Practice Questions Psych

In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption? a) 24 hours b) 48 hours c) 12 hours d) 18 hours

12 hours

The nurse is conducting a mental health assessment of a client who has been experiencing low mood, anxiety and loss of pleasure for the past month. The client tells the nurse he comes from a 'really big family.' Despite this, the client tells the nurse he continues to feel alone. Select the nurse's best response. a) "It is important to reach out to people in your social network to tell them you are sad." b) "Social networks can be overwhelming so it is better to be isolated." c) "You can have lots of people in your social network and still feel isolated." d) "It sounds like you have a level III sized social network."

"You can have lots of people in your social network and still feel isolated." Explanation: This response is one in which the client's concerns about being isolated are validated.

A client is prescribed carbamazepine as part of the treatment plan for bipolar disorder. The nurse obtains a CBC and differential before initiating therapy. The nurse would instruct the client to return to the outpatient facility for repeat blood testing at which time? a) 12 months b) 6 months c) 3 months d) 1 month

1 month. Explanation: Liver function tests and CBCs with differential are minimal pretreatment lab tests. They should be repeated about one month after initiating treatment, and at three months, six months, and yearly.

Disulfiram should not be administered until a client has abstained from alcohol for at least how long? a) 16 hours b) 8 hours c) 4 hours d) 12 hours

12 hours

The nurse is facilitating a wellness group which includes a client who was suspended from work for an angry outburst. The client most likely has the characteristics of which personality type? a) A b) D c) B d) C

A. Explanation: Type A personalities are characterized as competitive, aggressive, ambitious, impatient, alert, tense, and restless.

A client with bipolar disorder is prescribed divalproex sodium as part of the treatment plan. Before administering the medication, which tests should be done? Select all that apply. a) CBC b) blood glucose concentration c) platelet count d) urinalysis e) liver function tests

CBC, platelet count, and liver function tests. Explanation: Baseline liver function tests and a complete blood count with platelets should be obtained before starting therapy with divalproex sodium. Clients with known liver disease should not be given this medication. There is no need to obtain a urinalysis or blood glucose concentration.

A nurse is reviewing the medical record of a client prescribed lithium carbonate. The nurse would be alert for possible increases in serum lithium concentrations based on the client's use of which substance? Select all that apply. a) fluoxetine b) ibuprofen c) alcohol d) furosemide e) haloperidol

Fluoxetine, alcohol, and furosemide. Explanation: Furosemide, alcohol, and fluoxetine may increase serum lithium concentrations.

Which med class has most commonly been used to treat social phobia? a) MAOIs b) TCAs c) nonbenzodiazepines d) SSRIs

SSRIs

When conducting a suicide risk assessment with a patient, the nurse should identify the client as a high imminent risk if which of these statements is made? a) I just need someone to talk with b) I think about starving myself to death sometimes c) There are no solutions to my problems d) My son is really the only reason I stick around

There are no solutions to my problems Explanation: Hopelessness is the pervasive belief that undesirable events are likely to occur coupled with the belief that one's situation is unlikely to improve. Hopelessness is one of the components of the triad of suicidality

When conducting a risk assessment for suicide, the nurse most likely identifies which client as having the greatest risk for completing suicide? a) a 25 y.o. female client who attends school full time b) a 30 y.o. male client who is married with a new baby c) a 50 y.o. male client who lives on a farm outside the city d) a 30 y.o. female client who had a baby three months prior

a 50 y.o. male client who lives on a farm outside the city. Explanation: Males have a higher suicide completion rate four times more than females. Rural men have a much higher risk of suicide than urban men.

The nurse is preparing a community education session on suicide awareness. Which point should the nurse include in the presentation? a) being a Hispanic male poses the greatest risk for completing suicide b) a firearm in the house increases the risk that a person will complete suicide c) suicide is attributable solely to social and psychological factors d) suicide rates are lowest among adolescent minorities who identify as bisexuals

a firearm in the house increases the risk that a person will complete suicide

The nurse is counseling a female client who is the primary caregiver for her older adult mother who requires total care due to stroke. The client reports having difficulty recovering from the flu. She tells the nurse she has been experiencing flu like symptoms for over two weeks. The client is most likely experiencing which consequence of chronic stress? a) decreased hormonal activity b) lowered levels of serum cortisol c) a reduction in lymphocyte function d) overactivity of the immune system

a reduction in lymphocyte function. Explanation: In chronic stress, the immune system is suppressed.

The nurse who is developing a suicide prevention strategy would need to ensure which steps are included? Select all that apply. a) figuring out who is at risk for suicide b) using assertive interventions if there is a threat of suicide c) following up with interventions to prevent suicide in the future d) determining imminent risk of suicide e) consulting with family members about risk for suicide

a, b, c, d

According to the stage theories of grief, during which stage of grief and bereavement does social withdrawal occur? a) fear b) resolution c) shock d) acute mourning

acute mourning. Explanation: During acute mourning, an individual has intense feeling states, may socially withdraw, and identifies with the deceased. During the shock phase, there is denial and disbelief. Acceptance of loss, awareness of having grieved, a return to well-being, and ab ability to recall the deceased without subjective pain are components of the resolution phase.

The nurse is seeing a client who reports recent difficulty with sleep and decreased appetite. The client reports having pressure from work due to an upcoming deadline and moving to a different house at the same time. What is the client most likely experiencing? a) acute stress b) chronic stress c) type A personality d) diathesis

acute stress. Explanation: acute stress is time-limited but can occur repeatedly. In this situation, there is a clear reason for the introduction of stress resulting in changes to the client's health pattern. The client is likely to return to homeostasis.

Which must be present in a client diagnosed with serotonin syndrome? Select all that apply. ataxia agitation fever hyporeflexia diaphoresis constipation

agitation, fever, diaphoresis, and ataxia Explanation: The symptoms of serotonin syndrome include altered mental status, autonomic dysfunction, and neuromuscular abnormalities. At least three of the following must be present for a diagnosis: mental status changes, agitation, myoclonus, hyperreflexia, fever, shivering, diaphoresis, ataxia, and diarrhea.

Carbamazepine has a boxed warning for which adverse effect? a) liver damage b) skin rash c) agranulocytosis d) birth defects

agranulocytosis. Explanation: Carbamazepine has a boxed warning for aplastic anemia and agranulocytosis, but frequent, clinically unimportant decreases in WBC counts occur.

Which of the following is the most abused substance in the US? a) marijuana b) alcohol c) cocaine d) benzodiazepines

alcohol

A loss of pleasure or interest in a client diagnosed with depression would be documented as what? a) anhedonia b) flat affect c) discouragement d) hopelessness

anhedonia

When administering and monitoring antidepressant therapy in a client, what would be most appropriate for the nurse to do? Select all that apply. ask the client about the use of any herbal supplements obtain liver function studies at least once a week observe the client for cheeking of meds check plasma drug concentrations one hour before the next dose assess orthostatic vital signs before beginning therapy

ask the client about the use of any herbal supplements, observe the client for cheeking of meds, assess orthostatic vital signs before beginning therapy

Which of the following is a behavioral symptom of anxiety? a) impatience b) avoidance c) tremors d) apprehension

avoidance Explanation: behavioral symptoms of anxiety include avoidance, restlessness, postural collapse, and hyperventilation. Tremors are a physical symptom of anxiety. Apprehension and impatience are affective symptoms

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder? a) steak b) bananas c) spaghetti d) broccoli

bananas. Explanation: For a client who is unable to sit long enough to eat, snacks and high-energy foods that can be eaten while moving should be provided.

Which medication classifications used in the treatment of panic disorder can cause physical dependence? a) SNRIs b) SSRIs c) Benzodiazepines d) TCAs

benzodiazepines

A nurse is caring for a client receiving a tricyclic antidepressant and is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following? a) moist skin b) blurred vision c) urinary incontinence d) hyperactive bowel sounds

blurred vision Explanation: Anticholinergic effects are prominent with TCAs. These include potentiation of central nervous system drugs, dry mucous membranes, warm and dry skin, blurred vision, decreased bowel motility, and urinary retention.

A client who is prescribed a TCA is brought to the ED with a suspected overdose. Which would the nurse assess to support this suspicion? Select all that apply. headache pale, moist skin blurred vision urinary retention diarrhea

blurred vision, urinary retention Explanation: In acute overdose, almost all symptoms develop within 12 hours. Anticholinergic effects are prominent and include dry mucous membranes, warm and dry skin, blurred vision, decreased bowel motility, and urinary retention.

A mental-health nurse is reading an article about stress and the emotional responses to it. The nurse demonstrates understanding of the topic by identifying hope, compassion, empathy, and sympathy as being categorized as which type of emotion? a) non-emotions b) borderline c) negative d) positive

borderline. Explanation: Borderline emotions are somewhat ambiguous and include hope, compassion, empathy, sympathy, and contentment.

The student nurse is deliberately seeking to identify people who may be at risk for suicide with the goal of beginning treatment. This suicide prevention strategy is referred to as: a) risk assessment b) risk prevention c) case finding d) cognitive behavioral therapy

case finding

Which type of grief occurs when a person is stuck in a state of chronic grieving? a) bereavement b) complicated grief c) uncomplicated grief d) traumatic grief

complicated grief Explanation: During complicated grief, the person is frozen or stuck in a state of chronic mourning. Most bereaved people experience normal or uncomplicated grief after the loss of a loved one. Traumatic grief is a more difficult and prolonged grief in which external factors influence the reactions and potential long-term outcomes. Bereavement is the process of mourning and coping with the loss of a loved one.

Which mental health disorder has the most significant risk factor for suicide? a) anxiety b) depression c) schizophrenia d) mania

depression

When developing the plan of care for client experiencing stress, which goals would be most appropriate overall to include? Select all that apply. a) developing positive coping skills b) participating in group therapy c) reducing the stress response d) resolving the stressful person-environment situation e) gaining successful employment

developing positive coping skills, reducing the stress response, and resolving the stressful person-environment situation. Explanation: The overall goals in the nursing management of stress are to resolve the stressful person-environment situation, reduce the stress response, and develop positive coping skills. Successful employment and participation in group therapy are not overall goals in the nursing management.

During which types of anxiety does a person's perceptual field actually increase? a) severe b) moderate c) panic d) mild

mild Explanation: During mild anxiety, a person's perceptual field widens slightly, and the person is able to observe more than before and to see relationships.

A nurse is reviewing information about the drug, lithium carbonate. The nurse demonstrates understanding of the info by identifying which situation as a potential cause of lithium toxicity? Select all that apply. a) diarrhea b) hot climate c) strenuous exercise d) vomiting e) hypernatremia

diarrhea, hot climate, strenuous exercise, and vomiting. Explanation: If body fluid decreases significantly because of a hot climate, strenuous exercise, vomiting, diarrhea, or a drastic reduction in fluid intake, lithium concentrations can rise sharply, causing an increase in side effects and toxicity. The higher the sodium concentrations, the lower the lithium concentrations will be.

A nurse taking an admission history from a client suspects that the physician will diagnose major depression. For the physician to make this diagnosis, the client will have to demonstrate specific symptoms. What are some of these symptoms? Select all that apply. disruption in sleep disruption in appetite obsessive desire to exercise disruption in concentration excessive guilt

disruption in sleep, disruption in appetite, disruption in concentration, and excessive guilt

A nurse is developing a plan of care for a client with bipolar disorder. When preparing to administer medications, which agent would the nurse anticipate as being prescribed as the mainstay of pharmacotherapy? Select all that apply. a) fluoxetine b) divalproex c) carbamazepine d) lamotrigine e) lithium carbonate

divalproex, carbamazepine, lamotrigine, and lithium carbonate. Explanation: the mainstays of pharmacotherapy for bipolar disorder are mood-stabilizing drugs, including lithium, divalproex, carbamazepine, and lamotrigine. Antidepressants, such as fluoxetine, are not recommended in those with bipolar depression because of a risk of switching to mania.

For a client in crisis, what does assessment of the psychological domain focus on? Select all that apply. a) disturbances in sleep patterns b) emotions c) disturbances in nutrition d) capability of the community to respond in a supportive way e) coping strengths

emotions, coping strengths. Explanation: A psychological assessment focuses on an individual's emotions and coping strengths. Assessment of the social domain is essential because a crisis usually severely disrupts social proficiencies; the nurse should assess the severity of the crisis to determine the capability of the individual or the community to respond in a supportive way.

When a person wants what someone else has, which emotion is being experienced? a) shame b) envy c) disgust d) sadness

envy

A client is prescribed an SSRI as treatment for depression. Which would the nurse most likely administer? a) maprotiline b) venlafaxine c) phenelzine d) escitalopram

escitalopram Explanation: escitalopram is classified as an SSRI. Venlafaxine is an SNRI. maprotiline is a cyclic antidepressant. Phenelzine is an MAOI.

What are characteristics of complicated grief? Select all that appply. a) feeling that life has meaning b) exacerbation of depression c) increased trust of others d) trouble accepting the death e) excessive bitterness

exacerbation of depression, trouble accepting the death, and excessive bitterness.

Which stage of Hans Seyle's general adaptation syndrome (GAS) occurs if homeostasis is not achieved during stress? a) alarm b) equilibrium c) resistance d) exhaustion

exhaustion. Explanation: The GAS consists of three stages: the alarm reaction, stage of resistance, and stage of exhaustion (occurs if homeostasis is not achieved). There is not a stage of equilibrium.

A nurse is providing care to a client with a specific phobia. When developing the client's plan of care, which type of therapy would the nurse most likely expect to include as the treatment of choice? a) implosive therapy b) exposure therapy c) flooding d) systemic desensitization

exposure therapy Explanation: exposure therapy is the treatment of choice for clients with specific phobia.

A client with bipolar disorder has a plasma lithium concentration of 2.7mE/L. Which finding would a nurse most likely assess in this client? Select all that apply. a) fasciculations b) tinnitus c) incoordination d) seizures e) nystagmus

fasciculations, seizures, and nystagmus. Explanation: A plasma lithium concentration of 2.7 indicates severe toxicity manifested by seizures, nystagmus, and fasciculations. Tinnitus and incoordination are noted with moderate toxicity, with plasma drug concentration ranging from 1.5 to 2.5mE/L.

A nurse is providing care to a person involved in a disaster. The nurse interprets which finding as predictive of developing PTSD at a later time? Select all that apply. a) fear b) inability to access health care c) lack of family support d) lack of finances e) dissociation

fear and dissociation Explanation: Dissociation and fear are predictive of later developing PTSD and depressive symptoms. Lack of family support, inability to access health care, and lack of finances are not predictive of later developing PTSD.

The majority of suicides among men are attributed to: a) drowning b) overdose c) firearms d) hanging

firearms. Explanation: Men complete 79% of all suicides; 57.5% of these deaths are by firearms.

Which antidepressant medication is classified as an SSRI? a) phenelzine b) fluoxetine c) tranylcypromine d) isocarboxazid

fluoxetine Explanation: Fluoxetine is included among the SSRIs. Phenelzine, isocarboxazid, and tranylcypromine are MAOIs.

Concomitant use of antidepressants with MAOIs can cause which life-threatening drug interaction? a) sedation b) risk of seizures c) hypotensive crisis d) hypertensive crisis

hypertensive crisis Explanation: All antidepressant meds interact with MAOIs, causing hypertensive crisis.

After educating a client with bipolar disorder on his prescribed lithium therapy, the nurse determines that additional education is needed when the client states which of the following? a) i need to avoid drinking any alcohol b) i need to cut back on my salt intake when it's really hot outside c) i need to report any problems with severe diarrhea or slurred speech d) i can use sugarless candies to help with any metallic taste

i need to cut back on my salt intake when it's really hot outside. Explanation: Clients should increase salt intake during periods of perspiration and periods of increased exercise and dehydration.

Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension? a) get daily exercise b) eat a nutritionally balanced diet c) increase hydration d) take medication with food

increase hydration Explanation: Increasing hydration and sitting or standing up slowly are nonpharmacologic interventions for orthostatic hypotension.

In the stress response, what is consistent with activation of the sympathetic nervous system? a) decreased HR b) increased blood sugar c) decreased BP d) increased digestion

increased blood sugar. Explanation: When the brain interprets an event as a threat, the hypothalamus and autonomic nervous system are signaled to secrete adrenaline, cortisol, and epinephrine. These hormones activate the sympathetic nervous system, physiological stability is challenged, and a fight or flight response occurs. The HR, BP, and blood sugar increase.

Electroconvulsive therapy (ECT) has been shown to be an effective treatment for people with severe depression. However, ECT is contraindicated in which of the following disease processes? a) increased intracranial pressure b) anxiety disorder c) diabetes d) hypertension

increased intracranial pressure

A nurse is working with a client diagnosed with bipolar disorder and his family on relapse prevention. Which information would the nurse encourage the family to include in their emergency plan? Select all that apply. a) information about other health problems b) treatment preferences c) past meds taken d) self-care strategies e) list of emergency contacts

info about other health problems, treatment preferences, and list of emergency contacts. Explanation: An emergency plan should include a list of emergency contacts, a current list of all meds including dosages, info about other health problems, symptoms indicating that others need to take responsibility for care, and treatment preferences.

Which of the following is the treatment setting of choice for persons who are severely psychotic? a) partial hospitalization b) residential apartments c) intensive outpatient programs d) inpatient admission

inpatient admission. Explanation: patient is an immediate threat to self and others

According to recent studies, a person with a type D personality is more likely to experience which health issue? a) mild hypertension b) pre-diabetes c) insulin dependance d) stable angina

insulin dependence. Explanation: Type D (distressed) personalities experience increased negative emotion and pessimism and are unlikely to show their emotions to others. There is mixed research support for an association between a type D personality and mental health disorders. Emerging data suggests that type D personality is related to outcome severity of acute coronary syndrome and diabetes.

Which would be considered a situational crisis? a) flood b) war c) murder d) job promotion

job promotion. Explanation: A situational crisis occurs whenever a specific stressful event threatens a person's biopsychosocial integrity and results in some degree of psychological disequilibrium.

Which is an example of a traumatic crisis? a) leaving home for the first time b) graduation c) completing school d) kidnapping

kidnapping. Explanation: examples of a traumatic crisis include natural disasters, violent crimes such as kidnapping, and environmental disasters.

A client with bipolar disorder I is experiencing a depressive episode. Which of the following would the nurse expect to be prescribed? a) lithium b) carbamazepine c) lamotrigine d) valproate

lamotrigine. Explanation: Although lithium, valproate and carbamazepine are used to treat bipolar disorder, lamotrigine is often prescribed for a depressive episode.

A client is prescribed lithium to treat mania. The client also has a history of hypertension for which the client takes lisinopril and hydrocholorothiazide. When monitoring this client, the nurse would be especially alert for signs and symptoms of which condition? a) hypernatremia b) hypokalemia c) hypertensive crisis d) lithium toxicity

lithium toxicity. Explanation: Lisinopril is an ACE inhibitor; hydrochlorothiazide is a thiazide diuretic. Both drugs interact with lithium to increase serum lithium levels. Therefore, the nurse should be especially alert for signs and symptoms of lithium toxicity.

A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy? a) thyroid level b) cardiac enzymes c) WBC count d) liver function

liver function. Explanation: baseline liver function tests and a complete blood count with platelets should be obtained before starting therapy, and clients with known liver disease should not be given divalproex sodium. There is a boxed warning for hepatotoxicity.

The nurse is seeing a school-aged child who has been the victim of physical abuse by a parent. The nurse recognizes that the client is more likely to experience which mental health issues in adulthood? a) schizophrenia b) major depressive disorder c) anorexia d) bipolar disorder e) substance misuse

major depressive disorder, anorexia, and substance misuse. Explanation: Adverse events during childhood increase risk of alcohol and drug dependence, eating disorders, affective disorders, PTSD, and suicidal behavior.

After teaching a client about possible side effects of benzos, the nurse determines that additional teaching is needed when the client identifies which of these as a possible side effect of the drug? a) dizziness b) sedation c) visual disturbances d) metallic taste

metallic taste Explanation: metallic taste is a symptom of benzo withdrawal, not a common side effect.

A client is exhibiting rapid shifts in mood. The nurse documents this as which of the following? a) mood lability b) expansive mood c) irritable mood d) elevated mood

mood lability. Explanation: Mood lability is a term used for rapid shifts in mood that often occur with bipolar disorder. Elevated mood refers to exaggerated feelings of well-being or feeling ecstatic or high. An expansive mood is characterized by lack of restraint in expressing feelings, and overvalued sense of self-importance, and a constant and indiscriminate enthusiasm for interpersonal, sexual, or occupational interactions. An irritable mood is indicated by being easily annoyed and provoked to anger, especially when wishes are challenged or thwarted.

Both valproate and carbamazepine may be lethal if high doses are ingested, Toxic symptoms appear in 1 to 3 hours and include which of the following? a) tinnitus b) bradycardia c) urinary Frequency d) neuromuscular disturbances

neuromuscular disturbances. Explanation: symptoms include neuromuscular disturbances, dizziness, stupor, agitation, disorientation, nystagmus, urinary retention, N/V, tachycardia, cardiovascular shock, coma, and respiratory depression.

What is accurate regarding a crisis? a) occurs from a common precipitating event b) lasts longer than 6 weeks c) occurs when an individual is at a breaking point d) defined as being in constant turmoil

occurs when an individual is at a breaking point. Explanation: A crisis occurs when the individual is at a breaking point. It generally lasts no longer than four to six weeks. People who live in constant turmoil are not in crisis but in chaos.

Which is the greatest predictor of a future suicide attempt? a) previous attempt b) degree of hopelessness c) suicide planning d) seriousness of suicidal ideation

previous attempt

A client with bipolar disorder is experiencing acute mania. The client is unable to sit still, moving from place to place. Medication therapy has been prescribed but not yet initiated. Which would the nurse include in the plan of care to meet the client's physical needs? a) instituting a sleep hygiene program b) providing high energy snacks c) encouraging frequent rest periods d) increasing environmental stimuli

providing high energy snacks. Explanation: For the client experiencing acute mania, the nurse would provide snacks and high energy foods because it is highly likely that the client is unable to sit long enough to eat. Sleep hygiene is a priority but may not be realistic until meds take effect. Because of the client's activity level, frequent rest periods would be unlikely. Limiting stimuli would be helpful in decreasing agitation.

Adaptation is a person's capacity to survive and flourish. Adaptation affects which areas? Select all that apply. a) psychologial well-being b) health c) coping d) financial status e) social functioning

psychological well-being, health, coping, and social functioning. Explanation: Adaptation, or lack of it, affects three important areas: health, psychological well-being, and social functioning. A period of stress may compromise any or all of these areas. Successful coping results in an improvement in health, well-being, and social functioning.

Which phase of disaster focuses on implementing strategies for healing sick and injured people? a) disaster event occurs b) transition c) pre-warning d) recuperative effort

recuperative effort. Explanation: In the recuperative phase, the focus is on implementing strategies for healing sick and injured people, preventing complications of health problems, repairing damages, and reconstructing the community.

When developing a plan of care for a client diagnosed with panic disorder, which nursing diagnosis would be considered the priority? a) risk for self-directed violence b) powerlessness c) social isolation d) anxiety

risk for self-directed violence Explanation: people with panic disorder are often depressed and consequently are at high risk for suicide.

A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which nursing diagnosis has priority? a) spiritual distress related to conflicting thoughts about suicide and sin b) hopelessness related to recent divorce c) risk for suicide related to highly lethal plan d) ineffective coping related to inadequate stress management

risk for suicide related to highly lethal plan Explanation: safety is the priority.

A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which nursing diagnosis has priority? a) hopelessness related to recent divorce b) risk for suicide related to highly lethal plan c) ineffective coping related to inadequate stress management d) spiritual distress related to conflicting thoughts about suicide and sin

risk for suicide related to highly lethal plan. Explanation: safety is the priority.

The priority concern for people with mood disorders is what? a) safety b) basic care c) social functioning d) occupational functioning

safety

A nurse is caring for a client diagnosed with bipolar disorder. The client is experiencing a manic episode. The nurse would be especially alert for signs indicating what? a) weight loss b) dehydration c) self-injury d) sleep disruption

self-injury. Explanation: During a manic episode, client safety is a priority. Risk of suicide is always present for those having a depressive or manic episode.

People who complete suicide often have extremely low levels of which neurotransmitter? a) acetylcholine b) GABA c) norepinephrine d) serotonin

serotonin

A mental health nurse is conducting a presentation for a group of nurses at the local community center about depression. After the presentation, the nurse knows that it was successful when the group identifies which substances as potentially playing roles in depression? Select all that apply. serotonin epinephrine GABA Dopamine norepinephrine

serotonin, dopamine, norepinephrine

A nurse is reading a journal article about bipolar disorder and common comorbidities. The nurse demonstrates understanding of the article by identifying which condition as a common comorbidity? Select all that apply. a) personality disorders b) substance use c) anxiety disorders d) eating disorders e) schizophrenia

substance use & anxiety disorders;

In traumatic grieving, external factors influence reactions and potential long-term outcomes. Which characteristic would a nurse identify as an external factor? Select all that apply. a) suddenness b) anticipation of the death c) single death experience d) extent of violence e) degree of preventability

suddenness, extent of violence, and degree of preventability. Explanation: The external circumstances of death include suddenness and lack of anticipation, violence, mutilation and destruction, degree of preventability or randomness of the death, multiple deaths, and the mourner's personal encounter with death involving significant threat to personal survival or a massive and shocking confrontation with the deaths of others.

A nurse is preparing a presentation about suicide for a local community group. What would the nurse most likely include? a) suffocation is a common means of suicide among children b) women typically use firearms in their attempts c) hispanic individuals have the highest rates of suicide d) men often use pills to commit suicide

suffocation is a common means of suicide among children

What is a myth regarding suicide? a) the suicide rate is lowest in December b) most suicidal people are undecided about living or dying c) suicidal people are fully intent on dying d) many people who die by suicide have given definite warnings of their intentions

suicidal people are fully intent on dying

Which term describes a nonfatal, self-inflicted destructive act with an explicit or implicit intent to die? a) parasuicide b) suicide attempt c) suicidal ideation d) suicidality

suicide attempt. Explanation: A suicide attempt is a nonfatal, self-inflicted destructive act with explicit or implicit intent to die. Suicidal ideation is thinking about and planning one's own death. Suicidality refers to all suicide-related behaviors and thoughts of completing or attempting suicide and suicide ideation. Parasuicide is a voluntary, apparent attempt at suicide, commonly called a suicidal gesture, in which the aim is not death.

Which would be most important to assess and document in a client with depression? a) weight changes b) sleep disturbance c) appetite d) suicide risk

suicide risk

When developing a plan of care for a client with depression who is receiving medication therapy, what would the nurse identify as the primary goal during the acute phase? a) effective prophylaxis b) symptom reduction c) relapse reduction d) discontinuation

symptom reduction Explanation: The primary goal of therapy for the acute phase is symptom reduction or remission.

A client tells the nurse, "I'm taking care of a friend who is ill." The nurse interprets this statement as reflecting which function of social support? a) informational b) financial c) tangible d) emotional

tangible. Explanation: Direct aid is an example of tangible support. Examples include loans or gifts, services such as taking care of someone who is ill, and doing a job or chore.

The nurse is seeing a young adult client who has been depressed and expressing thoughts of hopelessness but has not overtly reported having thoughts of suicide. Despite the fact that the client has not reported suicidal thoughts, the nurse should initiate a suicide risk assessment for which reason? a) the client lives with extended family b) young adults tend to use manipulation c) the client feels vulnerable to stigma d) this is a standard assessment

the client feels vulnerable to stigma Explanation: suicide is so rejected in contemporary society that people with strong suicidal thoughts do not seek treatment for fear of being stigmatized by others

The nurse is seeing a client who recently received a letter of denial of admission to college. The client reports having difficulty sleeping and concentrating on work. The nurse recognizes that the significance of not getting into college is influenced by which factor? Select all that apply. a) the client incorporates religious values daily b) the client lives at home with her parents c) the client is physically active d) the client is Hispanic e) the client works at a coffee shop

the client incorporates religious values daily, the client lives at home with her parents, and the client is Hispanic. Explanation: Although people respond to stressful events in different ways, cultural, ethnic, family, and religious values shape the significance of an event, such as a car accident.

The nurse is seeing a client who is experiencing depression. The nurse recognizes that this client's personality fits best with type C personality. Which assessment findings would the nurse document as evidence for type C personality? a) the client is easily agreeable to any appointment time available b) the client is often observed pacing in the waiting room c) the client becomes defensive when challenged d) the client often misses or is late for appointments

the client is easily agreeable to any appointment time available. Explanation: Type C personalities are described as having difficulty expressing emotion and are introverted, respectful, conforming, compliant, and eager to please and avoid conflict.

Which client would the health care professional be obligated to take immediate and focused action to prevent imminent death? a) the client with depression who lives in poverty and has chronic pain b) the client with depression who has been using alcohol and owns a gun c) the client who is grieving is often tearful and doesn't want to be left alone d) the client with depression who is withdrawn and spends most of the time playing video games

the client with depression who has been using alcohol and owns a gun

Which activity occurs in the secondary level of the person's appraisal of the stressor? a) the person determines whether the goal is relevant b) the person determines whether a personal commitment is present c) the person explains the outcomes of events d) the person determines whether the goal is consistent with their values and beliefs

the person explains the outcomes of events. Explanation: In a secondary appraisal, the person explains the outcomes of events. There may be blame or credit given for the outcome. In a primary appraisal, a person evaluates the events occurring in their life as a threat, harm, or challenge. During primary appraisal of a goal, the person determines whether the goal is relevant, the goal is consistent with their values and beliefs, and a personal commitment is present.

Which is an accurate statement regarding women and suicide? a) they are less likely to complete suicide than men b) they are more likely to choose a more lethal method than men c) they are more likely to die from attempted suicide than men d) they attempt suicide less often than men

they are less likely to complete suicide than men. Explanation: Women are less likely to complete a suicide than men, in part because they are more likely to choose a less lethal method. Women are less likely to die from an attempted suicide than men, but they attempt suicide more often.

Wernicke's encephalopathy is a degenerative brain disorder characterized by which type of deficiency? a) vitamin A b) vitamin D c) viamin C d) thiamine

thiamine Explanation: Wernicke encephalopathy, a degenerative brain disorder caused by a thiamine (vitamin B1) deficiency, is characterized by vision impairment, ataxia, hypotension, confusion, and coma

Which of the following is a cognitive intervention for clients diagnosed with depression? a) activity scheduling b) thought stopping c) social skills training d) problem solving

thought stopping Explanation: cognitive interventions such as thought stopping and positive self-talk can dispel irrational beliefs and distorted attitudes, and in turn reduce depressive symptoms during the acute phase of major depression.

Women make how many suicide attempts for every attempt by their male counterparts? a) one b) four c) three d) two

three

The onset of major depressive disorder is most common among people who are in their: a) forties b) twenties c) thirties d) teens

twenties Explanation: The highest onset of depression occurs among people who are in their twenties

A client with acute mania is prescribed lithium. During this time, the nurse would anticipate obtaining blood concentrations how often? a) every three weeks b) monthly c) twice weekly d) weekly

twice weekly. Explanation: In acute mania, it is important for the client to obtain serum concentrations twice weekly in the acute phase. In uncomplicated maintenance, serum concentrations should be obtained every 2-3 months.

Which personality type is characterized by competitive and aggressive behavior? a) type A b) type C c) type B d) type D

type A. Explanation: Type A personalities are characterized as competitive, aggressive, ambitious, impatient, and restless. Type B personalities are more relaxed, easygoing, and easily satisfied. Type C personalities are described as having difficulty expressing emotion and being introverted, respectful, conforming, compliant, and eager to please and avoid conflict.

A client has experienced a first episode of major depression and has received medication and treatment, which has led to a complete remission of the symptoms. The client asks the nurse, "How much longer will I need to take the medication?" Which response by the nurse would be most appropriate? a) It's probably best to continue the med for another month, gradually decreasing the dosage over that time b) the med has eliminated your symptoms so you'll need to keep taking it for the rest of your life c) you'll need to continue the med for about 6-12 months to see how things go d) since you have no more symptoms, you can stop taking the med tomorrow

you'll need to continue the med for about 6-12 months to see how things go Explanation: Even after the first episode of major depression, medication should be continued for at least 6-12 months to one year after the client achieves complete remission of symptoms.