MENTAL HEALTH EXAM 1

A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L (2.5 mmol/L). The nurse plans care based on which representation of this level? 1.Toxic 2.Normal 3.Slightly above normal 4.Excessively below normal

1. toxic

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? 1.Monitoring intake and output 2.Reviewing daily serum lithium levels 3.Performing a weekly electrocardiogram 4.Observing for remission of a depressive state

1.Monitoring intake and output want to keep body fluid levels stable

The nurse has given instructions to a client prescribed lithium carbonate. What statement by the client indicates that the client needs further information? 1."I will take the lithium with meals." 2."I will decrease fluid intake while taking the lithium." 3."Lithium blood levels must be monitored very closely." 4."I will call my primary health care provider if I start vomiting."

2."I will decrease fluid intake while taking the lithium."

A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose? 1.On an empty stomach 2.At the same time each evening 3.Evenly spaced around the clock 4.As needed when the client complains of depression

2.At the same time each evening evening administration is preferable because of drowsiness side effect. this med is taken 1x/day

A client begins to experience extrapyramidal side effects from an antipsychotic medication. The nurse anticipates that the primary health care provider will prescribe which medication to treat this condition? 1.Haloperidol 2.Benztropine 3.Chlorpromazine 4.Prochlorperazine

2.Benztropine Benztropine is an anticholinergic medication used to treat drug-induced extrapyramidal reactions (except tardive dyskinesia). The remaining options are antipsychotic medications. Antipsychotic medications can cause extrapyramidal reactions.

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? 1.Cardiovascular symptoms 2.Gastrointestinal dysfunctions 3.Problems with mouth dryness 4.Problems with excessive sweating

2.Gastrointestinal dysfunctions The most common side and adverse effects related to fluoxetine include central nervous system and gastrointestinal system dysfunction.

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? 1.Plan rest periods into the client's daily routine. 2.Monitor the client for behaviors that suggests ataxia. 3.Document incidences that the client has begun to demonstrate mood stability. 4.Notify the client's primary health care provider that the medication dosage needs to be increased.

2.Monitor the client for behaviors that suggests ataxia.

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. 1.Diarrhea 2.Sedation 3.Dry mouth 4.Weight loss 5.Orthostatic hypotension 6.Presence of a fixed stare

2.Sedation 3.Dry mouth 5.Orthostatic hypotension 6.Presence of a fixed stare

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? 1.Suicidal ideations 2.The manic phase of bipolar disease 3.Both depressive and manic episodes 4.The depressive phase of bipolar disease

2.The manic phase of bipolar disease

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) 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. 1.Figs 2.Yogurt 3.Crackers 4.Aged cheese 5.Tossed salad 6.Oatmeal raisin cookies

3. Crackers 5. Tossed salad the rest of the foods contain tyranine. Foods to avoid include yogurt; aged cheeses; smoked or processed meats; red wines; and fruits such as avocados, raisins, or figs.

A client has a lithium level of 2.4 mEq/L. The nurse should immediately assess the client for which sign or symptom? 1.Diarrhea 2.Weakness 3.Blurred vision 4.Cardiac dysrhythmias

3.Blurred vision At lithium levels of 2.0 to 2.5 mEq/L, the client will experience blurred vision, muscle twitching, severe hypotension, and persistent nausea and vomiting. With levels between 1.5 and 2.0 mEq/L, the client experiences vomiting, diarrhea, muscle weakness, ataxia, dizziness, slurred speech, and confusion. At lithium levels of 2.5 to 3.0 mEq/L or higher, urinary and fecal incontinence occurs, as well as seizures, cardiac dysrhythmias, peripheral vascular collapse, and death.

A client is prescribed a monoamine oxidase inhibitor. What is the primary reason the nurse needs to assess this client closely? 1.Risk of liver damage may be increased. 2.Bradycardia and hypotension may indicate toxicity. 3.Headache, hypertension, and nausea and vomiting may indicate toxicity. 4.Hypotensive crisis may be precipitated by foods rich in tyramine and tryptophan.

3.Headache, hypertension, and nausea and vomiting may indicate toxicity.

The nurse instructs the client to be sure to take which action while taking newly prescribed lithium carbonate? 1.Limit salt intake. 2.Limit food intake. 3.Maintain a fluid intake of 2 to 3 L/day. 4.Stop the medication if gastrointestinal disturbances occur.

3.Maintain a fluid intake of 2 to 3 L/day.

A client diagnosed with depression has a prescription for sertraline. The nurse should withhold the medication and question the prescription if the client has a history of which disorder? 1.Diabetes mellitus 2.Myocardial infarction 3.Phenelzine sulfate use 4.Irritable bowel syndrome

3.Phenelzine sulfate use phenelzine is an MAOI, need to make sure an MAOI and an SSRI are not taken within 2 weeks of each other.

A monoamine oxidase inhibitor is prescribed for a client. Which sign or symptom is indicative of toxicity? 1.Lethargy 2.Depression 3.Restlessness 4.Constipation

3.Restlessness Acute toxicity of monoamine oxidase inhibitors (MAOIs) is manifested by restlessness, anxiety, and insomnia. Dizziness and hypertension also can occur in acute toxicity.

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 primary health care provider if which symptom develops? 1.Nausea 2.Dizziness 3.Sore throat 4.Drowsiness

3.Sore throat Carbamazepine may be prescribed for a client with a bipolar mood disorder to provide symptomatic control of the disorder. An adverse effect of carbamazepine is blood dyscrasia. With development of a fever, sore throat, mouth ulcerations, unusual bleeding, bruising, or joint pain, the primary health care provider should be notified because these findings may indicate a blood dyscrasia. Nausea, dizziness, drowsiness, and vomiting are frequent side effects associated with the medication.

A client diagnosed with schizophrenia is taking haloperidol. The nurse understands that this medication will exert its therapeutic effect through which mechanism? 1.Blocking serotonin reuptake 2.Inhibiting the breakdown of released acetylcholine 3.Blocking the uptake of norepinephrine and serotonin 4.Blocking dopamine from binding to postsynaptic receptors in the brain

4.Blocking dopamine from binding to postsynaptic receptors in the brain

When should the nurse advise a client being prescribed fluoxetine hydrochloride for depression to take the medication? 1.Just before bedtime 2.With the evening meal 3.At noon with an antacid 4.In the morning on first arising

4.In the morning on first arising

Which assessment findings suggest to the nurse that the client is experiencing tardive dyskinesia? 1.Severe headache, flushing, tremors, and ataxia 2.Abnormal breathing through the nostrils, accompanied by a thrill 3.Severe hypertension, migraine headache, and "marbles in the mouth" syndrome 4.Movements of the mouth, tongue, and face that are both abnormal and involuntary

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

The primary health care provider is planning to prescribe a medication for a client with major depression. Which medication should the nurse expect to be prescribed? 1.Diazepam 2.Lorazepam 3.Phenobarbital 4.Paroxetine hydrochloride

4.Paroxetine hydrochloride paroxetine is the only med not used for anxiety or insomnia

A client plans to have electroconvulsive therapy (ECT). Which member of the team is responsible for obtaining the client's informed consent? A. Physician B. Psychologist C. Case manager D. Registered nurse

A. Physician

Which individual with mental illness may need involuntary hospitalization? A.A person with alcoholism who has been sober for 6 months but begins drinking again B.An individual with schizophrenia who stops taking prescribed antipsychotic drugs C.An individual with bipolar disorder, manic phase, who has not eaten in 4 days D.Someone who repeatedly phones a national TV broadcasting service with news tips

C.An individual with bipolar disorder, manic phase, who has not eaten in 4 days unable to take care of themselves