Mental health #2
the nurse assesses a client diagnosed with bipolar disorder, acute manic phase. Which symptom does the nurse expect to observe in the client? 1. Anergia 2. Self blame 3. Negativism 4. Hyperactivity
CORRECT 4. increased non stop activity is typical of clients in an acute manic phase. The client may not sleep, rest, or eat. Bipolar disorder is a mood disorder that can include manic episodes that usually begin suddenly with rapid escalation. Symptoms include elevated or expansive mood, agitation, accelerated speech, thought, movement, distractability, self confidence, aggression, sarcasm, inappropriate dress, inattention to personal hygiene, anorexia, weight loss, constipation and insomnia. 1. The client with mania has increased energy demonstrated by increased activity and excessive talking 2. Self blame is exhibited by most depressed clients. Clients with mania typically show signs of an increased self-attitude. 3. the client with mania will exhibit an unusual optimism that may involve poor judgment
The home care nurse makes an initial visit to a client diagnosed with MI. The clients partner states the family is having difficulty coping with the clients OCD tendencies. Which client statement is consistent with OCD? 1. I have difficulty making decision and adjusting to change 2. I am sure I am being followed by someone from work 3. All of my life I have problems with being unkempt 4. I spend money excessively, which upsets my spouse
CORRECT 1. Clients with OCD have an extreme need to control and predict outcomes. Making decisions and changes are anxiety producing for these clients 2. Is an example of paranoia. Paranoia is an exaggerated suspiciousness and characteristic of schizophrenia 3. poor personal hygiene is often found in client diagnosed with schizophrenia 4. This is a characteristic of bipolar disorder. in which episodes of mood swings ranging from depressive low to manic highs
The nurse provides care for a client diagnosed with antisocial personality disorder. Which client statement BEST indicates improvement in the clients condition 1. I get into trouble because I don't think before I act 2. My parents have difficulty accepting my independence 3. I've spent very little time actually enjoying life 4. It's sad that others don't recognize my potential
CORRECT 1. The clients response is an introspective remark that shows the client is beginning to recognize activist out of anxiety or tension without realizing the consequence of the actions 2. A client diagnosed with antisocial personality disorder sees self as being free and unconfined by persons, obligations, or routines. Clients diagnosed with antisocial personality disorder are often untrustworthiness and unreliable 3. A client diagnosed with antisocial personality disorder will appear charming, intellectual and smooth talking 4. this statement indicates denial of behavior. It is immature and irresponsible
a client is placed on escitalopram 10 mg daily. Which adverse effect does the nurse instruct the partner to observe for? (SELECT ALL THE APPLY) 1. Photophobia 2. Dizziness 3. Epitaxis 4. hypertensive crisis 5. Insomnia 6. Decreased libido
CORRECT 2,5,6 2/ 5/6. Escitalopram is an SSRI used to treat depression and OCD. Adverse effects include insomnia, dizziness, diarrhea, nausea, sexual dysfunction, and lack of sex drive. Also monitor for suicidal tendencies. Administer in morning or evening with or without food. 1. Photophobia (intolerance to light) is not an adverse effect 3. Epitaxy's (nosebleed) can be caused by hypercoagulants 4. Hypertensive crisis is an adverse effect of MAOI
The nurse provides care for a client diagnosed with depression in the mental health clinic. the client joint an ongoing therapy group. Which is the initial goal of group therapy. 1. to introduce the client to others 2. to communicate acceptance to the client 3. To encourage decision-ming 4. to teach participants confidentiality
CORRECT 2. The most important thing to communicate initially is a sense of acceptance. Acceptance by others paves the way for self acceptance 1. it is appropriate to introduce the client to others when the client is ready. 3. A goal of group therapy is to communicate acceptance and increase self estem 4. Although confidentiality is important. It is not the goal of participation of group therapy.
the nurse plans for a client with a hx of substance abuse. It is MOST important for the nurse to select which approach? 1. A structured but permissive setting 2. An environment that increases reality testing 3. A structured, no permissive setting 4. An environment that decreases stimuli and redirects behavior
CORRECT 3. A structured non permissive setting is best environment for a client with a substance abuse. Goal of treatment is to have the client tolerated increasing amounts of anxiety without the need for substances. Intervention involves limit setting and having the client express frustration while exploring alternative coping patterns 1. Substance abuser are often manipulative. A permissive setting might foster manipulative behavior 2. This environment is not necessary 4. These are appropriate nursing actions for a client who is manic
The nurse provides care for a client diagnosed with alcoholism. Which statement by the client indicates to the nurse that the client has an accurate understanding of the problem? 1. When i can learn to stop after one drink, I will have my problem beat 2. When my family and work problems go away, I wont need alcohol anymore 3. I can't seem to cope with my problems without drinking 4. In my business, most people work hard and drink too much
CORRECT 3. When the client acknowledges that alcohol is used to cope with problems, the client is beginning to break through denial 1. Denial is a defense mechanisms used by clients with addictive problems. This statement indicates the client is still denying the problem. 2. This statement indicates the client is still in denial 4. This statement does not reflect that client acknowledges using alcohol to deal with problems
the nurse provides care for a client diagnosed with depression and encourages the client to join an activity. Which approach by the nurse is BEST? 1. Offer several appealing choices to the client 2. Tell the client the health care provider prescribed it 3. Describe the activity in detail to the client 4. Invite the client to join in.
CORRECT 4. A good example of how a nurse might lead a client into an activity is by inviting them to join. It is important for the nurse to demonstrate caring and acceptance 1. The nurse will limit choices because a client diagnosed with depression often feels too inadequate to make choices 2. Client diagnosed with depression often fear rejection. It is important that the nurse supports the clients self esteem by proving a warm supportive environment 3. The nurse will avoid long explanation because client diagnosed with depression often have decreases attentiveness and poor concentration
The nurse provides care for a client diagnosed with OCD. the client must wash, rinse, and dry door handles before entering or leaving a room. Which action by the nurse is BEST? 1. Encourage the client to control the ritualistic behavior because it interferes with the freedom of others. 2. Expect the client to participate in unit activities without the nurse giving special attention to the behavior 3.Place a time limit for completion of the ritual before expecting the client to comply with request to move to another room 4. Provide time for the client to complete the ritual before expecting the client to move from one area to another.
CORRECT 4. Denying the client the ritualistic behavior may precipitate panic level of anxiety. OCD is an anxiety disorder. Symptoms include repetitive uncontrollable thoughts (obsession) and actions (compulsions) 1. The client will be unable to control the ritualistic behavior until the client understands the precipitating factors 2. the client will be unable to function like other clients on the unit until the client understands the meaning and purpose of the behavior 3. placing time limits on the ritual would escalate the clients anxiety and possibly prolong the ritualistic behavior.
A client reports an inability to walk since the sudden death of a client father 2 months ago. A thorough physical examination shows no psychological basis for the client physical condition. which intervention is PRIORITY? 1. Avoid empathizing the client 2. Limit contact between the client and others in the family 3. Ignore the clients physical symptoms 4. provide for basic physiological needs that the client cannot meet
CORRECT 4. Until the client is aware of the connection between physical symptoms and emotional need, the inability to walk can compromise safety. the highest priority is given to nursing interventions that preserve life and safety needs. Conversion disorder is an anxiety disorder. 1. The client is unaware of the connection between the psychiatric trauma and the inability to walk. Empathizing with the client helps establish a trusting relationship 2. the nurse will assist significant others in supporting the clients behavioral changes. Change is one part of the family system affects all parts 3. the highest priority is given to nursing interventions that preserve life and safety needs. the clients inability to walk could compromise safety.
