Final Study Guide Mental Health
6 g = _________mg
6000
What is the best response by a nurse when a patient inquires how alcohol acts so quickly on his system?
Alcohol is metabolized into ethanol rapidly
What is the most likely result when an attempt at adaptation fails?
Anxiety
The nurse concludes that a significant goal of the care plan for an alcoholic patient has been met when the patient makes which statement?
"All my difficulties are related to my drinking"
300 mcg = __________mg
0.3
a variety of factors influence the level of anxiety experienced by the patient faced by a stressful situation. Which would the nurse outline? ( Select all the apply.)
present role of assumption previous experience with a similar situation influenced by how the event is perceived by the individual
A patient who has been prescribed a serotonin norepinephrine reuptake inhibitor (SNIR) one week ago reports that she has not noticed any difference in her depression level since beginning this drug. What is your best response?
" It may take several weeks for this drug to take effect"
The mother of a young woman being treated for amphetamine overdose asks the nurse when the manifestations will subside. What would the most correct answer by the nurse?
" The manifestations may be permanent".
You are preparing to give the benzodiazepine Valium to a patient as a premedication before surgery. The patient asks how this drug works. What is your best response?
" This drug is acts by preventing binding to the benzodiazepine receptors
A patient who is taking a monoamine oxidase inhibitor (MAOI) asks the nurse about the addition of St. John's wort to help with his depression. What would be the best response of the nurse?
"Did you know that St. John's wort can raise your blood pressure dramatically
The patient is concerned about confidentiality and asks the nurse not to tell anyone what is said. What is the best response by the nurse?
"I am required to report any intent to hurt yourself or others"
A patient who has been prescribed a serotonin norepinephrine reuptake inhibitor (SNRI) one week ago reports that she has not noticed any difference in her depression level since beginning this drug, What is your best response?
"It may take several weeks for this drug to take effect"
The nurse asks a patient with schizophrenia if he had any visitors on Sunday. Which response indicates loose association?
"We visited Yellowstone Park last Summer"
A patient who has been taking the atypical antipsychotic risperidone (Risperdal) reports weight gain after taking the drug for 3 months. What would you tell this patient?
"Weight gain is an expected side-effect of this drug"
A patient seems bewildered when he confides in the nurse that all of his friends and leisure time have been centered on a drug culture. Which would be the best response by the nurse?
"What other sort of activities might you enjoy?"
If the patient tell the nurse, "I'm not an alcoholic. I can stop whenever I want to". What should be the nurse's most therapeutic response?
"What would you call alcoholism?"
A patient who started taking the antidepressant fluoxetine (Prozac) stated he has not felt any relief from his depression and it has been 7 days. What is the best response?
"You need to start psychotherapy to get the effect you need"
The nurse reminds a group of high-school students that most states have laws limiting blood alcohol levels of drivers. What is the legal blood alcohol serum level in most states
0.08%
a 40 - year-old patient newly diagnosed with schizophrenia is to receive 2.5 mg of haloperidol IM for acute psychosis. Haloperidol is supplied in a vial of 54 mg/ml. How many mL will the patient receive?
0.5
For which patient would benzodiazepines be contranindicated
A woman who is 20 weeks pregnant
The Diagnostic and Statistical Manual or Psychiatric Disorders, V (DSM) V, is used by most hospitals and is the current tool used to examine mental health and illness. What approach does the DSM-V use to classify mental disorders?
Multiaxial system
When a patient is admitted with an overdose of an opioid narcotic, the nurse should anticipate an order for which drug to reverse the effects of the narcotic?
Narcan
A home health nurse has a patient who is taking lithium. What should be included in the teaching plan?
Have her drug blood level checked every month
You are caring for a patient in the clinic setting who has been taking a benzodiazepine Alprazolam (Xanax) for anxiety. What potential problem should you observe this patient for?
Addiction
Which drug category is useful in promoting sleep among patients with insomnia?
Sedatives
The home health nurse assesses a patient who creates elaborate excuses for not leaving home. Further questioning reveals the patient had not left home for 6 months. How should this be documented?
Agoraphobia
which of the following drugs would be appropriate for the treatment of bipolar illness?
Alprazolam
During the initial intake assessment of a drug user, the nurse should attempt to obtain which subjective data? (Select all that apply)
Amount of drug uses Time of last use Usual pattern of use Specific Drug
A 22-year-old patient presents in the emergency department with the characteristics of severe Parkinson's disease. The nurse should suspect an overdose of what drug?
Amphetamines
What coping mechanism demonstrated by a patient should indicate to the nurse that the patient is seeking ways to deal with and resolve stress?
An individual who develops ways to deal with stress and resolve it has adapted
What disorder is a severe form of self-starvation that can lead to death?
Anorexia nervosa
The nurse is sensitive to the fact that patients lose control over their lives when admitted to the hospital. In what does this loss of control frequently result?
Anxiety
The family members of a patient admitted for hallucinations and delusions tells you that the patient is currently taking chlorpromazine (Thorazine) for the treatment of schizophrenia. Which statement about this drug is true?
Thorazine is used for chronic mental illness
Adjunctive therapies are used for which reasons? ( Select all that appy)
To increase self-esteem To promote positive interaction To enhance reality orientation To stimulate communication
The nurse is assessing a female patient who has become rapidly and exceedingly anxious because her fingernail polish is chipped. What type of anxiety should the nurse conclude that the patient is exhibiting?
Anxiety traits
The nurse is performing an initial assessment on an alcoholic patient. Which of the following actions by the nurse would best ensure hones answers?
Having a nonjudgmental attitude
When all five axes of the Diagnostic and Statistical Manual of Psychiatric Disorders, V are used, it provides what type of assessment approach to comprehensive care?
Holistic
You are taking the history of a patient who is suspected of having lithium toxicity. What symptoms would you expect the patient to report?
Increased drowsiness, weakness and nausea
Which symptoms would you expect a patient who is experiencing mania? (Select all that apply)
Increased energy Catatonia Poor judgement
The patient is prescribed pheneizine (Nardil), a monoamine oxidase inhibitor, for depression. Which of the following foods should the patient avoid in his diet? (Select all that apply)
cheddar cheese, coffee, red wine, salami,
The patient talks with his dead brother an arranges furniture so that his brother will have a place to sit. How should the nurse document this behavior
Hallucination
When a patient demonstrates accelerated heart rate, trembling, choking and chest pain along with acute, intense, and overwhelming anxiety, the nurse should recognized that the patient is most likely experiencing what condition?
Panic
A nurse suspects here a coworker is abusing drugs. Which of the following symptoms, noticed in the coworker, would contribute to the suspicions? (Select all that apply)
Patient report they did not receive their medications Rapid changes in mood and performance Frequently absent from the unit
What definition should the nurse use to clarify the concept of "mental health"?
as a person's ability to cope and adjust to everyday stresses
The nurse uses a diagram to show how the four parts of "self" fit together. What are the four parts? ( Select all that apply)
body image self-esteem role identity
A family is informed that the brain damage to their daughter is irreversible. The father is later overheard making vacation plans and discussing what the family will do when his daughter leaves the hospital. The nurse recognizes the father is in which crisis stage?
denial
After finding the patient with diabetes eating candy, the nurse reminds the patient that the candy will elevate blood sugar levels. The patient's response is "its only a little bit, and it wont do anything" Which defense mechanism is the patient using?
denial
What does any event that requires change stimulate?
leads to stress, which is the nonspecific response of the body to any demand
What is the mental health nurse referring to when using the term behavior?
manner in which a person performs any or all of the activities of daily living.
Using the mental health continuum as a guide, the nurse observes behavior that usually places an individual on the illness end of the continuum. What is true of this behavior?
on the illness end of the mental health continuum, the person is rarely in touch with reality
What is a nursing intervention that helps to build trust, encourages the patient to have faith in the care being received, and meets psychosocial needs?
patient education
The majority of people function in a relatively healthy manner. What can diminish their functional capacity?
periods of crisis can decrease functional capacity, moving a person toward the illness end of the continuum
A patient believes himself to be the president of the United States and that terrorists are trying to kidnap him. The nurse records these observations as which type of behavior
positive behavior
The patient admitted to the hospital may adjust to illness by assuming a role in which everyday responsibilities are avoided. What is this role called?
sick role
A patient admitted to the hospital after a motorcycle crash that has left him paralyzed from the waist down tells the nurse he has feelings of helplessness and hopelessness. What other feelings may the patient have that should be recognized?
suicidal ideation
A young adult patient taking an SSRI for the past 2 weeks comes in for an evaluation and follow-up appointment. Which potential side effect should you check for in this patient?
suicidal thoughts
Using Freud's personality theory, what action by a patient identifies the influence of the superego?
the superego is the mediator between right and wrong ( the conscience)
A 14-year-old survivor of a school shooting screams and dives under a table when firecrackers go off. What does this behavior represents
Posttraumatic stress disorder
When the patient with a psychosis is thought to be a danger to self or others, by what method should the patient be admitted to the hospital?
Probating
What is the term used for the beginning stage of schizophrenia, characterized by a lack of energy and complaints of multiple physical problems
Prodromal
The patient complains to the nurse that the health care provider does not like him and wants him to fail at following the diet prescribed. The nurse recognizes that the patient is using which defense mechanism?
Projection
What should the nurse do to decrease the damage of brutish seen in a patient who has been abusing the drug ecstasy?
Provide the patient with a pacifier.
What is the term for a long-term and intense for m of psychotherapy developed by Sigmund Freud that allows a patient's unconscious thoughts to be brought to the surface?
Psychoanalysis
What must a patient in the late stages of dependence do in order to recover?
Receive treatment for substance abuse.
a 40-year-old patient cries and has a tantrum when the health care provider refuses to give her a prescription for diet pills. The nurse realizes that this is the use of which defense mechanium?
Regression ( return to an earlier form of coping)
When assisting the older adult who is despondent about the need to leave his home, what technique should the nurse use?
Reminisce with the patient and review his life
What should the nurse do when suspecting a coworker of abusing drugs while at work
Report observations to a supervisor
Which drug is often used in date rape?
Rohypnol
The nurse is assessing a young woman who is a teacher, happily married, raising two children, taking care of her disabled mother, and going to school to get a master's degree. How should the behavior of the young woman be classified?
Role integration
A profound, disabling mental illness is characterized by bizarre, nonreality thingking. What is the illness?
Schizophrenia
The nurse is assessing a nervous 18-year-old patient who has vital signs of P 120, r 30 and BP 160/90. The patient states that he feels something bad is about to happen. Based on this data alone, how should the nurse identify the patient's level of anxiety?
Severe
The patient complains of recurrent, multiple physical ailments for which there is no organic cause. How should the nurse assess this?
Somatic symptom disorder
A young adult patient taking SSRI for the past 2 weeks comes in for an evaluation and follow-up appointment. Which potential side effect should you check for in this patient?
Suicidal thoughts
a patient admitted for delirium demonstrates increased disorientation and agitation only during the evening and nighttime. What is the term applied to this type of delirium?
Sundowning syndrome
Which statement describes the impaired nurse who is in a peer assistance program?
The nurse will be allowed to work as a nurse under supervision
When developing a care plan for a mentally ill patient, what should the nurse assess first?
The nurse's first priority would be to assess the emotional status of the mentally ill patient
The nurse is discussing the difference between a patient with a neurosis and one with a psychosis. What is true of the patient experiencing a neurosis?
The patient experiences a flight from reality
The nurse cautions a patient to watch his step. What response indicates concrete thinking?
The patient fixedly begins to watch his feet.
What specific information should be part of the teaching plan for a patient taking a nonbenzodiazepine sedative?
These drugs can cause you to be physically active at night
The nurse is told that a patient believes he was born into the wrong body. What is the correct terminology for the desire to have the body of the opposite sex?
Transsexualism
Which of the following drug classifications for the treatment of mental health problems is contraindicated for patients with vision problem?
Tricyclic antidepressants
A pregnant adolescent tells the nurse that she. "Only drinks a little. "How many drinks per day can cause an adverse effect in an infant
Two drinks a day
What should the nurse do to decrease the patients disorientation at night during the detoxification period?
Use nightlights and remove extra furniture from room
what action by a student before taking a test should indicate to a nursing instructor that the student is demonstrating signs of moderate anxiety
Vocal changes, rapid speech, increased pulse, respirations, and blood pressure, tremors, restlessness, increased perspiration , nausea, decreased appetite, diarrhea, frequent urination, and vomiting
A 60-year-old man was admitted for cholecystokinin that resulted in a cholecystectomy. On his third day of hospitalization, he begins to sweat profusely, tremble , and has a blood pressure of 160/100. Based on these findings, what focused assessment should the nurse complete?
Withdrawal problems
During the 17th and 18th centuries, care of patients with mental illness often was cruel. What type of care was used by Dr. Philippe Pinel to bring about change
advocated humane care
A perceived threat to self causes what emotion?
anxiety
What action consistently done by a patient should indicate to a nurse that the patient has a poor self-concept?
apologizing repeatedly anger demanding attention
When the patient who overeats insists that weight gain is related to retained fluids, the nurse recognizes the patient is using which defense mechanism?
are unconscious reactions that offer protection to the self from stressful situations.
a 150-lb-man is to receive a medication based on milligrams/kilograms. He is to receive 2mg/kg. What dosage should the nurse administer? ( Round to the nearest whole number)
136
What age of onset of alcohol consumption is most predictive of alcohol addiction?
14 or younger
34 lb = _____kg (Round decimals to the nearest tenth
15.5
When was psychiatric training for nurses initially offered?
1882 Mclean Hospital in Waverly, Massachusetts
a 26-year old male patient with bipolar illness is to receive carbamazepine 200 mg by mouth twice daily in addition to lithium. The carbamazepine is available as 100 mg chewable tablets. How many tablets will the patient require each day?
4
How many people in the United States will develop a mental disorder during their lifetime
50% of people in the united states will develop a mental disorder during their lifetime
0.5 liter is equal to how many mL?
500
An ampule contains 500 my of ascorbic acid in 2 mL of solution. Which of the following amounts of ascorbic acid would be administered by giving 1 mL of the medication in the ampule?
500 mg
The nurse assesses an alcoholic patient carefully for signs of withdrawal. How soon after cessation of alcohol intake do withdrawal symptoms usually appear?
6 hours
A college student has brought his hallucinating roommate to the college clinic. The you're man says his roommate has been experimenting with phencyclidine (PCP). How long should the nurse expect the hallucinations to last?
6 to 12 hours
What is the typical schedule for electroconvulsive therapy (ECT)
6 treatments over 2 months
The nurse recognizes that researchers have identified that hereditary factors account for what percentage of mood disorders?
60% to 80%
Alcohol is involved in motor vehicle accidents, suicides, and homicides. Approximately how many deaths each year are related to alcohol consumption?
88,000
4.5 Kg = _________ lb
9.9
The nurse explains that Alcoholics Anonymous (AA) consists of abstinent alcoholics who help other alcoholics become and stay sober. What is the foundation of AA?
A 12-step program
What is the prognosis for a schizophrenic patient who is exhibiting positive behaviors?
Good
What should the entire health team focus on during the rehabilitation phase?
Abstaining from drug use
What should the nurse preparing a patient for a scheduled appointment for electroconvulsive therapy (ECT) remind the patient to do?
Arrange for transportation to and from the appointment
Which precaution is most important to teach a patient who is prescribed temazepam (Restorill)?
Avoid driving with 6 to 8 hours of taking this drug
You are preparing to teach a patient about the drug amitriptyline. Which of the following statements should be included in your teaching plan? (Select all that apply.)
Avoid ripe cheese and smoked meats Move slowly when changing positions Use sugarless gum or candy to relieve dry mouth This drug can affect your sleeping
What is the basis for classifying a person as having a mental illness?
Behavior exhibited and the context
Why is it important for the nurse to be observant of patient behavior?
Behavior is learned and has meaning.
For the past 3 weeks, the nurse has observed a patient interacting with staff and other patients, helping decorate the dining room for a party, and leading the singing in the activity room. Today, The nurse recognizes theses behaviors as evidence of which psychiatric disorder?
Bipolar disorder
The family of a patient who has been taking the antipsychotic fluphenazine (Prolixin) for the last 2 years. The patient's family reports the patient has suddenly begun smacking her lips, and involuntarily sticking out her tongue. What would be your best first action?
Call the healthcare provider to report these symptoms
When a patient denies any problems related to addiction, what is the nurse's most therapeutic response?
Can you think of any time your behavior created an unpleasant situation in your life?
Dementia is an organic mental disease secondary to what problem?
Cerebral disease
When a patient is experiencing a panic attack, how should the nurse best assist the patient?
Coach in deep breathing
While creating a methadone protocol for a patient rehabilitating from heroin addiction, the nurse explains that the patient will take methadone for what length of time?
Daily until stabilized, then gradually reduce the dose to zero
A nurse tearfully confides to the head nurse that being assigned to care for eight patients is stressful and overwhelming. what demonstrates the uses of a healthy coping mechanism?
Delegating appropriate care assignments to nursing assistants
A young man with malaria spikes a temperature of 105 F (40.5 C) and begins to hallucinate. How should the nurse assess this?
Delirium
How should the nurse document the behavior of a patient with mental illness
Differing from socially acceptable behavior
The nurse alters the care plan for a patient with depression to include what type of activity?
Domino game with three other patients
What are considered warning signs of suicide? ( Select all that apply.)
Drug or alcohol abuse Personality changes Talking about suicide
Which Theorist believed that personality development was based on task mastery?
Erik Erikson provided a framework for understanding personality development
Which event in the mental health care movement occurred first?
Establishment of Pennsylvania Hospital
Which role is an example of an ascribed role?
Ethnicity, sex, and nationality are examples of ascribed roles
The nurse should assess a patient for which criteria of addiction? (Select all that apply)
Excessive use of the substance Uncontrollable consumption Psychological disturbances
Too much serotonin can lead to the adverse effect known as serotonin syndrome. Which of the following symptoms are associated with serotonin syndrome? ( Select all that apply)
Extremely high blood pressure Dilated pupils Restlessness Confusion
Which drug would you anticipate will be given to a patient who experienced an overdose of a benzodiazepine?
Flumazenil
Which drug would you anticipate will be giving to a patient who experienced an overdose of a benzodiazepine?
Flumazenil
When the patient is told that his insurance will no longer pay for his physical therapy, the nurse is aware that this obstruction to his goal may result in which concept?
Frustration refers to anything that interferes with goal-directed activity
What disorders would a selective serotonin uptake inhibitor (SSRI) be prescribed for? ( Select all that apply)
General anxiety disorder Obsessive-compulsive disorder Traumatic stress disorder
During the detoxification period, what does the nurse aim to achieve when designing interventions?
Keep the patient safe from aspiration and seizure
What stage of dependence is described by a patient when he tells the nurse that he has tried to stop his drugs habit, but he does not feel " normal" without it?
Late
Using Freud's personally theory, what action by a patient indicates a strong ego?
Laughs at himself for being foolish
Which drug is classified as a benzodiazepine?
Lorazepam (Ativan)
You are caring for a patient with schizophrenia who is taking antipsychotic drugs for the control of hallucinations and delusions. Which symptoms experienced by the patient would alert you to that the development of neuroleptic malignant syndrome? ( Select all that apply)
Muscle rigidity Elevated temperature Increased white blood count
What severe side effect will occur if an alcoholic patient consumes alcohol while taking disulfiram (Antabuse)?
Nausea
A patient is frequently late for appointments because he goes back to his room numerous times to assure himself that none of his belongings have been stolen. What does this behavior represent?
Obsessive-compulsive
What nursing intervention should be included in the plan of care for a baby born to a drug-addicted mother?
Swaddle the baby closely
The nurse is caring for a patient with a diagnosis of catatonic schizophrenia. What behavior is consistent with this diagnosis?
Talks excitedly about going home
What is the greatest problem with lysergic acid diethylamide (LSD) use?
The drug causes flashbacks