Mental Health Exam #1

A client diagnosed with schizophrenia says to the nurse, "Will you protect me from the Grand Duchess?" and points to an older client who is sitting reading a book. Which statement is the therapeutic response by the nurse? 1. "Where is she? I'll talk to her." 2. "I can see no Grand Duchess. You will need to trust me on that." 3. "You will be safe here. Your thinking will be clearer after your medication starts to work." 4. "The Grand Duchess, huh? Well, I'm the Queen, and I will order her to stay away from you."

3. "You will be safe here. Your thinking will be clearer after your medication starts to work."

A patient has been prescribed PRN benzodiazepine antianxiety medication and is receiving teaching about his condition. The nurse determines the patient understands the priority actions of taking this mediation when he makes which of the following statements? 1. "I should request to be reassigned at work, I am a forklift operator." 2. "I should change my morning beverage from regular coffee to juice" 3. "I may take this medication more frequently than prescribes if needed." 4. "I need to increase my protein intake while on the medication."

1. "I should request to be reassigned at work, I am a forklift operator."

The parents of Suzanne, a child with attention deficit hyperactivity disorder, tell the nurse they have tried everything to calm their child and nothing has worked. Which action by the nurse is most appropriate initially? 1. Actively listen to the parents' concern before planning interventions. 2. Encourage the parents to discuss these issues with the mental health team. 3. Provide literature regarding the disorder and its management 4. Tell the parents they are overacting to the problem

1. Actively listen to the parents' concern before planning interventions.

A 73 year old patient admitted with depression and suicidal ideation. Which interventions would be most therapeutic for the patient. Select all that apply. 1. Focus on developing solution for suicidal ideation to ensure patient safety. 2. Assess the patient throughly and reassess the patient at regular intervals. 3. Avoid talking about these suicidal ideations as this may increase their risk for suicidal behavior 4. Meet regularly with the patient to provide the opportunity for the patient to express feelings 5. Help the patient identify positive self tributes and question negative perceptions

1. Focus on developing solution for suicidal ideation to ensure patient safety. 2. Assess the patient throughly and reassess the patient at regular intervals. 4. Meet regularly with the patient to provide the opportunity for the patient to express feelings 5. Help the patient identify positive self tributes and question negative perceptions

A depressed patient says "nothing matters anymore" Which responses by the nurse are least therapeutic? Select all that apply. 1. I am not sure I understand what you are trying to say. 2. Try to stay hopeful things have a way of working out. 3. Tell me more about what you are feeling right now. 4. Are you having thoughts of suicide? 5. You are depressed but you are safe here.

1. I am not sure I understand what you are trying to say. 2. Try to stay hopeful things have a way of working out. 5. You are depressed but you are safe here.

A nurse is teaching a patient diagnosed with depression about a new prescription for flurazepam. Which of the following statements by the patient indicated an understanding of the teaching? Select all that apply. 1. I should report increased feelings of self harm. 2. I will increase my water intake up to 8 glasses a day. 3. I should watch my diet to prevent an unexpected weight gain. 4. I will notice an improvement in my sex drive. 5. It may take 3 weeks or longer to reach the therapeutic effect.

1. I should report increased feelings of self harm. 3. I should watch my diet to prevent an unexpected weight gain. 5. It may take 3 weeks or longer to reach the therapeutic effect.

Which type of therapeutic approach has the characteristic of using the environment as an element of care and believes all team members are seen as equally important in helping patients meet their goals? 1. Milieu therapy 2. Interpersonal therapy 3. Behavior modification 4. Rational emotive therapy

1. Milieu therapy

A nurse is caring for a client who has major depressive disorder. The nurse should identify which of the following statements as a over comment about suicide? Select all that apply. 1. My family would be better off if I am dead. 2. The stresses in my life are hard you don't understand 3. I don't feel like I can ever be happy again 4. If I kill my self my problems will go away

1. My family would be better off if I am dead. 4. If I kill my self my problems will go away

A patient who has just been admitted to a psychiatric unit explains to the charge nurse he was admitted because his spouse is "out to get him", the government is "putting thoughts in my head" and that " I know all the government's secrets". In evaluation of these symptoms, the nurse anticipates the patient will be prescribed which of the following mediations? 1. Olanzapine 2. levetiracetam 3. nortriptalinsyline 4. Sertraline

1. Olanzapine

The police were called after a man on the street pulled a knife and threatened "I will kill myself if anyone tries to get near me." The man was safely disarmed and detained and placed in the back of a police car. Which statement best offers justification for the detainment and psychiatric patient admission. 1. The patient had potential to harm themselves 2. The patient was experiencing psychosis. 3. The patient presented a clear and present danger to others. 4. The patient presented an undeniable escape risk

1. The patient had potential to harm themselves

The nurse is providing medication teaching for a patient diagnosed with depression and will begin taking a monoamine oxidase inhibitor (MAOI) instead of a selective serotonin reuptake inhibitor (SSRI). Which of the following nursing statements is appropriate to include in the teaching? 1. "Your provider will start tapering your SSRI when you begin taking the MAOI." 2. "You will need to be off of the SSRI for a period of time before starting the MAOI." 3. "If the MAOI doesn't have the desired effect then your provider will likely have you take it as well as the SSRI." 4. "You will begin taking the MAOI two days after stopping the SSRI."

2. "You will need to be off of the SSRI for a period of time before starting the MAOI."

A nurse manager on a secured inpatient mental health unit is making modifications to improve the unit. Which changes by the nurse would need priority? 1. Allow for patient to discussed home life and environment 2. Liberal patient assess to linens and supply closet 3. Maintaining comfortable environmental temperature 4. Ensuring exit and entry doors are secure

2. Liberal patient assess to linens and supply closet

A child with attention deficit hyper activity disorder will begin medication therapy. What classification of drug used to treat attention deficit hyper activity disorder, should the nurse develop a teaching plan for the family? 1. Monoamine oxidase inhibitors 2. Psychostimulant drugs 3. Antipsychotic medications 4. Anxiolytic medications

2. Psychostimulant drugs

A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis: Impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? 1. The child has an improved ability to identify anxiety and use self-control strategies. 2. The child engages in cooperative play with other children 3. The child has increased expressiveness in communication with others 4. The child shows increased responsiveness to authority figures.

2. The child engages in cooperative play with other children

The nurse is monitoring a client diagnosed with schizophrenia who demonstrates a dysfunctional affect. Which situation is congruent with inappropriate affect? 1. When told that a beloved pet has died, the client responds, "OK." 2. The client giggled while describing being physically abused as a child. 3. The client's facial expressions are unchanged during the entire admission process. 4. When staff members attempt to engage the client in conversation, the client only mumbles.

2. The client giggled while describing being physically abused as a child.

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client? 1. Chess 2. Writing 3. Ping pong 4. Basketball

2. Writing

A patient has been medically cleared and admitted to the psych unit for the major depression disorder with current reports of suicidal ideation. What is the primary action of the nurse assigned to this patient? 1. Collect vital signs 2. Assess neurological status 3. Determine self harm methods 4. Evaluate substance use and abuse history

3. Determine self harm methods

A nurse is caring for a client who has autism spectrum disorder. Which of the following findings should the nurse expect? 1. Expressive affect 2. Associative looseness 3. Echolalia 4. Ambivalence

3. Echolalia

A child diagnosed with autistic disorder has a nursing diagnosis of impaired social interaction related to shyness and withdraw in self. Which of the following nursing inventions would be the most appropriate to address the problem. Select all that apply. 1. Prevent physical aggression by recognizing signs of agitation. 2. Allow the client to behave spontaneously, and shelter the client from peers. 3. Remain with the client during initial interaction with others on the unit. 4. Establish a procedure for behavior modification with rewards to the client for appropriatebehaviors. 5. Explain to other clients the meaning behind some of the client's nonverbal gesturesand signals.

3. Remain with the client during initial interaction with others on the unit. 4. Establish a procedure for behavior modification with rewards to the client for appropriatebehaviors. 5. Explain to other clients the meaning behind some of the client's nonverbal gesturesand signals.

A patient being treated for depression has taken 300mg of amitriptyline daily for a year. The patient calls the case manager at the clinic and says, "I stopped taking my antidepressant two days ago. Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares." What advise should the nurse give to the patient? 1. "Go to the nearest psychiatric treatment facility immediately." 2. "Do not to be alarmed. Take two aspirin and drink plenty of fluids." 3. "Resume taking your antidepressants for 2 more weeks and then discontinue them again." 4. "Take a dose of your antidepressant now and come to the clinic to see the health care provider."

4. "Take a dose of your antidepressant now and come to the clinic to see the health care provider."

Question???? 1. Assure there are an adequate amount of seclusion rooms are available 2. Contact the patent's physician to obtain an order for seclusion 3. Read and review the patent's history for clues about past behaviors 4. Ensure there is adequate staffing available on the unit

4. Ensure there is adequate staffing available on the unit

A nurse is assessing an adolescent client who has attention deficit hyperactivity disorder (ADHD). Which of the following findings should the nurse expect? 1. Emotional numbing 2. Elevated mood 3. Anxiety 4. Impulsivity

4. Impulsivity

A patient diagnosed with a depression selective serotonin reuptake inhibitor antidepressant therapy. What information to the nurse provide to the family and patient. 1. Restrict sodium to gram daily. 2. Minimize exposure to direct sunlight 3. Maintain a Tyramine free diet 4. Report increased suicidal thoughts

4. Report increased suicidal thoughts

A nurse is caring for a patient who has schizophrenia and exhibits a lack of grooming and flat affect. The nurse should expect a prescription for which of the following medications? A. Chlorpromazine (Thorazine) B. Thiothixene (Navane) C. Isocarboxazid D. Haloperidol (Haldol)

D. Haloperidol (Haldol)

The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. Which client symptoms require the nurse's immediate action? A. Incessant talking and sexual innuendoes B. Grandiose delusions and poor concentration C. Outlandish behaviors and inappropriate dress D. Nonstop physical activity and poor nutritional intake

D. Nonstop physical activity and poor nutritional intake

A patient has received maintenance doses of Fluphenazine 25 mg IM every two weeks for the last 2 years. The nurse notes that the patient is grimacing and seems to be constantly smacking her lips. On the next clinical visit the patient neck and shoulders twist in a slow snake like motion. Based on these findings suspects the presents of ________ and as a result should _________. A. agranulocytosis...check the patient's complete blood count for changes B. Tourette's syndrome...consult the patient's physician about a neuro evaluation C. anticholinergic effects...consult the physician about possible medication changes D. tardive dyskinesia...administer the Abnormal Involuntary Movement Scale

D. Tardive dyskinesia...administer the Abnormal Involuntary Movement Scale