CHRONIC FINAL

All of the following would be included as interventions for eating disorders to establish nutritional eating patterns except ...

Weighing the client twice daily

The nurse is counseling a client who lost a parent one year ago. The client states "I wish I could die too." The nurse is aware that the client is experiencing which type of grief?

complicated

A client is crying uncontrollably after having experienced an assault by a family member. The nurse is aware that the client is experiencing which type of crisis? The nurse is caring for a client who has recently lost a sibling due to suicide. Which type of grief does the nurse anticipate the client is experiencing?

traumatic

When describing intellectual disability to a group of parents, a nurse would identify which intelligent quotient (or less) as the usual threshold?

70

Which of the following clients being treated for anorexia displays assessment values that warrant hospitalization?

A 25-year-old whose weight is 70% of ideal and who has a serum magnesium level 1.2 mg/dL

A nurse completes a Global Assessment of Functioning (GAF) scale on an adolescent during an assessment. The nurse calculates a 55. What is the analysis of the score?

A moderate level of impairment

The nurse is working with a client who has been diagnosed with depression. When performing a strength assessment with the client, what is the nurse's best statement or question?

"How have you dealt with feelings like this in the past?"

The nurse is teaching a client with bulimia to use self-monitoring techniques. Which statement by the client would let the nurse know that this has been effective?

"I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging."

A nurse is assessing a person who has suffered a loss and is grieving. When applying the dual process model, the nurse would most likely interpret which client statement as reflecting loss-oriented coping?

"I just can't believe that my spouse is gone."

The nurse reviews the medication list for a client who is newly prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which client statement indicates a need to assess the client for serotonin syndrome?

"I started taking diet pills to assist with weight loss."

Which statement by a client would indicate the need for additional education regarding a prescribed lithium treatment regimen?

"I will restrict my intake of processed foods high in sodium."

Which nursing statement is most effective in communicating a positive expectation of the client?

"I will sit here quietly with you while you eat."

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the teaching has been effective?

"I'll eat small meals and snacks regularly."

A mental health nurse is working with a client with antisocial personality disorder. The nurse has just reviewed the unit rule of one cigarette per break. While telling the client about the unit rules, the client asks, "Well, if I have not done anything bad all day, can I have two cigarettes instead of one?" Which would be the most therapeutic nursing response?

"No, only one cigarette is allowed per break time."

A client with borderline personality disorder has had 21 admissions to the mental health unit, each of which was precipitated by a suicide attempt resulting in superficial cuts. During this admission, the client has developed a relationship with a highly supportive nurse and has progressed to having a pass to spend an afternoon in a nearby shopping mall. Later the day that the client uses the pass, the nurse is shocked when the emergency department calls to say that the client has just been brought in with multiple self-inflicted lacerations. The nurse asks a supervisor, "Everything was going well. How could this happen?" What response by the supervisor reflects an understanding of borderline personality disorder?

"The client's behavior seems personal, but it's really not. Clients with borderline personality disorder act out to relieve anxiety. I suspect having the pass provoked a great deal of anxiety."

A nurse is providing care to a child with Tourette disorder. In teaching the parent about the disorder and treatment, what will the nurse teach about the medication?

"The condition is treated with atypical antipsychotic medication."

A nurse is assessing language development of a 2-year-old. What is a normal language pattern for a 2-year-old?

"Want eat"

A nurse is working with an adolsecent client and is teaching about tobacco use and vaping. Which question(s) or statement(s) posed would lead to an increased interaction? Select all that apply.

"What other tobacco products or vape products have you seen being used?" "We have this place where some friends smoke or vape routinely." "How do you think families feel about your age group smoking or vaping?"

After the death of a client's spouse, the client tells the nurse, "I can never live without my spouse. They were my whole life." Which is the most therapeutic response from the nurse?

"Your spouse's death is a terrible loss for you."

Which of the following clients exhibits the most realistic perception of his or her present crisis?

A woman newly diagnosed with lung cancer laments the fact that she has never made a sincere effort to quit smoking.

A client with mania is demonstrating hypersexual behavior by blowing kisses to other clients, making suggestive remarks, and removing some articles of clothing. Which nursing intervention would be most appropriate at this time?

Accompany the client to his or her room to get dressed.

After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?

After teaching a group of mental health nursing students about the care of a client experiencing a panic attack, the instructor determines that additional education is required when the students identify which as an appropriate intervention?

Which signs would a nurse expect in a client diagnosed with serotonin syndrome? Select all that apply.

Agitation Elevated heart rate Elevated temperature

A client is diagnosed with generalized anxiety disorder (GAD) and is prescribed medication therapy. Which agent would the nurse expect to administer to the client to obtain the quickest relief from anxiety symptoms?

Alprazolam

Which medication classification has been found to be effective in reducing or eliminating panic attacks?

Antidepressants

Which of the following statements is true regarding the use of pharmacologic agents in children with anxiety disorders?

Anxiolytics and selective serotonin reuptake inhibitors (SSRIs) have been shown to help reduce anxiety.

A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm?

Approximately 2 weeks after starting antidepressant medication

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

The nurse is helping a client with an eating disorder to accept the client's body image. The client must first learn effective coping skills. Which statement best describes the relationship between body image and coping skills?

Being able to cope in healthy ways improves the ability to accept a realistic body image.

Adolescents receiving treatment for psychiatric disorders can be suspicious and guarded. The nurse understands what as a major reason for this type of behavior?

Belief that they will be blamed for their problems

A personality disorder is defined as a collection of traits that do what?

Cause behavioral dysfunction and inner distress

The client's spouse calls the health clinic stating that the client is having a manic episode. What information should alert the nurse to recommend that the client should go to the emergency room for treatment?

Client is avoiding eye contact and visibly shaking.

The nurse is caring for a client whose spouse passed away several years ago. Upon assessment, the nurse finds that the client has a history of signs and symptoms of depression since the spouse's death. Which term correctly describes the client's response to the loss?

Complicated grief

Individuals with anorexia nervosa concentrate on which body cue?

Controlling food intake

The nurse documents that the client is in a state of panic anxiety when she is observed doing which of the following?

Crying hysterically and complaining of a shortness of breath prior to a cardiac procedure

A client who otherwise is healthy is admitted for depression and reports feeling "all alone." The client reports recently losing a spouse to divorce. The client admits to drinking at least 12 beers every day. The client has which risk factors for the depression? Select all that apply.

Current substance use or abuse Life and environmental stressors Lack of coping abilities

A nurse is reviewing a journal article about the etiology and risk factors associated with the development of eating disorders. The nurse demonstrates understanding of the information by identifying which factor as being reflective of biologic theories? Select all that apply.

Decreased serotonin levels Genetic vulnerability Alterations in brain structures

An elderly client is admitted to the hospital with fatigue and weight loss of 20 pounds in 1 month. Upon further assessment, the client is diagnosed with depression. What other thing should the nurse assess this client for based on the weight loss?

Dehydration

The nurse is conducting an admission assessment of a client who has a history of generalized anxiety disorder. After gauging the client's level of anxiety, what other assessment should the nurse prioritize?

Determining whether there is potential for the client to harm himself or herself or others Correct response:

An example of a situational crisis is ...

Divorce

After teaching a group of nursing students about neurotransmitters associated with schizophrenia, the nursing instructor determines that the education was successful when the students identify what as playing a role in the positive symptoms of schizophrenia?

Dopamine

Which disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode?

Dysthymic disorder

The nurse provides education to a client who is experiencing wellness challenges due to a diagnosis of depression in which the client reports of lack of energy and sadness. Which strategy is appropriate to enhance coping with a lack of energy and sadness?

Encourage the client to start with easy tasks, such as talking to a friend.

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

Escitalopram

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

Which type of antipsychotic medication is most likely to produce extrapyramidal effects?

First-generation antipsychotic drugs

Which medication has been found to be worthy of a trial in clients with bulimia nervosa who have obsessive-compulsive traits?

Fluoxetine

A nurse is preparing to administer prescribed antipsychotic medication to a client with psychosis. The nurse identifies the prescribed medication as a first-generation antipsychotic drug. Which drug would the nurse most likely be administering?

Fluphenazine

Exacerbation of anorexia nervosa results from the client's effort to do what?

Gain control of one part of life

After teaching a group of nursing students about intellectual disability, the instructor determines that the teaching was successful when the students identify which as the most common etiology?

Genetic syndromes

A Global Assessment of Functioning (GAF) score of 80 would indicate which of the following?

Healthy functioning

The nurse is working in a prison setting with a client diagnosed with Antisocial Personality Disorder (ASPD). The client has identified impulse control issues particularly around urges for sexual intimacy. The client has assaulted people who have interfered with their gratification. What is the priority intervention for the nurse?

Helping to express anger in an adaptive and non-violent manner

The nurse is preparing to administer thiothixene to a client with schizophrenia and assesses muscle rigidity, a temperature of 103°F (39.4°C), an elevated serum creatinine phosphokinase level, stupor, and urinary incontinence. Which is the priority action by the nurse?

Hold the medication and notify the health care provider.

A nurse is developing the plan of care for a client with bulimia. Which intervention would the nurse most likely include?

Increasing client's coping skills for anxiety

Side effects of methylphenidate for ADHD:

Insomnia, weight loss, loss of appetite

A nurse is providing education to a group of parents who have children with attention deficit hyperactivity disorder (ADHD). Which statement would be accurate and should be included in the education? Select all that apply.

It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem. Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems. ADHD is not the fault of the parents or the child and techniques and school programs are available to help.

For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders?

It is much more difficult to diagnose psychiatric disorders in children and adolescents.

A nurse is reviewing the biologic theories associated with borderlline personalilty disorder. The nurse demonstrates understanding of the information by identifying which areas as being associated with brain dysfunction tied to borderline personality disorder? Select all that apply

Limbic system Frontal lobe

A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy?

Liver function

A client diagnosed with panic disorder has been receiving medication therapy, which is being discontinued. A nurse would be alert for possible withdrawal symptoms if the client was receiving what?

Lorazepam

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.

Mood disorder in first-degree relatives Substance abuse Divorced

A client presents to a mental health clinic. The nurse notes that the client is grandiose and brags that that they earn "a six-figure income" and tells the nurse that they are more well known that the president. Which diagnosis is grandiosity associated with?

Narcissistic personality disorder

The nurse is teaching a class to a group of individuals diagnosed with anxiety disorders. When describing the underlying cause of these disorders, which information would the nurse most likely include?

Neurotransmitter involvement

What is accurate regarding a crisis?

Occurs when an individual is at a breaking point

A couple comes to the emergency department with their 5-month-old child that is not breathing or with a pulse. After resuscitation efforts, the child dies in the emergency department (ED) with the parents in attendance. Which action by the parents will help with the grieving process?

Plan funeral arrangements for the child.

A nurse is preparing to assess a school-aged child. Which method would be most effective for the nurse to use to establish rapport with this child?

Playing cards

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

A nurse detects that a client is experiencing panic-level anxiety. Which intervention should be immediately implemented?

Provide calm, brief, directive communication

Which extrapyramidal side effect is noted by a client who has bradykinesia and a shuffling gait?

Pseudoparkinsonism

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?

Psychomotor retardation

A client has been admitted to a psychiatric-mental health facility in a manic state. The client's spouse accompanies the client to the facility and informs the nurse that the client has been displaying manic symptoms for the past 2 weeks. The spouse reports that the client has not slept for the past 2 days and that the client has not eaten anything for at least 3 days. Which would be the priority nursing diagnosis for this client?

Risk for imbalanced nutrition

Which would be the priority nursing diagnosis for a client diagnosed with borderline personality disorder (BPD)?

Risk for self-mutilation

Some research has suggested that schizophreniform disorder may be an early manifestation of which other mental health condition?

Schizophrenia

A client with major depression is prescribed paroxetine. The nurse develops an education plan for the client based on the understanding that this drug belongs to which class of drugs?

Selective serotonin reuptake inhibitors

Clients with borderline personality disorder (BPD) are usually admitted to the inpatient setting because they exhibit what?

Self-harm

Which behaviors are associated with purging? Select all that apply.

Self-induced vomiting Use of laxatives Misuse of diuretics Use of enemas

According to psychodynamic theorists, anxiety develops from which of the following?

Separation and loss

An adolescent client has been diagnosed with anorexia nervosa. Which intervention should be included in the client's plan of care?

Set up a strict eating plan for the client

A nurse who provides bereavement counseling is working with the family of a child who recently died from cancer. Which of the following statements may be a common expression of grief and guilt a by family member?

Sister: "It is all my fault; I wanted him to die."

A nursing student has difficulty with the rigorous workload of courses during the first semester of nursing school and does not pass all required classes. The type of crisis the student is experiencing is which of the following?

Situational crisis

A nurse is assessing a client experiencing grief reaction. Which finding would the nurse expect to note as an emotional grief response? Select all that apply.

Sobbing Irritabilty

When performing a spiritual assessment on a child, the nurse and child discuss church attendance and practices that are most important to the child. Which domain is the nurse addressing when doing this assessment?

Social

Administration of lithium affects which electrolyte?

Sodium

A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?

Somatic

A client with depression appears lethargic and apathetic but agrees to participate in a leisure activity group. Which of the following actions by the nurse is most likely to help the client be successful in this group?

Structuring the activity to facilitate completion of one specific task

A client who is taking paroxetine reports to the nurse that the client has been nauseated since beginning the medication. Which action is indicated initially?

Suggest that the client take the medication with food.

The parents of a child with attention deficit hyperactivity disorder (ADHD) bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives the first dose of methylphenidate at about 7:30 a.m. every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 p.m. Which might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Switch to a longer-acting preparation.

When a parent observes the parent's young child heading toward a busy road the parent becomes stressed, feeling the parent's heart pounding, breathing heavily, and hands becoming wet with perspiration. Which physiological system is activated with the parent's "fight or flight" reaction to this danger?

Sympathetic nervous system

The nurse is working with a child with a mental health problem and the family must be included in the care. Which is one of the best ways the nurse can advocate for the child?

Teach the parents age-appropriate expectations of the child.

The nurse conducts an assessment to rule out antisocial personality disorder (ASPD) in a young adult. What aspect of the client's childhood is the priority assessment?

Temperament

A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation?

The client is experiencing catatonia.

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?

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

A nurse cared for a terminally ill client over a month and developed a therapeutic nurse-client relationship. After the client's death, feelings of sadness, sleeping poorly, and feeling mildly depressed were experienced by the nurse. Which is the best action to improve resolution of grief?

The nurse and should seek an informal forum for discussing death.

A client who is a lawyer is meeting with a nurse therapist for the first time. The client has been highly anxious and increasingly consumed with thoughts about how he may have mismanaged a case and possibly committed malpractice. He relates that he has been pacing in his office and at home and cannot think clearly about what to do next. Which of the following interventions is appropriate at this time?

The nurse asks the client to relate the events that immediately preceded his feelings of anxiety.

A diagnosis of delusional disorder is based on the presence of one or more nonbizarre delusions for at least what period of time?

1 month

A client with bipolar disorder is receiving lithium therapy. The nurse is reviewing the client's serum plasma drug levels and determines that the client's level is therapeutic based on what?

1.0 mEq/L

An individual with which body mass index (BMI) would be classified as having mild anorexia nervosa?

17.4 kg/m2

For a person to be diagnosed with antisocial personality disorder, the individual must be a minimum of what age?

18 years