Mental Health Disorders & Addictions

Which disorder would the nurse classify as neurodevelopmental?

ADHD

Which meds are associated with sedation as a side effect? Select all that apply. Doxepin Zaleplon Suvorexant Nefazodone Mirtazapine Clonazepam

All of them Doxepin Zaleplon Suvorexant Nefazodone Mirtazapine Clonazepam

Which signs & symptoms are the "four A's" of Alzheimer's disease?

Amnesia Apraxia Agnosia Aphasia

Which action would the nurse take for a client with a diagnosis of conversion disorder manifesting as a paralysis of the legs?

Avoid focusing on the client's physical symptoms The physical symptoms are not the client's major problem & should not be the focus of care

Define Grandeur

Belief that you have great power, knowledge, or talent

Define confabulation

Filling in gaps of memory with false information It's used as a protective mechanism

Which term describes the client's use of made-up words that have no meaning to other people?

Neologisms

Which interventions would the nurse include when developing a plan of care for a client in the manic phase of bipolar disorder?

Redirect the client's excess energy to more constructive activities The hyperactive client is usually easily distracted

Define sadism

achievement of sexual satisfaction from the physical or psychological suffering (including humiliation) of the victim

Which intervention would the nurse use to promote the safety of a client experiencing alcohol withdrawal?

administer chlordiazepoxide because alcohol withdrawal can cause seizures & autonomic hyperactivity

When providing a change-of-shift report, which explanation would the nurse use to describe a schizophrenic client who is experiencing opposing emotions simultaneously?

ambivalence

For a client with OCD, which reaction is most likely to occur when the performance of a ritual is interrupted?

anxiety

Which feelings are often the basis of OCD?

anxiety & guilt Ritualistic behaviors seen in this disorder are aimed at controlling feelings of anxiety & guilt by maintaining an absolute set pattern of action.

Which behavior is most associated with narcissistic personality disorder?

arrogance

Which type of hallucination is the most common?

auditory

Define command hallucinations

auditory hallucinations that give verbal messages to do harm either to the self or others giving an identity to the hallucinated voice increases the risk of compliance

Which action would the nurse take for a client with borderline personality disorder?

be firm, consistent, & understanding while focusing on specific target behaviors

Which behavior is characteristic of panic during a crisis?

being physically immobile

Which clinical findings indicate positive signs & symptoms of schizophrenia?

bizarre behavior, auditory hallucinations, & loose associations positive symptoms reflect a distortion or excess of normal function

Define flat affect

blunted or constricted facial expression

Which side effect would the nurse monitor for in a severely depressed client who received electroconvulsive therapy (ECT)?

confusion immediately after the treatment The electrical energy passing through the cerebral cortex during ECT results in a temporary state of confusion after treatment

Which strategy would the nurse use to help a depressed, withdrawn client who exhibits sadness through nonverbal behavior?

cope with painful feelings by sharing them Sharing painful feelings reduces the isolation & sense of uniqueness that these feelings can cause. Sharing these feelings usually decreases depression

Which term described the disturbance in mood & affect seen in clients who are depressed?

dysphoric (means feelings of hopelessness & sadness)

Which behavior is most typical of a client with a schizotypal personality disorder?

eccentric behavior

Which prescribed treatment would a nurse anticipate for a client with severe, persistent, intractable depression & suicidal ideation?

electroconvulsive therapy This therapy interrupts established patterns of behavior, helps relieve symptoms, & limits suicide attempts in clients with severe, intractable depression that don't respond to antidepressant meds.

A client with generalized anxiety disorder presents with restlessness & fatigue. Which additional clinical manifestation would the nurse monitor for?

excessive worry

Which behavior would a nurse observe in a client who has a histrionic personality disorder?

extroverted & dramatic Clients with histrionic personality disorder draw attention to themselves, are vain, & demonstrate emotionality & attention-seeking behavior

Which type of sexual disorder describes a client who has a sexual obsession with shoes?

fetishistic This disorder is characterized by a sexual focus on objects (such as gloves, pantyhose, & stockings) that are intimately associated with the body.

Define erotomanic delusions

fixed ideas that another person is in love with the client

To keep the client with Alzheimer disease who has hyperorality safe, which parameter would the nurse have the staff closely monitor?

for attempts at eating inanimate objects Hyperorality is the compulsive need to taste, chew, & put everything in the mouth

Which feeling would the nurse anticipate a manic client with bipolar 1 disorder is likely experiencing?

grandeur During a manic episode, a client has an inflated self-esteem

Define double bind

having 2 conflicting messages, not emotions, in a single communication

Which strategy would the nurses use to minimize aggressive behaviors from the client with a neurocognitive disorder?

identify nursing staff members whom the client prefers The type of care needed by the client requires trust in the caregiver, which develops more rapidly when there is a cooperative relationship & the client input is accepted.

Which therapeutic approach would indicate the client is receiving desensitization therapy?

imagery

Which behavior is most typical for clients with borderline personality disorder?

impulsive

Define alogia

inability to speak or near-absence of speech

Define exhibitionistic disorder

intentional display of the genitals in a public place

Define persecutory delusions

involve the belief that one is being conspired against

Which behavior would be typical for a child with autism?

lack of eye contact

Define avolition

lack of motivation associated with a reduced emotional expression (flat affect)

Which signs & symptoms would the nurse observe in a client with schizophrenia?

loosened associations & hallucinations

Define anhedonia

loss of enjoyment in things that were formerly enjoyed

Which factor would precipitate a client's use of confabulation?

marked memory loss A client with this disorder has a loss of memory & adapts by filling in areas that can't be remembered with made-up info

Which approach would the nurse use for the involved parent who has a child diagnosed with Munchausen syndrome by proxy?

open communication

Define echolalia

parrotlike echoing of spoken words or sounds

Which primary symptom would the nurse assess for in a boy who has encopresis?

passing feces either voluntarily or involuntarily into inappropriate places (such as clothing, closets, floors, or toy boxes)

Define obsessions

persistent idea, thought, or impulse that can't be eliminated from the consciousness with logical reasoning

In the acute phase of bipolar disorder, manic episode, which biopsychosocial need is the priority?

physical During a manic episode, the excessive hyperactivity increases the risk for cardiac collapse, dehydration, nutritional deficiencies, & sleep pattern disruption. The client also has increased risk for physical injury secondary to poor judgement & impulsiveness.

In which type of room would the nurse tell the admissions clerk to place a client with bipolar 1 disorder, manic phase?

private The client who is manic needs a nonstimulating environment

Define frotteuristic disorder

rubbing or touching a non-consenting person

Which childhood problem has legal & emotional aspects?

school phobia This requires intervention & can't be legally ignored, because children must attend school

Define voyeurism

seeking sexual arousal through the viewing (usually secret) of other people engaged in intimate situations

Which interventions would be important when caring for a client who was admitted yesterday with borderline personality disorder?

setting limits Because clients with BPD are often manipulative & have a sense of entitlement, it is crucial for limits on behavior to be set

Define tangentiality

speaking about subjects unrelated or tangent to the main discussion topic or responding to questions without answering the question

Describe catatonia

stupor, immobility, rigidity, or extreme flexibility of the limbs excitability confusion lack of verbal expression/ unresponsive to questions

Which initial inference would the nurse make about a psychiatric client curled up in the fetal position in the corner of the dayroom?

the client is feeling more anxious today The fetal position represents regressive behavior. Regression is a way of responding to overwhelming anxiety.

Define ambivalence

the existence of 2 conflicting emotions, impulses, or desires

For a client with OCD, which purpose is served by ritualistic behavior?

the rituals temporarily relieve anxiety

Define universality

the sense that one is not alone in any situation

Which explanation would the nurse manager give about using group therapy for a client with schizophrenia who has paranoid delusions?

therapeutic group work tends to be threatening to individuals who are suspicious Suspicious individuals do not to well in groups, because they are unable to tolerate the give-and-take that is necessary for successful group function.

For a client with an obsessive- compulsive disorder, which rationale explains the function of obsessions & compulsions?

unconscious control of unacceptable feelings

Define compulsions

uncontrollable, persistent urge to perform an act repetitively to relieve anxiety

Which consistent approach would the nurse use for a client with an antisocial personality disorder?

warm & firm without being punitive The client needs positive relationships with other adults, but clear, consistent limits must be presented to minimize attempts at manipulation

Define grandiose delusions

when an individual claims that they have exceptional abilities/ special powers, wealth, or fame

Define malingering

when an individual consciously pretends to have an illness with no physical basis

Which clinical findings are negative symptoms associated with schizophrenia?

withdrawal, poverty of speech, inattentiveness, flat affect, decreased spontaneity, & asocial behavior negative symptoms reflect a diminution of absence of normal function