Prep U Quizzes - Mood & Affect and End of Life

In the space of 5 minutes, a client has been laughing and euphoric, then angry, and then crying for no reason that is apparent to the nurse. How would the nurse best describe this behavior? -Lack of insight -Flight of ideas -Tangential thinking -Labile mood

Labile mood

A seriously ill client asks the nurse "Am I dying?" What is the best response the nurse can give to enhance therapeutic communication with this client? -"Let's not worry about that right now. Let me give you this bed bath." -"Yes. But there is nothing to worry about since you will be going to a better place." -"This must be very difficult for you. What is on your mind?" -"I do not know. I hope not."

"This must be very difficult for you. What is on your mind?"

The nurse is caring for a 32-year-old client who is taking amitriptyline for depression. What nursing intervention would be appropriate if this client developed orthostatic hypotension? -Asking the client to sit on the side of the bed for 1 minute before getting up -Instructing the client to double the dosage until the adverse effect goes away -Informing the client this adverse reaction should be gone in a week -Consulting with the physician to change the medication

Asking the client to sit on the side of the bed for 1 minute before getting up

A patient with a history of major depression is brought to the ED by her parents. Which of the following nursing actions is most appropriate? -Conducting interviews in a brief and direct manner -Arranging for the patient to spend time alone to consider her feelings -Asking the patient if she has ever thought about taking her own life -Noting that symptoms of physical illness are not relevant to the current diagnosis

Asking the patient if she has ever thought about taking her own life

A client is in treatment for an anxiety disorder. The client's history reveals that the client was sexually abused repeatedly by the client's spouse. Which interventions would be appropriate in relation to this piece of data? -Help the client explore their own role in perpetuating the abuse. -Avoid discussing the abuse so as not to upset the client. -Request an anxiolytic to reduce the client's anxiety levels. -Encourage the client to talk about feelings related to the abuse.

Encourage the client to talk about feelings related to the abuse.

A client is showing no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which term when documenting the client's affect? -Absent affect -Flat affect -Restricted affect -Broad affect

Flat affect

A patient is brought to the ED by family members who tell the nurse that the patient has been exhibiting paranoid, agitated behavior. What should the nurse do when interacting with this patient? -Use therapeutic touch appropriately. -Keep the patient in a confined space. -Give the patient honest answers about likely treatment. -Attempt to convince the patient that his or her fears are unfounded.

Give the patient honest answers about likely treatment.

A client with end-stage lung cancer has been admitted to hospice care. The hospice team is meeting with the client and her family to establish goals for care. What is likely to be a first priority in goal setting for the client? -Promotion of spirituality -Social interaction -Maintenance of activities of daily living -Pain control

Pain control

The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize what? -Decreased problem-solving ability -Restlessness and irritability -Remorse -Severe muscle tension

Restlessness and irritability

A terminally ill client has feelings of rage toward the nurse. According to Elisabeth Kübler-Ross, the patient is in which stage of dying? -Depression -Anger -Bargaining -Denial

Anger

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. -Evidence collection according to procedures is not as important as treating the client's injuries. -The nurse will need to make decisions for this client. -The client should set aside any angry feelings until physical care is completed.

The client may feel threatened by some of the procedures.

A nurse assesses a depressed client who is lethargic during the day and does not actively participate in unit activities. The notes from the night shift document that the client did not sleep well. How should the nurse most appropriately interpret these data? -The client is being kept awake at night due to noise on the unit -The client's depressed mood may be impairing restful sleep patterns -The client is resisting treatment recommendations to participate in unit activities -The client's medications are ineffective

The client's depressed mood may be impairing restful sleep patterns

A nurse is counseling a female victim of sexual assault. Which of the following statements accurately describe the increased risks for this patient? -The patient is 10 times more likely to suffer from post-traumatic stress disorder. -The patient is 20 times more likely to abuse alcohol and 26 times more likely to abuse drugs. -The patient is 3 times more likely to suffer from depression. -The patient is 20 times more likely to contemplate suicide.

The patient is 3 times more likely to suffer from depression.

Palliation refers to -relief of symptoms of disease and promotion of comfort and quality of life. -the lowest point of white blood cell depression after therapy that has toxic effects on bone marrow. -the spread of cancer cells from the primary tumor to distant sites. -hair loss.

relief of symptoms of disease and promotion of comfort and quality of life.

The client has been diagnosed with severe depression. During the assessment of the client, the nurse is aware of which primary consideration with clients taking antidepressants? -decreased mobility -increased sleep -suicide -emotional changes

suicide

The nurse approaches a client who looks very sad and is sitting alone crying. Which is the best response by the nurse in this situation? -"Please don't cry. It will get better." -"What is bothering you?" -"I'm sorry you are sad. Is there anything I can do to help you feel better?" -"You look very sad. What is happening?"

"You look very sad. What is happening?"

A female client who has recently been diagnosed with end-stage lymphoma tells the nurse, "I need to be able to go to my son's wedding. God, will you please just give me a little more time so I can see my first grandchild?" The nurse identifies that the client is experiencing which stage of Kubler-Ross' stages of grieving? -denial -bargaining -acceptance -depression

bargaining

To adequately assist a client and family from a different culture with the death and dying process, the nurse should: -progress through the stages of grief. -have felt distress and anger. -be aware of the client's cultural beliefs. -experience death in his or her own life.

be aware of the client's cultural beliefs.

A client approaches the nurse and loudly states, "I'm not putting up with this anymore!" The most appropriate response by the nurse would be what? -"I can see you are angry. Tell me what's going on." -"Why do you say that?" -"You are not allowed to make threats. Please keep your voice down." -"You are here voluntarily. You can leave if you want."

"I can see you are angry. Tell me what's going on."

When the client asks the nurse how long it will take before the selective serotonin reuptake inhibitor (SSRI) antidepressant medication will be effective, which reply is most accurate and therapeutic? -"If you believe it will work, then it will. You have to have faith!" -"This is a good medication! It will be effective within 20 minutes of the first dose." -"It will probably take months for the medication to work. In the meantime, you should work on improving your attitude." -"You will have gradual improvement in symptoms over the next few weeks, but the changes may be so subtle that you may not notice them for a while. It is important for you to keep taking the medication."

"You will have gradual improvement in symptoms over the next few weeks, but the changes may be so subtle that you may not notice them for a while. It is important for you to keep taking the medication."

Which statement about hope and symptoms of mental illness are true? Select all that apply. -Hope is not realistic and therefore is not related to mental well-being. -A possible way to help clients manage and decrease symptoms would be to support the development of hope. -Hope is a cause of mental illness. -There is not a significant relationship between hopelessness and increased symptoms. -Persons having more hope experienced fewer actual symptoms.

-A possible way to help clients manage and decrease symptoms would be to support the development of hope. -Persons having more hope experienced fewer actual symptoms.

A client presents to the emergency department with a flat affect. The nurse suspects the client may be experiencing a major depressive episode. Which variable would the nurse need to keep in mind as representing the highest risk for this condition? Select all that apply. -Substance abuse -Divorced -Male gender -Mood disorder in first-degree relatives -Older adult age group

-Substance abuse -Divorced -Mood disorder in first-degree relatives

Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses? Select all that apply. A) Alzheimer's dementia B) Delirium C) Anorexia nervosa D) Acute alcohol intoxication E) Generalized anxiety disorder

A) Alzheimer's dementia B) Delirium D) Acute alcohol intoxication

The nurse is creating a care plan for a patient diagnosed with HF. When addressing the problem of anxiety, what interventions should the nurse include in the care plan? Select all that apply. A) Facilitate the presence of friends and family whenever possible. B) Teach the patient about the harmful effects of anxiety on cardiac function. C) Provide supplemental oxygen, as needed. D) Provide validation of the patients expressions of anxiety. E) Administer benzodiazepines two to three times daily.

A) Facilitate the presence of friends and family whenever possible C) Provide supplemental oxygen, as needed. D) Provide validation of the patient's expressions of anxiety

Which statement accurately describes pain experienced by the older adult? -Residents in long-term care facilities have a minimal level of pain. -Boredom and depression may affect an older person's perception of pain. -The older patient has decreased sensitivity to pain. -A heightened pain tolerance occurs in the older adult.

Boredom and depression may affect an older person's perception of pain.

The client has been diagnosed with depression. The client asks the nurse what imbalances influence depression. Which best explains the neurochemical processes responsible for depression? -Increased activity of dopamine -Decreased serotonin and norepinephrine activity -Decreased glucocorticoid activity -Potentiating of the kindling process

Decreased serotonin and norepinephrine activity

The client is being assessed for anger attacks. Which psychiatric disorder makes a person most susceptible to anger attacks that do not result in physical aggression? -Depression -Delirium -Dementia -Delusions

Depression

A client with a severe depression has been hospitalized, and the health care provider has ordered amitriptyline. What common adverse effect might this client have? -Hypertension -Decreased B/P -Dry mouth -Fever

Dry mouth

Which intervention would assist the client with the appropriate expression of anger? -Improve self-esteem -Isolate the client from others -Encourage verbalization -Encourage catharsis

Encourage verbalization

The nurse is interviewing a client with a history of physical aggression. Which should the nurse avoid? -Responding to verbal threats by terminating the interview and obtaining assistance -Anticipating that a loss of control is possible and planning accordingly -Explaining the consequences the client will face if control is lost -Interviewing the client with another staff member present

Explaining the consequences the client will face if control is lost

A client is diagnosed with a terminal illness and has been given less than 6 months to live. What type of referral should the nurse make to assist this patient and family at home? -Adult day care -A rehabilitation center -Hospice -Physical therapy

Hospice

A nurse is caring for a client with generalized anxiety disorder. When the client starts trembling and perspiring, the nurse becomes uncomfortable and anxious; develops cold, clammy hands; and has a racing pulse. When the nurse responds in this way during an interaction, what will the client most likely develop? -Improved self-esteem -Fatigue -Claustrophobia -Increased anxiety

Increased anxiety

The nurse is assessing a patient who had a pacemaker implanted 4 weeks ago. During the patient's most recent follow-up appointment, the nurse identifies data that suggest the patient may be socially isolated and depressed. What nursing diagnosis is suggested by these data? -Decisional conflict related to pacemaker implantation -Ineffective coping related to pacemaker implantation -Deficient knowledge related to pacemaker implantation -Spiritual distress related to pacemaker implantation

Ineffective coping related to pacemaker implantation

A dying client and family have requested that no attempts be made to resuscitate the client in the event of death. A doctor has written a DNR order. What is the nurse's responsibility if the client dies? -Follow his or her own conscience and perform CPR. -Follow a health care provider's verbal order for a slow code. -If the client is at home, call 911 and begin CPR. -Make no attempt to resuscitate the client.

Make no attempt to resuscitate the client.

The nurse should explain to the client's family member that a comfort-measures-only order is being implemented to obtain which expected outcome? -use of all available life-sustaining measures -a comfortable, dignified death for the client -harvesting of the client's organs for donation -prevention of family from making health care decisions

a comfortable, dignified death for the client