Mental Health Chpt. 17 Mood Disorders and Suicide 1-4

Orthostatic hypotension

A client has been diagnosed with major depression and placed on amitriptyline. Which is a side effect of amitriptyline? Excessive salivation Weight loss Orthostatic hypotension Diarrhea

Grandiosity

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

Persistent depressive disorder

A client is admitted to a mental health unit with reports of fatigue, poor appetite, and difficulty making decisions. The client also reports having felt unhappy most of the time for "as long as I can remember." Which diagnosis should the nurse anticipate for this client? Bipolar disorder Rapid cycling disorder Persistent depressive disorder Mild depressive disorder

1.0 mEq/L

A client with bipolar disorder is receiving lithium therapy. The nurse is reviewing the client's serum plasma drug levels and determines that the client's level is therapeutic based on what? 2.0 mEq/L 1.6 mEq/L 2.6 mEq/L 1.0 mEq/L

Assess the client's blood pressure

A client's depression is being treated in the community with phenelzine. The client has presented to the clinic stating, "I had a few beers and I'm feeling absolutely miserable." What is the nurse's best action? Assess the client's blood pressure Perform a Mini Mental Status Examination (MMSE) Assess the client's jugular venous pressure Call an emergency code

The client will reframe negative thoughts in a more positive way.

A mental health nurse has identified a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. Which outcome would be most appropriate for this nursing diagnosis? The client will discuss the cause of the fatigue. The client will reframe negative thoughts in a more positive way. The client will identify factors that contribute to depression. The client will differentiate between reality and fantasy.

Liver function

A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy? White blood cell (WBC) count Liver function Thyroid level Cardiac enzymes

Self-injury

A nurse is caring for a client diagnosed with bipolar disorder. The client is experiencing a manic episode. The nurse would be especially alert for signs indicating what? Self-injury Sleep disruption Weight loss Dehydration

observing the client frequently.

A nurse maintains a safe environment for a client who is suicidal by ... creating a stimulating environment. maintaining confidentiality at all times with the client. observing the client frequently. ensuring the client has access to all personal belongings to make the client feel at home.

The potential for life-threatening side effects such as Stevens-Johnson syndrome

After being prescribed several medications that were ineffective, a client is diagnosed with refractory mania. The physician decides to prescribe lamotrigine, an anticonvulsant that has been found to be effective for refractory mania. Which would the nurse need to include in the client's education plan? The potential for the development of addiction to the medication The potential for life-threatening side effects such as Stevens-Johnson syndrome The need to have blood levels drawn on a monthly basis The need to avoid certain types of foods while on the medication

The client has engaged in risky behaviors and tends to be impulsive.

The nurse is assessing a client for warning signs of suicide. Which would be a concern? The client has forgiven those who have caused emotional pain. The client is reaching out to family and friends. The client has engaged in risky behaviors and tends to be impulsive. The client has decreased substance use.

The client overdosed on pills 2 years earlier

The nurse is assessing a client who has presented to the emergency department in emotional distress. What client data represents the greatest risk for suicide? The client sits silently after being asked several of the assessment questions The client has been treated with a variety of antidepressants over the years. The client overdosed on pills 2 years earlier The client states, "Everything just seems really dark right now."

completing a daily journal entry before bedtime writing out the events leading up to the loved one's suicide cognitive behavioral therapy

The nurse is facilitating a support group for people who have lost a family member or friend to suicide. When discussing strategies for coping with grief, which should the nurse include? Select all that apply. completing a daily journal entry before bedtime writing out the events leading up to the loved one's suicide encourage time spent in solitude take anti-anxiolytic medications as often as possible cognitive behavioral therapy

Administering a mental status exam to assess for psychosis

The nurse is told by a client that the client is having suicidal thoughts. Which intervention has lowest priority? Assessing the client for past history of suicidal attempts Determining the client's concerns and if the client has a plan Administering a mental status exam to assess for psychosis Maintaining a safe, secure environment

"I might experience an increased appetite."

The nurse provides medication teaching to a client who is newly prescribed a serotonin norepinephrine reuptake inhibitor (SNRI) for the treatment of depression. Which client statement indicates a need for additional teaching? "I should change positions slowly to decrease my risk for falls." "I should wear sunscreen due to photosensitivity." "I can use sugar-free gum to treat dry mouth." "I might experience an increased appetite."

Assessing all clients carefully to identify those at risk for suicide

The policies and procedures at a community psychiatric-mental health center include an emphasis on case finding. How can a nurse at the center best perform case finding? Modifying the center's environment to maximize client safety Organizing the layout of the center to allow observation of clients Assessing all clients carefully to identify those at risk for suicide Encouraging clients not to be ashamed of previous suicide attempts or suicidal thoughts

Confusion

When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what in a client? Long-term memory impairment Full of energy Confusion Numbness and tingling in the extremities

Thyroid function tests

When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate? Renal function tests Coagulation profile Abdominal ultrasound Thyroid function tests

Fluoxetine

Which antidepressant medication is classified as a selective serotonin reuptake inhibitor (SSRI)? Tranylcypromine Isocarboxazid Fluoxetine Phenelzine

Hyperactivity, dismissing meals, and sleep disturbance

Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder? Bizarre, colorful, inappropriate dress Grandiose thinking and poor concentration Insulting, provocative behavior directed at staff Hyperactivity, dismissing meals, and sleep disturbance

Norepinephrine and serotonin

Which biogenic amines have been implicated in depression? Epinephrine and dopamine Dopamine and histamine Norepinephrine and serotonin Epinephrine and serotonin

Social isolation

Which is a primary risk factor for suicide? Unemployment Social isolation Poverty Economic deprivation

Divalproex

Which is an anticonvulsant used as a mood stabilizer? Phenelzine Bupropion Divalproex Venlafaxine

Identify a client who is thinking about suicide.

Which is the priority nursing action to prevent suicide and promote mental health? Intervene to change suicidal behavior. Identify a client who is thinking about suicide. Assess a client to determine the suicidal threat. Institute interventions to prevent future suicidal behavior episodes.