor related to side effects of haloperidol (Haldol)

c. who is a single parent and hears voices saying, "Smother your infant." Admission to the hospital would be justified by the risk of patient danger to self or others. The other patients have issues that can be handled with less restrictive alternatives than hospitalization.

1. John is 35 years old man who is brought into the emergency room by his mother because of an episode of slurred speech associated with the uncomfortable sensation that his tongue is thick and curling up. The episode stated suddenly 30 minutes ago. The patient is noted to be holding on to his tongue with his thumb and forefinger. When asked about this, the patient responds with dysarthria, saying that his medication has caused this once before and that he needs a shot to make it go away. His mother reports that the patient has had schizophrenia for 10 years and consistently take two medications prescribed by his psychiatrist. Several days ago he ran out of one of his medications, but has continued to take the other one. What is the most appropriate initial step in the management of this patient? Select one: a. Benzotropine (Cogentin) Alprazalam (Xanax) b. Haloperidol (Haldol) c. Benzotropine (Cogentin) d. Lorazapam (Ativan)

d. Lorazapam (Ativan)

Joni is a 54-year old woman presents to her primary care physician for her routine yearly health maintenance examination. She denies any new problems. Her only significant medical history includes a 25 year history of schizophrenia, which has been well controlled with antipsychotic agents, and a 4-year history of hypertension for which she takes a diuretic. Vital signs and physical examination are within normal limits. However, the patient is noted to have occasional irregular puckering and lip smacking movements she denies having notices the abnormal movements and her speech is normal. Which of the following is the most likely diagnosis? Select one: a. Acute Dystonia b. Pseudo-Parkinsonism c. Akathisia d. Tardive Dyskinesia

d. Tardive Dyskinesia

A nurse is providing medication instructions to a patient who is taking doxepin (Sinequan) daily. Which statement by the patient indicates a need for further instructions? Select one: a. "If I miss a dose, I need to take it as soon as possible unless it is almost time for the next dose." b. "The effects of the medication may not be noticed for at least two weeks." c. "I need to avoid alcohol while taking the medication." d. "I need to take the medication in the morning before breakfast."

d. "I need to take the medication in the morning before breakfast." The patient should be instructed to take the medication (a single dose) at bedtime and not in the morning because it causes fatigue and drowsiness.The patient is instructed to take the medication as directed, and if a dose is missed to take it as soon as possible unless it is almost time for the next dose.The patient is told that medication effects may not be noticed for at least 2 weeks, and to avoid alcohol or other central nervous system depressants during therapy.

A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response? Select one: a. "I can't give you those forms without your health care provider's knowledge." b. "I'll get the forms for you right now and bring them to your room." c. "Since you signed your consent for treatment, you may leave if you desire." d. "I will get them for you, but let's talk about your decision to leave treatment."

d. "I will get them for you, but let's talk about your decision to leave treatment." A patient who has been voluntarily admitted as a psychiatric inpatient has the right to demand and obtain release in most states. However, as a patient advocate, the nurse is responsible for weighing factors related to the patient's wishes and best interests. By asking for information, the nurse may be able to help the patient reconsider the decision. The statement that discharge forms cannot be given without the health care provider's knowledge is not true. Facilitating discharge without consent is not in the patient's best interest before exploring the reason for the request.

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. "I'm not sure I understand. Give me an example."

A client admitted to the inpatient unit is being considered for electroconvulsive therapy (ECT). The client is calm, but the client's daughter is hypervigilant and anxious. The daughter says to the nurse, "My mother's brain will be shocked with electricity. How can the doctor even think about doing this to her?" Which of the following responses by the nurse would be therapeutic? Select one: a. "Your mother has decided to have this treatment. You should support her." b. "Maybe you'll feel better if you see the ECT room and speak to the staff." c. "I think you need to speak directly to the psychiatrist." d. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure."

d. "It sounds as though you are very concerned about the procedure. Let's discuss the procedure." The most effective responses to a client or family member who is visibly anxious and upset are those that use therapeutic communication techniques. Therapeutic communication includes active collaboration that facilitates problem solving, change, learning, and growth. The correct option addresses the daughter's concerns while upholding the dignity of the client. When these concerns are verbalized, the nurse can then give information that may help allay fears. "I think you need to speak directly to the psychiatrist." "Maybe you'll feel better if you see the ECT room and speak to the staff." and "Your mother has decided to have this treatment. You should support her." are nontherapeutic responses.

A mental health nurse who has been meeting with a client with a diagnosis of post-traumatic stress disorder is in the termination phase of the nurse-client relationship. The nurse notes that the client has been quiet and withdrawn and interprets the client's behavior as: Select one: a. An indication of the need for additional therapy sessions b. An indication of the need for antidepressants c. An inability of the client to terminate from the nurse d. A normal behavior that can occur during termination

d. A normal behavior that can occur during termination In the termination phase of a relationship, it is normal for a client to demonstrate a number of regressive behaviors. Typical behaviors include the return of symptoms, anger, withdrawal, and minimizing the relationship. The behavior that the client is experiencing is normal during the termination phase and does not necessarily indicate the need for hospitalization, additional sessions, or antidepressants.

A Nurse is developing a teaching plan for a client who will be receiving phenelzine sulfate (Nardil). The nurse plans to tell the client to avoid: Select one: a. Cherries and blueberries b. Digitalis preparations c. Vasodilators d. Aged cheeses

d. Aged cheeses Phenelzine sulfate is in the monoamine oxidase inhibitor (MAOI) clasee of antidepressant medications.An individual on an MAOI must avoid aged cheeses, alcoholic beverages, avocados, bananas, and caffeine drinks.There are also other food items to avoid, including chocolate, meat tenderizers, picked herring, raisins, sour cream, yogurt, and soy sauce.Medications that should be avoided include amphetamines, antiasthmatics, and certain antidepressants.The client should also avoid antihistamines, antihypertensive medications, levodopa (L-Dopa), and meperidine (Demerol).

"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: Select one: a. Lithium toxicity b. Serotonin Syndrome c. Neurleptic melignant syndrome d. Anticholinergic toxicity

d. Anticholinergic toxicity Anticholinergic toxicity is a potentially fatal condition characterized by skin that is hot, dry and flushed, blurred vision, and CNS effects (hallucinations and delirium). Death can result from respiratory depression caused by the blockage of muscarinic cholinergic receptors.Many of the psychiatric drugs have anticoloinergic side effects, especially the tricyclic antidepressants and phenothiazine antipsychotics.These should be used coautiously in older adults and in patients taking multiple drugs with anticholinergic properties.

A client who attempted suicide by hanging is brought to the emergency department by emergency medical services. The immediate nursing action is which of the following? Select one: a. Perform a focused assessment, paying particular attention to the client's neurological status. b. Take the client's vital signs. c. Call the mental health crisis team and notify them that a client who attempted suicide is being admitted to the hospital. d. Assess the client's respiratory status and for the presence of neck injuries.

d. Assess the client's respiratory status and for the presence of neck injuries. The immediate nursing action for a client who attempted suicide is to assess physiological status. Airway is always the priority. Therefore, assessing the client's respiratory status and for the presence of neck injuries is the immediate action that the nurse takes. Although "take the client's vital signs," "call the mental health crisis team and notify them that a client who attempted suicide is being admitted to the hospital," and "perform a focused assessment, paying particular attention to the client's neurological status" identify appropriate nursing actions, they are not the priority.

The nurse notes that a client receiving lithium therapy is drowsy, has slurred speech, and is experiencing muscle twitching and impaired coordination. The nurse takes which of the following actions? Select one: a. Holds one dose of lithium b. Doubles the next lithium dose c. Increase fluids to 2000 ml per day d. Calls the physician

d. Calls the physician Signs and symptoms of lithium toxicity include vomiting and diarrhea, and nervous system changes such as slurred speech, incoordination, drowsiness, muscle weakness, or twitching.Before administering any further doses, the nurse should notify the physician.As long as there are no contraindications, the client should routinely take in between 2000 to 3000 ml of fluid per day while taking this medication.

A client has recently been diagnosed with mild to moderate NCD due to Alzheimer's disease.Which medication would the nurse expect the physician to order for the client's cognitive impairment? Select one: a. Quetiapine (Seroquel) b. Nortriptyline (Pamelor) c. Zaleplon (Sonata) d. Donepezil (Aricept)

d. Donepezil (Aricept) Donepezil is used to improve cognition in clients diagnosed with mild to moderate dementia associated with Alzheimer's disease.Its action improves cholinergic function by inhibiting acetlycholinesterase.

A client who has sustained severe injuries in a motorcycle accident was diagnosed with intensive care unit (ICU) psychosis. The nurse would be most likely to conclude that the client's status is improving if the client: Select one: a. Appears to be delirious but has stopped trying to pull out the nasogastric tube b. Tells his wife, "I feel better, but the doctors want to give me a lethal injection." c. Keeps his eyes fixed on the nurses while they are working in the room but has stable vital signs d. Increases the number of hours slept at one time and is increasingly alert

d. Increases the number of hours slept at one time and is increasingly alert The foreign environment of a hospital's critical care unit, the loss of a normal sleep-wake cycle, effects of injuries, and succumbing to placement of invasive lines, tubes, and possibly restraints can lead to delirium and feelings of powerlessness. The symptoms of psychosis are more likely to resolve when the client resumes a more normal sleep cycle and is physiologically stable. Improvement from ICU psychosis is evidenced by decreased hallucinations, anxiety, and aggressive behavior, along with increased sleep and absence of injuries.

A person who is speaking about a rival for a significant other's affection says in a gushy, syrupy voice, "What a lovely person. That's someone I simply adore." The individual is demonstrating: Select one: a. Repression b. Denial c. Projection d. Reaction formation

d. Reaction formation

A patient begins therapy with a phenothiazine medication. What teaching should a nurse provide related to the drug's strong dopaminergic effects? Select one: a. Increase dietary fiber. b. Chew sugarless gum. c. Arise slowly from bed. d. Report muscle stiffness.

d. Report muscle stiffness. Phenothiazines block dopamine receptors in both the limbic system and basal ganglia. Dystonia is likely to occure early in the course of treatment and is often heralded by sensations of muscle stiffness. Early intervention with an antiparkinsonian medication can increase the patient's comfort, prevent dystonic reactions and promote medication adherence.

With conventional (typical) antipsychotics, the higher the potency, Select one: a. The lower the risk for EPS b. the higher the risk for sedation c. The lower the risk for dystonia d. The higher the risk of EPS

d. The higher the risk of EPS Conventional (first generation) antipsychotics with high potency have a stronger D2 receptor blockade than those with low potency, thereby decreasing dopamine levels in the nigrostriatal pathway.This can result in drug-induced extrapyramidal side-effects involving movement, including parkinsonism (tremor, bradykinesia, rigidity), dyskinesias, and akathesia.

A patient who is on chlorpromazine (Thorazine) is preparing for discharge. In developing a health promotion plan for the patient, the nurse instructs the patient: Select one: a. On the signs and symptoms of relapse for depression. b. To adhere to a strict tyramine-resticted diet c. To have the therapeutic blood levels drawn because there is a narrow range between the therapeutic and toxic levels of the medication. d. To avoid prolonged exposure to the sun.

d. To avoid prolonged exposure to the sun. Chlorpromazine is an antipsychotic medication often used in the treatment of psychosis.Photosensitivity is sometimes a side effect of the phenothiazine class of antipsychotic medications to which chlorpromazine (Thorazine) belongs.Options 1, 2, and 4 are unrelated to the administration of this medication.