PrepU Chap 17 continued

Average affect and activity

Euthymic mood

Racing, often unconnected thoughts; excessive amount and rate of speech comprised of fragmented or unrelated ideas

Flight of Ideas

Unrelenting, rapid, often loud talking without pauses

Pressured Speech

A client has been recently diagnosed with depression and has just started taking an antidepressant medication. Which of the client's statements indicates an accurate understanding of this aspect of treatment? "I'm still trying to decide whether antidepressants will be helpful in my treatment." "I understand that I probably won't feel much better for a couple of weeks after I start the drugs." "I can tell that I get a lift each morning after I take my antidepressant." "I know that few people actually see an improvement in their mood with antidepressants, but I suppose I'll try anyhow."

"I understand that I probably won't feel much better for a couple of weeks after I start the drugs."

Lack of energy

Anergia

Episode lasts at least 2 weeks with loss of pleasure in nearly all activities with other symptoms which may include: anhedonia, change in weight, sleep, energy, concentration, and decision making SIGE CAPS

Major Depressive Disorder

In the past year, a client's parent reports the client has experienced six manic episodes, each lasting for 3 weeks. This is best described as what? Rapid cycling Cyclothymic disorder Hypomania Hypermania

Rapid cycling

This disorder is often treated with light therapy

SAD (seasonal affective disorder)

A client receiving lithium therapy has a plasma blood concentration of 2.2 mEq/L. Which would the nurse expect to assess? Slurred speech Fine resting hand tremor Loose stools Muscular weakness

Slurred speech

Pervasive alterations in emotions that are manifested by depression, mania, or both

Affective disorder

Chronic persistent mood disturbances characterized by symptoms including insomnia, loss of appetite, decreased energy, difficulty concentrating, feelings of sadness

Dysthymic Disorder

A mental health nurse is caring for a depressed client, whose spouse passed away 2 months ago. The client sates, "I'm going to kill myself." Which is a behavioral sign of suicide? Hopelessness Making a will Isolation Guilt

Making a will

Limit setting is most appropriate in which client population? Manic Anxious Depressed Suicidal

Manic

The majority of suicides among men are attributed to: firearms. hanging. overdose. drowning.

firearms

A distinct period during which mood is abnormally and persistently elevated, expansive or irritable

Mania

Which would be most important to assess and document in a client with depression? Appetite Weight changes Sleep disturbance Suicide risk

Suicide risk

The nurse has been asked to assess a client to determine if the client has a suicide plan. Which question would assist the nurse in assessing this area? "Are you a religious person?" "Do you have people in your life who are supportive of you?" "Are you thinking about killing yourself right now?" "How do you generally cope with problems in your life?"

"Are you thinking about killing yourself right now?"

A client whose mania is related to a medical condition asks why the physician has prescribed carbamazepine instead of lithium. Which is the nurse's best response? "This drug may be preferred by your physician for many reasons." "This drug is best for clients who do not respond to lithium or whose mania is related to a medical condition, as is yours." "You will be fine taking this drug, so don't worry." "I don't know. Make sure you discuss this with your doctor as soon as you can."

"This drug is best for clients who do not respond to lithium or whose mania is related to a medical condition, as is yours."

A nurse is completing an admission assessment of a young male client who has a history of depression and who was brought to the hospital by the client's partner. In response to the nurse's question regarding suicidal ideation, the client discloses that he is thinking about killing himself. Which question would be most appropriate for the nurse to ask next? "What does your partner think about your desire to kill yourself?" "What are your spiritual beliefs about suicide?" "What will killing yourself accomplish?" "What thoughts have you had about how you would kill yourself?"

"What thoughts have you had about how you would kill yourself?"

When completing discharge medication education for the client, the client asks how long it will take before the selective serotonin reuptake inhibitor (SSRI) medication will help the client's mood improve. Which is the correct response by the nurse? 1 to 2 days 5 to 7 days 7 to 10 days 3 to 4 weeks

7 to 10 days

The community mental health nurse is providing care for a large number of clients. What client should the nurse monitor most closely for the warning signs of suicide? A young male with schizophrenia who is in danger of becoming homeless An adult female who is mourning the death of her husband 5 months ago An older adult client who has recently been diagnosed with early stage Alzheimer disease A middle-aged female client who is receiving treatment for obsessive-compulsive disorder

A young male with schizophrenia who is in danger of becoming homeless

A 20-year-old client was admitted to the inpatient unit following a suicide attempt. The client is disheveled, disorganized, and dehydrated. The priority for the client's care during the first 24 hours of admission will be what? Assisting the client with activities of daily living, including a shower and clean clothing. Assessing the client's current suicidal ideation and putting the client on suicide precautions. Rehydrating the client by forcing fluids. Assessing the client's recent suicide attempt and identifying factors that may have contributed to it.

Assessing the client's current suicidal ideation and putting the client on suicide precautions.

A nurse suspects that a client has overdosed on the prescribed tricyclic antidepressant. Which assessment finding would support this suspicion? Select all that apply. Confusion Hallucinations Agitation Orthostatic hypotension Headache

Confusion Hallucinations Agitation

After teaching a group of nursing students about major depression, the instructor determines that the education was successful when the group identifies which information is accurate? Onset of depression is common in adolescence Depression is twice as common in women than in men Depression is correlated with low intellectual ability Onset of depression is most common in middle-aged persons

Depression is twice as common in women than in men

A client with a diagnosis of bipolar disorder is described by a family member as "flip-flopping between being happy and loving to irritable and hostile." Which characteristic symptoms of this disorder is the family member referring to? Euthymic mood Emotional lability Manic episode Grandiosity

Emotional lability

A client has been successfully treated on the psychiatric mental health unit following a suicide attempt. In preparation for discharge, the nurse should prioritize what action? Ensuring a plan is in place for the client's community-based care Ensuring that the client has created a commitment to treatment statement Documenting the client's psychiatric advance directive Communicating with the pharmacy where the client will obtain prescribed medications

Ensuring a plan is in place for the client's community-based care

On admission to the psychiatric unit, a client is dressed in a red leotard and exercise bra, with an assortment of chains and brightly colored scarves on the client's head, waist, wrists, and ankles. The client's first words to the nurse are, "I'll punch you, munch you, crunch you," as the client dances into the room, shadow boxing. The client shakes the nurse's hand and says cheerfully, "We need to become better acquainted. I have the world's greatest intellect, and you are probably an intellectual midget." How can the nurse document the client's mood? Belligerent and blunted. Expansive and grandiose. Anxious and unpredictable. Suspicious and paranoid.

Expansive and grandiose.

A client diagnosed with bipolar disorder and experiencing mania is admitted to the inpatient psychiatric setting. During the acute phase of mania, which medication(s) would the nurse expect to administer? Select all that apply. Lithium carbonate Carbamazepine Fluoxetine Paroxetine Divalproex sodium

Lithium carbonate Carbamazepine Divalproex sodium

A 30-year-old woman has been brought to the emergency department after causing a disturbance. She is wearing a pair of tight, pink yoga pants, high heels, a sports bra, and a bright-colored hat. The woman's care providers would recognize that the woman's dress may suggest what? Antisocial personality disorder Acute confusion Mania Chronic low self-esteem

Mania

A client in an acute manic phase is pacing the halls and talking in a loud voice with pressured speech. The client is overly involved with coclients and frequently threatens and disrupts others on the unit. After administering lithium treatment for the client, the nurse can expect the plan of care to include which additional intervention? Monitoring phototherapy response. Monitoring blood levels of the medication. Teaching the client to avoid foods with tyramine. Assessing for post-electroconvulsive therapy disorientation and confusion.

Monitoring blood levels of the medication.

Neurotransmitter that may be deficient in depression and increase in mania

Norepinephrine

A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply. Flight of ideas Obsessive rumination Hypersomnia Widespread shopping sprees Difficulty concentrating

Obsessive rumination Hypersomnia Difficulty concentrating

A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to the client's feelings of sadness and hopelessness, the nurse would expect to assess what? Increased focus Decreased complaints of pain Psychomotor retardation Increased energy level

Psychomotor retardation

This neurotransmitter influences behavior including mood, activity, aggressiveness, irritability, cognition, and pain

Serotonin

A client taking lithium for bipolar disorder is having mild diarrhea. The nurse informs the client that this is an example of what? Toxic effect Side effect Desired effect Therapeutic effect

Side effect

A client with depression is admitted to an inpatient psychiatric unit. The nurse provides a unit orientation. While observing the client's unpacking, the nurse can expect the client to exhibit what? A desire to initiate conversation with roommates Expansive and dramatic movements Slow movements and flat affect Overly excited interest in the admission

Slow movements and flat affect

Which is a primary risk factor for suicide? Social isolation Unemployment Poverty Economic deprivation

Social isolation

A nurse is with an adolescent who reports nothing to live for and wishing to be dead. Which nursing action would be the priority? Going to the client's psychiatrist to report the suicidal ideation Staying with the client to explore more of the client's thoughts about suicide Putting the client in seclusion with a staff member assigned to watch the client at all times Ascertaining the client's beliefs about what happens when you die

Staying with the client to explore more of the client's thoughts about suicide

The nurse is working with an outpatient who has a history of depression and suicide attempts. What assessment finding should the nurse interpret as indicating a high degree of planning for a future attempt? The client recently purchased a large bottle of over-the-counter analgesics The client stopped attending a depression support group, despite initially benefiting from it The client told the nurse, "I just want to stop being a burden to my wife and kids." The client has told the nurse, "I'm pretty sure my meds aren't working."

The client recently purchased a large bottle of over-the-counter analgesics

After being prescribed several medications that were ineffective, a client is diagnosed with refractory mania. The physician decides to prescribe lamotrigine, an anticonvulsant that has been found to be effective for refractory mania. Which would the nurse need to include in the client's education plan? The potential for life-threatening side effects such as Stevens-Johnson syndrome The potential for the development of addiction to the medication The need to have blood levels drawn on a monthly basis The need to avoid certain types of foods while on the medication

The potential for life-threatening side effects such as Stevens-Johnson syndrome

Which statement most accurately describes the relationship between psychiatric illness and suicide risk? Psychiatric-mental health clients are stereotyped as being at high risk of suicide, but this is untrue. The vast majority of people who commit suicide have a diagnosed mental disorder. Clients with depression are at increased risk of suicide, but suicide rates among persons with schizophrenia equal those of the general population. According to the DSM-5, suicide is considered to be a psychiatric diagnosis in and of itself.

The vast majority of people who commit suicide have a diagnosed mental disorder.

A client has just been diagnosed with a major depressive disorder following recent problems with the client's mood, work performance, and sleep quality. When planning this client's care, the nurse should anticipate what interventions? Select all that apply. Administration of a sustained serotonin reuptake inhibitor (SSRI) Administration of an monoamine oxidase inhibitor (MAOI) Phototherapy Cognitive therapy Repetitive transcranial magnetic stimulation (rTMS)

Administration of a sustained serotonin reuptake inhibitor (SSRI) Cognitive therapy

One or more manic or mixed episode usually accompanied by major depressive episodes (Mania, Hypomania (cyclothymia), major depression)

Bipolar I

One or more major depressive episodes accompanied by at least one hypomanic episode (Hypomania, minor depression, major depression)

Bipolar II

A period of abnormally and persistently elevated, expansive or irritable mood lasting 4 days; does not impair the ability to function and does not involve psychotic features

Hypomania

Mild mood swings between hypomania and depression without loss of social or occupational functioning

Cyclothymic Disorder

A client with major depression has been prescribed escitalopram. The nurse should address what topic in client education? The possibility of gastrointestinal upset The need to avoid food containing tyramine Strategies for preventing orthostatic hypotension The possibility of weight loss

The possibility of gastrointestinal upset

When conducting a suicide risk assessment, the nurse understands that which method has the least lethality? Hanging Wrist slashing Overdose of benzodiazepines Jumping

Wrist slashing

When assessing a client who reports mild symptoms of depression, the nurse expects that the diagnostic tests ordered will include: thyroid stimulating hormone (TSH). coagulation time. platelet count. liver function test

thyroid stimulating hormone (TSH).

A psychiatric nurse's colleague has expressed a reluctance to assess a client's risk for suicide, stating, "The last thing I want to do is to plant the thought in the client's head and bring on a suicide attempt." What is the nurse's best response? "Evidence shows that talking about suicide with clients doesn't cause suicide attempts." "We have an ethical responsibility to assess our clients for suicide risk, even if there are risks associated with doing so." "If a client is determined to make an attempt at suicide, there's nothing you or I can do to alter that." "Could it be that you're experiencing countertransference around your own fears of suicide?"

"Evidence shows that talking about suicide with clients doesn't cause suicide attempts."

A 52-year-old client with bipolar disorder tells the nurse, "I read that there are chemicals in my brain that can cause my symptoms." Knowing that the client is referring to neurotransmitters, which would be the best response by the nurse? "Recent studies have found that neurotransmitters do not play a role in bipolar disorders." "Clients with bipolar disorder often have high levels of gamma-aminobutyric acid (GABA) in manic states." "High levels of the neurotransmitter serotonin are associated with mania." "Low levels of the neurotransmitter dopamine are associated with mania."

"High levels of the neurotransmitter serotonin are associated with mania."

During a night shift, a hospitalized client with depression tells a nurse that the client is going to kill himself or herself. The client is placed on constant observation. When the client asks to use the toilet, the nurse follows the client into the bathroom. The client says, "You don't need to follow me into the bathroom. Give me some space." Which response by the nurse is most appropriate? "You're right. I don't need to come into the bathroom with you. I will wait outside the door." "I must stay with you until we are sure you will not hurt yourself." "If you think you are going to be OK, I will check on you in 5 minutes." "I can't imagine anything dangerous is in the bathroom. Go ahead. I will wait for you in the hallway."

"I must stay with you until we are sure you will not hurt yourself."

The nurse is interviewing a client with a diagnosis of depression and the client states, "Honestly, I know my family would be a lot better off if I wasn't around to be a burden on them. That's just between you and me, though, okay?" What is the nurse's best response? "I'm obliged to share what we talk about with the other people on your care team." "Why is it important to you that this be kept between you and I?" "In my experience, nothing good ever comes of keeping secrets." "What can I do to get your permission to share with the other members of the care team?"

"I'm obliged to share what we talk about with the other people on your care team."

A client is to receive three treatments of electroconvulsive therapy (ECT) per week for 3 weeks. After the third treatment, the client is forgetful and confused. When the client's spouse arrives to take the client home, the nurse discusses the client's condition with the spouse. Which statement is best? "Some confusion after ECT is normal. The client will regain memory in a few hours." "Confusion after ECT is not expected. Though it will resolve, the client probably will not be a candidate for ECT in the future." "Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer." "Some confusion after ECT is normal. Withhold the client's medications for today and call tomorrow to let us know how the client is doing."

"Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer."

A client is to receive three treatments of electroconvulsive therapy (ECT) per week for 3 weeks. After the third treatment, the client is forgetful and confused. When the client's spouse arrives to take the client home, the nurse discusses the client's condition with the spouse. Which statement is best? "Some confusion after ECT is normal. The client will regain memory in a few hours." "Confusion after ECT is not expected. Though it will resolve, the client probably will not be a candidate for ECT in the future." "Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer." "Some confusion after ECT is normal. Withhold the client's medications for today and call tomorrow to let us know how the client is doing."

"Some people experience mild confusion after ECT. Generally it clears in a few days, though it may take longer."

A psychiatric-mental health nurse is conducting an in-service education program about suicide for a group of nurses working at a community mental health center. The nurse determines that the teaching was successful based on which statement by the group? "Suicide is more of a concern in countries other than the United States." "Suicide does not occur in affluent neighborhoods, indicating poverty is a factor." "Suicide has profound effects on those connected to the individual." "Suicide rates among older adults are low."

"Suicide has profound effects on those connected to the individual."

The spouse of a client diagnosed recently with a mood disorder calls the nurse therapist to report a change in the client's mood. The spouse states, "The client is clearly in a better mood than usual. I would say the client seems mildly elated. The client is functioning fine at work and home. The client is energetic, up and doing things at 5:00 a.m. and really confident again. It seems fantastic, but unusual. Is this something to worry about?" Which potential response by the nurse accurately assesses the situation? "It sounds as though the antidepressants are working well. Just ask the client if the client is experiencing any side effects and let me know." "I'm concerned. Sometimes depressed people seem contented when they have decided to commit suicide. Let's schedule an appointment for tomorrow." "Since the client is eating, sleeping, and not behaving inappropriately, there's nothing to worry about. Just let me know if the client starts getting irritable or has trouble sleeping." "The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication."

"The client sounds hypomanic. Let's schedule an appointment for this week for an evaluation. The client may need additional or different medication."

A client comes to the emergency department reporting a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and the client's pulse is racing. The client states that the client is being treated for depression with an MAOI. Which question by the nurse would be most important to ask at this time? "When did you last have blood drawn to check your drug level?" "What have you had to eat or drink today?" "Are you having any chest pain?" "Do you use any herbal remedies?"

"What have you had to eat or drink today?"

A client has just been diagnosed with bipolar disorder and is upset with the diagnosis. The client tells the nurse, "It is probably my mother's fault, she has bipolar too." Which is the best response by the nurse? "Bipolar disorders have not been found to be genetic." "While bipolar disorders are genetic, there are other causes as well." "While bipolar disorders are genetic, the gene can only be passed on by a father." "Genetics are a minor factor in bipolar; it is more heavily influenced by psychological factors."

"While bipolar disorders are genetic, there are other causes as well."

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? "You'll need to continue the medication for about 6 to 12 months to see how things go." "It's probably best to continue the medication for another month, gradually decreasing the dosage over that time." "Since you have no more symptoms, you can stop taking the medications tomorrow." "The medication has eliminated your symptoms so you'll need to keep taking it for the rest of your life."

"You'll need to continue the medication for about 6 to 12 months to see how things go."

The mental health nurse appropriately provides education on light therapy to which client? 20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term 58-year-old showing signs of early Alzheimer's disease 45-year-old lawyer whose medication therapy needs an additional treatment 50-year-old farmer whose major depression has not responded to any treatment modality

20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term

Which individual has the highest number of risk factors for the development of depression? A 42-year-old woman who has experienced depression before but has a strong support system A 32-year-old man who has been diagnosed with cancer and has been abusing alcohol A 50-year-old woman who just lost her spouse and has a family history of depression A 62-year-old man who has had depression in the past and abuses alcohol

A 50-year-old woman who just lost her spouse and has a family history of depression

Which sleep pattern is suggestive of a manic episode? A client stays awake for several days and nights before "crashing" and sleeping for a long period. A client experiences day-night reversal, sleeping until late in the afternoon and going to bed near dawn. A client reports having fitful sleep that is characterized by frequent awakenings and nightmares. A client takes multiple short naps at varied times throughout the day and night.

A client stays awake for several days and nights before "crashing" and sleeping for a long period.

The clinical symptom that would be included when the clinician makes this diagnosis is what? Self-report of being sad after a break up A significant decrease in appetite Demonstrated examples of unwise decisions Claims by family, friends, or coworkers that the client is depressed

A significant decrease in appetite

Which characteristic is most common among suicidal clients? Ambivalence Psychosis Remorse Anger

Ambivalence

A client is admitted to the psychiatric unit after taking various medications and illegal substances to get "high." In addition to the underlying diagnosis of bipolar disorder, the client is diagnosed with delirium. Currently the client is experiencing mild hallucinations and confusion. Which intervention should the nurse do first? Loosely apply a vest restraint. Obtain an order for haloperidol. Arrange for an unlicensed assistant to sit with the client. Ask a family member to stay with the client and report any concerns.

Arrange for an unlicensed assistant to sit with the client.

When teaching a client who is recently diagnosed bipolar I disorder, the nurse correctly tells the client that the difference between bipolar I disorder and bipolar II disorder is what? Bipolar I disorder is often more disruptive than bipolar II disorder. Bipolar I disorder more often effects women. Bipolar I disorder is characterized by hypomanic episodes. Bipolar I disorder involves altered moods of anger and paranoia.

Bipolar I disorder is often more disruptive than bipolar II disorder.

A psychiatric-mental health nurse is conducting a refresher class for a group of psychiatric-mental health nurses returning to the field. After teaching about depressive disorders, the nurse determines a need for additional teachig when the class identifies which physical symptom as being associated with depression? Catatonia Fatigue Insomnia Worthlessness

Catatonia

A client who suffers from bipolar disorder is admitted to a mental health unit for a manic episode. The nurse knows that which takes priority? Phamacotherapy Client safety Cognitive-behavioral therapy Distraction therapy

Client safety

A client has just been admitted to the inpatient psychiatry unit following a suicide attempt. During the client's first 24 hours of care, what outcome should be identified? Client will express that the client feels safe on the unit Client will implement strategies for managing stress Client will participate actively in cognitive behavioral therapy Client will state that the client feels optimistic about the client's future

Client will express that the client feels safe on the unit

A client was admitted to the psychiatric unit 3 days ago because of suicidal ideation. The client's suicidal risk has lessened considerably, and the client currently denies having any desire to kill himself or herself. In addition, the client is able to identify reasons why the client wants to be alive. Which nursing intervention would be most appropriate at this time? Assigning nursing staff to stay with the client during the suicidal crisis Developing a personal plan for managing suicidal thoughts when they occur Advising the client to consider electroconvulsive therapy treatments Administering psychotropic drugs that decrease the client's serotonin levels

Developing a personal plan for managing suicidal thoughts when they occur

After several visits to the primary care provider, a client has been diagnosed with depression. Within the context of the behavioral theorists' beliefs about this disorder, which factors may underlie the client's diagnosis? Exaggerated response to stressful life event Irrational beliefs about one's self Maladaptive patterns in family interactions Early lack of love and care

Exaggerated response to stressful life event

A client has been diagnosed with depression and states that the client is reluctant to receive treatment, stating that the client "would prefer to just wait this out." What is the nurse's most appropriate action? Explain to the client that untreated depression often becomes increasingly severe and frequent over time Document a nursing diagnosis of ineffective denial and choose interventions accordingly Assess the client's knowledge of depression and describe the risks of suicide Document a nursing diagnosis of noncompliance and educate the client about the benefits of treatment

Explain to the client that untreated depression often becomes increasingly severe and frequent over time

After educating a class on the etiology of bipolar disorders, a nursing instructor determines that the education was successful when the class describes the kindling theory as involving what? A dysregulation in the circadian rhythm, leading to sleep disturbance A single gene or sequence of genes causing pathologic changes Exposure to repetitive subthreshold stressors at vulnerable times "Wear and tear" on the body from mood episodes leading to increased problems

Exposure to repetitive subthreshold stressors at vulnerable times

When teaching prevention to the parents of a 15-year-old client who recently attempted suicide by taking an overdose of alprazolam, the nurse describes which behavioral clue? Angry outbursts at significant others Inquiry about doses of lethal drugs Giving away valued personal items Experiencing the loss of a boyfriend or girlfriend

Giving away valued personal items

A client in the clinic appears to have elevated self-esteem, is more talkative than usual, and is easily distracted. This client is exhibiting symptoms of what? Anorexia Grandiosity Anxiety Depression

Grandiosity

The nurse is preparing to discharge a client from the inpatient facility where the client was treated following an unsuccessful suicide attempt. The priority assessment for the nurse to make is to assess whether or not the client can do what? Identify a person to whom he or she can turn to for help after discharge. Understand the need for daily medications. Feel stigmatized by the hospitalization experience. Complete activities of daily living independently.

Identify a person to whom he or she can turn to for help after discharge.

A psychiatric-mental health nurse is conducting a suicide assessment with a client. Why is it important to conduct a lethality assessment? It may assist in determining an individual's past suicide behaviors. It may assist in determining how long a client has been contemplating suicide. It may assist in evaluating the potential suicide protective factors of a client. It may assist in predicting how likely a person is to die by suicide.

It may assist in predicting how likely a person is to die by suicide.

Environmental factors may be associated with suicidal behavior. Which is an environmental factor? Spinal cord injury HIV infection Pain Job loss

Job loss

A 56-year-old client who suffers from seasonal affective disorder is being assessed by the nurse in an outpatient mental health clinic. The nurse is aware which treatment is the most effective type of treatment for this condition? Antidepressant therapy Psychotherapy Electroconvulsive therapy Light therapy

Light therapy

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. Liver function tests Complete blood count Platelet count Urinalysis Blood glucose concentration

Liver function tests Complete blood count Platelet count

A client has been diagnosed with major depression. The client reports that the client often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as suggesting what? Initial insomnia Terminal insomnia Hypersomnia Middle insomnia

Middle insomnia

Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with what? Anaclitic depression Moderate depression A mood disorder due to a general medical condition Postpartum psychosis

Moderate depression

Which biogenic amines have been implicated in depression? Norepinephrine and serotonin Epinephrine and dopamine Dopamine and histamine Epinephrine and serotonin

Norepinephrine and serotonin

Which is a true statement regarding depressive disorders? They are more prevalent in men than women. Depression in older adults is easier to diagnosis. Norepinephrine, dopamine, and serotonin have been implicated. It is the leading cause of U.S. disability in clients older than 44 years of age.

Norepinephrine, dopamine, and serotonin have been implicated.

A nurse is reviewing the medical record of a client with bipolar disorder. The nurse would most likely expect to find a history of what? Panic disorder Schizophrenia Delusional disorder Posttraumatic stress disorder

Panic disorder

A client is admitted to a mental health unit with reports of fatigue, poor appetite, and difficulty making decisions. The client also states feeling unhappy most of the time for "as long as the client can remember." Which diagnosis should the nurse anticipate for this client? Persistent depressive disorder Bipolar disorder Rapid cycling disorder Mild depressive disorder

Persistent depressive disorder

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? Instituting a sleep hygiene program Providing high energy snacks Encouraging frequent rest periods Increasing environmental stimuli

Providing high energy snacks

The nurse is caring for a client with major depressive disorder who has been admitted to a psychiatric-mental health facility. After assessing the client, the nurse has developed a nursing diagnosis of "risk for violence toward others related to agitation and low tolerance level." Which would be an appropriate intervention for this client? Encourage the client to engage in calming group activities. Remove all dangerous items from the client's room. Provide antianxiety medication to prevent an incident. Encourage the client to act on thoughts that are leading to aggression.

Remove all dangerous items from the client's room.

After assessing a client, the nurse identifies that the client is at risk for suicide. Which would be the nurse's priority intervention? Communicate a desire to help the client. Remove means of suicide from the client's access. Determine the course of the client's suicidal thoughts. Provide mood-stabilizing medications per physician order.

Remove means of suicide from the client's access.

After observing a bipolar client on the mental health unit, the nurse determines that the client is at risk for violence. Which would be an appropriate intervention? Ask the client to sit alone and write a letter. Restrict the client to the client's room until the client can calm down. Encourage the client to participate in an activity with other clients. Tell the client that if the client is violent, the client will be sent home.

Restrict the client to the client's room until the client can calm down.

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? Hopelessness related to recent divorce Ineffective coping related to inadequate stress management Spiritual distress related to conflicting thoughts about suicide and sin Risk for suicide related to highly lethal plan

Risk for suicide related to highly lethal plan

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? Self-injury Sleep disruption Dehydration Weight loss

Self-injury

Family education concerning the safe care of a client with a history of suicide attempts includes what? Select all that apply. Signs and symptoms that indicate a mood change that could indicate the client is suicidal Information regarding the stressors that trigger the client's suicidal ideations Techniques to help the client cope with known triggers List of emergency service telephone numbers Information on how to determine if the threat of suicide is legitimate

Signs and symptoms that indicate a mood change that could indicate the client is suicidal Information regarding the stressors that trigger the client's suicidal ideations Techniques to help the client cope with known triggers List of emergency service telephone numbers

A client has been treated following a suicide attempt. When providing anticipatory guidance during the client's discharge education, the nurse should teach the client that: The client is likely to experience stigma around the suicide attempt from some people. The client's commitment to treatment statement will be in effect for the next 6 months. A subsequent suicide attempt will likely cause the client to be declared legally incompetent. The client's long-term recovery will be primarily dependent on the adherence to group therapy.

The client is likely to experience stigma around the suicide attempt from some people.

The nurse is performing an assessment of a client with depression. It took more than four sessions to complete. What is the likely reason for needing multiple sessions? The client was unwilling to answer the nurse's questions. The client was too tired to answer all of the nurse's questions in one session. The client had an insufficient attention span to understand and answer the nurse's questions. The client had impaired cognition leading to the inability to answer the nurse's questions.

The client was too tired to answer all of the nurse's questions in one session.

When teaching a group of new mental health nurses about the major difference between bipolar I and bipolar II disorders, which would be most appropriate for the nurse to include? Unlike bipolar II, bipolar I disorder involves no symptoms of mania, but only depression. Bipolar II is more often recognized than bipolar I. The mania symptoms of bipolar II disorder have little effect on functioning. Both disorders are the same, except the risk for suicide is greater with bipolar I disorder.

The mania symptoms of bipolar II disorder have little effect on functioning.

A nurse is developing a presentation for families who have members who have been diagnosed with bipolar disorders. When describing this condition to the group, which would the nurse most likely include? As the person ages, the episodes tend to decrease. Environmental stressors are a key cause of these disorders. The risk for suicide is high with either depression or mania. Risk-taking behaviors are more common during a depressive episode.

The risk for suicide is high with either depression or mania.

A 51-year-old client with a history of an alcohol use disorder and depression has committed suicide. The care team has subsequently taken steps to organize a postvention. What is the goal of a postvention? To provide a chance for the client's family and friends to reminisce about the client. To allow the client's family and other close acquaintances to express their feelings about the suicide. To identify the clues that should have been acted upon in the days leading up to the client's suicide. To teach the client's close friends and family coping skills that they will need in the months ahead.

To allow the client's family and other close acquaintances to express their feelings about the suicide.

When caring for a client with mania, which would the nurse most likely assess? Unusual self-confidence Slow, repetitive speech Logical thinking Narrowed focus

Unusual self-confidence

A client taking lithium for bipolar disorder comes to the clinic and reports symptoms which the nurse interprets as consistent with moderate lithium toxicity. Which action should the nurse perform? Select all that apply. Withhold additional doses of lithium. Obtain a blood sample for lithium level. Perform a 12-lead electrocardiogram. Push fluids. Contact the physician.

Withhold additional doses of lithium. Obtain a blood sample for lithium level. Push fluids. Contact the physician.

During assessment of a client with depression, the client states, "I just feel so sad and hopeless. I just don't care anymore. I don't even enjoy doing the crossword puzzles like I used to." The nurse documents this finding as indicative of: dysthymic disorder. anhedonia. delusion. psychosis.

anhedonia

The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should ... assess for depression in the client's family history. prepare the client for diagnostic genetic testing to confirm the diagnosis. educate the client regarding the symptoms of related physical disorders. encourage the client to seek genetic counseling before considering a pregnancy.

assess for depression in the client's family history.

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 excessive guilt

A group of nursing students is reviewing information about suicide and associated concepts. The group demonstrates understanding of the information when members identify which as the probability that a person will successfully complete suicide? parasuicide suicidal ideation suicidality lethality

lethality

A client who has attempted suicide has an underlying diagnosis of depression. Which would the nurse anticipate being ordered for the client? selective serotonin reuptake inhibitor mood stabilizer tricyclic antidepressant atypical antipsychotic

selective serotonin reuptake inhibitor

When assessing risk of suicide, which are important assessment components? Select all that apply. seriousness of suicidal ideation degree of hopelessness previous attempt lethality of method Unemployment

seriousness of suicidal ideation degree of hopelessness previous attempt lethality of method

A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications? Mannitol Lithium Carbamazepine Methyldopa

Carbamazepine

A client is prescribed a selective serotonin reuptake inhibitor (SSRI) as treatment for depression. Which would the nurse most likely administer? Escitalopram Venlafaxine Maprotiline Phenelzine

Escitalopram

Which must be present in a client diagnosed with serotonin syndrome? Select all that apply. Agitation Hyporeflexia Diaphoresis Constipation Ataxia Fever

Agitation Diaphoresis Ataxia Fever

The nurse is conducting an interview with an adult client who is being treated for major depression. What question should the nurse prioritize in an effort to determine the client's risk for suicide? "Do you ever feel like your situation is hopeless?" "How would you describe your relationship with your parents?" "Do you feel like your antidepressant is helping your mood?" "What are your plans for the next few days?"

"Do you ever feel like your situation is hopeless?"

When conducting a focused assessment on a newly admitted client who attempted suicide, which question should the nurse include to ensure the client's safety? Select all that apply. "Do you still have a plan to harm yourself?" "Have you ever tried to hurt yourself before?" "Are you willing to tell us if you plan to harm yourself again?" "Did you really want to kill yourself?" "Is there a history of depression in your family?"

"Do you still have a plan to harm yourself?" "Have you ever tried to hurt yourself before?" "Are you willing to tell us if you plan to harm yourself again?"

A nursing instructor is teaching about different depressive disorders and identifies a need for further instruction when a student states what? "Dysthymic disorder is milder than major depression." "Dysthymic disorder is less chronic than major depression." "With dysthymic disorder, depressed mood exists for most days for at least 2 years." "Dysthymic disorder can significantly affect a patient's functioning."

"Dysthymic disorder is less chronic than major depression."

A 46-year-old client comes to the community mental health center because the client thinks they might be suffering from depression. When assessing this client, which symptom would the nurse identify as being necessary for the diagnosis of major depressive disorder to be made? Euphoria along with poor decision making ability Disregard for personal hygiene including cleanliness and appearance A loss of interest or inability to derive pleasure for previously enjoyed activities A stooped posture and nonverbal signs of a depressed mood

A loss of interest or inability to derive pleasure for previously enjoyed activities

A nurse is providing psycho-education to a client who has been admitted to the inpatient mental health unit for a manic episode. In order to ensure the teaching is effective, the nurse must first determine which regarding the client? Ability to concentrate and process the information Likelihood to assume responsibility for self-care Cognitive awareness and intellectual abilities Interest in learning about the disorder

Ability to concentrate and process the information

A 51-year-old client has been severely depressed and has been contemplating suicide. While feeling like the client has no other way out, the client also wishes someone would help. What is this is known as? Ambivalence Rescue syndrome Determination Vacillation

Ambivalence

The nurse is seeing a 43-year-old client whose spouse just died by suicide. Which is a common emotional response that the nurse should anticipate from this client? Anger toward the loved one who committed suicide The development of a panic disorder Turning toward alcohol or drugs Unpredictable behavior and a potential for risk-taking behaviors

Anger toward the loved one who committed suicide

Which is a food that might be incorporated into the plan of care for a client diagnosed in the manic phase of bipolar disorder? Bananas Brocolli Spaghetti Steak

Bananas

A client is admitted to the unit in an acute manic episode. The client has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which disorders would reflect the client's symptom profile? Bipolar II Cyclothymic disorder Bipolar I Euthymic state

Bipolar I

A nursing instructor is teaching about mood disorders and informs the class that bipolar disorder is divided into several groups. Those groups include what? Select all that apply. Bipolar I Bipolar II Bipolar III Bipolar mixed Bipolar IV

Bipolar I Bipolar II Bipolar mixed

A client on the inpatient psychiatric-mental health unit was discovered attempting to asphyxiate himself or herself using a blanket. Which measure should the care team prioritize in the client's immediate care? Assessing the specific motivation for the client's attempted suicide Placing the client under constant observation Teaching the client improved coping skills Managing the client's anxiety

Placing the client under constant observation

A 42-year-old client with major depression is in an inpatient psychiatric hospital. The client has been taking phenelzine, a monoamine oxidase inhibitor (MAOI), for depression. The therapist writes an order to discontinue the phenelzine and begin fluoxetine. Which action by the nurse is indicated? Begin educating the client about food restrictions when taking fluoxetine. Begin educating the client about selective serotonin reuptake inhibitors. Call the therapist to discuss the need for a washout period before starting fluoxetine. Note in the medication administration record to check the client's blood pressure for the first 2 days after starting fluoxetine.

Call the therapist to discuss the need for a washout period before starting fluoxetine.

A client is being screened for clinical symptoms related to depression over the past 2 weeks. Which self-assessment screening instruments would be most appropriate? Zung Self-Assessment Scale Beck Depression Inventory Hamilton Rating Scale for Depression Geriatric Depression Scale

Zung Self-Assessment Scale

A 32-year-old client is admitted to the inpatient unit for depression with suicidal thoughts. During the nursing assessment, why it is important for the nurse to assess and explore if there is any family member who has committed suicide? Genetic predisposition Disengagement of family Lack of conflict resolution skills Terminal illness

Genetic predisposition

A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which would the nurse include? Family members typically can understand how disabling depression can be. Depression in one family member affects the entire family. Abuse of the depressed person is a rare occurrence in families. Families of women older than 55 years of age with depression experience the majority of problems.

Depression in one family member affects the entire family.

A nurse is giving a presentation on mental health promotion at a community center. A participant states, "My friend tells me I'm depressed because I don't have a lot of energy and have trouble concentrating. I had to quit my full-time job because I don't seem to have the energy to manage it. But I don't want to kill myself or anything like that." Although more data are needed for diagnosis, the nurse suspects that the client may have what? Bipolar II disorder Cyclothymic disorder Dysthymic disorder Major depressive disorder

Dysthymic disorder

A client who has experienced the recent loss of an infant child and recent immigration to the United States is admitted to the inpatient psychiatric unit with severe symptoms of depression. The client has expressed thoughts of suicide. Which is the nurse's priority intervention for this client? Exploring the grief and loss issues concerning the baby's death. Encouraging the client to express feelings of isolation following the recent immigration. Encouraging attendance at group cognitive-behavioral therapy on the unit. Ensuring that the client is not permitted to use anything that would be potentially dangerous.

Ensuring that the client is not permitted to use anything that would be potentially dangerous.

The nurse knows that the most dangerous time period following a previous suicide attempt is what? First 3 months First 6 months First 9 months First year

First 3 months

A client with bipolar disorder has a history of multiple episodes and states, "I'm so frustrated with what's happened because of these episodes." Which would the nurse encourage to help support this client's recovery? Codependence Hope Self-control Independent decision making

Hope

To care for an acutely suicidal client, which is the most effective initial mode of treatment? Inpatient care Group therapy Behavioral therapy Outpatient care

Inpatient care

A client with major depression and a suicide attempt is admitted to the inpatient facility. The client is started on antidepressant therapy. The next day, the client demonstrates significantly higher energy and says, "I'll feel much better." The nurse would interpret this behavior as suggesting what? Possible decision to complete a suicide attempt Effectiveness of the drug therapy An act to cover up the client's true feelings A typical response to the medication

Possible decision to complete a suicide attempt

The nurse is assessing a client who gave birth to a baby 1 week ago. She has been feeling sad, fatigued, and has been crying often. The client is most likely experiencing what? Dysthymic disorder Postpartum depression Major depression Postpartum blues

Postpartum blues

A 27-year-old woman has a 4-month-old baby. For the past 3 months, the client has been experiencing intense sadness, anxiety, and hopelessness. After having thoughts of killing her baby, she decided to seek help. What is the likely the cause of this client's experience? Dysthymic disorder Postpartum depression Major depression Postpartum blues

Postpartum depression

In a therapy session, a client with a diagnosis of major depression admits to the nurse-therapist, "I actually went out driving on the interstate this morning and had every intention of getting up to speed and plowing right into the overpass by my exit. Maybe tomorrow." The nurse would recognize the client's statement as what? Suicidal ideation Suicidal intent Suicidal gesture Suicidal threat

Suicidal intent

A parent of four small children lost a spouse in an automobile accident 3 months ago and is admitted to the hospital with severe depression. Since the spouse's death, the client's mood has been somber; until now, the client has refused treatment. What is this client at high risk for? Bipolar disorder Suicide Schizophrenia Dysthymic disorder

Suicide

A nurse is reviewing the medical record of a patient to determine the patient's risk for suicide. Which factor would alert the nurse to an increased risk for this patient? Fear of growing older Acute illness Homosexuality issues Unemployment

Unemployment

A nurse is providing a presentation about suicide for a group of health professionals. Which would the nurse address as a major contributing factor to the rising suicide rate among men? substance abuse media influences lack of conflict resolution skills parenting practices

substance abuse