*Psych Review Test 1*, **Psych Unit 5 quizes for Test #2** P, **Psych Unit 6 Quizes for Test #2** P, **Psych quiz #7** P, Psych Unit 8 Tests P, P Psych Unit 9 Quiz questions, P Psych Unit 10 quiz ques, P Psych Unit 11 Quizes, P Psych Unit 12 Question...

15. Which of the following have been assessed as the most common types of mental illness identified among homeless individuals? (Select all that apply.)A. Schizophrenia B. Body dysmorphic disorder C. Antisocial personality disorder D. Neurocognitive disorder E. Conversion disorder

A, C, D

Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process? A. "We've discussed past coping skills. Let's see if these coping skills can be effective now." B. "Please tell me in your own words what brought you to the hospital." C. "This new approach worked for you. Keep it up." D. "I notice that you seem to be responding to voices that I do not hear."

A. "We've discussed past coping skills. Let's see if these coping skills can be effective now."

During a therapeutic group, two clients engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. The nurse has demonstrated which leadership style? A. Autocratic B. Democratic C. Laissez-faire D. Bureaucratic

A. Autocratic

What reaction is most commonly displayed by rape victims in the immediate aftermath of the rape? A. Disorganization B. Philosophical acceptance C. Total withdrawal from reality D. Display of seductive actions

A. Disorganization The acute phase of rape trauma syndrome occurs immediately after the assault and may last for a few weeks. This stage is seen by emergency department personnel. Nurses are the ones most involved in dealing with these initial reactions. During this phase, a great deal of disorganization is common in the person's lifestyle and somatic symptoms.

Most cultures label behavior as mental illness on the basis of which of the following criteria? A. Incomprehensibility and cultural relativity B. Strength of character and ethics C. Goal directedness and high energy

A. Incomprehensibility and cultural relativity

Which statistic concerning rape is true? A. Most male rape victims do not report the crime. B. Male rape is perpetrated by homosexual men. C. The peak incidence of rape occurs in the 25 to 29 age group. D. Most rapes occur after abductions.

A. Most male rape victims do not report the crime. Option A is the only true statement.

Which client response should a nurse expect during the working phase of the nurseclient relationship? A. The client gains insight and incorporates alternative behaviors. B. The client and nurse establish rapport and mutually develop treatment goals. C. The client explores feelings related to reentering the community. D. The client explores personal strengths and weaknesses that impact behaviors.

A. The client gains insight and incorporates alternative behaviors.

Rape is best described as A. an act of violence using sex as the weapon. B. assault by a stranger on an unsuspecting victim. C. sexual desire satisfied inappropriately. D. an act prompted by early childhood neglect.

A. an act of violence using sex as the weapon.

A client diagnosed with schizophrenia is exhibiting nonverbal behaviors indicating that the client is hearing things that others do not. Which nursing diagnosis accurately reflects this client's problem?A. Altered thought processes B. Altered sensory perception C. Anxiety D. Chronic confusion

B. Altered sensory perception

A 27-year-old client was diagnosed 5 years ago with schizophrenia. What course of treatment should the nurse expect to be implemented? A. Eventual admission for long-term care in a psychiatric facility B. Community-based care with numerous brief hospitalizations C. Case management in the community with few relapses D. Occasional contact with outpatient counselors and psychiatrists

B. Community-based care with numerous brief hospitalizations

Write the definition of mental illness according to your textbook author, Mary Townsend

Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and interfere with the individuals social, occupational, and or physical functioning

Defense mechanisms - introjection

integrating the beliefs and values of another individual into one's own ego structure

Defense mechanisms - repression

involuntarily blocking unpleasant feelings and experiences from one's awareness

Emotional brain

limbic system

MSE

mental status exam

Defense mechanisms - sublimation

rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive

Defense mechanisms - Denial

refusing to acknowledge the existence of a real situation or the feelings associated with it

Defense mechanisms - regression

retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning

Minimal goal for client in crisis is?

return to pre-crisis state

Defense mechanisms - isolation

separating a thought or memory from the feeling tone, or emotion associated with it

Orientation

Rapport; contract for intervention

Defense mechanisms - undoing

symbolically negating or canceling out an experience that one finds intolerable

Describe the onset and s/s of vascular NCDs (as opposed to Alzheimer's)

the client may seem to improve only to deteriorate further.

Defense mechanisms - displacement

the transfer of feelings from one target to another that is considered less threatening or that is neutral

Defense mechanisms - suppression

the voluntary blocking of unpleasant feelings and experiences from one's awareness

Observing coworkers bad behavior and doing nothing out of fear of retaliation is still?

unethical

S/S of physical abuse in children:

unexplained burns, bites, bruises, broken bones, black eyes, fading bruises or marks after absence from school, frightened of parents and adults, reports injury by a parent/adult, abuses animals or pets

Can a pt refuse meds from a home health nurse?

yes, respect it document it

What is learned helplessness?

When an individual comes to learn that no matter what their behavior is, the outcome is unpredictable and usually undesirable

Crisis

When an individual experiences a stressor & perceives coping strategies to be ineffective A crisis is precipitated by an event that is specific and identifiable.

Which of the following conditions increases the risk of adverse events associate with ECT? (Select all that apply). a. Increased intracranial pressure b. Recent myocardial infarction c. Severe underlying hypertension d. Congestive heart failure e. Breast Cancer

a, b, c, d a. Increased intracranial pressureb. Recent myocardial infarctionc. Severe underlying hypertensiond. Congestive heart failure

10. Which of the following issues have been identified as contributing to the rise in the population ofthose who are homeless? (Select all that apply.) a. Poverty b. Lack of affordable health care c. Substance abuse d. Severe and persistent mental illnesse. Growth in the number of family members living together

a, b, c, d

In planning care for a woman who presents as a survivor of domestic abuse, a nurse should be aware of which of the following data? (select all that apply) a. Economic factors rarely play a role in the decision to stay. b. Women in abusive relationships usually feel isolated and unsupported. c. It often takes several attempts before a woman leaves an abusive situation. d. Until children reach school age, they are usually not affected by abuse between their parents. e. Substance abuse is a common factor in abusive relationships.

b, c, e woman substance it often

Believes he has a "sixth sense" and knows what others are thinking

c Schizotypal personality disorder

Which of the following would be an appropriate medication for a child with ADHD? a. Carbamazapine (Tegretol) b. Halolperidal (Haldol) c. Atomoxetine (Strattera) d. Chlordiazepoxide (Librium)

c. Atomoxetine (Strattera)

Three of the following are positive outcome criteria for an Antisocial Personality client. Which one is NOT? a. Client recognizes when anger is escalating. b. Client experiences a true desire to change. c. Client manipulates others to his advantage. d. Client follows established rules.

c. Client manipulates others to his advantage.

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? a. "Suicidal threats and gestures should be considered manipulative and/or attention-seeking." b. "Suicide is the act of a psychotic person." c. "All suicidal individuals are mentally ill." d. "Between 50 and 80 percent of all people who kill themselves have a history of a previous attempt."

d. "Between 50 and 80 percent of all people who kill themselves have a history of a previous attempt."

Match the treatment goal with the appropriate medication. Heroin withdrawal? 1. Methadone (Dolophine) 2. Naloxone (Narcan) 3. Bupropion (Zyban) 4. Chlordiazepoxide (Librium) 5. Disulfiram (Antabuse)

1. Methadone (Dolophine)

16. Order the goals of the levels of prevention as they progress through the public health model set forth by Gerald Caplan. 1. ________ Interventions aimed at minimizing early symptoms of psychiatric illness and directed toward reducing the prevalence and duration of the illness 2. ________ Services aimed at reducing the residual defects that are associated with severe and persistent mental illness 3. ________ Services aimed at reducing the incidence of mental disorders within the population

2, 3, 1

Match the treatment goal with the appropriate medication. Morphine overdose? 1. Methadone (Dolophine) 2. Naloxone (Narcan) 3. Bupropion (Zyban) 4. Chlordiazepoxide (Librium) 5. Disulfiram (Antabuse)

2. Naloxone (Narcan)

A woman who has been widowed recently is unable to cope with the tasks of daily living because a hurricane has completely destroyed her home. She is unable to identify any available family support. The nurse identifies that the client is experiencing which type of crisis? 1) Dispositional crisis 2) Life transitions crisis 3) Traumatic stress crisis 4) Maturational/developmental crisis

3) Traumatic stress crisis

Match the treatment goal with the appropriate medication. Nicotine withdrawal? 1. Methadone (Dolophine) 2. Naloxone (Narcan) 3. Bupropion (Zyban) 4. Chlordiazepoxide (Librium) 5. Disulfiram (Antabuse)

3. Bupropion (Zyban)

When planning group therapy, a nurse should identify which configuration as most optimal for a therapeutic group? 1.Open-ended membership; circle of chairs; group size of 5 to 10 members 2.Open-ended membership; chairs around a table; group size of 10 to 15 members 3.Closed membership; circle of chairs; group size of 5 to 10 members 4.Closed membership; chairs around a table; group size of 10 to 15 members

3. Closed membership; circle of chairs; group size of 5 to 10 members

Match the treatment goal with the appropriate medication. Alcohol withdrawal? 1. Methadone (Dolophine) 2. Naloxone (Narcan) 3. Bupropion (Zyban) 4. Chlordiazepoxide (Librium) 5. Disulfiram (Antabuse)

4. Chlordiazepoxide (Librium)

A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness? 1. Bipolar disorder: mania 2. Schizophrenia spectrum disorder 3. Generalized anxiety disorder 4. Major depressive episode

4. Major depressive episode

A nursing instructor is teaching students about self-help groups like AA. Which student statement indicates that learning has occurred?1."There is little research to support AA's effectiveness." 2."Self-help groups used to be the treatment of choice, but their popularity is waning." 3."These groups have no external regulation, so clients need to be cautious." 4."Members themselves run the group, with leadership usually rotating among the members."

4."Members themselves run the group, with leadership usually rotating among the members."

How long is the crisis intervention stage for rape?

6-8 weeks

4. A client at the mental health clinic tells the case manager, "I can't think about living another day, but don't tell anyone about the way I feel. I know you are obligated to protect my confidentiality." Which case manager response is most appropriate? A. "The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care. "B. "Let's discuss steps that will resolve negative lifestyle choices that may have increased your suicidal risk. "C. "You seem to be preoccupied with self. You should concentrate on hope for the future. "D. "This information is secure with me because of client confidentiality."

A. "The treatment team is composed of many specialists who are working to improve your ability to function. Sharing this information with the team is critical to your care.

During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, what is the role of the group leader?A. To referee the debateB. To adamantly oppose physical discipline measuresC. To redirect the group to a less controversial topicD. To encourage the group to solve the problem collectively

ANS: D The role of the group leader is to encourage the group to solve the problem collectively. A democratic leadership style supports members in their participation and problem-solving. Members are encouraged to cooperatively solve issues that relate to the group.

Abuse occurs most often in which population?

Abuse affects all populations equally

What is a compounded rape reaction?

Additional symptoms occur like depression, suicide, substance abuse, psychotic behaviors

What parental/adult behaviors might indicate neglect?

Appears indifferent to the child; seems apathetic or depressed; behaves irrationally; is abusing alcohol or other drugs

14. Which of the following are characteristics of a Program of Assertive Community Treatment (PACT), as described by the National Alliance on Mental Illness (NAMI)? (Select all that apply.)A. PACT offers nationally based treatment to people with serious and persistent mental illnesses. B. PACT is a type of case-management program. C. The PACT team provides services 24 hours a day, 7 days a wk, 365 dys a year. D. The PACT team provides highly individualized services directly to consumers. E. PACT is a multidisciplinary team approach.

B, C, D, E

13. Which of the following clients should a nurse recommend for a structured day program? (Select all that apply.) A. An acutely suicidal teenager B. A chronically mentally ill woman who has a history of medication non-adherence C. A socially isolated older individual D. A depressed individual who is able to contract for safety E. A client who is hearing voices that tell the client to harm others

B, E

A community health nurse is teaching a class to expectant parents. All participants lack infant care knowledge. A student nurse asks, "If you had to assign a nursing diagnosis to this group, what would it be?" What is the best nursing reply? A. "I would assign the nursing diagnosis of cognitive deficit." B. "I would assign the nursing diagnosis of knowledge deficit." C. "I would assign the nursing diagnosis of altered family processes." D. "I would assign the nursing diagnosis of risk for caregiver role strain."

B. "I would assign the nursing diagnosis of knowledge deficit."

What is the best rationale for including the client's family in therapy within the inpatient milieu? A. To structure a program of social and work-related activities B. To facilitate discharge from the hospital C. To provide a concrete demonstration of caring D. To encourage the family to model positive behaviors

B. To facilitate discharge from the hospital

An abuse victim tearfully tells the nurse in the emergency department, "Don't tell my husband that you know he beats me because if he thinks anyone knows, he will beat me again." Based on this information, the most appropriate nursing diagnosis is A. chronic pain. B. fear. C. post-trauma syndrome. D. risk for self-directed violence.

B. fear. The client is expressing fear based on a known threat.

When there is reason to suspect that a child is being abused, the nurse must initially A. call the local police to report it. B. follow agency policy for reporting. C. confront the parent or parents. D. interrogate the child to obtain proof.

B. follow agency policy for reporting. Nurses are mandated reporters of child abuse. They must follow the rules set forth by the state regarding the steps to take to report child abuse.

7. A newly admitted homeless client diagnosed with schizophrenia states, "I have been living in a cardboard box for two weeks. Why did the government let me down?" Which is an appropriate nursing response? A. "Your discharge from the state hospital was done prematurely. Had you remained in the state hospital longer, you would not be homeless. "B. "Your premature discharge from the state hospital was not intended for patients diagnosed with chronic schizophrenia. C. "Your discharge from the state hospital was based on firm principles; however, the resources were not available to make the transition a success.

C. "Your discharge from the state hospital was based on firm principles; however, the resources were not available to make the transition a success.

Which intervention should the nurse consider as primary prevention for an individual who is on the verge of being homeless because of a job layoff? A. Referral to primary care provider to improve general health status B. Encouraging client to recognize reasons for job layoff C. Job training to increase employment options D. Encouraging the use of prn medications to control symptoms

C. Job training to increase employment options

Which statement reflects a truth about rape? A. Some women want to be raped. B. Rapists are oversexed. C. Most rapes are planned. D. Most women are raped by strangers.

C. Most rapes are planned. Many myths about rape exist. Most rapes are not impulsive, spur-of-the-moment acts, but are carefully planned and orchestrated.

The victim of abuse can expect the abuse to worsen when A. the perpetrator feels he is in complete control. B. the perpetrator is feeling remorseful for being abusive. C. the victim moves toward independence from the abuser. D. the victim submits to the domination of the perpetrator.

C. the victim moves toward independence from the abuser. When the abuser thinks he is losing control over the victim, the violence escalates.

Democratic

Clients discuss problems & situations

Which expected client outcome should a nurse identify as being correctly formulated? A. Client will feel happier by discharge B. Client will demonstrate two relaxation techniques. C. Client will verbalize triggers to anger by end of session. D. Client will initiate interaction with one peer during free time within 2 days.

D. Client will initiate interaction with one peer during free time within 2 days.

Anticipatory teaching of a rape victim should include information that a common survivor problem that often develops during the long-term reorganization phase of rape trauma syndrome is A. denial of the event. B. headaches and fatigue. C. shock and numbness. D. intrusive thoughts.

D. intrusive thoughts. Just as in posttraumatic stress disorder, intrusive thoughts haunt the rape victim in the weeks and months during which long-term reorganization is occurring. Knowing that this is a common occurrence is reassuring to the client, who often is frightened by the symptom.

What is agranulocytosis? S/S?

Decreased WBC count; a common side effect of taking antipsychotic medications long term.S/S: sore throat, fever, malaise.

Schizophrenia neurotransmitters

Dopamine elevated

What are indicators of neglect?

Frequent absences from school; begs or steals food/money; lacks medical/dental/vision care; is consistently dirty or has severe body odor; lacks warm clothing; abuses alcohol/drugs; states there's no one at home to provide care

Name the three major elements of informed consent.

Knowledge:The client has received adequate information on which to base his or her decision. Competency:The individual's cognition is not impaired to an extent that would interfere with decision making or, if so, that the individual has a legal representative. Free will:The individual has given consent voluntarily without pressure or coercion from others.

Laissez-faire

Lazy, no leadership

Autocratic

Leader makes decision w/o asking group

Panic

Loss of control

Depression neurotransmitter

Low serotonin

Mental Illness

Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are in-congruent with the local and cultural norms and interfere with the individual's functioning

What are Walker's 3 phases in the cycle of battering?

Phase 1: Tension Building; tolerance for frustration is declining, angry with little provocation, quick to apologize for lashing out. Woman may be nurturing, compliant. Accepts abuse as legitimately directed toward her. Denies her anger. May last a few weeks to years Phase 2: Acute battering incident. Lasts up to 24 hrs. Batterer justifies behavior to himself but then is confused and knows he lost control. Women often hide. Batterer minimizes severity. Phase 3: Calm, loving, respite "Honeymoon". Batterer is charming, begs forgiveness. Woman wants to believe

Who on the ID team, is responsible for diagnosis and treatment of mental disorders; prescribes medication and other somatic therapies

Psychiatrist

Who does psychological testing/diagnosing?

Psychologist

Nurse does a 45 min education group, whats an appropriate topic?

Stress management

What behaviors are seen in expressed response pattern (to rape)?

Survivor expresses feelings of fear, anger, anxiety through such behaviors as crying, sobbing, restlessness, and tension

Lithium: patient teaching

Take with mealsNEVER stop abruptlyMonitor blood lithium levelsContraindicated in renal failure

termination phase

The final, integral phase of the nurse-patient relationship.

How should a nurse care for the self-inflicted wounds of a client with borderline personality disorder?

The wounds should be treated in a matter-of-fact manner. Care should be taken not to give positive reinforcement to this behavior by offering sympathy or additional attention.

(SSRIs)?

Widely used, first line antidepressants (no psychosis)4-6wks

What demographic has the highest percentage of intimate violence?

Women 25-34

Chronic feelings of depression are common

a Borderline personality disorder

Swallows a bottle of pills after therapist leaves on vacation.

a Borderline personality disorder

Which of the following instructions regarding lithium therapy should be included in a nurse's discharge teaching? (Select all that apply) a. Avoid excessive use of beverages containing caffeine. b. Maintain a consistent sodium intake. c. Consume at least 2,500 to 3,000 mL of fluid per day. d. Restrict sodium content. e. Restrict fluids to 1,500 mL per day.

a, b, c

A nurse is caring for a client diagnosed with antisocial personality disorder. Which factors should the nurse consider when planning this client's care? (Select all that apply) a. This client has personality traits that are deeply ingrained and difficult to modify. b. This client needs medication to treat the underlying physiological pathology. c. This client uses manipulation, making the implementation of treatment problematic. d. This client has poor impulse control that hinders compliance with a plan of care. e. This client is likely to have secondary diagnoses of substance abuse and depression.

a, c, d, e

A nursing instructor is teaching about case management. What student statement indicates that learning has occurred? a. "Case management provides coordination of services required to meet client needs." b. "Case management exists mainly to facilitate client admission to needed inpatient services." c. "Case management is a method to facilitate physician reimbursement." d. "Case management is a method used to achieve independent client care."

a. "Case management provides coordination of services required to meet client needs."

A college student was sexually assaulted when out on a date. After several weeks of crisis intervention therapy, which client statement should indicate to a nurse that the student is handling the situation in a healthy manner? a. "I know that it was not my fault." b. "If I don't put myself in a dating situation, I won't be at risk." c. "My boyfriend has trouble controlling his sexual urges." d. "Next time I will think twice about wearing a sexy dress."

a. "I know that it was not my fault."

A nurse is assessing a client diagnosed with paranoid schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of "making observations?" a. "I notice that you are talking to someone who I do not see." b. "Please tell me what they are telling you." c. Why do you continually look up at the ceiling?" d. I understand that you see someone in the hall, but I do not see anyone."

a. "I notice that you are talking to someone who I do not see." Making observations involves verbalizing what is observed or perceived. This encourages the client to recognize specific behaviors and make comparisons with the nurse's perceptions.

A nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement would indicate a need for further follow-up instructions? a. "I will need to schedule blood work in order to monitor for toxic levels of this drug." b. "I won't stop taking this medicine abruptly because there could be serious complications." c. "I will not drink alcohol while taking this medication." d. "I won't take extra doses of this drug because I can become addicted."

a. "I will need to schedule blood work in order to monitor for toxic levels of this drug."

A client with Schizophrenia has recently begun a new medication, Clozapine (clozaril). Which potentially fatal side effect will the nurse teach the client about? a. Agranulocytosis b. Akathisia c. Dystonia d. Akinesia

a. Agranulocytosis

The client with schizophrenia is preparing for discharge. To minimize relapse, what is the most important feature of planning the client's aftercare? a. An accurate description of the medication regimen with a specific plan for obtaining refills b. Identification of three new methods of spending leisure time c. Ensuring that the client lists three potential sources of social support d. Identification of two new ways to bolster self-esteem

a. An accurate description of the medication regimen with a specific plan for obtaining refills The nurse should recognize that the most common reason patient's relapse or decompensate into their illness is because they have stopped taking their medication, so teaching should emphasize compliance with medication.

Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with borderline personality disorder (BPD)? a. Being firm, consistent, and empathetic, while addressing specific client behaviors b. Promoting client self-expression by implementing laissez-faire leadership c. Using authoritative leadership to help clients learn to conform to society norms d. Overlooking inappropriate behaviors to avoid providing secondary gains

a. Being firm, consistent, and empathetic, while addressing specific client behaviors

Which of the following situations is UNLIKELY to lead to PTSD in a client? a. Home invasion while away on vacation. b. Purse snatching in the mall parking lot. c. Battering by spouse. d. Burst of nearby dam while sleeping, resulting in loss of home and belongings.

a. Home invasion while away on vacation.

Which nursing intervention takes priority when working with a newly admitted client experiencing suicidal ideations?a. a. Monitor the client at close, but irregular intervals. b. Encourage the client to participate in group therapy. c. Enlist friends and family to assist the client in remaining safe after discharge. d. Remind the client that it takes 6-8 weeks for anti-depressants to be fully effective.

a. Monitor the client at close, but irregular intervals.

When attempting to provide health-care related services to the homeless, what should be a realistic concern for a nurse? a. Most individuals that are homeless relocate frequently. b. Most individuals that are homeless are suspicious of anyone who offers help. c. Most individuals that are homeless reject help. d. Most individuals that are homeless are proud and will refuse charity.

a. Most individuals that are homeless relocate frequently.

When questioned about bruises, a woman states, "It was an accident. My husband just had a bad day at work. He's being so gentle now and even brought me flowers. He's going to get a new job, so it won't happen again." This client is in which phase of the cycle of battering? a. Phase III: The honeymoon phase b. Phase IV: The resolution and reorganization phase c. Phase II: The acute battering incident phase d. Phase I: Tension-building

a. Phase III: The honeymoon phase

A 25 year old woman has been admitted to your unit with Borderline Personality Disorder. She self mutilates and is bulimic. What are the nurse's priorities when planning care for the client? a. Provide safety and close observation b. Close observation and medicate c. Set firm limits and medicate d. Provide safety and set firm limits

a. Provide safety and close observation

A client with Antisocial Personality Disorder is verbally threatening to the staff. Select the best, initial nursing intervention for this behavior. a. Set firm limits on client's behavior. b. Medicate the client c. Ignore the client's threats d. Call a Code

a. Set firm limits on client's behavior.

A client diagnosed with schizophrenia spectrum disorder is prescribed clozapine (Clozaril). Which client symptoms, related to the side effects of this medication, should prompt a nurse to intervene immediately? a. Sore throat, fever, and malaise b. Akathesia and hypersalivation c. Akinesia and insomnia d. Dry mouth and urinary retention

a. Sore throat, fever, and malaise Intervene immediately if client experiences signs of infectious process-such as sore throat, fever, & malaise-when taking the atypical antipsychotic drug clozapine. Clozapine can have a serious side effect of agranulocytosis, in which a potentially fatal drop in white blood cells can occur, leading to infection.

The priority nursing intervention for an abuse victim in the emergency department is: a. Tending to the immediate care of the wounds b. Providing the victim with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how they may go about bringing charges against their abuser

a. Tending to the immediate care of the wounds

A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate (Lithobid) because of excessive weight gain. In order to increase adherence, which medication should a nurse anticipate that a physician may prescribe? a. Valproic Acid (Depakote) b. Sertraline (Zoloft) c. Trazodone (Desyrel) d. Paroxetine (Paxil)

a. Valproic Acid (Depakote)

The best treatment for a client with a disabling phobia would be? a. facing the fear through gradual exposure b. administer 10 mg of Valium as needed c. hypnosis d. facing the fear through implosion therapy

a. facing the fear through gradual exposure

Which of the following represents a nursing intervention at the tertiary level of prevention? a. serving as case manager for a mentally ill homeless client b. leading a support group for newly retired men c. teaching prepared childbirth classes d. caring for a depressed widow in the hospital

a. serving as case manager for a mentally ill homeless client

Which of the following represents a nursing intervention at the primary level of prevention? a. teaching a class in parent effectiveness training b. leading a group of adolescents in drug rehab c. referring a married couple for sex therapy d. leading a support group for battered women

a. teaching a class in parent effectiveness training

Relapse is most likely to happen when the client? a.. returns to the same people, places and things after treatment. b. refuses to attend after care treatment. c. has a dual diagnosis. d. within the first month following discharge.

a.. returns to the same people, places and things after treatment. The nurse should recognize this as potential problems in the client's sobriety.

Alzheimer's neurotransmitters

acetylcholine decreased

Autonomy ch.3

allowing client to choose to attend group therapy or take meds (unless suicidal or harming someone else then we can medicate w/o consent)

Defense mechanisms - Intellectualization

an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis

Defense mechanisms - Identification

an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires

Client threatens to jump off bridge, brought to ER, nurse priority to ask? ch.10

are you thinking of harming yourself

Defense mechanisms - rationalization

attempting to make excuses or formulate logical reasons to justify unacceptable feelings or behaviors

Defense mechanisms - projection

attributing feelings or impulses unacceptable to one's self to another person

Refuses to enter into a relationship because of fear of rejection

b Avoidant personality disorder

Which of the following diagnostic criteria describe the characteristics of borderline personality disorder? (Select all that apply) a. Arrogant, haughty behaviors or attitudes. b. Frantic efforts to avoid real or imagined abandonment. c. Recurrent suicidal and self-mutilating behaviors. d. Unrealistic preoccupation with fears of being left to take care of self. e. Chronic feelings of emptiness.

b, c, e

A client who has been newly diagnosed with depression is beginning tricyclic antidepressant therapy. The nurse has just completed teaching with this client. Which statement by the client indicates the need for further education? a. I will continue to take this medication even if the symptoms have not subsided. b. I do not need to quit smoking. c. I may experience drowsiness or dizziness while taking this medication. d. I will stop drinking alcohol now that I am taking this medication.

b. I do not need to quit smoking.

A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, rates mood at 9/10, and is much more communicative. Which action should be the nurse's priority at this time? a. Give the client off-unit privileges as positive reinforcement. b. Increase frequency of client observation. c. Encourage the client to share mood improvement in group. d. Request that the psychiatrist reevaluate the current medication protocol.

b. Increase frequency of client observation.

Which nursing statement regarding the concept of psychosis is most accurate? a. Individuals experiencing psychoses are aware that their behaviors are maladaptive. b. Individuals experiencing psychoses experience little distress. c. Individuals experiencing psychoses are aware of experiencing psychological problems. d. Individuals experiencing psychoses are based in reality.

b. Individuals experiencing psychoses experience little distress.

A nurse is teaching a client diagnosed with an eating disorder about behavior-modification programs. Why is this the intervention the treatment of choice? a. It manages the client's uncontrollable behaviors. b. It allows clients to maintain control. c. It addresses the underlying client anger. d. It helps the client correct a distorted body image.

b. It allows clients to maintain control.

Ann is a psychiatric home health nurse. She has just received an order to begin regular visits to Mrs. W a 78 year old widow who lives alone. Mrs. W.'s PCP has diagnosed her as depressed. Which criteria would qualify Mrs. W for home health visits? a. Mrs W never learned to drive and hast o depend on others for her transportation b. Mrs. W is physically too weak to travel without risk of injury c. Mrs. W refuses to seek assistance as suggested by her physician "because I don't have a psychiatric problem"

b. Mrs. W is physically too weak to travel without risk of injury

A school nurse provides education on drug abuse to a high school class. This nursing action is an example of which level of prevention? a. Primary intervention b. Primary prevention c. Secondary prevention d. Tertiary prevention

b. Primary prevention

What would be the best nursing strategy to use when a client is attempting to split staff on the 3 shifts against one another? a. Assign one staff member to her each shift. b. Rotate staff assigned to her each shift. c. Have each shift develop a plan. d. Schedule a meeting with the client to discuss the problem.

b. Rotate staff assigned to her each shift.

Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level? a. Major depressive episode b. Schizophrenia c. Anorexia nervosa d. Alzheimer's disease

b. Schizophrenia

A client experiencing a panic attack would display which physical symptom? a. Fear of dying b. Sweating and palpitations c. Depersonalization d. Restlessness and pacing

b. Sweating and palpitations

Within the nurse's scope of practice, which function is exclusive to the advanced practice psychiatric nurse? a. Teaching about the side effects of neuroleptic medications b. Using psychotherapy to improve mental health status c. Using milieu therapy to structure a therapeutic environment d. Providing case management to coordinate continuity of health services

b. Using psychotherapy to improve mental health status

At what point should the nurse determine that a client is at risk for developing a mental disorder? a. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria b. When maladaptive responses to stress are coupled with interference in daily functioning c. When the client communicates significant distress d. When the client uses defense mechanisms as ego protection

b. When maladaptive responses to stress are coupled with interference in daily functioning

Three predominant client populations have been identified as benefiting most from psychiatric home health care. Which of the following is not included among this group? a. elderly individuals b. individuals living in poverty c. individuals with severe and persistent mental illness d. individuals in acute crisis situations

b. individuals living in poverty

A nurse is caring for a client who is experiencing a flat affect, paranoid delusions, anhedonia, anergia, neologisms, and echolalia. Which statement correctly differentiates the clients positive and negative symptoms of schizophrenia? a. paranoid delusions, anhedonia, an anergia or positive symptoms of schizophrenia b. paranoid delusions, neologisms, echolalia are positive symptoms of schizophrenia c. paranoid delusions, anergia, and echolalia or negative symptoms of schizophrenia d. paranoid delusions, flat effect, and anhedonia negative symptoms of schizophrenia

b. paranoid delusions, neologisms, echolalia are positive symptoms of schizophrenia

Under stress, he often decompensates and demonstrates psychotic behaviors.

c Schizotypal personality disorder

On the first day of a client's alcohol detoxification, which nursing intervention should take priority? a. Strongly encourage the client to attend 90 Alcoholics Anonymous meetings in 90 days. b. Educate the client about the biopsychosocial consequences of alcohol abuse. c. Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol. d. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.

c. Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol.

A nurse assesses an adolescent client diagnosed with conduct disorder who, at the age of 8, was sentenced to juvenile detention. How should a nurse interpret this assessment data? a. Childhood-onset conduct disorder is caused by a difficult temperment, and the child is likely to outgrow these behaviors by adulthood. b. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and, therefore, improvement is likely. c. Childhood-onset conduct disorder is more severe than the adolescent-onset type, & these individuals likely develop antisocial personality disorder in adulthood. d. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder.

c. Childhood-onset conduct disorder is more severe than the adolescent-onset type, & these individuals likely develop antisocial personality disorder in adulthood.

Looking at a slightly bleeding paper cut, the client screams, "Somebody help me quick! I'm bleeding. Call 911!" A nurse should identify this behavior as characteristic of which personality disorder? a. Schizoid personality disorder b. Obsessive-compulsive personality disorder c. Histrionic personality disorder d. Paranoid personality disorder

c. Histrionic personality disorder

A preschool child diagnosed with autistic spectrum disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate? a. Place client in restraints until the aggression subsides. b. Distract the client with a variety of games and puzzles. c. Hold client's head steady and apply a helmet. d. Sedate the client with neuroleptic medications.

c. Hold client's head steady and apply a helmet.

Which treatment should a nurse identify as most appropriate for clients diagnosed with general anxiety disorder (GAD)? a. Long-term treatment with diazepam (Valium) b. Acute symptom control with citalopram (Celexa) c. Long-term treatment with buspirone (BuSpar) d. Acute symptom control with ziprasidone (Geodon)

c. Long-term treatment with buspirone (BuSpar)

Which tool would be appropriate for a nurse to use when assessing mental acuity prior to and immediately following electroconvulsive therapy (ECT)? a. CIWA scale b. GGT c. MMSE d. CAPS scale

c. MMSE

Electroconvulsive therapy is most commonly prescribed for which of the following? a. Bipolar disorder, manic b. Paranoid schizophrenia c. Major depression d. Obsessive-compulsive disorder

c. Major Depression

What is being assessed when a nurse asks a client to identify name, date, residential address, and situation? a. Mood b. Perception c. Orientation d. Affect

c. Orientation

An instructor is teaching nursing students about the differences between partial and inpatient hospitalization. In what way does partial hospitalization differ from traditional inpatient hospitalization? a. Partial hospitalization does not use an interdisciplinary team. b. Partial hospitalization does not offer a comprehensive treatment plan. c. Partial hospitalization does not provide supervision 24 hours a day. d. Partial hospitalization does not provide medication administration and monitoring.

c. Partial hospitalization does not provide supervision 24 hours a day.

A client is brought to he emerge department after being violently raped. Which nursing action is appropriate? a. Probe for further, detailed description of the rape event. b. Discourage the client from discussing the rape, because this may lead to further emotional trauma. c. Remain nonjudgmental while actively listening to the client's description of the violent rape event. d. Meet the client's self-care needs by assisting with showering and perineal care.

c. Remain nonjudgmental while actively listening to the client's description of the violent rape event.

A client is diagnosed with schizophrenia. A physician orders haloperidol (Haldol) 50mg bid, benztropine (Cogentin) 1 mg prn, and zolpidem (Ambien) 10 mg HS. Which client behavior would warrant the nurse to administer benztropine? a. Tactile hallucinations b. Flat affect c. Restlessness and muscle rigidity d. Reports of hearing disturbing voices

c. Restlessness and muscle rigidity

In which phase of the Cycle of Battering does the victim just try to stay out of the perpetrator's way? a. Honeymoon phase b. Acute battering phase c. Tension building phase d. Separation phase

c. Tension building phase

John, a homeless person, has just come to live in the shelter. The shelter nurse is assigned to his care. Which of the following is a priority intervention on the part of the nurse? a. referring John to a social worker b. Developing a plan of care for John c. conducting a behavioral and needs assessment on John d. helping John apply for social security benefits

c. conducting a behavioral and needs assessment on John

Your client has been diagnosed with OCD-"handwashing". You initiate a treatment program that includes: a. titrating antianxiety medication with frequency of handwashing. b. setting limits on # of times handwashing can be done every 24 hours. c. permitting handwashing around clients scheduled activites. d. stopping all handwashing except before and after meals and toileting.

c. permitting handwashing around clients scheduled activites.

A client diagnosed with schizophrenia is hospitalized due to an exacerbation of psychosis related to nonadherence with antipsychotic medications. Which level of care does the clients hospitalization reflect? a. tertiary prevention level of care b. case management level of care c. secondary prevention level of care d. primary prevention level of care

c. secondary prevention level of care

Therapy group

closed, circle, 5-10 members is best

Emotional abuse might be suspected when the adult:

constantly blames, belittles, or berates the child; is unconcerned about the child and refuses offers of help for the child's problem; overtly rejects the child

Defense mechanisms - Compensation

covering up a real or perceived weakness by emphasizing a trait one considers more desirable

Believes she is entitled to special privileges others do not deserve.

d Narcissistic personality disorder

Requires a great deal of praise and becomes angry at the slightest criticism from others

d Narcissistic personality disorder

Which client statement demonstrates positive progress toward recovery from substance use disorder? a. "I have completed detox and therefore an in control of my drug use." b. "I will faithfully attend Narcotic Anonymous (NA) when I can't control my cravings." c. "As a church deacon, my focus will now be on spiritual renewal." d. "Taking those pills got out of control. It cost me my job, marriage, and children."

d. "Taking those pills got out of control. It cost me my job, marriage, and children."

A nurse is planning care for a 13-year-old client who is experiencing depression. Which medication is approved by the Food and Drug Administration (FDA) for the treatment of depression in adolescents? a. Paroxetine (Paxil) b. Sertraline (Zoloft) c. Citalopram (Celexa) d. Fluoxetine (Prozac)

d. Fluoxetine (Prozac)

A nurse is working with a client who has just been prescribed bupropion Wellbutrin. Which statement by the client indicates that further education is necessary? a. I will begin using sunblock when outdoors. b. I will only discontinue the medication under the guidance of my position. c. I would use caution when driving an using dangerous machinery. d. If I miss a dose, I will just take 2 pills the next day to catch up.

d. If I miss a dose, I will just take 2 pills the next day to catch up.

A male client diagnosed with a personality disorder boasts to the nurse that he has to fight off female attention and is the highest paid in his company. These statements are reflective of what personality disorder? a. Obsessive-compulsive personality disorder b. Avoidant personality disorder c. Schizotypal personality disorder d. Narcissistic personality disorder

d. Narcissistic personality disorder

A person experiencing heroin withdrawal would likely experience which of the following symptoms: a. Increased heartrate and blood pressure b. Tremors, insomnia and seizures c. Incoordination and unsteady gait d. Nausea and vomiting, diarrhea, and diaphoresis

d. Nausea and vomiting, diarrhea, and diaphoresis

John has a history of paranoid schizophrenia and non compliance with medications, which of the following might be the best choice of neuroleptic for John? a. Haldol b. Navane c. Lithium Carbonate d. Prolixin decanoate

d. Prolixin decanoate

Which nursing diagnosis should a nurse identify as appropriate when working with a client diagnosed with schizoid personality disorder? a. Altered thought processes R/T increased stress b. Risk for suicide R/T loneliness c. Risk for violence: directed toward others R/T paranoid thinking d. Social isolation R/T inability to relate to others

d. Social isolation R/T inability to relate to others

A client is experiencing a panic attack. The client states, "I'm losing control. I feel like I'm going crazy." Which nursing intervention takes priority? a. Encourage the client to express feelings. b. Teach the etiology and management of panic disorders. c. Distract the client by redirecting to physical activities. d. Stay with the client and offer support.

d. Stay with the client and offer support.

Which term should a nurse use to describe the administration of a central nervous system (CNS) depressant during the substance induced disorder of alcohol withdrawal? a. Antagonist therapy b. Deterrent therapy c. Codependency therapy d. Substitution therapy

d. Substitution therapy Various medications have been used to decrease intensity of sympt in an indiv withdrawing from, or who is experienc the effects of excessive use of, alcohol and other drugs. This is called substitution therapy and may be required to reduce the life-threatening effects of alcohol withdrawal.

A nurse is implementing care within the parameters of tertiary prevention. Which nursing action is an example of this type of care? a. Teaching a client the reportable side effects of a newly prescribed neuroleptic medication b. Teaching a client about his or her new diagnosis of bipolar disorder c. Teaching an adolescent about pregnancy prevention d. Teaching a client to cook meals, make a grocery list, and establish a budget

d. Teaching a client to cook meals, make a grocery list, and establish a budget

The most common side effects of ECT are: a. Permanent memory loss and brain damage b. Fractured and dislocated bones c. Myocardial infarction and cardiac arrest d. Temporary memory loss and confusion

d. Temporary memory loss and confusion

Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which statement regarding a client's home environment should a nurse associate with the development of anorexia nervosa? a. The home environment maintains loose personal boundaries. b. The home environment condones corporal punishment. c. The home environment places an overemphasis on food. d. The home environment is overprotective and demands perfection.

d. The home environment is overprotective and demands perfection.

A nurse administers 100% oxygen to a client during and after electroconvulsant therapy (ECT). What is the rationale for this procedure? a. To prevent increased intracranial pressure resulting from an anoxia. b. to prevent decreased blood pressure, pulse, and respiration owing to electrical stimulation c. to prevent blocked airway, resulting from seizure activity d. to prevent an anoxia resulting from medication induced paralysis of respiratory muscles

d. To prevent anoxia resulting from medication-induced paralysis of respiratory muscles

All of the following are examples of elder abuse except? a. restraining b. yelling c. lack of eyeglasses, hearing aides, & false teeth d. annual physician visits

d. annual physician visits

Immerses assessing a client diagnosed with schizophrenia spectrum disorder. The nurse asks the client, do you receive special messages from certain sources, such as the television or radio? For which potential symptom of this disorder is the nurse assessing? a. thought insertion b. paranoid delusions c. magical thinking d. delusions of reference

d. delusions of reference

Priority nursing care for a 16 year old Anorexic female would be: a. provide her with extra snacks to stash for later when she might be hungry. b. coaxing her to each as much as she can. c. rewarding her when she increases her caloric intake. d. sitting at the table with her for all meals and for 1 hour after meals.

d. sitting at the table with her for all meals and for 1 hour after meals.

A nurse is planning to teach a client diagnosed with a gora phobia about this disorder. Which fact should the nurse include in the teaching plan? a. The origin of agoraphobia is lack of control over life situations b. the origin of agoraphobia is a change in body functioning resulting from inner conflict c. the origin of agoraphobia is the direct physiological effect of a substance d. the origin of agoraphobia is the true fear of being separated from a source of security

d. the origin of agoraphobia is the true fear of being separated from a source of security

Indicators of sexual abuse

difficulty walking/sitting; suddenly refuses to change for gym or participate in physical activities; reports nightmares or bedwetting; sudden change in appetite; has unusual sexual knowledge/behavior; pregnant; venereal disease; runs away; reports sexual abuse;

Shows no remorse for exploitation and manipulation of others.

e Antisocial personality disorder

Parental/adult behaviors that may indicate sexual abuse:

unduly protective of the child or severely limits the child's contact with other children; secretive and isolated; jealous or controlling with other family members

What age group is rape most prevalent in?

16-34

Most rapists are in what age category?

25-44

Match the treatment goal with the appropriate medication. Alcohol abstinence? 1. Methadone (Dolophine) 2. Naloxone (Narcan) 3. Bupropion (Zyban) 4. Chlordiazepoxide (Librium) 5. Disulfiram (Antabuse)

5. Disulfiram (Antabuse)

Neurocognitive disorder (NCD)

A clinically significant deficit in cognition or memory that represents a significant change from a previous level of functioning. This category includes disorders of delirium and mild and major NCDs

Delirium

A mental state characterized by disturbance of cognition, which is manifested by confusion, excitement, disorientation, and a clouding of consciousness. Hallucinations and illusions are common.

What is Lithium? Levels?

A mood stabilizer; prototypical drug indicated for acute manic phase of bipolar disorder & maintenance. Blood levels 1.5-2 mEq/L Active:0.8-1.2 mEq/L Maintenance: 0.4-1.3 mEq/L

What is the definition of battering?

A pattern of coercive control founded on and supported by physical and/or sexual violence or threat of violence of an intimate partern

The emergency department nurse planning care for a rape victim must realize that the emotional reaction displayed by many rape victims during the initial assessment and treatment is A. fear. B. eagerness. C. suspicion. D. disinterest.

A. fear. Rape is an act of violence, and sex is the weapon used by the perpetrator. Rape engulfs its victims in fear and anxiety, resulting in withdrawal for some and causing severe panic reactions in others. After being traumatized, the person who has been raped often carries an additional burden of shame, guilt, fear, anger, distrust, and embarrassment.

Which statement would be an appropriate long-term outcome for a rape client? The client will A. integrate the rape event and resume an optimal level of functioning. B. identify and develop coping skills necessary to reduce level of anxiety. Incorrect C. blame the rapist rather than blame herself for the situation. D. repress feelings of shame, embarrassment, and self-blame.

A. integrate the rape event and resume an optimal level of functioning. This is the ideal long-term result of treatment for rape trauma syndrome, that life will go on and the client will return to the usual pre-trauma level of functioning.

Nurses working in emergency departments and walk-in clinics should be aware that some victims of violence may present: A. with vague physical complaints such as insomnia or pain. B. with extreme anger and unpredictable behavior. C. with many family members there to support them. D, with psychosis and/or mania as a result of long-term abuse.

A. with vague physical complaints such as insomnia or pain. Patients may present with symptoms that may be vague and can include chronic pain, insomnia, hyperventilation, or gynecological problems. Attention to the interview process and setting is important to facilitate accurate assessment of physical and behavioral indicators of family violence. Presenting with extreme anger is possible but not as common as presenting with vague physical complaints. Having many family members there is unlikely as many victims keep their history of being battered a secret. It is not known that psychosis or mania is a result of physical violence, and this would not be a usual presenting complaint.

Care planning for the rape victim is facilitated if the nurse understands that rape trauma syndrome is actually a variant of A. posttraumatic stress disorder. B. a maturational crisis. C. a dissociative disorder. D. generalized anxiety disorder.

A. posttraumatic stress disorder. Most of those who have been raped are eventually able to resume their previous lives after supportive services and crisis counseling. However, many carry with them a constant emotional trauma: flashbacks, nightmares, fear, phobias, and other symptoms associated with posttraumatic stress disorder.

To provide discharge treatment and support, the nurse should realize that the most common sequela(e) of acquaintance rape is the development of A. symptoms of sexual distress. B. anxiety and fear of men. C. a paranoid psychosis. D. an eating disorder.

A. symptoms of sexual distress. Women who have been raped by acquaintances frequently develop symptoms that prevent them from participating in normal sexual relations. Sexual distress is more common among women who have been sexually assaulted by intimates; fear and anxiety are more common in those assaulted by strangers. Depression occurs in both groups.

A battered woman presents to the ED with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. The PRIORITY nursing intervention is: A. tending to the immediate care of her wounds B. providing her with information about a safe place to stay C. administering the prn tranquilizer ordered by the physician D. explaining how she may go about bringing charges against her husband

A. tending to the immediate care of her wounds

Which statement made by a parent of a child diagnosed with Tourette's syndrome would be assessed as a risk factor for family violence? A. "My husband lost his job, and it seems all our savings are going to pay for our son's expensive medication and all the other things he needs." B. "Our son is really a good little boy, but he needs to be disciplined both at home and in school." C. "We shouldn't be, but we are ashamed of our son's disorder and his inability to control the tics in public." D. "We have become active in the support group but still find the suggestions extremely difficult to put into practice."

A."My husband lost his job, and it seems all our savings are going to pay for our son's expensive medication and all the other things he needs." Job loss, financial problems, and a child who is "different" and has special needs should alert the nurse to the risk for family violence, because all these factors contribute to a crisis situation.

6. A new psychiatric nurse states, "This client's use of defense mechanisms should be eliminated." Which is a correct evaluation of this nurse's statement? A. Defense mechanisms can be self-protective responses to stress and need not be eliminated. B. Defense mechanisms are a maladaptive attempt of the ego to manage anxiety and should always be eliminated. C. Defense mechanisms, used by individuals with weak ego integrity, should be discouraged and not eliminated

ANS: A

As part of discharge teaching, which guideline regarding lithium therapy will the nurse plan to include?

Avoid excess caffeine maintain consistent sodium intake consume at least 2500-3k mL of fluid per day

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her 3 small children. She tells the nurse her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is: A. "How often does he drink too much?" B. "It is not your fault. You did the right thing by coming here." C. "How many times has he done this to you?" D. "He is not a good husband. You have to leave before he kills you."

B. "It is not your fault. You did the right thing by coming here."

Jan, age 5, is sent to the school nurses's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jan has numerous bruises on her arms and torso, in various stages of healing. She also notices some small scars. Jan's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: A. Jan is experiencing physical and sexual abuse B. Jan is experiencing physical abuse and neglect C. Jan is experiencing emotional neglect D. Jan is experiencing sexual and emotional abuse

B. Jan is experiencing physical abuse and neglect

2. A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, I cant function any longer under all this stress. Which type of crisis is the client experiencing? A. Maturational/developmental crisis B. Psychiatric emergency crisis C. Anticipated life transition crisisD . Traumatic stress crisis

B. Psychiatric emergency crisis

2. At what point should the nurse determine that a client is at risk for developing a mental disorder? A. When thoughts, feelings, and behaviors are not reflective of the DSM-5 criteria B. When maladaptive responses to stress are coupled with interference in daily functioning C. When the client communicates significant distress D. When the client uses defense mechanisms as ego protection

B. When maladaptive responses to stress are coupled with interference in daily functioning

A nursing intervention directed at the psychological needs of an abused woman is to A. encourage the client to immediately leave the abuser. B. affirm that the client did not deserve or cause the abuse. C. provide a referral to social services for economic problems. D. facilitate contact with law enforcement to take legal action.

B. affirm that the client did not deserve or cause the abuse. Abused clients often believe that they are deserving of the abuse and, in some way, prompt the abuser to attack. They need specific reassurance that they did not deserve to be abused and they did not cause the attack.

When the nurse believes the cycle of abuse is escalating and that a woman may be in severe physical danger, the priority nursing intervention is to A. advise her to enter counseling at the mental health center. B. assist her to develop a plan to go to a shelter in case of a crisis. C. suggest she leave the abuser and go to a trusted friend's home. D. teach her to counter verbal abuse with assertive replies.

B. assist her to develop a plan to go to a shelter in case of a crisis. Every victim of abuse should have an escape plan, but one is particularly important when the nurse believes the client is in severe danger.

To best assure the safety of a 3-year-old child whose parent admits to finding it difficult to control their anger, the most appropriate short-term goal would be for the parent to A. understand the impact of violence on the child within 2 days. B. begin attending anger management training sessions within 2 weeks. C. state a willingness to attend a support group for physical abusers within 1 week. D. show remorse for their anger management issues within 2 days.

B. begin attending anger management training sessions within 2 weeks. Perpetrators of violence need help learning how to manage anger. A structured group is an excellent way to provide this teaching.

When treatment for injuries sustained during an incident of abuse is sought from the primary physician, the client is receiving A. primary prevention. B. secondary prevention. C. tertiary prevention. D. stop-gap therapy.

B. secondary prevention. Secondary prevention is synonymous with treatment

What do you give if an anti-psychotic med give a client EPS?

Benztropine (cogentin) think Parkinsons

Bill has relapsed three times in his alcohol recovery over the past 3 years. This is his fourth admission and he has monopolized his group therapy offering advice on recovery. The nurse recognized that: a. Bill is an expert on recovery. b. Bill is in denial. c. Bill needs more medication. d. Bill needs to go somewhere else for treatment.

Bill is in denial.

In the biological theory of predisposition to abuse, what factors are thought to be involved?

Brain: temporal lobe, limbic system, amygdaloid nucleus, brain tumors (esp. in limbic system and temporal lobes), trauma to the brain, encephalitis, epilepsy Aggressive impulse facilitation/inhibition: Norepinephrine, dopamine, serotonin

Which nursing statement best describes the current nature of mental health care in the community? A. "All homeless people have a history of institutionalization and are frequently admitted to acute care settings." B. "The deinstitutionalization movement in the United States was successful in transitioning clients into the community." C. "Today, the majority of clients admitted to psychiatric hospitals are in a crisis stage, and the treatment goal is stabilization."

C. "Today, the majority of clients admitted to psychiatric hospitals are in a crisis stage, and the treatment goal is stabilization."

Which child is at lowest risk for abuse? A. A 3-month-old who has colic and teenaged parents. B. A 4-year-old who has cerebral palsy and retarded parents. C. A 2-year-old who has leukemia and two working parents. D. A 5-year-old who has ADHD and a father who was abused as a child.

C. A 2-year-old who has leukemia and two working parents. Although the child in option C has a serious physical disorder, she is at lower risk than the child in option A, whose inconsolable crying can be frustrating; the child in option B, who will not be as independent as other children his age and who has parents who may not understand his needs; or the child in option D, whose hyperactivity can be annoying, especially to a parent who himself has been abused.

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her 3 small children. She tells the nurse her husband inflicted these wounds on her. In the interview, she tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge of the cycle of battering, what does this situation represent? A. Phase 1; Sharon was desperately trying to stay out of his way and keep everything calm B. Phase I; a minor battering incident for which Sharon assumes all the blame C. Phase II; the acute battering incident that Sharon provoked with her threat to leave D. Phase III; the honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

C. Phase II; the acute battering incident that Sharon provoked with her threat to leave

1. A nursing instructor is teaching about the Community Health Centers Act of 1963. What was a deterring factor to the proper implementation of this act? A. Many perspective clients did not meet criteria for mental illness diagnostic-related groups. B. Zoning laws discouraged the development of community mental health centers. C. States could not match federal funds to establish community mental health centers. D. There was not a sufficient employment pool to staff community mental health centers.

C. States could not match federal funds to establish community mental health centers.

Which statement reflects a fact about family violence? A. Ninety-five percent of abuse victims are women. B. The victim's behavior is often the cause of the violence. C. Violence occurs in families of all backgrounds. D. Alcohol and stress are the major causes of abuse.

C. Violence occurs in families of all backgrounds. Option C is a true statement. The others are false.

A rape victim in the emergency department keeps repeating, "I don't know why he did it." Although the nurse does not necessarily give the answer at this juncture, the nurse correctly identifies the motivation for most perpetrators of rape as A. anxiety relief. B. an overwhelming sexual desire. C. a desire to dominate and humiliate. D. a wish to be apprehended and punished.

C. a desire to dominate and humiliate. Power and domination, as well as humiliation of the victim, are the motivations for rape. In this scenario the nurse understands that rape is not a sexual act. Rape is a violent expression of aggression, anger, and the need for power.

An elderly woman who has been abused by her caregiver daughter tells the nurse, "You don't have to worry about me. My daughter cried and apologized. She promised me she will never hit me again." The nurse can assess that this is the stage in the cycle of violence known as A. tension building. B. acute battering. C. honeymoon. D. escalation.

C. honeymoon. During the honeymoon stage, the perpetrator apologizes, promises never to abuse again, and tries to make up for the violence. This stage is usually brief.

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client?1. clarify personal attitudes, values, and beliefs2. Obtain thorough assessment data3. Determine the client's length of stay4. Establish personal goals for the interaction.

Clarify personal attitudes, values, and beliefs..

5. When intervening with a married couple experiencing relationship discord, which nursing action reflects an intervention at the secondary level of prevention? A. Teaching assertiveness skills in order to meet assessed needs B. Supplying the couple with guidelines related to marital seminar leadership C. Teaching the couple about various methods of birth control D. Counseling the couple related to open and honest communication skills

D. Counseling the couple related to open and honest communication skills

A woman who has long hx of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is: A. "I just can't believe you have decided to go back to that horrible man." B. I'm just afraid that he will kill you or the children when you get back. C. What makes you think things have changed with him? D. I hope you have made the right decision. Call this number if you need help.

D. I hope you have made the right decision. Call this number if you need help.

10. A mother who has learned that her child was killed in a tragic car accident states, I cant bear to go on with my life. Which nursing statement conveys empathy? A. This situation is very sad, but time is a great healer. B. You are sad, but you must be strong for your other children. C. Once you cry it all out, things will seem so much better. D. It must be horrible to lose a child; Ill stay with you until your husband arrives.

D. It must be horrible to lose a child; Ill stay with you until your husband arrives.

Which therapeutic communication technique is being used in this nurse-client interaction?Client: "When I get angry, I get into a fistfight with my wife or I take it out on the kids."Nurse: "I notice that you are smiling as you talk about this physical violence." A. Encouraging comparison B. Exploring C. Formulating a plan of action D. Making observations

D. Making observations

What distinction can be made between abuse and neglect? A. Neglect occurs in the psychological domain; abuse occurs in the physical domain. B. Neglect is always physical; abuse can be verbal, physical, sexual, or emotional. C. Neglect is perpetrated against children; abuse victims can be children or adults. D. Neglect is a failure to provide; abuse is a failure to control aggression.

D. Neglect is a failure to provide; abuse is a failure to control aggression. Neglect is failure to provide necessary care, and abuse is physical maltreatment

A client diagnosed with schizophrenia was released from a state mental hospital aftr 20yrs of institutionalization. Which characteristic that is likely to be exhibited by this client? A. The client is likely to be compliant with treatment because of institutional dependency. B. The client is likely to find a variety of community support services to aid in the transition. C. The client is likely to adjust to the community environment if given sufficient support. D. The client is likely to be admitted at some time to an acute care unit for psychiatric treatment.

D. The client is likely to be admitted at some time to an acute care unit for psychiatric treatment.

Kantianism

Duty must be followed; people must do what is "right."

Antipsychotic meds cause?

Extra pyramidal side effects "EPS" Shuffling gait, tremors, dystonia

s/s of emotional abuse

Extremes in behavior-overly compliant, extremely passive, or aggressive; inappropriately adult; inappropriately infantile; physically/emotionally delayed; attempted suicide; reports lack of attachment to parent

Who else would you include in clients therapy to facilitate discharge

Family

What do you see in a controlled response pattern?

Feelings are masked or hidden, person is calm, composed, or a subdued affect is seen

AA meetings who runs the groups

Members and alternate leadership role

Preintroductory phase

Nurse should clarify beliefs/feelings about client

What are the primary psychosocial predisposing factors to avoidant personality disorder?

Parental rejection and censure, which is often reinforced by peers.

What are some of the types of family dynamics that may predispose a person to antisocial personality disorder?

Physical abuse, absence of parental discipline, extreme poverty, removal from the home, growing up without parental figures of both genders, erratic and inconsistent methods of discipline, being "rescued" each time they are in trouble, maternal deprivation

What societal influences are thought to play a part in predisposition to abuse?

Relative deprivation: poverty is a powerful predictor of homicide and violent crime. Decreased social capital is associated with increased firearm homicide

What are the 7 stages of Alzheimer's Disease (AD), the cause of 50-60% of NCDs?

STAGE1. asymptomatic STAGE2. Forgetfulness: STAGE3. Mild cognitive decline: work performance, getting lost, names/words STAGE4. Mild to moderate cognitive decline:forget child's/own b-day, confabulation, depression STAGE5. Moderate cognitive decline: Loss some ADLs.Forgets address/phone number, names of close relatives. Frustration,w/d,self-absorption common STAGE6. Moderate to severe cognitive decline: Disorientation to surroundings, can't ADl, incontinence Sleeping, worse evening, commun more difficult STAGE 7 . Severe cognitive decline: End stage.

What is a silent rape reaction?

This occurs in the long term, where the survivor tells no one about the assault, anxiety is suppressed, and the burden may become overwhelming

Lithium toxicity S/S

Toxicity, WT GAIN Gastric Irritation (Initial Sign) Slurred Speech, Course tremors Hallucination, Tinnitus Strabismus / Nystagmus, Seizure Oligura / Anuria, Death

The deinstitutionalization movement closed state mental hospitals and caused the discharge of individuals with mental illness? T/F

True

Working phase

What phase when client incorporates alternative behaviors; clients insight & perception of reality

What is the psychodynamic theory about predisposition to abuse?

Unmet needs for satisfaction and security cause an underdeveloped ego and weak superego. The frustrated abuser gets power and prestige from aggression and violence.

Which of the following nursing interventions fall within the standards of psychiatric mental health clinical nursing practice for a nurse generalist? (Select all that apply.) a. Assist the client to perform activities of daily living. b. Consult with other clinicians to provide services for clients and effect system change. c. Encourage the client to discuss triggers for relapse. d. Use prescriptive authority in accordance with state and federal laws. e. Educate the family about signs and symptoms of alcohol dependence and withdrawal.

a, c, e a. Assist the client to perform activities of daily living. c. Encourage the client to discuss triggers for relapse. e. Educate the family about signs and symptoms of alcohol dependence and withdrawal.

A nursing counselor is about to meet with a client suffering from codependency. Which of the following data would further support the assessment of this dysfunctional behavior? (Select all that apply) a. The client has a long history of focusing thoughts and behaviors on other people. b. The client, as a child, experienced overindulgent and overprotective parents. c. The client is a people pleaser and does almost anything to gain approval. d. The client exhibits helpless behaviors but actually feels very competent. e. The client can achieve a sense of control only through fulfilling the needs of others.

a,c,e The nurse should recognize the symptoms of codependency: they focus on other people and can only achieve a sense of control through fulfilling the needs of others, they are "people pleasers."

A family member is seeking advice about an older parent who seems to worry unnecessarily about everything. The family member states, "Should I seek psychiatric help for my mother?" Which is an appropriate nursing response? a. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning." b. "My mother worries unnecessarily. I think it is part of the aging process." c. "From what you have told me, you should get her to a psychiatrist as soon as possible." d. "Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications."

a. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning."

A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications. Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply) a. The staff nurse is frequently absent from work. b. The staff nurse experiences mood swings. c. The staff nurse makes elaborate excuses for behavior. d. The staff nurse frequently uses the restroom. e. The staff nurse has a flushed face.

b,c,d,e The nurse should recognize the symptoms of substance use by a coworker: Mood swings, elaborate excuses for behavior, frequently using the restroom and a flushed face are all signs of an impaired nurse.

Which nursing statement about the concept of neuroses is most accurate? a. "An individual experiencing neurosis is unaware that he or she is experiencing distress." b. "An individual experiencing neurosis feels helpless to change his or her situation." c. "An individual experiencing neurosis is aware of psychological causes of his or her behavior." d. "An individual experiencing neurosis has a loss of contact with reality."

b. "An individual experiencing neurosis feels helpless to change his or her situation."

The nurse is planning a teaching session for a client who has recently been prescribed disulfiram (Antabuse) as deterrent therapy for alcohol use disorder. What statement indicates that the client has accurate knowledge of this subject matter? a. "Over-the-counter cough and cold medication should not affect me while I am taking the disulfiram." b. "I'll have to stop using my alcohol-based aftershave while I am taking the disulfiram ." c. "Disulfiram should decrease my cravings for alcohol and make my recovery process easier." d. "Disulfiram is used as a substitute for alcohol to help me avoid alcohol withdrawal symptoms."

b. "I'll have to stop using my alcohol-based aftershave while I am taking the disulfiram ." Alcohol can be absorbed through the skin. Alcohol-based aftershaves should be avoided when taking disulfiram. This client's statement indicates that the client has accurate knowledge related to this important information.

Which of the following client statements would demonstrate a major symptom of schizophrenia spectrum disorder? a. "I've been depressed ever since our house was destroyed by fire." b. "You can read my mind. This light of mine will shine, fine; blinding world will end at nine." c. "I had too much to drink last night, started feeling all-powerful, and stupidly drove my truck into a tree." d. ''A stitch in time saves nine' means that prevention is easier than fixing a real problem."

b. "You can read my mind. This light of mine will shine, fine; blinding world will end at nine." The nurse should recognize this statement is a rhyming statement and is called a clang association and is a positive symptom of schizophrenia spectrum disorder.

A child diagnosed with oppositional defiant disorder (ODD) begins yelling at staff members when asked to leave group therapy because of inappropriate language. Which nursing intervention would be appropriate? a. Administer prn medication to decrease acting-out behaviors. b. Accompany the child to a quiet area to decrease external stimuli. c. Institute seclusion following agency protocol. d. Allow the child to stay in group therapy to monitor the situation further.

b. Accompany the child to a quiet area to decrease external stimuli.

Which nursing behavior will enhance the establishment of a trusting relationship with a client diagnosed with schizophrenia spectrum disorder? a. Establishing personal contact with family members. b. Being reliable, honest, and consistent during interactions. c. Sharing limited personal information. d. Sitting close to the client to establish rapport.

b. Being reliable, honest, and consistent during interactions. The nurse can enhance the establishmt of a trusting relationship w/a client diagnosed w/schizophrenia spectrum disorder by being reliable, honest, and consistent during interactions. The nurse should convey acceptance of the client's needs and maintain a calm attitude when dealing with agitated behavior.

Sharon has a history of of bulimia. Which of the following symptoms would be congruent with her diagnosis? a. Binging, purging, obesity, hyperkalemia. b. Binging, purging, normal weight, hypokalemia. c. Binging, purging, severe weight loss, hyperkalemia. d. Binging, laxative abuse, amenorrhea, severe weight loss.

b. Binging, purging, normal weight, hypokalemia.

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had no alcohol to drink in the last 48 hours. When the nurse reports to the ED physician, which client symptom should be the nurse's first priority? a. Hearing and visual impairment b. Blood pressure of 180/100mm Hg c. Mood rating of 2/10 on a numeric scale d. Dehydration

b. Blood pressure of 180/100mm Hg

When admitting a child diagnosed with conduct disorder, which symptom would the nurse expect to assess? a. Excessive distress about separation from home and family. b. History of cruelty toward people and animals c. Confabulation when confronted with wrongdoing. d. Repeated complaints of physical symptoms such as headaches and stomachaches.

b. History of cruelty toward people and animals

Which of the following represents a nursing intervention at the secondary level of prevention? a. teaching a class about menopause to middle-aged women b. providing support in the emergency room to a rape victim c. leading a support group for women in transition d. making monthly visits to the home of a client with schizophrenia to ensure medication compliance

b. providing support in the emergency room to a rape victim

A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia. Which of the following commonly used behavioral therapies for phobias should the nurse explain to the client? Select all that apply a. benzodiazepine therapy b. systematic desensitisation c. imploding flooding d. assertiveness training e. aversion therapy

b. systematic desensitisation c. imploding flooding

Which of the following characteristics of accurately developed client outcomes should a nurse identify? (Select all that apply.) a. Client outcomes are specifically formulated by nurses. b. Client outcomes are not restricted by time frames. c. Client outcomes are specific and measurable. d. Client outcomes are realistically based on client capability. e. Client outcomes are formally approved by the psychiatrist.

c. Client outcomes are specific and measurable. d. Client outcomes are realistically based on client capability.

Symptoms of alcohol withdrawal include? a. period euphoria, hyperactivity, insomnia, b. Depression, suicidal ideation, and hyperinsomnia c. Diaphoresis, nausea, vomiting & tremors. d. Unsteady gait, nystagmus, and profound disorientation

c. Diaphoresis, nausea, vomiting & tremors.

A client diagnosed with schizophrenia states, can you hear him? It's the devil. He's telling me I'm going to hell. Which is the most appropriate nursing response? a. Did you take your medicine this morning? b. You are not going to hell, you are a good person c. I'm sure the voices sound scary, but the devil is not talking to you. This is part of your illness. d. The devil only talks to people who are receptive to his influence.

c. I'm sure the voices sound scary, but the devil is not talking to you. This is part of your illness.

A nurse discovers a client's suicide note that details the time place and means to commit suicide. What should be the priority nursing intervention and the rationale for this action? A,, Administering the Raza Pam add a van PRN, because the client is angry about the discovery of the note. b. Establishing room restrictions, because the clients threat is an attempt to manipulate the staff. c. Placing this client on one to one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide. d. Calling an emergency treatment team meeting, because the clients threat must be addressed.

c. Placing this client on one to one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide.

A nursing instructor is developing a lesson plan to teach about domestic violence. Which information should be included? a. Emotional injury and learned helplessness are central to the dynamic of domestic violence. b. Poor communication and social isolation are central to the dynamic of domestic violence. c. Power and control are central to the dynamic of domestic violence. d. Erratic relationships and vulnerability are central to the dynamic of domestic violence.

c. Power and control are central to the dynamic of domestic violence.

A client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication should a nurse expect a physician to order to address this type of symptom? a. Haloperidol (Haldol) to address the negative symptom. b. Clonazepam (Klonopin) to address the positive symptom. c. Risperidone (Risperdal) to address the positive symptom. d. Clozapine (Clozaril) to address the negative symptom.

c. Risperidone (Risperdal) to address the positive symptom. The nurse should recognize that appearing to listen to unseen others is an example of experiencing an auditory hallucination which is a positive symptom of the illness and Risperidone is an antipsychotic medication for this purpose.

A client diagnosed with schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse prioritize? a. Respirations of 22 beats/minute b. Weight gain of 8 pounds in 2 months c. Temperature of 106 degrees F d. Excessive salivation

c. Temperature of 106 degrees F high temperature could be an indicator of neuroleptic malignant syndrome (NMS), a serious and potentially fatal side effect of anti-psychotic medication, notify HCP immed.

When a home health nurse administers an outpatient's injection of haloperidol decanoate (Haldol decanoate), which level of care is the nurse providing? a. Primary prevention level of care b. Secondary prevention of care c. Tertiary prevention level of care d. Case management level of care

c. Tertiary prevention level of care

During group therapy, a client diagnosed with chronic alcohol dependence states,"I would not have boozed it up if my wife hadn't been nagging me all the time to get a job. She never did think that I was good enough for her." How should the nurse interpret this statement? a. The client is using denial by avoiding responsibility. b. The client is using displacement by blaming his wife. c. The client is using rationalization to excuse his alcohol dependence. d. The client is using reaction formation by appealing to the group for sympathy.

c. The client is using rationalization to excuse his alcohol dependence. The nurse should recognize the use of rationalization by this patient as a way to justify his drinking.

A client diagnosed with generalized anxiety disorder is placed on clonazepam (Klonopin) and buspirone (Buspar). Which client statement indicates teaching has been effective? a. The client verbalizes that the clonazepam is to be used for long-term therapy in conjunction with buspirone. b. The client verbalizes that buspirone can cause sedation and should be taken at night. c. The client verbalizes that clonazepam is to be used short-term until the buspirone takes full effect. d. The client verbalizes that tolerance could result with the long-term use of buspirone.

c. The client verbalizes that clonazepam is to be used short-term until the buspirone takes full effect.

When planning care for clients diagnosed with personality disorders, what should be the goal of treatment? a. To stabilize the client's pathology with the correct combination of psychotropic medications. b. To change the characteristics of the dysfunctional personality. c. To reduce inflexibility of personality traits that interferes with functioning and relationships. d. To decrease the prevalence of neurotransmitters at receptor sites

c. To reduce inflexibility of personality traits that interferes with functioning and relationships.

A homeless client comes to the emergency department reporting cough, night sweats, weight loss, and blood-tinged sputum. Which disease, which has recently become more prevalent among the homeless community, should a nurse suspect? a. Mononucleosis b. Meningitis c. Tuberculosis d. Encephalopathy

c. Tuberculosis

A nursing instructor is teaching about reminiscence therapy. What student statement indicates that learning has occurred? a. Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives." b. "Reminiscence therapy encourages members to share positive memories of significant life transitions." c. "Reminiscence therapy is a social group where members chat about past events and future plans." d. "Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution."

d. "Reminiscence therapy encourages members to share both positive and negative significant life memories to promote resolution."

A nurse is planning care for a client diagnosed with bipolar disorder: manic episode. In which order should the nurse prioritize the client outcomes? The following are the outcomes: 1. Maintains nutritional status 2. interacts appropriately with peers 3. remains free from injury 4. sleep 6-8 hours at night. a. 2, 1, 3, 4 b. 1, 4, 2, 3 c. 4, 1, 2, 3 d. 3, 1, 4, 2

d. 3, 1, 4, 2

In which situation would the nurse suspect a diagnosis of social anxiety disorder? a. A client abuses marijuana daily and avoids social situations because of fear of humiliation. b. An 8 year-old child isolates from adults because of fear of embarrassment but has good peer relationships in school. c. A client diagnosed with Parkinson's disease avoids social situations because of embarrassment regarding tremors and drooling. d. A college student avoids taking classes that include an oral presentation because of fear of being scrutinized by others.

d. A college student avoids taking classes that include an oral presentation because of fear of being scrutinized by others.

How can the nurse assist a newly admitted schizophrenic client to become comfortable initially, on the psychiatric unit? a. Assign him a unit responsibility. b. Allow him to stay in his room the first few days. c. Put him group therapy and introduce him to others. d. Allow him to move at his own pace.

d. Allow him to move at his own pace. The nurse should recognize that the new environment could promote fear and discomfort to this client, so allowing him to move at their own pace and not to force them into any situation that may be uncomfortable for them, will help in developing a trusting nurse-client relationship.

The autistic child has difficulty with trust. Which of the following nursing actions would be most appropriate? a. Avoid eye contact, as it is extremely uncomfortable for the child, and may even discourage trust. b. Assign a different staff member each day so the child will learn that everyone can be trusted. c. Encourage all staff to hold the child as often as possible, conveying trust through touch. d. Assign the same staff person as often as possible to promote feelings of security and trust.

d. Assign the same staff person as often as possible to promote feelings of security and trust.

A child has been recently diagnosed with mild intellectual developmental disorder (IDD). What information about this diagnosis should the nurse include when teaching the child's mother? a. Children with mild IDD have significant sensory-motor impairment. b. Children with mild IDD need constant supervision. c. Children with mild IDD appear different from their peers. d. Children with mild IDD develop academic skills up to a sixth-grade level.

d. Children with mild IDD develop academic skills up to a sixth-grade level.

Which expected client outcome should a nurse identify as being correctly formulated? a. Client will feel happier by discharge. b. Client will demonstrate two relaxation techniques. c. Client will verbalize triggers to anger by end of session. d. Client will initiate interaction with one peer during free time within 2 days.

d. Client will initiate interaction with one peer during free time within 2 days.

A client tells the nurse, "When I was a waiter, I used to spit in the dinners of the annoying customers." This statement would be associated with which personality trait? a. Paranoid personality trait b. Schizoid personality trait c. Antisocial personality trait d. Passive-aggressive personality trait

d. Passive-aggressive personality trait

A client diagnosed with bipolar disorder has been taking lithium carbonate (Lithobid) for 1 year. The client presents in the emergency department with a temperature of 101 F (38 C), severe diarrhea, blurred vision, and tinnitus. How should the nurse interpret these symptoms? a. Symptoms indicate consumption of foods high in tyramine. b. Symptoms indicate lithium carbonate discontinuation syndrome. c. Symptoms indicate the development of lithium carbonate tolerance. d. Symptoms indicate lithium carbonate toxicity.

d. Symptoms indicate lithium carbonate toxicity.

Which assessment data should a school nurse recognize as a sign of physical neglect? a. The child is very insecure and has poor self-esteem. b. The child has sophisticated knowledge of sexual behaviors. c. The child has multiple bruises on various body parts. d. The child is often absent from school and seems apathetic and tired.

d. The child is often absent from school and seems apathetic and tired.

A kindergarten student is frequently violent towards other children. A school nurse notices bruises and burns on a child's face and arms. What other symptoms should indicate to the nurse that the child may have been physically abused? a. The child is frequently absent from school. b. The child begs or steals food or money. c. The child is delayed in physical and emotional development. d. The child shrinks at the approach of adults.

d. The child shrinks at the approach of adults.

An older, emaciated client is brought to an emergency department by the client's caregiver. The client has bruises and abrasions on shoulders and back in multiple stages of healing. When directly asked about these symptoms, which type of client response should a nurse anticipate? a. The client may have forgotten what caused the injuries. b. The client will ask to be placed in a nursing home. c. The client will honestly reveal the nature of the injuries. d. The client may deny or minimize the injuries.

d. The client may deny or minimize the injuries.

After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss? a. Hyperactivity seen in ADHD causes increased caloric expenditure. b. Increased ability to concentrate allows the client to focus on activities rather than food. c. Side effects of methylphenidate (Ritalin) cause nausea, and, therefore, caloric intake is decreased. d. The pharmacological action of methylphenidate (Ritalin) causes a decrease in appetite.

d. The pharmacological action of methylphenidate (Ritalin) causes a decrease in appetite.

Believes everyone must follow the rules and that the rules can be "bent" for no one—ever.

f Obsessive-compulsive personality disorder

Has a devotion to productivity to the exclusion of personal pleasure.

f Obsessive-compulsive personality disorder

Accepts a job he does not want to do, then does a poor job and delays past the deadline. Is negative and hostile toward others

g Personality disorder trait specified

Suspicious of all others with whom he comes in contact.

g Personality disorder trait specified

Suspect abuse when the parent or caregiver:

offers conflicting, unconvincing, or no explanation for injury; describes child as evil; uses harsh physical discipline; has hx of abuse as a child; has hx of abusing animals or pets

Defense mechanisms - reaction formation

preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behavior