Psych (Questions)

B (akathisia = restlessness)

A client begins taking haloperidol. After a few days, the client experiences severe tonic contractures of muscles in the neck, mouth, and tongue. The nurse should recognize this as a) psychotic symptoms. b) dystonia. c) akathisia. d) parkinsonism.

A

A nurse explains the guidelines for the unit's seclusion room to a client with an impulse control disorder. Which client statement indicates that the nurse has adequately communicated the client's rights? a) "Although I don't think I will, I can ask to go into seclusion, but I know you can make me go into the seclusion room." b) "When I go into seclusion, I won't be able to see my physician until I calm myself down." c) "Every time I decide that I won't attend a group meeting, I'll be put in seclusion." d) "If I lose my temper in the community room, I'll be locked up in the seclusion room."

A (psychogenic amnesia is often seen r/t a traumatic event)

A nurse is admitting a client diagnosed with psychogenic amnesia. The client is in apparent good health. The nurse would expect the client to exhibit which of the following behaviors? a) demonstrating disinterest toward the impact of the memory loss b) exhibiting a preoccupation with discovering a true identity c) switching from one distinct personality to another d) exhibiting fluctuating levels of speech functioning

D

A nurse is assessing a client suffering from stress and anxiety. The most common physiologic response to stress and anxiety is: a) urticaria. b) sedation. c) vertigo. d) diarrhea.

D

A nurse meets frequently with a depressed client. The client stays mostly in his room and speaks only when addressed, answering briefly and abruptly while keeping his eyes on the floor. Initially, the nurse should focus on the client's ability to do which function? a) Relate to other clients. b) Make decisions. c) Function independently. d) Express himself verbally.

A

A nurse notices that a client with obsessive-compulsive disorder dresses and undresses several times each day. Which comment by the nurse would be most therapeutic? a) "I saw you change clothes several times today. Do you find this tiring?" b) "It might be helpful if you dress only once per day so you will not be so tired." c) "It must really bother you to change your clothes so often. How can I help?" d) "I see that you are a perfectionist about the clothes you wear."

C (tend to have insomnia, abnormal dreams)

The nurse is caring for a client who is receiving paroxetine for a major depressive disorder. What is the nurse's most important intervention? a) Monitor thyroid function. b) Determine electrocardiogram changes. c) Ask about sleeping difficulties. d) Assess for peripheral edema.

A (antipsychotic used to treat schizophrenia - so extrapyramidal effects)

The nurse is teaching a client who has been prescribed thiothixene. Which adverse reaction is most important for the nurse to discuss with this client? a) akinesia b) hypotension c) sedation d) weight gain

B, C, F

A client is prescribed sertraline, a selective serotonin reuptake inhibitor. Which adverse effects would the nurse review when creating a medication teaching plan? Select all that apply. a) seizures b) agitation c) sleep disturbance d) persistent cough e) agranulocytosis f) dry mouth

B, C

A nurse is caring for a client with agoraphobia. Which signs and symptoms would the nurse anticipate? Select all that apply. a) hallucinations. b) panic attacks. c) inability to leave home. d) eating disorders. e) alcohol consumption. f) tobacco use.

C

A nurse is caring for a severely depressed client who is barely functioning. The priority nursing goal for this client would be to: a) assess for level of depression and continue antidepressant medication. b) assess for the client's hygiene needs and ensure that these needs are met. c) assess for and maintain adequate nutrition and hydration. d) involve the family in the client's care as much as possible.

A (confusion and temporary memory loss are the most common SE of ECT)

A nurse is developing a care plan for a client who has undergone electroconvulsive therapy (ECT). The nurse should include which intervention? a) reorienting the client to time and place b) placing the client in Trendelenburg's position c) monitoring the client's vital signs every hour for 4 hours d) encouraging early ambulation

D

The nurse is performing an admission interview when the client attempts to shift the session focus to the nurse by asking personal questions. Which statement by the nurse is most appropriate? a) "It is preferred for the nurses to control the interview." b) "It is not appropriate for you to ask me personal questions." c) "What do you want to know about me?" d) "I have a family. Tell me about you and your family."

A (b/c excess sweating can increase serum lithium level)

The nurse should advise which client who is taking lithium to consult with the health care provider regarding a potential adjustment in lithium dosage? a) client who is beginning training for a tennis team b) a client who can now care for her children c) a client who attends college classes d) a client who continues work as a computer programmer

D

A client has refused to take a shower since being admitted 4 days earlier and tells a nurse, "There are poison crystals hidden in the showerhead. They'll kill me if I take a shower." Which nursing action is most appropriate? a) explaining that other clients are complaining about the client's body odor b) asking a security officer to assist in giving the client a shower c) dismantling the showerhead and showing the client that there is nothing in it d) accepting these fears and allowing the client to take a sponge bath

D

A client with acute mania is to receive lithium carbonate 600 mg PO three times daily and 2 mg of haloperidol PO at bedtime. Which action should the nurse take? a) Give the lithium only. b) Request a decreased dosage of lithium. c) Refuse to give the medications as prescribed. d) Give the medications as prescribed.

A

The client, who is a veteran and has posttraumatic stress disorder, tells the nurse about the horror and mass destruction of war. He states, "I killed all of those people for nothing." Which response by the nurse is appropriate? a) "You did what you had to do at that time." b) "Maybe you didn't kill as many people as you think." c) "How many people did you kill?" d) "War is a terrible thing."

C (PCP will be excreted with an acidic environment so give cranberry juice)

Which liquid should the nurse administer to a client who is intoxicated on phencyclidine (PCP) to hasten excretion of the chemical? a) water b) milk c) cranberry juice d) grape juice

B

What is a generally accepted criterion of mental health? a) absence of anxiety b) self-acceptance c) ability to control others d) happiness

B (provides faster med absorption)

What is the best site to admin haloperidol IM in an acute situation? a) Deltoid b) Ventrogluteal c) Vastus lateralis

A, C, D

The nurse is developing a long-term care plan for an outpatient client diagnosed with dissociative identity disorder. Which interventions should be included in this plan? Select all that apply. a) selecting a method for alter personalities to communicate with each other, such as journaling b) trying different medicines to find one that eliminates the dissociative process c) learning how to manage feelings, especially anger and rage d) identifying resources to call when there is a risk of suicide or self-mutilation e) joining several outpatient support groups that are process-oriented f) helping each alter accept the goal of sharing and integrating all their memories

A

A client is admitted to the psychiatric unit with a diagnosis of functional neurologic symptom disorder. Since witnessing a beating at gunpoint, the client is paralyzed. Which action should the nurse initially focus on when planning this client's care? a) helping the client identify and verbalize their feelings about the incident b) helping the client identify any stressors or psychological conflicts c) teaching the client to deal with any limitations of the paralysis d) exploring personal relationships that may be related to the paralysis

C(other s/s: tremors, n/v, malaise, irritable)

A client is voluntarily admitted to a substance use disorder unit. The client admits to drinking at least 1 qt (1 L) of vodka each day and occasionally using cocaine. Several hours after admission, a nurse suspects that the client is likely experiencing early alcohol withdrawal. What assessment findings will the nurse document as evidence of alcohol withdrawal? a) dehydration, temperature above 101°F (38.3°C), and pruritus b) vomiting, watery frequent diarrhea, and pulse below 80 beats/minute c) pulse of 135 beats/minute, blood pressure of 160/90 mmHg, and nervousness d) blood pressure of 90/50 mmHg, decreased appetite, and somnolence

C (pt experiencing dystonic rxn/dyskinesias to haloperidol... reversed with Benadryl)

A client received haloperidol 12 hours previously. The client develops an oculogyric crisis and tongue protrusion. Which is a nursing priority intervention? a) administering midazolam as ordered b) administering diazepam as ordered c) administering diphenhydramine as ordered d) administering chlorpromazine as ordered

C

A client taking clozapine states, "I don't like feeling so sedated during the day. I can hardly keep my eyes open." Which response by the nurse would be most appropriate? a) "Try waking up an hour earlier to see if that helps." b) "Sleep as long as you need to, and nap fairly often." c) "Let's talk to your health care provider about taking most of the drug at bedtime." d) "Going to bed earlier at night might help."

B (SE of bone marrow depression!)

A nurse is teaching a client with bipolar disorder about the drug carbamazepine. The nurse determines teaching was effective when the client states a) "I will drink plenty of water so I don't develop kidney problems." b) "I need to have my blood counts checked periodically." c) "My hair will fall out after I take this drug for a few months." d) "I can't take any other drugs while I am taking this one."

A, C, E, F

A client on a mental health unit becomes increasing agitated and barricades themself 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? Select all that apply. a) Identify one nurse to interact with the client. b) Yell for assistance to obtain help quickly. c) Direct other clients away from the area. d) Speak to the client in an authoritarian manner. e) Discretely notify security to assist. f) Identify with the client's perspective and reason for agitation.

D

A client seeking help at a community mental health center complains of fatigue, sensitivity to criticism, decreased libido, and feeling self-conscious. The client also has aches and pains. A nursing diagnosis for this client might include: a) delayed growth and development. b) ineffective role performance. c) post-trauma syndrome. d) situational low self-esteem.

C (ideas of reference = a person's view that other people recognize that one has an important characteristic of power) (Thought insertion is a belief that others can put a thought into one's mind)

A client tells the nurse, "Everybody smiles at me because they know that I was chosen by God for this mission." The nurse interprets this statement as which finding? a) visual hallucination b) idea of reference c) neologism d) thought insertion

A (symptom exacerbation = often r/t noncompliance)

A client with a chronic mental illness has worked as a hotel maid for the past 3 years. She tells the nurse she is thinking of quitting her job because "voices on television are talking about me." What should the nurse do first? a) Obtain information about the client's medication compliance. b) Remind the client that hearing voices is a symptom of her illness that she can cope with. c) Check with the client's employer about her work performance. d) Arrange for the client to be admitted to a psychiatric hospital for a short stay.

A

A client with schizophrenia states "I can't stay here. I have to get away." The nurse observes that the client is very agitated. What should be the nurse's first action? a) Approach the client in a calm, nonthreatening manner. b) Allow the client to express feelings. c) Ask the client to take lorazepam 1 mg orally. d) Call for help from the other staff.

D (delay in getting tx = s/s of abuse)

A nurse is assessing the family of a 10-year-old child brought into the emergency department with severe injuries. Which statement made by the parents could indicate child abuse? a) "You should ask my child about his injuries. They will know best what happened." b) "My child fell off his bike and into the street." c) "I don't know what I will do if something happens to my child." d) "The injury happened a few days ago but I didn't think it was bad."

C

A client with alcohol dependency is prescribed a B-complex vitamin. The client states, "Why do I need a vitamin? My appetite is just fine." Which of the following responses by the nurse is most appropriate? a) "Your doctor wants you to take it for at least 4 months." b) "You've been drinking alcohol and eating very little." c) "The vitamin is a nutritional supplement important to your health." d) "The amount of vitamins in the alcohol you drink is very low."

B, C, E (D is for schizophrenia)

A 54-year-old client with generalized anxiety disorder is admitted to the facility. Which therapeutic modalities are typically used to treat this disorder? Select all that apply. a) Electroconvulsive therapy b) Biofeedback c) Relaxation techniques d) Fluphenazine therapy e) Buspirone therapy

D

A client with moderate Alzheimer's-related dementia is being prepared for discharge. What statement by the caregiver demonstrates that discharge teaching about client safety has been effective? a) "I should encourage the client to be active and do as much as the client can." b) "Showering alone is fine as long as the client remains seated and holds tightly to the safety rails." c) "I need to place signs in each room to help remind the client about the surroundings." d) "Someone should supervise the client at all times."

A (signs of lithium toxicity!)

An elderly client's lithium level is 1.4 mEq/L. The client complains of diarrhea, tremors, and nausea. The nurse should: a) hold the lithium and notify the physician. b) reassure the client that these are normal adverse effects. c) administer another lithium dose. d) discontinue the lithium.

A (notice it says psychoMOTOR behavior)

As a client's level of anxiety increases to a debilitating degree, the nurse should expect which psychomotor behavior as indicating a panic level of anxiety? a) suicide attempts or violence b) desperation and rage c) disorganized reasoning d) loss of contact with reality

A

Erikson described the psychosocial tasks of the developing person in his theoretical model. He proposed that the primary developmental task of the young adult (ages 18 to 25) is: a) intimacy versus isolation. b) industry versus inferiority. c) generativity versus stagnation. d) trust versus mistrust.

B

For the client with a substance abuse problem, which intervention would be most helpful to aid the client in dealing with feelings and concerns related to alcohol and drugs? a) individual therapy b) group sessions c) solitary activities d) recreation

C

In closed or locked units, the nurse judges the milieu as therapeutic when priorities are given to which factors? a) socialization and self-understanding b) recreation and vocation counseling c) safety, structure, and support d) communication, social, and leisure skills

A (used when client extremely agitated)

Lorazepam is commonly given along with a neuroleptic agent. What is the purpose of administering the drugs together? a) to reduce anxiety and potentiate the neuroleptic's sedative action b) to counteract the neuroleptic's extrapyramidal effects c) to manage depressed clients d) to increase a client's level of awareness and concentration

C, D (not a b/c limits autonomy)

Which approaches would be most therapeutic for clients with borderline personality disorders? Select all that apply. a) Offer solutions for problems. b) Interact on a superficial level. c) Assist with management of emotions. d) Use supportive confrontation when needed. e) Minimize fears regarding responsibility for self.

D (other s/s = coarse hand tremors, diarrhea, twitching, polyuria, lethargy, confusion)

Which clinical manifestation should alert the nurse to lithium toxicity? a) increasingly agitated behavior b) markedly increased food intake c) sudden increase in blood pressure d) lethargy and weakness with vomiting