Mental Health Straight A's ?'s

The nurse is teaching the family of a client who has a diagnosis of GAD. Which info will the nurse include in the teaching plan? SATA 1. Assist family members to handle their anxiety 2. Teach the family how to prevent the client from becoming paranoid. 3. help the family assess their own level of functioning 4. develop a family plan for emergency intervention 5. encourage family members not to take on the clients responsibilities 6. discuss the family's ability to solve problems.

1, 3,5,6 RATIONALE: by assisting the family members in handling their anxiety effectively, they'll communicate less anxiety to the client. The lvl of family functioning can either + or - influence the individual client's lvl of functioning. It isn't useful for the family to take on the client's responsibilities. It's better for the client to learn how to handle stress and the tasks that need to be done. If the family has sufficient problem solving ability, they can role model problem solving behavior for the client.

Which group of characteristics would the rn expect to find in the client with schizophrenia? 1. Loose associations, grandiose delusions and auditory hallucinations 2. periods of hyperactivity and irritability alternating with depression 3. delusions of jealousy and persecution, paranoia and mistrust 4. sadness, apathy, feelings of worthlessness, anorexia, and weight loss

1. Loose associations, grandiose delusions and auditory hallucinations RATIONALE: schizophrenia clients can't care for their physical appearance, frequently hear voices telling them to do something to either themselves or others; verbally ramble from one topic to the next.

A person loses an important advertising account and has a flat tire while driving home. That evening, the person begins to find fault with everyone. Which defense mechanism is the person using? 1. Displacement 2. projection 3. regression 4. sublimination

1. displacement RATIONALE: a mechanism by which feelings of anger and rejection are discharged in an indirect way that is perceived as safe.

A client with chronic schizophrenia receives fluphenazine decanoate (prolixin Decanoate) by IM injection. Three days later, the client has muscle contractions that contort the neck. This client is exhibiting which pxtrapyramidal reaction? 1. dytonia 2. akinesia 3. akathisia 4. tardive dyskinesia

1. dystonia RATIONALE: a common extrapyramidal reaction to fluphenazine decanoate, manifests as muscle spasms in the tongue, neck face, back and sometimes, the legs. akinesia refers to decreased/absent movment akathisia, to restlessness or inability to stand still tardive dyskinesia to abnormal muscle movements, particularly around the mouth

A nurse is planning to start a smoking-cessation group for clients in the clinic. Which factor is most important to consider when beginning to plan for the group? 1. which types of problems the clients are having 2. which clients would be interested in joining the group 3. which staff members are prepared to be leaders 4. what time of day to hold the sessions

1. which types of problems the clients are having RATIONALE: when planning groups the nurse must begin by assessing the clients' needs and resources. Determining the nature of their problems is crucial.

The nurse is leading group therapy with psychiatric clients. During the working phase what should the nurse do? 1. Explain the purposes and goals of the group 2. offer advice to help resolve conflicts 3. Encourage group cohesiveness 4. encourage a discussion of feelings of loss regarding termination of the group.

3. Encourage group cohesiveness RATIONALE: during the working phase, the nurse continues to encourage cohesiveness among its members. During the orientation phase, or intro phase the nurse leading the group should explain the purpose and goals of the group. During the termination phase, the leader encourages a discussion of feelings associated with termination. offering advice isn't appropriate - the group members should work together to resolve conflicts

"Yesterday, a client with schizophrenia began treatment with haloperidol (Haldol). Today, the nurse notices that the client is holding his head to one side and complaining of neck and jaw spasms. What should the nurse do? 1. Assume the client is posturing 2. tell the client to lie down and relax 3. evaluate the client for adverse reactions to haloperidol 4. put the client on the list for the physician to see tomorrow.

3. Evaluate the client for adverse reactions to haloperidol RATIONALE: haloperidol can cause muscle spasms in the neck, face, tongue back and sometimes legs as well as torticollis (twisted neck position.). The RN should be aware of these adverse reactions and assess for related reactions promptly.

Which is the drug of choice for treating Tourette syndrome? 1. fluoxetine (prozac) 2. fluvoxamine (Luvox) 3. haloperidol (haldol) 4. paroxetine (Paxil)

3. haloperidol (haldol) RATIONAL: Prozac, Luvox, and Paxil are antidepressions and aren't used to treat Tourette syndrome.

A 29-year-old client who is agitated and incoherent comes into the ED with complaints of visual and auditory hallucinations. The hx reveals that the client was hospitalized for paranoid schizophrenia from ages 20-21. The MD prescribes Haldol 5 mg IM. The nurse understands that this drug is used in this client to treat: 1. dyskinesia 2. dementia 3. psychosis 4. tardive dyskinesia

3. psychosis RATIONALE: decreases agitation

A client with OCD and ritualistic behavior must brush the hair back from his forehead 15 times before carrying out any activity. The nurse notices that the client's hair is thinning and the skin on his forehead is irritated - possible effects of this ritual. When planning the client's care, the rn should assign highest priority to: 1. helping the client identify how the ritualistic behavior interferes with daily activities 2. exploring the purpose of the ritualistic behavior 3. setting consistent limits on the ritualistic behavior if it harms the client or others. 4. using problem solving to help the client manage anxiety more effectively

3. setting consistent limits on the ritualistic behavior if it harms the client or others. RATIONALE: Client safety is the paramount concern and must be maintained. Therefore, setting consistent limits on the potentially harmful ritualistic behavior takes highest priority.

A pt. on the behavioral health unit tells the nurse that she experiences palpitations, trembling and nausea while traveling alone, outside her home. These symptoms have severely limited her ability to function and have caused her to avoid leaving home whenever possible. The nurse recognizes that this pt has symptoms of what disorder? 1. Thanatophobia 2. aerophobia 3. hodophobia 4. agoraphobia

4. agoraphobia RATIONALE: avoidance of open spaces accompanied by the concern that escape to safety would be difficult or embarrassing. It's commonly accompanied by physical symptoms such as palpitations, trembling, nausea, and SOB.

A client is admitted to the psych. unit of a hospital with chronic undifferentiated schizophrenia. During the next several days, the client is seen laughing, yelling, and talking to herself. This behavior is characteristic of: 1. delusion 2. looseness of association 3. illusion 4. hallucination

4. hallucination Auditory hallucination, in which on hears voices when no external stimuli exist, is common in schizophrenic clients. Such behaviors as laughing, yelling and talking to oneself suggest such a hallucination

A 36-year-old client with paranoid schizophrenia believes that his room is bugged by the CIA and that a roommate is a foreign spy. The client has never has a romantic relationship, has no contact with family members, and hasn't been employed for the past 14 years. Based on Erickson's theories, the nurse should recognize that his client is in which stage of psycho social development? 1. autonomy vs shame and doubt 2. generativity vs stagnation 3. integrity vs despair 4. trust vs mistrust

4. trust vs mistrust This client's paranoid idealization indicates difficulty trusting others.

A client is admitted to an inpatient psych unit. after the assessment and admission procedures are completed, the nurse states, "ill try to be available to walk with you when needed and will spend time with you each morning from 10 until 1030 in the corner of the dayroom." What is the main rationale for communicating these planned nursing interventions? 1. to attempt to establish a trusting relationship 2. to provide a structured environment for the client 3. to instill hope in the client 4. provide time for completing nursing responsibilities

to attempt to establish a trusting relationship RATIONALE: availability, reliability, and consistency are critical factors in establishing trust with a pt.