Mental Health Wk6 RUNOFF

Forensic clients have complex issues. Which of the following is a factor to consider when working with this population?

Prevalence of mental disorder (Factors to consider when working with forensic populations include prevalence of mental disorder, cultural and demographic variations, and the needs of special at-risk groups.)

Which of the following is a sentence of revocable release under the supervision of an officer for a specified time?

Probation

The nurse is conducting an admission assessment in a forensic setting. The client demonstrates a closed body posture and reluctance to speak. How should the nurse respond to this finding?

Provide reassurance about the reasons for conducting the assessment (Clients incarcerated in forensic settings may be uncomfortable discussing their crimes for fear of rejection by the nursing staff and treatment team. They may also be reluctant to disclose personal information if they perceive there is a risk for further prosecution because of their disclosure. The nurse should reassure the client that the focus of the assessment is mental health issues and behaviors but not specific details of the crimes.)

The community health nurse meets with the family members of an elderly client. The nurse includes which in the plan of care as a preventive measure to guard against elder abuse?

Provide the primary caregiver with additional resources to meet the elder's needs (Elder abuse may develop gradually as the burden of care exceeds the caregiver's physical or emotional resources. Relieving the caregiver's stress and providing additional resources may help to correct the abusive situation and keep the caregiving relationship intact.)

Intimate partner violence is the mistreatment or misuse of one person by another in the context of an emotionally intimate relationship. Which type of abuse includes name calling and belittling?

Psychological abuse

Which statement requires additional education regarding the truth about rape?

Rape is a crime of passion. (if you say this then your whole family needs to stop inbreeding)

A client comes to the emergency department after being attacked and sexually assaulted. What is the most accurate nursing diagnosis for this client?

Rape-trauma syndrome

The nurse is caring for a client reaching the Thiem date in a forensic setting. What should the nurse expect to occur?

Re-assesment (The Thiem date is the date marking the end of the maximum period of sentencing. After the Thiem date expires, the forensic hospital will do an assessment, and if the client is still a threat to him- or herself or others, the hospital will petition the court for involuntary commitment.)

A client is diagnosed with schizophrenia and substance use and is prescribed an atypical antipsychotic. The nurse understands that in addition to treating schizophrenia, atypical antipsychotics also function in the treatment of substance use by which action?

Reducing cue-trigger craving (Not only do these agents treat symptoms of schizophrenia, but also they appear to reduce cue-trigger cravings of the substances and prevent relapse. Atypical antipsychotics do not reduce the length of withdrawal, prevent intoxication, or prevent withdrawal-related seizures intact they increase the chance for seizures by lowering the threshold.)

The nurse is seeing a client who has cancer pain from a metastatic tumor. The client reports feeling that the pain is quite intense before she is due to take the next dose of morphine. Which of the following actions should the nurse take?

Refer the client to the prescribing health care provider for a medication review (Cancer pain arises from malignant tumors that is caused by local infiltration or metastatic spread involving specific organs, bones, peripheral or cranial nerves or the spinal cord.)

Avery is a 37-year-old man who has been diagnosed with a mental disorder due to a general medical condition. This classification represents what?

Underlying medical conditions that directly cause psychiatric symptoms (According to the DSM-IV-TR, this classification represents underlying medical conditions that directly cause psychiatric symptoms.)

A nurse is giving a talk about child abuse to a local community group. When discussing risk factors for child abusers, which would the nurse identify as the most likely profile of the perpetrator of fatal child abuse?

Unemployed young woman who dropped out of high school (Perpetrators of fatal child abuse are most likely to be caregivers who are young, poorly educated, and living at or below poverty level.)

A defendant is unable to assist in his defense because he is diagnosed with paranoid schizophrenia. This defendant would be considered which of the following?

Unfit to stand trial (UST)

Seven clients with co-occurring disorders are receiving cognitive behavioral therapy in a group therapy setting. What type of assignment would the nurse require the clients to do between the group therapy sessions?

Use a checklist to document the cognitive distortions that occur between sessions.

A depressed male client with a dependent personality disorder verbalizes that he feels a worsening of his symptoms, despite the fact that he is using alcohol on a daily basis. What is the best assessment question that the nurse can ask to find out additional information about the client's current situation?

"Are you taking your prescribed medication as ordered?"(Often people stop taking the prescribed medication and rely on a substance to help alleviate the symptoms of the mental health disorder. By asking this question, the nurse can ascertain if the client is self-medicating with alcohol instead of taking the prescribed medication.)

The nurse is seeing a male client who reports that he continues to have low back pain despite seeing his primary health care provider several times and being instructed to take analgesic medications and do daily stretching activities. The client tells the nurse he feels frustrated with his lack of progress. Which is the nurse's best response?

"Can you tell me more about when you take your pain medications?" (The nurse's best response in this scenario is to assess any barriers to pain management for this client. The nurse should explore the client's use of analgesic medications, particularly the client's understanding of how often the medication can be taken and the most effective times of the day to take the medication.)

The nurse is seeing a client who experiences chronic pain. The client tells the nurse she has tried everything her health care provider has prescribed without success. Which of the following is the nurse's best response?

"Have you thought about what has worked well to manage your pain in the past?" (The nurse can help identify circumstances when the pain was diminished and use this information to develop strategies.)

Which statement made by a client raises the greatest concern that the client may be experiencing relationship violence?

"I don't know what else I can do to keep him from getting angry at me." (A warning sign of relationship violence is feeling that you must change your life or yourself so you won't anger him or her.)

What client statement is typical of the information that an anorexic client who uses cocaine may share with the nurse during the intake process?

"I got into the habit of using cocaine every morning." (A person with anorexia nervosa can easily get into the habit of using cocaine every morning because it prevents the person from feeling hungry.)

A 19-year-old man introduced heroin to his 16-year-brother who has schizophrenia. The younger brother overdoses and is admitted to the intensive care unit. What statement by the older brother will facilitate the nurse's understanding of the situation?

"I just thought he would be happier if he were one of the group." (The nervous older brother probably introduced his brother to drugs so that he could be part of the social group and spend time with people who share in this drug use habit.)

The nurse is caring for a non-English speaking client who is admitted to a hospital psychiatric unit for major depressive disorder. The client has an existing diagnosis of osteoarthritis. On physical examination, the nurse notes the client is sitting with a rigid posture. Which action should the nurse take first?

Ask the client to rate pain using the Wong-Baker pain scale

The nurse is assessing an elderly client in the emergency department. There are many bruises present on the client's body in varying stages of healing. After documenting the bruising in the assessment, what should the nurse do next?

Ask the client when and how the bruises occurred (The nurse should not assume the bruises were caused by abuse; the client's explanation is an important step in the assessment of potential abuse.)

The nurse is caring for clients in a forensic setting. Which scenario best represents a boundary violation by the nurse?

Asks client details about crimes committed

The nurse is seeing a client with type 2 diabetes mellitus. While conducting a physical examination, the nurse notes the client has a small lesion on the heel of his foot. Which of the following actions should the nurse take next?

Assess the sensation in the client's feet

The parents of an adult client with bipolar disorder and alcohol use disorder are scheduled for a family meeting prior to discharge. The parents decline to participate in the meeting and state, "After so many hospitalizations, another family meeting will not help; he does what he wants to do and we know he will never change." What is the nurse's best initial response?

"Let's talk about a support group for you to attend." (It is difficult for parents to cope with a family member with mental illness. Families need support and it is appropriate to talk to them and provide information on a support group to assist them to gain insight from the challenges and successes of other families facing similar circumstances.)

Initiation of forensic psychiatric care ideally begins at which time?

At the time of arrest

Which of the following medication classifications is the primary agent used in the treatment of clients with comorbid schizophrenia with substance abuse?

Atypical antipsychotics

Which of the following medication classifications is used in clients with comorbid schizophrenia and substance use?

Atypical antipsychotics

Nursing care of individuals with mental illness is challenging in the forensic setting. Which factors influence treatment for these clients? Select all that apply.

-Stigma may affect health care delivery for mentally ill clients -Nurses must provide high-quality care while enforcing rules -Clients are reluctant to provide crucial information for fear of rejection

The nurse is preparing an educational session on trauma. When discussing adaptation to trauma, which of the following points should the nurse include?

-The age at which a traumatic event occurs affects how well people adapt -The type of trauma influences how people adapt -Having supportive family members has an impact on the ability to adapt

The nurse is collecting assessment data on a client who is suspected to be a victim of violence. Which assessment data would support the suspicion that the client is a victim of abuse? Select all that apply.

-The client has few friends. -There is a large amount of alcohol use in the home. -The client reports that the client's father was abusive during childhood.

The nurse is aware that fewer than half of rapes and sexual assaults are reported. Which are some of the reasons people do not report being sexually assaulted? Select all that apply.

-The client is embarrassed of the assault. -They have a fear of being blamed for the incident. -The perpetrator may use coercion or threats to control the victim.

The nurse is conducting a mental status examination with a client who has a diagnosis of hypothyroidism. Which of the following factors should the nurse consider important while conducting the assessement?

-The client is female -The client has hypertension -The client has trouble taking medications -The client's mother had depression (4/5)

The nurse is seeing a client with hypothyroidism in the outpatient clinic. The client reports feeling as though her disease is poorly managed. Which of the following reports would support the client's perception of her illness?

-The client is having trouble concentrating on her school work -The client finds it difficult to initiate exercise -The client feels overwhelmed by her lack of energy

The nurse is seeing a client with chronic pain who has dysphagia. Which pain management techniques should the nurse recommend? Select all that apply.

-Topical analgesic agent -Trigger point injection -Acunpuncture -Meditation

After a series of admissions to the emergency department over the past several months, an 80-year-old client's malnutrition, vague history, and pattern of physical injuries lead the nurse to suspect elder abuse. Which aspect of the client's situation may contribute to elder abuse? Select all that apply.

-the client is physically dependent on the client's son since losing mobility. -The client has no income or savings of the client's own. -The client's son describes the client as "needy, helpless, and pathetic."

When the school nurse is assessing an adolescent who reports troubling sleeping, which characteristics of the client indicate there may be violence in the home? (Select all that apply.)

-the client's father monitors contact with friends -has a family history of alcohol abuse -must go straight home after school each day

A college student stated, "I just borrowed my roommate's Xanax (alprazolam) because my anxiety became too overwhelming to handle, and she reported me and now I need to get treatment." What factor will the nurse identify as a potential barrier(s) to the client's participation in treatment? Select all that apply.

-the roommate's negative attitude -the view of treatment as punishment -the belief that no problem exists

The nurse is instructing a client with a co-occurring disorder on the best strategies to use to address the issue of relapse. Place the needed changes in lifestyle from highest to lowest priority for the nurse to provide the client.

1 "Stop going places where there are drugs and being with people who use drugs." 2 "Learn effective coping strategies to use when experiencing drug cravings." 3 "Focus on your feelings and write down the triggers, cravings, and other stressors.' 4 "Continue in treatment for your mental health and substance use problem."

The nursing student learning about child abuse correctly identifies which of the following individuals to be at the highest risk for abuse?

5-year-old girl

Criminalization of the mentally ill is frequently attributed to the deinstitutionalization movement that occurred in

60s-70s

Approximately what percentage of women rape victims are raped by someone they know?

65% (Approximately two-thirds of women are raped by people they know, including spouses, boyfriends, friends, or acquaintances. Among young women, about 50% of rapes are date rapes)

A nursing student learning about intimate partner violence (IPV) correctly identifies the percentage of deaths attributed to IPV to be what?

70% women and 30% men

A nurse is aware of the high incidence of intimate partner violence (IPV) and actively seeks opportunities to screen women for IPV. Which female client represents the best opportunity for assessing for IPV?

A client who is in the third trimester of pregnancy and who is having biweekly prenatal appointments at a clinic. (pregnant women are at increased risk for domestic violence, see fallout 4 memes)

The nurse recognizes that which client demonstrates having a secondary mental illness?

A client with chronic back pain and major depressive disorder (Persons with chronic physical health issues are at risk for developing co-morbid anxiety disorders, substance abuse disorders, depressive episodes, and other mood disorders.)

The nurse fails to obtain informed consent on a forensic client prior to initiation of an antipsychotic medication. Which legal liability is this nurse committing?

Medical battery

The nurse is counselling a client who has just been diagnosed with HIV. The client tells the nurse he is wants to keep his diagnosis private as much as possible. Which of the following is the nurse's bes response?

"You and I should work together to figure out the best time and way to disclose your illness"

Which of the following are last resorts used to promote de-escalation of the mentally ill client? Select all that apply.

-Restraints -Seclusion -Physical holds

A 39-year-old man has just received word that he has tested positive for HIV, and he is now forced to face the prospect of telling his friends and family. This task is typically associated with what?

Anxiety and guilt

The nurse working in the mental health system is providing care to a client who was determined to be guilty but mentally ill (GBMI). The nurse interprets this determination as indicating which of the following?

Mental illness is a factor, but the person can distinguish right from wrong.

Which statement, made by a nurse who experienced sexual abuse as as a child, demonstrates being best prepared to work with sexual abuse and trauma survivors?

"I've been supported by health care professionals and now I want to support other survivors."

A nurse is working with a client who is a survivor of rape. The client asks the nurse, "It's been 6 months since it happened. Why can't I get back into doing the things I did before?" What is the nurse's best response?

"It can take at least a year or more to get back to where you were before." (It often takes one or more year for survivors of rape to regain previous levels of functioning. It is important to remind clients that it is possible to return to previous levels of functioning.)

A nursing instructor teaching about sexual assault identifies a need for further instruction when one of the students makes which statement?

"It is not considered rape if it occurs with same-sex couples."

When a male client with bipolar disorder becomes depressed, he uses methylphenidate to "even out my moods." After experiencing the first overdose of the drug, his parents ask the nurse, "What is the worst problem that can happen to our son if he overdoses again?" What is the nurse's best reply?

"This drug can cause severe heart attack and sudden death."

The nurse is discussing expectations of raising a child with a pregnant teenager expecting her first baby. The father will not be a participant in the parenting. Which statement made by the expectant mother would be of greatest concern to the nurse?

"My child will love me, unlike my parents ever did." (In some instances, the parent feels the need to have children to replace his or her own faulty and disappointing childhood. When the parent's unrealistic expectations are not met, abuse often follows.)

A client with schizophrenia and substance use disorder attends a weekly group meeting for clients with co-occurring disorders. Which client statement indicates to the nurse that additional teaching is immediately needed in the group session?

"My friend has something to help me if my mother gets on me about things."

Nursing students are learning about people with mental illness who have a record of criminal behavior. During the class the instructor mentions not guilty by reason of insanity (NGRI). The instructor realizes a need for further instruction when one of the students makes which of the following statements?

"NGRI is a loophole used in 40% of cases." (A possible outcome of a trial is NGRI, whereby the accused is judged to not know right from wrong. The rationale underlying this ruling is one of fairness. After a finding of NGRI, the individual is ordered to a forensic facility for evaluation. Almost all people found NGRI are also subject to involuntary commitment in a secure setting. Despite popular belief, the insanity defense is used in fewer than 1% of criminal cases.)

Repeated hospitalizations because of the distressing symptoms of mental illness that are exacerbated by substance use is referred to as

"Revolving door"

A female college student with an anxiety disorder used dextroamphetamine prior to taking final exams and is brought by her roommate to the emergency department having chest pain. The client tells the nurse, "I get worried about not doing well on my exams, so I take it to help me study. Nothing like this has ever happened before." What information should the nurse explain to the client about her condition?

"Right now we know that you are experiencing some of the cardiac side effects of the drug." (The explanation that the client is having some of the cardiac side effects from the use of dextroamphetamine keeps her informed about her current condition.)

A male client with bipolar disorder who overdosed from cocaine is admitted to the intensive care unit. His spouse told the nurse, "We were at a party and he only used a little bit of the stuff. I don't understand how this could happen." What is the nurse's most appropriate reply to the spouse?

"Small amounts of the drug can be very toxic to a person." (It is important to recognize that even a small amount of a drug, such as cocaine, can be very physiologically and psychologically damaging to the body.)

A male client with a long-standing history of schizophrenia is admitted to the psychiatric emergency department after eating cannabis plants. What explanation will the nurse give to the client to help him understand the reason for completing a drug screening instrument?

"The screening instrument gives information to determine if a drug problem could be occurring." (Drug screening instruments assists the health care provider to determine if a drug problem exists and if additional screening is necessary. According to the National Institute on Drug Abuse, drug screening needs to be a routine part of the assessment provided to all adults receiving care in a health care agency.)

The father of a client asks the nurse why his 19-year-old son with schizophrenia started using illegal drugs after he was diagnosed with a mental illness. What explanation will the nurse share with this family member?

"There are times when people attempt to self-medicate the symptoms of their mental illness."

A nurse is assessing a client in a community clinic who reports feeling anxious lately because she is considering leaving her marriage. The client describes a long history of partner abuse associated with this relationship. How should the nurse respond to this client?

"You have the right to be safe and respected." (When working with someone who is a victim of partner abuse, it is important that the nurse assertively support the client's decision. The affirmation of the client's decision can help to improve the client's self-confidence as she begin the process of leaving her partner.)

The nurse is working with a client at the battered women's shelter who is in a violent and abusive relationship. The client is considering a separation and asks the nurse, "What do you think about that?" Which is the best response by the nurse?

"You may be in more physical danger after you leave him."

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client? Select all that apply.

-A 6-year-old is being seen for the 5th time for a urinary tract infection -A baby with contrecoup injuries to the brain -A 3-month-old with a fractured femur

The nurse is providing health teaching to a client using sensory modulation and integration activities. Which of these demonstrates grounding techniques? Select all that apply.

-Arm massages -Aerobic exercise (sensory modulation and integration activities. Arm massages, and aerobic activities are considered grounding physical activities.)

A nurse is preparing a presentation about chronic medical illnesses and mental health problems that can occur as a result of the medical illness. The nurse would describe depressive symptoms as being most commonly associated with which medical illness? Select all that apply.

-Cancer -Epilepsy -AIDS -Rheumatoid arthritis

What are some types of behavior that the nurse would recognize as qualifying as psychological abuse? Select all that apply.

-Criticizing -Ridiculing -Threatening a victim's dog (aggressive language, not so much)

The nurse is seeing a client who has been diagnosed with HIV- associated neurocognitive disorder (HAND). The client is most likely to report which of the following problems associated with diagnosis? Select all that apply.

-Difficulty typing -Difficulty reading a novel -Difficulty remembering appointments

The graduate nurse is caring for clients in a forensic setting. Place the steps in the order in which the nurse provides care in a call line system.

-Inmate notifies guard. -Guard contacts nurse. -Nurse conducts assessment. -Nurse administers first aid. -Nurse notifies health care provider.

Which are common characteristics of violent families regardless of the type of abuse that exists? Select all that apply.

-Intergenerational transmission -Social isolation -Alcohol and other drug abuse -Abuse of power and control

A nurse is working in the emergency department. Which situation would lead the nurse to suspect possible abuse of a client

-Makes a spare car key -Compile a list of important phone numbers -Keep emergency money available -Identifies safe places to go

Which risk factors in a client's history would alert the nurse to screen for intimate partner violence? Select all that apply.

-Multiracial -Low income -Live in a rural area (all fcuked up question)

The nurse is conducting a community education session on chronic pain. The nurse includes which reason pain management may not be successful?

-Nonadherence to prescription changes -Lack of use of combined treatment approaches -Nonacknowledgement of pain by health care providers

A nurse is assessing a client diagnosed with HIV infection who was brought to the facility because of behavioral and cognitive changes. The client was diagnosed with HIV-associated neurocognitive disorder (HAND). When assessing this client, which finding would the nurse most likely note? Select all that apply.

-Problems with attention -Memory impairments -Deficits in executive functioning

A depressed client admitted to the hospital multiple times for alcohol intoxication and subsequent withdrawal tells the nurse, "I'm never going to be able to stop drinking, because every time I get really down, I drink." What are attainable short-term goals for this client? Select all that apply.

-Recognize the relationship between alcohol and depression. -Learn about the prescribed antidepressant medication. -Establish a strong relationship with the treatment team.

Which type of elder abuse involves leaving an older adult and no longer providing care for the individual?

Abandonment

Jonathan has been diagnosed with adjustment disorder. He has been displaying symptoms of minor depression. Which of the following types of adjustment disorder is Jonathan most likely experiencing?

Adjustment Disorder with depressed mood (The DSM-IV-TR further identifies six types of ADs: AD with depressed mood: symptoms are that of a minor case of depression; AD with anxious mood: symptoms of anxiety dominate the clinical picture; AD with mixed anxiety and depressed mood: symptoms are a combination of depression and anxiety; AD with disturbance of conduct: symptoms are demonstrated in behaviors that break societal norms or violate the rights of others; AD with mixed disturbance of emotions and conduct: symptoms include combined affective and behavioral characteristics of AD with mixed emotional features and AD with disturbance of conduct; AD NOS: this residual diagnosis is used when a maladaptive reaction that is not classified under other ADs occurs in response to stress.)

Kelly is a 54-year-old woman who suffered a myocardial infarction two months ago. She has been under a great deal of stress because of her diagnosis of coronary heart disease. Her level of stress is beginning to interfere with her personal relationships and job functioning. What is the name for the condition from which Kelly is suffering?

Adjustment disorder (Adjustment disorder (AD) is an appropriate psychiatric diagnosis when an identifiable stressor leads to impaired relationships or functional occupational or social limitations.)

Which cultural group of women has the highest rate of being victimized by sexual assault?

African American

The client with chronic pain reports her pain associated with menstrual cramping is much worse recently. The client reports she has been experiencing increased stress at work due to impending deadlines. The nurse suspects the client is experiencing which type of pain?

Allodynia (Allodynia refers to central or neuropathic pain that is unrelated to a noxious stimuli but causes a lowered threshold for pain.)

Which of the following substances have effects similar to cocaine but more prolonged in duration?

Amphetamines

Which medication classification is used for clients exhibiting aggressive episodes despite taking antipsychotic medication as prescribed?

Antianxiety (and hypnotic medications such as lorazepam (Ativan) and diphenhydramine (Benadryl) are used for as-needed management of aggressive episodes that occur despite taking antipsychotic medication as prescribed.)

Which personality disorder carries with it the highest risk of a person developing a comorbid substance abuse problem?

Antisocial (80%)

The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR) is a classification system for identifying psychiatric disorders. Which DSM-IV-TR diagnosis is associated with the highest prevalence of substance-related disorders?

Antisocial personality disorder

Which of the following psychiatric disorders has the highest increased risk for substance-related disorders?

Antisocial personality disorder

The psychiatric nurse recognizes the importance of assessing for a substance-related disorder when caring for a client with a psychiatric diagnosis of

Antisocial personality disorder (80% of clients diagnosed with antisocial personality disorder also abuse a substance, making the assessment especially important.)

Of the following psychiatric disorders, which has the highest risk for substance abuse?

Antisocial personality disorder (80%)

The nurse is working with a client who is recovering from ischemic stroke. The nurse is assessing the client's ability to participate in activities that will help him be as independent as possible at home. Which of the following scales should the nurse use in this assessment?

Barthel Index (Function ability for self care can be measured using the Barthel Index. This assessment tool can help the nurse determine a client's strengths or limitations in the ability to carry out activities of daily living after ischemic stroke.)

Which of the following is a psychotropic drug associated with mental illness in medically ill clients?

Benzodiazepine )Benzodiazepine is a psychotropic drug associated with mental illness in medically ill clients. )

Neurologic impairment is most often related to

Brain cell neuron destruction

A community is holding a forum on mental health and the criminal justice system. Which information is most appropriate to include in the discussion?

Mentally ill individuals are convicted of crimes more often than those without a mental illness

The nurse is documenting on a group of forensic clients. Which subjective information is included in the nursing assessment?

Client reports neck stiffness

The forensic nurse is providing health teaching regarding early recognition method for aggressive behavior. Which statement is true regarding this method?

Clients and staff focus on warning signs rather than aggressive reactions.

A nurse has transferred recently to a forensic practice setting from an acute care medical setting. During the orientation period, the nurse's mentor helps the nurse learn the culture of a forensic setting. The nurse learns to be alert to one of the most dominant barriers to building a therapeutic relationship with forensic clients. What is this barrier?

Clients commonly struggle with trusting others.

Some of the nurses in a large, suburban emergency department are exasperated to see that a well-known client with a dual diagnosis has again been brought by ambulance for treatment. Which of the following factors is known to make assessment of clients with dual diagnoses difficult?

Clients with dual diagnoses are often poor historians.

The nurse is caring for a male client with hemiparesis from ischemic stroke. The client tells the nurse he is unwilling to take any medications prescribed for post-stroke treatment. Which action should be taken first?

Clinical evaluation for depression

A nurse is planning discharge for a sexual offender diagnosed with a mental illness. Which additional criteria is expected for this client upon discharge?

Community notification

A nurse providing care to a client and family with AIDS should promote their sense of

Competence and control in relation to living with AIDS

A forensic nurse working in a prison must view all clients as people who deserve respect and professionalism. What should the nurse do to enforce this viewpoint?

Conduct ongoing self-reflection and self-awareness.

Which of the following is an endocrinopathy associated with symptoms of depression?

Cushing's syndrome (Endocrinopathies include Cushing's syndrome, hyperthyroidism, hypothyroidism, and Addison's disease. Neurologic disorders include multiple sclerosis, epilepsy, and Parkinson's disease.)

A nurse is reviewing the various legal issues associated with forensic clients. The nurse identifies which ruling as applying to those who knew the wrongfulness of their actions and had the ability to act otherwise?

Guilty but mentally ill (if the forensic nurse is looking into someone they must have some mental issue)

Clients with schizophrenia self-medicate with alcohol to decrease which positive symptom associated with the thought disorder?

Hallucinations (Clients with schizophrenia self-medicate with alcohol or drugs to decrease the intensity of hallucinations, a positive symptom)

A frequent problem of clients diagnosed with co-occurring disorders is relapse. Which of the following is the first phase of relapse?

Decompensation (The relapse cycle is characterized by a pattern of decompensation, hospitalization, stabilization, discharge, and then decompensation.)

A veteran with posttraumatic stress disorder who uses alcohol to cope with the flashbacks of his combat experience is attending an outpatient group therapy session. Which goal on the client's treatment plan will the nurse consider of primary importance?

Demonstrate effective coping skills for handling distress. (The primary goal is for the client to identify and effectively handle stressors in order to prevent self-medicating with alcohol when feeling a loss of control.)

According to the Bureau of Justice, 65% of women murdered by spouses or boyfriends were attempting to leave or had left the relationship. Which of the following is the most common trait found in abused wives who stay with their husbands?

Dependency

According to research finding, the nurse must be most vigilant in observing the client recently diagnosed with HIV/AIDS for

Depression

Apathy and psychomotor retardation in HIV-associated neurocognitive disorder (HAND) overlap with which disease process?

Depression

A 33-year-old man has been brought to the emergency department after being found unconscious outside a store. The man's known schizophrenia and history of heavy cocaine and heroin use are characteristics of a dual diagnosis, and the nurse's assessment confirms this fact. After he has stabilized medically, which of the following aspects of care should the nurses caring for the man prioritize?

Detoxification (For many clients who have dual diagnoses, detoxification must take place prior to other interventions and assessments.)

A client with Parkinson's disease is beginning treatment. It is important for the nurse to understand that this particular disease is caused by a deficiency in which neurotransmitter?

Dopamine

Which of the following neurotransmitters has been implicated in people diagnosed with schizophrenia?

Dopamine (A neurobiologic model suggests that a dysregulated dopamine-mediated mesocorticolimbic network in clients with schizophrenia may also underlie substance use)

The nurse is seeing a male client who suffers from neuropathic pain secondary to type 2 diabetes and chronically low mood. The client tells the nurse in a visit with his health care provider, he was was told to consider taking a psychiatric medication. Which medication was most likely suggested for this client?

Duloxetine (Severe or chronic pain may affect mentally healthy people in adverse ways. The prevalence and impact of pain have led to numerous therapeutic approaches, including the use of antipsychotic drugs, antidepressants, antianxiety agents, and stimulants. Considerable evidence suggests that these psychiatric medications and interventions can also be effective in treating both acute and chronic pain. In this scenario, the health care provider would most likely recommend duloxetine as it is an SNRI, a class of antidepressants that have been found effective in the treatment of various chronic pain syndromes. Due to the greater likelihood of adverse side effects and medication interactions, the health care provider would be less likely to recommend phenelzine (an MAO inhibitor) or desipramine ( a tricyclic antidepressant). Although antipsychotics have been shown effective in the treatment of chronic pain, risperidone is one that can cause metabolic syndrome, therefore it would not be an ideal medication for a client with type 2 diabetes.)

Clients with co-occurring disorders are more likely than others to seek assistance from which health care facility?

Emergency department (they wait until the symptoms are no longer tolerable even with the substance abuse)

Which type of elder abuse involves harm of self-worth?

Emotional

A client discloses to a nurse therapist that the client has been verbally abusive to the client's 6-year-old child and belittles the child routinely. Which form of abuse best describes the client's treatment of the child?

Emotional abuse

The forensic nurse is conducting an admission interview with a client. Which technique is most appropriate when establishing the nurse-client relationship?

Empathy

Pain response can vary from person to person. Which of the following are neurotransmitters that exhibit opioid-like behavior?

Endorphins

Which phase of recovery entails establishing a treatment relationship and enhancing motivation to make behavior changes?

Engagement (Engagement entails establishing a treatment relationship and enhancing motivation to make behavior changes and a commitment to treatment. Persuasion or motivation is used to increase engagement in treatment and help the client identify his or her own goals. Active treatment includes two models of assertive outreach: the case management model and assertive community treatment.)

A 33-year-old client has been treated for a periorbital hematoma and a broken nose that the client suffered when the client's spouse struck the client. The client does not know where the spouse currently is, and the client is scheduled for discharge. What action should the care team prioritize in this client's care?

Ensuring that the client goes to a safe place

At the encouragement of his parents, a client with bipolar disorder and an addiction to methamphetamine has agreed to enter treatment. Which of the following nursing activities takes place during the engagement phase of treatment for a client who has a dual diagnosis?

Establishing a therapeutic relationship (The engagement phase begins with the establishment of a therapeutic treatment relationship. Detoxification and medical stabilization are in the acute stabilization phase. The development of vocational skills takes place later in the rehabilitation and recovery phase.)

A client has been admitted to the medical unit from the emergency department after experiencing a violent assault. What action should the nurse prioritize when planning this client's care?

Establishing rapport with the client (Therapeutic rapport and trust are absolutely foundational to the care of a client who has suffered violence.)

Which phase of the nursing process focuses on client compliance with interventions?

Evaluation

A nurse wants to transfer from a surgical unit to a forensic unit and will have to be trained. The first step toward being an effective psychiatric nurse in a forensic unit is to do what?

Examine personal beliefs and attitudes about clients and crimes.

When a client diagnosed with chronic alcoholism is prescribed risperidone (Risperdal) while undergoing detox, the psychiatric nurse managing the client's care is aware that the client may

Experience adverse effects of risperidone (Risperdal) that are greatly exaggerated (The impact of alcohol and drug abuse may alter pharmacokinetics and thereby exacerbate adverse effects when psychotropic medication is administered.)

A female college student admits to the nurse in the health center that she has struggled with severe anxiety for the last two years. She takes buspirone daily, but also uses alcohol daily to socialize with peers. What is the nurse's first intervention with this client?

Explain the interaction of alcohol with the prescribed medication. (It is essential to explain that using buspirone and alcohol can increase the severity of the effects that both drugs will have on the client's central nervous system.)

A client with generalized anxiety disorder states, "My medications are not working well, and I started drinking a glass of wine at bedtime. It worked for a while, but now I'm drinking more and more and it is not working." What intervention can the nurse implement to decrease complications of alcohol withdrawal?

Explain the purpose and need for hospitalization while going through detoxification. (The best course of action to decrease the complications of alcohol withdrawal is hospitalization for the client. It is important that clients with co-occurring disorders obtain both medical and psychiatric care for both disorders at the same time)

Which of the following is a client barrier to pain management?

Fear of addiction (Client barriers include fear of tolerance and addiction, fear that the pain means the disease is worse, and concern about the primary treatment of the underlying disease.)

Which of the following are biologic indicators of posttraumatic stress disorder (PTSD)?

Flashbacks (Biologic indicators, such as elevated pulse and blood pressure, sleep and appetite disturbances, exaggerated startle responses, flashbacks, and nightmares, may suggest PTSD or depression. Signs and symptoms of dissociation include memory difficulties, a feeling of unreality about oneself or events, a feeling that a familiar place is strange and unfamiliar, auditory and visual hallucinations, and evidence of having done things without remembering them)

The nurse is working with a client in the acute recovery phase from a traumatic brain injury. In order to identify barriers that may impact the client's rehabilitation process, which of the following tools should the nurse use in the assessment?

Hamilton Rating Scale for Depression (For clients with traumatic brain injuries, depressed mood may become evident in the acute recovery phase or during rehabilitation and often negatively affects survival and recovery. It impedes progress throughout the rehabilitation process and ultimately prevents an optimal outcome. By using the The Hamilton Depression rating scale in the assessment, the nurse can identify if depressed mood is likely to become a barrier to the client's recovery.)

A nurse is discussing ways to prevent violence in various relationships. Which of the following nursing interventions would be most appropriate to prevent a client from becoming violent?

Helping the client identify and express feelings of anxiety and anger (The most appropriate nursing intervention for a client who may become violent is to help him or her identify and express feelings of anxiety and anger.)

Which of the following nursing interventions would be the most appropriate to prevent a client from becoming violent?

Helping the client identify and express feelings of anxiety and anger (The most appropriate nursing intervention for a client who may become violent is to help him or her identify and express feelings of anxiety and anger.)

A client with schizophrenia is admitted to the ICU after overdosing on cocaine. What is the most serious aspect of cocaine overdose that the nurse would report to the health care team after obtaining the results of the client's liver function studies?

Hepatic toxicity (Since acute liver injury can cause acute hepatic necrosis to occur in a client after experiencing a cocaine overdose, the nurse would immediately report hepatic toxicity to the health care team. A damaged liver cannot breakdown and clear drugs (such as cocaine) from the body.)

The nurse is seeing a client who reports she recently saw her primary health care provider for a a full phyiscal examination with follow up. The client has a 30 year history of depression with no other co-morbid medical illness. Which of the following findings should the nurse expect would arise from this client's physical examination?

High fasting blood glucose (Depression has been shown to be an independent risk for type 2 diabetes. The nurse can expect that a client with a longstanding history of depression with no other medical illness would be at risk for this condition.)

In many cases, family members tolerate abusive and violent behavior from relatives that they would never accept from strangers. In violent families, which normal safe haven may be the most dangerous place for victims?

Home

Which of the following is defined as increased nociceptor sensitivity?

Hyperesthesia

The nurse is assessing a client with a longstanding history of schizoaffective disorder. Which clinical finding indicates the client is at risk for metabolic syndrome?

Hyperlipidemia

Depression and anxiety are often present in clients with

Hypothyroidism (Depression and anxiety are often present in clients with hyperthyroidism and hypothyroidism)

The nurse is caring for a client with schizophrenia and HIV. The client is being cared for in hospital and tells the nurse he wants to exercise his right to refuse any further treatment. Which of the following is the most important for the nurse to consider prior to taking any further action?

If the client is mentally competent to make medical care decisions

A young client telephones the emergency department and loudly tells the nurse, "I've been raped! Please help me!" Which is the priority for the nurse to determine?

If the client was in a safe place, the client's condition, and if transportation is available

The nurse is seeing a female client who developed depression six months after witnessing the death of her mother in a car accident. The client has been prescribed venlafaxine to treat depressive symptoms. Which medication teaching should be the nurse's priority?

Immediately report any thoughts of self-harm to the health care provider or seek emergency help

A nurse manager is working with the nursing staff of a busy community-based walk-in clinic that provides care to a large number of survivors of domestic violence. When helping the staff provide care, which information would be most important for the nurse manager to convey to the staff?

Importance of measuring the clients' progress in small steps (Nurses must become accustomed to measuring gains in small steps when working with survivors. Making any changes in significant relationships has serious consequences and can be done only when the adult survivor is ready.)

Forensic nursing practice has been recognized as a significant resource in which of the following client populations?

Incarcerated

Which of the following is a social outcome measure for clients with pain control?

Increased participation in outside activities

A nurse is reviewing the chart of a forensic client who is guilty but mentally ill. The client has a recent diagnosis of paranoid schizophrenia with positive symptoms. Which intervention is a priority for this client?

Management of aggression

A nursing student is developing a research project about mental illness among incarcerated offenders. Which information is most appropriate to include in the research?

Individuals with first-time, untreated psychosis have a higher incidence of violence (There is a higher risk of serious violence (homicide) for those with a first-episode psychosis who have not yet been treated than for those who have previously received treatment.)

The nurse is seeing a client with a diagnosis of Lyme disease who has painful neuropathy in the knee joints. When providing education to the client about the underlying cause of the neuropathy, which of the following type should the nurse explain to the client?

Inflammatory (Inflammatory neuropathy is related to the presence of chemical or microorganic pathogens such as the case with Lyme disease. Traumatic neuropathy refers to to nerve pain caused by avulsion or compression. Diabetic neuropathy is characterized by neuropathy caused by diabetes mellitus;)

A client is currently enrolled in a residential treatment program that is simultaneously addressing his schizophrenia and his cocaine use. What treatment approach is this client receiving?

Integrated model (In the integrated or unified treatment model, both diagnoses are considered primary and staff members are trained and experienced in providing care for clients with a dual diagnosis. In the serial or sequential model, treatment for one disorder follows treatment for another in different sites with different staff. In the parallel model, concurrent treatment for both problems occurs in separate facilities or separate programs with separate staff.)

The nurse at a university health services clinic has been asked to meet with a freshman class about warning signs of relationship violence. The nurse points out which danger sign the students should be alert for in a date?

Is excessively jealous

A nursing student is interested in the specialty of forensic nursing and asks a nurse working in the field, "In what setting is a forensic nurse likely to practice?" Which of the following would be an appropriate response?

Jails, secure units in general hospitals or state psychiatric hospitals (Forensic psychiatric nursing occurs in various secure environments, which may belong to the mental health system, criminal justice system, or both. The continuum of controlled environments includes community-based outpatient clinics, secure units in general hospitals, state psychiatric hospitals, forensic psychiatric hospitals, and custodial-type settings)

A nursing instructor is teaching students about nursing care in correctional facilities. Whom does the nurse identify as regulating these facilitates?

Judicial system

Correctional facilities are regulated by which entity?

Judicial system

African American men usually receive fewer mental health services in the forensic setting. Which ethical principle does this violate?

Justice (Autonomy is fundamental right of self-determination. Veracity is the duty to tell the truth. Beneficence of the health care provider uses knowledge of science and incorporates the art of caring to develop an environment in which individuals achieve their maximal health care potential.)

When a client diagnosed with AIDS enters into the final phase of the illness, the nurse provides most effectively in facilitating the social support so vital to the client by

Keeping those identified by the client as his support system both supported and informed

A nurse is caring for an aggressive client who demonstrates boundary violations and combative behavior in a forensic setting. The client is currently taking antipsychotic medications for schizophrenia. Which medication is most appropriate to treat the client's immediate symptoms?

Lorazepam (is indicated for as-needed (PRN) management of agitation and aggressive episodes that occur despite taking antipsychotic medication as prescribed. Lorazepam is completely absorbed when given intramuscular and rapidly enters the CNS, because it is highly protein bound. This facilitates decreased aggression in the schizophrenic client.)

The nurse is assessing a client with hypothyroidism. Which symptom of depression is the nurse likely to observe in this client?

Low motivation

The nurse is seeing a client who reports experiencing a visual aura, nausea and vomitting prior to experiencing which of the following types of pain?

Migraine (Migraine headache pain is a cerebrovascular disorder in which a focal reduction of cerebral blood flow initiates an ischemic headache. It may be preceded by a visual aura and followed by nausea, vomiting and incapacitating head pain. Orofacial pain occurs at the temporomandibular joint pain and includes trigeminal neuraligia. This type of pain that is highly correlated with dental issues such as a toothache or abscess. Plexopathy refers to neuropathy involving a peripheral nerve plexus. Myofascial pain occurs when pressure on sensitive points (trigger points) in the body causes pain in unrelated areas of the body also called referred pain.)

Many of the symptoms of substance use are similar to which mental health disorder?

Mood disorder

The forensic nurse manager is orienting a new nurse to the facility. When reviewing the policies and procedures for de-escalating agitated clients, the nurse manager informs the new nurse that agitated clients should be de-escalated by whom?

More than one staff member (For safety reasons, agitated clients should be de-escalated by more than one staff member.)

Which characteristic of the abuser should the nurse look for when completing the family assessment of a victim of intimate partner violence?

Needy and possessive of the partner (An abuser often believes the abuser's spouse belongs to the abuser (like property) and becomes increasingly violent and abusive if the spouse shows any sign of independence, such as getting a job or threatening to leave.)

The nurse is involved in a community education program for new parents and plans to include information on child abuse. The nurse will teach the parents that the most common form of child abuse is what?

Neglect (Sixty-four percent of child maltreatment victims suffered neglect; 16% were physically abused; 8.8% were sexually abused; 6.6% were psychologically or emotionally abused; and 2.2% were medically neglected. Also, 15% suffered "other" types of maltreatment such as abandonment, physical threats, and congenital drug addiction.)

A client diagnosed with a mental health condition is being accused of murder. Which ruling occurs when the accused does not know right from wrong at the time of the crime?

Not Guilty by Reason of Insanity (NGRI)

The nurse has committed a boundary violation while caring for a forensic client. What should the nurse do next?

Notify immediate supervisor

When a family member is diagnosed with AIDS, the family is forced to undergo a process of adjusting and responding to the diagnosis and providing support for the diagnosed individual. Family dynamics are often stressed and may include which of the following elements?

Older parents may have to adapt to having a previously independent adult who has now become dependent on them. (Usually, those diagnosed with AIDS have already been independent from their families of origin and their parents are typically retirement age. Finances are a large concern because much of AIDS care is not supported by insurance companies. In addition, families are often isolated due to the stigma that a diagnosis of AIDS carries with it in the American culture. Coleman (1988) describes the diagnosis of AIDS as creating major challenges to the fragile balance of roles in the family system.)

A nurse assessing a cardiac surgery client for depression six days postoperatively considers the client's

Past psychiatric history (Factors to consider in diagnosing depression in medical clients is the past psychiatric history of the client.)

The nurse educator is teaching a class on post traumatic stress disorder (PTSD). When explaining the difference between an expected psychological response to trauma versus PTSD, which of the following is true?

People with PTSD have long lasting disruptive symptoms

A nurse being oriented on a new forensic unit asks the preceptor if informed consent is necessary before initiation of pharmacological treatment for forensic clients. The preceptor informs the nurse that it is required and the party responsible for getting this informed consent is

Physician

A nurse is conducting an in-service education program for a group of staff nurses on acute and chronic pain. The nurse determines that the teaching was successful when the group identifies which situation as an example of acute pain?

Postoperative incisional pain (Acute pain is characterized by a sudden, severe onset of symptoms at the time of injury or illness. )

The forensic nurse best fulfills the specialty's obligation to science by

Reflecting regularly on the necessity of an unbiased approach to all interventions

The nurse is providing health teaching about the early recognition method for client safety in a forensic setting. Which intervention is most appropriate to include in the health teaching?

Reinforce self-management skills (Early recognition method (ERM) is a collaborative approach to increase client self-awareness of early signs of their aggressive behavior and reinforce self-management skills that decrease the likelihood of using aggression in future situations.)

The nurse is reviewing the chart of a guilty but mentally ill client scheduled for discharge. Which criteria best describes this type of discharge?

Release is subject to the correctional system's parole decision making

The nurse is administering medication to a forensic client diagnosed with schizophrenia. The nurse notices tongue protrusion, lip smacking and involuntary movements of the head and neck. What should the nurse do next?

Report findings to the psychiatrist

When a nurse is caring for a client with criminal behavior, which of the following is the primary goal of de-escalation?

Resolve violent conflict.

The nurse is conducting an admission assessment on a client in a forensic setting. Which is a priority care issue?

Risk assessment

The nurse is caring for a client who has been aggressive during hospital recovery from a traumatic brain injury. Upon planning discharge, for which potential problem related to aggression should the nurse plan care?

Risk for social isolation

In the medically ill population, treatment of depression to promote a side-effect profile within a wider therapeutic range is more tolerable using

SSRI (SSRI's have the lowest number of side effects?)

The nursing student learning about intimate partner violence correctly identifies its prevalence in same-sex couples as what?

Same frequency as in heterosexual couples

A graduate nurse is attending a new employee orientation in a forensic setting. Which of these principles should the nurse consider first?

Self-awareness

During pain, which of the following neurotransmitters causes the release of endorphins?

Serotonin

The nurse is seeing a client who has longstanding history of pain from osteoarthritis. The client presents with a one-month history of low mood, loss of interest, poor appetite, and sleep disturbance. The nurse recognizes which pharmacological treatment is most appropriate for this client?

Sertraline (know your SSRIs FKUCAS!)

An older adult client has been attending a local day program for the elderly. The nurse who facilitates the program notices the client has multiple bruises on the arms, has scrapes to the hands and face, and is socially withdrawn. A referral to the client's family physician confirms the client has genital herpes. Which type of elder abuse should the nurse suspect?

Sexual abuse

A client comes to the clinic for a prenatal visit. While the client is in the examining room, her estranged husband appears and insists on seeing the client. The client tells the nurse that they are in the process of getting a divorce and she does not want to be around him. "He's been following me to work and at my home everyday." What should the nurse suspect?

Stalking

The nurse is preparing to explain what a co-occurring disorder is to the family of an adolescent client diagnosed with bipolar disorder and daily marijuana use. What information is most important for the family to understand about the complexity of a co-occurring disorder?

Substance use can hide psychiatric symptoms, and psychiatric symptoms can imitate drug use problems. (A main characteristic of co-occurring disorders is that substance use may mask psychiatric symptoms and psychiatric symptoms may mimic alcohol and other drug use problems. It is not accurate to tell a family that the two disorders require a much longer time in treatment because they are difficult to diagnose. Treatment needs to be ongoing and tailored to the client's individual needs. Clients with co-occurring disorders usually self-medicate in an attempt to handle the problematic symptoms of their illness or condition.)

A 39-year-old woman was the victim of a violent assault 1 year ago and, in the ensuing period, has developed the symptoms of posttraumatic stress disorder (PTSD). Additionally, she has become heavily dependent on alcohol and required multiple visits to the emergency department for alcohol poisoning. What pattern of co-occurring disorder does this client exhibit?

Substance-related disorder and mood disorder occurring due to an underlying traumatic experience (This client's PTSD and alcohol use are both rooted in the trauma of her assault.)

The nurse is providing counselling to a male client who has a pancreatic malignancy. The client's chart indicates the client has a poor prognosis. The client tells the nurse he is feels hopeless at times. Which assessment should the nurse conduct?

Suicide risk assessment (hopelessness)

A nursing instructor is teaching a class about people with mental illness who exhibit criminal behavior. The teacher tells students that one key person involved in this area is the forensic examiner, whose role is best described as which of the following?

Testify to the client's competency, responsibility, and mental state at the time of the crime.

Which behavior would first alert the school nurse or teacher to suspect sexual abuse in a 7-year-old child?

The child tells sexually explicit stories to peers. (only a few ways this kid would know about that shit)

A young female immigrant presents in the rural health clinic with facial bruising and a fractured nose. The client is reluctant to give details of the nature of her injuries. Which should be a consideration in providing care for this client?

The client may fear deportation if she seeks public assistance. (Battered immigrant women face legal, social, and economic problems different from US citizens who are battered and from people of other cultural, racial, and ethnic origins who are not battered.)

The nurse is working in the emergency department with a client who was raped 1 hour ago. Which is most important for the nurse to remember when planning care?

The client may feel threatened by some of the procedures.

A depressed client in a group therapy session is challenging what group members say about using alcohol to handle their problems, and how sharing in group is helping them to see alternative ways of addressing problems. What does the nurse suspect is preventing this client from benefitting from the group therapy?

The client needs to become actively engaged in the treatment. (Clients must be engaged in the treatment process if they are to be able to make behavioral changes and learn from the staff's therapeutic interventions)

A nurse is screening a new client for intimate partner violence (IPV). What aspect of this woman's current circumstances is the most significant risk factor?

The client's family lives on less than $1,000 per month. (Low income is a salient risk factor for IPV.)

The nurse is engaged in individual counseling for a client with co-occurring disorders. What is the primary principle to use when counseling this client?

The discussion needs to contain useful content and the information must be reinforced. (Counseling is a process where appropriate educational information is presented, and the material discussed is frequently reinforced.)

The pediatric nurse is caring for a 15-month-old child recently admitted to the hospital for a fractured femur. Which data obtained during the assessment would raise the nurse's suspicion that the child has suffered physical abuse?

The injury occurred several days before the parents sought treatment (what the hell is wrong with you peeps, yo kid broke his damn leg and you just sat there!? nah-uh sit yo ass down im dialing 911)

Which would not increase the likelihood that an older adult will incur physical abuse?

The older adult is independent with activities of daily living.

The nurse understands that not guilty by reason of insanity (NGRI) can best be explained as which of the following?

The person is judged to not know right from wrong.

Which complicating factor should the nurse be alert for when a client has both dysthymia and a substance use disorder?

The substance being used can place the person at increased risk for mental health deterioration. (The use of alcohol may place the client at an increased risk for deterioration in their physical and emotional functioning, and may even progress to suicidal thoughts and behaviors. Although the substance is used to self-medicate, it is usually used to augment, not replace the prescription medication.)

A female college student comes to the counseling center and tells the nurse she is afraid of her boyfriend. She states, "He is so jealous and overprotective; he wants to know where I am and who I'm with every minute." The nurse recognizes this as which of the following?

The tension-building phase of the violence cycle

A client who has a history of using cocaine several times each week is now experiencing panic attacks. What should the nurse focus on when teaching the client about the use of cocaine and panic attacks?

The use of cocaine can increase anxiety and make a person susceptible to panic attacks.

Which statement is true regarding children being raised in a home where they have witnessed intimate partner violence?

They are at increased risk for being abused.

A nurse is reviewing information about Assertive Community Treatment (ACT) . The nurse demonstrates understanding of this type of treatment by identifying that it was developed for which individuals?

Those prone to relapse

Which of the following statements regarding distress experienced by cancer clients is correct?

Those with active cancer experience more distress than those in remission. (Women had more significant scores of distress than did men, particularly those who were younger than 65 years. Reduced activity status predicted increased distress, as did cancer in an active phase versus cancer in remission.)

Clients using cognitive strategies such as suggestion are able to

Tolerate higher levels of pain

Most cognitive impairment in individuals in early stages of recovery from substance use is

Transitory and resolves with the first month of abstinence

Which concept regarding the nurse-client relationship is most likely to promote medication adherence in the forensic setting?

Trust

A male client who is in treatment for opioid addiction also admits to overusing his sleep medication, eszopiclone, and sometimes taking it with alcohol when he cannot sleep. What important information should the nurse include in the teaching plan?

Using the sleeping medication with alcohol will create an increase in its sedative effects. (If a client uses the sleeping medication with the alcohol, there will be an increase in its sedative effects and gives the potential for adepressed respiratory system.)

The cycle of violence or abuse is a reason often cited for why women have difficulty leaving abusive relationships. Which of the following is an inaccurate picture of the cycle of abuse that occurs over time?

Violent episodes are less frequent

The course and outcome of associated medical illnesses may be affected if mental illness remains untreated, resulting in

Weakening motivation for self-care (When psychosocial dysfunction remains unexamined and untreated, the course and outcome of associated medical illness may be affected. Mental illness may weaken the motivation for self-care.)

During a family meeting, the nurse is discussing the progress that a client with bipolar disorder and alcohol use has made in the treatment program and the plan of care for discharge. Which information about the occurrence of relapse will the nurse include in the pre-discharge discussion with the client and the family?

When bipolar symptoms occur, the client will need to acknowledge the symptoms and seek professional help. (When the symptoms of the bipolar disorder reoccur, the individual will need to acknowledge the symptoms and obtain the assistance of a health care provider.)

The nurse is preparing an educational session regarding stroke for family members of clients who have had an ischemic stroke. What should the nurse include in the educational session?

Your family member may experience mood changes and lack of motivation within one year of the stroke

Early recognition is approached from examining which behavior?

aggression

Which of the following drugs precipitate or mimic mood disorders during their use?

alcohol

The nurse is seeing a client with a diagnosis of HIV-associated neurocognitive disorder (HAND) and the client's partner. The client's partner reports the client has no desire to engage in previously enjoyed activties such as watching movies and playing board games. The nurse knows the client's partner is describing which of the following behavioral changes characteristic of HAND?

apathy

Nursing care for clients with dual disorders is often difficult because of

frequent relapses.

A client who was determined to be unfit to stand trial is hospitalized in a forensic mental health facility. The nurse working at the facility understands that the goal of this hospiitalization is to:

help the person become able to stand trial

In violent families, which environment may be the most dangerous place for victims?

home

The forensic nurse experiences countertransference while caring for a client. Which principle does this violate?

boundaries (It is essential to maintain professional boundaries, and the nurse should seek assistance if he or she is unable to maintain these professional boundaries. Trust is enhanced when staff participate in unit activities such as sports, games, and other activities. Talking in a friendly, open manner (rapport) about ordinary everyday events such as weather, TV and sports is helpful in building trust. Self-assessment is an ongoing process in which the nurse examines personal beliefs and attitudes about patients and crimes. It is the first step toward being an effective psychiatric nurse in a forensic setting.)

A 16-year-old male who has oppositional defiant disorder is in the psychiatric emergency department due to acute renal failure related to PCP (phencyclidine) intoxication. What type of withdrawal behavior would the nurse expect after the client is admitted to the hospital unit?

bizarre speech related to temporary psychosis (PCP intoxication will often mimic temporary symptoms of psychosis or schizophrenia, and it is common for the client to experience bizarre behavior and speech. A client who experiences sleeping difficulties related to disturbing dreams is experiencing withdrawal from sedative or hypnotic drugs. When a client has periods of disorientation related to grandiosity, it is probably related to amphetamine withdrawal symptoms. Memory and learning difficulties are withdrawal symptoms related to us of cannabis.)

An elderly client is brought to the clinic by her daughter. The client's daughter tells the nurse that her mother has been acting strangely and forgetful for the past few days and sometimes makes poor decisions. The nurse should plan to assess the client for

cerebrovascular accident

An adolescent with oppositional defiant disorder admitted to the staff, "I use heroin whenever I can get it because it makes me feel good." Which information is most important to include in a teaching plan for this client?

consequences to physical health (its fcuking heroin, next to meth there's nothing worse)

The fate of the forensic client may lie with the legal agent, which includes which of the following?

court

Thiem means

date marking the end of the maximum period of sentencing

The nurse and student nurse are assessing a client with a diagnosis of Parkinson disease. The client is experiencing symptoms of depression. The correct biological basis for depression co-morbid to Parkinson's disease has led to:

dysfunction of serotonin activity. (Evidence suggests that altered serotonergic function may be responsible, at least in part, for the depressive symptoms seen in Parkinson's disease.)

A community health nurse visits a home and finds a child who stayed home from school to care for a younger sibling. The nurse observes that the house is cluttered and dirty. When asked about the parents, the child states he does not think his father likes him because he calls him "stupid." The nurse suspects which type of abuse?

emotional abuse

A male client with HIV and major depressive disorder tells the nurse that he has been using LSD (D-lysergic acid diethylamide) and this is the first time that he had a bad experience and gotten hurt. What important sign should the nurse be alert for if the client has flashbacks to the bad drug experience?

engaging in atypical behavior (When LSD results in the client experiencing a bad trip, sometimes engaging in atypical behaviors is a precursor to re-experiencing flashbacks to the bad parts of the drug-induced experience. After having a bad trip on LSD, a person may become more anxious and fearful, and will want to be around other people to feel safe.)

Which of the following basic concepts underlies the criminal judicial process?

fairness

A clinical nurse specialist is conducting a program on pain for a group of staff nurses. Part of the program involves a discussion of the gate-control model of pain response. The nurse describes the pathways in the dorsal horn of the spinal cord that relay noxious stimuli to the brain as playing a role in pain perception. The nurse goes on to explain the role of certain other interneurons. Which role would the nurse most likely describe?

inhibit the pain response (At the site of the tissue injury, pain receptors (nociceptors) cause of release of prostaglandins (an unsaturated fatty acid that helps control smooth muscle contraction, blood pressure, inflammation, and body temperature) and substance P (a peptide found in body tissues, especially nervous tissue, that is involved in the transmission of pain and in inflammation), as well as potassium, histamine, leukotrienes (short-range chemical messengers that help regulate the state of blood vessels and airways and influence the activities of some white blood cells), and bradykinin (chemical that dilates blood vessels))

A forensic nurse is participating in a job fair. One of the participants asks the nurse, "What does forensic nursing involve?" The nurse explains that forensic nursing practice is a blend of nursing and which specialty?

law

A client with depression is crying uncontrollably when talking about the death of her husband. Which area of the brain is responsible for this emotion?

limbic system (Both serotonin and endorphins are probably responsible for pain tolerance, but they may also influence emotion (limbic area), mood (medial frontal lobes), and behavioral response to pain (motor and sensory areas).)

The school health nurse is asked to see a child who has been coming to school with no lunch for the past week. The child tells the nurse, "I don't get a lunch this week, I have been wetting the bed." The nurse identifies that this child is experiencing which type of abuse?

neglect (Neglect, in this case, is the malicious withholding of a physical necessity for this child's well-being. For this child, the neglect is intended to be punitive for bed wetting. if i ever find out you did this to your kid, i will find your ass)

A client has not been to work in three days. When she returns to work, she is wearing dark glasses. Facial and body bruises are visible. Her supervisor takes her to the occupational nurse. Which assessment is the priority for the nurse?

physical injuries (The first priority would be the primary focus of the assessment, which are the physical injuries.)

Informed consent is the legal responsibility of which of the following health care members?

physicians

During withdrawal from opiates, a female client states that she is experiencing symptoms of depression that are more severe than usual. In addition to being on suicide precautions, what other behavior change should the nurse be monitoring?

problems with usual daily activities (People with severe depression can have serious problems with their daily activities, where they do not perform even their basic care functions.)

A client has just presented at the emergency department after being raped. The initial nursing action would be to:

provide emotional support.

Which is a priority nursing intervention when child abuse or neglect is suspected?

safety

A client with bipolar I disorder visits the mental health clinic. The client tells the nurse, "I've stopped using sedatives to calm me down." The nurse should instruct the client that one psychological effect of withdrawal from sedatives is

sleep disorders (The nurse should explain to the client that one psychological effect of withdrawal from sedatives is sleep disorder. Other effects include confusion, slurred speech, ataxia, stupor, withdrawal delirium, and dementia.)

The nurse makes a home visit to a client in the latter stages of AIDS, who is suffering from chronic pain. The nurse should explain to the client and client's family that the psychological impact of AIDS is considerably worsened by the

social stigma

A newly admitted client is hospitalized for panic disorder and opiate abuse. The nurse should instruct the client that one psychological effect of opiate withdrawal is

suicidal ideation

A nurse educator is discussing the ischemic cascade with a group of nursing students. If learning has been effective, the students will state that the ischemic cascade begins with:

too little oxygenation to the brain (The ischemic cascade begins with hypoxia, a decrease in oxygen reaching brain tissue. This event sets off a series of problems that perpetuate brain tissue death including oxidative degradation of lipids, paralysis of calcium influx across membranes and free radical production.)

The nurse is planning a relapse prevention program for family members who assist their relatives with co-occurring disorders. Which information would be essential for the nurse to emphasize during the educational program?

valuing the use of integrated treatment (The use of integrated treatment for clients with co-occurring disorders is essential because it includes the necessary approaches (therapy, medication management, vocational training, employment, housing assistance, case management, etc.) for individualizing care. Sometimes using a halfway house is an option, but it would not the emphasis of the educational program. Removing substances from the home that may contribute to relapse is worth mentioning, but it is not the point of emphasis in this program.)