psych 2

Which of the following clusters of personality disorders is associated with odd or eccentric behaviors?

Cluster A

Which cluster of personality disorders exhibits anxious and fearful types of behavior?

Cluster C

Which client outcome is most appropriately achieved in a community approach setting in psychiatric nursing?

The client demonstrates self-reliance and social adaptation.

Clients taking a monoamine oxidase inhibitor (MAOI) should avoid which of the following in their diet?

Tyramine

The effectiveness of monoamine oxidase (MAO) inhibitor drug therapy in clients with posttraumatic stress disorder can be demonstrated by which of the following client self-reports?

"I'm sleeping better and don't have nightmares".

David with paranoid schizophrenia repeatedly uses profanity during an activity therapy session. Which response by the nurse would be most appropriate?

"Your cursing is interrupting the activity. Take time out in your room for 10 minutes."

Meryl, age 19, is highly dependent on her parents and fears leaving home to go away to college. Shortly before the semester starts, she complains that her legs are paralyzed and is rushed to the emergency department. When physical examination rules out a physical cause for her paralysis, the physician admits her to the psychiatric unit where she is diagnosed with conversion disorder. Meryl asks the nurse, "Why has this happened to me?" What is the nurse's best response?

"Your problem is real but there is no physical basis for it. We'll work on what is going on in your life to find out why it's happened."

Which of the following statements is expected from a client with borderline personality disorder with a history of dysfunctional relationships?

. "I'm determined to look for the perfect partner."

The nurse is assessing a client who has just been admitted to the emergency department. Which signs would suggest an overdose of an antianxiety agent?

. Emotional lability, euphoria, and impaired memory

Chuck is a 20-year-old student diagnosed with obsessive-compulsive behavior. A psychiatrist prescribes clomipramine (Anafranil) to treat his condition. Nurse Nicolette understands the rationale for this treatment is that the clomipramine:

. Increases serotonin levels

Malingering is different from somatoform disorder because the former:

. It is a deliberate effort to handle upsetting events.

Nurse Alexandra notices other clients on the unit avoiding a client diagnosed with antisocial personality disorder. When discussing appropriate behavior in group therapy, which of the following comments is expected about this client by his peers?

. Lack of honesty

In order for a client to be diagnosed with an anxiety disorder, the client must have had symptoms for longer than which time frame?

1 month

A client is receiving lithium carbonate. Which of the following is a therapeutic blood level for lithium?

1.0 mEq/L

A client seeks care because she feels depressed and has gained weight. To treat her atypical depression, the physician prescribes tranylcypromine sulfate (Parnate), 10 mg by mouth twice per day. When this drug is used to treat atypical depression, what is its onset of action?

3 to 5 days

To be diagnosed with generalized anxiety disorder, the client experiences an increased level of anxiety and worry on most days over which time frame?

6 months

Which of the following should be included in the health teachings among clients receiving Valium:

A. Avoid taking CNS depressants like alcohol.

A group of community nurses sees and plans care for various clients with different types of problems. Which of the following clients would they consider the mostvulnerable to post-traumatic stress disorder?

A 20-year-old college student with DM who experienced date rape.

The psychoanalytic theory explains the etiology of anorexia nervosa as:

A conflict between mother and child over separation and individualization.

Alfred was newly diagnosed with anxiety disorder. The physician prescribed buspirone (BuSpar). The nurse is aware that the teaching instructions for newly prescribed buspirone should include which of the following?

A warning about the drug's delayed therapeutic effect, which is from 14 to 30 days.

Nurse Anne is caring for a client who has been treated long term with antipsychotic medication. During the assessment, Nurse Anne checks the client for tardive dyskinesia. If tardive dyskinesia is present, Nurse Anne would most likely observe:

A. Abnormal movements and involuntary movements of the mouth, tongue, and face.

Nurse Vicky is assessing a newly admitted client for symptoms of post-traumatic stress disorder (PTSD). Which symptoms are typically seen with this diagnosis? Select all that apply.

A. Anger with numbing of other emotions. E. Frequent nightmares. F. Survivor's guilt.

The school nurse assesses for anorexia nervosa in an adolescent girl. Which of the following findings are characteristic of this disorder? Select all that apply.

A. Bradycardia B. Hypotension E. Irregular or absent menses F. Refusal to maintain a minimally normal weight

A client with borderline personality disorder is admitted to the unit after slashing his wrist. Which of the following goals is most important after promoting safety?

A. Establish a therapeutic relationship with the client.

A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with the parents, which information would the nurse expect to be included in the client's history? Select all that apply.

A. Impulsiveness B. Lability of mood E. Self-destructive behavior

A teenage girl is diagnosed to have borderline personality disorder. Which manifestations support the diagnosis?

A. Lack of self-esteem, strong dependency needs, and impulsive behavior.

A client is admitted to the inpatient mental health unit with paranoid schizophrenia. Which of the following assessment parameters would be most important for the nurse to observe?

Ability to make decisions

Which of the following assessment findings is seen in a client diagnosed with borderline personality disorder?

Abrasions in various healing stages.

When asking the parents about the onset of problems in young client with the diagnosis of schizophrenia, Nurse Linda would expect that they would relate the client's difficulties began in:

Adolescence

Which nursing intervention would be most appropriate if a male client develops orthostatic hypotension while taking amitriptyline (Elavil)?

Advising the client to sit up for 1 minute before getting out of bed

Jerome who has an eating disorder often exhibits similar symptoms. Nurse Lhey would expect an adolescent client with anorexia to exhibit:

Affective instability

When being admitted to a mental health facility, a young female adult tells Nurse Mylene that the voices she hears frighten her. Nurse Mylene understands that the client tends to hallucinate more vividly:

After going to bed

Situation: An old woman was brought for evaluation due to the hospital for evaluation due to increasing forgetfulness and limitations in daily function. The daughter revealed that the client used her toothbrush to comb her hair. She is manifesting:

Agnosia

Genevieve only attends social events when a family member is also present. She exhibits behavior typical of which anxiety disorder?

Agoraphobia

A client has been prescribed clozapine (Clozaril) for the treatment of schizophrenia. The nurse notes that this medication is associated with which of the following life-threatening side effects?

Agranulocytosis

When reviewing a care plan of a client diagnosed with obsessive-compulsive disorder, the nurse would expect to see which of the following nursing interventions early in treatment?

Allow time for the client to perform the ritual.

Which medications have been found to help reduce or eliminate panic attacks?

Antidepressants

Which of the following treatment approaches has been proven to be the most beneficial for the client diagnosed with an anxiety disorder?

Antianxiety medications combined with psychotherapy

A client is being discharged on a tricyclic antidepressant (TCA). The nurse should include which of the following in the discharge teaching?

Avoid consuming alcohol.

10. A client diagnosed with schizophrenia comes to the outpatient mental health clinic very disheveled, with body odor and an unkempt beard. The nurse suspects which of the following negative symptoms of schizophrenia?

Avolition

The psychiatric nurse uses cognitive-behavioral techniques when working with a client who experiences panic attacks. Which of the following techniques are common to this theoretical framework? Select all that apply.

B. Encouraging the client to restructure thoughts. C. Helping the client to use controlled relaxation breathing. D. Helping the client examine evidence of stressors. F. Teaching the client about anxiety and panic.

A hospitalized client, diagnosed with a borderline personality disorder, consistently breaks the unit's rules. This behavior should be confronted because it will help the client:

Become more self-aware

The client is experiencing extrapyramidal side effects from taking antipsychotic drugs. Which medication may be used to counteract these side effects?

Benztropine (Cogentin)

In planning care for a client with borderline personality disorder, a nurse must be aware that this client is prone to develop which of the following conditions?

Binge eating

Dennis has a lithium level of 2.4 mEq/L. The nurse immediately would assess the client for which of the following signs or symptoms?

Blurred vision

Tranylcypromine sulfate (Parnate) is prescribed for a depressed client who has not responded to the tricyclic antidepressants. After teaching the client about the medication, Nurse Marian evaluates that learning has occurred when the client states, "I will avoid:

Chocolate milk, aged cheese, and yogurt"

A client diagnosed with bipolar disorder is verbalizing, "The mare, doesn't care, over there, if you dare, anywhere." This is an example of which type of thought pattern?

Clang association

Nurse Wayne is planning a psychoeducational discussion for a group of adolescent clients with anorexia nervosa. Which of the following topics would Nurse Wayne select to enhance understanding about central issues in this disorder?

D. Self-control and self-esteem

Which of the following conditions is likely to coexist in clients with a diagnosis of borderline personality disorder?

Depression

A client diagnosed with borderline personality disorder who is self-mutilating has been admitted to the inpatient medical unit. Which of the following interventions would take priority for this client?

Develop a no-harm contract.

A client taking the MAOI phenelzine (Nardil) tells the nurse that he routinely takes all of the medications listed below. Which medication would cause the nurse to express concern and therefore initiate further teaching?

Diphenhydramine (Benadryl)

When assessing a client diagnosed with an anxiety disorder, the nurse should use which type of questioning?

Direct

The nurse is teaching a group of clients about the mood-stabilizing medications lithium carbonate. Which medications should she instruct the clients to avoid because of the increased risk of lithium toxicity?

Diuretics

Loretta, a newly admitted client was diagnosed with delirium and has a history of hypertension and anxiety. She had been taking digoxin, furosemide (Lasix), and diazepam (Valium) for anxiety. This client's impairment may be related to which of the following conditions?

Drug intoxication

Which of the following mood disorders is less severe than major depressive disorder but tends to be more chronic?

Dysthymic disorder

Nurse Gina understands that her client Glenda who is bulimic feels shame and guilt over binge eating and purging. This disorder is therefore considered:

Ego-dystonic

Josefina is to be discharged on a regimen of lithium carbonate. In the teaching plan for discharge the nurse should include:

Encouraging the client to have blood levels checked as ordered.

Which of the following interventions is important for a Cely experiencing a paranoid personality disorder taking olanzapine (Zyprexa)?

Explain that the drug is less effective if the client smokes.

The parents of a young man with schizophrenia express feelings of responsibility and guilt for their son's problems. How can the nurse best educate the family?

Explain the biological nature of schizophrenia.

After seeking help at an outpatient mental health clinic, Ruby who was raped while walking her dog is diagnosed with posttraumatic stress disorder (PTSD). Three months later, Ruby returns to the clinic, complaining of fear, loss of control, and helpless feelings. Which nursing intervention is most appropriate for Ruby?

Exploring the meaning of the traumatic event with the client.

The following statements describe somatoform disorders:

Expression of conflicts through bodily symptoms.

The psychiatrist orders lithium carbonate 600 mg p.o t.i.d for a female client. Nurse Katrina would be aware that the teaching about the side effects of this drug were understood when the client state, "I will call my doctor immediately if I notice

Fine hand tremors or slurred speech.

Which of the following is considered a negative symptom of schizophrenia?

Flat affect

Nurse Martha is teaching her students about anxiety medications; she explains that benzodiazepines affect which brain chemical?

Gamma-aminobutyric acid (GABA)

Situation: A 42-year-old male client, is admitted to the ward because of bizarre behaviors. He was given a diagnosis of schizophrenia paranoid type. The client should have achieved the developmental task of:

Generativity vs. Stagnation

It would be most helpful for the nurse to deal with a client with severe anxiety by:

Give specific instructions using speak in concise statements.

Jose is diagnosed with amphetamine psychosis and was admitted to the emergency room. Nurse Ronald would most likely prepare to administer which of the following medication?

Haldol

Which is the best indicator of success in the long-term management of the client with a somatic disorder?

He learns to verbalize his feelings and concerns.

Which nursing intervention is most appropriate for a client with anorexia nervosa during initial hospitalization on a behavioral therapy unit?

Help establish a plan using privileges and restrictions based on compliance with refeeding.

Tim is admitted with a diagnosis of delusions of grandeur. The nurse is aware that this diagnosis reflects a belief that one is:

Highly important or famous.

Tristan is on Lithium and has suffered from diarrhea and vomiting. What should the nurse in-charge do first:

Hold the next dose and obtain an order for a stat serum lithium level.

Nurse Mickey is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is to:

Identify anxiety-causing situations.

The primary nursing diagnosis for a female client with a medical diagnosis of major depression would be:

Impaired verbal communication related to depression

Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder is:

Increase calories, carbohydrates, and protein.

The nurse is caring for a severely depressed client. The nurse should be aware of suicide warning signs. Which of the following would be inconsistent as a warning sign?

Increased appetite

Which of the following would be a sympathetic nervous system response to panic anxiety?

Increased heart rate

The nursing diagnosis that would be most appropriate for a 22-year old client who uses ritualistic behavior would be:

Ineffective coping

Nurse Jen is caring for a male client with manic depression. The plan of care for a client in a manic state would include:

Listening attentively with a neutral attitude and avoiding power struggles.

During a conversation with Nurse John with a client, he observes that the client shifts from one topic to the next on a regular basis. Which of the following terms describes this disorder?

Loose association

A client has been diagnosed with generalized anxiety disorder. In order to establish a nurse-client relationship, which of the following steps is most important?

Lower the client's anxiety level

Which of the following thought patterns is consistent with the diagnosis of schizotypal personality disorder?

Magical thinking

Which of the following nursing interventions has priority for a client with borderline personality disorder?

Maintain consistent and realistic limits.

Clients with a personality disorder will most likely:

Manifest enduring patterns of inflexible behaviors.

Which is the highest priority in the post-ECT care?

Monitor respiratory status.

The nurse evaluates the treatment of Mrs. Montez with somatoform disorder as successful if:

Mrs. Montez verbalizes anxiety directly rather than displacing it.

A physiologic response to generalized anxiety includes which of the following?

Muscle tension

A client is taking haloperidol (Haldol) for chronic schizophrenia. The nursing assessment reveals muscular rigidity, hyperthermia, and an altered level of consciousness. These symptoms are consistent with which of the following?

Neuroleptic malignant syndrome

Ricky with chronic schizophrenia takes neuroleptic medication and is admitted to the psychiatric unit. Nursing assessment reveals rigidity, fever, hypertension, and diaphoresis. These findings suggest which life-threatening reaction:

Neuroleptic malignant syndrome

Which of the following neurotransmitters has been implicated in mania?

Norepinephrine

Which of the following interventions should be prioritized in the care of the suicidal client?

Remove all potentially harmful items from the client's room.

Which information is most important for the nurse Trinity to include in a teaching plan for a male schizophrenic client taking clozapine (Clozaril)?

Report a sore throat or fever to the physician immediately.

Nurse Kenzo is teaching a client about sertraline (Zoloft), which has been prescribed for depression. A significant side effect is an interference with sexual arousal by inhibiting erectile function. How should Nurse Kenzo approach this topic?

Nurse Kenzo should advise the client to report any changes in sexual functioning in case medication adjustments are needed.

A soldier has been back from Iraq for two weeks. He is being seen in the outpatient mental health clinic due to complaints of inability to sleep, nightmares, and flashbacks. The nurse would expect the client to be diagnosed with which of the following?

PTSD

A client states, "Everyone is out to get me. They are trying to get into my head. They are watching me." The nurse suspects which type of schizophrenia?

Paranoid

Francis tells the nurse that her coworkers are sabotaging the computer. When the nurse asks questions, the client becomes argumentative. This behavior shows personality traits associated with which of the following personality disorder?

Paranoid

A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is:

Patient will learn problem-solving skills.

A client has been diagnosed with obsessive-compulsive anxiety disorder. The nurse would expect to find which of the following clinical manifestations?

Persistent unwanted thoughts

Water intoxication is associated with schizophrenia. The possible cause is related to the effects of antipsychotic drugs on which gland of the body?

Pituitary

When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to?

Provide foods, fluids, and rest.

Which method would a nurse use to determine a client's potential risk for suicide?

Question the client directly about suicidal thoughts.

A client has had five mood shifts within a year, alternating between mania and depression. The nurse would correctly document this shift as which of the following?

Rapid cycling

The client joins a support group and frequently preaches against abuse, is demonstrating the use of:

Reaction Formation

Mike is admitted to a psychiatric unit with a diagnosis of undifferentiated schizophrenia. Which of the following defense mechanisms is probably used by Mike?

Regression

Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while other clients are watching television. He begins cursing and throwing furniture. Nurse Oliver first action is to:

Remove all other clients from the dayroom

A client with a diagnosis of narcissistic personality disorder has been given a day pass from the psychiatric hospital. The client is due to return at 6 pm. At 5 pm the client telephones the nurse in charge of the unit and says "6 o'clock is too early. I feel like coming back at 7:30." The nurse would be most therapeutic by telling the client to:

Return on time or restrictions will be imposed.

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and command hallucinations. Which of the following is the priority nursing diagnosis?

Risk for other-directed violence

The nurse is reviewing a care plan for an assigned client diagnosed with paranoid schizophrenia. Which of the following would be a priority diagnosis for this client?

Risk for self-directed violence

A nurse is caring for a client diagnosed with borderline personality disorder. The nurse would expect which priority nursing diagnosis in the care plan?

Risk for violence, self-directed, related to self-mutilating behaviors

When assessing a client diagnosed with borderline personality disorder, it would be most important for the nurse to assess for which of the following?

Scars or cuts

Which of the following psychotic disorders is exhibited by a mood episode and active symptoms of schizophrenia that occur together, which is preceded by delusions and hallucinations?

Schizoaffective disorder

Which personality disorder would be consistent with the nursing diagnosis of impaired social interaction, related to indifference toward others?

Schizoid personality disorder

Nurse Marco is developing a plan of care for a client with anorexia nervosa. Which action should the nurse include in the plan?

Set up a strict eating plan for the client.

Marty is pacing and complains of racing thoughts. Nurse Lally asks the client if something upsetting happened, and Marty's response is vague and not focused on the question. Nurse Lally assess Marty's level of anxiety as:

Severe

Cely with manic episodes is taking lithium. Which electrolyte level should the nurse check before administering this medication?

Sodium

When assessing a client taking lithium, the nurse should be aware of which of the following electrolyte levels within the client's diet?

Sodium

Jose, who has been hospitalized with schizophrenia tells Nurse Ron, "My heart has stopped and my veins have turned to glass!" Nurse Ron is aware that this is an example of:

Somatic delusions

A client is upset with a nurse on the inpatient mental health unit. She states to another client, "That nurse is mean and hates me. I want to have another nurse take care of me because that nurse is nice all the time." The client is exhibiting which manifestation of borderline personality disorder?

Splitting

A client with a diagnosis of borderline personality disorder has negative feelings toward the other clients on the unit and considers them all to be "bad." The nurse understands this defense is known as:

Splitting

Miranda, a psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against

Staying in the sun.

Mark, with a diagnosis of generalized anxiety disorder, wants to stop taking his lorazepam (Ativan). Which of the following important facts should nurse Betty discuss with the client about discontinuing the medication?

Stopping the drug can cause withdrawal symptoms.

Aira has taken amitriptyline HCL (Elavil) for 3 days, but now complains that it "doesn't help" and refuses to take it. What should the nurse say or do?

Suggest that it takes a while before seeing the results.

7. A client states to the nurse, "I want to kill myself. I don't have anything to live for." The nurse understands that this statement is an example of which of the following?

Suicidal threat

The nurse understands that which of the following antidepressants are fatal in overdose?

TCAs

Prior to administering chlorpromazine (Thorazine) to an agitated client, the nurse should:

Take the client's blood pressure

Which of the following is included in the health teachings among clients receiving Valium?

Take the medication after meals.

A client is exhibiting lip smacking, facial grimacing, and protruding tongue movements. This extrapyramidal side effect would accurately be documented as which of the following?

Tardive dyskinesia

Nurse Ron enters a client's room, the client says, "They're crawling on my sheets! Get them off my bed!" Which of the following assessments is the most accurate?

The client is experiencing visual hallucination.

Which of the following characteristics is expected for a client with paranoid personality disorder who receives bad news?

The client responds from a rational, objective point of view.

A client with a bipolar disorder exhibits manic behavior. The nursing diagnosis is Disturbed thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the following outcome criteria would indicate improvement in the client?

The client speaks in coherent sentences.

A nurse is working with a client who has schizophrenia, paranoid type. Which of the following outcomes related to the client's delusional perceptions would the nurse establish?

The client will demonstrate realistic interpretation of daily events in the unit.

Which factors are the most essential for the nurse to assess when providing crisis intervention for a client?

The client's perception of the triggering event and availability of situational supports.

Which information is the most essential in the initial teaching session for the family of a young adult recently diagnosed with schizophrenia?

The distressing symptoms of this disorder can respond to treatment with medications.

A nurse is evaluating therapy with the family of a client with anorexia nervosa. Which of the following would indicate that the therapy was successful?

The parents reinforce increased decision making by the client.

The client jumps up and throws a chair out of the window. He was restrained after his behavior can no longer be controlled by the staff. Which of these documentations indicates the safeguarding of the patient's rights?

The staff carried out less restrictive measures but were unsuccessful.

A client has failed to respond to medication therapy for depression. The physician has ordered electroconvulsive therapy (ECT). Which of the following is most important to include in the teaching plan for this client?

This type of therapy will induce a seizure.

A client states, "Little green men implanting destructive asteroids in my brain." This statement is reflective of which type of thinking?

Thought insertion

Nurse Kerrick observes Toni who is hospitalized on an eating disorder unit during mealtimes and for 1 hour after eating. An explanation for this intervention is:

To prevent purging behaviors.

The nurse should avoid which of the following interventions when dealing with a client having a panic attack?

Touching the client

A client has been diagnosed with schizophrenia. The nurse is able to move the client's arm in a certain position and it will remain in that position until it is moved again. The nurse would document this behavior alteration as which of the following?

Waxy flexibility

Which of the following is a true statement regarding schizophrenia?

Women tend to experience less severe symptoms.

nurse discusses job possibilities with a client with schizoid personality disorder. Which suggestion by the nurse would be helpful?

Your idea of applying for the position of filing and organizing records is worth pursuing."

The nurse correctly teaches a client taking the Benzodiazepine Oxazepam (Serax) to avoid excessive intake of:

coffee

Nurse Krina knows that the following drugs have been known to be effective in treating obsessive-compulsive disorder (OCD):

fluvoxamine (Luvox) and clomipramine (Anafranil)

Nurse Maureen knows that the non-antipsychotic medication used to treat some clients with schizoaffective disorder is:

lithium carbonate (Lithane)

Which of the following would be listed as a cluster A personality disorder according to the DSM-IV-TR?

paranoid