EXAM 1

DMDD diagnostic criteria

-6-18yr -temper tantrums -out of proportion -must last > 12 months -irritability in between outbursts

post partum depression

->2 weeks -rejecting infant -food cravings -weight gain

what is adaptive

-adaptive defense mechanisms help lower anxiety to achieve goals in acceptable ways

beta blockers to relieve anxiety symptoms

-atenolol -propanolol -metoprolol

teaching for antidepressants

-trial for treatment is 3 months -takes 3 weeks (4-6) to take effect

A client diagnosed with depression is scheduled to receive three sessions of electroconvulsive therapy. The nurse should tell the client that he or she will likely start to see improvement in approximately what time frame?

1 week after the third treatment session

The nurse working on an inpatient hospice unit has received the change-of-shift report. Which patient does the nurse assess first?

26-year-old with metastatic breast cancer who is experiencing pain rated at 10 (0-to-10 scale) and anxiety management of discomfort is the priority in hospice

normal dosage for citalopram

<40 mg a day

situational crisis

A situational crisis arises from external rather than internal sources external situations include: -loss or change of a job -the death of a loved one -abortion -change in financial status -divorce -addition of new family members -pregnancy -severe illness.

Neuroleptic Malignant Syndrome

Adverse reaction to antipsychotics with severe "lead pipe" rigidty, FEVER, and mental status changes occurs from a combination of drugs

Which behavior would the nurse anticipate a client diagnosed with nyctophobia to demonstrate?

Always turns on the overhead light before entering a darkened room

Which is the primary goal of crisis intervention therapy?

Assist the client in returning to the level of precrisis functioning.

The nurse should include which information in the medication teaching plan for a client diagnosed with schizophrenia?

Coffee, tea, and soda consumption should be limited.

The nurse is reviewing the medical record of a hospitalized client who received electroconvulsive therapy (ECT) 3 years ago. Which assessment data would support that the therapy resulted in retrograde amnesia in the client?

During the admission interview, the client can't remember why the ECT treatment was originally prescribed.

Which goal addresses the therapeutic management needs of a client experiencing hallucinations?

Facilitate the client's awareness that the hallucination is not the reality of the world.

Phenelzine side effects

MAOI -drowsiness -weakness -decreased libido -weight gain

The nurse should question a prescription for which medication in the client concurrently receiving tramadol?

Monoamine oxidase inhibitors (MAOIs) Tramadol can precipitate a hypertensive crisis if combined with an MAOI

What is the appropriate nursing intervention for a client diagnosed with posttraumatic stress disorder and paranoid tendencies who begins to pace and fidget?

Share the observation with the client so the behavior can be recognized.

Confusion Assessment Method (CAM)

Tests for delirium

What therapeutic benefit will the nurse include in the patient teaching regarding fluphenazine decanoate?

The medication is administered weekly not daily

The nurse is caring for four patients with different health conditions. Which patient is most likely to develop psychotic behavior?

a 33 year old female receiving treatment for thyroid storm

mutism

absence of verbal speech

Which group of drugs is most likely to be prescribed to a patient diagnosed with schizophrenia?

antipsychotic

rules for MAOIs

avoid tyramine can cause hypertensive crisis

The nurse is caring for an older adult patient who is experiencing hallucinations. The nurse administers a medication prescribed by the primary health care provider. Which adverse affect of the drug will the nurse have to report to the health care provider immediately?

bradycardia life threatening to an older adult patient

With the implementation of the concepts of therapeutic community, what is the rationale upon which decision making is based?

daily group meetings serve as a forum for all patients to be involved in the decision making process

The nurse should provide instructions concerning which side effect to a client prescribed chlorpromazine?

dry mouth

mono phobia

fear of being alone

Clanging

form of rhyming that is not comprehensible; a client whose speech features clanging seems to be caught up in the sound of the words.

The nurse notes that a client attending a group therapy session is cooperative, sharing with peers, and making appropriate suggestions during group discussions. How should the nurse interpret this behavior?

improvement

A client immobilized in skeletal leg traction complains of being bored and restless. Based on these complaints, the nurse identifies which client problem as the priority?

inability to entertain self

what is a phobia

irrational fear

Which intervention assists the patient with acute pulmonary edema in reducing dyspnea?

place the patient in high fowlers position with legs down

inappropriate affect

refers to an emotional response to a situation that is incongruent with the tone of the situation.

A client diagnosed with schizophrenia is experiencing anhedonia. Which nursing diagnosis addresses concerns regarding this client's problem?

risk for suicide

risk of haloperidol?

tardive dyskensia

clanging association

words rhyme

The nurse tells the client that a music therapy session has been scheduled as part of the treatment plan. The client tells the nurse, "I can't sing" and refuses to attend. Which nursing response is most likely to meet the client's needs?

you don't have to sing just listen and enjoy the music

The client diagnosed with mild depression says to the nurse, "I haven't had an appetite at all for the last few weeks." Which response by the nurse best assesses the client's nutritional issue?

you haven't had an appetite at all?

Which patient diagnosed with neurologic injury is typically at highest risk for depression?

young man with SCI

The nurse assigned to care for a female client diagnosed with acute depression would be appropriate in making which statement to the client?

youre wearing a new blouse Neutral comments such as that identified in the correct option will avoid negative interpretations.

The client who is actively hallucinating is fearful that the voices will direct him to kill himself. Which therapeutic statement should the nurse make at this time?

"I don't hear them, but it must be frightening to hear voices that others can't hear."

overt comment

"I wish I was dead"

The novice nurse working in a nursing home is learning about minimizing effects of relocation stress. Which statement made by the novice nurse shows understanding of this concept?

"The patient's family should bring in special personal items and family photographs from the patient's home."

A postoperative bariatric patient comes in for a four week follow-up. The patient reports feeling depressed and somewhat anxious. What statement by the nurse is most appropriate?

"This is a normal experience for people going through bariatric surgery; we often call it the 'hibernation phase.'"

Which teaching will the nurse provide to a patient with chronic obstructive pulmonary disease (COPD) who expresses having disruptive feelings of anxiety?

"You should recall the plan that you and your primary care provider have devised and try to work through that."

A client diagnosed with acute depression says to the nurse, "Things would be so much better for everyone if I just weren't around." Which response should the nurse make at this time to assess the client's state of mind?

"You sound very unhappy. Are you thinking of harming yourself?"

The nurse should plan which goals of the termination stage of group development? Select all that apply.

- the group evaluates the experience -the group explores feelings about the group and the impending seperation

risk factors for suicide

-19 years of age or younger -45 years of age or older (especially older clients, age 65 years or older). -previous suicide attempts -mental disorders -co-occurring mental and alcohol and substance abuse disorders -family history of suicide -impulsiveness -aggressive tendencies.

The nurse recognizes which assessment and diagnostic data as being associated with a newly diagnosed schizophrenic client? Select all that apply.

-A birthday of March 30 -A loss of interest in hobbies -A suicide attempt 6 months ago -Magnetic resonance imaging shows temporal lobe atrophy

A client with end-stage renal disease (ESRD) has the problem of ineffective coping. Which nursing interventions are appropriate in working with this client? Select all that apply.

-Acknowledge the client's feelings -Assess the client and family's coping patterns. -Explore the meaning of the illness with the client. -Give the client information when the client is ready to listen.

safety precautions

-bed alarm -sitter -nonskid socks -well lit room -reorientation -verify patient has hearing aids/glasses/dentures within reach -

can patients with cancer experience PTS

-clients dealing with cancer may develop PTS (post traumatic stress) -can occur during or after treatment -generally not as severe as PTSD

antipsychotic medications

-haloperidol -fluphenazine -olanzipine -clozapine -risperidone

what are defensive mechanisms for anxiety

-repression -displacement -undoing -dissociation

signs and symptoms of neuroleptic malignant syndrome

-very high fever (102 to 104 degrees F) -irregular pulse -accelerated heartbeat (tachycardia) -increased rate of respiration (tachypnea) -muscle rigidity -altered mental status

post partum blues

-within first 2 weeks of birth -fatigue -tearful -insomnia

The nurse determines that which client is at highest risk for suicide?

An 18-year-old who abuses both alcohol and drugs and who will not meet the requirements for graduation

A client is unable to get out of bed and get dressed unless the nurse prompts every step. This is an example of which behavior?

Avolition refers to impairment in the ability to initiate goal-directed activity.

Which finding is an indication of hyperglycemia in a patient who is on risperidone?

BG level of 160

Circumstantiality

Before getting to the point or answering a question, client gets caught up in countless details and explanations

A client diagnosed with schizophrenia is taking haloperidol. The nurse understands that this medication will exert its therapeutic effect through which mechanism?

Blocking dopamine from binding to postsynaptic receptors in the brain

A newly admitted client is diagnosed with posttraumatic stress disorder. Which behavioral symptom would the nurse expect to assess?

Diminished participation in significant activities is a behavioral symptom of PTSD. To answer this question correctly, the test taker should take note of the keyword "behavioral," which determines the correct answer

The nurse is caring for a client diagnosed with schizophrenia who states, "I decided not to take my medication because I realize that it really can't help me. Only I can help me." Which question asked by the nurse has the besttherapeutic value?

Do you recall what it was like before you started your medication?"

Your patient, Emma, is crying in your one-to-one session while telling you of her father's recent death from a car accident. Which of the following responses illustrates empathy?

Emma, that must have been such a hard situation to deal with

What is the priority nursing action when admitting a client who has just attempted suicide?

Ensure constant observation of the client at all times. Constant observation status (one-on-one by the nurse) and never being less than an arm's length away are the best interventions.

foods high in tyramine

Fermented, smoked, aged foods, cheese, foods with yeast, beer, wine, chocolate, Ginseng, yogurt, raisins, (cough meds)

A client asks the nurse about the meaning of behavioral therapy. Which description describes the purpose of behavioral therapy?

Fosters positive behavioral change

hypertensive crisis from using MAOIs

Hypertensive crisis can occur from the use of monoamine oxidase inhibitors characterized by -hypertension -occipital headache radiating frontally -neck stiffness and soreness -nausea -vomiting.

The patient who will require further teaching while on lithium would make what statement?

I am really enjoying my aerobics dance classes strenuous exercise increases diaphoresis which causes lithium levels to increase

What statement should the nurse make to a client diagnosed with posttraumatic stress disorder who appears to be experiencing anxiety?

I can see that youre becoming upset

The nurse is working with a client who is demonstrating delusional thinking. The client says to the nurse, "The leaders of a religious cult are being sent to assassinate me." Which is the bestresponse by the nurse?

I don't know about a religious cult. Are you afraid that people are trying to hurt you?"

A client who has been hospitalized with a paranoid disorder refuses to turn off the lights in the room at night and states, "My roommate will steal me blind." Which is the appropriate response by the nurse?

I hear what you are saying, but I have no reason to believe your roommate steals."

The spouse of a client prescribed an antidepressant tells the home health nurse, "Now that the antidepressant is working, the suicidal risk is over and you can stop making these home visits." How does the nurse appropriately respond?

I need to continue visiting since the client may now have the energy to act on suicidal intentions." Rationale: Most suicides occur within 3 months after the beginning signs of improvement, when the client has the energy to carry out suicidal intentions.

which statement reflects an individuals attempt to explain PTSD symptoms using what is considered the cardinal symptom of the disorder

I really don't remember anything about those months I was in combat

A client admitted to the mental health unit after attacking his father for disturbing him at his computer, interrupts the nurse during morning rounds and says, "I need to get out of here so I can work on my computer project to save the world!" Which nursing response will have the greatest therapeutic impact?

I will be back to talk with you in 15 minutes after I complete nursing rounds."

A new nurse will best ensure that the therapeutic environment is healthy when he or she verbalizes: which statement?

I will closely monitor my own personal values and preconceptions

The registered nurse is teaching a student nurse about providing the emotional support to a patient with psoriasis. Which statement made by the student nurse indicates the need for further teaching?

I will wear gloves while touching the patient during social interactions

When should the nurse advise a client being prescribed fluoxetine hydrochloride to take the medication?

In the morning on first arising administered in the early morning so that the client will experience an elevated mood during the daytime hours. In addition, fluoxetine can cause insomnia so taking the medication early in the day will prevent interference with sleep.

word salad

Incoherent mixture of words, phrases, and sentences

Which client behavior indicates to the nurse that the status of a client diagnosed with intensive care unit psychosis is improving?

Increased number of hours slept at one time and is increasingly alert

Which is true regarding anxiety-related chest discomfort?

It can be a dull ache or a sharp stabbing pain

The nurse is aware that antipsychotic medications may cause which of the following adverse effects?

Lower seizure threshold Antipsychotic medications exert an effect on brain neurotransmitters that lowers the seizure threshold and can, therefore, increase the risk of seizure activity

aversion therapy

Negative reinforcement is used.

Several nurses are engaged in an assignment report when a client with a history of aggressive behavior approaches the nurses' station. The client becomes very loud and offensive, and demands to be seen by the health care provider (HCP) immediately. Which intervention will address the needs of both the client and the milieu?

Offer to assist the client to an examination room until the HCP is notified.

The health care provider is planning to prescribe a medication for a client with major depression. Which medication should the nurse expect to be prescribed?

Paroxetine hydrochloride

The nurse caring for a client diagnosed with schizophrenia should include which interventions in the plan of care to assist in managing the client's concrete thinking?

Present verbal instructions regarding expectations in single, simple commands.

Which information is most important for the nurse to include in a teaching plan for a schizophrenic client taking clozapine (Clozaril)?

Report a sore throat or fever to the physician immediately. A sore throat and fever are indications of an infection caused by agranulocytosis, a potentially life-threatening complication of clozapine.

SAL

S - specificity A - accessibility L - lethality

citalopram side effects

SSRI -nausea -dry mouth -fatigue -yawning

Which client's death was achieved by what is considered a soft suicide method?

Sat in a running car parked in her locked garage to die of the carbon monoxide inhalation

client taking carbamazepine asks the nurse what to do if a dose is inadvertently missed. The nurse responds that which action should be taken?

Take the dose as long as it is not close to the time for the next dose. If more than 1 dose is omitted, the client should call the HCP.

A client prescribed chlorpromazine hydrochloride calls the mental health clinic to report urine that is much darker than usual. The client currently has no other urinary symptoms. What instructions should the nurse provide the client based on this information?

That this is an expected side effect of the medication

Which behavior in a client with schizophrenia demonstrates the client's cognitive inability to appropriately process data from external stimuli?

The client is convinced that the curtains are actually ghosts.

Which patient is at the highest risk for developing relocation stress syndrome?

The patient who is moving to an assisted-living facility that schedules all patients' activities for a uniform routine patients who are not involved in decision making increases risk for developing relocation stress syndrome

What information regarding possible prognosis will the nurse provide to the parents of a 15-year-old newly diagnosed with schizophrenia?

Their child will be treated for an imbalance of the chemical dopamine.

self control therapy

Uses combination of cognitive and behavioral approaches to dealing with.

the nurse is caring for a patient who has been taking clozapine for 2 months. which lab tests should be performed regularly while the patient is taking this medication

WBC count can cause agranulocytosis antipsychotic

Which is a primary behavior of a client diagnosed with antisocial personality disorder?

Will take personal items from other clients' rooms A central defining characteristic of the antisocial personality is disregard for the rights and feelings of others. Taking the belongings of others would demonstrate this characteristic

A client diagnosed with depression shares with the outclinic nurse, "I lost my job this week and can't pay my rent. My daughter is my only family, but I don't want to burden her with my problems." Which response by the nurse would effectively address the client's concern?

Wouldn't you want to know if your daughter was having difficulties so you could help if you could?"

A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic?

You're feeling angry that your family continues to hope for you to be cured?"

neologism

a newly devised word that has special meaning only to the client

Which patient with parathyroid disorder is at risk of coma?

a patient with a serum calcium level of 14

what medications cause neuroleptic malignant syndrome

antipsychotics

what can happen if depression is untreated

can become mute or hallucinate

What condition should women diagnosed with migraines be assessed for?

depressive disorder

retrograde amnesia

difficulty recalling information learned before ECT -can be long term

Which statement made by an unlicensed assistive personnel (UAP) indicates to the registered nurse that the UAP understands the concepts related to suicide?

discussing suicide with the client is not harmful

loose associations

disorganized thinking

To create a safe environment for the client diagnosed with major depression with psychotic features, the nurse most importantly devises a plan of care that deals specifically with which problem?

disturbed thinking

Buspirone hydrochloride is prescribed for a client with an anxiety disorder. The nurse plans to include which teaching point when reviewing this medication with the client?

dizziness and nervousness may occur

A client says to the nurse, "The federal guards were sent to kill me." Which is the best response by the nurse to the client's concern?

do you feel afraid that people are trying to hurt you

In discharge teaching, the nurse should emphasize that which of the following is a common side effect of clozapine (Clozaril) therapy?

extreme salivation

claustrophobia

fear of closed spaces

Which adverse drug event increases the risk of falls in an older adult receiving antipsychotic drugs?

orthostatic hypotension

In assessing a patient in the rehabilitative phase of burn therapy, which priority problem does the nurse anticipate?

reduced self image

catatonia

stuporous state that renders the client incapable of physical movement.

letting-go phase

the mother may -grieve over the separation of the baby from part of her body.

which statement is most important for the nurse to include when caring for a patient who is currently experiencing a panic attack that involves perceived chest pain?

you are safe. I am here and will stay with you

The registered nurse is teaching a nursing student about anti-psychotic drug haloperidol. Which nursing student statement indicates effective learning?

"It is commonly used in a low dose to treat terminal delirium in dying patients."

A client diagnosed with a borderline personality disorder says to the nurse, "Sometimes I do things to get my parents mad, and sometimes I do them because I'm bored. That's what happened the night I crashed the family car. I wasn't drunk or suicidal or anything like the police thought. It was just for kicks!" Which is the appropriate nursing response?

"It is scary when you feel out of control with such feelings of emptiness and anger that you can't stop."

covert comment

"soon everything will be over" "I won't be here much longer"

Which interventions should the nurse include in the plan of care for an acutely depressed client involved in cognitive-behavioral therapy? Select all that apply.

-Assisting the client to identify and test negative cognition -Assisting the client to participate in the treatment process -Assisting the client to develop alternative thinking patterns -Assisting the client to rehearse new cognitive and behavioral responses

ECT prep

-Before electroconvulsive therapy (ECT) blood tests are performed -electrocardiogram is done to determine a baseline status of the client -Maintaining NPO status for 6 to 8 hours before treatment

Anxiety is a symptom that can result from which of the following physiological conditions? Select all that apply.

-COPD -hyperthyroidism -hypoglycemia

A depressed client who appeared sullen, distraught, and hopeless a few days ago now suddenly appears calm, relaxed, and more energetic. Which is the nurse's best initial action with regard to the client's altered demeanor?

-Engage the client in one-to-one supervision -share with the client the observations that have been assessed -ask whether the client is thinking about suicide.

discontinuation syndrome

-GI distress -behavior or perceptual presentations -movement problems -sleep disturbances -hyperarousal lasts a few weeks

Antipsychotic medications

-Haloperidol -Chlorpromazine -Prochlorperazine

The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who is experiencing anxiety. Which of the patient's statements indicates that teaching about anxiety has been successful? Select all that apply.

-I will perform diaphragmatic breathing when I am anxious -I will attend counseling sessions during periods of emotional distress -I will take my prescribed anti anxiety medication if I begin to feel panicky

The nurse is planning to instruct a mental health client and the family about the importance of medication compliance. The nurse should plan for which interventions that are associated with increased compliance? Select all that apply.

-Including the family in the medication planning process -Working with the psychiatrist to find the right medication at the right dose -Providing the client with the injectable, long-acting form of the medication if available -Working with the psychiatrist to find the medication that provides the least side effects for the client

MAOI medications

-Isocarboxazid (Marplan) -Phenelzine (Nardil) -Tranylcypromine (Parnate) -selegiline

what medications may be used with OCD, what teaching is required

-SSRIs are effective -psychotherapy - CBT -exposure and response therapy to things that may be causing anxiety

Which information provided by the nurse accurately describes electroconvulsive therapy? Select all that apply.

-The average series involves 8 to 12 treatments. -Some confusion may be noted after the procedure. - Memory loss will occur but will resolve with time.

Which client behavior is indicative of negative symptoms associated with schizophrenia? Select all that apply.

-The client needs frequent redirection because of short attention span. -verbal communication is almost nonexistent Negative symptoms refer to a diminishment or absence of characteristics of normal function. Restricted speech and attention deficits are examples of negative symptoms that generally respond to atypical antipsychotic medications

positive symptoms of schizophrenia

-abnormal thoughts -bizarre behavior -delusions -hallucinations -grandiosity -paranoia

The nurse is teaching a new mother how to care for her newborn. The nurse notes that the client is very fearful and reluctant to handle the newborn and also notes that this is the client's first child. Which nursing interventions are most appropriate in assisting the promotion of mother-infant interaction and bonding? Select all that apply.

-accepting the clients feelings -acknowledging the clients apprehension -assisting the client with giving baths to allow her to become more at ease

delirium signs and symptoms

-acute/abrupt -confusion -disruptive thoughts can be caused by fecal impacting, infection, UTI, or sepsis

SNRIs

-affect serotonin and norepinephrine levels when depression does not respond to treatment -venlafaxine -duloxetine

serotonin syndrome

-akathisia -elevated temp -muscle rigidity -increased reflexes

signs of depression in children

-anger -irritable -withdrawn -aggressive -fatigued

cardinal sign of depression

-anhedonia -depressed mood

what medication may be used with a patient who has PTSD

-antidepressants -antianxiety

signs and symptoms of postpartum depression

-anxiety -appetite changes -difficulty concentrating -feelings of guilt -fatigue -suicidal thoughts -less responsive to infant -loss of pleasure

The nurse is caring for a patient who reports unrelieved pain despite scheduled administration of opioid analgesic medication. When the nurse attempts to conduct a pain assessment, the patient becomes angry and states, "This is the worst care I have ever received." Which issues are appropriate for the nurse to consider as possible motivations for the patient's behavior? Select all that apply.

-anxiety -desperation -powerlessness

what is separation anxiety

-anxiety related to separation from someone (leaving, death) -occurs at 8 months of age, peaks at 18 months -it can happen to adults

what medications may be used with patients who have phobias

-anxiolytic drugs *benzodiazepines -alprazolam -clonazepam -lorazepam -buspirone

The nurse creating a plan of care for the client demonstrating paranoia should include which interventions in the plan of care? Select all that apply.

-ask permission before touching the client -eliminate all unnecessary physical contact with the client -Defuse any anger or verbal attacks with a nondefensive stance -Use simple and clear language when communicating with the client.

During an interview, the female client tells the psychiatric nurse in a mental health clinic, "Sometimes I feel like life is not worth living. I am going to kill myself." Which interventions should the nurse implement? Select all that apply.

-assess the clients support system -make a no suicide contract -ask whether they have a plan A no-suicide contract is one of the first interventions the nurse implements with the client. It states that if the client feels suicidal, he or she will talk to someone and will not take action on the thoughts. The nurse should ask the client whether she has a plan. The more the specific the plan is, the more seriously the statement should be taken. The nurse should assess the client's support system and the type of help each person or group can give the client, such as hotlines, church groups, and self-help groups, as well as family members.

A 72-year-old patient has been admitted to the hospital for a knee-replacement surgery. What nursing interventions can help reduce the stress of hospitalization? Select all that apply.

-assess the patients food likes and dislikes -place a favorite family picture on the patients bedside -carefully explain all procedures and routines before occurring

The nurse suspects that an older patient who is unable to talk is experiencing pain as indicated by grimacing. Which pain assessment tool should the nurse use to rate the patient's pain?

-checklist of nonverbal pain indicators

TCAs

-clomipraminene - used for OCD -amatriptaline

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior? Select all that apply.

-communicate expected behaviors to the client -assist the client in identifying ways on setting limits on personal behaviors -follow through with consequences of behavior in a nonpuntitive manner -have the client state the consequences for behaving in ways that are viewed as unacceptable

what is panic level anxiety and what assessment findings would you expect

-complete lack of focus -loss of rational thoughts -disorganized personality -unable to communicate or function effectively -tendency to misperceive environment -dread or terror -if prolonged, can lead to exhaustion and death

signs and symptoms of serotonin syndrome

-confusion -agitation -tachycardia -hypertension -nausea -abdominal pain -myoclonus -muscle rigidity -fever -sweating -tremor

The critical care nurse is caring for a patient with flail chest. Which nursing interventions would the nurse expect to be included in the care for this patient? Select all that apply.

-deep breathing -tracheal suctioning -pain management -humidified oxygen

positive symptoms of schizophrenia

-excess or distortion of normal functions -Delusional thoughts (delusions) -loose associations of thought -bizarre behaviors such as inappropriate body movements

Which assessment findings does the nurse identify as associated with depression in older adults? Select all that apply.

-fatigue -change in appetite -early morning insomnia

While conducting an assessment, a nurse concludes the patient may be experiencing delirium. Which factors that support this conclusion might the nurse be noting while documenting the assessment? Select all that apply.

-fecal impaction -unfamiliar setting -electrolyte imbalance -undergoing psychoactive drug therapy

what is severe anxiety and what assessment findings would you expect

-feeling that something bad is about to happen -focus is on minute or scattered details -all behavior is aimed at relieving anxiety -learning and problem solving are not possible -individual needs direction to focus -concentration is progressively narrowed

food options for patients with bipolar disorder

-finger foods -sandwiches -French fries

antidepressant drugs

-fluoxetine -sertraline -SSRIs

Which drugs are considered antipsychotic drugs? Select all that apply.

-haloperidol -thiothixene

The nurse is preparing a client for electroconvulsive therapy, which is scheduled for the next morning. Which interventions would be included in the preprocedural plan? Select all that apply.

-have the client void -obtain informed consent -remove dentures and contact lenses -withhold food and fluid for 6 hours

Dystonias

-involuntary eye movements -facial grimacing -twisting of the torso

Which characteristics would the nurse expect to note for a client with seasonal affective disorder? Select all that apply.

-is related to melatonin metabolism -improves during spring and summer months -Is a result of alterations in the available amounts of sunlight -A craving for carbohydrates lessens during sunnier and spring months

interventions for post partum depression

-kangaroo therapy (skin to skin) -SSRI -psychotherapy

diagnostic data for schizophrenia

-late winter, early spring birthday (viral theory) -apathy and anhedonia (the inability to experience pleasure from activities usually found enjoyable) -suicidal ideations -atrophy of brain tissue

The hospice nurse is caring for an older patient with prostate cancer. What are common emotional signs of approaching death? Select all that apply.

-letting go -saying goodbye -withdrawal

Which factors contribute to insomnia in the acute and long-term care setting? Select all that apply.

-lighting -excessive pain -chronic disease -staff conversations -environmental noise

suicide interventions

-lock up medications -no access to weapons -acknowledge 5 people they can trust and talk to

nursing interventions for bipolar disorder

-maintain consistency -set limits -trust -dim lighting -decrease stimuli

The nurse is caring for a patient with schizophrenia who is on antipsychotic drug therapy. Which nursing interventions would be mostappropriate for this patient? Select all that apply.

-maintaining a calm environment -administering laxatives -advising the patient to increase fluid intake Constipation is a common adverse effect of antipsychotic drugs, so laxatives may be administered. An increase in fluid intake can reduce dryness of the mouth which may be a side effect of antipsychotic drugs.

what is maladaptive

-maladaptive defense mechanisms are used in excess and immature

risk factors for psychosis

-multiple medications -comorbidity -genes, not triggered till stressful event

how would you care for a patient on a general floor with PTSD

-nonjudgemental and supportive -assure feelings and behaviors are normal reactions -assist patient in recognizing association between feelings/behaviors and the experience -adaptive coping mechanisms and relaxation techniques -support groups -safety -low stimuli

The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. Which client symptoms require the nurse's immediate action?

-nonstop physical activity -poor nutritional intake

Clients with which diagnoses are commonly prescribed interventions to manage anxiety? Select all that apply.

-panic disorder -PTSD -OCD

nursing interventions for depression

-reframe thoughts -encourage exercise -eating healthy -spiritual/religion -exploring underlying beliefs = builds trust -motivational interviewing

immediate nursing action for clients with anxiety

-remain with the patient -decrease stimuli in the environment -provide calm environment

how would you care for a patient on a general floor with anxiety

-remain with the patient, attend physical symptoms -assist patient in identifying cause of anxiety -assist patient in changing unrealistic thoughts to realistic -administer anti anxiety medications if prescribed

cooccurring disorders of bipolar disorder

-substance abuse -boarderline personality disorder

what is a panic attack

-sudden onset of intense feelings of dread and terror -cause usually cant be defined -choking sensation, labored breathing -pounding heart, chest pain -dizziness -nausea -blurred vision, sense of unreality, helplessness -fear of being trapped

The nursing instructor is reviewing the plan of care for a postpartum client with a student. The instructor asks the nursing student about the taking-in phase according to Rubin's phases of regeneration and the client behaviors that are most likely to occur during this phase. Which responses made by the student indicate an understanding of this phase? Select all that apply.

-the client may complain of fatigue and lack of sleep -the client is self focused and talks to others about labor

the nurse is teaching a patient about treatment with an SSRI. which teaching considerations are appropriate

-the patient should not take any products with st. johns wart -this medication should not be stopped abruptly -the patient should be instructed to use caution when standing from a sitting position

important assessment guidelines for OCD

-thorough physical and neurological exam -determine current level of anxiety -assess for potential self harm/suicidal ideations -assess for nay self care deficits -psychosocial assessment "what is going on in your life that may be contributing to your anxiety?"

what is OCD

-thoughts, impulses, images that persist and recur and cannot be ignored even when the patient attempts to do so -preoccupation with persistently intrusive thoughts/ideas -ritualistic behaviors as a patient feels driven to perform an attempt to reduce anxiety, prevent an imagined disaster, or make unacceptable thoughts go away

The nurse is creating a plan of care for a patient with insomnia. Which interventions should the nurse include in the plan? Select all that apply.

-turn off the lights in the room -put up a do not disturb sign on the door -do not let the patient sleep during the day time

what problems may occur with anxiety

-unexpected panic attacks with physical symptoms -keep patient safe and try to help them remain calm

risk factors for depression

-women -unmarried -low socioeconomic status -childhood trauma -negative life events -family hx -substance abuse

. A client on an in-patient psychiatric unit refuses to take medications because, "The pill has a special code written on it that will make it poisonous." What kind of delusion is this client experiencing?

A persecutory delusion type of delusion in which the individual believes he or she is being malevolently treated in some way. Frequent themes include being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals. The situation described in the question reflects this type of delusion.

Your patient with mania has been started on lithium. What patient teaching about this medication should the nurse provide before the patient is discharged? Select all that apply.

A.Need for periodic blood tests to monitor lithium levels B.Signs of hypothyroidism C.Dry mouth may occur. D.Avoid excessive amounts of coffee, tea, and cola E.Impaired level of consciousness Patients also need to know that two major long-term risks of lithium therapy are hypothyroidism and impairment of the kidneys' ability to concentrate urine. (coffee, tea, and cola have a diuretic effect)

A client admitted 72 hours ago with a diagnosis of major depression presents for breakfast today appropriately dressed and well groomed, and appears to be calm and relaxed, yet more energetic than before. Which initial action should the nurse take after noting this client's behavior?

Ask the client directly about the presence of any suicide-related thoughts. A sudden improvement in a depressed client's mood may indicate that the client has decided to commit suicide

A client begins to experience extrapyramidal side effects from an antipsychotic medication. The nurse anticipates that the health care provider will prescribe which medication to treat this condition?

Benztropine Benztropine is an anticholinergic medication used to treat drug-induced extrapyramidal reactions (except tardive dyskinesia)

Which diagnostic intervention is necessary at regular intervals during clozapine treatment?

CBC

A preoperative patient wears a hearing aid and is extremely hard of hearing without it. What does the nurse do to help reduce this patient's anxiety?

Check to see whether the operating room (OR) staff minds if the patient wears the hearing aid until anesthesia is given

Hormonal effects of the antipsychotic medications include which of the following?

Decreased libido, retrograde ejaculation, and gynecomastia are all hormonal effects that can occur with antipsychotic medications

The history assessment of a client diagnosed with schizophrenia confirms a routine that includes smoking two packs of cigarettes and drinking 10 cups of coffee daily. Considering the assessment data, the nurse recognizes which as placing the client at most risk for injury?

Diminishing the effectiveness of psychotropic medication Both caffeine and nicotine can inhibit the action of psychotropic medications, which are commonly prescribed for schizophrenia.

A patient receiving mechanical ventilation and anticoagulant medication after experiencing a pulmonary embolism appears tense and is unable to sleep or rest. Which action should the nurse take next?

Explain all interventions to the patient and provide reassurance that care is appropriate

A client has been receiving lithium (Lithane) for the past two weeks for the treatment of bipolar illness. When planning client teaching, the nurse understands that it is important to emphasize that the client must?

Have blood lithium levels drawn during the summer months . Clients taking lithium therapy need to be aware that hot weather may cause excessive perspiration, a loss of sodium and consequently an increase in serum lithium concentration.

The nurse assesses for a therapeutic effect of ziprasidone by asking the client which question?

Have you experienced an increase in concentration during daily activities?" Ziprasidone is an antipsychotic used as a mood stabilizer. The nurse should evaluate a therapeutic response by determining if the client obtained an increase in concentration.

Which symptom experienced by a client diagnosed with schizophrenia would predict a less positive prognosis?

Having little or no interest in work or social activities

Benztropine mesylate is prescribed for a client. What statement by the client indicates that the client needs further teaching about the medication?

I will sit in the sun for an hour a day to enhance medication effectiveness." benztropine mesylate may have decreased tolerance to heat as a result of diminished ability to sweat and should plan rest periods in cool places during the day.

which statement is associated with the nurses initial intervention when working with a patient experiencing extreme anxiety

I will stay with you as long as you need me

Laboratory work is prescribed for a client who has been experiencing delusions. When the nurse approaches the client to obtain a specimen of blood, the client begins to shout, "You're all vampires. Let me out of here!" Which nursing response addresses the client's anxiety?

It must be frightening to think that others want to hurt you."

The client with a diagnosis of dependent personality disorder is most likely to have problems coping with which situation?

Making decisions about living arrangements after discharge A central defining characteristic of the dependent personality is the inability to make decisions with excessive dependence on others

A client who is receiving lithium carbonate has a serum level of 1.8 mEq/L. Which intervention will the nurse implement in response to this diagnostic result?

Monitor the client for behaviors that suggests ataxia. A serum lithium level of 1.8 mEq/L indicates moderate toxicity

Which assessment findings suggest to the nurse that the client is experiencing tardive dyskinesia?

Movements of the mouth, tongue, and face that are both abnormal and involuntary

The nurse notes documentation that a newly admitted client experiences flashbacks. What diagnosis would this notation support?

PTSD

The nurse in a long-term care facility is reviewing the health care provider's (HCP's) prescriptions on an assigned client. The nurse notes that the HCP prescribed ropinirole hydrochloride. The nurse determines that this medication has been prescribed to treat which condition in the client?

Parkinsonism syndrome

intervention for patient with concrete thinking

Present verbal instructions regarding expectations in single, simple commands. A client with concrete thinking often has difficulty with multiple-step tasks and commands.

A client scheduled for electro-convulsive therapy asks the nurse how the therapy helps relieve her depression. The nurse's response is based on an understanding that ECT:

Produces a seizure that temporarily alters brain chemicals

The nurse is planning a stress management seminar for clients in an ambulatory care setting. Which concept should the nurse plan to include in the content of the seminar?

Progressive muscle relaxation techniques are useful for easing tension from many causes.

A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to feeling sad and hopeless, the nurse would assess for?

Psychomotor retardation or agitation

The multidisciplinary team discusses the potential side effects of what medication prescribed to treat a patient's negative symptoms of schizophrenia?

Quitipine targets both negative and positive s/s of schizophrenia

what medications cause serotonin syndrome

SSRIs

During a mental status examination, the client states, "Glass breaks if you throw stones or shoot at it with a gun. My cousin shoots guns at the police all the time at target practice. People who live in glass houses shouldn't throw stones." How will the nurse appropriately document the client's speech?

Speech is illogical and loosely associated.

tardive duskinesia

Tardive dyskinesia is a reaction that can occur from antipsychotic medication. It is characterized by -uncontrollable involuntary movements of the body -extremities -particularly the tongue.

A new RN demonstrates an understanding of clozapine when making what statement?

The patients WBC and ANC meet the criteria to start clozapine`

A client who was started on clonazepam tells the nurse of increasing clumsiness and unsteadiness since starting the medication. The client is visibly upset by these manifestations and asks the nurse what to do. The nurse's response is based on which understanding?

These symptoms are most severe during initial therapy and decrease or disappear with long-term use.

persecutory delusion

a person's false belief that someone is plotting against him or her with the intent to harm

The nurse is discussing the past week's activities with a client receiving amitriptyline hydrochloride. The nurse determines that the medication is most effective for this client if the client reports which information?

ability to get to work on time each day This medication is prescribed for the management of depression. Depressed individuals may demonstrate a lack of energy that results in sleeping for extended periods and being unable to fulfill employment obligations.

The nurse is assessing a client who has been admitted to the coronary care unit. The client seems to fluctuate in the ability to focus during the day. On the basis of this assessment, which client problem should the nurse suspect?

acute confusion as a result of hospital induced psychosis

The nurse is evaluating a function of the limbic system as a part of the neurological status of a client. What should the nurse assess?

affect or emotions part of the role of the limbic system and involve both hemispheres of the brain.

catatonic stupor

an immobile, expressionless, comalike state

Which does the nurse recognize as the likely cause of an older adult patient's constipation, dry mouth, and urinary retention?

antipsychotic therapy

Which does the nurse recognize as the likely cause of an older adult patient's constipation, dry mouth, and urinary retention?

antipsychotic therapy Antipsychotics cause anticholinergic effects in older adults including dry mouth, parkinsonism, and orthostatic hypotension

treatment for neuroleptic malignant syndrome

antipyretics to decrease fever

The nurse is caring for a client who is terminally ill. When assessing the client, the nurse recognizes which as the most common distress symptom near the end of life?

anxiety

What is a behavioral illness that is known to relate to irritable bowel syndrome (IBS)?

anxiety

Which patient condition may be treated by oxygen therapy?

anxiety

An individual calls the hospital during the night shift in crisis and is considering suicide. The nurse will begin the interaction by saying which assessment question?

are you willing to let me help to work this out

What is the best nursing intervention when talking with the family members of a patient who died suddenly in the emergency room?

ask the family members if they would like a clergy member present

Which nursing intervention is most appropriate for the post-crisis depression phase of the assault cycle?

asking "can we talked about what triggered your angry behavior"

Which behavior demonstrated by a client diagnosed with depression indicates a need for suicide precautions?

asks about how to get a will notarized

When considering a group home setting, what is the common need demonstrated by all the residents?

assistance with independent living tasks

Which intervention will best address the nursing goal of maintaining unit safety while decreasing the use of limit-setting

at admission each patient will be given both an explanation of and copy of the units rules

for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose?

at the same time each evening

The nurse reviewing a client's diagnostic results recognizes that which is a possible positive indication for a diagnosis of schizophrenia?

atrophy of the lateral and/or third ventricles of the brain

Which activity should the nurse include in the plan of care for a client who is experiencing psychomotor agitation?

attending a clay molding class that is scheduled for today When a client is experiencing psychomotor agitation, it is best to provide activities that involve the use of hands and gross motor movements. Such activities can include volleyball, finger-painting, drawing, and working with clay.

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought processes. In formulating a nursing plan of care, which best intervention should the nurse include?

avoid using a whisper voice in front of the client

The nurse is caring for an older adult patient who is experiencing hallucinations. The nurse administers a medication prescribed by the primary health care provider. Which adverse affect of the drug will the nurse have to report to the health care provider immediately?

bradycardia can be life threatening in the older adult

What presents the greatest postnatal risk to a newborn whose mother is now managing her bipolar disorder with lithium?

breastfeeding

The patient expresses a desire to quit smoking but says the depression and irritation experienced with withdrawal have made past attempts unsuccessful. Which therapy does the nurse recognize that may be beneficial?

bupropion

What is the priority nursing intervention when working with a patient who has entered the escalation phase of the assault cycle?

calling the patient by name and letting them know that the staff are there for them

The nurse should monitor the client prescribed thioridazine hydrochloride carefully for which adverse effect?

cardiac dysrhythmias

When an older adult is prescribed an antipsychotic medication, which intervention has priority regarding the patient's safety?

changing from sitting to standing position slowly hypotension is a negative side effect

Parkinsonism

characterized by -tremors -masklike facies -rigidity -shuffling gait.

Incoherence

characterized by speech that cannot be understood.

In formulating a discharge teaching plan, the nurse should include which precaution for a client who is prescribed lithium carbonate therapy?

check with the psychiatrist before using any over the counter medications

A client's risk for the development of blurred vision is high when prescribed which antipsychotic medication?

clozapine

Which assessment finding would be a manifestation associated with dementia?

confabulation

How does bupropion help in smoking cessation?

decreases craving for nicotine

a patient who has been taking lithium for 6 months has had severe vomiting and diarrhea form GI flu. the nurse will assess for which potential problem at this time

dehydration monitor sodium 135-145

A 75-year-old patient who has been using a urinary antispasmodic drug reports to the health care unit. For which side effect does the nurse anticipate?

delirium

Which statement regarding delirium and dementia is correct?

delirium is a short term disorder, and dementia is a long-term illness

Which condition can be treated with haloperidol?

delusions

The nursing care plan indicates a problem of self-directed violence and the risk for suicide, related to suicidal ideations with a specific plan. The nurse develops a plan of care for the client and identifies which expected client outcome?

denies presence of suicidal ideations

A patient is newly diagnosed with tongue and esophageal cancer. Which response to the diagnosis does the nurse expect the patient to have?

depression related to the changes in the face and neck after surgery

The nurse is performing an admission assessment on a client at high risk for suicide. Which assessment question will best elicit data related to this risk?

do you have a plan to commit suicide

The nurse caring for a client diagnosed with severe depression is planning activities for the client. Which activity would be most appropriate for this client?

drawing Concentration and memory are poor in severe depression. When a client has a diagnosis of severe depression, the nurse needs to provide activities that require little concentration, such as drawing

The nurse is exhausted after caring for victims of a massive highway accident. What actions may be required to prevent post-traumatic stress disorder?

drink plenty of water and eat healthy snacks

The mental health nurse notes that a client diagnosed with schizophrenia is exhibiting flat affect. Which situation supports this documentation?

during the entire family visit the patient presented with an expressionless blank look

A client with chronic schizophrenia receives 20 mg of fluphenazine decanoate (Prolixin Decanoate) by I.M. injection. Three days later, the client has muscle contractions that contort the neck. This client is exhibiting which extrapyramidal reaction?

dystonia

A patient with burn injuries states, "I feel so helpless." Which nursing intervention is most helpful for this patient?

encouraging participation in wound care

Which pre-electroconvulsive therapy intervention will the nurse implement for a hospitalized client?

ensure that an electrocardiogram is performed within 24 hours

A patient who is preparing to undergo a vaginal hysterectomy is concerned about being exposed. How does the nurse ensure that this patient's privacy will be maintained?

ensure that drapes will cover perianal area

A client in a manic state presents to the dayroom only partially dressed and is making sexual remarks and gestures toward the staff and other clients. Which is the initial nursing action?

escort the client to their room and help them dress appropriately

A manic client begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement?

escort the client to their room, with assistance from other staff

The nurse is creating a plan of care for a newly admitted client at high risk for suicide. With the focus of the plan being to promote a safe and therapeutic environment, which intervention should the nurse include?

establish a therapeutic relationship

The nurse is developing a plan of care for a client admitted to the mental health unit with a diagnosis of obsessive-compulsive disorder. What is the nurse's priority in the plan of care?

establish a trusting nurse-patient relationship

A patient is hospitalized with posterior nasal bleeding and has a gauze pack in the posterior nasal cavity. The nurse assesses the patient and notes restlessness and anxiety and an oxygen saturation of 92%. Which initial action by the nurse is correct?

evaluate the position of the packing string

when should lithium levels be checked

every 1-2 months and every 12 hours in the hospital

A nurse takes the blood pressure of an older adult patient who is on antipsychotic medication. Which risks might the nurse be addressing? Select all that apply.

falls fractures

A 52-year-old patient relates to the nurse that she has never had a mammogram because she is terrified that she will have cancer. Which response by the nurse is therapeutic?

finding cancer in the early stages increases the chance for cure

The nurse should be prepared to manage which occurrence unique to the abuse of hallucinogenic drugs?

flashbacks

A client gives the home health nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication?

frequent handwashing with hot soapy water Clomipramine is a tricyclic antidepressant used to treat obsessive-compulsive disorder

The nurse suspects that a client prescribed clomipramine hydrochloride has been noncompliant with taking the medication as prescribed. Which client behavior would support the nurse's suspicion?

frequently checking for the car key Clomipramine is an antidepressand that is commonly used in the treatment of obsessive-compulsive disorder. Frequent checking for the car key is a nonproductive repetitive activity that is characteristic of this disorder

bizarre affect

grimacing, laughing, and self-directed mumbling is marked when the client is unable to relate logically to the environment.

the patient is experiencing panic, 4+ anxiety. the stage on the unit will prepare to implement which plan of care

guide and control the patient and administer a medication as prescribed

trichotillomania

hair pulling disorder

A patient requires limit-setting by the RN. In accomplishing this intervention, what statement will the RN make?

here are the unit rules, lets review them

Which behavior demonstrates the most lethal plan by an individual who has recently expressed suicidal ideations?

hoarding a large number of barbiturates

To best achieve implementation of balance on an inpatient acute-care unit, which statement the RN make to the patient?

how about taking a walk with the group facilitates independence

Which assessment question will the nurse ask to help identify the cause of a patient's decreased lithium levels?

how much coffee do you drink daily caffeine and alcohol decrease lithium levels

What adverse effect can risperidone cause?

hyperglycemia

The nurse is caring for a client with a diagnosis of agoraphobia. Which statement made by the client would support this diagnosis?

id be sure to have a panic attack if I left my house

The nurse is caring for a patient with early-stage chronic kidney disease. Which nursing intervention is appropriate to promote the patient's emotional well-being?

identifying the patients social support systems

Anhedonia

inability to experience pleasure

When a patient is prescribed carbamazepine when lithium is ineffective at managing the symptoms of bipolar disorder, the nurse will include what information in the patient education plan?

initially CBCs will be scheduled weekly

the nurse assesses poor wound healing and worsening cognitive symptoms in a patient with dementia. What does the nurse anticipate may be the causative factor?

insomnia

A client is having the dosage of clonazepam adjusted. The nurse should plan to perform which action?

institute seizure precautions Clonazepam is a benzodiazepine that is used as an anticonvulsant

The nurse notes that a client's lithium level is 3.9 mEq/L (3.9 mmol/L). What is the nurse's priorityaction in response to this finding?

instituting seizure precautions

The nurse is reviewing a plan of care for a preoperative patient who is experiencing anxiety. Which of the plan's interventions needs revision?

instructing the patient to avoid visiting friends 24 hours before surgery

tardive dyskinesia

involuntary movements of the facial muscles, tongue, and limbs; a possible neurotoxic side effect of long-term use of antipsychotic drugs that target certain dopamine receptors

anhedonia

lack of interest

Avolation

lack of motivation

waxy flexibility

limbs can be manipulated and posed by another person STIFF body - extremities can get stuck in a position

A patient's family is expressing concern about the new diagnosis of chronic obstructive pulmonary disease (COPD) in their loved one. What should the nurse do next?

listen to the basis of the families concern and then develop a focused teaching plan

The client in the psychiatric unit tells the nurse, "Someone just put a bomb under the couch in the lobby." Which action should the nurse implement first?

look under the couch for the bomb In some instances, the nurse should not attempt to look for a bomb, but because the client is on a psychiatric unit, the nurse should look for a suspicious-looking object before notifying the bomb squad and evacuating the clients.

Which antianxiety drug has the shortest duration of action?

lorazepam

short term anterograde amnesia

loss of the clients ability to retain newly learned information -resolves usually within the first few weeks after ECT

neologisms

made up words

The nurse determines that the client understands the basis of the diagnosis of obsessive-compulsive disorder after making which statement?

my rituals are a way for me to control unpleasant thoughts or feelings

What may listlessness in an older adult in a family indicate?

neglect

Which of the following classifications of medications would be MOST often used for clients with schizophrenia?

neuroleptics

Which is a type of nicotine replacement therapy (NRT)?

nicotine gum

What factors determine when seclusion of an aggressive patient is terminated?

nursing judgements and facility protocols

The nurse has a prescription to administer diazepam 5 mg by the intravenous (IV) route to a client. The nurse should administer the medication over a period of at least how long?

one minute The recommended rate of infusion of diazepam is to give each 5 mg of the medication over at least 1 minute. This will prevent adverse effects, including apnea, bradycardia, hypotension, and possibly cardiac arrest.

Flight of ideas

overproductive speech, characterized by the client's quickly switching from one subject to another.

soft suicide

painless and include -ingesting pills -inhaling natural gas -carbon monoxide

Which statement incorrectly describe a child-adolescent inpatient unit?

patients are stabilized before being admitted

What nutritional education should a nurse provide when managing the care of a patient who has been prescribed a newer antipsychotic medication?

prepare to cope with a craving for carbohydrates

The nurse is assigned to care for a chemically dependent client who has the potential for violent episodes. In planning care for the client, which action by the nurse should receive priority?

projects an attitude of calmness

A client diagnosed with depression is not eating adequately and at times even refuses to eat at all. What should the nurse plan to do to meet the client's nutritional needs?

provide small frequent meals that include the patients favorite foods

Laboratory reports of a confused patient reveal a two-hour postprandial blood glucose level of 140 mg/dl and normal urine culture. The patient's oxygen saturation is 85%. What is the appropriate nursing intervention to reduce the state of confusion?

provide supplemental oxygen therapy

The nurse is caring for a client who is at risk for suicide. What is the priority nursing action for this client?

provide: -authority -action -participation

When considering the elements required of the treatment environment, which statement addresses the need for norms?

provides predictability to all patients

Which condition can be prevented by maintaining quite environment for better sleep?

psychosis

Verbigeration

purposeless repetition of words or phrases

A client who has been taking buspirone for 1 month returns to the clinic for a follow-up assessment. The nurse determines that the medication is effective if the absence of which manifestation has occurred?

rapid heart beat or anxiety

flight of ideas

rapidly changing or disjointed thoughts

A 72-year-old man who underwent colorectal surgery reports confusion and sleep disturbances. Which priority action should the nurse take while caring for the patient?

reassuring family that postop delirium resolves within a day or two

While counseling a patient who experienced a cardiac event, the nurse observes that the patient angrily speaks with members of the health care team and throws a lunch plate to the ground. What is the patient likely trying to achieve through anger?

regain control of their life

Which intervention will be most effective in reducing anxiety in a patient with a pulmonary embolism (PE)?

remain with the patient and provide oxygen in a calm manner

Post-procedure nursing interventions for electroconvulsive therapy include?

remaining with the client until oriented

echopraxia

repeating the movements of another person

echolalia

repetition of words or phrases heard from another person

clang association

repetition of words or phrases that are similar in sound but in no other way

During an admission assessment, the nurse notes that the client's diagnosis is documented as obsessive-compulsive disorder. The nurse plans care knowing that the client is most likely to experience which type of compulsive behavior?

repetitive actions to manage anxiety

The nurse is planning the care of a female patient with severe diarrhea-predominant irritable bowel syndrome (IBS-D). Which nursing invention is most appropriate for the patient?

report symptoms of constipation early if taking alosetron

magical thinking

result of concrete thinking that causes the client to interpret a statement literally.

hallucinations

result of distortions in perceptions of the senses, but they are not reliant on internal or external stimuli.

The nurse preparing to admit a client with a diagnosis of obsessive-compulsive disorder to the mental health unit should expect to note which behaviors in the client?

rigidness in thought inflexibility

A nurse is caring for a patient with hyperparathyroidism. Which laboratory finding indicates a high risk of psychosis?

serum calcium 15

The nurse is conducting a counseling session for smoking cessation. What should the nurse include as a strategy?

set a date to quit smoking

associative looseness

shift of ideas from one unrelated topic to another fragmented thoughts

buspirone

side effects: -paradoxical anxiety -dizziness -blurred vision -headache -nausea -must be administered on a schedule

The nurse is creating a discharge plan for the family of a client diagnosed with a mood disorder. The nurse should plan to provide which priorityinformation to the family?

signs that indicate the client may be considering suicide

The nurse is caring for a client just admitted to the mental health unit and diagnosed with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriatenursing intervention?

sit besides the client in silence with occasional open ended questions

excoriation

skin picking

The nurse in the mental health unit is performing an assessment in a client who has a history of multiple physical complaints involving several organ systems. Diagnostic studies revealed no organic pathology. The care plan developed for this client will reflect that the client is experiencing which disorder?

somatization disorder

A client diagnosed with bipolar mood disorder has been given a prescription for carbamazepine. The nurse teaching the client about medication side and adverse effects instructs the client to notify the health care provider if which symptom develops?

sore throat An adverse effect of carbamazepine is blood dyscrasia. With development of a fever, sore throat, mouth ulcerations, unusual bleeding, bruising, or joint pain, the health care provider should be notified because these findings may indicate a blood dyscrasia.

The nurse has observed that an older client has episodes of extreme agitation. Which measure is most appropriate for the nurse to implement to avoid episodes of agitation?

speak and move slowly toward the client while assessing the clients needs

pressured speech

speaking as if the words are being forced out quickly

Which statement by the nurse is the most effective when communicating with a patient who was just been diagnosed with fibromyalgia after waiting for over 10 years for a diagnosis?

tell me what are you feeling now that you finally got a diagnosis

A patient with colorectal cancer (CRC) is scheduled for colostomy surgery. Which comment from the nurse is most therapeutic for this patient?

tell me what worries you the most about this procedure

when should lithium blood tests be performed

tests generally are prescribed every 3 to 4 months.

confabulation

the act of filling in memory gaps

The nurse is monitoring a client diagnosed with schizophrenia who demonstrates a dysfunctional affect. Which situation is congruent with inappropriate affect?

the client giggled while describing being physically abused as a child

Which assessment data would indicate that a client is most at risk for suicide?

the client has an immediate plan for a suicide attempt

During the termination phase of the nurse-client relationship, the clinic nurse observes that the client has made several sarcastic remarks and has an angry affect. Which is the most appropriate interpretation of the client's behavior?

the client is displaying typical behaviors In the termination phase of a relationship, it is normal for a client to demonstrate a number of regressive behaviors that can be disturbing to the nurse. Typical behaviors include return of symptoms, anger, withdrawal, and minimizing the relationship. The anger that the client is experiencing is a normal feeling during the termination phase and does not necessarily indicate the need for hospitalization or treatment.

taking-hold phase

the client is more -active -independent -initiates activities -partakes in mothering tasks

The registered nurse (RN) is listening to a lecture on pulmonary edema. Which statement by the RN indicates that the teaching has been effective?

the client will experience extreme anxiety and agitation may complain of a sense of drowning, suffocation, or smothering

The nurse is providing emergency measures to a client in labor who has been diagnosed with a prolapsed cord. The mother becomes anxious and frightened and says to the nurse, "Why are all of these people in here? Is my baby going to be all right?" Which client problem is most appropriate to address at this time?

the clients fear

During a therapy session a client with a personality disorder says to the nurse, "You look so nice today. I love how you do your hair, and I love that perfume you're wearing." Which response by the nurse would best address this breech of boundaries?

the focus of todays assessment is on your issues, so lets get started

Meeting the immediate safety needs of an aggressive patient is based on which principle of care?

the least restrictive option is implemented

The patient who was relocated to a new room in the nursing home has been lethargic for the two days spent in the new room. This morning, the patient became aggressive when the nurse attempted to administer medication. What does the nurse suspect?

the patient has mixed delirium

The nurse is assessing a new patient in a nursing home. Upon viewing the patient's file, which information alerts the nurse that the patient may be at risk for delirium?

the patient has recently experienced the death of a spouse

Which intervention demonstrates a need for further education regarding the effective use of physical restraints/seclusion?

the patient is allowed to listen to their own radio while in seclusion

Older patients are at an especially high risk for stress and anxiety. Which patient will generally be most able to cope with stress-inducing events?

the patient who has three very close stable relationships

Which statement made by a client demonstrates an understanding of the use of antipsychotic medications during pregnancy?

their use should be monitored closely by PCP

A client experiencing a great deal of stress and anxiety is being taught to use self-control therapy. Which statement by the client indicates a need for further teaching about the therapy?

this form of therapy provides a negative reinforcement when the stimulus is produced description of aversion therapy

What migraine medication is associated with suicide in patients who have bipolar disorders?

topiramate

The nurse is caring for an older adult patient who is prescribed antipsychotic drugs. Which symptoms does the nurse observe that may indicate the development of Parkinsonism? Select all that apply.

tremors bradycardia shuffling gait

A client who is watching television in the dayroom shares with the nurse that he has begun seeing his mother being assaulted on the television screen. Which is the nurse's initial intervention?

turn off the TV

Clients diagnosed with obsessive-compulsive disorder commonly use which mechanism?

undoing Undoing is a defense mechanism commonly used by individuals diagnosed with OCD. Undoing is used symbolically to negate or cancel out an intolerable previous action or experience. An individual diagnosed with OCD experiencing intolerable anxiety would use the defense mechanism of undoing to undo this anxiety by substituting obsessions or compulsions or both

A patient's inability to de-escalate his aggressive behavior has resulted in the response team coming to the unit. When the patient demands to know, "Why are all these people here?", the nurse responds most therapeutically when making what statement?

we are here to keep you safe and prevent you from hurting anyone else

What is the nurse's best response when asked by a patient who will begin lithium therapy, "When can I expect to see improvement in my symptoms?"

we generally see symptom improvement within 7-10 days

Erotomanic delusions

when an individual believes falsely that another person is in love with him or her

The nurse is caring for a patient who has anxiety resulting from a pulmonary embolism. When might the nurse expect the health care provider to prescribe a sedative to the patient?

when the patient is mechanically ventilated

A client with schizophrenia has been started on medication therapy with clozapine. The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication?

white blood cell count may experience agranulocytosis

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client?

writing

The nurse suspects that the client hospitalized with a diagnosis of acute depression could benefit from further development of coping strategies. Which client statement supports this suspicion?

"I know that I won't become depressed again as long as I reduce my stressors."

The nurse is discussing discharge and outpatient follow-up plans with a client hospitalized for acute depression. Which statement demonstrates the client's use of a defense mechanism and would indicate the need for follow-up treatment?

"I was really depressed about not getting the promotion I was promised. Looking back on it, the pay raise wouldn't have been worth the huge increase in responsibility. It's just as well; it all worked out in the end." Rationalization is substituting acceptable reasons for actual reasons for behavior.

The nurse is teaching a student nurse about management of anxiety in a preoperative patient. Which statements made by the student nurse indicate effective learning? Select all that apply.

-I will provide ample time for the patient to ask questions -I will continuously assess the patients responses and anxiety levels -I will encourage the patient to relax by listening to music before surgery

what to avoid while taking phenelzine

-alcohol -foods with tyramine

A 78-year-old patient with chronic back pain is suspected to be suffering from depression. What conditions can this lead to if not assessed and treated right away? Select all that apply.

-alcoholism -increased pain -suicidal ideation

what is mild anxiety and what assessment findings would you expect

-alert -associated with tense experiences occurring in everyday life -can be motivating, produce growth, enhance creativity, and increase learning -perceptual field is increased -heightens awareness/sharp senses

what kind of therapy may be used with patients who have phobias

-allow client to verbalize feelings about phobia -talking frequently about the feared object is the first step in the desensitization process -relaxation techniques -promote desensitization by gradually introducing feared object in small doses -always stay with the client to promote safety and security -never force a patient to have contact with a phobic object or situation

negative symptoms of schizophrenia

-alogia -anergia -decreased attention -avocation -blunted affect -poverty of speech -poor hygiene

interventions for severe to panic level anxiety

-always remain with the client -provide clear simple statements -use low pitched voice

What symptom will the nurse observe in a preoperative patient with anxiety? Select all that apply.

-anger -crying -urinary frequency

The nurse is assessing an older patient with relocation trauma. Which emotional signs and symptoms does the nurse suspect in the patient? Select all that apply.

-anger -depression -withdrawal

signs of bipolar disorder in children

-anger -irritability -outbursts

patient teaching for haloperidol

-apply sunscreen before being exposed to the sun -take medication with food

A client requiring surgery is anxious about the possible need for a blood transfusion during or after the procedure. The nurse suggests to the client to take which actions to reduce the risk of possible transfusion complications? Select all that apply.

-ask a family member to donate blood ahead of time -give an autologous blood donation before the procedure

The nurse is creating a plan of care for a client diagnosed with depression whose food intake is poor. The nurse should include which interventions in the plan of care? Select all that apply.

-assist the client on selecting foods from the menu -offer high calorie fluids throughout the day and evening -offer small high calorie, high protein snacks throughout the day and evening

what assessment findings are expected with phobias

-associated with panic level anxiety if feared things cannot be avoided -defense mechanisms: repression and displacement -never force client to have contact with phobia

causes of psychosis

-autism in children -schizophrenia -post partum depression in childbearing women -depression -substance/alcohol intoxication -cocaine high -LSD hallucinations -brain tumor -hypoglycemia -hypothyroidism

TCA patient teaching

-blocks reuptake of norepinephrine and serotonin -can reduce seizure threshold -if used with alcohol can cause CNS depression -contraindicated in pregnancy -take at bedtime -ECG before treatment and periodically -overdose is life threatening

education for lithium

-body treats it like salt -cannot have renal or heart issues -do not drive

sign and symptoms of postpartum psychosis

-break with reality -confusion -delirium -delusions -hallucinations -panic

what plan of care is appropriate for mild to moderate anxiety

-calm environment -ask client to identify how they feel -help patient identify trigger -encourage problem solving -encourage gross motor exercise

SSRIs

-cannot be taken with MAOI - increases rate for serotonin syndrome -fluoxetine -duloxetine

Which assessment findings are consistent with the nonprogressive (compensatory) phase of shock? Select all that apply.

-cool skin -restlessness -tachypnea -anxiety

The nurse is concerned that a patient who had a myocardial infarction (MI) has developed cardiogenic shock. Which findings indicate shock? Select all that apply.

-cool, diaphoretic skin -crackles in the lung fields -anxiety and restlessness

The registered nurse is teaching a nursing student regarding the differences between delirium and dementia. Which statements made by the nursing student indicate effective learning? Select all that apply.

-delirium is reversible while dementia is irreversible -delirium is an acute condition, whereas dementia is a chronic condition -Delirium has known etiological factors whereas etiology of dementia is still being researched.

The nurse is teaching family members of an older adult patient about newly prescribed antipsychotic medications. Which statements made by family members indicate a need for further teaching? Select all that apply.

-delusions will be controlled by these drugs -these drugs will likely increase anxiety levels -these drugs will eliminate the diagnosis of schizophrenia

What symptoms are included in geriatric failure to thrive (GFTT)? Select all that apply.

-depression -undernutrition -cognitive impairment -impaired physical functioning

Which symptoms are most likely related to myocardial infarction? Select all that apply.

-difficulty breathing -feeling of fear and anxiety -pain or discomfort in the chest without cause -pain or discomfort in the chest in the morning

command hallucination responses

-do you plan to follow the command? -what is the voice telling you to do? -do you recognize the voice? -do you believe the voice is real?

side effects of TCAs

-dry mouth -difficulty voiding -dilated pupils -blurred vision -decrease GI motility -constipation

. The nurse is caring for a 90-year-old patient who is on antipsychotic drug therapy. For which adverse side effects will the nurse monitor the patient? Select all that apply.

-dry mouth -parkinsonism -orthostatic hypotension

what assessment findings would you expect with PTSD

-emotional numbness -detachment -depression -anxiety -sleep disturbances/nightmares -flashbacks -hyper vigilance -guilt about surviving -poor concentration and avoidance of activities that may trigger memories

what psychoeducation is needed for PTSD

-ensure client that their feelings and behavior are normal reactions -support groups -hypnotherapy or systematic desensitization

autonomic nervous system fight or flight response

-flush -sweating -dilated pupils

what is moderate anxiety and what assessment findings would you expect

-focus on immediate concerns -narrows perceptual field -selective inattentiveness occurs -restless

What are likely reasons that a homeless person may seek intervention in the emergency department? Select all that apply.

-food -shelter -human interaction

The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine. Which information would be important for the nurse to obtain during this client visit regarding the side and adverse effects of the medication?

-gastrointestinal dysfunction The most common side and adverse effects related to fluoxetine include central nervous system and gastrointestinal system dysfunction. Fluoxetine affects the gastrointestinal system by causing nausea and vomiting, cramping, and diarrhea.

stressors that could cause PTSD

-natural disaster -terrorist attack -combat experiences -accidents -rape -crime or violence -abuse -reexperiencing the event as flashbacks

what teaching is necessary for anxiolytic drugs

-no alcohol -no other CNS depressants -do not stop abruptly -hypotension -fall risk -drowsiness -dizziness

The nurse assesses a patient with BPH and notices that he has some signs and symptoms of depression. What urinary symptoms most likely contributed to his depression? Select all that apply.

-nocturia -sexual dysfunction -post void incontinence

Which changes in behavior and personality in a patient diagnosed with Alzheimer's disease should the nurse educate family members about to help cope with the patient in a better way? Select all that apply.

-paranoia -hallucinations -aggressiveness

extrapyramidal side effects of clozapine

-parkinsonism -tremors -masklike facies -rigidity -shuffling gait -dysphagia -drooling

wha at should the nurse always do with a patient who has phobias

-promote safety and security -never force a client to have contact with the phobia

treatment for DMDD

-psychotherapy -CBT -parent involvement -trigger predicting -medication = stimulants, antidepressants, antipsychotics (lowest dose possible)

what plan of care is appropriate for severe anxiety

-reduce anxiety quickly, use calm manner -stay with the client -minimize environmental stimuli -attend to physical needs -provide gross motor activity -administer medications as prescribed

internal discharge factors for schizophrenia

-resilience -coping skills

operant conditioning

-rewarding a client for desired behaviors and is the basis for behavior modification. -It uses a positive reinforcement approach

A client diagnosed with schizophrenia has been prescribed clozapine. The nurse should monitor the client for which side/adverse effects of this medication? Select all that apply.

-sedation -dry mouth -orthostatic hypotension -presence of a fixed stare

what is social anxiety disorder

-severe anxiety provoked by exposure to social events or a performance situation that could be evaluated negatively by others

external discharge factors for schizophrenia

-social support -living arrangement -economic resources

A patient is diagnosed with irritable bowel syndrome (IBS). What factors does the nurse suspect as possible causes of the patient's problem? Select all that apply.

-stress -anxiety -caffeinated drinks

what is generalized anxiety disorder

-unrealistic anxiety about everyday worries that persist over time and is not associated with another psychiatric or medical disorder

diagnostic tests for altered mental status

-urinalysis to rule out UTI -CBC - WBC check for infection -BUN/Creatinine - kidney function -basic metabolic panel - may have F/E imbalance

which of the following statements indicate a non therapeutic communication technique

-why didnt you attend group this morning -if I were you I would quit the stressful job and find something else -what did your boyfriend do to make you leave? are you angry at him? did he abuse you in some way? -im really proud of you for the way you stood up to your brother when he visited today

you are caring for William, a 55 year old patient who recently came to the US from England. he was admitted for severe depression following the death of his wife from cancer 2 weeks ago. while telling you about his wife's death and how it has affected him, William shows little emotion. which of the following explanations is most plausible

-williams response may reflect cultural norms

therapeutic lithium levels

0.6-1.2 mEq/L

A confused client has recently been prescribed sertraline (Zoloft). The client's spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect and what could be its possible cause? A. Neuroleptic malignant syndrome caused by ingestion of two different seratonin reuptake inhibitors (SSRIs) B. Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) C. Serotonin syndrome caused by ingestion of an SSRI and an MAOI D. Serotonin syndrome caused by ingestion of two different SSRIs

D The nurse should suspect that the client is suffering from serotonin syndrome possibly caused by ingesting two different SSRIs (Zoloft and Paxil). Symptoms of serotonin syndrome include confusion, agitation, tachycardia, hypertension, nausea, abdominal pain, myoclonus, muscle rigidity, fever, sweating, and tremor.

The nurse is developing a daily care program for a depressed client who was just admitted to the mental health unit. Which is the best approach when planning activities for this client?

Provide a structured daily program of activities, and encourage the client to participate.

The nurse caring for a client with a diagnosis of acute schizophrenia should use which approach when planning care?

Provide assistance with grooming and nutrition until the client's thinking has cleared. In the acute phase, the nurse must assume responsibility for planning for the client's basic human needs, such as nutrition, hygiene, sleep, and activities of daily living.

A client receiving long-term therapy with lithium carbonate has a serum lithium level of 1.0 mEq/L. Which nursing intervention should the nurse be prepared to implement based on this result?

Provide positive support for the client's compliance with the therapy.

A client with paranoid schizophrenia is admitted to the psychiatric unit of a hospital. Nursing assessment should include careful observation of the client's:

Thinking, perceiving, and decision-making skills

Which client is at greatest risk for committing suicide?

a client with metastatic cancer clients with terminal illness are at highest risk Other high-risk groups include -adolescents -drug abusers -persons who have experienced recent losses -those who have few or no social supports -those with a history of suicide attempts and a suicide plan.

A patient with severe benign prostatic hypertrophy has elected to undergo holmium laser enucleation of the prostate (HoLEP). The patient admits to having a very active lifestyle, and he expresses fear that the surgery will cause permanent incontinence. What teaching point can the nurse use to calm this patient's anxiety?

after recovery is complete, most patients have better urinary control than before surgery

A client receiving fluphenazine decanoate (Prolixin Decanoate) therapy develops pseudoparkinsonism. The physician is likely to prescribe which drug to control this extrapyramidal effect?

amantadine (Symmetrel) An antiparkinsonian agent, such as amantadine, may be used to control pseudoparkinsonism.

A client with diabetes mellitus is told that amputation of the leg is necessary to sustain life. The client is very upset and tells the nurse, "This is all my health care provider's fault. I have done everything I've been asked to do!" Which nursing interpretation is best for this situation?

an expected coping mechanism

grandiosity

an overvaluation of one's significance or importance

the nurse notes that patient is often late to meals because of time needed to ritualistically wash and rewash their hands. in working with the patient to reduce stress, what intervention should the nurse implement

announce to the patient, your meal will be served in 30 minutes

The nurse is assessing an older adult patient who is on urinary antispasmodic drug therapy. During the assessment, the patient appears to be experiencing hallucinations. What may be responsible for this condition?

anticholinergic effect of the medication

A client has just had surgery to deliver a nonviable fetus resulting from abruptio placentae. As a result of the abruptio placentae, the client develops disseminated intravascular coagulation (DIC) and is told about the complication. The client begins to cry and screams, "God, just let me die now!" Which client problem should be the priority for the client at this time?

concern about the loss of the baby and personal health

Which tool uses nine open-ended questions and a diagnostic algorithm to identify delirium?

confusion assessment method (CAM) used to determine delirium

A patient is diagnosed with psychosis. The primary health care provider prescribes haloperidol. Which anticholinergic effect will the nurse anticipate that the patient may experience?

constipation

The nurse is caring for an older adult patient receiving antipsychotics. What adverse drug event is most likely to happen?

constipation and urinary retention

A transwoman presents to her provider's office reporting difficulty sleeping, anxiety, and hypervigilance. She states, "I just can't stop thinking about what they did to me last New Year's Eve at work. They slashed my tires. They took my purse. I see it over and over." What is the nurse's best action?

consult with the HCP for referral to a counselor

A patient's spouse expresses concern that the patient, who has Guillain-Barré syndrome, is becoming very depressed and will not leave the house. What is the nurse's best response?

contact the GBS foundation international for resources

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which condition that should be the focus of this consult?

conversion disorder alteration or loss of a physical function that can not be explained by any pathophysiological mechanism

A hospitalized client is started on phenelzine for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication? Select all that apply.

crackers tossed salad Phenelzine is a monoamine oxidase inhibitor (MAOI). The client should avoid ingesting foods that are high in tyramine. Ingestion of these foods could trigger a potentially fatal hypertensive crisis

adventitious crisis

crisis of disaster, is not a part of everyday life, and is unplanned and accidental. examples include: -(e.g., floods, fires, tornadoes, earthquakes) -a national disaster (e.g., war, riots, airplane crashes) - a crime of violence (e.g., rape, assault, murder in the workplace or school, bombings, or spousal or child abuse).

To which client would the nurse question administering lithium (Eskalith), an antimania medication?

e 42-year-old client taking a loop diuretic Diuretics increase the excretion of lithium from the kidneys; therefore, the nurse would question administering lithium to this client.

A client recently admitted to the hospital in the manic phase of bipolar disorder is unkempt, taking antipsychotic medications, and complaining of abdominal fullness and discomfort. Which intervention addresses the prioritysign/symptom?

encourage frequent fluid intake and a high fiber diet

A patient is admitted to the medical floor with a new diagnosis of lung cancer. How does the nurse assist the patient initially with the anxiety associated with the new diagnosis?

encourage the patient to ask questions and verbalize concerns

A patient being treated with lorcaserin for obesity calls the health care provider's office and reports feeling depressed with suicidal thoughts. What nursing action is priority?

encourage the patient to go to the emergency room

A patient with CRC had colostomy surgery performed yesterday. The patient is very anxious about caring for the colostomy and states that the health care provider's instructions "seem overwhelming." What does the nurse do first for this patient?

encourages the patient to look at and touch the colostomy stoma

somatic delusion

false belief that one's appearance or part of one's body is diseased or altered

What is the pattern of inheritance of schizophrenia in adults?

familial clustering

nyctophobia

fear of darkness

what is agoraphobia

fear of open spaces

What statement by the nurse is most important for a patient experiencing a myocardial infarction who is upset and tells the nurse he or she is afraid of dying?

im sure youre scared but I am not going to leave you

The nurse is teaching a client who is being started on imipramine about the medication. The nurse should inform the client to expect maximum desired effects at which time period following initiation of the medication?

in two to three weeks

Akathesia

inability to remain still; motor restlessness and anxiety

Tangential speech

inappropriate response to a statement in which the content of the statement is disregarded

The nurse is planning relapse prevention information for a client diagnosed with schizophrenia. The nurse understands that it is important to ensure which primary intervention?

including the clients support system in the teaching

A client with schizophrenia is receiving antipsychotic medication. Which nursing diagnosis may be appropriate for this client?

ineffective protection related to blood dyscrasias Antipsychotic medications may cause neutropenia and granulocytopenia

The nurse is developing a plan of care for a client who was experiencing anxiety after the loss of a job. The client is now verbalizing concerns regarding the ability to meet role expectations and financial obligations. What is the prioritynursing problem for this client?

lack of ability to cope effectively

Which non-antipsychotic medication is used to treat some clients with schizoaffective disorder?

lithium carbonate (Lithane)

A rehabilitation patient is being discharged home. Which nursing intervention provides the best assessment for home modification, while helping diminish the patient's anxiety about the process of discharge?

making a leave of absence visit possible

During the assessment, what is the nurse's primary goal for a confused and disoriented client diagnosed with posttraumatic stress disorder?

making the client feel safe

A patient's lithium level is 2.3 mEq/L. Which nursing intervention will the nurse be prepared to implement when ordered?

managing the administration of parenteral normal saline

flat affect

manifested as an immobile facial expression or blank look

physiological signs and symptoms after ECT

may experience -disorientation -attention difficulty -transient neurological abnormalities, which usually resolve within a few hours or days

A patient has intensive care unit (ICU) psychosis. What procedure is the most probable cause?

mechanical ventilation

Hard suicide

methods include using a -gun -jumping off a high place such as a bridge -hanging -staging a car crash

blunted affect

minimal emotional response or outward affect that typically does not coincide with the client's inner emotions.

The nurse is caring for a client who is taking a maintenance dosage of lithium carbonate. What nursing action should be included in the client's plan of care?

monitoring intake and output This medication is very dependent on stable body fluid levels, and so monitoring daily intake and output is critical.

lithium side effects

mood stabilizer -headache -nausea -tremors -diarrhea

Which behavior would be the most problematic and require vigilance to prevent danger to self or others?

motor agitation

dystonia

muscle spasms consisting of tightening or twisting a limb -jaw clenching -monitor airway

Medication teaching regarding lithium is regarded as successful when the nurse hears the patient makes which statement?

my body treats lithium just like salt

MAOIs are contraindicated with

patients with comorbid substance use disorder patients taking antipsychotics

delusion

personal belief that is the product of dysfunctional processing of information derived from external reality This cognitive processing dysfunction is the basis of schizophrenia.

antidote for hypertensive crisis caused by MAOI toxicity due to excess tyramine

phentolamine by IV injection

The nurse is caring for a patient with chronic renal impairment who presents with acute confusion, delirium, and bizarre thinking. Which intervention is appropriate to include in the patient's plan of care?

placing a clock and calendar at the patients bedside

A patient has suddenly become restless, inattentive, and agitated. The patient often tries to climb out of bed. A family member who visits asks the nurse for advice on what to do. The nurse discusses the disorder the patient may have and makes what suggestion?

please bring a doll or stuffed animal your family member might like having around

are hallucinations and delusions a positive or negative effect of schizophrenia

positive

neuroleptic malignant syndrome

potentially fatal syndrome that may occur at any time during therapy with neuroleptic (antipsychotic) medications. characterized by -dyspnea or tachypnea -tachycardia or irregular pulse rate -fever -blood pressure changes -increased sweating -loss of bladder control -skeletal muscle rigidity.

how often must the nurse perform visual checks on a patient who is in suicide precuations

q 15 minutes

A client plans and follows through with the wake and burial of a child lost in an automobile accident. Using Engel's model of normal grief response, in which stage would this client fall?

restitution Engel's model consists of five stages of grief, including shock and disbelief, developing awareness, restitution, resolution of the loss, and recovery. The client in the question is exhibiting signs associated with Engel's stage of restitution. Restitution is the third stage of Engel's model of the normal grief response. In this stage, the various rituals associated with loss within a culture are performed. Examples include funerals, wakes, special attire, a gathering of friends and family, and religious practices customary to the spiritual beliefs of the bereaved.

The nurse is developing a plan of care for a client who is scheduled to have electroconvulsive therapy. Which problem is a priority for this client?

risk for aspiration Aspiration is safeguarded against by keeping the client on nothing by mouth status for 6 to 8 hours before electroconvulsive therapy, removing dentures, and administering preprocedure medications as prescribed.

An understanding of borderline personality disorder should help the nurse determine that which problem is the priority for the client?

risk for self harm

priority for patients with schizophrenia

safety

The nurse taking a medication history for a client who has been admitted to the nursing unit notes that the client is receiving olanzapine. The nurse interprets that this client most likely has a history of which disorder?

schizophrenia

A nursing instructor asks a nursing student to explain the pattern of inheritance of schizophrenia. Which student nurse response is accurate?

schizophrenia is a complex disorder and has familial clustering

A child has been diagnosed with schizophrenia. What is the most caring response the nurse can offer when the mother asks what she could have done to prevent the illness?

schizophrenia is a multifactorial disease just like hypertension. please do not blame yourself or your parenting for it,

Which statement regarding depression in older adults is correct?

secondary depression may occur due to cardiac disease

A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse determines that which is an adverse effect, indicating that the client is taking an excessive amount of medication?

seizure activity Seizure activity can occur in clients taking bupropion dosages greater than 450 mg daily.

Which statement does the nurse recognize as accurate regarding depression and its management in older adult patients?

stroke and other cardiac diseases can lead to secondary depression

What is the common mental health diagnosis seen in all patients admitted to a co-occurring-disorders unit of a psychiatric hospital?

substance abuse

The patient refuses lithium for acute mania but is agreeable to another medication. The nurse will expect the prescriber to respond with what intervention?

substituting the lithium for an anticonvulsant medication

thought blocking

sudden cessation of a thought in the middle of a sentence. client is unable to continue train of though

A client is anxious about an upcoming diagnostic procedure. The client's pupils are dilated, and the respiratory rate, heart rate, and blood pressure are increased from baseline. The nurse determines that the client's clinical manifestations are due to what type of physiologic response?

sympathetic nervous system responsible for fight or flight mechanism

The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication?

tardive dyskinesia

A patient who was the sole survivor of a house fire says, "I feel so guilty. Why did I survive?" What is the best response by the nurse?

tell me more

The nurse instructor is teaching a student nurse about the critical incident stress debriefing (CISD) team. Which statement made by the student nurse indicates a need for further learning?

the incident stress debriefing team is called to train the health care team members after a disturbing incident the CISD deals with emotional needs and not training

A client diagnosed with bipolar disorder is prescribed lithium carbonate. The nurse who administers the medication knows that lithium is used primarily to treat which condition?

the manic phase of bipolar disease

The nurse is assessing a client for signs of postpartum depression. Which observation, if noted in the new mother, indicates a need for follow-up or further assessment related to this form of depression?

the mother constantly complains of tiredness and fatigue

taking-in phase

the new mother is attempting to integrate her labor and birth experience. She tends to -need sleep -feels fatigued -talks about labor -self-focused and dependent.

To provide paternalistic care implies that the nurse bases nursing interventions on which belief?

the nurse making the decisions knows what is best for the patient

Which intervention demonstrates responsibility for the milieu in an inpatient psychiatric setting?

the nurse managing an aggressive client

What aspect of traditional antipsychotic medication therapy is most responsible for a patient's medication nonadherence and resulting rehospitalization?

the occurrence of EPSEs

An older adult patient is prescribed risperidone for the treatment of psychotic behavior. What will the nurse assess when the patient returns for a follow-up visit?

the patients blood sugar levels

A nurse has arranged for someone from the American Cancer Society (ACS) Visitor Program to speak to a patient before having a laryngectomy. Which indicates a favorable patient outcome from the visit?

the patients exhibits effective use of coping strategies

A patient being discharged from a co-occurring-disorders psychiatric unit will especially benefit from what area of patient education?

the role of the community based treatment center

The characteristics of a therapeutic milieu are constantly being changed as a result of demands created by which treatment-related factor?

the short hospital stays of todays mentally ill patients

What intervention is met by occupational therapy specialists?

the successful completion of activities of daily living

Which circumstance contraindicates the use of haloperidol in a dying patient?

use of another antipsychotic drug

Anticholinergic drugs

used to decrease extrapyramidal side effects of antipsychotics -benztropine

A patient with pneumonia has a cough productive of thick green mucus, is in bed with the head of bed elevated to 30 degrees, and has an oxygen saturation of 94% with 3 L/min of oxygen via nasal cannula. The nurse notes that the patient is anxious and tense. Which is the prioritynursing action for this patient?

using a calm slow approach with the patient

A patient with a history of aggressive behavior begins pacing while talking on the telephone. The RN suspects that the patient is in the triggering phases of the assault cycle and implements which intervention?

using a calm voice, ask the patient to end the phone call immediately

A client is taking benztropine mesylate orally daily. In monitoring this client for medication side effects, the nurse should plan to focus the assessment on which item?

voiding pattern