mental health exam 2 meds and prep u

The nurse has been asked to explain electroconvulsive therapy to a client and his family. Which of the following statements made by the nurse would be correct?

A tapering schedule may be used to end your treatments to try to prevent rehospitalization

Which is the most commonly seen adverse side effect of typical antipsychotics?

Extrapyramidal symptoms and tardive dyskinesia

A client with extreme anxiety associated with flying is involved in cognitive behavior therapy to help manage those fears. Which statement demonstrates the client's attempt to refute the belief that supports the fear of flying?

I've read that flying is safer than traveling in a car

A nurse awaits the arrival of a client who is being transferred from a nursing home. The client has a history of schizophrenia and has been behaving bizarrely. The nurse begins preparing the plan of care by outlining expected outcomes. The nurse's actions are which of the following?

Inconsistent with the nursing process, because assessment always comes first

A nurse is communicating with a client who is highly anxious. During the conversation, the nurse notices that the nurse's speech is matching the fast pace of the client's speech, and the nurse's heart rate is increasing. The nurse identifies this as:

empathic linkages

When leading a medication group, which educational method is least effective

lecture

When conducting a psycho-social assessment, the nurse inquires about the client's social supports. In order to effectively do this, which does the nurse need to explore?

length and quality of relationships

A group of nursing students are being taught information related to drug therapy for mood disorders. The instructor determines that teaching has been effective when the students identify which agent as the gold standard for treating bipolar disorder

lithium

The nurse is caring for a client who suffers from anxiety. The client informs the nurse that he has been taking the herb kava. What should the nurse be aware that kava is associated with?

liver damage

Which of the following indications is the primary use for ECT?

major depression w/ psychotic features

Which of the following do somatic therapies involve?

meds and body based modalities

During an assessment, which would be the most important question topic?

suicidal ideation

The nurse asks a client diagnosed with bipolar disorder how they are feeling today. The client replies, "guns and bombs are exploding". Which documentation by the nurse would be appropriate for the client?

symbolism

During which group may the client learn how to avoid relapse

symptom management

Considering that cognitive behavioral therapy (CBT) requires a clear understanding of one's own belief system, which client is not a candidate for effective CBT?

the client diagnosed with schizophrenia two years ago

A nurse is viewing laboratory values for a client on psychotropic drugs who has elevated BUN (blood urea nitrogen) and serum creatinine levels. Why should the nurse be concerned regarding these laboratory values?

The client may be at risk for toxicity from the medication

Harry has noticed that in the fall and winter months he has a loss of energy, difficulty sleeping, and sadness. After seeking treatment, Harry is diagnosed with seasonal affective disorder. Which of the following treatments is effective for this condition?

phototherapy

When assessing a client who has been referred to the outpatient mental health clinic with symptoms of depression, the psychiatric nurse should closely observe the client's affect and which assessment component?

phsyical appearance

The nurse is seeing a male client who is obese and wants to lose weight. The client discusses why he wants to lose weight, how he recognizes that being obese is unhealthy, and that he plans to remain committed to a healthy lifestyle. The nurse recognizes that the client is engaging in which activity

primary appraisal

A nurse is interviewing a client who is describing difficulties with their family. The client begins crying and says, "I don't want to talk about this anymore." What boundary would the nurse be mindful to avoid crossing with the client?

psychological

The nurse is performing an assessment on a mental health client. She is asking him about relationships in his life and his use of coping skills. What type of assessment is the nurse performing?

psychosocial assessment

A family's genogram reveals that two family members have struggled with issues involving alcohol use. When intervening with the family, which question would be most appropriate for the nurse to ask

How did the alcohol problems of these family members affect others in the family

The nurse is engaged in health teaching with a client who has expressed a willingness to learn about their schizophrenia diagnosis. Which client statement indicates the teaching has progressed to the next phase of the teaching process?

I want to be able to identify what is going to cause my relapse

A client is prescribed a monoamine oxidase inhibitor (MAOI) for treatment of severe depression. Which statement made by the client indicates that there is understanding of education provided by the nurse related to dietary restrictions?

I will avoid foods that are high in the amino acid tyramine since they can cause severe side effects

The nurse provides care to a client who is prescribed a psychopharmacologic agent and is experiencing xerostomia. After providing education on ways to alleviate this side effect, which client statement indicates a need for additional teaching?

I will increase the fiber in my diet

An instructor is teaching a class about the use of cognitive therapies in psychiatric nursing. Which statement made by a student identifies a need for further instruction?

Lengths of stay for clients in inpatient settings are becoming longer each year

A 52-year-old woman is seeing a nurse therapist for moderate depression. The client has been taking fluoxetine (Prozac) for 3 weeks, but her mood has not improved. She states, "I need more than this to get better. I'm taking St. John's wort, too." Why does the nurse tell the client to immediately stop taking St. John's wort?

St. John's wort with fluoxetine may lead to serotonin syndrome

In the discharge instructions for a client who is taking alprazolam, the nurse should include what?

Sudden cessation of alprazolam can cause rebound insomnia and nightmares

In planning the care of a client who has been admitted to the hospital after a suicide attempt, an expected outcome should relate directly to what?

The client's refraining from suicide attempts

A nurse is teaching a group of nursing students about the concept that long term stress causes an increase in the wear and tear on the brain and body. Which statement by the nursing student indicates understanding of this concept?

The increase in the wear and tear on the body from stress is allostatic load

A client reports anxiety over "sounding stupid" when talking to strangers. As a part of cognitive behavioral therapy, the client is expected to speak to a stranger on the bus ride home and to journal about the experience. What information will be evaluated to determine the effect the activity has on the client's irrational belief about "sounding stupid"?

What actually happened compared to what the client feared would happen

A group member is describing some of the painful events experienced during childhood. The member does not elaborate on the feelings surrounding the events apart from saying that they made the member feel "upset." How should the group leader best apply the leadership technique of probing

When you say that these things made you 'upset,' how exactly did you feel

A client is sitting alone, slouched, with eyes closed. The nurse approaches. Which statement by the nurse is most likely to encourage the client to communicate?

You look like you are deep in thought

A client states to the nurse, "my parent screamed at me in front of several people in the grocery store when I dropped the eggs." Which statement will be an empathetic response to this client?

You must have been embarrassed when your parent yelled at you in the grocery store

Which client is most likely to benefit from treatment with an antiparkinsonism agent

a client who has medication induced movement disorder

Reminiscence therapy would be most appropriate for what group

a group of clients in the early stages of dementia

In the process of electroconvulsive therapy, what is electricity used to induce?

a seizure

If the client provides a literal explanation of a proverb and cannot interpret its meaning, which thought process is lacking?

abstract thinking

Assessment of an adult client reveals that he lives with his wife and three children. The client's father-in-law lives in an in-law suite attached to the client's home. The client's parents live about a block away and visit the family often. The nurse interprets this as which type of family

extended

A nurse is reviewing a genogram created for a family. When evaluating the information, which aspect would the nurse review first

family composition

A psychiatric-mental health nurse is working with a client who is receiving rational emotive behavior therapy. While reviewing the client's history, the nurse identifies statements that reflect common themes associated with irrational beliefs. Which theme would the nurse most identify in these beliefs?

absolute thinking

In viewing the stages of the family life cycle, those families in later life undergo which emotional transition

accepting the shifting of generational roles

A client is receiving clozapine. For which life-threatening disorder should the nurse be alert when assessing this client?

agranulocytosis

According to Hans Selye, which stage of reaction to stress stimulates the body to send messages from the hypothalamus to the glands and organs to prepare for potential defense needs

alarm reaction

A client diagnosed with antisocial personality disorder is exhibiting aggressive behavior. Which intervention would be most appropriate for this client?

anger management

After conducting an interview with a psychiatric-mental health client, the nurse documents in the client chart that "the client is depressed." The nurse is engage in which part of the nursing process?

assessment

Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)?

atypical blocks serotonin and dopaminergic receptors

A nurse observes a client talking at the end of the hall to himself. The client states, "No, I don't want to go." What does the nurse suspect regarding this information?

auditory hallucinations

When teaching a client about restrictions for tranylcypromine, the nurse will tell the client to avoid which food?

fava beans

The Calgary family assessment model and the Calgary family intervention model are dimensional frameworks that conceptualize the family into categories of structural, developmental, and

functional

Which electrode placement during electroconvulsive therapy (ECT) is associated with the best outcomes?

bilateral electrode placement on the temporal areas

The nurse has been asked to sit in and observe a support group for individuals who were once addicted to drugs. The nurse notices that one group member disagrees with statements made by all other group members. What role is this individual playing in the group

blocker

A client taking lithium comes to the hospital for a 2-week follow-up. The client complains of a hand tremor that keeps from holding a coffee cup and states that the client feels confused, has stomach aches, and trips occasionally. Which would be the most therapeutic intervention of the psychiatric nurse?

call psychiatrist about moderate toxicity

Which of the following terms, according to Lazarus, refers to the process through which an event is evaluated, with respect to what is at stake and what might/can be done

cognitive appraisal

The nurse therapist is setting goals for a family in therapy. One goal is for the family to adopt a healthy family structure. Which would be an appropriate outcome criterion for this goal

conflicts are resolved in a rational manner

A nurse is reviewing the events that occur in the body as it responds to stress. The nurse demonstrates understanding of the information by identifying which hormone as primarily secreted by the adrenal cortex during stress

cortisol

A client is admitted to the psychiatric unit and states, "I am president of the largest corporation in the world. Everyone comes to me for advice." Which behavior does the nurse document the client is exhibiting?

delusion

St. John's wort is an herbal product for

depression

A psychiatric-mental health nurse practitioner is conducting a psychotherapy group and applying Yalom's model of psychotherapy. The nurse integrates understanding of this model, emphasizing the importance of which aspect?

development of interpersonal relationships

A psychiatric-mental health nurse is assessing a family. During the interview, the nurse asks how each family member acts when the member gets angry with the family. One member responds by saying, "I might be angry, but I take the time to think about things and try to figure out what might be going on before I say or do anything." The nurse interprets this statement as indicating which concept

differentiation of self

A client has been discharged from the hospital with a prescription for lorazepam. Which instruction should the nurse provide to this client?

dont drink alcohol

A client states, "I don't want to eat anything because I am afraid that my food is poisoned." Which intervention is best for the nurse to perform to encourage the client to eat?

encourage the client to help with meal prep

A nurse is caring for a client at the community health care facility. The client informs the nurse that the client and the client's partner will be adopting a child in 1 week. Which stage of family life is the client entering

expanding family stage

A psychiatric-mental health nurse is assessing a family's structure, integrating knowledge of the Calgary Family Assessment Model The nurse is focusing specifically on the family's internal structure. Which information would the nurse assess? Select all that apply

gender and sexual orientation of members

The nurse fails to assess personal values surrounding a client's gender assignment before caring for a client who is transgender. Which issue is the nurse at most at risk for that may hinder development of the nurse-client relationship?

holding a prejudice towards this client

The client has an elevated serum thyroxine concentration. This finding indicates which disease processes?

hyperthyroidism

Which action by the nurse or client represents the working phase of the therapeutic relationship?

identifying past effective behaviors

In the stress response, what is consistent with activation of the sympathetic nervous system

increased blood sugar

The nurse asks the client, "What is similar about a cow and a horse?" and "What do a bus and an airplane have in common?" These questions would best assess which area?

intellectual function

Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug?

its ability to block the reuptake of serotonin

Which indicates that the nurse, acting as a leader for a group of recovering clients with alcohol abuse, is addressing the responsibility of maintaining the group's process

keeping the group on task be restating goals

In the space of five minutes, the client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. This behavior would be best described as ...

labile mood

A client comes to the clinic for an evaluation. During the interview, the client describes the frequent travel required by the job and feelings of being jet lagged all the time. The client asks, "Is there any supplement that I could use that might be helpful? Which suggestion would the nurse most likely include in the response?

melatonin

A client is undergoing ECT. The nurse would be correct to inform the client of which aspect prior to the ECT?

npo 8 hrs prior

The nurse is reviewing the client's history, identifies themes, and considers how the nurse can be most therapeutic to a client who was recently admitted to a psychiatric unit. The nurse is functioning in which phase of the therapeutic relationship?

orientation

In providing post-op care for the client who has just undergone ECT, which of the following findings would indicate that ECT has been effective and the client is displaying normal sequelae of this procedure?

patient doesnt remember what unit he or she is returning to

A nurse analyzes the results of the family assessment. Which characteristics of family boundaries should the nurse recognize as promoting the emotional health of the family

permeable

The nurse wears a cross and has a Facebook page displaying pictures of the family, home and updates on what the nurse is currently doing. These actions are examples of what?

self disclosure

A psychiatric-mental health nurse is assessing a client who has come to the community mental health center for an evaluation. The client has a history of alcohol abuse. During the assessment, the client says, "I've been clean and sober for the last 10 years, but I continue to go to my meetings at least once a week." The nurse interprets the client's statement as indicating participation in which type of group

self help group

A client is prescribed a monoamine oxidase inhibitor (MAOI) as part of the treatment plan for depression. When disussing the medication with the client, the client tells the nurse that the client applies the medication as a patch on the skin. The nurse interprets the client's statement as indicating which medication?

seligiline

Which statement guides the work of the cognitive behavior therapist especially when evaluating the client's progress towards treatment goals?

setbacks in treatment are both normal and expected

Prior to undergoing ECT, brief general anesthesia is given to prevent which of the following?

severe muscle contractions

What should the nurse avoid when demonstrating genuine interest for a client by making a self-disclosure?

shifting the emphasis to the nurse

The nurse asks the client, "What was it like for you when you first realized you had no place to go?" The client looks down and pauses for quite some time. Which action by the nurse is most therapeutic?

sit quietly until the client responds

A psychiatric-mental health nurse is conducting an in-service program for a group of colleagues at a community mental health center. The topic is families and family systems. After discussing the different system models used in caring for families, the nurse determines that the program was successful when the group identifies which concept as being associated with Bowen's Family Systems Therapy Model

triangle

A mental health nurse is teaching a client with depression about ECT. The nurse understands that treatments are typically given how often

twice a week

Clients taking monoamine oxidase inhibitors (MAOIs) for depression must be placed on a diet that is low in:

tyramine

A nurse is caring for a client in the hospital who was admitted for injuries sustained from an abusive spouse. The client says she's scared to leave her husband for fear he will hurt her. Which actions should the nurse plan to include in the plan of care for this client? Select all that apply

social services, team meeting, resources available

A client with a diagnosis of depression has been taking citalopram (Celexa) for several weeks but is frustrated by the persistence of his depression. The client has told the nurse that he has just begun supplementing his antidepressant with St. John's wort. How should the nurse respond?

stop taking St. John's wort until you talk to your doctor

Pre-existing genetic, biologic, and psychological vulnerabilities interact with negative or stressful life events to cause illness. This describes the

stress diathesis model

A client diagnosed with depression is being counseled by the nurse for cognitive distortions. The client says, "Bad things always happen to me." Which response by the nurse would be therapeutic?

tell me about a time when things went your way

A client's frequent night awakenings, early morning rising, and daytime drowsiness have prompted the nurse to add a diagnosis of "disturbed sleep pattern" to the client's plan of care. What information should immediately follow this diagnosis?

the evidence supporting the diagnosis

An electrician who has been working 14 to 16 hour days for several weeks presents to his family physician reporting persistent headaches and insomnia. The electrician experienced these symptoms last year when his business experienced financial difficulty. The family physician attributes the physical symptoms to ongoing stress. Which factor most likely contributed to the man's response to this stressful period of his life?

the fact that he has previously had difficulty coping with stress

Which of the following is accurate when dealing with older people in groups

the pace of the group should be slowed because of possible memory deficits

An advanced practice nurse has chosen to apply motivational interviewing (MI) in the care of a client who will transition back to the community from inpatient treatment. The nurse should begin to apply this method by:

validating the client's ability to make decisions and effect change

The nurse states to a client who calls out for help, "I am happy to help you. Please let me know what I can do." Which process is the nurse using with this statement?

validation

A psychiatric-mental health nurse is working as part of the interdisciplinary team to develop the plan of care for a client who is to receive solution-focused behavior therapy. Which question would the nurse identify as being most appropriate to ask during the client's initial session?

what brought you here today

A psychiatric-mental health is completing a self-reflection with the goal of "know thyself" in order to care for their clients better. What is a question that the nurse can reflect on that encourages self-reflection?

what significant traumatic life events have you experienced?

A group is trying to handle issues related to dominance, control, and power within the group. In what stage of group development is this group?

working

The client tells the nurse, "I am regularly doing my sitting breathing exercises. Why do I still feel breathless while walking?" The nurse replies, "Sitting breathing exercises alone may not achieve the desired effects. You also should perform daily deep breathing exercises while walking. This should help you to reduce breathlessness while walking." According to Peplau's model, the nurse and client are in which phase?

working