Wk 7 Anxiety and Mood Disorders
A patient who is taking prescribed lithium carbonate is exhibiting signs of diarrhea, blurred vision, frequent urination, and an unsteady gait. Which serum lithium level would the nurse expect for this patient?
1.5 or higher mEq/L ✓
Following a fatal automobile accident, the client reports insomnia and terrifying nightmares. The symptoms persist for months. Diagnostic testing reveals no physical basis for these recurrent symptoms. These symptoms suggest the client is experiencing which of the following?
Post-traumatic stress disorder ✓
The nurse is caring for a client with a disturbance in thought process who is disoriented and aggressive. Which of the following nursing actions may produce further agitation?
Presenting the reality of the situation ✓
While caring for an elderly client, the nurse notices the client is exhibiting increased episodes of forgetfulness, restlessness, and increased anxiety. Which assessment data is most significant for this client?
Recent loss of spouse ✓
A client with bipolar disorder is having a disturbed thought process. Which of the following nursing interventions can help the client to be oriented and accurately perceive circumstances surrounding admission?
Reduce distracting stimuli. ✓
The nurse is assisting an older adult patient, diagnosed with type 2 diabetes, with self-injection of insulin. What is the most appropriate intervention for this patient at discharge?
Request an insulin pen prescription ✓
An 8-year-old child is newly diagnosed with asthma. Which nursing intervention best promotes self-efficacy for the parents to help the child follow the prescribed treatments?
Requesting a spacer for the metered dose inhaler ✓
To control the symptoms associated with anxiety, the client is ordered a beta- adrenergic blocker. Which is the most important teaching point for the nurse to include about the use of these agents?
Rise slowly from lying or sitting position. ✓
Which of the following nursing diagnosis is of highest priority when caring for a client who is depressed and considers suicide?
Risk for Suicide ✓
The nurse is caring for a client who states he is not feeling very well. When asking the client for specific symptoms, the client is vague with details but does state feeling better when the sun is shining. With this information, the nurse would document which disorder as a possibility?
Seasonal affective disorder ✓
Which finding is likely to cause anxiety in a client who has obsessive-compulsive disorder?
Skewed wall hanging ✓
A patient with a diagnosis of depression and suicidal ideation was started on an antidepressant 1 month ago. When the patient comes to the community health clinic for a follow-up appointment he is cheerful and talkative. What priority assessment must the nurse consider for this patient?
Specific assessment for suicide plan must be evaluated. ✓
The client who is waiting to be transported to the operating room tells the nurse of a fear of waking up during the operation. The client is visibly upset with sweaty palms, wringing of the hands, and increased heart rate. Which is the best action to be taken by the nurse?
Stay with the client until anesthesiologist evaluates situation. ✓
When caring for a geriatric client diagnosed with bipolar disorder, which manifestation of the disease is anticipated?
The depression increases as the client ages. ✓
Which of the following is a true statement regarding a panic disorder?
The first instinct is to escape to a safer place. ✓
The nurse has been working with a client who has difficulty controlling mood. The client continues to experience anger outbursts, which make it difficult to maintain employment. When explaining this dysfunction to the client's family members, which area of the brain does the nurse identify as being the site for mood generation?
The limbic system ✓
A client, who caused a house fire by leaving a pot on the stove, often returns home to recheck the burners. The nurse understands this action is performed for which main purpose?
To alleviate anxiety ✓
A client, who is a nursing student, reports increased anxiety with test taking. Which behavioral technique is most appropriate for this client to put into practice?
Use breathing techniques to reduce anxiety. ✓
Which nursing consideration is most important when administering medications to a suicidal client?
View the inside of the mouth to make sure that all medications are swallowed. ✓
The nurse planning care for a patient realizes that which acute medical event requires self-management?
femur fracture ✓
Anticonvulsants enhance which neurotransmitter in clients diagnosed with bipolar disorder?
gamma-aminobutyric acid ✓
The nurse is providing instruction to a community class regarding seasonal affective disorder (SAD). Which gland and hormone would the nurse stress is responsible?
Pineal gland and melatonin ✓
The nurse is caring for a client who has selected transcranial magnetic stimulation to treat depression. For which side effect would the nurse provide preprocedural instructions?
headache ✓
What clinical manifestation should the nurse periodically monitor for while a client is being administered valproic acid?
hepatoxicity ✓
The nurse is developing a plan of care for a newly diagnosed hypertensive patient who is being discharged on medications and given the Dietary Approaches to Stop Hypertension (DASH) diet to follow. What statement by the patient signals to the nurse that the patient is motivated to learn?
"I can't wait to try the new recipes, and I'm hopeful I will lose weight." ✓
Which of the following is an example of subacute symptoms that may be observed in the older adult who may be depressed?
lack of energy ✓
A patient who has been diagnosed with depression is scheduled for cognitive therapy in addition to receiving prescribed antidepressant medication. The nurse understands that the goal of cognitive therapy will be met when what is reported by the patient?
"I will tell myself that I am a good person when things don't go well at work." ✓
One week ago, the client was prescribed Buspirone for anxiety. The client calls the office and reports the medication has not eliminated the symptoms. Which is the best response by the nurse?
"It may take up to 4 weeks for full therapeutic response." ✓
The client is brought to the emergency department with complaint of chest pain, rapid breathing, and palpitations. Cardiovascular event is ruled out, and the client is diagnosed with acute panic attack. The client seems embarrassed and states, "I thought I was going to die." Which is the best response from the nurse?
"It must have been frightening for you." ✓
A patient newly diagnosed with depression states, "I have had other people in my family say that they have depression. Is this an inherited problem?" What is the nurse's best response?
"Members of the same family may have the same biological predisposition to experiencing mood disorders." ✓
Which of the following nursing instructions is most helpful to a client experiencing mild seasonal affective disorder symptoms?
Open window curtains or shades during the day. ✓
Which is the most important teaching point the nurse can stress to a client who experiences panic attacks?
Panic attacks are time limited and will subside. ✓
Clients with obsessive-compulsive disorder (OCD) may be concerned about which of the following signs and symptoms?
Performing ritualistic behaviors ✓
The client reports an embarrassing event in which the client jumped on the hood of the car to avoid a dog running on the walkway. The client discloses suffering from a severe dog bite in younger days. The nurse differentiates this symptom as which of the following?
Phobic disorder ✓
A nurse stops at the scene of an accident and attempts to assist a client who is lying in an overturned vehicle. When the nurse crawls into the vehicle, the client starts screaming "in coming, in coming" and is violently thrashing and attempting to kick the nurse. Which is the best interpretation by the nurse?
The accident has triggered a flashback. ✓
A client who is being interviewed by the nurse begins pacing and wringing hands, and repeating, "I just need to keep moving." Which statement by the nurse is most appropriate and therapeutic for this client?
"Are you feeling anxious?" ✓
The nurse is admitting a client to a mental health clinic following a recent suicide attempt and hospitalization. In assessing the client's status, which question is best?
"Do you have a suicide plan or feel like ending your life?" ✓
The nurse is providing education via phone to a client who called stating that the newly prescribed imipramine is not working as depression is still a problem. Which question is most important to ask first?
"How long have you been taking the medication?" ✓
56. A patient has been prescribed a selective serotonin reuptake inhibitor (SSRI) antidepressant. After taking the new medication, the patient states, "This medication isn't working. I don't feel any different." What is the best response by the nurse?
"It usually takes a few weeks for you to notice improvement from this medication." ✓
The nurse is employed in a pediatric mental health clinic. Which statement, made by the client, is an indication of a clinical effect of selective serotonin reuptake inhibitors (SSRI)?
"No one cares about me. I just want to die." ✓
The client with anxiety disorder is prescribed an antianxiety medication. Which response by the client indicates a need for more teaching regarding the use of this group of medications?
"The cause of my stress is gone." ✓
The nurse is assessing a patient's readiness to be discharged and ability to manage care at home. What is the most appropriate question for the nurse to ask to determine the patient's learning needs before planning teaching activities?
"What do you need to know before you go home from the hospital?" ✓
When developing a plan of care to promote self-management, which patient is least likely to be affected by depression?
42 year old with private insurance ✓
A client is scheduled for magnetic resonance imaging (MRI) of the head and neck. Which action by the nurse would be most helpful in calming the anxious client?
Allow the client to express fears and concerns. ✓
The nurse is caring for a client diagnosed with seasonal affective disorder (SAD). When caring for the client, at which time of the year does the nurse limit nursing interventions due to an uplifting of mood?
April/May ✓
As a nurse in the emergency department, you are caring for a patient who is exhibiting signs of depression. What is a priority nursing intervention you should perform for this patient?
Assess for depression and ask directly about suicide thoughts. ✓
Building trust is especially critical to developing a therapeutic relationship with an anxious client. Which of the following interventions contributes to this trust?
Be available and attentive to the client's requirements. ✓
Which is the primary pathophysiologic effect that is intended from the use of a central- acting sympatholytic in the client who exhibits hypertension and anxiety?
Block receptors for norepinephrine in the brain ✓
The nurse is developing a teaching plan for a patient diagnosed with congestive heart failure. Which are the most appropriate teaching points to include that will assist in self-management of the disease? (Select all the apply.)
Blood pressure monitoring ✓ Daily weights ✓ Activity restrictions ✓ Side effects of medications ✓
A nurse is caring for a newly admitted client to the emergency department. The nurse obtains the following vital signs: temperature, 101.6 °F; pulse rate, 92 beats/minute; respiratory rate, 28 breaths/minute; and blood pressure, 160/100 mm Hg. The client appears disheveled and disoriented. Upon physical assessment, the nurse notes restlessness and muscle spasms with rigidity. Which documented finding in the health history is evaluated as a potential causative factor?
Changing from one psychotherapeutic to another ✓
Upon admission to an acute care facility, which of the following symptoms would be most significant in the nursing management of a client with the history of anxiety reaction?
Chest tightness, rapid pulse ✓
The nurse is evaluating an elderly client who is constantly fretful and worries about finances, living alone, and being lonely. The nurse understands these are symptoms of which fear?
Fear of the unknown ✓
Avoiding places or situations in which panic attacks occur is how the agoraphobic manages fears. Which is a common symptom of agoraphobia?
Feeling safer at home ✓
Which of the following is a manifestation of panic anxiety?
Fragmented thoughts ✓
The nurse is assessing a client's affect while discussing common issues such as the weather and family. The client appears sad with a slow speech pattern. The nurse considers that this may be a sign of depression but understands that the physician will want to rule out which medical condition first?
Hypothyroidism ✓
A nurse is developing a plan of care for a patient admitted with a diagnosis of bipolar disorder, manic phase. Which nursing diagnoses address priority needs for the patient? (Select all that apply.)
Imbalanced nutrition, less than body requirements ✓ Risk for injury ✓ Sleep deprivation ✓
Following the death of a spouse, a client is prescribed a short-term use of lorazepam . Which is the best rationale to support taking this medication at bedtime?
Induces drowsiness and sleep ✓
Which of the following nursing interventions should a nurse perform when caring for a female client with mood disorder who is prescribed lithium?
Instruct to avoid breastfeeding. ✓
Which type of therapy is facilitated by a bond that developed between the therapist and the client?
Interpersonal psychotherapy ✓
A client with major depression is having a disturbed sleep pattern. Which of the following nursing interventions will help the client to get maximum sleep during the night?
Keep the client busy during the day. ✓
The nurse is completing a plan of care for a client on lithium therapy to manage bipolar symptoms. Which nursing interventions will be included? Select all that apply.
Monitor intake and output. ✓ Increase fluid intake to 3000 mL/day. ✓ Monitor for symptoms of nausea, vomiting, muscle weakness, and lack of coordination. ✓ Monitor kidney and liver functioning. ✓
Which provides the best data to support the diagnosis of anxiety disorder in clients of any age? Select all that apply.
Client history ✓ Presenting symptoms ✓
The nurse is caring for a client on long-standing lithium therapy for a bipolar disorder. Which component of drug therapy administration would require follow-up?
Client states, "I only take lithium after breastfeeding." ✓
Which type of therapy assists the clients to alter their irrational thinking?
Cognitive Therapy ✓
When providing a clinical reference guide to a client on monoamine oxidase inhibitor (MAOI) drug therapy, which over-the-counter medications should be highlighted to avoid?
Cold and allergy medications ✓
An older adult has experienced severe depression for many years and is unable to tolerate most antidepressant medications due to adverse effects of the medications. He is scheduled for electroconvulsive therapy (ECT) as a treatment for his depression. What teaching should the nurse give the patient regarding this treatment?
Common side effects include headache and short-term memory loss. ✓
A patient has been resistant to treatment with antidepressant therapy. The care provider prescribes a monoamine oxidase inhibitor (MAOI) medication. What teaching is critical for the nurse to give the patient?
Eating foods such as blue cheese or red wine will cause side effects. ✓
The Beer's list is helpful in providing the nurse with a quick reference on potential risks and benefits for which likely group of clients?
Elderly ✓
The nurse is instructing a client in treatment options often provided to resolve clinical depression. Which option does the nurse instruct as producing a brief, generalized seizure?
Electroconvulsive therapy ✓
A client who reports moderate to severe anxiety requires intervention. Which of the following teaching points would be helpful in assisting this client in the management of anxiety? Select all that apply.
Visualizing a relaxing place ✓ Listen to music ✓
The nurse is completing a medication history for a client diagnosed with bipolar disorder. When assessing the medications, which medication classification is noted as an adjunct to lithium therapy?
anticonvulsant ✓
What is another name for the drug classification known as minor tranquilizers?
anxiolytics ✓
A client, who has an intense fear of flying, has elected to participate in a therapy that culminates in a short air flight. This is an example of which type of therapy?
behavioral therapy ✓
Which of the following is a side effect of beta-adrenergic blockers?
bradycardia ✓
Which of the following mood disorders has alternating sad and elated mood, resembling bipolar disorder, but less extreme mood shifts?
cyclothymia ✓
A nurse is counseling a client diagnosed with depression. When asked questions, the client responds with words of self-blame and self-pity. When the nurse uses the monoamine hypothesis, which chemical is thought to be elevated?
dopamine ✓
Which of the following observations is helpful in determining a client's mood? Select all that apply.
energy level ✓ cient appearance ✓ speech ✓ body language ✓
Administering a monoamine oxidase inhibitor (MAOI) with food containing tyramine may develop a potentially fatal condition known as which of the following?
hypertensive crisis ✓
Which level of anxiety is constructive and prepares a person to take action in appropriate situations?
mild ✓
A client with major depression has been placed on phenelzine . The nurse is instructing on dietary practices. Which food selection would be omitted from the diet?
pepperoni pizza ✓
A client is diagnosed with post-traumatic stress disorder (PTSD). The client is exhibiting withdrawal and ignoring problems and issues. This is recognized as which of the following?
psychic numbing ✓
During the assessment of a client with mood disorder, the nurse observes that the client experiences hallucinations and delusions. Which of the following forms of depressive disorders does the client experience?
psychotic depression ✓
The nurse is caring for a middle-aged client who is prescribed a selective serotonin reuptake inhibitor (SSRI). Which side effect of medication therapy leads to the most common cause of noncompliance?
sexual dysfunction ✓
