NSG 450 PrepU

Which question(s) should the nurse include when assessing a client who is noncompliant with prescribed psychopharmacologic medications? Select all that apply. "Are you having trouble paying for your prescribed medications?" "Are the side effects to your medications causing problems at work?" "Are you confused about when you should take each of your medications?" "Are you afraid that you will become addicted to your prescribed medication?" "Are you concerned about the stigma associated with taking the prescribed medications?"

"Are you having trouble paying for your prescribed medications?" "Are the side effects to your medications causing problems at work?" "Are you confused about when you should take each of your medications?" "Are you afraid that you will become addicted to your prescribed medication?" "Are you concerned about the stigma associated with taking the prescribed medications?"

The nurse assesses an adult client who presents with depression. Which question does the nurse include in the health history interview to determine if the client is at risk for suicide? Select all that apply.

"Do you have any physical illnesses?" "Do you have a history of alcohol use disorder?" "Have you experienced the loss of a job recently?" "Has anyone in your family ever attempted self-harm?" "Were you subjected to any type of abuse when you were a child?"

The nurse is working with a client diagnosed with compulsive hoarding syndrome. Which client statement(s) suggests successful implementation of strategies introduced by cognitive behavioral therapy (CBT)? Select all that apply.

"I keep reminding myself what life would be like if all the clutter was gone." "I know my child's allergies would be so much less of a problem if the house was clean." "I feel so overwhelmed when I think about getting rid of some of the clutter in the house."

The nurse assesses a client diagnosed with posttraumatic stress disorder (PTSD) who is supposed to be using coping skills that enhance resilience. Which client statement indicates a need to intervene due to the use of a negative coping skill?

"I tend to drink wine or beer when I have to attend a family function."

A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. The nurse will explain the reason for restraints to the client by saying ...

"This is a means of keeping you and others safe."

A client's physician has prescribed paroxetine for the treatment of the client's depression. Which teaching points should the nurse include in the client education related to this treatment?

"Make sure that you don't change the quantity or timing of your medication without first consulting your doctor."

A client is receiving ziprasidone as part of the treatment plan. On a return visit to the clinic, the client reports some anticholinergic side effects. When teaching the client about ways to minimize these effects, which statement would be most appropriate for the nurse to make? Select all that apply

"Make sure to include high fiber foods in your diet." "Try sucking on some sugarless candies."

The nurse is working with a client who has been experiencing nightmares, hyperarousal and negative thoughts following a bomb threat at the client's workplace. The nurse's colleague states, "It turned out to be just a threat, not a bombing, so technically she can't have posttraumatic stress disorder (PTSD)." What is the nurse's best response?

"PTSD is a real possibility, even though the bombing never actually took place."

A nurse is educating a client about heart disease and stress. The nurse knows that the client understood the teaching when he/she states:

"Stress can affect your body's immune system, which can increase the symptoms of your disease."

A client diagnosed with posttraumatic stress disorder (PTSD) has been encouraged to engage in exposure therapy. What education should the nurse provide to help the client prepare to effectively engage in this treatment? Select all that apply.

"Therapy will help you face and control fear through controlled expose to the trauma." "Physically revisiting the site of the traumatic event, when possible, will be helpful for you." "Writing down or journaling the details of the trauma will be therapeutic."

A client suddenly jumps up from the chair and begins yelling and cursing at the nurse. Which would be the best response by the nurse?

"You seem angry. Tell me more about how you're feeling."

A client is pacing the hall near the nurses' station and swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and say response?

"You seem upset. Tell me about it."

The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When educating the client about this procedure, which would the nurse include? Select all that apply.

"You will be awake and alert during the procedure." "You can resume your normal activities right after the treatment."

A nurse is conducting an assessment of a client's social network. Which question would be most appropriate for the nurse to ask? Select all that apply.

-"Do any of the members know one another?" -"How big is your network of contacts?" -"Who gives you the best advice?" -"Who is responsible for providing support?

The nurse develops a teaching plan for a client who is diagnosed with somatic symptom disorder (SSD). Which topic does the nurse include in the client's teaching plan? Select all that apply.

-exercise -nutrition -appropriate health care practices -nonpharmacologic pain management -relaxation and anxiety-reduction techniques

A client with a mood disorder is receiving psychopharmacologic therapy as part of the treatment plan. Place the interventions in the proper sequence that the nurse would complete them throughout the phases of the client's drug treatment.

1. Cultural assessment and laboratory testing 2. Assessment for improvements in target symptoms 3. Client teaching about what to do if symptoms return 4. Assisting with tapering of drug dosage

Of the following list of nursing interventions for the patient with posttraumatic stress disorder (PTSD), place them in order of priority, with the first being the highest priority.

1. Ensure that the client's physical needs are met. 2. Establish suicidal/aggressive safety measures. 3. Have the client identify the original trauma that started the PTSD. 4. Begin intensive one-on-one counseling.

Which of the following individuals should the nurse screen most closely for signs and symptoms of post-traumatic stress disorder (PTSD)?

A female client who has recently escaped from a relationship marked by intimate partner violence

Nursing interventions for the depressed person should include which approach?

Acceptance, honesty, empathy, and patience

A client diagnosed with depression is being treated with Phenelzine (Nardil). The nurse should teach the client to avoid which of the following foods?

Aged cheese

When traveling alone and away from home, a client experiences trembling and palpitations. These symptoms have impeded the client from leaving her home. The nurse would correctly note that these are symptoms of which type of phobia?

Agoraphobia

The primary goal of de-escalation is to resolve which that can happen on an inpatient unit?

Angry conflicts

The nurse plans care for a client in the primary care setting who is diagnosed with somatic symptom disorder (SSD). Which intervention does the nurse include in the client's plan of care?

Ask the client if there is a history of trauma.

A psychiatric-mental health nurse can best prevent suicide by performing what action?

Assess clients carefully for the warning signs of suicide

What is the difference between depressive disorders and bipolar disorders?

Bipolar disorders involve mood swings ranging from depression to mania.

The nurse is aware that a person who repeatedly seeks cosmetic surgery to correct a perceived flaw in his or her appearance may have which disorder?

Body dysmorphic disorder

A client who suffers from bipolar disorder is admitted to a mental health unit for a manic episode. The nurse knows that which takes priority?

Client safety

The nurse is performing a strength assessment on a client diagnosed with bipolar disorder. What finding would alert the nurse that further follow-up is needed?

Client states that they have missed a dose of scheduled medication.

When teaching a client with generalized anxiety disorder, the nurse instructs the client to avoid which of the following?

Caffeine

A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which of the following would the nurse do first?

Decrease the client's environmental stimuli

A nurse is providing care to a client with anxiety. The client's history reveals use of defense mechanisms. Which information would the nurse need to intergrate into the plan of care about the use of defense mechanisms in persons with anxiety disorders is accurate? Select all that apply.

Defense mechanisms are a human's attempt to reduce anxiety. Defense mechanisms can be harmful when overused. Defense mechanisms are cognitive distortions. Defense mechanisms can control the awareness of anxiety.

The client has been diagnosed with depression and asks the nurse several questions regarding depression and how it came to be diagnosed. Which explanation would the nurse include when describing the psychodynamic view of the etiology of depression?

Depression is an anger turned inward

A teen has been diagnosed with body dysmorphic disorder (BDD). Which assessment question(s) demonstrates the nurse's effective understanding of comorbid coexisting psychiatric disorders associated with this disorder? Select all that apply

Do you generally feel hopeful about your life?" "Would you consider yourself to be more anxious than your friends?" "Do you ever find yourself thinking about or planning to end your life?"

The nurse provides education regarding the introduction of virtual services provided by mental health care practitioners. Which expectation of virtual service does the nurse include in the teaching session? Select all that apply.

Encrypt client data in transit and in storage. Protect display screens from incidental viewing. Exchange protected health information (PHI) only when necessary. Ensure that audio transmissions are protected from eavesdropping. Negotiate HIPAA-compliant business associate agreement (BAA) with cloud ho

A client diagnosed with bipolar disorder is admitted to an inpatient psychiatric facility with acute mania and threats of attacking others in the household. Which would be the priority?

Ensuring safety

During an interview, the nurse has asked a client with depression about any hopes or plans for the future. In response, the client silently made a gesture of drawing the index finger from one side of the client's throat to the other. The nurse has informed the client that this must be communicated to the care team. What is the main rationale for the nurse's action?

Ensuring the client's safety

Following a suicide attempt, a client with obsessive-compulsive disorder (OCD) is being admitted to the psychiatric unit. When planning this client's care, which action would be most appropriate? Select all that apply.

Express empathy regarding the client's need to perform compulsive rituals Integrate the client into meaningful unit activities as anxiety levels allow

Which is the most common obsession experienced by a client diagnosed with obsessive-compulsive disorder?

Fear of contamination

A group of nurses is reviewing the signs and symptoms associated with anxiety. The nurses demonstrate an understanding of the information when they identify which manifestation as a cognitive symptom? Select all that apply.

Feelings of unreality Difficulty concentrating Tunnel vision

The nurse is assessing a client diagnosed with posttraumatic stress disorder (PTSD). Which symptom would the nurse categorize as reflecting intrusion? Select all that apply.

Flashbacks Difficulty sleeping

A client has no expression when conversing with the nurse. This would be documented as which type of affect?

Flat

A nurse is providing care to a client with a situational phobia. Which technique would the nurse most likely expect to include in the client's plan of care? Select all that apply.

Flooding Systematic desensitization

A nurse is preparing a continuing education presentation about various psychopharmacologic agents for a group of psychiatric-mental health nurses. The nurse is planning to discuss selective serotonin reuptake inhibitors. Which agents would the nurse include in this group? Select all that apply.

Fluoxetine Sertraline

A nurse is reviewing the medical record of a client prescribed lithium carbonate. The nurse would be alert for possible increases in serum lithium concentrations based on the client's use of which substance? Select all that apply.

Fluoxetine alcohol furosemide ibuprofen

A client with hyperarousal symptoms is likely to experience increased noradrenergic activity in the brain. Identify the region of the brain most likely affected

HOT SPOT

The nurse is assisting a client with obsessive-compulsive disorder (OCD) during a behavior therapy session. How does the nurse assist the client with "response prevention"? Select all that apply.

Help the client to accept thoughts and related anxiety. Teach that anxiety will recede without disastrous consequences. Assist the client to take charge of thoughts and manage anxiety.

Which of the following best describes a steady state within the body?

Homeostasis

A group of nurses is reviewing information about the epidemiology of depressive disorders. The nurses demonstrate understanding of the information when they identify which factor as increasing the risk for depression? Select all that apply.

Inadequate coping skills Concomitant medical illnesses Little social support

A nurse is caring for a client with generalized anxiety disorder. When the client starts trembling and perspiring, the nurse becomes uncomfortable and anxious; develops cold, clammy hands; and has a racing pulse. When the nurse responds in this way during an interaction, what will the client most likely develop?

Increased anxiety

The nurse is planning a presentation to a group of nursing students on the topic of anxiety disorders. Which detail would the nurse include when describing panic disorder?

Individuals may believe they are having a heart attack when a panic attack occurs.

A nurse is working with a client diagnosed with bipolar disorder and his family on relapse prevention. Which information would the nurse encourage the family to include in their emergency plan? Select all that apply.

Information about other health problems Treatment preferences List of emergency contacts

A nurse is reading a journal article about women and somatic symptom disorder. The nurse would expect to find which medical problem as being commonly treated in women coexisting with SSD? Select all that apply.

Irritable bowel syndrome Polycystic ovary syndrome Chronic pain Hypertension

The nurse is working with a client who going through the process of getting divorced. In order to ensure the client is using healthy coping mechanisms, which activities should the nurse suggest? Select all that apply.

Joining a fitness community Taking nutrition classes Going to bed at the same time every night

The client suffers from bipolar disorder. The client is experiencing a downward spiral. For which drug should the nurse expect the client to require serum level monitoring?

Lithium

nurse is reviewing the history of a client with documented bipolar and seizure disorders and notes a change in therapy from lithium to carbamazepine. What information would alert the nurse to this change in therapy? Select all that apply.

Lithium therapy was not effective. There are decreased cardiovascular effects. Carbamazepine has a clinical primary indication for seizures.

A client is admitted to an inpatient unit for treatment of mania. Which priority action should the nurse implement?

Maintain round-the-clock monitoring of the client.

A client who has experienced intimate partner violence (IPV) for many years has just been diagnosed with post-traumatic stress disorder (PTSD). The nurse realizes that this will increase the client's risk for which of the following?

Suicide

A client with posttraumatic stress disorder (PTSD) is hospitalized on a medical unit due to unstable blood sugars. The nurse identifies a sleep pattern disturbance in the client's admission documentation. Which are consistent problems associated with a sleep pattern disturbance? Select all that apply. Difficulty falling asleep Difficulty arousing from sleep Narcolepsy Nightmares Being easily startled and awakened

Nightmares Difficulty falling asleep Being easily startled and awakened

A client is being treated for bipolar disorder and the health care provider has ordered milieu therapy. What best practice method should the nurse use? Arrange for the client to attend group activity sessions. Stress the importance of participating in group sessions. Place the client in a private room away from the nurse's station. Make sure that the client has access to both phone and television.

Place the client in a private room away from the nurse's station

The nurse is conducting an admission assessment for a client with major depressive disorder. Which is the priorityassessment for the nurse?

Suicide risk assessment

Flashbacks and feelings of unreality are associated with what?

Posttraumatic stress disorder (PTSD)

A high risk for suicide would be assessed as what?

Previous suicidal behavior

A client arrives on the psychiatric unit exhibiting restlessness, disorientation, incoherent speech, agitation, purposeless physical activity, and suicidal ideations. Which is the priority nursing diagnosis for this client?

Risk for self-harm

The priority concern for people with mood disorders is what?

Safety

When developing the plan of care for a client with major depression, which is the priority?

Safety

A nurse is assessing several clients. Which factor would the nurse most likely identify as increasing a client's risk for committing suicide?

Social isolation

An adolescent experiencing severe abdominal pain after the client's parents' argument is an example of what?

Somatization

The primary reason for considering cultural issues when caring for the client with somatization disorders is what?

Somatization disorders differ in type and frequency of symptoms and depend on the culture in which they are expressed.

A client with a history of depression and use of antidepressant therapy is brought to the emergency department for evaluation. After assessing the client, the nurse suspects serotonin syndrome. Which finding would the support the nurse's suspicion? Select all that apply. Tachycardia Hypothermia Hyperreflexia Vomiting Hallucinations

Tachycardia Hyperreflexia Vomiting Hallucinations

The nurse is performing an assessment of a client who has obsessive-compulsive disorder (OCD). When assessing the client's risk for suicide, the nurse should prioritize what assessment finding?

The client expresses that he feels "utterly hopeless" change his behavior

A 28-year-old client is being treated with lithium carbonate for bipolar disorder. The nurse emphasizes the signs and symptoms of toxicity based on which factor associated with the client?

The client runs marathons frequently.

A psychiatric-mental health nurse is developing a plan of care for a client who has survived trauma. Which outcomes would the nurse identify as the immediate priorities? Select all that apply.

The client will be physically safe. The client will distinguish between ideas of self-harm and taking action on those ideas.

A client is diagnosed with early-onset obsessive-compulsive disorder (OCD). Based on the nurse's understanding of this disorder, which aspect would the nurse most likely anticipate?

The client will most likely experience a poorer outcome

The nurse is conducting a mental status assessment with a client who has major depressive disorder. The client tells the nurse, "I really feel like I can't take it anymore." What additional information should the nurse seek out in order to determine if an emergency alert is warranted?

The client's history of previous suicide attempts

A nurse is reading a journal article about anticonvulsant agents used in psychiatric-mental health commonly used to treat clients with bipolar disorder. Which medication would the nurse most likely find being discussed in the article? Select all that apply. Valproate Carbamazepine Lamotrigine Lithium Clozapine

Valproate Carbamazepine Lamotrigine Lithium

The psychiatric nurse is preparing to provide education to a client who has recently been prescribed lithium. The nurse should include which information? Select all that apply. The intended outcome of the therapy will be the prevention of manic behavior. The drug appears to balance the neurotransmission of serotonin. Blood levels of the drug should be monitored at least monthly with a sample drawn 12 hours after a dose. Your health care provider should be notified immediately of any vomiting, diarrhea, or profuse perspiration. The effects of the medication should be established within 10 to 14 days.

The intended outcome of the therapy will be the prevention of manic behavior. The drug appears to balance the neurotransmission of serotonin. Blood levels of the drug should be monitored at least monthly with a sample drawn 12 hours after a dose. Your health care provider should be notified immediately of any vomiting, diarrhea, or profuse perspiration.

A psychiatric-mental health clinical nurse specialist is preparing a seminar about major depression. What would the nurse most likely include? Select all that apply.

The risk for suicide is especially high during the midadolescent years. Response to treatment in older adults is slower than that for younger adults. Episodes of depression tend to occur more frequently over time. Depressive disorders are most often treated in the primary care setting

Which is an important part of therapeutic communication for clients who have obsessive-compulsive disorder (OCD)?

To encourage the client to discuss his or her obsession with the nurse.

To defuse a critical situation, the nurse can use the therapeutic communication techniques for which reason?

Try to clarify what has upset the client

A nurse is monitoring a client on lithium therapy and observes that the client has a fine motor tremor of the hand and reports a metallic taste. Which action(s) should the nurse take? Select all that apply.

Verify dosage and time of last lithium medication taken. Withhold next lithium dose until serum levels have been drawn. Increase fluids to maintain hydration. Obtain serum sodium level.

An example of a long-term coping strategy is ...

Walking briskly three times a week for 20 minutes

After an angry outburst, the client is tearful and remorseful. Which statement by the nurse would be most supportive?

What could you have done when you first started to feel angry?"

Which client should be assessed as demonstrating aggression?

a client who stomps away from the nurses' station, goes into the day room, and grabs a pool cue from another client standing at the pool table

The nurse provides care to a client who presents to the emergency department (ED) having an acute panic attack. Which prescribed medication is best for the nurse to administer to provide immediate relief to the client's symptoms? lorazepam clonazepam diazepam alprazolam

diazepam

A client diagnosed with bipolar disorder has a lithium drug concentration of 1.2 mEq/L. Which finding would the nurse expect to assess? Select all that apply.

metallic taste, diarrhea, muscle weakness

A psychiatric-mental health nurse practitioner is conducting a class on the pharmacodynamics of psychiatric medications for a group of psychiatric-mental health nurses. The nurse practitioner determines that additional education is needed when the group identifies which as a site of action? Ion channels Neurotransmitters Enzymes Receptor

neurotransmitters

A client with schizophrenia who is experiencing hallucinations and delusions is prescribed risperidone. When administering this drug, the nurse understands that this drug works to achieve its acton by primarily blocking which type of receptor?

serotonin