Psych Final - Childhood Disorders, Eating Disorders, Bipolar Disorder, Depressive Disorders, Schizophrenia, Neurocognitive Disorders, Personality Disorders, Substance Use
A nurse is assessing a client who is diagnosed with borderline personality disorder. Which statement by the client indicates the client is at risk for self-injurious behavior?
"I have felt so down lately. I don't enjoy doing anything anymore."
A nurse is caring for a client diagnosed with borderline personality disorder. The nurse has instructed the client about effective ways to communicate. The nurse determines that the client has understood the teaching when the client makes which statement?
"I should start by stating my feelings as an 'I' statement."
"While pacing in the hall, a client with paranoid schizophrenia runs to the nurse and says, ""Why are you poisoning me? I know you work for central thought control! You can keep my thoughts. Give me back my soul!"" How should the nurse respond during the early stage of the therapeutic process?
"I'm a nurse, and you're a patient in the hospital. I am not going to harm you"
A client asks the nurse to go to lunch with the client one day next week after the client is discharged. Which statement is the most therapeutic response?
"My role here is to help you recover. Let's talk about what else you can be doing after discharge."
The nurse is interviewing a client with a history of violence. The client boasts that the client "put a kid in a wheelchair" once when the client was younger and has maimed others. The client states, "Who cares? Life's tough." Violence and insensitivity are associated with which personality disorder?
Antisocial personality disorder
An older adult diagnosed with dementia wanders the halls of the locked nursing unit during the day. To ensure the client's safety while walking in the halls, what should the nurse do?
Assess the client's gait for steadiness
A 40-year-old client with schizophrenia lives in a rooming house. The client scratches vigorously and reports creatures eating at the skin. Which intervention should be done first?
Assess the client's physical problems
An agitated client diagnosed with schizophrenia and the client's family arrive in the psychiatric unit for admission. Which action should the nurse do first?
Assess the client's risk for suicide, homicide, and other violent behavior
Which drug to treat EPS symptoms is the first choice?
Benztropine (Cogentin)
A client is admitted to the mental health unit after the client's spouse brings the client to the emergency department. Upon arrival, the spouse explained that the client had been crying all weekend and stating that the client wanted to die. Upon further assessment, the spouse reports that the client always has difficulty controlling anger and frequently worries that the spouse will leave the client. Recently, the client has been getting drunk every night, which the client never used to do. What diagnosis should the nurse suspect applies to this client?
Borderline Personality Disorder
Impulsivity and difficulty controlling anger are characteristic of which mental health diagnosis?
Borderline Personality Disorder
The nurse is performing an assessment of a client admitted to the behavioral health unit with schizophrenia. Which behavior by the client would the nurse document as positive symptoms? SATA
Client states, "do you see all the rats crawling on the floor? Kill them!" Client is copying the movements of the client next to them Client states, "I am King of England"
The nurse is administering medications to a client with advanced Alzhiemer's dementia who is confused to person, place, time. Prior to administering medication, what action should the nurse perform to verify the patient's identity?
Compare the name and ID number on the patient's wristband with the one on the MAR
The nurse is teaching the family of a client with psychiatric disorder about traditional antipsychotic drugs and their effect on symptoms. Which symptoms would be most responsive to these types of drugs?
Delusions
A client with submissive and clinging behavior related to an excessive need to be taken care of by others is what disorder?
Dependent
A nurse is planning discharge for a client who has borderline personality disorder. Which interventions should be included for this client?
Dialectical behavior therapy
A client with attention-seeking behavior and excessive emotionality who views relationships as being closer than they really are. Which disorder is this?
Historionic
A client is admitted to the psychiatric emergency department with difficulty sleeping, poor judgement, and incoherent speech. The client reports being a special messenger from the Messiah who needs to be sacrificed to save the world. Which action should the nurse take first?
Initiate suicide precautions
When providing care to a client who consistently attempts to manipulate the staff, the nurse can best maintain the therapeutic milieu by doing what?
Instructing the staff to enforce all the unit rules consistently
A client with dementia must be temporarily hospitalized. The family wants to take proactive measures to assure the client does not experience further confusion. Which measure if suggested by the family would the nurse discourage?
Keeping lights dimmed during daylight hours
A nurse caring for a client with borderline personality disorder (BPD) consistently informs the client of the length of the relationship and routinely prepares the client for termination and the end of hospitalization. Which is the nurse trying to prevent?
Maladaptive expression of emotions
Nursing staff are trying to provide for the safety of an elderly female client with moderate dementia. She is wandering at night and has trouble keeping her balance. She has fallen twice but has had no resulting injuries. The nurse should:
Move the client to a room near the nurse's station and install a bed alarm
A client with feelings of grandiosity and a need for admiration who has a lack of empathy for others is which disorder?
Narcissistic personality disorder
The nurse is working in a community mental health clinic. A client who is diagnosed with schizophrenia is taking clozapine and reports a sore throat. What is the most appropriate action for the nurse to take?
Obtain and order for the client to have a white blood cell count drawn
A psychiatric-mental health nurse is reviewing information about the possible theories associated with narcissitic personality disorder. The nurse demonstrates understanding of the information by identifying which concept as being associated with the development of this personality disorder?
Parental overindulgence of a child
A 26-year-old is being treated for delirium d/t acute alcohol intoxication. The client is restless, does not want to stay seated, and has a staggering gait. What should the nurse do first?
Provide one-to-one supervision of the client until detoxification tx can begin
A nurse is completing a health history on a psychiatric client brought to the ED. the client states that they are a relative of the president of the United States and have very important business to attend to that involves national security. What is the nurse's best interventions?
Respect the client's POV while refocusing on issues based on the immediate reality
A client who lacks social skills and has no desire for personal intimacy. What disorder is this?
Schizoid
The nurse-therapist is conducting a group therapy session in which one of the participants is an adult who has been diagnosed with narcissistic personality disorder. The nurse recognizes the significance of childhood experiences in the etiology of personality disorders, which for this client may have included what pattern?
The client's parent catered to the client's every need and the client used temper tantrums to successfully get the client's way.
The nurse is reviewing laboratory values of a client receiving clozapine. Which of the following lab values does the nurse immediately report to the HCP?
WBC of 3,500
A nurse is prioritizing care for four new admissions to the inpatient psych unit. Which client should the nurse assess first?
a client with new-onset of confusion and disorientation
The nurse should include which of the following in the plan of care for someone with dependent personality disorder?
acknowledge the client's situation but encourage independence
A client comes to the clinic for a follow-up visit. Despite being warm and friendly with the nurse on a previous visit, today the client presents with anger and sarcastic undertones with the same nurse. The client is presenting which behavior commonly seen in borderline personality disorder?
affective instability
Avoidant, dependent, and obsessive-compulsive personality disorders are characterized by what?
anxious or fearful behaviors
A client diagnosed with schizophrenia is brought to the hospital from a group home where he became agitated, threw a chair at another client, and has been refusing medication for 8 weeks. The client exhibits a flat affect, is not caring for his hygiene, and has become increasingly withdrawn and asocial. The health care provider prescribes treatment with risperdone to improve the client's negative and positive symtpoms of schizophrenia. When evaluating the drug's effectiveness on the client's negative symptoms, the nurse should expect improvement in which symptom?
apathy, affect, social isolation
An older adult experiences short-term memory problems and occasional disorientation a few weeks after her husband's death. She also is not sleeping, has urinary frequency and burning, and sees rats in the kitchen. The home care nurse calls the woman's HCP to discuss the client's situation and background, assess, and give recommendations. The nurse concludes that the client most likely has which problem?
delirium and UTI
The nurse is caring for a client with schizotypal personality disorder that was experiencing transient psychotic episodes that lead to admission. The client was unkempt and appeared not to have bathed for quite some time. When planning the care of this client, which will be the focus of the nursing intervention(s)? Select all that apply.
development of self care skills, development of social skills, improve functioning in the community
When communicating with the client who is experiencing dementia and exhibiting decreased attention and increased confusion, which intervention should the nurse employ as the first step?
eliminating distracting stimuli such as turning off the tv
A client experiencing a schizophrenic episode is hospitalized. The client is attempting to hit and bite the staff. When the nurse phones the primary care provider for orders to help calm the client, the nurse anticipates what medication is likely to be ordered?
haloperidol
A nurse caring for a client who has been diagnosed with a personality disorder should expect that the client will exhibit which of the following?
inflexible and maladaptive responses to stress
A nurse is caring for a client diagnosed with antisocial personality disorder. The client has a hx of fighting, cruelty to animals, and stealing. Which trait is the nurse likely to uncover furring the assessment?
low tolerance for frustration
A nurse is preparing an inservice program for a group of mental health nurses on the topic of borderline personality disorder. When discussing the need for hospitalization, which would the nurse include as the most likely reason for inpatient hospitalization?
nonsuicidal self injury
A client is a 25-year-old who has a long history of being suspicious of the client's friends and spouse. The client persistently accuses the client's spouse of being unfaithful. The client accuses friends of making statements that are insulting to the client's character. Which is the most accurate description of the client's personality?
paranoid
A nurse is working with clients with delirium on a medical unit. What is the nurse's priority concern?
safe environment
The most serious consequence of behaviors seen in borderline personality disorder includes what?
self-injury
A client on an inpatient psychiatric unit has features of borderline personality disorder. The client is frequently angry, has an unstable sense of self, and is highly impulsive. The client can be verbally abusive to staff, who feel manipulated by the client's behaviors. Which intervention does the nurse determine as priority?
setting limits
A client with borderline personality disorder (BPD) who evaluates experiences, people, and objects in terms of mutually exclusive categories (e.g., good or bad, success or failure) is demonstrating which type of thinking?
splitting
A client with BPD dramatically expresses feelings about each nurse on the unit, stating the there nurse today is the only one who is understanding and trustworthy. What is this behavior called?
splitting (people are all good or all bad)
A client has been receiving chlorpromazine to tx psychosis. Which findings should alert the nurse that the client is experiencing pseudoparkinsonism?
tremors, shuffling gait, and masklike face
The nurse is in the process of planning the care of a psychiatric-mental health client and has specified the following outcome: The client will be free from self-inflicted harm. What is this client's most likely diagnosis?
Borderline personality disorder
A client has a diagnosis of borderline personality disorder and lives at home with the client's parents. The client has been in the psychiatric unit for 2 weeks and is scheduled to be discharged tomorrow. Which would be most therapeutic when the client's parents come in to discuss discharge plans?
ask the parents to keep a written schedule of activities for each day for the client
While the nurse is performing an admission assessment, the client stops talking in the middle of a sentence, tips his head to the side, and listens carefully. The nurse recognizes that the client most likely experiences which problem?
auditory hallucinations
A client with schizophrenia who receives fluphenazine develops pseudoparkinsonism and akinesia. What drug should the nurse administer as ordered to minimize this client's extrapyramidal symptoms?
benztropine
A nurse is assessing a client who has borderline personality disorder (BPD). Which should be given priority during the assessment?
Nutrition patterns
A nursing instructor is teaching about the importance of bonding and how an easy temperament can serve as a protective factor against psychopathology. Which statement made by a student demonstrates a need for further instruction?
"Temperament is non-changable"
The client is to undergo a series of diagnostic tests to determine if the client's cognitive impairment is treatable. Which state can lead to nonreversible cognitive impairment?
Alzhiemer's disease
A nurse is caring for a client receiving a dopamine receptor agonist for tx of extrapyramidal symptoms caused by antipsychotic medications. What evaluation would indicate a therapeutic response to this drug?
Client experiences a decrease in dystonia
Which cluster of disorders corresponds to symptoms of being dramatic and emotional?
Cluster B
A nurse is preparing a teaching plan for a client with antisocial disorder. Which would the nurse most likely employ to promote successful education?
Engaging the client in a discussion to direct the topic to the client.
Which personality disorder would be placed in Cluster B?
borderline
