Mental Health test4

A nurse is reinforcing teaching with a client who has a prescription for nortriptyline. Which of the following client statements indicates an understanding of the teaching?

"I should sit on the side of the bed before standing up in the morning."

A nurse is providing medication teaching for client with depression and who is taking a monoamine oxidase inhibitor (MAOI) instead of a selective serotonin reuptake inhibitor (SSRI). Which of the following nursing statements is appropriate to include in teaching?

"You will need to be off the SSRI for a period of time before starting the MAOI.

A client with schizophrenia is admitted to the psychiatric unit in an acutely disturbed violent state. The client is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds, the nurses notices the client has the head rotated to one side in the stiffly fixed position. The lower jaw is thrust forward and the client appears severely anxious. The client i mostly experiencing what?

A dystonic reaction

A client has a new prescription for citalopram (Celexa). Which of the following must the nurse make sure the client is not also taking? (Select all that apply)

A monoamine oxidase inhibitor (MAOI) A tricyclic antidepressant (TCA) St John's wort

Affects men more than women Characteristics can be seen in children Smooth talkers Deceitful, manipulative, risk takers

Anti social personality disorder

Treatment is usually forced and substance abuse is often present No capacity for intimacy

Anti social personality disorder

What drug group calls for nursing assessment for development of abnormal movement disorders among individuals who take therapeutic dosages?

Antipsychotics

Requires firm consistent limits, need to outline inappropriate behavior and be aware they may attempt to split staff

Antisocial personality disorder and borderline personality disorder

Selective serotonin reuptake inhibitors are the first line of treatment for which of the following disorders?

Anxiety disorders

Approach when taking care of wounds or injuries with someone that has Borderline personality disorder

Avoid rescuing or rejecting

Displays low self esteem, terrified in social situations. Linked to excessive parental criticism and peer rejection

Avoidant Personality Disorder

Characterized by unstable moods, poor relationships with others, impulsivity Can be self destructive

Borderline personality disorder

May see abuse -physical, sexual and emotional abuse in the history of these individuals. Suicidal and aggressive behaviors are usually present

Borderline personality disorder

May be related to profound learning experiences as a child with a chronic illness. "Learned helplessness"

Dependent personality disorder

These individuals have moderate to low problems in functioning. Are submissive and like to be taken care of

Dependent personality disorder

A client diagnosed with major depression began taking escitalopram (Lexapro) 5 days ago. The client now says, "This medicine isn't working." The nurse's best intervention would be to:

Explain the time lag before antidepressants relieve symptoms.

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for Lithium. The nurse should reinforce teaching on which of the following behaviors that could cause lithium toxicity?

Fasting

These individuals have a good quality of life. Display excessive emotion, can be provocative and impulsive

Histrionic personality disorder

A client is experiencing a sudden severe episode of anxiety. The nurse understands that _______ will assist in decreasing the client's anxiety and is often ordered PRN?

Lorazepram (Ativan)

An outpatient diagnosed with bipolar disorder takes lithium carbonate 300 mg three times daily. The client reports nausea. To reduce the nausea most effectively, the nurse suggests that the lithium be taken with:

Meals

The nurse is caring for a client that was recently started on a second generation antipsychotic medication. The nurse understands that the generation antipsychotic medications can cause which of the following?

Metabolic syndrome

Not very common. Display self importance, entitlement Poor relationships Actually feel shame, fear of abandonment

Narcissistic personality disorder

Nursing approach with this disorder is to convey confidence, avoid power struggles and defensiveness

Narcissistic personality disorder

Strive for perfectionism and orderliness is a must

OCD disorder

May see in the workplace. Display rigidity, are inflexible. Actions/behaviors may be self defeating but have no insight Their way or highway

Obsessive compulsive personality disorder

Characterized by suspiciousness, hypervigilant behavior. Can be hostile and controlling

Paranoid personality disorder

What people see, what makes us "us"

Personality

A nurse cares for a client diagnosed with a morphine (opioid) overdose. Which focused assessment has the highest priority?

Respiratory

For these personality disorders, you want to avoid being "too nice" or friendly. You want to be calm and confident.

Schizoid and paranoid personality disorder

Uncommon Characteristics: "loner, shy, emotionally detached."

Schizoid personality disorder

You are able to reason with the person that has this personality disorder and these individuals have very odd beliefs. They have severe social and interpersonal deficits

Schizotypal personality disorder

A client diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the client says, "I don't think I can keep taking these pills. They make me so dizzy, especially when i stand up." The nurse will:

Teach the client strategies to manage postural hypotension

Key feature of all individuals with personality disorders

They accept and are comfortable with their altered behaviors and personality

Client has begun taking psychotropic medication. The nurse is providing education to the client on the purpose of psychotropic drug therapy and is correct in stating that the drug therapy is used for which of the following reasons?

To decrease symptoms and facilitate other therapies

A client has been started on Clozapine to treat the positive and negative symptoms of schizophrenia. Which lab result noted by the nurse would be of concern for this client?

White blood cell count of 3000