Psych Jersey Exam 2/Final

An older client has been diagnosed with infection-induced delirium. Which statement by the nurse to the client's family best demonstrates an understanding of the disorder while addressing the family's concerns?

"Delirium isn't permanent when treated appropriately. The prescribed medication should eliminate the infection causing the symptoms."

the goal of cognitive-behavioral therapy is accomplished by assisting patients in the following:

1.identify and "testing" negative or distorted cognitions or viewpoints 2. developing alternative thinking patterns by challenging the cognitive distortions 3. rehearsing new cognitive and behavioral responses

In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption?

12 hours

The nurse is caring for a client experiencing panic post fireworks display over the holiday weekend. The client routinely takes a prescribed dose of alprazolam 1.5 mg PO TID. An additional PRN dosage is also prescribed as 1.5 mg PO every 4 hours. The maximum daily dose is 8 mg. How many additional doses of the PRN medication might the client take safely?

2

Which assessment question is directed at a primary concern associated with the initiation of antidepressant medication therapy for an older client?

"Have you been experiencing any side effects since starting the medication?"

Which statement made by a client receiving treatment for a substance abuse problem best indicates an understanding of relapse prevention?

"I abuse when I'm bored or lonely but now I know how to keep busy."

Which statement indicates the existence of a codependent relation between a client diagnosed with substance abuse and their life partner?

"I'm always so angry about how the addiction controls our lives."

Which statement made by a community leader demonstrates a common stigma associated with the serious and persistent mentally ill (SPMI)?

"It's difficult to use government money to support people who are unemployable."

Which statement is reflective of a commonly held myth about the older adult?

"It's not realistic to expect grandma to learn to use her "smart phone" effectively."

Which statement, by a child who recently lost "Sammy" a beloved pet, best demonstrates the parent's role in nurturing the child's resiliency?

"Mom, Dad, and I talk about how much fun we had with Sammy."

Which statement, made by a nurse to the family of a terminal ill client, requires immediate attention to prevent future demonstration of ageism?

"She's had a good life so don't be sad that she is dying."

Which statement by a nurse providing care for clients diagnosed with personality disorders demonstrates therapeutic management of manipulative client behavior?

"Tell me what triggered your angry response to what I said.", "The staff is responsible for determining unit rules that are fair to all clients.", "Remember that all clients must follow the rules regarding the use of the telephone."

Which nursing assessment question is focused on determining the client's motivation for binge eating?

"Would you say that you are less depressed after binging?"

Identify the serum lithium level for maintenance and safety.

0.8 to 1.2 mEq/L

The mental health nurse appropriately provides education on light therapy to which client?

20-year-old college student who reports being "too tired, sad, and unfocused" to enroll for classes in the winter term

A client diagnosed with schizophreniform disorder must have symptoms present for at least 1 month but with a duration of less than:

6 months

Which scenario presents the most risk factors for suicide?

82-year-old widowed while male recently diagnosed with pancreatic cancer

Which client exhibits the characteristics that are typical of the prodromal phase of schizophrenia?

A 20-year-old is experiencing a gradual decrease in the ability to concentrate, be productive, and sleep restfully.

Which scenario presents the highest risk for a pregnancy resulting in offspring with an intellectual developmental disability (IDD)?

A 32-year-old woman diagnosed with anorexia nervosa

Which newly hospitalized patient should the nurse monitor closely for the development of delirium?

A 48-year-old who usually drinks a six-pack of beer daily

A client with a diagnosis of anorexia nervosa, who is in a state of starvation, is in a 2-bedroom. A newly admitted client will be assigned to this client's room. Which client would be the best choice as a roommate for the client with anorexia nervosa?

A client undergoing diagnostic tests

The nurse is creating a plan of care for a client in a crisis state. When developing the plan, the nurse should consider which factor?

A client's response to a crisis is individualized and what constitutes a crisis for one client may not constitute a crisis for another client

A nurse teaching a client about prescribed antipsychotic medication informs the client to contact a health care provider immediately if the client notices:

A dramatic change in temperature

During an admission assessment with a psychiatric-mental health nurse, a client states that the client hears the voice of God in the client's head and the voice is telling the client that the client is worthless. How should the nurse document this symptom?

A hallucination

A client is admitted to the mental health unit with a diagnosis of depression. The nurse should develop a plan of care for the client that includes which intervention?

A structured program of activities in which the client can participate

On review of the client's record, the nurse notes that the admission was voluntary. Based on this information, the nurse plans care anticipating which client behavior?

A willingness to participate in the planning of the care and treatment plan

A nurse is employed at an outpatient rehabilitation facility caring for clients withdrawing from opioids. When assessing clients who present for their counseling session, which findings are anticipated at this time?

Abdominal cramps, rhinorrhea, dilated pupils

The nurse has been closely observing a client who has been displaying aggressive behaviors. The nurse observes that the behavior displayed by the client is escalating. Which nursing intervention is most helpful to this client at this time?

Acknowledge the client's behavior, assist the client to an area that is quiet, and maintain a safe distance from the client

A nurse managing the care of a client diagnosed with an eating disorder has begun to experience frustration when the client consistently pushes back against the planned interventions. What action on the part of the nurse is indicated to help strengthen the nurse-client relationship?

Acknowledging to the client that working toward these treatment goals must be very frightening

When beginning a client on newly prescribed antipsychotic medications, which symptoms are commonly seen within the first few weeks of treatment?

Acute dystonic reactions, akathisia, neuroleptic malignant syndrome, orthostatic hypotension

A young adult has reported heavy use of alcohol and prescription drugs since mid-adolescence. This individual now has an ataxic gait and uses a cane. Which comment by the nurse presents reality while demonstrating compassion?

Addiction is powerful. You are young yet cannot walk without a cane. Your health has been significantly affected by your long-term use of drugs and alcohol.

A nurse is working in the emergency room when a police officer walks in with a rape victim to be examined. If the nursing goal is to reduce patient anxiety, which interventions would be appropriate?

Admit the patient to the treatment area right away, Assure the patient of safety in the examination room, Allow a third party to be present if the patient requests it, Ask factual questions to determine the type of assault

A client is preparing to attend a Gamblers Anonymous meeting for the first time. The nurse should tell the client which is the first step in this 12-step program?

Admitting to having a problem

The mental health nurse is preparing a presentation about prescription drug abuse to a local community group. When describing the incidence, which age group would the nurse identify as experiencing an increase?

Adolescents

Clients from which continent or country may have symptoms of somatization disorder that include the nondelusional sensation of worms in the head or ants under the skin?

Africa

A nurse tells a 22-year-old male client on an inpatient psychiatric floor that it is time to attend group therapy. The client states, "I do not want to go." The nurse insists that the client attends as part of the client's prescribed care. The client states they feel like they might have a seizure and drops to the floor, but the nurse suspects the client has fallen in an attempt to further delay therapy. Select the most appropriate nursing response.

After assessing the client's safety, calmly wait until the client stops the behavior to speak with them again

A nurse is preparing discharge instructions for a client with resistant depression who was prescribed a new medication regimen that includes phenelzine, a monoamine oxidase inhibitor (MAOI). If the teaching was successful, what foods would the client state that they need to avoid?

Aged cheese, wine, salami

A client is prescribed sertraline, a selective serotonin reuptake inhibitor. Which adverse effects would the nurse review when creating a medication teaching plan?

Agitation, sleep disturbance, dry mouth

A mental health client has been prescribed clozapine for the treatment of schizophrenia. The nurse should be alert to which potentially life-threatening adverse effects of this medication?

Agranulocytosis

When planning a substance abuse information program for a local university, the nurse will prioritize which screening?

Alcohol

A mental health nurse assesses a patient diagnosed with an antisocial personality disorder. Which comorbid problem is most important for the nurse to include in the assessment?

Alcohol or substance use disorder

Histamine?

Alertness, inflammatory response, stimulates gastric secretion

Benzodiazepines?

Alprazolam, chlordiazepoxide, clonazepam, diazepam, lorazepam, oxazepam

Serotonin (5-HT)

An important regulator of sleep, appetite and libido. serotonin-circuit dysfunction can result in poor impulse control, low sex drive, decreased appetite, disturbed regulation of body temperature, and irritability

A nurse working in the county jail assesses four new inmates. The nurse should direct officers to place which inmate under suicide watch?

An inmate charged with a lewd and lascivious act perpetrated on a minor

Which client will likely have a history of intermittent explosive disorder?

An older adult found guilty of assault stemming from an incidence of road rage.

The nurse is seeing a 43-year-old client whose spouse just died by suicide. Which is a common emotional response that the nurse should anticipate from this client?

Anger toward the loved one who committed suicide

After assessing a client with schizophrenia, the nurse notes that the client exhibits signs and symptoms related to being unable to experience pleasure. The nurse documents this finding as what?

Anhedonia

Antipsychotic side effects?

Anticholinergic, Orthostatic hypotension, Nausea, GI upset, Drowsiness and sedation, Phtosensitivity, rash, Agranulocytosis, Extrapyramidal symptoms, Tardive Dyskinesia, Neuroleptic Malignant syndrome, hyperglycemia, hyperlipidemia, glucose intolerance, false positive pregnancy test, lactation, wieght gain, amenorrhea, decreased libido

What are medications used to treat bipolar disorder?

Anticonvulsants, Antipsychotics, Antidepressants, Lithium

Lithium is prescribed for a client admitted with a diagnosis of bipolar disorder. Which other therapy is also initially prescribed to temporarily help manage the client's symptoms?

Antipsychotic medication

Transient psychotic symptoms that occur with borderline personality disorder are most likely treated with which type of drug?

Antipsychotics

A person shoplifts merchandise from a community cancer thrift shop. When confronted, the person replies, "All this stuff was donated, so I can take it." This comment suggests features of which personality disorder?

Antisocial

Cluster B personality disorders?

Antisocial, Borderline, Histrionic, Narcissist

SSRI adverse effects?

Anxiety, insomnia, sexual dysfunction, gastrointestinal disturbances (Serotonin toxicity) Children, adolescents, and young adults may experience suicidal ideation and aggressive behaviors

A nurse is conducting a group session for children and adolescents who have been diagnosed with depression. Which behaviors would a nurse anticipate in this group?

Anxiety, irritability, somatic symptoms, suicidal thoughts

What are negative symptoms of Schizophrenia?

Apathy, withdrawl, lack of motivation, Anhedonia, Attention deficits

A client says to the nurse, "You are the best nurse I've ever met. I want you to remember me." What is an appropriate response by the nurse?

Are you thinking of suicide?

Atypical Antipsychotics?

Aripiprazaole, Ziprazadone, Risperidone, Quetiapine, Clozapine, Olanzapine, Lurasidone, Iloperidone, Paliperidone, Asenapine, Brexpiprazole, Cariprazine

A nurse begins a therapeutic relationship with a patient diagnosed with schizophrenia. The patient has severe paranoia. Which comment by the nurse is most appropriate?

As you get to know me better, I hope you will feel comfortable talking to me

The home health nurse visits a client at home and determines that the client is dependent on drugs. During the assessment, which action should the nurse take to plan appropriate nursing care?

Ask the client about the amount of drug use and its effect

The nurse is leading a group session when the nurse notices that a member of the group is tearful and shaking. Which nursing actions would be therapeutic at this time?

Ask the client to share the emotions that the client is feeling, direct a staff member to assist the client and continue the group

A nurse is working with a schizophrenic client who suddenly begins experiencing auditory hallucinations. Which interactions are appropriate at this time?

Ask the client, What are you experiencing right now, encourage the client to relate the history of the hallucinations, tell the client, Id like to spend time with you to discuss your hallucinations. Is that ok with you, ask the client if they have recently taken any drugs or alcohol

The police arrive at the ER with a client who has lacerated both wrists. Which is the best initial nursing action?

Assess and treat the wound sites

A client recovering from the manic phase of bipolar disorder is distraught to realize all savings account money was spent during the episode. Which action would the nurse make a priority for this client?

Assess for risk of suicide

A patient diagnosed with schizophrenia complains to the nurse about persistent feelings of restlessness and says, " I feel like I need to move all the time." What is the nurse's next action?

Assess the patient for other extrapyramidal symptoms

A patient diagnosed with schizophrenia says, "I hear the voices every day. They always say bad things about me." Which action by the nurse has the highest priority?

Assess the patient for suicidal thinking and plans

When considering comorbid conditions, which nursing intervention is most appropriate for a client diagnosed with a somatic symptom disorder?

Assessing client for suicidal ideations

Clonidine (Catapres) is prescribed for symptoms of opioid withdrawal. Which nursing assessment is essential before giving a dose of this medication?

Assessing the client's blood pressure

When assuming the management of the care of a delusional client, which should be the nurse's priority intervention?

Assure the client that he or she is safe in this milieu

A client's medication sheet contains a prescription for sertraline. To ensure safe administration of the medication, how should the nurse administer the dose?

At the same time each evening

The nurse is preparing the following medication for a client who has a long-term history of situation anxiety and is now experiencing a panic attack. Ativan (lorazepam) injection 2 mg per mL. When assessing the client 15 minutes after medication administration, the nurse notes the following symptoms. Which client symptoms is the MOST concern?

Ataxia

A client with schizoaffective disorder is prescribed long-term medication therapy. The nurse would most likely expect what to be prescribed as the mainstay of treatment?

Atypical antidepressant

A client with schizoaffective disorder is prescribed long-term medication therapy. The nurse would most likely expect what to be prescribed as the mainstay of treatment?

Atypical antipsychotic

The family of a client with schizophrenia asks the nurse about the difference between conventional and atypical antipsychotic medications. The nurse's best answer may include which information?

Atypical antipsychotics are dopamine and serotonin antagonists; conventional antipsychotics are only dopamine antagonists.

A patient is hospitalized with a diagnosis of anorexia nervosa. The nurse reviews the patient's laboratory results, as follows: Sodium 143, Potassium 3.1, Chloride 102, Magnesium 2.2, Calcium 8.4, Phosphate 3.0. The nurse should take which action?

Auscultate the patient's heart rate, rhythm, and sounds

A client is scheduled for discharge and will be taking phenobarbital for an extended period. The nurse would place the highest priority on teaching the client which point that directly relates to client safety?

Avoid drinking alcohol while taking this medication

The nurse is caring for a client diagnosed with paranoid personality disorder who is experiencing disturbed thought processes. In formulating a nursing plan of care, which best intervention should the nurse include?

Avoid using a whisper voice in front of the client

A client is unwilling to go to his church because his ex-girlfriend goes there and he feels that she will laugh at him if she sees him. Because of this hypersensitivity to a reaction from her, the client remains homebound. The home care nurse develops a plan of care that addresses which personality disorder?

Avoidant

Cluster C personality disorders?

Avoidant, dependent, OCD

The nurse calls security and has physical restraints applied to a client who was admitted voluntarily when the client becomes verbally abusive, demanding to be discharged from the hospital. Which represents the possible legal ramifications for the nurse associated with these interventions?

Battery, assault, false imprisonment

What intervention will have the greatest positive impact on the older client's quality of life?

Being screened for depression

Which would a nurse expect to administer to a client with schizophrenia who is experiencing a dystonic reaction?

Benztropine

What is the difference between depressive disorders and bipolar disorders?

Bipolar disorders involve mood swings ranging from depression to mania

Toxic effects of Lithium?

Blurred vision, ataxia, tinnitus, persistent nausea and vomiting, severe diarrhea, excessive urine output, muscular irritability, extreme lethargy, confusion and altered mental status, seizures, cardiovascular collapse

The mental health nurse should focus on preventative efforts including educational interventions related to the abuse of prescription drugs on which client group?

Both genders between the age of 12 and 17

A community mental health nurse counsels a group of patients about the upcoming flu season. What instruction does the nurse provide for patients who are prescribed lithium?

Call the clinic if you have nausea, vomiting, and/or diarrhea or are unable to stay well hydrated

A hospitalized client with a history of alcohol misuse tells the nurse, "I am leaving now. I have to go. I don't want any more treatment. I have things that I have to do right away". The client has not been discharged and is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. What action should the nurse take?

Call the nursing supervisor

To monitor for a significant health risk, the nurse will prepare to implement which intervention for a client admitted for alcohol detoxification?

Cardiac consult

A nurse is caring for a client who has experienced frontal lobe damage in a car accident. Which psychosocial behaviors are indications of this damage?

Change in personality, overt sexual behavior, difficulty controlling temper, fewer spontaneous facial expressions

An 8-year-old child, diagnosed with obsessive-compulsive disorder (OCD), is admitted by the nurse to a psychiatric facility. During the admission assessment, which behaviors would be characterized as compulsions?

Checking and rechecking that the television is turned off before going to school, repeatedly washing the hands, routinely climbing up and down a flight of stairs three times before leaving the house

Typical Antipsychotics?

Chlorpromazine, Thioridazine, Thiothixene, Haloperidol, Fluphenazine, Trifluoperizine, Prochlorperazine

A client with schizoaffective disorder is engaging in an extremely long conversation about a current affairs in the world. The client goes on to provide the nurse with minute details. The nurse interprets this as suggesting what?

Circumstantiality

Which nursing intervention will best address the intense need to control demonstrated by a client receiving treatment of bulimia nervosa?

Clearly stating expectations and admitting that they differ from those of the client

A client receiving tricyclic antidepressants arrives at the mental health clinic. Which observation would indicate that the client is following the medication plan correctly?

Client arrives at the clinic neat and appropriate in appearance.

Which assessment data confirms that the client diagnosed with anorexia nervosa has achieved a fundamental treatment outcome?

Client has maintained weight at 87% of ideal body weight for 2 months.

Which is a significant obstacle in providing psychiatric care for clients who have somatic symptom illnesses?

Clients are often unrecognized because clients receive treatment in different primary care offices, and care is often fragmented

The nurse is managing a group of clients diagnosed with somatic symptom disorders. Which client behavior best demonstrates the nurse's ability to manage manipulative behaviors therapeutically?

Clients direct all requests to a designated nurse

A healthcare provider prescribes haloperidol PO 1 mg TID. When assessing the client for extrapyramidal adverse effects, which nursing measures would be initiated?

Closely monitor vital signs, especially temperature, observe for increased pacing and restlessness, and provide the client with sugar-free hard candy

A nurse is caring for a client with an acute substance intoxication. The client's pupils are dilated, and the nurse notes the client's blood pressure is 166/108 mm Hg. Which substance is the most likely cause of the client's symptoms?

Cocaine

Which nursing interventions are appropriate for a hospitalized client with mania who is exhibiting manipulative behavior?

Communicate expected behaviors to the client, assist the client in identifying ways of setting limits on personal behaviors, follow through about the consequences of behavior in a nonpunitive manner, have the client state the consequences for behaving in ways that are viewed as unacceptable

A nurse interviews the family of a client hospitalized with severe depression and suicidal ideation. What family assessment information is essential when formulating an effective discharge plan?

Communication patterns, role expectations, current family stressors

A patient smiles broadly at the nurse and says, "Look at my clean teeth. I brushed them with scouring powder because the label said, 'It brightens and whitens everything.'" Which term should the nurse include when documenting this encounter?

Concrete thinking

A patient has a long history of bipolar disorder with frequent episodes of mania secondary to stopping prescribed medications. The patient says, " I will use my whole check next month to buy lottery tickets. Winning will solace all my money problems." Select the nurse's best action.

Confer with the treatment team about appointing a legal guardian for the patient

A patient tells the nurse, "After many years, I finally quit smoking. Now I use e-cigarettes only." Which is an appropriate response?

Congratulations on quitting, but -cigarettes contain nicotine and other hazardous chemicals.

A delusional client says to a nurse, "I am an alien from Mars," and insists that the nurse refers to them as such. The belief appears to be fixed and unchanging. Which nursing interventions would the nurse implement when working with this client?

Consistently use the client's name in interactions, and redirect the client with structured activities.

A client admitted voluntarily for treatment of an anxiety problem demands to be released from the hospital. Which action should the nurse take INITIALLY?

Contact the client's healthcare provider

A client is admitted to a medical nursing unit with a diagnosis of acute blindness after being involved in a hit-and-run accident. When diagnostic testing cannot identify any organic reason why this client cannot see, a mental health consult is prescribed. The nurse plans care based on which mental health condition?

Conversion disorder

Which disorder is characterized by unexplained, sudden deficits in sensory or motor function?

Conversion disorder

Which characteristic differentiates conversion disorder from malingering disorder?

Conversion disorder is an unconscious process, while malingering disorder is a deliberate fabrication of symptoms

A hospitalized client is started on a monoamine oxidase inhibitor (MAOI) for the treatment of depression. The nurse should instruct the client that which foods are acceptable to consume while taking this medication?

Crackers, tossed salad

A client who otherwise is healthy is admitted for depression and reports feeling "all alone." The client reports recently losing a spouse to divorce. The client admits to drinking at least 12 beers every day. The client has which risk factors for the depression?

Current substance use or abuse, Life and environmental stressors, Lack of coping abilities

Which assessment data best establishes that the client has demonstrated the ability to meet a challenge commonly faced by someone diagnosed with a serious mental illness (SMI)?

Currently employed

A client enters the emergency room exhibiting tremors, agitation, and restlessness. Upon assessment, the client's blood pressure is 160/90, pulse is 110, and respirations are 22. It has been 36 hours since the client's last drink of alcohol. The nurse would suspect which conditions to be occurring?

Delirium tremens

A client with schizophrenia states that the client is God's messenger and the client's mission is to become president. The nurse documents these comments as evidence of what?

Delusional thinking

The nurse is preparing to perform an admission assessment on a client with a diagnosis of bulimia nervosa. Which assessment findings should the nurse expect to note?

Dental decay, loss of tooth enamel, electrolyte imbalances

A nurse is caring for a client with somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of which?

Depression

A client with a somatic symptom disorder (SSD) reports severe abdominal pain. The nurse suspects the client's pain is related to SSD. Which action should the nurse take first?

Determine the quality of the client's pain

Which would be most important for a nurse to do when caring for a client with somatic symptom disorder?

Develop a sound, positive nurse-client relationship

Which is the nurse's priority on the first meeting with a client who is diagnosed with somatic symptom disorder (SSD)?

Develop a therapeutic relationship

During the nurse's shift in the ER, a nurse assesses a client who is suspected of being under the influence of amphetamines. Which symptoms are indicative of amphetamine use?

Diaphoresis, shallow respirations, tremors, dilated pupils

Clonidine is most effective for which symptom of opioid withdrawal?

Diarrhea

During an assessment, a client states the inability to have long-term relationships and fears being abandoned. Which question would the nurse ask to help identify the reason for the client's feelings?

Did your parents consume alcohol when you were growing up?

The nurse is caring for a client who has been taking fluphenazine (Prolixin) for 2 days. The client suddenly cries out, his neck twists to one side, and his eyes appear to roll back in the sockets. The nurse finds the following PRN medications ordered for the client. Which one should the nurse administer?

Diphenhydramine (Benadryl), 25 mg IM, PRN

The nurse is teaching a client diagnosed with a generalized anxiety disorder how to effectively cope with severe distress. Which interventions would the nurse use to promote effective coping with anxiety?

Discuss previous methods that were effective, encourage the client to limit to a mutually decided amount of time spent on worrying, help the client to establish a goal and develop a plan to meet the goal, teach the client how to label feelings and how to express them

The relationships and associations among the words used to express thoughts are markedly disturbed in clients with schizophrenia. What is this disturbance characterized by?

Disorganized speech

When interviewing any client with a personality disorder, the nurse would assess for which?

Disruption in some aspects of his or her life

The nurse is developing a care plan for a client with somatic delusions. Which would be an appropriate nursing diagnosis for this client?

Disturbed thought process

Which is an anticonvulsant used as a mood stabilizer?

Divalproex

What are the most common types of side effects from SSRIs?

Dizziness, drowsiness, and dry mouth

Tricyclic Antidepressant adverse effects?

Dizziness, hypotension, sedation, weight gain, prolonged QT interval, arrhythmias, heart block, seizures, serotonin syndrome, anticholinergic delirium

A client says to the nurse "The federal guards were sent to kill me." Which is the BEST response by the nurse to the client's concern?

Do you feel afraid that people are trying to hunt you?

The nurse documents the following note in the medical record, "The patient has bruising on the upper arms in the shape of finger marks. Bruising in various degrees of resolution is noted on the lower back and abdomen. When the patient is asked about the marks the patient states I fell down the steps". Which communication is BEST to determine if domestic abuse is occurring?

Do you feel safe in your living situation?

The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

Dopamine

Monoamine neurotransmitters?

Dopamine, norepinephrine, serotonin

The nurse is talking with a client that grew up in a home where both parents were alcoholics. Which behavior(s) does the nurse identify when assessing this client that correlate with this home life?

Drinks alcohol to excess 3 days a week, Divorced 3 times with tumultuous relationships with spouses, States that they hold on to bad relationships due to fear of being alone

Lithium side effects?

Drowsiness, dizziness, headache, dry mouth, thirst, nausea/vomiting, changes in bowel routine, fine tremor, weight gain, arrhythmias

Which intervention associated with bipolar disorder best minimizes the risk for the development of suicidal ideations?

Early diagnosis

Parrot-like repetition of another person's words or phrases is called?

Echolalia

Over the past 2 months, a patient made eight suicide attempts, with increasing lethality. The health care provider informs the patient and family that electroconvulsive therapy is needed. The family whispers to the nurse, " Isn't that dangerous treatment?" How should the nurse reply?

Electroconvulsive therapy is very effective when urgent help is needed. Your family member was carefully evaluated for possible risks.

The nurse is educating the spouse of a client with a somatic symptom disorder about how to best help the client. Which strategy should the nurse suggest?

Empathize about physical discomfort but encourage independence

Neurotensin?

Endogenous antipsychotic-like properties

The nurse is performing the initial assessment of a client diagnosed with schizophrenia. What should be the nurse's approach while assessing this client?

Engage in a one-to-one interaction with the client, Establish a therapeutic relationship

A client, diagnosed with Alzheimer's disease, is a new resident in a long-term care facility. The client has difficulty finding their room and is seen wandering into the room of others. When discussing the situation at a multidisciplinary conference, which client-centered actions would the nurse suggest?

Ensure that the client has prescribed hearing aids and glasses on throughout the day, place a box with familiar personal items outside the client's door for visual recognition, assign the client to a room close to the nursing station for closer monitoring, provide verbal cueing as to where the client's room is located

The nurse would assess for which characteristics in a client with narcissistic personality disorder?

Entitlement

A manic client begins to make sexual advances toward visitors in the dayroom. When the nurse firmly states that this is inappropriate and will not be allowed, the client becomes verbally abusive and threatens physical violence to the nurse. Based on the analysis of this situation, which intervention should the nurse implement?

Escort the client to their room, with the assistance of other staff

Signs/symptoms of manic episodes?

Esily distractible, flight of ideas, inflated self-esteem, overtalking, racing thoughts, decreased need for sleep, increased energy or agitation, euphoria, increased of risky activities

How often must clients receiving clozapine get white blood cell counts drawn?

Every week for the first 6 months

A client with anorexia nervosa is a member of a predischarge support group. The client verbalizes that she would like to buy some new clothes, but her finances are limited. Group members have brought some used clothes to the client to replace the client's old clothes. The client believes that the new clothes are much too tight and has reduced her calorie intake to 800 calories daily. How should the nurse evaluate this behavior?

Evidence of the client's disturbed body image.

Patient centered therapy?

Existentially based emphasis is on self-awareness and on the present, not dwelling on the past or future, focus on NOW

A hospitalized patient becomes angry and belligerent toward a nurse after speaking on the phone with their mother. The nurse learns that the mother cannot visit as expected because of her work. Which interventions will the nurse use to help the client deal with the displaced anger?

Explore the patient's unmet needs, Acknowledge the patient's behavior as inappropriate, Invite the patient to a quiet place to talk after they settle down, assist the patient in identifying alternate ways of approaching the problem

After educating a client's family on the etiology of bipolar disorders, a nurse determines that the education was successful when the family describes the kindling theory as involving what?

Exposure to repetitive sub-threshold stressors at vulnerable times

A client has been taking haloperidol for 5 years when the client is admitted to the inpatient unit for relapse of symptoms of schizophrenia. Upon assessment, the client demonstrates akathisia, dystonia, a stiff gait, and rigid posture. The nurse correctly identifies these symptoms are indicative of what?

Extrapyramidal side effects

In which disorder is the individual motivated solely by the desire to become a client?

Factitious disorder

Which disorder would the nurse suspect when a person takes their child from doctor to doctor and from hospital to hospital with a variety of intentionally induced symptoms?

Factitious disorder imposed by another

A 28-year-old second-grade teacher is diagnosed with major depressive disorder. She grew up in Texas but moved to Alaska 10 years ago to separate from an abusive mother. Her father died by suicide when she was 12. Which combination of factors in this scenario best demonstrates the stress-diathesis model?

Family history of mental illness coupled with a history of abuse

Which underlying emotion is commonly seen in an avoidant personality disorder?

Fear

A client has been prescribed an antipsychotic medication for the management of symptoms associated with schizophrenia. Which behaviors will show improvement as a result of adhering to the medication therapy?

Fears being abducted by alien creatures, Acknowledges regularly hearing voices

Dopamine?

Fine motor movement, integration of emotions and thoughts, decision making, stimulates hypothalamus to release hormones

A client with bipolar disorder begins taking lithium carbonate (lithium) 300 mg four times a day. After 3 days of therapy, the client says, "My hands are shaking." Which is the best response by the nurse?

Fine motor tremors are an early effect of lithium therapy that usually subsides in a few weeks.

The nurse is conducting an admission assessment with a 45-year-old client who has been demonstrating signs of bipolar disorder. While conducting the assessment, the client starts speaking in illogical rhymes and using word associations. What is the name for this thought pattern?

Flight of ideas

Which term typifies the speech of a person in the acute phase of mania?

Flight of ideas

Cognitive Reframing?

Focuses on recognizing and correcting maladaptive patterns of thinking that create stress or interfere with coping

What should Lithium be taken with?

Food

A client gives the home health nurse a bottle of clomipramine. The nurse notes that the medication has not been taken by the client in 2 months. Which behavior observed in the client would validate noncompliance with this medication?

Frequent hand washing with hot, soapy water

Which nursing intervention best meets the unique needs of the client diagnosed with delirium?

Frequently assessing level of consciousness and orientation

The nurse is performing a follow-up teaching session with a client discharged 1 month ago. The client is taking fluoxetine. Which information would be important for the nurse to obtain during this client visit regarding the side and adverse effects of this medication?

Gastrointestinal dysfunctions

The nurse is administering risperidone to a client with schizophrenia who is scheduled to be discharged. Before discharge, which instruction should the nurse provide to the client?

Get up slowly when changing positions

When teaching prevention to the parents of a 15-year-old client who recently attempted suicide by taking an overdose of alprazolam, the nurse describes which behavioral clue?

Giving away valued personal items

A client with delusional disorder tells the nurse that the client has discovered how to jump to the moon. The nurse would document this belief as what?

Grandiose delusion

During the nurse's assessment of a 15-year-old client diagnosed with bulimia nervosa, the nurse evaluates for findings that accompany binge eating. Which are most applicable?

Guilt, dental caries, self-induced vomiting, normal weight

What are positive symptoms of Schizophrenia?

Hallucinations, delusions, Bizarre behavior, Positive Thought Disorder and Speech patterns

A client who is taking antipsychotic medication to control schizophrenia asks the nurse to explain the causes of the disorder. The nurse knows that an overactive dopamine system in the brain is one of the leading causes of schizophrenia and tells the client that excessive dopamine activity is responsible for symptoms. Which symptoms is the nurse referring to?

Hallucinations, suspiciousness, delusional thinking

A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as belonging to what class?

Hallucinogen

A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?

Hallucinogen

The nurse assesses a new patient suspected of having a schizotypal personality disorder. Which assessment question is this patient most likely to answer affirmatively?

Has anyone in your family ever been diagnosed with a mental illness?

What assessment history data indicates that a client is at increased risk for developing Alzheimer's disease (AD)?

Has sustained two serious concussions

A nurse plans a psychoeducational group about physical health in an outpatient program for patients diagnosed with serious mental illness. Which topic has priority?

Heart-healthy living

A person diagnosed with serious mental illness has been homeless for 8 years and says, "I don't have any money because I've never had a job. I can't afford a place to live." Which intervention should the outpatient mental health nurse add to the plan of care?

Help the patient apply for Supplemental Security Income (SSI).

The nurse is meeting a patient in the mental health unit. When beginning a therapeutic relationship, which nursing actions are appropriate?

Help the patient explore different problem-solving techniques, encourage the practice of new coping skills

The nurse in an outpatient rehabilitation program is speaking with a group of clients who have recently recovered from alcohol abuse. Which issue should the nurse raise before the clients leave for the day?

Help them to identify appropriate diversional activities

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what?

Helping the client identify positive coping mechanisms

Emotion-focused coping strategies are designed to accomplish which outcome?

Helping the client manage the intensity of symptoms

When a client is admitted to an inpatient mental health unit with the diagnosis of anorexia nervosa, a cognitive behavioral approach is used as part of the treatment plan. The nurse plans care based on which purpose of this approach?

Helping the client to examine dysfunctional thoughts and beliefs

When considering oppositional defiance disorder (ODD), which behavior will be viewed as a mandatory diagnostic criteria?

Hid the backpack of a classmate who refused to give up answers to a test.

How can the nurse manager on a mental health unit devoted to the care of clients diagnosed with personality disorders address the needs of the nursing staff?

Hold a daily meeting to focus on communication between nursing and supervisory staff.

Which stress management behavior is most reflective of those associated with personality disorders?

Holding spouse responsible for the client's poor work performance

The nurse provides care to a client who is diagnosed with somatic symptom disorder (SSD) and who presents with anxiety and depression in addition to physical symptoms that affect the gastrointestinal (GI) system. Which is the priority question from the nurse when conducting the interview portion of the assessment process?

How long have you been experiencing the GI symptoms?

The nurse suspects that a client is experiencing somatic symptom disorder (SSD). Which question should the nurse include in the assessment process to determine specific gastrointestinal (GI) symptoms?

How many episodes of diarrhea do you have each week?

A nurse assesses a 78-year-old patient who lives alone at home and is beginning three new prescriptions. Which question by the nurse will best provide for the patient's safety?

How much alcohol do you drink on a normal day?

The nurse is providing care for a client who deliberately overdosed on acetaminophen several days ago. The nurse should assess the current severity of the client's suicidal ideation by asking what question?

How often are you having thoughts about suicide this morning?

Which behaviors would indicate stimulant intoxication?

Hyperactivity, talkativeness, euphoria

The nurse is assessing a client who was admitted 24 hours ago for a fractured humerus. Which findings should alert the nurse to the potential for alcohol withdrawal delirium?

Hypertension, changes in level of consciousness, hallucinations

MAOI adverse effects?

Hypertensive crisis, dietary restrictions (tyramine), sexual side effects, GI side effects, headache, insomnia, nervousness

Which mental health disorder is characterized by a fear of developing a serious illness based on a misinterpretation of body sensation?

Hypochondriasis

A nurse is caring for a client with substance use disorder. The nurse determines that education was successful when the client makes which statement?

I am not alone with addiction because it affects every class and gender

The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse "How is Carol doing? She is my best friend and is seen at your clinic every week." Which is the MOST APPROPRIATE nursing response?

I cannot discuss any client situation with you

The nurse is caring for a client who began drinking a six-pack of beer every day in freshman year of college. By sophomore year, the client was drinking two six-packs to get the same effect. After educating the client on the chronic use of alcohol, the nurse determines education has been effective when the client makes which statement describing this phenomena?

I developed a tolerance to alcohol over this period of time

Which statement demonstrates a characteristic of depression-associated behaviors that is especially associated with children and adolescents?

I don't care that friends say I'm grumpy

A client with somatic symptom disorder has been attending group therapy. Which statement indicates therapy is having a positive outcome for this client?

I feel better physically just from getting a chance to talk.

Which statement reflects successful achievement of a therapeutic long-term goal for a client diagnosed with somatic symptom disorder?

I haven't missed a day of work in the last 6 months

The school nurse assesses four adolescents who appear to have a healthy weight. Which comment would lead the nurse to explore further for an eating disorder?

I know everything in my life will be better once I lose 15 more pounds

A nurse is caring for a client displaying extreme mood swings with suicidal tendencies. A healthcare provider prescribes lithium and diagnoses the client with bipolar disorder. When teaching the client, which statements, verbalized by the client, indicate a good understanding of the teaching of medication management?

I need to watch for signs and symptoms of drug toxicity including blurred vision and ringing in the ears, I will need to consistently monitor blood levels, The therapeutic effect of the medication takes time to occur.

The nurse determines that the wife of an alcoholic client is benefiting from attending an AL-Anon group if the nurse hears the wife make which statement?

I no longer feel that I deserve the beatings my husband inflicts on me

The nurse observes that a client with depression sat at a table with two other clients during lunch. Which is the best feedback the nurse could give the client?

I see you were sitting with others at lunch today.

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, a nurse determines that the education was successful when the client makes which statement?

I should eat small frequent meals if I get nauseated

The nurse reviews the medication list for a client who is newly prescribed a selective serotonin reuptake inhibitor (SSRI) for the treatment of depression. Which client statement indicates a need to assess the client for serotonin syndrome?

I started taking diet pills to assist with weight loss

The nurse is educating a client regarding the use of disulfiram as treatment for alcohol use disorder. Which statement made by the client indicates that teaching is effective?

I will avoid all products containing alcohol

Which statement would indicate that teaching about somatic symptom disorder has been effective?

I will feel better when I begin handling stress more effectively.

Which statement made by the client demonstrates an understanding of the benefit of clozapine?

I'm at a risk for developing infections

A patient diagnosed with bipolar disorder lives in a community and is showing early signs of mania. The patient says, " I need to go visit my daughter, but she lives across the county. I put some requests on the Internet to get a ride. I'm sure someone will take me." What is the nurse's best therapeutic response?

I'm concerned about your safety when meeting or riding with strangers

Recognizing that somatic symptom disorders focus on physical symptoms, which client statement best demonstrates the unique characteristic of this type of disorder?

I've been to so many doctors but none can find out what's wrong with me

A nurse assesses four adolescents with various eating disorders. Which comment would the nurse expect from the adolescent diagnosed with anorexia nervosa?

I've lost 60 pounds, but I'm still a size 2. I want to be a size 0

A client in a mental health unit becomes increasingly agitated and barricades himself in a corner room holding another client hostage. Verbal exchanges indicate an escalation in client desperation. Which nursing actions would be taken at this time?

Identify one nurse to interact with the client, direct other clients away from the area, discreetly notify security to assist, identify with the client's perspective and reason for agitation

When planning the discharge of a client with chronic anxiety, which is the most appropriate maintenance goal?

Identifying anxiety-producing situations

An 85-year-old woman says to the nurse, "I raised three children, but now two of them barely speak to me. I did not do a good job of instilling a family spirit." Which response should the nurse provide?

If you could relive those earlier years, what would you do differently?

A 47-year-old client has been admitted to the hospital after being found unconscious in a park. Upon regaining consciousness, the client admits to heavy alcohol use over many years. Assessment reveals a low body mass index, low electrolyte levels, and impaired skin integrity. Vital signs are within normal ranges. What nursing diagnosis should be prioritized in the care of this client?

Imbalanced nutrition: less than body requirements related to chronic alcohol intake

When considering signs of risk for an adult client diagnosed with a serious and persistent mental illness, which characteristic presents the greatest threat?

Impaired judgment

A client has been diagnosed with adjustment disorder with mixed anxiety and depression. What are the primary nursing diagnoses the nurse would associate with this type of adjustment disorder?

Impaired social interaction, the risk for situational low self-esteem

Which nursing intervention is generally included in the plan of care for any hospitalized client experiencing a severe psychotic episode associated with schizophrenia to address safety issues?

Implementing institution's suicide precautions

Clients with a schizotypal personality disorder are most likely to benefit from which nursing intervention?

Improving community functioning

After interviewing a client diagnosed with recurrent depression, a nurse determines the client's potential for death by suicide. Which factors listed below might contribute to the client's risk?

Impulsive behavior, overwhelming feelings of guilt, chronic debilitating illness, repression of anger

The nurse is teaching a client who is being started on imipramine about the medication. The nurse should inform the client to expect maximum desired effects at which time period following initiation of the medication?

In 2 to 3 weeks

The client usually thinks anxiety is behind the symptoms

In somatoform disorders, clients are not consciously aware that they are meeting needs through physical complaints.

The nurse is describing the medication side and adverse effects to a client who is taking amitriptyline. Which information should the nurse incorporate in the discussion?

Increase fluids and bulk in the diet

Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension?

Increase hydration

A client asks a nurse about altering any activites because of taking lithium carbonate. Which response would be most appropriate?

Increase your salt intake if an activity causes you to perspire heavily.

Positive symptoms seen in schizophrenia are believed to be a result of which type of neurological dysfunction?

Increased amount of dopamine

Which intervention is best associated with minimizing the effects of dementia-induced aphasia?

Increasing reliance on nonverbal communication methods

A moderately depressed client who was hospitalized 2 days ago suddenly begins smiling and reporting that the crisis is over. The client says to the nurse "I'm finally cured". Based on the client's behavior and statement, which intervention should the nurse include in the plan?

Increasing the level of suicide precautions

The nurse is caring for a client with a conversion disorder. Which finding will the nurse expect during assessment?

Indifference about the physical symptom

A nurse plans care for a patient diagnosed with borderline personality disorder. Which patient problem is most likely to apply to this patient?

Ineffective relationships relating to frequent splitting

The nurse is working with a client who despite making a heroic effort was unable to rescue a neighbor trapped in a house fire. Which client-focused action should the nurse engage in during the working phase of the nurse-client relationship?

Inquiring about and examining the client's feelings for an that may block adaptive coping.

A nurse caring for a client diagnosed with persistent depressive disorder. Which defining characteristics are associated with this disorder?

Insomnia or hypersomnia, loss of interest in daily activities, appetite disturbance

A young adult tells the nurse, "I have a new prescription for medical marijuana. I use it several times a day for my frequent muscle spasms." What information should the nurse provide first to this patient?

Instructions about safety issues associated with driving or operating machinery

Biofeedback?

Instruments that give feedback about bodily functions

The nurse is caring for a female client who was admitted to the mental health unit recently for anorexia nervosa. The nurse enters the client's room and notes that the client is engaged in rigorous push-ups. Which nursing action is most appropriate?

Interrupt the client and offer to take her for a walk

A patient in the emergency room was seen for the third time in a month with complaints of tremors and paresthesia in the lower extremities. Neurological functional disorder was diagnosed. While preparing for discharge, the patient says," Now I'm having chest pain, but it's probably nothing." How should the nurse respond?

Interrupt the discharge and arrange an additional medical evaluation of the patient.

A client is prescribed disulfiram as part of the alcohol treatment program to prevent relapse. The client asks the nurse, "How will this drug help me?" Which response by a nurse would be most appropriate?

It can help to prevent you from drinking

When discussing methadone treatment with a client, the nurse should include what?

It decreases the severity of heroin withdrawal symptoms

Which statement by a client scheduled for a series of electroconvulsive therapy (ECT) treatments indicates to the nurse that the client has an understanding of the goals of this treatment?

It is expected that my chance for remission is very good.

A student nurse has been assigned to provide care for an inpatient psychiatric-mental health client who has a diagnosis of schizophrenia. The student nurse is apprehensive about interacting with the client. The client's detailed explanations of the client's delusions accompanied by unpredictable movements have prompted fear in the student. How should this nursing student interpret such feelings?

It is natural to feel fear when a client exhibits unpredictable behavior, and this can cause the student to be reasonably cautious.

Which of the following statements would indicate family teaching about schizophrenia had been effective?

It's a relief to find out that we did not cause our son's schizophrenia

A male patient states feelings of sadness and is seeking suggestions for strategies to keep active after the loss of his spouse. Which activities might the nurse suggest to the patient?

Joining a golf league at a club, attending regular spiritual/church services, participating in a community charity event

Which behavior is most characteristic of a client diagnosed with antisocial personality disorder?

Justifying taking another client's dessert by stating, "I deserve two desserts."

A patient experiencing depression says to the nurse, " My health care provider said I need 'talk' therapy, but I think I need a prescription for an antidepressant medication. What should I do?" Select the nurse's best response.

Let's consider some ways to address your concerns with your health care provider

A patient at a general medical clinic tells the nurse, "I have so many ailments that I need to see six different doctors. None of them has discovered what is really wrong with me." Which comment should the nurse offer next?

Let's review all the medications you currently take

A nurse leads a milieu meeting in an outpatient program for adults diagnosed with serious mental illness. Four patients complain that another patient is "always begging us for money." Which comment by the nurse is therapeutic?

Let's review what we have learned about being assertive with others

An 84-year-old tells the nurse, "I do four or five number puzzles every day to keep my brain healthy and sharp." When considering a holistic approach to maintaining mental health, the nurse should respond

Let's think of some other activities we can add to your daily routine

A 56-year-old client who suffers from seasonal affective disorder is being assessed by the nurse in an outpatient mental health clinic. The nurse is aware which treatment is the most effective type of treatment for this condition?

Light therapy

What is the rationale for a person taking lithium to have enough water and salt in his or her diet?

Lithium is a salt that has greater affinity for receptor sites than sodium chloride.

A nurse is caring for a client diagnosed with a delusional disorder. While assessing this client, which element would a nurse expect to find?

Living with one or more delusions for a period of time

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

The nurse at a local clinic reviews phoned-in requests from patients for prescription refills. As the nurse confers with the health care provider about which prescription refill requests should be authorized, which refill request should be considered first?

Lorazepam (Ativan) 1 mg PO BID for an adult who has taken it daily for 3 years for episodes of anxiety

An elderly client with Alzheimer's disease has begun to strike out at staff members when they try to assist the client to bed at night. In addition, the staff members report that the client is awake and restless most of the night. After further assessment, the nurse decides to contact the provider for a medication order. Which of the following medications, should the nurse anticipate that the provider will prescribe?

Lorazepam (Ativan) PRN

What is typically used to detox a person from alcohol?

Lorazepam, diazepam, and chlordiazepoxide

A rehabilitation nurse is caring for a young client recovering from a motor vehicle accident in which he lost both legs. The client states "I will never be able to work again or live a normal life". Which responses by the nurse would be considered therapeutic?

Losing both legs is hard to accept, how are you feeling now? The occupational therapist will teach the use of adaptive equipment to promote independence, I am here to help you. Let's devise a plan so you are working toward your goals

A nurse is caring for a client recently diagnosed with cancer and experiencing moderate situational anxiety. Which interventions would the nurse include in the care plan?

Maintain a calm, nonthreatening environment, encourage the client to verbalize concerns regarding the diagnosis, and encourage the client to use deep breathing exercises and other relaxation techniques during periods of increased stress

Which best describes the concept of somatization?

Manifestation of physical symptoms from psychological distress

A client is experiencing severe alcohol withdrawal. Which would the nurse identify during the assessment that correlates with the withdrawal symptoms?

Marked diaphoresis, Auditory hallucinations, Gross uncontrollable tremors

When working with a client with a narcissistic personality disorder, the nurse would use which approach?

Matter-of-fact

A client is diagnosed as a child with attention-deficit/hyperactivity disorder (ADHD). Achieving which long-term goal will best indicate personal effective condition management as an adult?

Medication therapy discontinued by health care provider.

A client is participating in a therapy group and focuses on viewing all team members as equally important in helping the clients meet their goals. The nurse is implementing which therapeutic approach?

Milieu therapy

A client who habitually uses cocaine asks if there are any medications to reduce the cravings for the drug. Which medication(s) would the nurse anticipate preparing teaching for this client?

Modafinil, disulfiram, propranolol, topiramate

What level of anxiety decreases a person's ability to perceive and concentrate? The person is selectively inattentive (focuses on immediate concerns), and the perceptual field narrows.

Moderate

When reviewing the admission assessment, the nurse notes that a client was admitted to the mental health unit involuntarily. Based on this type of admission, the nurse should provide which intervention for this client?

Monitor closely for harm to self or others

A client with a history of alcohol use disorder has presented to the emergency department with hallucinations and relays being followed by the police. Which action will the nurse take given this information?

Monitor for Korsakoff syndrome from long-term effects of alcohol use

Which interventions are most appropriate for caring for a client in alcohol withdrawal?

Monitor vital signs, provide a safe environment, address hallucinations therapeutically, and provide reality orientation as appropriate

A client diagnosed with depression has been prescribed various first-line antidepressant agents but has demonstrated only minimal improvement. In preparation for the prescription of a second-line agent, the nurse will educate the client on which classification of antidepressant?

Monoamine oxidase inhibitors

Which medication classification is considered first-line drug therapy for bipolar disorder?

Mood stabilizers

Norepinephrine?

Mood, attention and arousal, stimulates sympathetic branch of autonomic nervous system for "fight or flight" in response to stress

Serotonin?

Mood, sleep regulation, hunger, pain perception, aggression and libido, hormonal activity

The nurse has provided an in-service program on impaired professionals. She knows that teaching has been effective when staff identify which as the highest risk for substance abuse among professionals?

Most nurses are exposed to various substances and believe they are not at risk of developing the disease.

The nurse interviews the parent of a 7-year-old child diagnosed with moderate autism spectrum disorder. Which comment from the parent best describes autistic behavior?

My child swings for hours on our backyard gym set

The nurse is caring for a client with Wernicke encephalopathy. The nurse determines that teaching has been effective when the client makes which statement?

My condition is a degenerative brain disorder caused by nutrient deficiency

The nurse is interviewing family members of a client being treated for substance use disorder. Which statement by a family member would alert the nurse to the possibility of codependency?

My sibling would not drink as much if their spouse was more understanding

A client arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. The friend who came with the client reports that the client had just "shot up" heroin and then became unconscious. Which medication would a nurse most likely expect to administer?

Naloxone

A group of nursing students is reviewing information about nutritional supplementation used during alcohol detoxification. The students demonstrate the need for additional review when they identify which of the following is being used?

Naloxone

The nurse must be aware that individuals from diverse ethnic groups might describe troubling experiences in terms of physical problems or specific culture-bound syndromes. The syndrome of ghost sickness is exhibited by which culture?

Native American

Paroxetine (Paxil) has been prescribed for a client with a somatic symptom illness. The nurse instructs the client to watch out for which side effect?

Nausea

What are words that the patient invented?

Neologisms

A client with schizophrenia is receiving antipsychotic therapy. The nurse understands that which is a medical emergency should it develop in the client?

Neuroleptic malignant syndrome

Three days after beginning a new regime of haloperidol (Haldol), the nurse observes that a hospitalized patient is drooling, has stiff and extended extremities, and has skin that is damp and hot to the touch. The patient has difficulty responding verbally to the nurse. What are the nurse's correct analysis and action in this situation?

Neuroleptic malignant syndrome has developed; prepare the patient for immediate transfer to a medical unit

When a client demonstrates symptoms associated with delirium, the nurse institutes care focused on the prevention of which result?

Neurological damage

The nurse obtains a psychosocial history from a client who may have psychological factors affecting the medical condition. Which should the nurse recognize as pertinent to this diagnosis?

No physiologic cause has been found for the client's symptoms

A client tells the nurse that the client has bugs in the client's brain and asks the nurse if the nurse can see them. Which response by the nurse is most therapeutic?

No, I don't see any bugs. That sounds scary for you

Which is a true statement regarding depressive disorders?

Norepinephrine, dopamine, and serotonin have been implicated.

Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include which nursing interventions?

Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered

A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?

Offering reassurance in a soft, nonthreatening voice

A client has been prescribed quetiapine for delusional disorder. In teaching the client about this medication, the nurse must be certain to include which information?

One of the common side effects is dry mouth

The nurse is planning care for a client being admitted to the nursing unit who attempted suicide. Which priority nursing intervention should the nurse include in the plan of care?

One-to-one suicide precautions

What classic characteristic is noted in clients diagnosed with bulimia nervosa?

Onset in late adolescence

A nurse is managing the care of a 19-year-old adult diagnosed with Level 1 autism spectrum disorder. Which intervention will the nurse include in the client's plan of care?

Organization and planning strategies

A depressed older adult client is being treated with a tricyclic antidepressant (TCA). For which clinical manifestations should the nurse monitor the client?

Orthostatic hypotension and urinary retention

A client is being seen in the clinic after returning from military service abroad. The nurse documents restlessness at night with nightmares leaving the veteran irritable and fatigued during the day. When discussing the possibility of posttraumatic stress disorder (PTSD), which statements about PTSD are accurate?

PTSD is characterized by nightmares and flashbacks, Hypervigilance is characteristic of clients with PTSD, Substance abuse is a common coping mechanism used by clients with PTSD, Psychotic episodes can occur in clients with PTSD, and clients with PTSD may complain of feeling empty inside

A nurse is assessing a client who is suspected of having somatic symptom disorder (SSD). Which would the nurse expect to report as the most common report?

Pain

A nurse is caring for a client with agoraphobia. Which signs and symptoms would a nurse anticipate?

Panic attacks, inability to leave home

A nurse is reviewing the medical record of a client with bipolar disorder. The nurse would most likely expect to find a history of what condition?

Panic disorder

Cluster A personality disorders?

Paranoid, Schizoid, Schizotypal

Which nursing intervention is believed to have the greatest effect on antipsychotic medication therapy adherence?

Patient education regarding management of side effects

Which interventions should be considered appropriate for a patient in the withdrawn phase of catatonia?

Perform passive range of motion once each shift, Reposition every 2 hours

A 44-year-old client has been experiencing intense job stress. In recent weeks, the client has confided in the client's spouse that the client believes the client's firm monitors every aspect of the client's personal performance and that the firm is engaged in deception and cover-up of its "true purpose." A nurse would recognize that the primary theme of the client's delusional disorder is what?

Persecutory

A client diagnosed with schizophrenia is having delusions that the client is being plotted against by the government. This would be documented as which type of delusion?

Persecutory

While assessing a client with schizophrenia, the client states, "Everywhere I turn, the government is watching me because I know too much. They are afraid that I might go public with the information about all those conspiracies." The nurse documents the client's statement as which type of delusion?

Persecutory

What is used to detox a person from benzodiazepines?

Phenobarbital

Opioid withdrawl symptoms?

Piloerection (goose-flesh), cramping and other GI disturbances, restlessness, yawning, dilated pupils, rhinorrhea, agitation

A nurse is caring for a patient who exhibits behaviors that test the nurse-patient relationship. When discussing this behavior at a multidisciplinary team conference, which behaviors would the nurse provide as examples of this behavior?

Placing the nurse in the role of parent, requesting personal information from the nurse, stating information to try to shock the nurse, violating the nurse's personal space

Glutamate (NMDA, AMPA)?

Plays a role in learning and memory

Acetylcholine?

Plays a role in learning, memory, regulates mood, mania, sexual aggression, affects sexual and aggressive behavior, stimulates parasympathetic nervous system

The primary nursing goal for a client who is admitted for suicidal ideation or attempt would be what?

Prevent self-destructive behavior.

Which is the name given to a direct internal benefit that being sick provides, such as relief from anxiety?

Primary gain

While weighing patients on an eating disorders unit, the nurse overhears a psychiatric technician say, "I wish I had an eating disorder; maybe I'd lose a little weight." What is the nurse's best action?

Privately discuss the importance of sensitivity with the psychiatric technician

What are the phases of Schizophrenia?

Prodromal, Acute, Stabilization, and Maintenance

A client with a diagnosis of schizophrenia has a history of auditory and visual hallucinations. Which intervention is most likely to minimize the client's hallucinations?

Provide frequent contact and communication with the client

A client with a diagnosis of schizophrenia spectrum disorder is admitted to the inpatient unit after developing water intoxication. Once the client is medically stable and no longer exhibiting the behavior of seeking water, which nursing interventions are appropriate at this time?

Provide gum for the client, weigh the client every day, monitor the client's intake and output, and maintain a structured environment

The nurse observes that a client is pacing, agitated, and presenting aggressive gestures. The client's speech pattern is rapid, and affect is belligerent. Based on these observations, which is the nurse's immediate priority of care?

Provide safety for the client and other clients on the unit

A nurse is caring for an anorexic client with a nursing diagnosis of imbalanced nutrition: less than body requirements related to dysfunctional eating patterns. Which interventions would be supportive for this client?

Provide small, frequent meals, monitor weight gain, allow the client to determine food choices from a menu, monitor the client during meals and for 1 hour afterward

A nurse is caring for a client with borderline personality disorder. Which interventions are appropriate for clients with this disorder?

Providing emotional consistency, exploring anger in appropriate ways, promoting gradual separation and individuation, ensuring the client's safety

Which nursing intervention has priority during the acute phase of a client's manic episode?

Providing fluids frequently to promote hydration

A client is being seen in the health clinic. The nurse observes a shuffling gait, drooling, and slowness of movement. The client is currently taking an antipsychotic for treatment of schizophrenia. The nurse knows that which side effect is occurring?

Pseudoparkinsonism

The nurse observes that a client with bipolar disorder is pacing in the hall, talking loudly and rapidly, and using elaborate hand gestures. The nurse concludes that the client is demonstrating which?

Psychomotor agitation

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 would expect to assess what?

Psychomotor retardation

After educating a client on antipsychotic agents, a nurse determines that the education was successful when the client identifies which medication as an example of a second-generation antipsychotic agent?

Quetiapine

After teaching a class on antipsychotic agents, the instructor determines that the education was successful when the class identifies which as an example of a second-generation antipsychotic agent?

Quetiapine

A client who has been taking buspirone for 1 month returns to the clinic for a follow-up assessment. The nurse determines that the medication is effective if the absence of which manifestation has occurred?

Rapid heartbeat or anxiety

A nurse is preparing to interview a client diagnosed with somatic symptom disorder (SSD). The nurse anticipates that the client will most likely exhibit which?

Rapidly changing moods during the interview

Which intervention will the nurse identify for the care plan of a client diagnosed with a moderate form of intellectual disability?

Re-enforcing the concepts of money management

A client has been admitted to the ED following a rape. The nurse expects that the client may manifest symptoms of PTSD. The nurse should be aware that this syndrome can best be described as?

Re-experiencing the fear and hopelessness of the original trauma, intense fear, helplessness, horror, avoidance of stimuli

The nurse in the ER is caring for a young female victim of sexual assault. The client's physical assessment is complete, and physical evidence has been collected. The nurse notes that the client is withdrawn, distracted, tremulous, and bewildered at times. How should the nurse interpret these behaviors?

Reactions to a devastating event

A nurse is monitoring a client who appears to be hallucinating. The client is gesturing at a figure on the television and appears agitated with a speech containing paranoid content. Which nursing interventions are appropriate at this time?

Reassure the client that there is no danger, acknowledge the presence of the hallucinations, and give simple commands in a calm voice.

Which life event related to a client demonstrating depressive symptoms supports a diagnosis of persistent depressive disorder (PDD)?

Recognized symptoms of depression over 2 years ago

A patient has been identified as having a somatoform disorder. Which of the following should the nurse do when interacting with the patient?

Redirect conversation away from feelings but show interest toward the patient.

y-Aminobutyric acid (GABA)?

Reduces anxiety, excitation, aggression, may play a role in pain perception, anticonvulsant and muscle-relaxing properties, may impair cognition and psychomotor functioning

A client has been prescribed clozapine for schizoaffective disorder (SCA) with depression. The nurse should explain to the client that one advantage of clozapine is that it can provide what?

Reduction of hospitalizations and risk for suicide

The nurse is reviewing the process recording of a school-aged client describing how the client felt about their mother's recent death by suicide. Which nursing interventions are appropriate to add to the plan of care? Progress note, "My mother's suicide made me feel alone and sad. I did not want to come out of my room. I did not want to see anyone or talk about what happened. I just went to school every day and did what I needed to do."

Refer the client to a support group for kids who have lost parents, offer self by sitting with the client and allowing them to express their feelings, state "So you are feeling pretty sad", sit directly across from and focused on the child

While caring for a hospitalized client diagnosed with schizophrenia, a nurse observes that the client is listening to the radio. The client tells the nurse that the radio commentator is speaking directly to the client. The nurse interprets this finding as which type of thinking?

Referential

A client who has Alzheimer's disease becomes agitated and combative when the nurse approaches her for morning care. Appropriate action?

Remain calm and talk quietly to the client, may be able to distract client thoughts away from the refusal and then reintroduce the idea

The nurse is planning discharge teaching for a client taking clozapine (Clozaril). Which teaching is essential to include?

Remind the client to go to the lab to have blood drawn for a white blood cell count.

An outpatient nurse has lunch with a group of patients diagnosed with serious mental illness. The nurse observes an obese adult ask a malnourished adult, "If you aren't going to eat your apple, will you give it to me?" What is the nurse's best action?

Remind the malnourished adult of treatment goals related to weight gain.

The nurse concludes that the treatment plan for a client diagnosed with a somatic disorder best demonstrates success when which observation is made?

Reports of physical pain have lessened substantially

A 24-year-old with schizophrenia and paranoid delusions is admitted to the hospital. The student nurse asks the charge nurse about what approach to take with the client, who has been exhibiting hostility and isolation. Which approach would be the most appropriate direction from the charge nurse?

Respect the client's need for personal space and avoid physical contact

The nurse in the mental health unit plans to use which therapeutic communication techniques when communicating with a client?

Restating, active listening, maintaining neutral responses, providing acknowledgment and feedback

A nurse is explaining client rights for psychiatric patients to a patient who has voluntarily sought admission to an inpatient psychiatric facility. Which rights would the nurse include in the discussion?

Right to refuse treatment, right to a written treatment plan, right to confidentiality, right to personal mail

An adult diagnosed with stage 2 Alzheimer's disease begins a new prescription for Rivastigmine (Exelon). Which nursing diagnosis has the highest priority to add to the plan of care?

Risk for impaired nutritional status

A 52-year-old client has a history of alcohol dependence and is admitted to a detoxification unit. The client has tremors, is anxious, has a pulse that has risen from 98 to 110 beats/min, has blood pressure that has risen from 140/88 to 152/100 mm Hg, and has a temperature 0.6º above normal. The client is slightly diaphoretic. Which nursing diagnosis would be the priority?

Risk for injury

Which teaching-focused intervention will have the greatest impact on reducing the risk of relapsing for a client diagnosed with bipolar disorder?

Role of family as support

A 92-year-old lives alone, but family members assist with transportation and home maintenance. This adult tells the nurse, "They mean well, but sometimes my family treats me like a child." What is the nurse's best action?

Role-play with the adult ways to share these feelings with family members

1st line agents of antidepressants

SSRI's, Dual action antidepressants: SNRIs, NDRIs, etc

Which type of antidepressants are used in patients with borderline personality disorder?

SSRIs

A patient tells the nurse, " No matter what I do, I feel like there's always a dark cloud following me." Select the nurse's initial action.

Say to the patient, " Tell me more about what you mean by 'dark cloud'"

A client who has a major depressive episode tells a nurse that, for the past 2 weeks, the client has been hearing voices and at times thinks that they are being followed. History reveals that the client had these alternating symptoms before. The client also has experienced time with neither of these symptoms and has been able to function adequately. The nurse interprets these findings as suggesting which condition?

Schizoaffective disorder

Some research has suggested that schizophreniform disorder may be an early manifestation of which other mental health condition?

Schizophrenia

The parent of an adolescent recently diagnosed with schizophrenia says to the nurse, "This is entirely my fault. I should have spent more time with my child when he was a toddler." Which response by the nurse is correct?

Schizophrenia is genetically transmitted, so it was not in your control

When reviewing the diagnostic criteria for schizophrenia based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), which would be most accurate?

Schizophrenia lasts at least 6 months and includes at least 1 month of two or more characteristic symptoms.

A nurse is assessing a new client and notices clang associations in the speech pattern. From this assessment finding, the nurse begins to evaluate for the potential of which psychiatric conditions?

Schizophrenia, mania, cognitive disorders

What do antipsychotics typically treat?

Schizophrenia, psychosis, schizoaffective disorder, and bipolar disorder

A client with schizophrenia is exhibiting positive and negative symptoms. The nurse anticipates that the client would be prescribed what?

Second generation antipsychotic

Cognitive Behavioral Therapy?

Seeks to modify negative thoughts that lead to dysfunctional emotions and actions by having patient reflect on the negative thought and think of something positive.

A hospitalized client has begun taking bupropion as an antidepressant agent. The nurse determines that which is an adverse effect, indicating that the client is taking an excessive amount of medication?

Seizure activity

Bupropion contraindications?

Seizure disorder, bulimia nervosa or anorexia nervosa, patients undergoing abrupt discontinuation of alcohol or sedatives

A client with major depression is prescribed paroxetine. The nurse develops an education plan for the client based on the understanding that this drug belongs to which class of drugs?

Selective serotonin reuptake inhibitors

Which drug classification has been shown to be effective in treating somatization disorders?

Selective serotonin reuptake inhibitors

Which nursing intervention will have the greatest impact on both the management of care and on milieu environment when considering the clients diagnosed with bipolar disorder?

Setting and maintaining consistent unit policies that are enforced by all staff

The nurse is conducting a group therapy session. During the session, a client diagnosed with mania consistently disrupts the group's interactions. Which intervention should the nurse initially implement?

Setting limits on the client's behavior

Somatic symptom disorder is characterized by what?

Severe physical symptoms unexplainable by any organic or physical pathology

The nurse will encourage the client to engage in regular involvement with which formalized groups as an intervention directed toward the treatment of a primary risk factor associated with depression?

Sexual assault survivors group, New moms support group, Alcoholics Anonymous (AA)

A client who is abusing substances is to undergo brief intervention. The nurse understands that this technique is most effective for a client who exhibits which symptoms?

Short history of drug use

What do antipsychotic medications do?

Short-acting, will calm a person's severe anxiety and reduce symptoms of psychosis relatively quickly

A client with a long history of schizophrenia has managed well on fluphenazine. The client reports smacking of the lips and sticking out the tongue. Based on this report, what does the nurse suspect is occurring with the client?

Signs of tardive dyskinesia (TD) associated with neuroleptic medication

The nurse is caring for a client just admitted to the mental health unit and diagnosed with catatonic stupor. The client is lying on the bed in a fetal position. Which is the most appropriate nursing intervention?

Sit beside the client in silence with simple open-ended questions

A client diagnosed with delusional disorder who uses excessive health care resources most likely has which type of delusions?

Somatic

A nurse is assessing a client who is reporting the sensation of "bugs crawling under the skin" and intense itching and burning. The client states, "I know bugs have invaded my body." There is no evidence to support the client's report. The nurse interprets this as which type of delusion?

Somatic

A client is admitted for the third time for a substance use disorder. Which statement indicates the nurse is approaching the client with an open and objective attitude?

Sometimes it takes a few times before relapses stop occurring

The nurse is monitoring a client with schizophrenia who is prescribed clozapine. During the morning mental health team meeting, which symptoms indicating adverse effects of the medication would immediately be brought to the psychiatrist's attention?

Sore throat, fever, orthostatic hypotension

A client asks what occurs in an Alcoholics Anonymous (AA) meeting. Which information would the nurse include about the 12-step program?

Sponsors help to progress through the 12 steps, People with alcohol use disorder need support of others to remain sober, Once sober, the person can be a sponsor for someone else, It is based on the philosophy that total abstinence is essential

A nurse is providing a presentation about suicide for a group of health professionals. Which element would the nurse include as a major contributor to the rising suicide rate among men?

Substance use disorders

When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?

Suicide

A 55-year-old client was admitted to the psychiatric unit after an incident in a department store in which the client accused a sales clerk of following the client around the store and stealing the client's keys. The client was subdued by the police after destroying a window display because voices had told the client that it was evil. As the nurse approached the client, the client says, "You're all out to get me, and you're one of them. They're Rostoputians and grog babies here." This demonstrates what?

Suspiciousness and neologisms

A client is prescribed chlordiazepoxide as needed to control the symptoms of alcohol withdrawal. Which symptoms may indicate the need for an additional dose of this medication?

Tachycardia, elevated blood pressure and temperature, tremors, increasing anxiety

The nurse notes that a client with schizophrenia and receiving an antipsychotic medication is moving her mouth, protruding her tongue, and grimacing as she watches television. The nurse determines that the client is experiencing which medication complication?

Tardive dyskinesia

The nurse cares for a hospitalized adolescent diagnosed with major depressive disorder. The health care provider prescribes a lower-dose antidepressant. In consideration of published warnings about the use of antidepressant medications in younger patients, which action should the nurse employ?

Teach the adolescent about Black Box warnings associated with antidepressant medications, and monitor the adolescent closely for evidence of adverse effects, particularly suicidal thinking or behavior

Shortly after hospitalization, an adolescent diagnosed with anorexia nervosa says to the nurse, "Being fat is the worst thing in the world. I hope it never happens to me." Which response by the nurse is appropriate?

Tell me how your world would be different if you were fat.

The nurse asks an 87-year-old, "How are you doing?" The patient replies, "I have good days and bad days." Select the nurse's therapeutic response.

Tell me more about that

A nurse plans to lead a group in a residential facility for kindergarten-age, abused children. Which strategy should the nurse incorporate?

Telling a story about a child who felt sad

What is the MOST APPROPRIATE nursing action to help manage a manic client who is monopolizing a group therapy session?

Thank the client for the input, but inform the client that others now need a chance to contribute

When considering substance abuse, which individual is at the greatest risk for developing functional deficits in the future?

The 15 year old abusing cannabis

Which behavior observed by the nurse indicates a suspicion that a depressed adolescent client may be suicidal?

The adolescent gives away a DVD and a cherished autographed picture of a performer

The nurse is caring for a mental health client who exhibits passive-aggressive behavior when interacting with the nursing staff. When reporting client behaviors to the next shift, which actions are consistent with this assessment?

The client agrees with the staff but then complains to others, the client feels angry about the group session so they scatter papers in the lunchroom

A client demonstrating delusional behavior is escalating as a result of increasing anxiety regarding his or her safety. Which action demonstrates that the client has an understanding of actions to de-escalate his personal anxiety?

The client asks to be allowed to voluntary seclude.

Which assessment findings in a client who is suspected of having a delusional disorder would be suggestive of a diagnosis of schizophrenia?

The client experiences frequent and sustained hallucinations

While assessing a client diagnosed with impulse control disorder, the nurse observes the client's violent, aggressive, and assaultive behavior when having to wait for a lunch tray to be delivered from the dietary department. Which history and assessment findings documented in the medical record is the nurse also likely to find?

The client functions well in other areas of life, the degree of aggressiveness is out of proportion to the stressor, the client has a history of parental alcoholism and a chaotic, abusive family life

Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder?

The client had six drinks a few hours ago

A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation?

The client is experiencing catatonia.

A nurse selects a priority nursing diagnosis of fear related to being embarrassed in the presence of others for a client who exhibits symptoms of social phobia. Which outcomes if met would demonstrate improvement in the client's symptoms?

The client manages fear in group situations, verbalizes feelings that occur in stressful situations, develops a plan for responding to stressful situations

The nurse is assessing a client who has been unable to speak after witnessing a murder. The assessment and subsequent testing reveal no physical abnormality that may cause speech impairment. What is the most likely cause of this speech impairment in the client?

The client may be attempting to block the witnessed event to reduce anxiety.

The client was diagnosed with cocaine abuse at age 30. When the client was 23, the client was diagnosed with major depressive episode, and has continued to have depression off and on since then. Which statement would reflect this situation?

The client most likely has a dual diagnosis since she has both a substance dependence and depression

After teaching a group of nursing students about somatic symptom disorder, the instructor determines that additional education is needed when the students identify which as true?

The client usually thinks anxiety is behind the symptoms

When describing the course of illness associated with somatic symptom disorder, which would the nurse include?

The client will report going to many different providers without satisfaction

A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which would be most important for the nurse to keep in mind?

The client's experience of pain is real

The nurse is reviewing the assessment data of a client admitted to the mental health unit. The nurse notes that the admission nurse documented the client is experiencing anxiety as a result of a situational crisis. The nurse plans care for the client, determining that this type of crisis could be caused by which event?

The death of a loved one

A client with opioid addiction is prescribed methadone maintenance therapy. When explaining this treatment to the client, which of the following would the nurse need to keep in mind?

The drug helps to satisfy the craving for the opioid

The nurse is teaching basic physical exercises and meditation techniques to a client recently diagnosed with conversion disorder. What outcome does the nurse expect from teaching the client these exercises? Choose the best answer.

The exercises may help the client manage stress underlying the disorder

A nursing instructor is describing somatic symptom disorder (SSD) to a group of nursing students. The instructor determines that the education was successful when the students state which?

The first symptom usually appears during adolescence

The nurse should plan which goals of the termination stage of group development?

The group evaluates the experience, the group explores members' feelings about the group and the impending separation

According to the immunovirological theory, a person is at risk for developing schizophrenia when which factors were present while the person's was in utero?

The mother had the influenza virus while pregnant, The mother resided in a crowded urban city while pregnant, The mother had a sexually transmitted disease while pregnant

A nurse was placed in charge of the pediatric care unit. Over a period of time it was discovered that most of the children on the unit experienced sudden cardiac arrest. Although the nurse went to great lengths to revive the children, most of these children died. On further investigation, it was found that the nurse had been injecting high doses of digoxin drug in the children, which caused the cardiac arrest. The nurse was arrested and found guilty. What would have been the most likely cause of the nurse's behavior?

The nurse might have Munchausen's syndrome by proxy

The nurse is working with a client with alcohol use disorder that has difficult behaviors to manage. Which action by the nurse is a priority to effectively care for this client?

The nurse must recognize their own beliefs, backgrounds, and attitudes related to substance use disorder

The nurse is caring for a client with conversion disorder. The nurse asks the client about the client's relationships with family and friends. What is the nurse trying to determine with this question? Choose the best answer.

The nurse wants to learn if the client has any conflicts with family or friends.

While assessing a client thought to have a factitious disorder, a nurse asks the client to describe when the client felt nurtured as a child. Which response would the nurse interpret as supporting the client's diagnosis?

The only time I ever felt loved was when I was sick enough to miss school

The nurse is caring for a patient with severe depression. In which conditions would the nurse anticipate the use of electroconvulsive therapy (ECT) as an option?

The patient cannot tolerate monoamine oxidase inhibitors (MAOIs), the patient has not responded to conventional and antidepressant medication therapy, the patient is having acute suicidal thoughts

A nurse has developed a therapeutic relationship with a patient who has an addiction disorder. Which patient behaviors would indicate that the therapeutic interaction is in the working phase?

The patient discusses how the addiction has contributed to family distress, The patient verbalizes difficulty identifying personal strengths, the patient discusses the financial problems related to addiction, The patient acknowledges the addiction's effects on their children

A client with schizophrenia is prescribed an antipsychotic medication. Which immediate side effects would the nurse include in the education plan for this medication?

The potential for sedation

A nurse is assessing a client for a neurocognitive disorder such as dementia. What history findings would the nurse anticipate while talking with the client and family?

The progression of symptoms has been slow, the client admits to feelings of wanting to be alone, the family cannot determine when the symptoms first appeared, the client has been exhibiting basic personality changes, the client has great difficulty paying attention to others

A nurse in an outpatient medical clinic talks to a patient with a long history of malingering and doctor-shopping. The patient continues to express complaints of multiple problems. Select the nurse's best comment to the patient.

The treatment team discussed your care and wants to begin a special case management program for you

A client is brought to the emergency department confused and agitated with aggressive behaviors toward the staff. The client is ordered haloperidol decanoate 100 mg IM STAT once the agitation escalated to include behaviors of screaming and throwing objects. In considering the client condition and behaviors exhibited, which location is BEST for the nurse to administer the IM injection?

The ventrogluteal (hip) region provides the most acceptable location for IM injection and the fastest route of absorption.

A family member asks the nurse, "I know my uncle's Alzheimer's disease has progressed, but is there any medication that can help him now?" Which response by the nurse is correct?

There are a few medications that may help. Let's discuss it with the health care provider.

Which statement demonstrates a defense mechanism often implemented by clients diagnosed with a borderline personality disorder?

There is nothing good I can say about my mother.

Which is true about clients with illness anxiety disorder?

They may interpret normal body sensations as signs of disease.

The nurse is meeting with the family of a client who uses alcohol. Which statement indicates to the nurse that the family believes a myth about alcohol use?

They only drink after work

Guided Imagery?

Thinking of being in a calming circumstance/place

When assessing a client with a delusional disorder who is experiencing somatic delusions, which would the nurse expect as within normal parameters?

Thinking, Orientation, Attention

Which statement would indicate that teaching about naltrexone (ReVia) has been effective?

This medication will block the effects of any opioid substance I take.

A nurse teaches a patient with alcohol use disorder about a new prescription for naltrexone (ReVia, Vivitrol). Which comment by the patient indicates the teaching was effective?

This medicine is one part of a bigger treatment plan to help me stay sober

The nurse is planning care for a client with a somatic symptom illness. What should the nurse's goals be while formulating the plan to treat the client?

To help the client express emotions freely, To help the client cope with interpersonal conflicts, and To help the client identify the cause of the physical illness

A client taking lithium reports vomiting, abdominal pain, diarrhea, blurred vision, tinnitus, and tremors. The lithium level is 2.5 mEq/L (2.5 mmol/L). The nurse plans care based on which representation of this level?

Toxic

What is the goal of therapy for dissociative disorder?

Treat the trauma that caused the dissociating, work on living in the present, integration of identities into a unified, subjective sense of self, and development of coping strategies

The nurse is assessing a client who is a polysubstance abuser, with cocaine being one of the drugs most frequently used. Which physiological symptoms are suggestive of early (phase 1) cocaine intoxication?

Tremors, psychomotor agitation, cardiac arrhythmias, dilated pupils

A client is diagnosed with a delusional disorder. While providing care to the client, the nurse assesses the client's delusions. Which would be least appropriate for the nurse to do?

Try to change the client's delusional belief

Which statements characterizes the major difference between the typical and atypical antipsychotic medications?

Typical antipsychotics most often relieve positive symptoms but do not have a significant impact on negative symptoms

Psychodynamic theory attributes the development of mood disorders to what?

Unexpressed and unconscious anger

A client, brought to the emergency department by the police, is found wandering the streets of town and appears to be disoriented. During initial contact by the nurse, the client begins to laugh inappropriately and states feeling dizzy. Which client behaviors suggest that the client is symptomatic for hugging aerosols?

Unsteady gait, impaired memory of where they had been, slurred speech during a conversation, hallucinations of spiders crawling on the bed

A client diagnosed with delirium becomes disoriented and confused at night. Which intervention should the nurse implement initially?

Use an indirect light source and turn off the television

While interacting with a 62-year-old adult diagnosed with a progressive neurocognitive disorder, the nurse observes that the adult has slow responses and difficulty finding the right words. What is the nurse's best initial action?

Use silence to allow the adult an opportunity to compose responses

A nurse is developing a care plan for a client with acute mania. In what order would the behaviors progress from normal through mania.

Uses relevant, calm speech patterns, shows high productivity and competitive attitude in work and leisure activities, becomes easily irritated, demonstrates poor judgment and impulse control, has delusions of grandeur

A client experiencing disturbed thought processes believes that his food is being poisoned. Which communication technique should the nurse use to encourage the client to eat?

Using open-ended questions and silence

A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client makes which statement(s) regarding information about the drug?

Using this drug will reduce the appeal of alcohol, I can take this medication once a day

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what?

Verbalize feeling safe and comfortable

A client diagnosed with schizophrenia states, "I want to go home, go home, go home." This is an example of which speech pattern?

Verbigeration

Which event described in the life of an older client demonstrates a successful transition after his or her retirement?

Volunteers 10 hours a week at a local homeless shelter.

A client is admitted to the psychiatric hospital with a diagnosis of schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. The nurse interprets this as what?

Waxy flexibility

Which is a nonneurologic side effect of antipsychotic medications?

Weight gain

A community mental health nurse talks with a 6-year-old child whose divorced parents have shared custody. Which initial question will best help the nurse explore the child's perception of home life?

What are some of the good and bad things about living in two places?

The spouse of a client admitted to the mental health unit for alcohol withdrawal says to the nurse "I should get out of this bad situation". Which is the most helpful response by the nurse?

What do you find difficult about this situation?

A client who is delusional and paranoid refuses to take antipsychotic medication as prescribed. Which is the most therapeutic response by the nurse to this refusal?

What is it about the medicine that you don't like?

The nurse is conducting an initial assessment of a client in a crisis. When assessing the client's perception of the precipitating event that led to the crisis, which is the most appropriate question?

What leads you to seek help now?

The nurse is preparing a client with schizophrenia a history of command hallucinations for discharge by providing instructions on interventions for managing hallucinations and anxiety. Which statement in response to these instructions suggests to the nurse that the client has a need for additional information?

When I have command hallucinations, I'll call a friend for help

Assessment of genetic predisposition supports asking a client who is exhibiting symptoms of a delusional disorder what?

Whether any family members have been diagnosed with schizophrenia

A client with schizophrenia has been started on medication therapy with clozapine. The nurse should assess the results of which laboratory study to monitor for adverse effects from this medication?

White blood cell count

a combination of jumbled words and phrases that are disconnected or incoherent and make no sense to the listener

Word Salad

When conducting a suicide risk assessment, the nurse understands that which method has the least lethality?

Wrist slashing

The nurse is planning activities for a client diagnosed with bipolar disorder with aggressive social behavior. Which activity would be most appropriate for this client?

Writing

Which comment by a patient diagnosed with bipolar disorder best indicates the patient is experiencing mania?

Yesterday I made 487 posts on my social network page

In the emergency department, a patient reveals to the nurse a lethal plan for dying by suicide and agrees to voluntary admission to the psychiatric unit. Which information would the nurse discuss with the patient to answer the question "How long do I have to stay here?"

You may leave the hospital at any time unless you're suicidal or homicidal or unable to meet your basic needs, Let's talk more after the healthcare team has assessed you, Because you have stated that you want to hurt yourself, you must be safe before being discharged

The nurse observes that a client with a potential for violence is agitated, pacing up and down the hallway, and making aggressive and belligerent gestures at other clients. Which statement would be most appropriate to make to this client?

You seem restless, tell me what is happening

After a power outage, a facility must serve a dinner of sandwiches and fruit to patients. Which comment is most likely from a patient diagnosed with a narcissistic personality disorder?

You should have ordered a to-go meal from a local restaurant for me

A depressed client on an inpatient unit says to the nurse, "My family would be better off without me". Which is the nurse's best response?

You sound very upset. Are you thinking of hurting yourself?

A client diagnosed with terminal cancer says to the nurse, "I'm going to die, and I wish my family would stop hoping for a cure! I get so angry when they carry on like this. After all, I'm the one who's dying." Which response by the nurse is therapeutic?

You're feeling angry that your family continues to hope for you to be cured?

The nurse visits a client at home. The client states "I haven't slept at all the last couple of nights". Which response by the nurse demonstrates therapeutic communication?

You're having difficulty sleeping?

A client with a diagnosis of depression who has attempted suicide says to the nurse "I should have died. I've always been a failure. Nothing ever goes with for me". Which response by the nurse demonstrates therapeutic communication?

You've been feeling like a failure for a while?

A patient was diagnosed with bipolar disorder many years ago. The patient tells the nurse, " When I have a manic episode, there's always a feeling of gloom behind it, and I know I will soon be totally depressed." What is the nurse's best response?

Your comment indicates you have an understanding of and insight about your disorder

Which client does the nurse identity as having the greatest risk for developing somatic symptom disorder (SSD)?

a female of African descent who works two minimum wage jobs

Major depressive disorder (MDD)

a medical illness that affects how you feel, think, and behave, causing persistent feelings of sadness and loss of interest in previously enjoyed activities.

The client's family asks the nurse, "What is illness anxiety disorder?" The best response by the nurse is, "Illness anxiety disorder is

a persistent preoccupation with getting a serious disease. (previously hypochondria)

What are extrapyramidal symptoms?

abnormal involuntary motor symptoms

The most important short-term goal for the client who tries to manipulate others would be to

acknowledge own behavior.

Foods rich in Tyramine.

aged cheese, chicken liver, avocados, bananas, meat tenderizer, salami, bologna, wine, beer

When the client describes fear of leaving his apartment as well as the desire to get out and meet others, it is called

ambivalence.

a blocked Ach (Acetylcholine) can cause what potential effect?

anticholinergic effects

a blocked a1 (specific receptor for epinephrine) can cause what potential effects

antipsychotic effect, postural hypotension, dizziness, reflux tachycardia, ejaculatory and or impotence, memory dysfunction

Amygdala

anxiety and reduced motivation

The nurse is caring for a client with schizoaffective disorder with depression. The nurse should instruct the client that the most effective medication therapy for this disorder is:

atypical antipsychotic medications

What type of bipolar disorder is characterized by at least one manic episode that is accompanied by hypomania?

bipolar II

A patient who has ingested alcohol can not have what drug because it may cause over-sedation and respiratory depression?

chlorpromazine (Thorazine)

An adult client diagnosed with a somatoform disorder is referred to therapy. Which therapy would the nurse anticipate the client is referred to?

cognitive-behavioral therapy (CBT)

The nurse is assessing a client who uses alcohol daily. On which reason(s) would the nurse focus the assessment when the client denies a family history of alcohol use?

cope with life, relieve stress and tension, increase feelings of power, decrease psychological pain

In a patient who has anorexia nervosa, what is the highest treatment priority?

correction of nutritional and electrolyte imbalances

persistent depressive disorder symptoms

daytime fatigue, can function at work and in social situations but not at an optimal level, chronic low depressed/irritable mood , eating too much or too little, difficulty with sleeping: usually difficult to get to sleep/ then hypersomnia, loss of energy, fatigue, chronic tiredness, decreased capacity to experience pleasure, enthusiasm, or motivation, irritability , negative, pessimistic thinking, low self esteem

a blocked 5-HT (Serotonin) can cause what potential effects?

decreased depression, antianxiety effects, GI disturbances, Sexual dysfunction

A blocked NE (norepinephrine) can cause what potential effects?

decreased depression, tremors, tachycardia, erectile and/or ejaculatory dysfunction

prefrontal cortex

decreased mood, problems concentrating

a blocked DA (dopamine reuptake) can cause what potential effects?

decreased psychosis, Psychomotor agitation, parkinsonian effect

The nurse is caring for a client with chronic alcohol use disorder that is experiencing an alteration in memory function. Which laboratory result will the nurse correlate with this assessment finding?

decreased thiamine level

A client comes to day treatment intoxicated but says he is not. The nurse identifies that the client is exhibiting symptoms of

denial.

The nurse provides care for an older adult client who is newly diagnosed with somatic symptom disorder (SSD). Which psychiatric disorder is the priority to assess this client for based on the current diagnosis of SSD?

depression disorder

limbic system

emotional alterations

A client is admitted to a mental health unit because they were found trying to inject diluted feces into their hospitalized child's intravenous line. The client has a history of similar attempts of harming the child. A nurse would most likely suspect which?

factitious disorder imposed on another, and Münchausen's by proxy

A nurse is preparing an inservice program about substance use disorder. Which information would the nurse include in the presentation when discussing possible contributors to the development of substance use disorder?

genetic predisposition

Decreased levels of norepinephrine (NE)

in the medial forebrain bundle (MFB) may account for symptoms of anergia, anhedonia, decreased concentration a diminished libido.

These imbalances can cause lithium retention and lead to lithium toxicity.

insufficient sodium and fluid intake

The client who hesitates 30 seconds before responding to any question is described as having

latency of response.

Selective Reuptake Inhibitors (SSRIs)

may experience both suicidal and aggressive behaviors as a side effect.

Hippocampus

memory impairments; feelings of worthlessness, hopelessness, and guilt

A client with mania begins dancing around the day room. When she twirled her skirt in front of the male clients, it was obvious she had no underwear on. The nurse distracts her and takes her to her room to put on underwear. The nurse acted as she did to

minimize the client's embarrassment about her present behavior.

Hypothalamus

mood regulation

Dopamine

neurons in the mesolimbic system are thought to play a role in the reward and incentive behavior processes, emotional expression, and learning processes that are disrupted in depression. this is particularly true in melancholic depression.

plays a role in stress regulation and can be over-taxed through stressful events

norepinephrine, serotonin, acetylcholine

A nurse is caring for a hospitalized client who has schizophrenia. The client has been taking antipsychotic medications for 1 week when the nurse observes that the client's eyes are fixed on the ceiling. The nurse interprets this finding as:

oculogyric crisis

The 12 steps of AA teach that

once a person is sober, he or she remains at risk for drinking.

The client tells the nurse that she has a drink every morning to calm her nerves and stop her tremors. The nurse realizes the client is at risk for

physical dependence.

A client who developed numbness in the right hand could not play the piano at a scheduled recital. The consequence of the symptom, not having to perform, is best described as

primary gain.

Contraindications of TCAs

recent MI, or other CV problems, narrow angle glaucoma, BPH, history of seizures should not be treated with TCAs and pregnancy

The overall goal of psychiatric rehabilitation is for the client to gain

recovery from the illness.

Anergia

reduction or lack of energy

Cognitive restructuring techniques include all of the following, except

relaxation.

A nurse observes a fellow nurse colleague who has an unsteady gait and slurred speech. The nurse suspects that the colleague is impaired. Which would be the appropriate action to take?

report the nurse colleague's behavior to the supervisor on the floor

Anxiolytic side effects?

sedation, somnolence, dizziness, ataxia, cognitive disorder, memory impairment, dependence, orthostatic hypotension, paradoxical excitement, nausea/vomiting, anticholinergic effects

A client is being evaluated 3 days after beginning a new prescription for an antidepressant medication. Upon assessment, the client is agitated, has a fever, and is shivering. Which adverse reaction is the client experiencing?

serotonin syndrome

TCAs common adverse effects

the anticholinergic effects are dry mouth, blurred vision, tachycardia, constipation, urinary retention, esophageal reflux, photophobia, and sexual dysfunction.

atypical antidepressants

trazadone, mirtazapine, vilazodone, and bupropion

A client has been prescribed clozapine for treatment of schizophrenia. The client must be taught to monitor which blood concentrations weekly while taking this drug?

white blood cells