Mental Health Final
Failure of the duty to warn is another form of malpractice the psychiatric mental health nurse faces
True
Periactin (cyproheptadine) is usually given in divided doses prior to meals and the client should be instructed to avoid taking with alcohol.
True
Psychiatric nursing demands knowledge of the law as it pertains to patient rights, patient legal status, and the quality of care rendered.
True
Rape is the most common trigger of PTSD
True
Sertraline (Zoloft) is classified as an antidepressant
True
When completing discharge medication education for the client, he asks how long it will take before the effects of lithium (Eskalith) take place. The nurse states that it will take
10-14 days
Your patient weighs 35 lbs. What is the patient's weight in kg?
15.9kg
Your client is to receive haloperidol 4mg IM qhs. Available 2mg/ml. How many mls to administer?
2ml
Which of the following are types of anxiety?
Anxiety trait, anxiety state
The patient stays on a superficial level of communication. What is the most likely cause of motivation?
Fear of rejection by the nurse
As a nursing student, you are told to wear street clothes and a name tag when providing care of your assigned patient at the local community mental health center. Which of the following items of clothing do you think would be most appropriate for a female student to wear in the clinical setting?
Clean and professional but casual attire
A 21 year old woman has been recently diagnosed with agoraphobia. Which of the following situations is most likely to cause the woman anxiety?
Going to a crowded, outdoor market on her own
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 assessed the following somatic or physiologic symptoms of depression
Guilt, indecisiveness, and impulse control Psychomotor retardation and agitation
A mental health nurse is caring for a client with an anxiety and substance use disorder. The family is requesting to see the client's records. The nurse understands that this would be a violation of which law.
HIPAA
A client is exhibiting dysfunctional grieving. When obtaining a health history, the nurse would expect which assessment finding to be noted?
Hostility
Following a series of visits to her primary care provider and the hospital, a 22 year old retail clerk has been diagnosed with anorexia nervosa. Which of the client's following statements demonstrates an accurate understanding of her diagnosis?
I guess it's probably safe to say that anorexia runs in my family.
Eight months ago, a client was in a hotel fire and was the last person to be rescued from the roof. She watched her husband burn to death from the helicopter. She continues to have nightmares and is fearful that she will die in a fire. An appropriate nursing diagnosis for the client is
Sleep pattern disturbances related to recurrent nightmares
The major difference between spirituality and religion encompasses which of the following?
Spirituality is a personal quality that strives for purpose in life
Authoritative statements used by the nursing profession to describe the responsibilities for which nurses are accountable are referred to as
Standards of Practice
You overhear two of your coworkers talking about mental illness. They agree that mentally ill people are incapable of living by themselves or working. Which behavior are your coworkers exhibiting?
Stereotyping
The mental health nurse is interviewing a client of Asian descent regarding his health care practices. The nurse understands that cultural competence is important in the care of this client. Cultural competence in health care can be best described as
Striving to achieve the ability to work within the cultural context of an individual or community from a diverse cultural or ethnic background
Which of the following is different in current mental health nursing than in prior years
Use of nursing diagnosis
What is recognition of one's personal and social behaviors and their impact on other's called?
self awareness
Which of the following clients is most likely to be at risk for drug dependence and difficulties with withdrawal?
A woman who has been taking Lorazepam (altivan) for several months after witnessing a traumatic motor vehicle accident
Which of the following represents inappropriate maintenance of client confidentiality and a potential breach of HIPAA by the psychiatric nurse?
sending a copy of client records to referring agency without client's written consent
Dextrose to infuse at 100ml/hr. Drop factor 10gtt/ml. What is the rate in gtt/min?
17 gtt/min
During the admission assessment of a 27 year old male client who has been diagnosed with an anxiety disorder, the nurse observes that he is becoming increasingly restless and agitated. How should the nurse respond to this development?
Inform the client that the assessment can be postponed if he is currently finding it overwhelming
A client is asking the nurse about hospice care. The nurse would be correct in giving which information regarding this form of end of life care?
It is for clients with a terminal diagnosis
Which of the following pharmacologic agents are useful in treating anxiety disorders?
Tricyclic antidepressants, SSRIs, Benzodiazepines
A client comes to the health clinic for a physical exam. HE is complaining that he is not happy with himself about being overweight. He has been depressed for several weeks. When discussing his weight goal, he asks the nurse, "What is a normal or healthy BMI?" The nurse's correct response would include which of the following?
18.5-24.9
When working with clients with bulimia, the nurse should be aware that the nurse's own feelings and needs may affect care. Feelings that may be aroused in the nurse may include
Control
Which of the following pharmacologic agents are classified as Appetite Stimulants?
Cyproheptadine (periactin) and Megestrol acetate (megace)
Frequently psychiatric patients are stereotyped by the public. Which of the following is a common stereotype of this patient population?
Violent
Order librium 10mg IM stat. Available 25mg/2ml. How many mls should be administered?
0.8ml
Your patient is receiving Lasix 20mg PO daily. You are monitoring his urine output. At the end of your shift, he has voided a total volume of 1500ml. What is his output in ounces?
50 oz
Order: Levodopa 3mg PO BID Available: Levodopa 1mg How many tablets in 24 hours?
6 tablets
Which of the following represents appropriate criteria for involuntary admission of a patient into a mental health facility?
A client who has threatened suicide
A client undergoing a colonoscopy tomorrow is receiving preoperative teaching regarding the procedure. Which of the following nursing tasks best describes the explanation of the procedure and the associated risks and benefits.
Acquiring informed consent
Match
An emotional response to an unknown object or situation: anxiety A response to a known or recognized danger: fear
Cachexia is most likely to be an assessment finding in a client who has been diagnosed with what?
Anorexia nervosa
A woman diagnosed with terminal breast cancer discusses with her husband her wishes for end of life care including funeral arrangements. Which type of loss is this couple experiencing?
Anticipatory loss
Match the items
Antisocial personality: aggressive, manipulative Borderline personality: impulsive, self destructive Histrionic personality: emotional, dramatic OCD: perfectionistic, controlling Paranoid personality: suspicious, distrustful Dependent personality: dependent, submissive
The depressed client is deciding which type of treatment would be beneficial for him. The nurse would document that the patient is utilizing which of the following ethical principles in this situation?
Autonomy
A 27 year old male complains that he is unable to sleep since his spouse died recently due to terminal cancer. He also complains that he has a poor appetite and feels sad even when in the company of their two small children aged 5 and 7 years old. Which of the following responses to the death of his spouse is the client experiencing?
Bereavement
When discussing various types of anxiolytic medications with a client, the nurse recognizes that which of the following medications does not have abuse potential?
Buspirone (BuSpar)
All except which of the following are considered clinical symptoms of anxiety?
Decreased pulse
A client was admitted to the eating disorder unit with bulimia. Which of the following complications are associated with bulimia?
Dental erosion and chronic edema
As a student nurse, your first assignment in the psychiatric mental health clinical setting is to provide care for a female patient who appears sad and verbalizes hopelessness to the staff. You are uncertain how to approach the patient. Which of the following actions would be the most effective?
Discussing your apprehension and possible approaches with your instructor before approaching the patient
A client has been diagnosed with Iarrophobia. The nurse identifies Iarrophobia as being a fear of which of the following?
Doctors
When administering the drug paroxetine, you, the student nurse should monitor your patient for which of the following adverse reactions?
Drowsiness, headache, tremor, and somnolence
In teaching a client who has been prescribed a Benzodiazepine for panic disorder, the nurse must be certain to
Educate the client that this medication has a high risk for withdrawal symptoms, and he should not discontinue without a doctor's supervision.
When comparing social interactions with therapeutic interactions, the nurse understands that therapeutic interactions
Encourage patient to engage in personal goal setting
A nurse knows that ethnic differences affect the efficiency of psychoactive medications and the incidence of adverse effects. What is this known as?
Ethnopharmacology
Hospice care is focused on curative
False
Mood disorders are considered the least widespread psychiatric disorders
False
Of chronic psychiatric disorders, anxiety disorders are the least prevalent
False
Buspirone (BuSpar) should be given in 3 divided doses
False (in 2 divided doses)
An agitated patient has been put in restraints against his will because of inadequate staffing. The nurse determines this as which form of malpractice?
False imprisonment
During a physical assessment, the nurse would recognize that there is the potential for medication induced weight loss in a client who is being treated with which of the following medications?
Fluoxetine (Prozac)
Which action is most effective in assisting the nurse to provide culturally competent care?
Identifying one's own biases and feelings about different cultural groups
Your client has just arrived at the doctor's office. She is seen wearing excessive attire and jewelry of bright colors in unusual combination. Her chart states that she often exhibits hyperactivity, agitation, irritation, accelerated thinking, and speaking. Which of the following is the client experiencing?
Mania
A care plan for a client with anorexia has been developed by the mental health nurse. The nurse would anticipate that which medication would be prescribed for this client as an appetite stimulant?
Megestrol acetate (Megace)
Which of the following would be the most therapeutic student nurse response to the client's question, "Hi what is your name?"
My name is Dorothy and I am a student nurse.
A nurse fails to assess a patient with retrains every 2 hours as ordered. The nurse on the following shift notices the skin is red and beginning to breakdown. What could the nurse be accused of?
Negligence
The nurse observes that the client is breathing heavily and perspiring. Her hands are trembling and her eyes dart around the room. This is an example of which of the following?
Nonverbal communication
A client is receiving lithium carbonate (Eskalith) for treatment of mania. The nurse would reinforce which teaching component regarding lithium treatment?
Obtain scheduled lithium levels
It is important that the student displays which type of attitude when dealing with mentally ill clients?
Open minded
A client was admitted to the psychiatric unit after being picked up by police officers who found her frantically running back and forth across the freeway. Her husband related that she stayed up all night, ate very little, and talked incessantly. Additional assessments that indicate a manic episode include:
Pressured speech, combative behavior, and impaired judgment
The nurse is interviewing a client who expresses the cultural belief that mental illness is caused by offending one's ancestors. When planning care of the client, which of the following has priority in order to increase the chances of successful treatment?
Respecting this belief
The client with bulimia complains of feeling helpless, having a black future, and says, "What's the use?" Based on this data, what is the most appropriate nursing diagnosis?
Risk for self directed violence
Ethnocentrism can be counteracted by the nurse's use of which of the following?
Self analysis
According to the biochemical theory of mood disorders, a client with a diagnosis of depression is likely to have altercations in the levels and function of which of the following neurotransmitters?
Serotonin, norepinephrine, and dopamine
You are working with a 50 year old woman admitted for major depressive episode. The client has remained isolated and withdrawn since her admission and is reluctant to speak. Which of the following therapeutic communication skills is most likely to encourage the client to vent her feelings?
Silence and active listening
The student nurse is beginning her first day of clinical in a mental health unit. The nurse realizes that therapeutic communication can occur even if the nurse is not certain of how to initiate the conversation. This is because
Sincerity, honesty, respect, and caring are the most important elements in communication and will overcome anything you may say that could be nontherapeutic.
A nurse is encouraging a client to identify the progress she has made regarding sobriety of alcohol. Which phase of the therapeutic relationship are they in?
Terminating phase
Which of the following would indicate that the nurse client relationship has passed from the orienting phase to the working phase?
The client recognizes feelings of anger and expresses them appropriately.
Match the items.
The leading cause of disability in the US for individuals between 15 and 44: MAJOR DEPRESSIVE DISORDER Appears to occur equally in men and women and across races: BIPOLAR I DISORDER Believed to occur more frequently in women than in men: BIPOLAR II DISORDER
A 51 year old male has been admitted to the detoxification unit with acute symptoms of alcohol withdrawal. Nursing assessment is likely to reveal
Tremors, nausea, and hallucinations
Grief is a normal response to an actual or perceived loss
True
The use of clomipramine (Anafranil) is contraindicated during or within 14 days of MAOI therapy and should be administered with food and monitored for anticholinergic effects
True
Unresolved grief is also known as morbid grief reaction
True
A client from Korea has been admitted to the mental health facility. It has been assessed by the nurse that the client has difficulty speaking in English. What is the best intervention for the plan of care for this patient?
Use the assistance of the hospitals' translation services
According to Maslow, mentally healthy people who achieve self actualization have the ability to do what?
Use varied approaches to solve problems
Match
Used in the treatment of bulimia: amitriptyline (Elavil) Used in treatment of anorexia: risperidone (Risperdal) Used in treatment of both anorexia and bulimia: fluoxetine (Prozac)
Kim, a nursing student, is admittedly nervous about beginning her upcoming clinical rotation in a psychiatric setting. Reflection on which of the following questions may aid Kim's readiness for this new care setting?
What do I envision about these clients that make me uneasy?
The first day of a psychiatric mental health nursing clinical, a student nurse is assigned to work with a 24 year old client who is being treated for major depression due to a recent diagnosis of AIDS. Which of the following questions of your instructor would reflect prejudice regarding the client?
Why do gay men seem to get depressed more often? could it be related to IV drug abuse?"
Which of the following criteria is the most important component of a definition of mental health? The individual is
able to cope with daily stressors
The instructor is educating the students on "The Dying Persons' Bill of Rights" that states that I have the right to
be cared for by caring people, not die alone, discuss and engage my religion or spirituality
When assessing a client with anxiety, the nurse should recognize that anxiety may often be a result of
cognitive defects, organic brain changes, medications
A client has just had an explanation of the reason that he must undergo an MRI. When the nurse asks the client if he understands the teaching and he correctly describes what has been said to him, the client is said to be
competent
Robo tripping has increased dramatically among teenagers in recent years. This is also known as
cough medicine abuse
Legal issues in psychiatric mental health nursing includes
diversion of narcotics professional misconduct entering information into a client's medical record that is known to be inaccurate
Implementation of the nurse treatment plan for the client with bulimia may include
increasing coping skills for anxiety
An adolescent client reveals that she is about to take a math test from her tutor. Nursing assessment reveals mild anxiety. You explain that this level of anxiety
is conducive to concentration and problem solving
Therapeutic communication
is directed toward meeting patient needs
When teaching a client with newly diagnosed bipolar 1 disorder, the nurse explains that bipolar I
is often more disruptive than bipolar II
The Omnibus Reconciliation Act is
long term care facility must not admit residents needing active mental health treatment
Palliative care differs from hospice care because palliative care
may be provided in the early stage of a chronic disease
The reason why obesity is not categorized as an eating disorder in the DSM IV is that obesity is
not associated consistently with any particular psychological or behavioral syndrome
Which of the following is a characteristic of an introvert?
reserved and quiet
