Mood, Adjustment, and Dementia Disorders

A client with stage 1 Alzheimer's disease is diagnosed with terminal lung cancer. The client wonders about "reaching the end" asks the nurse what to do. How should the nurse respond?

"An advance directive will help to make sure that your wishes are carried out."

A nurse is caring for a client diagnosed with bipolar disorder who is taking lithium carbonate. When reviewing information about this therapy, what instruction would be most important to reinforce with this client?

"Be sure to drink at least 2 ½ quarts [2500 mL] a day."

A nurse is caring for a client who states, "I can't keep living like this. I just want to end it all." What is the nurse's best response?

"Do you plan to harm yourself?"

The daughter of a client diagnosed with Alzheimer's disease tells a nurse, "My mother is incompetent. You'll need to contact me or my sister if any decision must be made about my mother's care." Which response by the nurse is best?

"I must respect your mother's rights until she is legally deemed incompetent."

A nurse is preparing to talk with a client who recently attempted suicide. Before engaging in the conversation, which statement by the nurse would be most appropriate?

"I'll need to share information with the rest of your health care team if it's important to your care."

A client who has been taking imipramine, 125 mg P.O. daily, for 1 week wants to stop taking the medication because the client still feels depressed. Which response by the nurse would be mostappropriate at this time?

"Imipramine must build up to a therapeutic level; it may take 3 to 4 weeks to reduce depression."

A client avoids leaving home to shop for groceries and states to the nurse, "I feel crazy from the fear even when I know it is unrealistic." What is the best response by the nurse?

"It is better if you gradually face your fear with professional coaching."

A client with moderate Alzheimer's-related dementia is being prepared for discharge. What statement by the caregiver demonstrates that discharge teaching about client safety has been effective?

"Someone should supervise the client at all times."

In the emergency department, a client reveals to a nurse a plan for committing suicide and agrees to a voluntary admission to the psychiatric unit. The client asks, "How long do I need to stay here?" Which response by the nurse would be appropriate?

"You must be safe before being discharged."

A nurse is caring for an older adult client who exhibits signs of dementia. When assisting with the development of the client's plan of care, the nurse incorporates understanding that which condition is the most common cause of dementia?

Alzheimer's disease

A client is admitted to the mental health unit in the manic phase of bipolar disorder. The client refuses to take the prescribed medication. Which would be the most appropriate action by the nurse?

Ask the client the reason for not taking the medication.

A client with self-inflected wrist lacerations was stabilized in the emergency department and then transferred to the inpatient psychiatric unit for observation and treatment with antidepressants. After initiating antidepressant therapy, the client is now exhibiting an increase in energy levels. What nursing intervention is most appropriate?

Continue suicide precautions.

A client is diagnosed with somatic symptom disorder. What understanding should the nurse have regarding somatic symptom disorder when rendering care to this client?

Symptoms are real to the client, even though there may not be an organic etiology.

The nurse is gathering data from a client suspected of early dementia. Which finding shows impairment in abstract thinking and reasoning?

The client can't find similarities and differences between related words or objects.

The nurse is obtaining data from a client to determine whether the client has dementia or depression. Which information helps the nurse suspect dementia rather than depression? Select all that apply.

The progression of symptoms is slow. The family can't identify when the symptoms first appeared. The client's personality has changed. The client has great difficulty paying attention to others

A client who is diagnosed with anxiety is prescribed sertraline, a selective serotonin reuptake inhibitor (SSRI). Which adverse effects would the nurse reinforce when assisting in creating a medication teaching plan? Select all that apply.

agitation sleep disturbance dry mouth

The nurse observes a child with autism banging his or her head against the floor repetitively. Which nursing action is the priority?

apply a helmet on the child

Which behaviors from a client with dementia would prompt nursing intervention?

attempting to hit others

Which intervention can the nurse discuss with the parents of a child with attention deficit hyperactivity disorder (ADHD) to help their child to achieve daily tasks?

break up the task into smaller steps

A client with major depression hasn't responded to antidepressants. Which intervention should the nurse prepare the client for?

electroconvulsive therapy (ECT)

A client exhibits signs of dementia. Which condition, that can cause a dementia similar to Alzheimer's disease (AD), is reversible?

electrolyte imbalance

A client with major depression is prescribed a selective serotonin reuptake inhibitor. When reviewing the orders for this medication, which agent would the nurse most likely observe as being documented on the medication administration record?

fluoxetine

Which communication guideline should the nurse use when talking with a client experiencing mania?

focus and redirect the conversation as necessary

A client with Alzheimer's disease mumbles incoherently and rambles in a confused manner. To help redirect the client's attention, the nurse should encourage the client to:

fold towels and pillowcases.

The nurse is assigned to care for a client with early-stage Alzheimer's disease (AD). Which nursing interventions should be included in the client's care plan? Select all that apply.

furnish the client's environment with familiar possessions assist the client with activities of daily living (ADLs) as necessary assign tasks in simple steps

The nurse is caring for a client who has been diagnosed with narcolepsy. Which actions may assist the client in managing this condition? Select all that apply.

limit caffeine intake avoid smoking follow a regular schedule for sleep and rest

The nurse is assisting with the admission of a client with an amnestic disorder. Which evaluation would the nurse anticipate preparing to help identify the cause of the disorder?

metabolic and endocrine tests

The nurse is caring for a client immediately after the client has received electroconvulsive therapy (ECT) for the treatment of severe depression. What is a priority intervention for this client?

orient the client to the surroundings

A client is suspected of experiencing early stage Alzheimer's disease (AD). Which symptoms does the nurse document that correlate with this suspicion? Select all that apply.

significant recent memory impairment experiencing difficulty grocery shopping

A nurse is reinforcing education for the parents of a teenage client about the warning signs of potential adolescent suicide. Which signs should the nurse include?

statements such as not being around much longer

The nurse is assigned to care for a client with amnesia. When preparing to deliver care, which action will best meet the needs of this client?

use short, simple commands when providing instruction

A client with paranoid personality disorder responds aggressively to something another client said during a psychoeducational group session. Which rationale explains the likely underlying cause of the client's response to the interaction?

The client took the statement as a personal criticism.

A client diagnosed with posttraumatic stress disorder (PTSD) has a history of nightmares, depression, hopelessness, and alcohol abuse. When assisting with developing the client's plan of care, which therapy would the nurse identify as most effective in helping to address the client's symptoms?

cognitive behavioral therapy

A client with bipolar disorder is having difficulty sleeping. Which behavior modification technique should the nurse reinforce with the client?

develop a sleep ritual

A home health care nurse is working with the family of a client who has Alzheimer's disease. The client's spouse is too exhausted to continue providing care alone and the client's adult children live too far away to provide relief on a weekly basis. Which nursing intervention would be mosthelpful?

investigate community resources for adult day care and other services

A client with a paranoid personality disorder tells a nurse "one of the nurses is out to get me." Which actions by the nurse may cause distress for this paranoid client? Select all that apply.

laughing and smiling with a group of clients talking to another client in the corner of the lounge conferring with the nurse in question in front of the client

A client with depression doesn't respond to drug therapy. At a team conference, staff members recommend electroconvulsive therapy (ECT). The nurse knows that most people respond negatively to the thought of an electric current passing through the brain. Therefore, when discussing ECT with the client, the nurse should:

refer to the procedure as a "treatment" instead of "shock therapy."

The nurse is caring for a client with illness anxiety disorder. Which behavior would the nurse be most likely to encounter?

Expression of fear of colorectal cancer following 3 days of constipation

A 26-year-old male reports losing his sight in both eyes. He's diagnosed as having functional neurologic symptom disorder and is admitted to the psychiatric unit. Which nursing intervention would be appropriate for this client?

Not focusing on his blindness

A client with bipolar disorder is being treated with lithium for the first time. The nurse should observe the client for which early adverse effect of lithium?

Polyuria