ADN 450 Exam #2 - PrepU

A female client 25 years of age has begun taking lithium for treatment of bipolar disorder. Which statement indicates that the client needs further instruction?

"I will need to stop taking my birth control pills while I take lithium."

The nurse is interviewing a client with a diagnosis of depression and the client states, "Honestly, I know my family would be a lot better off if I wasn't around to be a burden on them. That's just between you and me, though, okay?" What is the nurse's best response?

"I'm obliged to share what we talk about with the other people on your care team."

A client has entered treatment for substance abuse and psychotherapy. The client asks about what to expect from individual psychotherapy sessions if the client "works really hard at it." The nurse can answer the question most effectively with which response?

"Psychotherapy will help you adapt healthy coping mechanisms."

The nurse is preparing a community education session on suicide awareness. Which point should the nurse include in the presentation?

A firearm in the home increases the risk that a person will complete suicide.

The nurse is planning care for a group of female adolescents with either anorexia nervosa or bulimia nervosa. The nurse incorporates what common characteristic of both these conditions into the plan of care?

Abnormal concern with body image

The nurse is told by a client that the client is having suicidal thoughts. Which intervention has lowest priority?

Administering a mental status exam to assess for psychosis

A client is 5 feet 6 inches tall, weighs 105 pounds, exercises 4 hours per day, and does not engage in any binging or purging behaviors. The client believes that he or she is becoming obese and states, "I'm shocked that you think I'm underweight. You don't understand me." The most likely diagnosis for this client is what?

Anorexia nervosa, restricting type

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder?

Bananas

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?

Benzodiazepines

A 17-year-old client with a long-standing diagnosis of bulimia nervosa has been admitted to the emergency department after collapsing in a mall. The care team that admits the client to the hospital should prioritize which assessment?

Cardiac assessment and measurement of electrolyte levels

When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what in a client?

Confusion

A client was admitted to the eating disorder unit with bulimia. When the nurse assesses for a history of complications of this disorder, which are expected?

Dental erosion and chronic edema

Which mental health disorder has the most significant risk factor for suicide?

Depression

An adolescent has been diagnosed with bulimia, and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent?

Develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals.

A psychiatric-mental health nurse working in the community is planning an educational program for fifth- and sixth-grade teachers. Which would the nurse include?

Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders

On admission to the psychiatric unit, a client is dressed in a red leotard and exercise bra, with an assortment of chains and brightly colored scarves on the client's head, waist, wrists, and ankles. The client's first words to the nurse are, "I'll punch you, munch you, crunch you," as the client dances into the room, shadow boxing. The client shakes the nurse's hand and says cheerfully, "We need to become better acquainted. I have the world's greatest intellect, and you are probably an intellectual midget." How can the nurse document the client's mood?

Expansive and grandiose

Following a change in job position, a minister asks a client how the client likes the new job. The client states, "Oh everything is great. I can really see myself going far in this new position." However, the client's voice is monotone and the client's face is nearly absent of affective expression. The minister is worried about this client and describes this facial expression as what?

Flat

A client in the clinic appears to have elevated self-esteem, is more talkative than usual, and is easily distracted. This client is exhibiting symptoms of what?

Grandiosity

An adolescent male tells the nurse that he has been smoking cigarettes for the last 3 years. The nurse recognizes that this adolescent is at the greatest risk of substance abuse based upon what family history finding?

He has been previously diagnosed with depression.

The nurse in an outpatient rehabilitation program is speaking with a group of clients who have recently recovered from alcohol abuse. Which issue should the nurse raise before the clients leave for the day?

Help them to identify appropriate diversional activities.

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what?

Helping the client identify positive coping mechanisms

Which area of the brain has been associated with the symptoms of eating disorders?

Hypothalamus

A nurse is reviewing a bipolar client's serum lithium level, which is 1.8 mEq/L. What is the nurse's best action?

Inform the prescriber and monitor for GI and CNS effects

The nurse is caring for a child who has been hospitalized repeatedly at multiple hospitals. There is no clear medical diagnosis and the mother is threatening to leave the hospital against medical advice. The nurse suspects what issue?

Medical child abuse

The nurse is planning a presentation about suicide to a group of health professionals. Which should be included in the nurse's teaching plan?

Men are more likely to commit suicide than women are.

A client in an acute manic phase is pacing the halls and talking in a loud voice with pressured speech. The client is overly involved with coclients and frequently threatens and disrupts others on the unit. After administering lithium treatment for the client, the nurse can expect the plan of care to include which additional intervention?

Monitoring blood levels of the medication

A 20-year-old client arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. There are "tracks" visible on the client's arms. The friend who came with the client reports that the client had just "shot up" heroin when the client became unconscious. Which medication would the nurse most likely expect to administer?

Naloxone

Heroin is classified as which type of street drug?

Opioid

A client has been prescribed naltrexone for treatment of alcohol dependence. The nurse has explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which about the drug?

Reduces the appeal of alcohol

After assessing a client, the nurse identifies that the client is at risk for suicide. Which would be the nurse's priority intervention?

Remove means of suicide from the client's access.

After observing a bipolar client on the mental health unit, the nurse determines that the client is at risk for violence. Which would be an appropriate intervention?

Restrict the client to the client's room until the client can calm down.

Which would be the priority diagnosis for the client in the manic phase of bipolar disorder who is exhibiting aggressive behavior?

Risk for other-directed violence

The nurse is obtaining the history of an adolescent female who is suspected of having anorexia nervosa. What findings would the nurse expect? Select all that apply.

Secondary amenorrhea Desire for perfectionism Syncope

A client has been diagnosed with bulimia. Which cognitive behavioral technique would be useful for the client?

Self-monitoring

The nurse is caring for a postoperative client with a history of opioid abuse who has been ordered to receive a dose of an opioid antagonist medication. Which issues should the nurse be prepared to address?

The client may begin to demonstrate symptoms of withdrawal.

A mental health nurse has formed a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. An appropriate outcome for this nursing diagnosis would include what?

The client will demonstrate improved ability to express self.

Which is a true statement regarding depressive disorders?

The neurotransmitters norepinephrine, dopamine, and serotonin have been implicated.

Which medication is used to prevent Wernicke-Korsakoff syndrome?

Thiamine(vitaminb1)

The client is taking a monoamine oxidase inhibitor (MAOI) for depression. The nurse educates the client to avoid foods containing what while taking this medication?

Tyramine

The nurse is assessing a client who is a polysubstance abuser, with cocaine being one of the drugs most frequently used. Which physiological symptom is suggestive of early (phase 1) cocaine intoxication? Select all that apply.

tremors psychomotor agitation cardiac arrhythmias dilated pupils