Behavioral Health Nursing - D2L - Quizzes - Test#2
(A)
A confused patient is being admitted to the hospital and the nurse is attempting to gather his health history. The patient denies the presence of any diseases, but he admits to discontinuing donepezil. The nurse understands that this medication is used to treat (A) Alzheimer's disease (B) Bipolar disorder (C) Parkinson's disease (D) Schizophrenia
(B)
A patient's spouse died three months prior. The patient says, "I would like my friend Tom to have my art collection because I don't need to look at them anymore." Which of the following responses by the nurse would be appropriate? Select all that apply. (A) Did Tom ask for the artwork? (B) Are you planning to commit suicide? (C) Does Tom know that you want to give him the artwork? (D) Why do you want to give the artwork away?
(A)
A schizophrenic patient has been admitted due to paranoia and disturbed thought processes. The nurse should instruct the staff to take what actions? (A) Avoid laughing near the patient's room (B) Encourage socialization and communication with the patient (C) Have them begin patient education about how they can help (D) Treat the patient normally
(D)
A 45-year-old woman is referred to the clinic due to bizarre social interactions and inappropriate anger. When the patient called to schedule her appointment with the nurse, she sounded very energetic and jumped from topic to topic. Upon assessment, which of the follwing signs and symptoms suggest mania? (A) Exaggerated self-esteem and increased sleep (B) Interpersonal conflict and irritability in spring and summer (C) Persistent sad or depressive mood, loss interest in things that were once pleasurable, and sleep disturbances (D) Pressured speech, flight of ideas, and intense level of energy
(B)
A client diagnosed with bulimia admits to vomiting every time she eats too much. The defense mechanism used by the client is (A) Projection (B) Undoing (C) Conversion (D) Rationalization
(B)
A client is admitted to the inpatient unit with the diagnosis of anorexia? What is a priority initial goal? (A) The client will make a contract with the nurse that sets a target weight. (B) The client will establish adequate daily nutritional intake (C) The client will identify self-perceptions about body size as unrealistic. (D) The client will verbalize three possible physiologic consequences to self starvation.
(B)
A client is being discharged after 3 days of hospitalization for a suicide attempt that followed receiving notice that his wife wanted a divorce. Which of the following patient statements indicates to the nurse that the client is ready to discharge home? (A) "I feel ready to go home now." (B) "I have lots of people to help me and a support group for grieving and divorced people." (C) "Things will be better very soon." (D) "I have the name and phone number of a few divorce lawyers."
(D)
A client seeks crisis intervention. She tells the nurse, "I can't take it anymore! It has to stop. Last year my husband had an affair, and we do not communicate anymore. Three months ago, I found a lump in my breast. Yesterday, my son decided to drop out of college." The priority assessment for the nurse is (A) How the client feels about the possibility of having a mastectomy. (B) Whether the husband is still engaged in the affair. (C) What strategies can be implemented to help the couple to better communicate. (D) What the client has in mind when she says she cannot "take it anymore"
(D)
A client with anorexia nervosa is being seen in the outpatient eating disorders clinic. Two weeks ago, she had started refeeding. Her weight indicates that she has gained 9 pounds. What is the nurse's priority response? (A) Suggest use of an exercise program (B) Praise the client for weight gain (C) Establish a higher target for weight gain for the next week (D) Assess lung sounds and extremities
(B)
A nurse finds a patient slumped on the floor with a razor blade in hand and blood pouring from the wrist. What is most important for the nurse to do? (A) Telephone the doctor to explain the situation. (B) Call another nurse for help. Stay with the patient. (C) Ask nurse assistant to hold his wrist while the nurse calls the doctor. (D) Find out why the patient tried to commit suicide
(A)
A patient admitted to the psychiatric unit is prescribed aripiprazole. The nurse understands that this medication is a(n) (A) Atypical antipsychotic (B) Selective serotonin reuptake inhibitor (C) Serotonin-Norepinephrine reuptake inhibitor (D) Typical antipsychotic
(C) Yes, rationalization is making excuses. It is a very common defense mechanism in substance abuse (along with denial, minimization and blaming)
A patient arrives intoxicated to an outpatient therapy appointment and tells the nurse, "It's not my fault. I am an alcoholic and cannot control my drinking." The nurse best identifies this as being the defense mechanism of: (A) Compensation (B) Projection (C) Rationalization (D) Conversion
(A)
A patient diagnosed with depression is interested in smoking cessation. The physician would most likely prescribe what antidepressant that also aids in smoking cessation? (A) Bupropion (B) Mirtazepine (C) Nefazadone (D) Trazadone
(B) Direct observation requires staff to keep visual contact of the patient at all times and to remain within arms reach of the patient. Assigned staff have no other responsibilities while on 1:1 except for observation of the patient. Observation continues during sleep as well as the patient's hygiene and toileting activities.
A patient has been admitted to the unit due to an intentional overdose of narcotics. The patient is put on suicide precautions (1:1) and a nursing assistant is assigned to monitor him. Which of the following is correct? (A) The nurse should verify this with the physician (B) This is an appropriate delegation of a task (C) This is illegal, an RN must provide 1:1 monitoring of a suicidal patient (D) This is poor nursing practice since the nurse is responsible for patient care
(B), (E)
A patient has been prescribed phenelzine for the treatment of depression. The nurse should instruct the patient about which common side effects of monoamaine oxidase inhibitors (MAOIs)? Select all that apply. (A) Arrhythmias (B) Dizziness (C) Excessive salivation and tears (D) Incontinence (E) Orthostatic hypotension
(C) Opiod receptor competitive antagonist used for opiod overdose
A patient is admitted to the hospital for an overdose of oxycodone. The nurse should expect the physician to order the administration of (A) Flumazenil (B) Methadone (C) Naloxone (D) Naltrexone
(B) GABA antagonist used for benzo overdose. Inhibits benzo activity on GABA receptors
A patient is admitted to the hospital for overdose of lorazepam. The nurse should expect the physician to order the administration of: (A) Methadone (B) Flumazenil (C) Naloxone (D) Naltrexone
(D)
A patient is admitted to the psychiatric unit after a failed suicide attempt. The nurse plans to write a suicide prevention contract. To promote compliance and build a trusting relationship with the patient, the contract should... Select all that apply. (A) Be written by the patient (B) Be written by the physician (C) Be written by the social worker (D) Be written jointly by the nurse and patient
(C)
A patient is admitted to the psychiatric unit for psychosis. When asked how she got to the hospital, the patient responds, "I took my car because people like brown hair, but then how did I get to Sesame Street? Angry birds!" This response is a(n) (A) Distractible speech (B) Grandiose delusion (C) Loose association (D) Somatic delusion
(C), (D), (F) Escitalopram is a SSRI with common side effects including sexual dysfunction, nausea, diarrhea, headache, dizziness, dry mouth, and weight gain, drowiness and insomnia
A patient is admitted to the psychiatric unit for suicidal ideation. The physician prescribes escitalopram and asks the nurse to review the side effects with the patient. The nurse should include which common side effect in the patient's education? Select all that apply. (A) Confusion (B) Constipation (C) Insomnia (D) Sexual dysfunction (E) Weight loss (F) Weight gain
(B) continued use of a substance shows a lack of commitment. The nurse should recognize a lack of commitment in a patient with substance abuse problems
A patient is being seen in the clinic for a substance abuse follow-up. While evaluating the patient's progress, the nurse should recognize that which of the following is the best indicator of a lack of commitment? (A) Appointment no-shows (B) Continued drug use (C) Crisis recurrence (D) Rationalization
((B), (E) Lethargy, fatigue, hypotension and anticholinergic effects such as dry mouth and eyes, constipation, blurred vision, and urinary retention are common
A patient is prescribed amitriptyline for the treatment of depression. The nurse educates the patient about what common side effects? Select all that apply (A) Diarrhea (B) Dry mouth and eyes (C) Excessive Tears (D) HTN (E) Lethargy
(D) Seizures
A patient is prescribed imipramine for the treatment of depression. The nurse should educate the patient about which dangerous side effect? (A) Congestive Heart Failure (B) Guillian-Barre Syndrome (C) Hyperglycemia (D) Seizures
(A) a benzo with a medium to long half-life. Used for alchohol withdrawal due to it hypnotic and sedative effects. Ativan is also commonly used.
A patient on a medical-surgical floor is experiencing delirium tremens. Which of the following medications can the nurse expect to be ordered for the management of this acute episode? (A) Chlordiazepoxide (B) Flumazenil (C) Naloxone (D) Ziprasidone
(A) Cogentin is an anticholinergic used to treat extrapyramidal symptoms (EPS) in patients with Parkinson's disease or patient taking antipsychotics
A patient receiving ziprasidone for schizophrenia has Parkinson-like symptoms. To decrease the Parkinson-like side effects, the nurse should advocate for which of the following medications? (A) Benztropine (B) Bethanechol (C) Levodopa (D) Ropinirole
(A)
A patient states, "Nothing matters anymore." What is the nurse's priority response? (A) "Are you having thoughts about suicide?" (B) "I am not sure I understand what you are saying." (C) "Try to stay hopeful. Things will work out." (D) "What used to matter, before the depression?"
(A), (D), (E)
A patient taking fluoxetine is admitted to the hospital due to serotonin syndrome. Which of the following are symptoms of serotonin syndrome? Select all that apply. (A) Agitation (B) Constipation (C) Hypotension (D) Myoclonic jerking (E) Tachycardia
(D)
A patient who is diagnosed with depression is taking a monoamine oxidase inhibitor (MAOI). What medication should be immediately available for administration when the nurse is assessing the patient for a hypertensive crisis? (A) Atenolol (B) Digoxin (C) Furosemide (D)Phentolamine
(C) sandwich, banana, and milk *Foods patients can eat on the go
A patient with bipolar disorder is in a manic state. The nurse should select which of the following foods for this patient's lunch? (A) Eggs, bacon, and coffee (B) Fruit salad and broth (C) Sandwich, banana, and milk (D) Spaghetti and milk
(A) Avolition refers to a negative symptom of schizophrenia. It is the impairment of motivation or the ability to initiate goal-directed activity
A patient with schizophrenia is unable to get out of bed and get dressed ujless the nurse prompts every step. This is an example of which behavior? (A) Avolition (B) Perseveration (C) Tangentiality (D) Word salad
(D)
An elderly man is brought to the emergency room after being found wandering around at night. The patient is disoriented and does not know where or who he is. After the patient's identity is confirmed, his wife is called into the hospital. the wife expresses concern over the patient's progressing dementia and states she is worried about caring for her husband. Which of the following responses is best? (A) "Can your children take care of your husband?" (B) "I can recommend a great nursing home." (C) "The social worker can direct you to support groups" (D) "What part of taking care of your husband is most concerning?"
(B)
Family members of a patient with bipolar disorder tell the nurse that they are concerned that the patient is becoming manic. The nurse knows that the manic phase is marked by (A) Decreased self-esteem and increased physical restlessness (B) Flight of ideas and inflated self-esteem (C) Increased sleep (D) Obsession with rules and maintaining order
(C)
The nurse care for a post-operative patient. The nurse notices admission notes where the patient states, "Most day I drink about one pint of vodka." The nurse understands that the most likely time for the patient to develop alcohol withdrawal is (A) 6-12 hours after cessation of drinking (B) 12-18 hours after cessation of drinking (C) 24-48 hours after cessation of drinking (D) 72 hours after cessation of drinking
(A)
The nurse cares for a patient with Korsakoff's psychosis. The nurse should assess for which of the following? (A) Memory loss (B)Nystagmus (C) Seizures (D) Ataxia
(D) frequent vomiting causes hypertrophy of the parotid glands and puffy cheeks. Edema is often noted
The nurse is assessing a 15-year-old girl who has been admitted for bulimia nervosa. Which clinical manifestation is the nurse most likely to find? (A) Coarse hair growth (B) Hypertension (C) Metabolic acidosis (D) Parotid gland tenderness
(D)
The nurse is assessing a patient in the manic phase of bipolar disorder. While assessing the patient, the nurse can expect to observe (A) Distractibility and dysthymia (B) Dysphoria and racing thoughts (C) Dysphoria and rapid cycling (D) Grandiosity, pressured speech and racing thoughts
(C) All of these statements should cause at least mild suspicion from the nurse. However, the most concerning is that she exercises
The nurse is caring for a 16-year-old girl recently hospitalized. She is slender but does not appear abnormal. Which of the following statements is the most concerning? (A) I am 12% below my ideal body weight (B) I check my weight 2 times per day (C) I exercise 3.5 hours a day (D) My best friend has been treated for anorexia
(A)
The nurse is caring for a patient with Alzheimer's disease who is taking donepezil. The nurse should assess the patient for which of the following side effects associated with donepezil? (A) Bradycardia (B) Constipation (C) Dry mouth (D) Tachycardia
(C), (D) The nurse should deal with socially inappropriate behavior nonjudgmentally and matter of factly. This means making facual statements with no overtones of scolding in order to redirect the patient to appropriate activities and behavior.
The nurse is talking with a patient diagnosed with schizophrenia. Which of the following nursing approaches can help the schizophrenic patient improve self-concept? Select all that apply. (A) Allow her to express her feelings in drawing (B) Allow her to participate in competitive games (C) Involve her in simple tasks that she can complete (D) Redirecting to appropriate activities
(A), (D), (E), (F)
The nurse is with a patient in the psychiatric unit watching for signs of alcohol withdrawal. Which of the following are early signs of withdrawal? Select all that apply. (A) Anxiety (B) Hypersomnia (C) Hypotension (D) Irritability (E) Tachycardia (F) Tremors
(B) Yes, amenorrhea is the hallmark of anorexia (along with the other symptoms)
The patient presents with the following signs and symptoms: Constipation, K+ 3.1, Ht: 65 inches, weight 110 pounds, weakness, amenorrhea, and feelings of always being cold. Which disorder is this patient likely to be diagnosed with? (A) Bulimia (B) Anorexia (C) Failure to thrive (D) Binge-eating disorder
(C)
When a patient is admitted to the psychiatric unit, he proclaims, "I am the Duke of York! How dare you touch me!" This is an example of (A) Delusion of reference (B) Delusional parasitosis (C) Grandiose delusion (D) Persecutory delusion
(A), (C), (D), (E)
When assessing the patient with suspected bulimia, the nurse expects to find what? Select all that apply. (A) Swelling in feet (B) Amenorrhea (C) Dental caries (D) Normal body weight (E) Callused fingers
(C) Finding out what triggers the binging gives care providers direction of how to prevent the binging
When providing teaching for a patient with bulimia, what is the priority nursing statement? (A) "Do you eat because you're lonely?" (B) "The amount that you eat needs to be balanced with the amount of energy you produce in order to not gain weight." (C) "What do you think triggers you to binge eat?" (D) "You need to work on eating food from all of the food groups."
(C) Tricyclic antidepressants can be fatal due to their narrow therapeutic index (ie...the therapeutic dose is close to the toxic dose)
Which of the following classes of drugs is the most fatal if a patient overdoses? (A) Antihistamines (B) Benzodiazepines (C) Tricyclic antidepressants (D) Typical antipsychotics
(B), (C), (E)
Which of the following should be included in the discharge plan of a recovering cocaine addict? Select all that apply. (A) Confront your friends from your former lifestyle (B) Discuss exercise and nutrition (C) Discuss relapse prevention (D) Encourage chewing tobacco as an alternative to other drugs (E) Encourage participation in a support group
(A), (B), (E)
Which patient statement is an example of correct use of cognitive behavioral modifications used for a patient with an eating disorder? Select all that apply. (A) "I don't need to be perfect." (B) "If I gain 1 pound per week, then I can exercise three times per week for 30 minutes each time." (C) "People only like me when I am thin." (D) "If I screw up and vomit even once, I'm going to give up." (E) "When I feel anxious or nervous, I will journal my feelings instead of turning to food for comfort."
(C)
Which patient statement reflects correct understanding of the plan for inpatient management of the eating disorder? (A) "If I gain 5 pounds this week, then I can go home." (B) "If I gain 2 pounds this week, then I get to exercise as much as I want." (C) "You need to watch me while I eat and after I am done eating." (D) "I filled out today's menu so that I can get a balanced diet: 1 orange for breakfast, 4 carrots for lunch, 3 crackers and peanut butter for supper."
(A), (B), (C), (E)
Which variable(s) influence suicide? Select all that apply. (A) Use of alcohol (B) Being single or widowed (C) Presence of a chronic physical illness (D) Ability to openly communicate needs to others (E) Presence of mental illness
(D)
While receiving disulfiram (Antabuse) therapy, the client becomes nauseated and vomits severely. Which of the following questions should the nurse ask first? (A) "Do you feel like you have the flu?" (B) "How long have you been taking Antabuse?" (C) "Have you ever felt like this before?" (D) "How much alcohol did you drink today?"
