Cumulative Psych Nursing
Which of the following factors is not associated with increased incidence of NCD due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age
a
Which of the following is a concern with children on long-term therapy with CNS stimulants for ADHD? a. Addiction b. Weight gain c. Substance abuse d. Growth suppression
a
If someone who has voluntarily chosen to be hospitalized should want to leave the hospital, which assessment would be the most important in deciding to release the client against medical advice (AMA)? a. potential danger to self or others b. reason that client wants to leave c. response to medication d. mental status of client
a
Which medication should the nurse give to immediately relieve the muscle spasms in the client's neck and jaw? A. Lorazepam (Ativan) IM. B. Benztropine (Cogentin) PO. C. Diphenhydramine (Benadryl) IM. D. Acetaminophen (Tylenol) PO.
C (relieves symptoms of dystonia)
Mrs. S. asks the nurse, "Do you think I should tell my husband about my affair with my boss?" Which is the most appropriate response by the nurse? a. "What do you think would be best for you to do?" b. "Of course you should. Marriage has to be based on truth." c. "Of course not. That would only make things worse." d. "I can't tell you what to do. You have to decide for yourself."
a
Which technique is most useful in helping a client with AD recognize the bathroom? a. place a picture of a toilet on the bathroom door b. place a sign that says "bathroom" on the bathroom door c. place a colored flag on the bathroom door d. place a colored strip of tape at the bathroom entrance
a (Picture recognition is a useful tool in helping the client with AD)
How should the nurse should explain the therapeutic effect of donepezil (Aricept) to the couple? a. Improves thinking and functioning abilities b. restores destroyed cells c. decreases hallucinations and delusions d. reduces periods of depression
a (Stabilizes cognitive decline. Aricept is an acetylcholinesterase inhibitor, is used in AD to delay the onset of cog decline.)
Two months later the patient's spouse calls to update nurse. Which information indicates that the Trazodone is having the desired effect? a. the patient sleeps through the night b. the patient is able to control the bladder c. the patient often wanders around the house d. the patient denies feeling any pain
a (Trazodone is an antidepressant often used to improve sleep with AD patients)
Which of the following is NOT a positive symptom treatment of antipsychotics? a. Avolition b. delusions c. hallucinations d. muddled speech and disorders of thinking
a (avolition, withdrawal, poor memory, and impaired personal hygiene are negative. Phenothiazines target positive symtpoms. Atyicals target negative and positive.)
The nurse asks Bob is he has any allergies to meds. He reports an allergy to Haldol. "My neck got real stiff, and I couldn't move it". What type of reaction should the nurse suspect? a. dystonia b. parkinsonism c. akathisia d. synergistic
a (dystonia is acute, tonic muscle spasms often of head and facial muscles that may occur in first few days of antipsychotic medication treatment)
What is the safe, therpeutic blood level for lithium? a. 1-1.5 mEq/L for acute mania and 0.6-1.2 mEq/L for maintenance b. 2 mEq/L for acute mania and 1 mEq/L for maintenance c. 3.5 mEq/L for acute mania and 2 mEq/L for maintenance d. 2000 to 3000 mL per day
a (levels over 2 mEq/L could cause tremors, sedation, and confusion. Levels over 3.5 mEq/L could cause delirium, seizures, coma, cardiovascular collapse, and death. Fluid intake should be 2000 to 3000 mL per day)
Which medication with potentially life-threatening side effects should the nurse expect the healthcare provider to prescribe for client who do not respond to the use of other antipsychotics? a. clozapine (clozaril) b. perfenazine (trilafon) c. fluphenazine decanoate (prolixin decanoate) d. haloperidol decanoate (haldol decanoate)
a (when a client fails to respond to antipsychotic meds this long acting one may be initiated. Though it does have potentially serious side effects like agranulocytosis which requires a WBC done every week or 2 weeks)
Sally was sexually abused as a child. She is a client on the milieu unit with a diagnosis of borderline personality disorder. She has refused to talk to anyone. Which of the following therapies might the IDT team recommend for Sally? (Select all that apply.) a. Music therapy b. Art therapy c. Seclusion d. Electroconvulsive therapy
a and b
Which of the following are NOT the components of the Mental status assessment? (Select all) a. Family History b. appearance c. behavior d. financial status e. speech f. mood g. affect h. thought content i. thought process j. attention and concentration k. orientation l. memory m. judgement and insight
a and d
Clozapine (Clozaril) is an antipsychotic required to have an approved risk evaluation and mitigation strategy (REMS) program. Which of the following actions are included in that program? (Select all that apply.) a. Absolute neutrophil counts are assessed before initiation of treatment. b. Initially only 1-week supply of clozapine is dispensed at a time. c. Acceptable ANC levels for continuation of treatment are identified as 1,500 µL. d. Patients are not permitted to smoke cigarettes while on clozapine.
a, b, and c
Which of the following are basic assumptions of milieu therapy? (Select all that apply.) a. Each individual owns his or her own environment. b. Each individual owns his or her behavior. c. Peer pressure is a useful and powerful tool. d. Inappropriate behaviors are punished immediately.
a, b, and c
Which of the following behaviors suggests a possible breach of professional boundaries? (Select all that apply.) a. The nurse repeatedly requests to be assigned to a specific patient. b. The nurse shares the details of her divorce with the patient. c. The nurse makes arrangements to meet the patient outside of the therapeutic environment. d. The nurse shares how she dealt with a similar difficult situation.
a, b, and c
Which of the following nursing interventions are appropriate to address safety issues for patients at risk for psychiatric drug interactions? (select all) a. Monitor I&O b. Provide heat or cooling blankets c. Use soft restrains to protect from injury d. Monitor vital signs
a, b, and d (you should protect the patient from injury if they have muscle rigidity or change in mental status, but restrains should be limited and require a doctors order. They are not considered a nursing intervention.
The nurse is concerned that the patient will develop sundowning syndrome. Which instructions should be included when teaching some measures to reduce this problem? (select all) a. provide relaxing backrubs at bedtime b. keep light on in the bedroom at night c. eliminate fluid intake after the evening meal d. increase toileting to every hour from supper until bedtime e. provide a calm atmosphere during the day
a, b, and e
What are the advantages for prescribing the atypical antipsychotic, olanzapine (Zyprexa)? A. Lower incidence of extrapyramidal symptoms (EPSEs). B. Rapid onset. C. Less weight gain. D. Alpha-adrenergic blockade. E. Acute and maintenance therapy.
a, b, and e
Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? (Select all that apply.) a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne)
a, b, and e
A patient with schizophrenia will experience which benefit from Prolixin if administered intramuscular? a. prevent more extra-pyramidal side effects b. maintain long term medication compliance c. prevent risk of cardiac or renal disease d. minimize side effects from benztropine (congentin)
b (this is a long acting medication needed every 7 to 28 days)
Which side effects would the nurse most likely observe with Prolixin, a traditional antipsychotic? a. blood dyscrasias such as thrombocytopenia b. high extrapyramimdal effects, low anticholinergic effects c. high antiholinergic effects and low extrapyramidal effects d. risk for agranulocytosis, fever, and elevated blood pressure
b (true for traditional anti-psychotics)
Which side effects are characteristic of atypical antipsychotics? a. increased tardive dyskinesia b. dry mouth c. more extrapyramidal effects d. fewer extrapyramidal effects e. less incidence of weight gain
b and d (anticholinergic side effects and and fewer extrapyramidal effects)
Which lab values from the urinalysis can the nurse expect to be related to Adam's 10-pound weight loss in the past 2 weeks? A. Positive for red blood cells. B. Positive ketones. C. Decreased urine pH. D. Increased urine specific gravity. E. Absence of glucose.
b and d (increased specific gravity means dehydration which could make weight loss worse and ketones in urine suggest malnutrition and starvation)
Which of the following tasks are associated with the orientation phase of relationship development? (Select all that apply.) a. Promoting the patient's insight and perception of reality. b. Creating an environment for the establishment of trust and rapport. c. Using the problem-solving model toward goal fulfillment. d. Obtaining available information about the patient from various sources. e. Formulating nursing diagnoses and setting goals.
b and e
Which assessment data are the best indicators of the potential for violence? A. Gender and age. B. Past suicide attempts. C. History of violence. D. Medication compliance. E. Medication noncompliance.
b, c, and e
Bob talks to the nurse for nearly 30 mins without mentioning FBI agents in his apartment. When the nurse asks him about plans for discharge, Bob states that he wants to return to his apartment. He denies having any thoughts of hurting himself or others. The treatment team meets to review Bob's discharge plan and response to the new atypical antipsychotic. The discharge plan is to dismiss Bob in 1 week. A criterion for discharge is that Bob will attend a weekly wellness group. What will be the most important group activity to promote wellness in the community? a. identify community coping resources b. practice social skills c. explore symptom management d. review education about medications
c
In prioritizing care within the therapeutic environment, which of the following nursing interventions would receive the highest priority? a. Ensuring that the physical facilities are conducive to achievement of the goals of therapy b. Scheduling a community meeting for 8:30 each morning c. Attending to patients' physiological and safety needs d. Establishing contacts with community resources
c
Initial symptoms of lithium toxicity include which of the following? a. Constipation, dry mouth b. Dizziness, thirst c. Vomiting, diarrhea d. Anuria, arrhythmias
c
Joselyn is a new patient at the mental health clinic. She has been diagnosed with Body Dysmorphic Disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie? a. Alprazolam (Xanax) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Olanzapine (Zyprexa)
c
Judy has been in the hospital for 3 weeks. She has used Valium "to settle her nerves" for the past 15 years. She was admitted by her psychiatrist for safe withdrawal from the drug. She has passed the physical symptoms of withdrawal at this time but states to the nurse, "I don't know if I will make it without Valium after I go home. I'm already starting to feel nervous. I have so many personal problems." Which is the most appropriate response by the nurse? a. "Why do you think you have to have drugs to deal with your problems?" b. "Everybody has problems, but not everybody uses drugs to deal with them. You'll just have to do the best that you can." c. "Let's explore some things you can do to decrease your anxiety without resorting to drugs." d. "Just hang in there. I'm sure everything is going to be okay."
c
On Tom's day of discharge from the hospital, his wife brings a bouquet of flowers and box of chocolates to give to his primary care nurse. Tom presents these gifts to the nurse saying, "Thank you for taking care of me." What is a correct response by the nurse? a. "I don't want a gift from you!" b. "Thank you so much! I think you're really extra special, too!" c. "Thank you. I will share these with the rest of the staff." d. "I love chocolate but let me pay you for them!"
c
Sandy, a patient with OCD says to the nurse, "I've been here four days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness. b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior.
c
Tam has a new diagnosis of panic disorder. Dr. S has written a prn order for alprazolam (Xanax) for when Tam is feeling anxious. She says to the nurse, "Dr. S prescribed buspirone for my friend's anxiety. Why did he order something different for me?" The nurse's answer is based on which of the following? a. Buspirone is not an antianxiety medication. b. Alprazolam and buspirone are essentially the same medication, so either one is appropriate. c. Buspirone has delayed onset of action and cannot be used on a prn basis. d. Alprazolam is the only medication that really works for panic disorder.
c
The night nurse finds Mrs. G, a client with Alzheimer's disease, wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which statement by the nurse reflects the most patient-centered approach to the situation? a. "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." b. 'You look confused, Mrs. G. What is bothering you?" c. "This is the patio door, Mrs. G. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while."
c
The patient's spouse described behaviors like memory loss, wandering, inability to do self-care, incontinence, and limited conversational ability. Which is the best response by the nurse to explain what the spouse can expect next? a. "They are showing signs of late stage disease and will soon stabilize at the current level of functioning" b. "The HCP will explain the disease progression at your next appointment" c. Every person responds differently to the disease, but it is likely that there will be continued decline" d. It is important to maintain a positive attitude and not worry about what will happen next"
c
What is the most accurate assessment if the client believes that the healthcare providers are FBI agents and that there are cameras in his apartment to monitor his moves? a. confabulation b. thought broadcasting c. delusions d. hallucinations
c
What must be done before starting lithium, an antimanic mood stabilizer? a. Serum blood level b. 2 weeks without salt c. Renal and thyroid test d. Stopping all medication 1 week prior
c
When the nurse asks a patient to share one goal for the day in community meeting, he states, "I'm going to take a shower and ..." He pauses for several seconds and begins talking again. Which thought process does this exemplify? a. concrete thinking b. flight of ideas c. thought blocking d. word salad
c
Which nursing problem should be included on the treatment plan for someone with avolition? a. anxiety b. confusion c. social isolation d. impaired adjustment
c
Which of the following activities would be a responsibility of the clinical psychologist member of the IDT team? a. Locates halfway house and arranges living conditions for patient being discharged from the hospital b. Manages the therapeutic milieu on a 24-hour basis c. Administers and evaluates psychological tests that assist in diagnosis d. Conducts psychotherapy and administers electroconvulsive therapy treatments
c
Which of the following is NOT a symptom of hypertensive crisis? a. fever b. Nausea and vomiting c. diarrhea d. severe occipital headache e. sore neck f. palpitations g. chest pain
c
Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid b. Group therapy with other people with agoraphobia c. Facing her fear in gradual step progression d. Hypnosis
c
Which example represents the forgetfulness typical of Alzheimer's disease? a. forgetting to buy all the ingredients needed to prepare a meal b. forgetting to invite the neighbor over for a meal c. forgetting to serve dinner after preparing the meal d. forgetting to put the dirty dishes in the dishwasher
c (The other options are typical for average people)
What neurotransmitter is targeted by haloperidol (Haldol)? A. GABA. B. Serotonin. C. Dopamine. D. Norepinephrine.
c (anti-psychotics block excessive dopamine, an excitatory neurotransmitter)
Mrs. G, who has NCD due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now."
b
The initial care plan for a patient with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the patient's bathroom locked so she cannot wash her hands all the time. b. Structure the patient's schedule so that she has plenty of time for washing her hands. c. Place the patient in isolation until she promises to stop washing her hands so much. d. Explain the patient's behavior to her because she is probably unaware that it is maladaptive.
b
The nurse recognizes that caregivers need respite from the constant demands. Which option provides the best respite? a. Hospice care b. Adult day care c. Meals on Wheels d. A visiting nurse to assess status
b
The patient progressively gets worse at home. Which member of the home care team should be assigned to revise the plan of care to reflect her changing condition? a. the nurse manager of the home health agency b. the home health RN who visits every other week c. The home health LPN who visits twice a week d. the home health aide who visits three times a week
b
The patient's spouse calls and advises that the patient is deteriorating more quickly than they were expecting. They states it's only been 2 years, "I thought this disease progressed slowly, Am I doing something wrong." What response should the nurse give regarding AD? a. Alzheimer's disease is a rapidly progressing disease, with deterioration that results in a typical lifespan of 2 to 5 years b. Alzheimer's disease is a chronic disease that can progress with no set sequence and that has a typical lifespan of 5 to 20 years c. Alzheimer's disease is a chronic, progressive disease with a clearly defined course and a typical lifespan of 20 to 30 years d. Alzheimer's disease is a chronic disease that stabilizes after an initial rapid deterioration and has no defined lifespan
b
There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed which of the following levels? a. 0.15 mEq/L b. 1.5 mEq/L c. 15 mEq/L d. 150 mEq/L
b
What is the reason that doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed? a. To prevent orthostatic hypotension b. To prevent seizures c. To prevent hypertensive crisis d. To prevent extrapyramidal symptoms
b
Which findings depicts negative symptoms of schizophrenia? a. rapid and disorganized speech b. flat affect and social inattentiveness c. delusional statements d. difficulty sitting still
b
Which of the following activities would be a responsibility of the psychiatric clinical nurse specialist on the IDT team? a. Manages the therapeutic milieu on a 24-hour basis b. Conducts group therapies and provides consultation and education to staff nurses c. Directs a group of patients in acting out a situation that is otherwise too painful for a patient to discuss openly d. Locates halfway house and arranges living conditions for patient being discharged from the hospital
b
A patient is scheduled for MRI and PET. The patient's spouse asks the nurse what these tests will show. What is the best response by the nurse? a. "These tests are only used to help ruse out other causes for patients symptoms, since there are no tests that can be used to diagnose Alzheimer's disease" b. "The healthcare provider is looking for changes in the brain that are consistent with Alzheimer's disease or for other conditions that can cause patients symptoms" c. "The tests will provide information about the staging of Alzheimer's disease, so the healthcare provider will know which medications to prescribe for the best treatment" d. "The imaging test results will be used to analyze the effectiveness of the treatment protocol used to shrink the diseased brain tissue"
b (Alzheimer's doesn't have specific diagnostic tests, but imaging provides significant data to make conclusions about Alzheimer's and dementia)
The spouse reports that the patient frequently makes statements that are inaccurate, but he is reluctant to correct her too often, because they say they feel stupid. What is the best response by the nurse? a. "You must correct inaccurate statements to promote reality orientation" b. "You are right to balance feelings with the need to promote reality" c. They are attempting to manipulate you and make sure they get their way" d. "There is no reason to correct them because they will not understand"
b (As AD progresses, reality orientation often causes the client to become agitated.)
The nurse administers a mental status exam to assess cognitive function. This exam includes which component? a. Appetite b. Judgement c. pupillary response d. babinski's reflex
b (Judgment. Eval includes assess of attention, concentration, judgment, perception, learning, memory, communication, language, and speed of processing information.)
Because the patient is taking Aricept, the nurse should schedule her for lab test in 6 months. Which lab test should be scheduled? a. serum BUN and creatinine b. serum liver enzymes c. urinalysis d. white blood count
b (Serum liver enzymes. Liver toxicity is a side effect of acetylcholinesterase inhibitors.)
The patient is placed in long-term care facility. The spouse = states, " I think she would be better off if she died, but I feel so guilty for even thinking that." Which response is best for the nurse to provide? a. "I would feel guilty for thinking that too" b. "Why do you feels he would be better off?" c. "You are probably just too tired to think clearly" d. "You have many conflicting emotions right now"
d
Nancy, a depressed patient who has been unkempt and untidy for weeks, today comes to group therapy wearing makeup and a clean dress and having washed and combed her hair. Which of the following responses by the nurse is most therapeutic? a. "Nancy, I see you have put on a clean dress and combed your hair." b. "Nancy, you look wonderful today!" c. "Nancy, I'm sure everyone will appreciate that you have cleaned up for the group today." d. "Now that you see how important it is, I hope you will do this every day."
a
What is the most important benefit Adam can receive from his attendance at the community meeting? A. Reality orientation. B. Limits set on behaviors. C. Psychosocial skills. D. Mutual goal setting.
A
Why is Adam prescribed this medication? A. To reduce severity of extrapyramidal effects. B. To prevent the risk for tardive dyskinesia. C. To potentiate haloperidol (Haldol) so that it will be more effective. D. To further alleviate dystonic reactions.
A
Which of the following are extrapyramidal side effects? (select all) a. Pseudoparkinsonism b. Akinesia c. Akathisia d. Dystonia e. Oculogyric crisis f. Tardive dyskinesia
All ( tremor, shuffling gait, drooling, rigidity, absence or impaired movement, continuous restlessness and fidgeting, involuntary facial spasms, uncontrolled rolling back of the eyes, and tardive dyskinesia are all extrapyramidal side effects)
Which of the following are safety issues for patients taking antianxiety agents? (select all) a. tolerance b. abrupt withdrawal c. drowsiness, confusion and letharthy d. anxiety and depression e. orthostatic hypotension f. paradoxical excitment g. blood dyscrasias h. congenital malformations
All of the above (patients cannot stop taking the drug abruptly or they may experience N&V, sweating, agitation, tremors, delirium, and seizures; assess for suicide risk; assess for unusual bleeding or flu like symptoms; should not take if pregnant)
When Adam looks around the room and mumbles to himself, how should the nurse respond? A. "How are you feeling?" B. "Are you hearing voices?" C. "Have you been here before?" D. "Tell me what you're thinking."
B
Which action should the nurse implement first? A. Offer Adam a glass of juice and ask him if he ate breakfast. B. Take Adam's blood pressure while he is sitting and standing. C. Tell Adam that his dizziness is orthostatic hypotension that will subside after he eats. D. Hold the morning dose of haloperidol (Haldol), and notify the healthcare provider.
B
Which assessment data provides evidence that Adam can be involuntarily committed to the hospital, if he insists on leaving? A. Past history of suicide attempts. B. Losing 10 pounds in 2 weeks. C. Auditory hallucinations. D. Persecutory delusions.
B (unable to provide for one's own basic needs requires immediate treatment, it is considered a danger to oneself)
When Adam explains that someone has been following him and is waiting outside the door of the ED, how should the nurse respond? A. "Believe me. No one has followed you here." B. "You must be concerned, but you are safe here." C. "The police will make sure no one is out there." D. "Why do you think that someone is out there?"
B (you want to respond to the underlying emotion, not question them about the delusion or play into the delusion)
On what aspect is it most important for the nurse to perform follow-up before discharge? A. Contracts to follow discharge plans. B. Resources to provide community support. C. Thoughts of harm to self or others. D. Significant others for support.
C
What is a goal of being in this activity group? A. Learn social behaviors and gain insight about one's personality. B. Gain information about disorders, symptoms, and medications. C. Gain self-acceptance and express feelings. D. Identify and resolve specific problems related to the treatment plan.
C
What is the purpose of a baseline complete blood count (CBC) prior to initiation of the antipsychotic medication? A. To determine the presence of cardiac disease. B. To monitor for hepatotoxicity. C. To determine if other medical issues are present. D. To assess elevations in liver enzymes.
C
Which term fits the nurse's observation that Adam looks to the corner of the room and mumbles to himself? A. Delusions. B. Depersonalization. C. Hallucinations. D. Disorientation.
C
Which thought process describes one's inability to leave their apartment because they think someone is waiting to kill them? A. Hallucination. B. Phobia. C. Delusions. D. Confabulation.
C
What is the difference between group process and group content? A. Group content refers to the group rules. Group process is how clients react to the rules. B. Group process refers to where the group meets, while group content refers to the type of group that is meeting. C. Group content is client-led and group process is nurse-led. D. Content includes the clients' words, and group process is how the clients communicate.
D
Which response from the client indicates that the haloperidol (Haldol) has been effective? A. Feels less anxious and nervous. B. Reports that mood is more stable. C. Initiates more social interactions. D. Experiences fewer hallucinations.
D
Adam admits that the voices he hears have been getting louder over the past couple of weeks. Which question should the nurse ask Adam next? A. "What helps the voices go away?" B. "How long have you heard voices?" C. "When do the voices get louder?" D. "What do the voices say?"
D (assess for command hallucinations)
What is the most important part of this admission process? A. Ask Adam if he has any valuables that need to be locked in a safe place. B. Allow Adam to explain his understanding of the reason for his hospital admission. C. Introduce Adam to the nursing staff and explain the role of the case manager and the staff members. D. Take away Adam's cigarettes and lighter.
D (safety issues)
True of False Patients taking Lithium and Chlorpromazine do not need to have blood levels drawn to monitor serium lithium levels.
False (Chlorpromazine may mask the early signs of lithium toxicity. Serum lithium levels should be monitored.)
True of False Akathesia is visible muscle rigidity, mainly seen in the facial muscle, but occasionally causes rigidity or twisting of all parts of the body.
False (the description given is Acute Dystonia. Akathesia is a feeling of nervousness or anxiety and is manifested through suicide, sexual dysfunction like chronic masturbation, or looking like they are in terror in extreme cases)
One of the goals of therapeutic community is for patients to become more independent and accept self-responsibility. Which of the following approaches by staff best encourages fulfillment of this goal? a. Including patient input and decisions into the treatment plan b. Insisting that each patient take a turn as "president" of the community meeting c. Making decisions for the patient regarding plans for treatment d. Requiring that the patient be bathed and dressed and attend breakfast on time each morning
a
Part of the nurse's continual assessment of the patient taking antipsychotic medications is to observe for extrapyramidal symptoms. Examples include which of the following? a. Muscular weakness, rigidity, tremors, facial spasms b. Dry mouth, blurred vision, urinary retention, orthostatic hypotension c. Amenorrhea, gynecomastia, retrograde ejaculation d. Elevated blood pressure, severe occipital headache, stiff neck
a
The UAP reports that the patient is weak, drowsy, and diaphoretic two afters receiving oxazepam. What action should the nurse take? a. evaluate the patients vital signs before transferring her to bed b. monitor blood glucose levels after they are in bed c. assist with transferring and turn on a night light d. advise the UAP to turn off the room light and let the patient stay in their chair
a
The nurse understands that the patient has a thought disorder rather than a mood disorder. Thought disorders include psychosis and schizophrenia. Which behavior is characteristic of a thought disorder? a. blunted affect b. irritability c. preoccupation with guilty feelings d. lability of mood
a
The patient has an infection and is admitted. By the second day of hospitalization, Mary's behavior becomes agitated. While the nurse is administering antibiotics she tries to climb out of bed and demonstrates hostile, belligerent behavior towards the nurse. What action should the nurse implement first? a. redirect the patient attention to holding a stuffed animal b. quietly leave the room until they calm down c. assign a UAP to remain with Esther d. Apply soft vest restrains and a bed alarm
a
Tina, who is experiencing a panic attack, has just arrived at the emergency department. Which is the priority nursing intervention for this patient? a. Stay with Tina and reassure her of her safety. b. Administer a dose of diazepam. c. Leave Tina alone in a quiet room so that she can calm down. d. Encourage Tina to talk about what triggered the attack.
a
What is the RNs role in the therapeutic milieu? a. Assessment, diagnosis, outcome identification, planning, implementation, and evaluation b. Therapeutic communication c. Safety and respect d. Communication and trust
a
True of False The FDA requires that all antiepileptic (anticonvulsant) drugs carry a warning label indicating that use of the drug increases risk for suicidal thoughts and behaviors. Patients being treated with these medications should be monitored for the emergence or worsening of depression, suicidal thoughts or behavior, or any unusual changes in mood or behavior.
True
True of False When a patient feels sadness and loss, behaviors to delay termination may become evident. If the nurse experiences the same feelings, he or she may allow the patient's behaviors to delay termination. For therapeutic closure, the nurse must establish the reality of the separation and resist being manipulated into repeated delays by the patient.
True
True or False Serotonin syndrome occurs when taking SSRI and manifests as hyperpyrexia, unstable VS, cognitive changes, hallucinations, muscle rigidity, seizures, renal failure, and death. It most commonly occurs with combinations of SSRI and MAOI or with street drugs like demerol, cocaine, and LSD.
True
True or False The nurse must convey an aura of trustworthiness, which requires that he or she possess a sense of self-confidence.
True (Confidence in the self is derived out of knowledge gained through achievement of personal and professional goals as well as the ability to integrate these roles and to function as a unified whole)
True of False Ensure that eye contact conveys warmth, is accompanied by smiling and intermittent nodding of the head, and does not come across as staring or glaring.
True (Staring or glaring can create intense discomfort in the patient)
True of False Patients taking antipsychotic medications may need to wear sunblock or sunglasses when in the sun.
True (antipsychotic medications may cause photosensitivity)
True of False Patients taking Clozapine have a lower seizure threshold.
True (assess for hx of seizure disorder and report seizure activity to physician)
True of False Developing trust means keeping promises. It means total acceptance of the individual as a person, separate from behavior that is unacceptable. It means responding to the patient with concrete behaviors that are understandable to him or her.
True. (If you are frightened, I will stay with you; If you are cold, I will bring you a blanket; If you are thirsty, I will bring you water)
A patient refuses treatment and wants to leave the ED. He is admitted involuntarily for 96 hours. What behavior validates the need for involuntary hospitalization? a. violence towards father b. guarded and suspicious c. diagnosis of schizophrenia d. beliefs about FBI surveillance
a
A patient with OCD spends many hours each day washing her hands. What is the most likely reason she washes her hands so much? a. To relieve her anxiety b. To reduce the probability of infection c. To gain a feeling of control over her life d. To increase her self-concept
a
After several weeks, a patient begins to demonstrate more initiative to attend daily groups without prompting by the nurse. He awakens in the morning for the community meeting but continues to answer questions only when asked. Answers are simple, one-word answers without any elaboration. Which speech process should the nurse document on the daily mental status exam record? a. poverty of speech b. tangential c. loose associations d. monotone
a
Chelsea says to the nurse, "I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!" Which is an empathetic response by the nurse? a. "You are very angry now. This is a normal response to your loss." b. "I know what you mean. Men can be very insensitive." c. "I understand completely. My husband is a jerk, too." d. "You are depressed now, but you will feel better in time."
a
How can you treat Acute dystonia? a. diphenhydramine b. massage c. water d. no treatment
a
How do antianxiety medications, such as benzodiazepines, produce a calming effect by which of the following actions? a. Depressing the CNS b. Decreasing levels of norepinephrine and serotonin in the brain c. Decreasing levels of dopamine in the brain d. Inhibiting production of the enzyme MAO
a
Which information indicates possible serious side effect of trazodone. (select all) a. patient is taking MAOIs b. patient is complaining of perineal pain c. patient has urinary urgency d. patient has a history of depression e. patient has a history of cardiac disease
a, b, and e (MAOIs and trazadone are antidepressants and cannot be used together/must have two weeks without one to start the other, a rare side-effect is engorgement of genitalia called priaprism, and trazadone may exacerbate coronary problems)
Annie has hair-pulling disorder. She is receiving treatment at the mental health clinic with HRT. Which of the following elements would be included in this therapy? (Select all that apply.) a. Awareness training b. Competing response training c. Social support d. Hypnotherapy e. Aversive therapy
a, b, c
To promote the well-being of a group of clients with AD, which goals are important for a nurse-manager of an adult day care center to include in the Plan of Care? (select all) a. provide forms of moderate sensory stimulation b. ensure opportunities for physical activity c. maintain a calm and consistent environment d. encourage games that include high energy levels e. incorporate pet therapy
a, b, c, and e
The nurse recognizes the spouse is experiencing caregiver role strain. What questions are most important to ask before developing the plan of care? (select all) a. "How are your children coping?" b. "What do you find most stressful in your daily life?" c. "Do you attend a caregiver support group?" d. "How must time do you spend taking care of yourself?" e. "What activities do you attend outside of your home?"
a, b, d and e
On the milieu unit, duties of the staff psychiatric nurse include which of the following? (Select all that apply.) a. Medication administration b. Patient teaching c. Medical diagnosis d. Reality orientation e. Relationship development f. Group therapy
a, b, d, and e
What symptoms should you assess to determine if a patient taking olanzapine is experiencing drug reaction with eosinophilia and systemic symptoms (DRESS)? (select all) a. fever b. hypotention c. rash d. facial swelling e. muscle rigidity
a, c, and d (hypotension may occur while taking antipsychotic medications, but it is not related to DRESS. Muscle rigidity may occur while taking antipsychotic medication, but is related to neuroleptic malignant syndrome)
A client is taking MAOI therapy. Which foods should the nurse instruct the patient to completely avoid? (select all) a. Aged Cheese b. All beans c. Wine and liquer d. Pickles and caviars e. Yeast, cultured dairy, and meat extract f. chocolate g. Carrotts h. Figs
a, c, and d (not all beans are restricted: but fava beans, flat Italian beans, and Chinese pea pods are. Carrots are not restricted. All foods that are restricted contain tyramine. Foods that one should completely avoid are high tyramine. Other foods like yogurt, chocolate, figs, and meat extract do contain moderate to low amounts tyramine, but are allowed in limited quantities)
In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (Select all that apply.) a. Personality b. Vision c. Speech d. Hearing e. Mobility
a, c, and e
The nurse provides teaching to help reduce urinary incontinence. Which actions should the spouse initiate? (select all) a. keep a commode at the bedside b. keep a bell handy to ring when needing to void c. take them to the bathroom every 2 hourss d. ask them if they need to use the restroom after meals e. establish a toileting scheduling that is consistent
a, c, d, and e
When the nurse is assessing cognitive function, which questions are appropriate to include in the mental status exam? (select all) a. ask patient to list three different types of fruits, colors, and animals b. tell patient to write a ten-sentence story about their childhood c. instruct patient to find fie different objects hidden in the room d. give patient a photo of a circle and ask them to fill in the times on the clock e. ask patient what they would do if they smelled gas in the house
a, d, and e (no complex tasks)
Which statement represents an accurate understanding of Alzheimer's disease? a. Changes in behavior and personality often occur in early Alzheimer's disease b. Behavior changes may indicate that she has already progressed to a later stage of the disease c. behavior changes are probably the result of her effort to cope with her altered mental function d. behavior changes usually indicate that the person is feeling depressed about the situation
a. (Subtle changes in behavior and personality, which would easily be recognized by a loved one, occur in early Alzheimer's. Other options may be contributing factors, but no other option is an early sign)
A patient taking antipsychotic medication is experiencing constipation. What are recommendations the nurse can make to help the patient with this issue? a. one hour daily exercise b. high fiber diet c. laxatives d. Call the doctor
b (regular exercise can help, but patients taking antipsychotics are at risk for tachycardia, hypotention, blurred vision, and dizziness. One hour a day may not be realistic. Laxatives should be prescribed. Call the doctor only after symptoms do not improve with other suggestions)
A patient states, "I refuse to shower in this room. I must be very cautious. The FBI has placed a camera in here to monitor my every move." Which of the following is the most therapeutic response? a. "That's not true." b. "I have a hard time believing that is true." c. "Surely you don't really believe that." d. "Let's search the room together to see if we can find a camera."
b
A patient's family member begins to cry. Which initial intervention should the nurse implement? a. Quietly leave the room until they have control of their emotions b. Remain seated next to them c. reassure them that they are taking the best action d. encourage them to share feelings at their support group
b
Abbey, an adolescent, just returned from group therapy and is crying. She says to the nurse, "All the other kids laughed at me! I try to fit in, but I always seem to say the wrong thing. I've never had a close friend. I guess I never will." Which is the most appropriate response by the nurse? a. "Why will you never have any friends?" b. "You're feeling pretty down on yourself right now." c. "I'm sure they didn't mean to hurt your feelings." d. "You don't need friends to be happy."
b
After 3 weeks of hospitalization, Bob continues to be delusional and to talk to himself. The nurse often finds him sitting alone in the dining area. He declines some of the group activities and sits for several hours without initiating any activity. Persistent nursing interventions are required to get Bob to perform routine tasks. Which nursing assessment accurately describes Bob's lack of energy? a. affective b. avolition c. apathy d. anhedonia
b
Antipsychotic medications are thought to decrease psychotic symptoms by which of the following actions? a. Blocking reuptake of norepinephrine and serotonin b. Blocking the action of dopamine in the brain c. Inhibiting production of the enzyme MAO d. Depressing the CNS
b
If extrapyramidal symptoms should occur, which of the following would be a priority nursing intervention? a. Notify the physician immediately. b. Administer prn trihexyphenidyl (Artane) as ordered. c. Withhold the next dose of antipsychotic medication. d. Explain to the patient that these symptoms are only temporary and will disappear shortly.
b
In the community meeting, which of the following actions is most important for reinforcing the democratic posture of the therapy setting? a. Allowing each person a specific and equal amount of time to talk b. Reviewing group rules and behavioral limits that apply to all patients c. Reading the minutes from yesterday's meeting d. Waiting until all patients are present before initiating the meeting
b
Jareth has a diagnosis of generalized anxiety disorder. His physician has prescribed buspirone 15 mg daily. Jareth says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse? a. "Xanax is not effective for generalized anxiety disorder." b. "Buspirone must be taken daily in order to be effective." c. "I will ask the doctor if he will change your dose of buspirone to prn so that you don't have to take it every day." d. "Your friend really should be taking the Xanax every day."
b
John tells the nurse, "I think lights out at ten o'clock on a weekend is stupid. We should be able to watch TV until midnight!" Which of the following is the most appropriate response from the nurse on the milieu unit? a. "John, you were told the rules when you were admitted." b. "You may bring it up before the others at the community meeting, John." c. "Some people want to go to bed early, John." d. "You are not the only person on this unit, John. You must think of others besides yourself."
b
Mr. Stone is a patient in the hospital with a diagnosis of vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following statements by the nurse is correct? a. "He will probably live longer than if his disorder was of the Alzheimer's type." b. "Vascular NCD shows stepwise progression. This is why he sometimes seems okay." c. "Vascular NCD is caused by plaques and tangles that form in the brain." d. "The cause of vascular NCD is unknown."
b
Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? a. Ensuring that she receives food she likes to prevent hunger b. Ensuring that the environment is safe to prevent injury c. Ensuring that she meets the other patients to prevent social isolation d. Ensuring that she takes care of her own ADLs to prevent dependence
b
Bob is admitted for 96hrs. The nurse reviews the routine admission lab and medication prescriptions and notes that the client will resume the Prolixin. The Cogentin has not been prescribed. Which nursing action is best? a. ask sam if he had any side effects from the prolixin b. do not give the prolixin and document the reason c. obtain a prescription to begin the congentin d. monitor sam for medication side effects
c (congentin will help prevent extrapyramidal side effects of prolixin, except tardive dyskenesia)
The nurse asks a patient what he would like to be called. He replies, "You've seen me on TV. My name is Bob!" The nurse assesses that Bob's behavior is guarded and suspicious. Based on this, what is the most important nursing intervention? a. Plan to give PRN antipsychotic b. maintain adequate social space c. establish rapport and trust d. assess for hallucinations
c (rapport and trust ~ sometimes more readily established through nonverbal communication)
A client with late stage AD becomes distraught when members try to reorient him to reality. Immediately after lunch, he starts yelling and screams in a loud voice that he is hungry. Which action should the nurse implement? a. confront the client about his disruptive behavior b. reorient the client to scheduled meal times c. provide a snack that the client can eat d. reassure the client that he has just eaten
c (this is validation therapy and is useful intervention to reduce client agitation)
Bob's healthcare provider decides to discontinue Prolixin and begins a new antipsychotic, Zyprexa. Which data is most important to obtain before Bob begins the Zyprexa, which is an atypical antipsychotic? a. screening for tardive dyskinesia b. complete blood count c. baseline weight d. orthostatic blood pressure
c (weight gain occurs with the atypical antipsychotics, especially zyprexa and clozapine)
What should you do if a patient taking olanzapine is experiencing drug reaction with eosinophilia and systemic symtpmos (DRESS)? a. Assess for newly developing impulse control problems b. Instruct patient to report ongoing signs of sore throat, fever or malaise c. Hold medication and contact the physician immediately d. Do not drive or operate dangerous machinery
c (you would assess for impulse control problems for patients taking aripiprazole, you would report signs of flu for clozapine, you would instruct the patients experiencing sedation to not operate or drive dangerous machinery)
An example of a treatable (reversible) form of NCD is one that is caused by which of the following? (Select all that apply.) a. Multiple sclerosis b. Multiple small brain infarcts c. Electrolyte imbalances d. HIV disease e. Folate deficiency
c and e
Which of the following interventions is most appropriate in helping a patient with Alzheimer's disease with her ADLs? (Select all that apply.) a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9:00 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform as many of her ADLs as possible independently.
c and e
Which serious, anticholinergic side effects are related to the use of benztrophine (Cogentin)? A. Feeling tired. B. Dizziness. C. Urinary retention. D. Hand tremors. E. Tachycardia.
c and e
What additional interventions are essential to a successful plan during the acute phase of the illness? (select all) A. Isolation. B. Daily activities. C. Consistency. D. Medications. E. Adequate rest.
c, d, and e
The nurse completes the mental status exam and records that the patients grooming and hygiene are fair. The patient continually paces the hall and is unable to sit still for longer than 1 or 2 minutes. His speech is rapid and difficult to follow. He describes his mood as "blase". His affect is anxious, and his facial expression is flat with a blank smile. He is inattention and appears distracted. The nurse understands that schizophrenia can be differentiated from psychosis by which assessment? a. disorganized speech b. disorganized behavior c. auditory hallucinations d. negative symptoms
d
After the nurse assists the patient to the bed, which nursing action has the highest priority with the following vital sign data: T 96.8 F, 98 BPM HR, 22 RPM, 74/44 BP, and 96% O2. a. administer O2 via nasal cannula b. notify HCP c. provide several warm blankets d. Educate UAP of need to rise slowly and monitor closely after sitting or laying down
d
Bill, who has been diagnosed with schizophrenia and has been on medication for several months, states, "I'm not taking that stupid medication anymore!" Which of the following responses demonstrates a motivational interviewing style of communication? a. "Don't you know that if you don't take your medication you will never recover?" b. "Why won't you cooperate with the treatment your doctor prescribed?" c. "Bill, the medication is not stupid." d. "Tell me more about why you don't want to take the medication."
d
Dorothy was involved in an automobile accident while under the influence of alcohol. She swerved her car into a tree and narrowly missed hitting a child on a bicycle. She is in the hospital with multiple abrasions and contusions. She is talking about the accident with the nurse. Which of the following statements by the nurse is most appropriate? a. "Now that you know what can happen when you drink and drive, I'm sure you won't let it happen again." b. "You know that was a terrible thing you did. That child could have been killed." c. "I'm sure everything is going to be okay now that you understand the possible consequences of such behavior." d. "How are you feeling about what happened?"
d
Education for the patient who is taking an MAOI should include which of the following? a. Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity b. Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks c. Short-term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter medications without physician notification
d
Joe has been in rehabilitation for alcohol dependence. When he returns from a visit to his home, he tells the nurse, "We were having a celebration and I did have one drink, but it really wasn't a problem." The nurse notices that his breath smells of alcohol. Which of the following responses by the nurse demonstrates a motivational interviewing style of communication? a. "You are obviously not motivated to change so perhaps we should discuss your discharge from the treatment program." b. "You need to abstain from alcohol in order to recover, so let me talk to your doctor about the consequences for your behavior." c. "Why would you destroy everything you've worked so hard to achieve?" d. "What do you mean when you say, 'it really wasn't a problem'?"
d
Mrs. G has been diagnosed with NCD due to Alzheimer's disease. This disorder is associated with the presence of which of the following? a. Multiple small brain infarcts b. Lewy bodies c. Cerebral abscess d. Amyloid beta plaques and neurofibrillary tangles
d
Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime. c. Make Mrs. G a cup of tea with honey before bedtime. d. Ensure that Mrs. G gets regular physical exercise during the day.
d
Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T experiences panic anxiety when she encounters snakes. b. Ms. T refuses to fly in an airplane. c. Ms. T will not eat in a public place. d. Ms. T stays in her home for fear of being in a place from which she cannot escape.
d
One of the behavioral interventions that the nurse plans to teach the clients is ways to cope with symptoms such as hallucinations and delusions. Which strategy is best for clients who hear voices? a. take more medication b. decrease caffeine use c. smoke more cigarettes d. avoid certain situations
d
Patient teaching is an important nursing function in milieu therapy. Which of the following statements by the patient indicates the need for knowledge and a readiness to learn? a. "Get away from me with that medicine! I'm not sick!" b. "I don't need psychiatric treatment. It's my migraine headaches that I need help with." c. "I've taken Valium every day of my life for the last 20 years. I'll stop when I'm good and ready!" d. "The doctor says I have bipolar disorder. What does that really mean?"
d
The spouse goes to a meeting one morning a week with people who are experiencing the same situation. One male member of the group jokes about the problems he has taking care of his spouse. How should the nurse respond to this person's joking behavior? a. Confront the man about his inappropriate behavior b. Help the man recognize the need to approach his responsibilities seriously c. Ask the other members of the group to ignore the man's behavior d. Encourage all group members to use humor as a coping mechanism
d
What is the first step the nurse should teach about effective symptom management? a. discuss other ways to manage symptoms b. review current ways to manage symptoms c. talk about specific support systems d. identify problem symptoms
d
Which nursing problem has priority? a. sensory-perceptual disturbance b. ineffective denial c. ineffective community coping d. disturbed thought processes
d
With implosion therapy, a client with phobic anxiety would be: a. Taught relaxation exercises. b. Subjected to graded intensities of the fear. c. Instructed to stop the therapeutic session as soon as anxiety is experienced. d. Presented with massive exposure to a variety of stimuli associated with the phobic object or situation.
d
The patient's spouse wants to wait until the patient worsens before they start the medication. How should the nurse respond? a. "That is a good idea because their condition will worsen, and they will develop a tolerance to the medication" b. "that may be beneficial, so do not start giving the patient the medication until I discuss this option with the healthcare provider" c. "This medication has many side effects, and it should be taken early in the disease while they are still physically strong" d. "This medication provides the most benefit to people with early stages of the disease so it is important to start it right away"
d (Acetylcholinesterase inhibitors, such as Aricept are most useful in stabilizing cog decline in early stages)
Which question is best to ask a patient and their spouse to elicit information about possible risk factors of Alzheimer's disease? a. "Do you have a family history of depression or manic behavior?" b. "Have you ever been diagnosed with thyroid gland problems?" c. "Have you recently experienced a stroke, cerebrovascular accident, or transient ischemic attack?" d. "Does anyone in your family have Alzheimer's disease?"
d (Alzheimer's disease seems to have a genetic predisposition. Other good options would be information about previous head trauma, exposure to toxic or metal waste, or viral illness. Modd disorders, thyroid problems, CVA, and TIA are not risk factors for Alzheimer's)
The patient's lab test include a CBC, TSH, T3, T4, electrolytes, BUN and glucose. The results are normal. How should the nurse explain this information to the patient and spouse? a. "These results probably indicate that the disease is in the early stages" b. "It is common for test results to change as the disease progresses" c. "Normal lab tests are not typical; the healthcare provider may want to test you again" d. "normal lab test results help rule out other causes of the symptoms"
d (Lab tests rule out treatable causes of dementia)
Tremors, parkinsonism, dizziness, and flu like symstomps are part of discontinuation syndromes for SSRIs, TCAs, and MAOIs. Which of the following is strictly associated with discontinuation syndrome for MAOIs? a. Akathisia b. cardiac arrhythmias c. panic attacks d. Myoclonic jerks
d (akathisia is associated with SRRI discontinuation, cardiac arrhythmias and panic attacks are associated with TCA discontinuation)
Which of the following is NOT en example of NONtherapeutic communication? a. I'm sure he must still love you. Everything will be fine. b. You shouldn't tell your wife c. I can't believe that's true d. What do you think you should do? Let's explore options for solving this.
d (all other options are NONtherapeutic communication)
Bob is unable to report his current med regimen, so the nurse contacts his case worker. Additional info from the case worker indicates that Bob has been sleeping only 3-4hrs each night for the past few nights. Bob has demonstrated less energy and states that he feels "really bad and pretty down". The case worker reports that Bob was taking Prolixin 5mg in the morning and 10mg at bedtime, along with Cogentin 2mg BID because he cannot afford the newer antipsychotics. Why is Prolixin prescribed? a. stabilize client's mood b. feelings of depression c. difficulty sleeping at night d. disorganized thoughts
d (anti-psychotic medication)
The nurse understands that an atypical antipsychotic requires what period of time to reach a steady state? a. 2 days b. 4 or more weeks c. 2 weeks d. 1 week
d (steady state is generally reached in 1 week)
What is sympathy? a. Validating a patient's emotions b. Briefly crying when a patient shares a difficult emotion/experience or smiling wide when a patient shares joy c. Seeing the patient's viewpoint clearly d. Sharing a personal story and opinion to show how you identify with a patient's emotions
d (the other options are forms of empathy. It is OK to cry with a patient as long as you do not get caught up in feelings or overly identify with the patient's emotions)
The patient is scheduled to go home. The patient indicates by her behavior that the IV site is painful. Which tasks can be delegated to the LPN. (select all) a. observe the IV site for phlebitis while d/c the IV b. teach the patient about oral antibiotics for home use c. communicate with the social worker regarding d/c needs d. administer first dose of oral antibiotics e. calculate the I/O
d and e
What nursing interventions should be included in the care plan that is initiated early after admission and reinforced until discharge? (select all) A. An understanding of psychosis and the causes of it. B. The importance of attending support groups after discharge. C. Depression and anxiety are common causes of psychosis. D. Client safety. E. The purpose and side effects of psychotropic medication
d and e
Which of the following is NOT risk while taking antidepressants? a. Risk for suicide b. Risk for social isolation c. Risk for depression d. Risk for injury related to sedation, lowered seizure threshold, and orthostatic hypotension e. Risk for constipation f. Insomnia g. Bleeding disorder
g
skip
skip
True or False All antidepressants carry an FDA black-box warning for increased risk of suicidality in children and adolescents.
true
True or False As antidepressants begin to take effect, the individual may have increased energy with which to implement a suicide plan.
true (the nurse should be particularly alert to sudden or dramatic changes in mood)
