mental health test 3
Which behaviors create interpersonal relationship problems for an individual diagnosed with narcissistic personality disorder? (Select all that apply.) a. Grandiose self-importance b. Sense of entitlement c. Lack of empathy d. Risk-taking e. Shyness
a. Grandiose self-importance b. Sense of entitlement c. Lack of empathy
A newly admitted patient diagnosed with Alzheimer disease (AD) has demonstrated apraxia. The nurse should assist the patient with which activity? a. Grooming and hygiene b. Reading written material c. Word finding d. Orientation
a. Grooming and hygiene
For pts. diagnosed with bipolar disorder, valproate anticonvulsants are likely to help control rapid-cycling episodes by what process? a. inhibition of kindling activity in the brain b. decreasing availability of norepinephrine c. increasing dopamine levels at synapses d. decreasing GABA metabolism
a. inhibition of kindling activity in the brain
Teaching for a pt. who is to be discharged on a maintenance dose of lithium should emphasize the importance of management activity? a. keeping appointments for serum lithium level testing b. engaging in daily cardiotonic exercise c. reporting anticholinergic side effects d. maintaining a tyramine-free diet
a. keeping appointments for serum lithium level testing
A pt. who is to be discharged on a maintenance dose of lithium should be taught to report which symptoms/signs immediately? (select all that apply) a. large amounts of dilute urine b. prolonged nasal congestion c. severe muscle stiffness d. unusual sweating e. blurred vision
a. large amounts of dilute urine e. blurred vision
Which assessment finding validate that a pt. with bipolar disorder is experiencing mania? (select all that apply) a. pacing b. agitation c. drowsiness d. delusional thoughts e. psychomotor retardation
a. pacing b. agitation d. delusional thoughts
A nurse teaching about bipolar disorder should inform patients and their families of possible depressive symptoms. Which symptoms should the nurse include? (Select all that apply.) a. Passivity b. Aggression c. Hyperactivity d. Psychomotor retardation e. Preoccupation with death
a. passivity d. psychomotor retardation e. preoccupation with death
A hyperactive, aggressive patient diagnosed with bipolar disorder threatens to physically assault another patient. What initial nursing intervention should be implemented? a. Provide firm verbal limits. b. Place the patient in seclusion. c. Ask the patient, "Why are you so angry?" d. Distract the patient with diversional activities.
a. provide firm verbal limits
An adult has a history of intoxication and promiscuity. After stealing money from a grandparent, this person says, "I deserved that money. My family had no right to press charges against me." The scenario depicts features of which personality disorder? a. Histrionic b. Narcissistic c. Antisocial d. Borderline
c. Antisocial
A nurse assesses a new pt. experiencing a manic episode. Which behavior is most likely to have occurred before hospitalization? a. watching others closely but avoiding interaction b. taking frequent rest periods during the day c. going rapidly from one activity to another d. remaining at home for long periods
c. going rapidly from one activity to another
A patient diagnosed with delirium stares at the corner of the room, wrings hands, and says, "I'm scared those snakes will bite me." What term should the nurse use to best document this event? a. Agnosia b. Disorientation c. Confabulation d. Visual hallucinations
d. Visual hallucinations
Maintenance of a therapeutic serum level of lithium is dependent on adequate serum levels of which electrolyte A. Sodium B. Chloride C. Potassium D. Magnesium
A. sodium
a pt. diagnosed with mania begins lithium therapy on October 1. What is the earliest date a nurse can expect to see clinical improvement in the pt.'s condition? a. October 3 b. October 8 c. October 21 d. November 1
B. October 8 (7days)
What phrase represents accurate information about the pharmacokinetics of lithium? A. wide therapeutic index B. Excreted by the kidneys C. Poorly absorbed in the gi tract D. Provides immediate relief of symptoms
B. excreted by the kidneys
Which pt. would require careful assessment for toxic effects of lithium when combined with what additional medication? a. hydrochlorothiazide b. lorazepam c. clozapine d. oxazepam
a. hydrochlorothiazide
Which pt. should be assessed most carefully for evidence of lithium toxicity when lithium is prescribed with which additional medication? a. indomethacin b. risperidone c. ziprasidone d. olanzapine
a. indomethacin
A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history provides by family members contributes to confirmation of the diagnosis? a. "He became confused all of a sudden." b. "He is always conscious and alert." c. "He doesn't seem to understand jokes anymore." d. "He is so distrustful of everyone now."
a. "He became confused all of a sudden."
Since admission, a patient diagnosed with antisocial personality disorder has been highly manipulative and constantly tests staff. Now, the patient insists on watching a late movie instead of complying with the bedtime. Select the nurse's best response. a. "It's a unit rule that bedtime is at 10 P.M." b. "I will not allow you to manipulate me again." c. "If you ask again, tomorrow's bedtime will be 9 P.M." d. "I understand your sleep problems and can allow it just this once."
a. "It's a unit rule that bedtime is at 10 P.M."
When caring for a patient diagnosed with dependent personality disorder, the nurse should positively reinforce which behavior? a. Choosing which clothing to wear b. Asking another patient for advice c. Sitting next to the nurse at a community meeting d. Concealing anger with a family member
a. Choosing which clothing to wear
An older adult presents with symptoms of delirium. The family says, "Everything was fine until yesterday." What is the most important assessment information the nurse should gather? a. A list of medications the patient currently takes. b. Whether or not the patient has experienced any recent losses. c. Whether or not the patient has ingested aged or fermented foods. d. The patient's recent personality characteristics and changes.
a. A list of medications the patient currently takes.
Effective management of a client diagnosed with Huntington disease is best demonstrated by which documentation made by the nurse? a. Bilateral lung sounds clear with no signs of dyspnea. b. Client denies any visual hallucinations. c. Disorientation noted only in the evenings. d. Client denies any hearing limitations.
a. Bilateral lung sounds clear with no signs of dyspnea.
An older adult patient diagnosed with delirium is anxious, agitated, and experiencing visual hallucinations. The nurse entering the room to assess vital signs should implement which intervention to best address this behavior? a. Calmly announce yourself by name and title, and explain what is going to happening. b. Limit talking with the client while taking the vital signs to minimize stimulation. c. Ask the patient to identify place, person, and time to trigger memory. d. Turn on all lights in the room to minimize misinterpretation of events.
a. Calmly announce yourself by name and title, and explain what is going to happening.
A nursing assistant reports to the nurse that a pt. diagnosed with AD is experiencing severe diarrhea. Administration of which classification of medication is most associated with this problem? a. ChE inhibitor b. secretase inhibitor c. NDMA antagonist d. nonsteroidal anti-inflammatory drug
a. ChE inhibitor
The spouse of a patient diagnosed with bipolar I disorder says, "We want to have children, but I worry they could inherit this problem. There is also bipolar disorder on my side of the family." What is the nurse's most appropriate action to address the spouse's concern? a. Direct the couple to seek genetic counseling. b. Encourage the couple to consider adopting children. c. Encourage the spouse to discuss options with a spiritual advisor. d. Educate the spouse about environmental determinants of bipolar disorder.
a. Direct the couple to seek genetic counseling.
What assessment data suggest that a client is at risk for the development of vascular dementia? (Select all that apply.) a. History of type 2 diabetes b. Currently prescribed antihypertensive medication c. Presents early signs/symptoms of Parkinson disease d. Being treated for atrial fibrillation e. 2 pack a day cigarette habit
a. History of type 2 diabetes b. Currently prescribed antihypertensive medication d. Being treated for atrial fibrillation e. 2 pack a day cigarette habit
The nurse teaches a family who provides in-home care for a patient diagnosed with dementia. Which measure to facilitate environmental safety should the nurse include? a. Install gates at the tops and bottoms of stairs. b. Store medications in a clearly visible place. c. Vary the daily schedule to provide variety and stimulation. d. Include daily activities that call for use of higher cognitive functions.
a. Install gates at the tops and bottoms of stairs.
The care plan of an agitated patient diagnosed with dementia with Lewy body (DLB) should have which assessments as priorities? (Select all that apply.) a. Level of consciousness b. Presence of auditory or visual hallucinations c. Signs of depression d. Delusional thinking e. Heart sounds
a. Level of consciousness b. Presence of auditory or visual hallucinations c. Signs of depression d. Delusional thinking
Which characteristic of individuals diagnosed with personality disorders in the dramatic-erratic cluster makes it advisable for staff to have frequent patient-centered meetings? a. Manipulating others to avoid limits b. Behaving responsibly in the peer group c. Withdrawing from interactions with others d. Depending excessively on others for support
a. Manipulating others to avoid limits
What is the nursing care priority for a patient diagnosed with stage 7 Alzheimer disease? a. Nutrition and hydration b. Promoting self-care activities c. Supporting attempts to communicate d. Preserving problem-solving abilities
a. Nutrition and hydration
A patient demonstrating borderline personality disorder says, "When I met him, he was perfect and gave me everything. Now I know how bad he really is. He left me alone tonight to go out with others, so I had to cut myself." Which feature is evident? a. Splitting b. Paranoia c. Grandiosity d. Submissiveness
a. Splitting
Which nursing interventions are appropriate for the management of a client demonstrating the behaviors associated with dementia-related "sundowning"? (Select all that apply.) a. Staff is trained to de-escalate an agitated client. b. Frequent reorientation to time and place helps minimize the effects of sundowning. c. Client is closely monitored during the late afternoon and evening hours. d. The client is provided with a safe place to pace. e. The client's family is educated to the fact that this behavior is a result of overstimulation.
a. Staff is trained to de-escalate an agitated client. c. Client is closely monitored during the late afternoon and evening hours. d. The client is provided with a safe place to pace.
Patients diagnosed with dependent personality disorders behave submissively and cling to others. What is the best explanation of this behavior? a. The patients are afraid of being alone or functioning without direction. b. The patients adhere to strict standards and fear failure. c. The patients have little regard for the rights of others. d. The patients are suspicious of the motives of others.
a. The patients are afraid of being alone or functioning without direction.
When should the nurse scheduling the serum lithium level blood draw for a pt. arrange for it to be obtained? a. before the first morning dose b. 2 hours after the morning dose c. at bedtime d. any time during the day
a. before the morning dose (should be drawn 8 to 12 hours after last dose)
What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-to-moderate Alzheimer disease (AD)? a. Better daily function than without treatment b. Temporary interruption of disease process c. Remissions of varying lengths of time d. Marked decrease in memory impairment
a. better daily function than without treatment
A patient is hospitalized with new onset of manic behavior. It would be important for the nurse to inspect and report results of which laboratory tests? (Select all that apply.) a. Calcium b. Creatinine c. Potassium d. Drug screens e. Thyroid function
a. calcium d. drug screens e. thyroid function
A pt. diagnosed with mild lithium toxicity with a serum level of 1.6 mEq/L. Which assessment finding are most likely and will require nursing attention? (select all that apply) a. coarse hand tremor b. elevated white blood cell count c. dizziness d. facial tics e. coordination problems
a. coarse hand tremor c. dizziness e. coordination problems
An older adult patient has fluctuating levels of awareness, anxiety, and appears to be picking things out of the air. The patient says, "I saw my granddaughter standing at the foot of the bed last night." The nurse should suspect which disorder? a. Delirium b. Dementia c. Schizophrenia d. Bipolar disorder
a. delirium
The spouse of a pt. with Alzheimer disease asks, "Can you give me a simple explanation of what happened in my partner's brain?" Select the nurse's best response. a. "dementia developed" b. "the brain became overstimulated with chemical messages." c. "brain cells and chemical messengers that form memories are dying" d. "the substantia nigra, a tissue that makes dopamine, has degenerated."
a. dementia developed ?
A patient diagnosed with borderline personality disorder impulsively self-mutilates and has severe mood lability with explosive outbursts, poor interpersonal relations, and inability to sustain employment. Which referrals should the nurse consider for the patient? (Select all that apply.) a. Dialectic behavior therapy b. Alcoholics Anonymous c. Vocational rehabilitation d. Desensitization therapy e. Anger management
a. dialectic behavior therapy c. vocational rehabilitation e. anger management
A nurse explains galantamine therapy to family members of a pt. who is to begin treatment with the drug. What information should be included? (select all that apply) a. facial flushing and leg cramps might worsen b. it acts by making more dopamine available c. report slow heartbeat immediately d. restrict fluid intake to 1500 mL/day e. side effects include gi symptoms
a. facial flushing and leg cramps might worsen c. report slow heartbeat immediately e. side effects include gi symptoms
A patient has been diagnosed with cyclothymic disorder. Which assessment data provided by the patient support this diagnosis? (Select all that apply.) a. Patient describes periods that suggest hypomanic episodes b. Current symptoms began 4 years ago c. Patient has been hospitalized for depression numerous times d. Patient reports depression worsens in the winter e. Patient reports being "moderately depressed" at times
a. pt. describes periods that suggest hypomanic episodes b. current symptoms began 4 years ago e. pt. reports being "moderately depressed" at times
An adult tells the nurse, "I'm taking large doses of vitamin B. I read that it prevents AD, but I don't understand how it works." Which statements would be applicable as the nurse responds to the individual (select all that apply) a. research has not proven the effectiveness of B vitamins in Alzheimer prevention b. B vitamins lower the amino acid homocysteine, which is associated with a lower incidence of AD c. a favorable response occurs when these vitamins block NMDA d. B vitamins may reduce risk of AD by lowering cholesterol levels e. B vitamins reduce the body's inflammatory response
a. research has not proven the effectiveness of B vitamins in Alzheimer prevention b. B vitamins lower the amino acid homocysteine, which is associated with a lower incidence of AD
A newly admitted patient experiencing a manic episode is verbally and physically aggressive. The plan for care should include which interventions to minimize the risk of injury and manage the milieu effectively? a. Setting clear limits, providing a quiet environment, and limiting activities b. Avoiding use of antipsychotic drugs for 24 hours and providing nourishment ad lib c. Orienting to unit activities, encouraging gross motor activity, and watching television d. Avoiding confrontations by not enforcing limits and encouraging physical exercise at bedtime
a. setting clear limits, providing a quiet environment, and limiting activities
A pt. diagnosed with bipolar disorder asks the nurse, "Why can't i take my lithium just once a day at bedtime? It's hard to remember to take it 3 times." The nurse's rely should be based on what information? a. the half-life of lithium is short b. renal excretion is greater at night c. gi absorption is diminished at night d. the toxicity potential increases with once-a-day dosing
a. the half-life of lithium is short
What is the most realistic short-term goal for the care of a pt. with mild AD who takes donepezil? a. to maintain present cognitive ability b. to show improved cognitive ability c. to engage effectively in abstract thinking d. to consistently communicate clearly
a. to maintain present cognitive ability
Which statement made by a client demonstrates the characteristics associated with personality disorders? a. "My problem involves only my work relationships." b. "I follow rules regardless of the situation." c. "What people think of me is really important to me." d. "I can't concentrate when I'm around people who don't agree with me."
b. "I follow rules regardless of the situation."
A psychiatric nursing assistant says, "I get annoyed with patients who self-mutilate over things other people would ignore. I think they just do it to get attention." What is the nurse's best response to take advantage of this teachable moment? a. "Many people feel the way you do. If you are unable to come to terms with the issue, we can transfer you." b. "Self-mutilation is a serious problem. Patients with this personality disorder may complete suicide." c. "We have to consider each case individually. Some are manipulative, and others are serious." d. "You seem to be having difficulty empathizing and remaining nonjudgmental."
b. "Self-mutilation is a serious problem. Patients with this personality disorder may complete suicide."
A nurse caring for a person diagnosed with schizoid personality disorder demonstrates an understanding of the disorder when making what statement? a. "I need to be alert for demonstrates of socially aggressive behavior." b. "The client will not engage in much conversation with either staff or with other clients." c. "Staff will need to be accepting of the client's odd personal behaviors." d. "I expect the client to be socially cold and standoffish."
b. "The client will not engage in much conversation with either staff or with other clients."
A pt. has taken lithium 600mg 3 times daily for 1 week. A laboratory result in which range shows that the desired serum lithium level was achieve? a. 0.2 to 0.6 b. 0.6 to 1.2 c. 1.2 to 2 d. 2 to 2.6
b. 0.6 to 1.2
A clinic nurse encounters a new patient diagnosed with schizoid personality disorder. What is the best initial nursing intervention? a. Set firm limits. b. Engage in trust building. c. Involve the patient in group activities. d. Encourage identification of feelings.
b. Engage in trust building.
Which interventions are appropriate for inclusion into the plan of care for a client diagnosed with Parkinson disease? (Select all that apply.) a. Speech therapy for language skills impairment b. Falls risk precautions c. Frequent depression screening d. Monitoring for obsessive-compulsive disorder (OCD) tendencies e. Education concerning risks associated with prescribed atypical antipsychotic medication therapy
b. Falls risk precautions c. Frequent depression screening e. Education concerning risks associated with prescribed atypical antipsychotic medication therapy
A patient diagnosed with vascular dementia does not remember family members' names. The family insistently reorients the patient, and the patient becomes more agitated. What is the most likely reason for the patient's reaction? a. He or she is using agitation to distract the family from the cognitive deficits. b. He or she is overstimulated by the reorientation and reacting negatively. c. He or she is reliving family chaos that was previously unresolved. d. He or she is experiencing guilt about the memory deficits.
b. He or she is overstimulated by the reorientation and reacting negatively.
A person recently sustained a paper cut on a finger and called an ambulance. Later when discussing the incidence the person says, "I can't believe my supervisor denied my sick leave request." This behavior is most related to which mental health diagnosis? a. Dependent personality disorder b. Histrionic personality disorder c. Antisocial personality disorder d. Borderline personality disorder
b. Histrionic personality disorder
A patient has had long-term conflicts with two siblings over their parents' wills. The patient reacts quickly with anger, suspicious that the siblings are plotting to take all the inheritance. These characteristics are most consistent with which personality disorder? a. Schizoid b. Paranoid c. Borderline d. Narcissistic
b. Paranoid
A distinctive characteristic in a patient with antisocial personality disorder is manifested in which behavior? a. Expressing a high degree of guilt and remorse b. Showing no regret over stealing another's patient's ring c. Unwillingness to comply with prescribed antipsychotic therapy d. Requiring frequent reinforcement of personal self-worth
b. Showing no regret over stealing another's patient's ring
Which patient behavior demonstrates the best outcome for a patient with schizotypal personality disorder? a. Adhering willingly to program norms b. Talking to a stranger in a social situation c. Reporting decreased incidence of impulses to self-mutilate d. Demonstrating fewer attempts at splitting or manipulating staff
b. Talking to a stranger in a social situation
An older patient had a subtotal gastrectomy after being diagnosed with stomach cancer. What long-term mental health risk related to this procedure should the nurse discuss with the patient? a. The increased risk of depression b. The risk of vitamin B12-related dementia. c. The risk of postsurgical delirium d. The increased risk of Parkinson disease
b. The risk of vitamin B12-related dementia.
A patient diagnosed with dementia is watching a crime story on television. Suddenly, the patient begins to yell, "Stop! He's got a gun." What is the nurse's best intervention? a. Administer a PRN dose of an atypical antipsychotic medication. b. Turn off the television and tell the patient, "You are safe." c. Reassure the patient that there are no guns nearby. d. Provide a snack, and put the patient in bed.
b. Turn off the television and tell the patient, "You are safe."
A pt.'s serum lithium level is 1.8 mEq/L. What is the nurse's priority action related to the evidence. a. restrict fluid intake b. assess for signs of toxicity c. encourage intake of high-K+ foods d. ensure that the pt. is swallowing the capsules
b. assess for signs of toxicity (0.6-1.2 is the level 1.8 is to high)
Which indicator of disordered communication is the nurse most likely to assess in a pt. having a manic episode? a. loose associations b. flight of ideas c. echolalia d. mutism
b. flight of ideas
A pt. diagnoses with AD is being treated with an acetylcholine inhibitor drug. The pt. develops facial flushing, sweating, and leg cramps. The nurse should attribute these symptoms to what process? a. irreversible acetylcholine stimulation b. inhibition of butyrylcholinesterase (BChE) c. Neurodegeneration in the hippocampus d. cytochrome p-450 system activation
b. inhibition of butyrylcholinesterase (BChE)
The nurse prepares to take vital signs for a pt. experiencing mania. What is the nurse's best intervention when the pt.'s talking interferes with the assessment? a. use a voice volume louder than the pt.'s to say "Stop talking now." b. interrupt by saying, "It's time to take your vital signs now." c. delay taking the vital signs until the pt. is quieter d. wait tolerantly for the pt. to finish talking
b. interrupt by saying, "It's time to take your vital signs now."
Of the drugs given to treat AD, which one has a potential to slow neurodegeneration? a. galantamine b. memantine c. rivastigmine d. donepezil
b. memantine
What is the foundation of the cognitive process? a. Reasoning and logic b. Memory and learning c. Orientation and speech d. Perception and behavior
b. memory and learning
A nurse presents a psychoeducational program to pts. diagnosed with bipolar disorder and their families. Information about which collection of signs associated with an impending relapse of mania should be included? a. diarrhea, thirst, and gross tremor b. sleep disturbances and racing thoughts c. decreased libido, anhedonia, and hypersomnia d. delusional thinking, excessive guilt, and passivity
b. sleep disturbances and racing thoughts
An older adult patient is admitted with a diagnosis of delirium secondary to a urinary tract infection. The family asks whether or not the patient will recover. Select the nurse's best response. a. "The health care provider is the best person to answer your question." b. "The confusion will probably get better as we treat the infection." c. "Unfortunately, delirium is a progressively disabling disorder." d. "I will be glad to contact the chaplain to talk with you."
b. the confusion will probably get better as we treat the infection
An adult says, "I take vitamins B and E to prevent AD, but these vitamins are so expensive." What is the nurse's most informative response? a. yes, these vitamins are very expensive, but it is money well spent to prevent AD b. there is conflicting research evidence about effectiveness of these vitamins for prevention of AD. c. most researchers now believe that preventing anemia is more important than taking vitamins to prevent AD d. aspirin is much cheaper. You should take it instead if you want to prevent AD
b. there is conflicting research evidence about effectiveness of these vitamins for prevention of AD.
Which principle is most useful and effective when interacting with a pt. experiencing a manic episode? a. encourage the pt. to freely express feelings. b. use a calm, matter-of-fact approach c. do not interrupt the pt. d. frequently use silence
b. use a cam, matter-of-fact approach
A patient diagnosed with borderline personality disorder has demonstrated self-mutilation and inappropriate expressions of anger. Which statement by the patient would the nurse evaluate as an improvement? a. "I think you are the nicest nurse on the unit." b. "I got drunk last night, but I won't ever do it again." c. "I felt like cutting myself, so I came to talk to you." d. "I hate my friends. They never help me when I need it."
c. "I felt like cutting myself, so I came to talk to you."
An older adult diagnosed with dementia is documented as demonstrating agnosia. Which client statements support this documentation? (Select all that apply.) a. "My hands seem to shake all the time." b. "I can't hold that cup without spilling the coffee." c. "I signed my name with that thing that writes." d. "I don't remember ever meeting you before." e. "The water came out of that thing you turn."
c. "I signed my name with that thing that writes." e. "The water came out of that thing you turn."
When contrasting schizophrenia and schizotypal personality disorder with other staff members, which statement made by the nurse demonstrates an understanding of the disorder? a. "In schizotypal personality disorder, the patient remains psychotic much longer." b. "The patient with schizophrenia has better social skills and is not usually overtly psychotic." c. "The person with schizotypal personality disorder may have cognitive distortions but not psychosis." d. "Schizotypal personality disorder is associated with more frequent and prolonged hospitalizations."
c. "The person with schizotypal personality disorder may have cognitive distortions but not psychosis."
The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which nursing statement? a. "The client's plan of care is individualized to meet his or her specific needs." b. "I think that reminiscence therapy will help the client remember past events better." c. "If we give the client enough time they can dress themselves appropriately each morning." d. "The client was so proud when they talked about their war experiences."
c. "if we give the client enough time they can dress themselves appropriately each morning"
The history of an individual diagnosed with borderline personality disorder often includes what assessment data? a. The loss of a parent at an early age b. A family history of bipolar disorder c. A dysfunctional, abusive childhood d. An overindulged childhood with few limits
c. A dysfunctional, abusive childhood
Within a 15-minute period, a patient having a manic episode states, "Dinner was cold and the solarium is too hot. I have a sore throat and there is no clean towel for my shower." What action should the nurse take to address the patient's concerns? a. Listen but not act on the patient's reports. b. Suggest the patient use the unit's suggestion box. c. Assess the patient's throat, and show him or her where clean linen is stored. d. Invite the patient to share the concerns about the food and temperature at the community meeting.
c. Assess the patient's throat, and show him or her where clean linen is stored.
A nurse gives anticipatory guidance to the family of a patient diagnosed with stage 2 Alzheimer disease (AD). Which problem common to that stage should be addressed? a. Violent outbursts b. Emotional disinhibition c. Communication deficits d. Inability to feed or bathe self
c. Communication deficits
A nurse presents a psychoeducational program to patients diagnosed with bipolar disorder and their families. Information about which collection of signs associated with an impending relapse of depressive episode should be included? a. Diarrhea, thirst, and gross tremor b. Sleep disturbances and racing thoughts c. Decreased libido, anhedonia, and inertia d. Anorexia, excessive guilt, and aggression
c. Decreased libido, anhedonia, and inertia
Which assessment data is commonly noted among clients diagnosed with avoidant personality disorders? a. Claims to enjoy risk-taking behaviors. b. Regularly acts impulsively. c. Displays evidence of poor self-confidence. d. Demonstrates helplessness as a means of manipulation.
c. Displays evidence of poor self-confidence.
Which intervention demonstrates the nurse's understanding of the management of behaviors demonstrated by a patient diagnosed with borderline personality disorder? a. Scheduling the client for group grief counseling b. Arranging for short interactions with unit staff c. Frequent discussions concerning unit rules and expectations d. Helping the client de-escalate both verbal and physical anger
c. Frequent discussions concerning unit rules and expectations
Which personality traits most likely describe a patient diagnosed with obsessive-compulsive personality disorder? a. Friendly; generous b. Dramatic; impulsive c. Perfectionist; inflexible d. Suspicious; submissive
c. Perfectionist; inflexible
An older adult patient developed delirium secondary to diphenhydramine use. The patient usually took this drug for allergies but recently added a cough syrup that also contained the drug. What information is most important to teach the family? a. Older adults are more prone to delirium. b. The patient is now susceptible to progressive cognitive decline. c. Toxic medication levels often occur because of slower metabolism in older adults. d. The older adult brain has fewer neurotransmitters than the brain of a younger person.
c. Toxic medication levels often occur because of slower metabolism in older adults.
What are the best menu selections for lunch for a hyperactive patient during a manic episode? (Select all that apply.) a. Cherry pie b. Macaroni and cheese c. A banana d. Tossed salad with ranch dressing e. Roast beef sandwich on whole-grain bread
c. a banana e. roast beef sandwich on whole-grain bread
during community lunch, a manic pt. tells another pt., "Push yourself away from the table. You're to fat for your own good!" Which intervention demonstrates the nurse's best ability to manage the milieu? a. say to the pt., "you may remain at lunch only if you apologize." b. tell the pt., you must leave lunch and go to your room now c. calmly tell the pt. that insulting others is not permitted d. extinguish the behavior by ignoring it
c. calmly tell the pt. that insulting others is not permitted
Most drugs used to treat AD affect what system and or process? a. monoamine oxidase reuptake systems b. serotonin and norepinephrine production c. cholinergic pathways, enzymes, and receptors. d. the Krebs cycle and GABA neuronal inhibition
c. cholinergic pathways, enzymes, and receptors
A pt. has taken lithium 300 mg 3 times daily for 1 week. The pt. reports the presence of fine hand tremors and thirst. What is the nurse's priority action to these assessment finding? a. increase sodium in the pt.'s diet b. immediately obtain a serum lithium level determination c. comfort the pt. that these effects will probably decrease over time d. withhold the lithium until the pt. no longer exhibits these side effects
c. comfort the pt. that these effects will probably decrease over time
A pt. who has taken lithium for 6 months reports, "I go to the bathroom many times a day and pass large amounts of very pale urine." The nurse's action should be based on the understanding that these symptoms may indicate which problem? a. Atactic toxicity b. uremic syndrome c. diabetes insipidus d. interstitial nephritis
c. diabetes insipidus
A pt. with a long history of multiple sclerosis developed psychosis with acute mania. The nurse should anticipate that the health care provider will probably prescribe which medication to help stabilize the mania? a. lithium b. amitriptyline c. divalproex d. diphenhydramine
c. divalproex
The family of a pt. diagnoses with Alzheimer disease asks the nurse, "How can drugs help our parents?" Which reply provides the most realistic expectations for medication therapy? a. "unfortunately, drugs are not helpful" b. drugs are available to stop the disease process. c. drugs can help preserve mental abilities for a time d. we will teach you ways of helping your parent adjust
c. drugs can help preserve mental abilities for a time
A nurse prepares to lead a psychoeducational group for pts. who take anticonvulsants to manage bipolar disorder. The nurse should invite pts. who take which drugs? (select all that apply) a. lithium b. aripiprazole c. lamotrigine d. gabapentin e. carbamazepine
c. lamotrigine d. gabapentin e. carbamazepine
A pt. takes donepezil for AD. Vital sings for this pt. are: temp. 98.2' F; bp 135/82, pulse 54; rr 18. Which variance should the nurse consider most likely attributable to donepezil therapy? a. temp b. bp c. pulse rate d. rr
c. pulse rate
An adult says, "I take provastatin for my high cholesterol. It will prevent stroke and heart attack." What is the nurse's most informative response regarding the effects of this classification of drugs? a. that's correct. I'm glad to see you taking such good care of yourself b. there is limited research-based evidence of the effectiveness of statin medications c. some research indicates that stain drugs may also interfere with development of AD d. perhaps you should discuss your family history with your doctor. Statin drugs may cause early development of AD
c. some research indicates that stain drugs may also interfere with development of AD
A medication teaching plan for a patient receiving lithium should include which instruction? a. Eat one or two bananas daily. b. To limit daily sodium intake. c. To restrict daily fluid intake to 1000 mL. d. Comply with scheduled laboratory testing of lithium level.
d. Comply with scheduled laboratory testing of lithium level.
Which vector is associated with transmission of variant Creutzfeldt-Jakob disease? a. Dog ticks b. Mosquito bites c. Airborne particles d. Contaminated meat
d. Contaminated meat
Which nursing intervention is most likely to result in heightened self-awareness for a patient diagnosed with a personality disorder in the dramatic-erratic cluster? a. Setting firm limits on behavior b. Providing clear expectations for acceptable behavior c. Using confrontational approaches to reduce self-mutilation d. Encouraging the patient to keep a daily journal to be shared with the nurse
d. Encouraging the patient to keep a daily journal to be shared with the nurse
Which receptors carry out primary functions of the parasympathetic nervous system? (select all that apply) a. NMDA b. COX-1 c. COX-2 d. Nicotinic e. Muscarinic
d. Nicotinic e. Muscarinic
The family of a patient diagnosed with Alzheimer disease (AD) is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion? a. Use adult diapers. b. Put a sign on the bathroom door. c. Limit fluid intake to 1000 mL daily. d. Take the patient to the bathroom every 2 hours.
d. Take the patient to the bathroom every 2 hours.
What information should the nurse provide the family of a client diagnosed with normal-pressure hydrocephalus (NPH)? a. It eventually develops into Pick disease b. There is currently no treatment for this condition c. Few clients regain cognitive abilities d. The related dementia is potentially reversible
d. The related dementia is potentially reversible
A nurse should schedule a weekly complete blood cell count (CBC) for a pt. beginning therapy with which antimanic drug? a. lithium b. valproate c. quetiapine d. carbamazepine
d. carbamazepine
A pt. with rapid-cycling bipolar disorder is not responding to lithium therapy. At the next multidisciplinary team meeting, the nurse should point out that many rapid-cycling pts. have been effectively treated using what medication? a. sertraline b. phenytoin c. benztropine d. divalproex
d. divalproex
A pt. offers to lead the next medication group session stating, "I have studied all the effects and problems with drugs on the Internet, so I can answer pt.'s questions." How should the nurse document this finding? a. flight of ideas b. distractibility c. limit-testing d. grandiosity
d. grandiosity
Characteristic behaviors a nurse would expect when working with a patient diagnosed with narcissistic personality disorder are: a. preoccupied with details; perfectionism. b. socially isolated; odd, eccentric behavior. c. dramatic expression; easily influenced by others. d. grandiosity; sense of entitlement; lack of empathy.
d. grandiosity; sense of entitlement; lack of empathy.
A patient diagnosed with bipolar disorder is laughing and giddy one minute and seconds later is angry and sarcastic. How should the nurse document the patient's mood? a. Incongruent b. Inappropriate c. Blunted d. Labile
d. labile
For 2 weeks a pt. has taken lithium and risperidone daily for mania. The pt. now reports diarrhea, vomiting, and blurred vision. The nurse observes a coarse hand tremor. What is the nurse's priority action to these assessment finding? a. administer a prn dose of benztropine to relieve extrapyramidal symptoms (EPSEs) b. hold the next dose of risperidone to prevent further drug-drug interaction c. reassure the pt. that these side effects will decrease with time d. notify the prescribing physician immediately
d. notify the prescribing physician immediately
The spouse of a pt. diagnosed with bipolar disorder tells the nurse, "Every time my partner recovers from a manic episode, depression follows soon. It's very discouraging." The nurse's reply should include what information? a. as the partner ages, rapid cycling will decrease b. combining lithium with haloperidol (Haldol) might prevent rapid cycling. c. depression associated with bipolar disorder is usually time-limited, so treatment is not indicated d. recent addition of olanzapine to the pt.'s drug regime can be helpful as a mood stabilizer
d. recent addition of olanzapine to the pt.'s drug regime can be helpful as a mood stabilizer
Before beginning lithium therapy, the nurse should educate a pt. about laboratory tests assess for adequate function of which system? a. peripheral vascular b. reproductive c. respiratory d. renal
d. renal
Which statement by a family member of a pt. diagnosed with AD demonstrates that medication education was effective? a. the medication affects glutamate receptors and will stabilize late-stage dementia b. the medication inhibits the action of dopamine and will restore short-term memory c. the medication offers no positive effects on performance of activities of daily living d. the medication inhibits breakdown of an important neurotransmitter and may slow disease progression
d. the medication inhibits breakdown of an important neurotransmitter and may slow disease progression
A 63-year-old woman says, "I want to take estrogen to prevent AD, but my doctor won't prescribe it." What is the nurse's most informative response? a. perhaps you should seek a second opinion. estrogen clearly provides protection against AD b. most research now believe that estrogen is not actually deficient after menopause. It simply works in different ways. c. most online resources indicate that estrogen provides important protection against development of AD d. there is conflicting evidence about whether estrogen prevents AD, but research clearly shows cardiovascular problems with estrogen therapy.
d. there is conflicting evidence about whether estrogen prevents AD, but research clearly shows cardiovascular problems with estrogen therapy.
