Mental Health Test CH 14,15,& 16

substance abuse

A 12 year old boy is diagnosed with bulimia nervosa. When providing client education to the parents of the client, the nurse points out that what is common in client's afflicted with bulimia nervosa?

She has anorexia nervosa, restricting subtype

A 12 year old girl is brought to the pediatrician for her annual physical examination. The nurse notes that the girl has lost 15lbs over the past 6 months when she was seen for bronchitis. The nurse asks the child if she has been dieting and the girl proudly responds "yes." What would the nurse suspect in this child?`

Bulimia nervosa

A 14 year old girl is brought to the clinic by her mother. Her mother tells the nurse that on "several" occasions, she has found her daughter during the night eating things like a whole pizza or a carton of ice cream. The nurse asks the girl about this behavior and the girl begins to cry. The nurse knows that this behavior is a symptom of what?

Dissociative Fugue

A 42 year old male is brought to the emergency department by his brother. The brother tells the nurse that the client has traveled across the country to attend the funerals of their parents who died in a car accident a week ago. The brother tells the nurse that the client claims to be someone he is not but otherwise seems quite normal. What would the nurse suspect that this client has?

"Substance dependence means the person has a maladaptive pattern of use that shows physiologic, cognitive, and behavioral indications that the person continues to use the substance despite the negative effects."

A client calls the mental health clinic and asks to speak with the nurse. The client explains that he/she has recently been diagnosed with a substance problem and the way it was explained is that it has "dependence." The client asks if the nurse can explain what that means. What should be the nurse's response?

Mood swings, suicidal behaviors, assumption of a new identity

A client has a differential diagnosis of dissociative fugue. What signs and symptoms would the nurse know to assess for?

Hypnosis, creative art process, and cognitive technique

A client has been diagnosed with a dissociative disorder. What treatments would the nurse know could be used for this client?

Self-care deficit, related to aimlessly wandering

A client has been diagnosed with dissociative fugue. What would be an appropriate nursing diagnosis for this client?

Dissociative disorder

A client is brought into the emergency department by her spouse. The spouse tells the nurse that when they woke up that morning, his wife did not know who she was. The nurse knows that a differential diagnosis for this client would be what?

Depersonalization disorder

A client presents at the mental health clinic with complaints of experiencing a feeling of being unreal. The client is a 37-year old female who lost her husband and two children in an automobile accident 3 months ago. The client retains insights and is aware that the experience is not real. The nurse knows that this client is displaying signs and symptoms of what?

Antianxiety drugs and nonnarcotic pain relievers

A client with a dissociative disorder is being seen in the mental health clinic. Pharmacology is being discussed with the client. What classifications of drug does the nurse know that are used to treat these disorders?

To determine if there are any coexisting mental health conditions

A client with a dissociative disorder is undergoing treatment. Why is the diagnostic testing done with these clients?

Written methods of expression, physical exercise, and task-oriented activities

A client with a dissociative identity disorder tells the nurse that he/she is having thoughts of self-injury. The nurse knows that it is important to assist the client to identify alternative actions to self-injury. What are these actions?

To integrate the fragmented personalities into one identity

A client with dissociative disorder is going through the therapeutic process. What is the ultimate goal of the therapeutic process for this patient?

Dissociative identity disorder

A female client, aged 27, is being seen at the clinic. The client describes her symptoms as auditory hallucinations, memory gaps, and sudden breaks in the continuity of her thought process. The nurse recognizes that the client is describing symptoms for what dissociative disorder?

Clients are overwhelmed with fear of not knowing or being out of control

A mental health nurse is developing a plan of care for a new client diagnosed with a dissociative disorder. A nursing intervention that is important to include in the plan of care for this client is to encourage and support the client in achievement of control over anxiety and previous dissociative response to those situations that trigger the symptoms. Why is this intervention so important?

The burden on society by drug-related criminal behaviors that involve both the participation in usage and the sale of drugs

A mental health nurse is providing an educational event for the parent organization of one of the local high schools. The nurse is speaking on substance abuse. What is one of the topics the nurse knows should be included in this educational event?

Selective amnesia

A nurse working in a small rural hospital is on duty when a fire breaks out in the local movie theater. The hospital emergency department is used to triage and stabilize many of the townspeople before having them transported to trauma centers and burn units in neighboring cities. Shortly after the last client is transported, the nurse asks one of the physicians what happened to all the townspeople. She tells the physician that she remembers the hospital was notified of a fire in the movie theater and she remembered receiving four clients into the emergency department who had been injured in the fire, but she thought there should have been many more admitted. This nurse was exhibiting signs and symptoms of what?

Localized amnesia

After a tornado flattens her home, a 65 year old female is brought to the local clinic by her son. He tells the nurse that his mother cannot remember anything that has happened since the storm hit and has forgotten pieces of her identity such as having lived in the house she lost for 10 years. What would the nurse know is wrong with this patient?

Dissociative amnesia

After a train accident, a 19 year old male is admitted to a local hospital unable to remember any personal information covering the entire scope of his life. What diagnosis would the nurse expect this patient to have?

Demonstrates willingness to participate in a group recovery treatment program

An expected outcome toward long-term sobriety is what?

Risk for injury

An intoxicated client is admitted through the emergency department after being found passed out on the sidewalk in a temperature of 33 degrees C. What would be an appropriate nursing diagnosis for this client?

Altered nutrition

An intoxicated client is admitted to your unit and standard orders are instituted including a "banana bag" of I.V fluids and a nutritional assessment. Based on these standard orders, what nursing diagnosis would be most appropriate for this client?

Behaviors aimed at sustaining the relationship

Codependency people internalize a form of guilt for the behavior of the abuser. What does this result in for them?

peer pressure

During adolescence, what etiologic factor contributing to substance abuse is at its highest?

Ability to recall past traumatic events

During the evaluation and revision process, the nurse needs to consider the client's progress towards understanding the relationship between the dissociative state and the increased anxiety felt as repressed past trauma is triggered by environmental factors,. What would the nurse use to evaluate the client's progress toward this understanding so that revisions can be made if necessary?

Catapres

In a detoxification setting, what drug minimizes opiate withdrawal symptoms?

Wernicke-Korsakoff syndrome

In the detoxification phase of a client's treatment for alcohol abuse, multivitamin therapy, and thiamine replacement therapy are used to prevent what?

Alcohol dependency

Nurses on your unit often use the CAGE questionnaire when screening for what?

Perform seizure precautions every 15min

Nursing interventions toward preventing injury to the client during acute substance withdrawal may include what?

Difficulty expressing feelings, feelings of emotional isolation, and low frustration tolerance

Personality characteristics cannot be discounted in the etiology of substance abuse. Which of these personality characteristics have been identified as part of the etiology of substance abuse?

Children of substance-abusing parents are at a greater risk for substance abuse

Research has shown that social learning involves imitation, the effects of modeling, and identification behaviors. What is the best explanation of the result of this research in the etiology of substance abuse?

Type of substance being used, amount and frequency of use, and method of administration

The mental health nurse is conducting an assessment interview with a new client. What should this initial assessment be directed towards?

Model positive and desired behaviors

The mental health nurse spends a great deal of time with clients diagnosed with a dissociative disorder. Because of this fact, what is it important for the nurse to do?

Identifies alternative coping mechanisms

The nurse is talking with a client who has a diagnosis of substance abuse. The client states, "I don't know what to do to handle the stress in my life that makes me want to take drugs." Based on the client's statement, what expected outcome would the nurse identify when updating the client's plan of care?

To assist the client in living a substance-free full and productive life as a member of society

The nurse's efforts in reaching of treatment goals toward long-term sobriety are directed at what?

"A multigenerational pattern of coping mechanisms that lead to self-defeating behaviors evolving from family dynamics that discourage a member from feeling or expressing needs."

The spouse of an alcoholic is attending their first Al-anon meeting. They ask what codependency means. What would be the best answer they could receive?

11%

The staff educator is orienting new nurses at the local substance abuse clinic. Today she is discussing the need for treatment by the population that abuses alcohol and drugs. What percentage of those requiring treatment would the staff educator cite who actually receive treatment?

Family systems model

What approach to substance abuse theorizes that substance abuse is a disease where family members are either drug users or codependent?

The client exhibits no signs or symptoms of substance intoxication. The client has sustained no injuries during the detoxification period. The client exhibits no signs and substance withdrawal.

What are the criteria for evaluation outcomes during the acute withdrawal phase as achieved?

A safe and trusting environment

What can the nurse provide that allows the client a positive forward progression in the treatment process?

Identifies the drug as a problem and takes ownership of the problem

What is an appropriate expected outcome for a client in the recovery phase of substance abuse?

Memory, Identity, and Conscious awareness

When a client has a dissociative disorder, the ordinarily organized functions become disturbed. What are these functions?

They may display defensive actions to excuse the behavior of the drug user

When a member of a family has a substance abuse problem, how may this affect family members?

Verbalizes realistic expectations for the client's behavior and treatment process

When caring for a client with a dissociative disorder, the mental health nurse knows that the family must be included in the plan of care. What is an appropriate outcome for the family of the client with a dissociative disorder?

Avoid flooding the client with detail of past traumatic events

When caring for a client with a dissociative disorder, what is the best nursing intervention to aid in preventing the client's regression further into the dissociative state?

The anticipated outcome

When caring for a client with substance abuse issues, what will the evaluation process used by the nurse depend on?

Assists the client to develop personal insight

When caring for the clients with dissociative disorders, the mental health nurse knows that a trusting and therapeutic relationship with the client must first be established. Why are active listening and communication techniques that encourage verbalization of feelings, conflicts, and information regarding the traumatic event that led to the current dissociative state part of this process?

Problems affecting the client's ability to function in ADLs

When developing a plan of care for a client identified with substance abuse issues, the nurse selects appropriate nursing diagnoses resulting from what?

Assist the client to remember past experiences without the risk of precipitating increased trauma

When engaging in a therapeutic relationship with a client with a dissociative disorder, it is important to use stimuli that stimulate pleasant memories and pleasurable feelings for the client. Why?

Helpful to decreasing the dissociative response

When evaluating the client's progress towards identifying and demonstrating a more adaptive response to stressful stimuli, the nurse knows that this step is what?

Recovery is an ongoing process of commitment toward a goal of abstinence

When evaluation outcomes for a client with substance abuse problems, what must the nurse remember?

Verbalizes perceptions of environmental stimuli that are different from what others experience when faced with stressful situations

Which of the following would be the least likely expected outcome for a client with a diagnosis of dissociative identity disorder?

Laxative or diuretic use

You are assessing clients on the eating disorder unit. You know that it is important to assess changes in bowel elimination or decreased urine output because they relate to what?

Every 1-2 hours during the first 3-4 days of withdrawal

You are caring for a client during acute substance withdrawal. What is considered the nursing standard of care for monitoring vital signs?

Altered thought process, related to memory loss and repressed trauma

You are developing a care plan for a client diagnosed with dissociative amnesia. What nursing diagnosis would you be sure to include in the client's plan of care?

The client's acknowledgement of the existence of more than one personality

You are evaluating the progress on a care plan for a client with dissociative identity disorder. What does evaluation center on for this client?

Data regarding drug use

You have admitted a client diagnosed with substance abuse intoxication to your unit. What will your nursing assessment be directed toward first?

Sensory perceptual alteration, related to depersonalization and view of self

You have just been admitted a client to your unit diagnosed with depersonalization disorder. What would be the most appropriate nursing diagnosis for this client when developing the client's care plan?

Begins to develop or reestablish a support system with family, employer, and non-substance using friends

Your client is in the recovery phase of the substance abuse treatment. What outcome would you assess for?