Mental Health Test 2 FA Davis Q’s

A client who has been taking fluvoxamine (Luvox) without significant improvement asks the nurse, "I heard about something called a monoamine oxidase inhibitor (MAOI). Can't my doctor add that to my medications?" Which is the most appropriate nursing reply?

"A combination of an MAOI and fluvoxamine can lead to a life-threatening hypertensive crisis."

A highly agitated patient paces the unit and states, "I could buy and sell this place." The patient's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this patient's behavior?

"Agitated and pacing. Exhibiting grandiosity. Mood labile."

The nurse should frequently assess a client with a depressive disorder for lethality risk related to suicidal ideation. Which questions should the nurse include? Select all that apply.

"Are you thinking about killing yourself or someone else?" "Where do you keep your gun?" "Have you thought about how you would kill yourself?"

The nurse is educating the parents of a child diagnosed with schizophrenia on how to reply when their child experiences auditory hallucinations. Which is the nurse's best reply?

"Ask him what the voices are saying to him."

A 16-year-old client diagnosed with schizophrenia is experiencing auditory command hallucinations. The client reports the voices are telling him to harm others. The client's parents ask the nurse, "Where do the voices come from?" Which is the nurse's most appropriate reply?

"Auditory hallucinations are caused by increased dopamine levels in the brain."

The nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder (MDD). The client states, "I'm feeling a lot better, so you can stop watching me. I have taken up too much of your time already." Which is the best nursing reply?

"Because we are concerned about your safety, we will continue to observe you."

A newly admitted client diagnosed with major depressive disorder (MDD) states, "I have never considered suicide." Later, the client confides to the nurse about plans to "end it all" by medication overdose. Which is the most helpful nursing reply?

"Bringing this up is a very positive action on your part."

A client diagnosed with major depressive disorder (MDD) states, "I've been feeling down for 3 months. Will I ever feel like myself again?" Which statement by the nurse best assesses this client's affective symptoms?

"Help me understand what you mean when you say you've been feeling down."

A patient's spouse asks, "What evidence supports the possibility of genetic transmission of bipolar disorder?" Which is the best nursing reply?

"Higher rates of relatives with bipolar disorder are found in families of people diagnosed with this disorder."

A client is admitted with a diagnosis of persistent depressive disorder (PDD). Which client statement describes a symptom consistent with this diagnosis?

"I have been sad most of the time for the past several years."

Which patient statement indicates to the nurse that the patient understands dietary teaching related to lithium carbonate (Lithobid) treatment?

"I will maintain normal salt intake."

The psychiatric-mental health nurse is providing discharge teaching for a patient diagnosed with bipolar disorder. Which statement indicates that the nurse's teaching is effective?

"I'll be the designated driver since I shouldn't have alcohol with lamotrigine."

After teaching a patient about lithium carbonate (Lithane), the nurse would conclude that teaching was successful based on which statement?

"I'll call my doctor immediately if I experience any diarrhea or ringing in my ears."

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to the nurse that discharge teaching about this medication has been successful? Select all that apply.

"I'll have to let my surgeon know about this medication before surgery." "Guess I will have to give up my glass of red wine with dinner." "I'll have to be very careful about reading food and medication labels." "I'll be sure not to stop this medication abruptly."

An isolative client was admitted 4 days ago with a diagnosis of major depressive disorder (MDD). Which nursing statement would best motivate the client to attend a therapeutic group being held in the milieu?

"I'll walk with you to the dayroom. Group is about to start."

The nurse learns at report that a newly admitted patient experiencing mania is demonstrating grandiose delusions. The nurse should recognize that which patient statement provides supportive evidence of this symptom?

"I'm the world's most perceptive attorney."

A client diagnosed with schizophrenia says, "Can't you hear him? The devil keeps telling me I'm going to hell!" Which is the nurse's most appropriate reply?

"It must be scary to hear that, but I don't hear a voice."

The nurse is providing discharge teaching to an elderly client diagnosed with schizophrenia. The client's medications include an antipsychotic (risperidone) and a beta-adrenergic blocking agent (propranolol). Which statement indicates the nurse understands the combined side effects of these medications?

"Move slowly when you change from a lying down or sitting position."

Which statement expresses the typical underlying feeling of clients diagnosed with major depressive disorder (MDD)?

"Nothing will help me feel better."

Which statement indicates to the nurse that a client is experiencing a delusion?

"Spies are watching everything I do."

The parent of a child newly diagnosed with schizophrenia asks the nurse, "Did I give this to my child?" Which response from the nurse is correct?

"The cause of schizophrenia is unknown."

A client diagnosed with schizophrenia tells the nurse, "The 'Shopatouliens' took my shoes out of my room last night." Which is the correct charting entry to describe this client's statement?

"The client is expressing feelings with a neologism."

A client who is diagnosed with major depressive disorder (MDD) asks the nurse what causes depression. Which is the nurse's most accurate response?

"The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role."

A nursing instructor determines that teaching on the premorbid phase of schizophrenia was effective when a student makes which comment?

"The person is withdrawn and may have poor peer relationships."

A nursing instructor is teaching about the prevalence of bipolar disorder. Which student statement indicates learning has occurred?

"This disorder is more prevalent in higher socioeconomic groups."

An adult who is diagnosed with bipolar I disorder is prescribed lamotrigine (Lamictal) 400 mg three times a day for mood stabilization. Which statement about this medication order is true?

"This dosage is more than twice the recommended dosage range."

A nursing instructor is discussing various challenges in the treatment of people diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these patients?

"Treatment is compromised when people choose not to take their medication."

A patient began taking lithium for the treatment of bipolar disorder approximately 1 month ago. The patient asks if it is normal to have gained 12 lb in this time frame. Which is the appropriate nursing reply?

"Weight gain is a common but troubling side effect."

A patient diagnosed with bipolar I disorder is exhibiting severe manic behavior. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The patient's spouse questions the Zyprexa order. Which is the appropriate nursing reply?

"Zyprexa calms hyperactivity until the Eskalith takes effect."

A patient diagnosed with bipolar disorder I who is prescribed lithium presents to the emergency department with mania and suicidal ideation. What lithium level does the nurse expect to find?

0.3 mEq/L

A patient has been taking lithium for several years with good symptom control. The patient presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. Which lithium level should the nurse correlate with these symptoms?

1.7 mEq/L

Electroconvulsive therapy (ECT) is considered the treatment of choice for which client?

A 67-year-old man describing a recent suicide attempt

A client is admitted to the psychiatric unit with a diagnosis of major depressive disorder (MDD). The client is unable to concentrate, has no appetite, and is experiencing insomnia. Which of the following should be included in the client's plan of care?

A simple, structured daily schedule with limited choices of activities

The nurse understands that psychotic postpartum depression is characterized by which symptoms? Select all that apply.

Agitation Fear the infant will be harmed Guilt

A person diagnosed with bipolar I disorder is distraught over insomnia experienced over the past three nights and a 12-lb weight loss over the past 2 weeks. Which should be the priority nursing diagnosis?

Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss

Which of the following carries a warning label stating that use of the medication increases risk of suicidal thoughts and behaviors?

Antiepileptics

A client exhibits paranoia, bizarre behaviors, neologisms, and delusions of persecution. While eating breakfast in the dayroom, the client starts yelling at others. Which is the nurse's first action?

Asking other clients to step out of the dayroom

A client diagnosed with psychosis asks the nurse to make the voices stop talking so he can go to sleep. Which is the most important nursing intervention?

Asking the client what the voices are saying

A patient on an inpatient unit is diagnosed with bipolar disorder: manic episode. During a discussion in the dayroom about weekend activities, the patient raises his voice, becomes irritable, and insists that plans change. Which should be the nurse's initial intervention?

Assisting the patient in moving to a calmer location

Which condition appears to have a connection to bipolar disorder in youth?

Attention deficit-hyperactivity disorder (ADHD)

A newly admitted client is diagnosed with major depressive disorder (MDD) with suicidal ideation. Which is the priority nursing intervention for this client?

Carefully observing at varied intervals

The psychiatric-mental health nurse is creating a plan of care for a child diagnosed with a depressive disorder. The parents report that the child does not seem to know how to make friends and does not seem to be doing as well in school as a family member who is in the same grade. Recently, their child started picking fights while waiting for the bus. The nurse recognizes that the child's depressive symptoms occur among which age group?

Childhood

The nurse is providing counseling to clients diagnosed with major depressive disorder (MDD). The nurse chooses to help the clients alter their mood by teaching them how to change the way they think. The nurse is functioning under which theoretical framework?

Cognitive theory

The psychiatric-mental health nurse is evaluating the care of a client recovering from an episode of psychosis. Which is the most appropriate long-term goal for the client?

Define and test reality.

The nurse is assessing a client diagnosed with schizophrenia and asks, "Do you ever get messages through things like the television or microwave?" Which symptom of schizophrenia is the nurse assessing for?

Delusions of reference

A depressed client reports to the nurse a history of divorce, job loss, family estrangement, and cocaine abuse. According to learning theory, which of the following is the cause of the client's symptoms?

Depression as a result of repeated failures

What is the priority reason for the nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder (MDD)?

Depression can be a symptom of several medical conditions.

Which of the following best defines secondary depression?

Depressive symptoms that occur as a consequence of an adverse side effect of certain medications

A patient diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorder?

Divalproex sodium (Depakote)

An individual experiences sadness and melancholia from September to November. Which of the following factors should the nurse identify as most likely to contribute to these symptoms? Select all that apply.

Drastic temperature and barometric pressure changes Increased levels of melatonin Variations in serotonergic functioning

A client diagnosed with major depressive disorder (MDD) was raised in a strongly religious family where bad behavior was equated with sins against God. Which nursing intervention is most appropriate to help the client address spirituality as it relates to the illness?

Encouraging the client to bring into awareness underlying sources of guilt

A nurse working in a clinic is obtaining a medical and mental health history on a new patient. The patient reports having tried several different antidepressants, and "none seem to work" and "they take too long to work." Which medication should the nurse be prepared to educate the patient on?

Esketamine (Spravato)

The nurse is admitting a client to the inpatient psychiatric unit. Which intervention is most appropriate to reduce the client's delusional thinking?

Exploring the client's feelings about the delusions

A newly admitted patient is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to find on assessment?

Flight of ideas

The nurse is planning care for a child who is experiencing depression. Which medication is approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children and adolescents?

Fluoxetine (Prozac)

The nurse notes elevated levels of prolactin while reviewing the laboratory results of a client diagnosed with schizophrenia. Which symptoms should the nurse expect to assess? Select all that apply.

Galactorrhea Gynecomastia

Which of the following is considered a predisposing factor for depression?

Genetic factors

A client is diagnosed with persistent depressive disorder (PDD) (dysthymia). Which should the nurse classify as an affective symptom of this disorder?

Gloomy and pessimistic outlook on life

When planning care for clients diagnosed with schizophrenia, which of the following should the nurse recognize as an integral part of a rehabilitation program? Select all that apply.

Group therapy Medication management Supportive family therapy Social skills training

The nurse is assessing a new client diagnosed with schizophrenia. The client states, "Those people behind the desk won't stop laughing at me." The nurse determines the client is experiencing which symptom?

Ideas of reference

As patients are leaving the dayroom following a group therapy session, the nurse notices that a patient admitted for acute mania is clenching and unclenching both fists, swearing, and glaring at a staff member. Which action should the nurse take first?

Instruct patients to return to the dayroom.

The nurse is administering medications to a client experiencing acute psychosis. The client's medication orders include haloperidol 50 mg PO bid, benztropine 1 mg PO daily, and zolpidem 10 mg PO at bedtime daily. The nurse administers benztropine to address which of the following?

Involuntary facial movements

A client admitted to the psychiatric unit following a suicide attempt is diagnosed with major depressive disorder (MDD). Which behavioral symptom(s) should the nurse expect to assess?

Lack of attention to grooming and hygiene

A patient who has been diagnosed with bipolar I disorder states, "God has taught me how to decode the Bible." The nurse should anticipate which combination of medications would be ordered to address this patient's symptoms?

Lithium carbonate (Lithobid) and risperidone (Risperdal)

A person diagnosed with bipolar disorder has taken lithium carbonate (Lithane) for 1 year and presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. The nurse should interpret these symptoms as indicative of which of the following?

Lithium carbonate toxicity

The nurse assesses a client who exhibits a flat affect, paranoia, anhedonia, anergia, neologisms, and echolalia. Which statement indicates the nurse understands the characteristics of positive and negative symptoms of schizophrenia?

Paranoia, neologisms, and echolalia are positive symptoms.

A psychiatrist prescribes a monoamine oxidase inhibitor (MAOI) for a client. Which foods and beverages should the nurse teach the client to avoid?

Pepperoni pizza and red wine

Which of the following is associated with premenstrual dysphoric disorder (PMDD)?

Progesterone

The parent of a 20-year-old client recently diagnosed with paranoid schizophrenia asks the nurse what causes schizophrenia. The nurse recognizes which of the following are implicated in the etiology of schizophrenia? Select all that apply.

Prostaglandins Glutamate Dopamine

The nurse notices a client is becoming very agitated. Which nursing intervention is most appropriate?

Providing the client with adequate personal space

A patient is diagnosed with bipolar I disorder: manic episode. Which nursing intervention should be implemented to achieve the outcome "Patient will gain 2 lb by the end of the week?"

Providing the patient with high-calorie finger foods throughout the day

The nurse is planning care for a patient diagnosed with bipolar disorder: manic episode. Which should be the first priority of the listed patient outcomes?

Remains free of injury

A 75-year-old client with a long history of depression is currently taking doxepin (Sinequan) 100 mg daily. The client also takes a daily diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign highest priority?

Risk of injury R/T orthostatic hypotension

The nurse is caring for a college student who started hearing voices, has not attended classes for the past 4 weeks, was yelling accusations at others, and has stopped communicating with family and friends. Which is the nurse's priority nursing diagnosis?

Risk of other-directed violence R/T yelling accusations

A patient diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family reports that the patient has experienced anorexia, insomnia, and recent job loss. What should be the priority nursing diagnosis for this patient?

Risk of suicide related to (R/T) hopelessness

A newly admitted patient is experiencing a manic episode associated with bipolar I disorder and presents as very agitated. The nurse should assign which priority nursing diagnosis to this patient?

Risk of violence: directed toward others R/T agitation and hyperactivity

A client diagnosed with brief psychotic disorder states, "The voices keep telling me I must kill the president." Which is the priority nursing diagnosis?

Risk of violence: other-directed

The nurse observes that a client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication does the nurse anticipate the provider will prescribe?

Risperidone

The inpatient psychiatric unit is being redecorated. At a unit meeting, the staff discusses bedroom decor for clients experiencing mania. The nurse manager evaluates which suggestion as most appropriate?

Rooms should be painted with neutral colors and contain pale accessories.

Who influenced currently held beliefs about depression?

Sigmond Freud

The nurse expects a client experiencing prodromal symptoms of schizophrenia to demonstrate which of the following?

Significant deterioration in functioning

A client is diagnosed with major depressive disorder (MDD). Which nursing diagnosis should the nurse assign to the client to address a behavioral symptom of this disorder?

Social isolation R/T poor self-esteem AEB secluding self in room

The nurse is administering risperidone to a client diagnosed with schizophrenia. The nurse anticipates the mediation to have a therapeutic effect on which symptoms? Select all that apply.

Somatic delusions Gustatory hallucinations Clang associations

The nurse is administering clozapine to a client diagnosed with schizophrenia. Which symptoms require the nurse to intervene immediately?

Sore throat, fever, and malaise

A 20-year-old female has a diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following should the nurse identify as consistent with this diagnosis? Select all that apply.

Symptoms are causing significant interference with daily activities. Mood swings occur the week before onset of menses. Client reports subjective difficulty concentrating.

The nurse is obtaining the mental health history of a client diagnosed with schizophrenia. The client's family reports that the client is hearing voices and cannot stay focused on the topic of a discussion. The nurse recognizes the client is demonstrating which symptom?

Tangentiality

A newly admitted client exhibits symptoms of paranoia and hallucinations. The client's spouse states, "I don't understand. My spouse hasn't hallucinated since the doctor prescribed thioridazine 2 years ago." The nurse recognizes which of the following as the most likely explanation for the recurrence of the client's symptoms?

The client has not been taking the medication as prescribed.

The nurse suspects the client of having major depressive disorder (MDD) due to the client's having psychomotor retardation. Which of the following would be an example of psychomotor retardation?

The client is disheveled and malodorous.

Which client information does the nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)?

The client's cognitive ability to understand information about the medication

A patient is diagnosed with cyclothymic disorder. Which of the following should the nurse expect to find on assessment?

The patient has endured periods of elation and dysphoria for more than 2 years.

A patient is diagnosed with bipolar disorder and admitted to an inpatient psychiatric unit. Which is the priority outcome for this patient?

The patient will remain safe from harm throughout hospitalization.

The nurse is reviewing the provider's orders for a client experiencing acute psychosis. The client's family tells the nurse the client has allergies to penicillin, prochlorperazine, and bee stings. Which medication order should the nurse question?

Thioridazine 100 mg PO three times daily

A patient diagnosed with bipolar disorder states, "I hate oatmeal. Let's get everybody together to do exercises. I'm thirsty and I'm burning up. Get out of my way; I have to see that guy." Which is the priority nursing action?

To assess the patient's vital signs

The nurse begins the intake assessment of a patient diagnosed with bipolar I disorder. The patient shouts, "You can't do this to me! Do you know who I am?" Which is the priority nursing action in this situation?

To provide staff and patient with a safe environment

The nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a Mini-Mental State Examination?

To rule out a neurocognitive disorder (NCD)

The nurse is caring for four clients taking various medications, including imipramine (Tofranil), doxepin (Sinequan), ziprasidone (Geodon), and tranylcypromine (Parnate). The nurse orders a special diet for the client receiving which medication?

Tranylcypromine (Parnate)

The nursing instructor asks a nursing student to describe concepts of the recovery model. Which concepts should the nursing student include? Select all that apply.

Uses personal values to determine meaning in life Allows client primary control over care decisions

A patient is admitted experiencing a manic episode associated with bipolar I disorder. Which nursing intervention is most therapeutic for this patient?

Using a calm, unemotional approach during patient interactions

Which nursing action is most appropriate to establish trust with a suspicious client?

Using a passive communication approach

A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should the nurse teach the client?

Ways to make eye contact when communicating