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Mental Health
Final Exam
| question | answer |
|---|---|
| One week after begining therapy with Haldo. the client demonstrates muscle reidgidity, a T-103, an increased serum creatinine (CPK) level, stupor and incontinence. The nurse should notify the physician because these symptoms are indicative of | Neuroleptic malignant syndrome |
| Persons receiving any of the MAO inhibitors would be cautioned about avoiding foods containing tyramine because they can precepitate | hypertensive crisis |
| A client with bipolar disorder has been taking lithium, and today the serum b lood level is 2.0 .mEq?. What effects would the nurse expect to see | Nausea, diarrhea, and confusion |
| Benztropine (Congentin) is frequently given concurrently with haloperidol (haldol). Congentin can | Reduce the extrapyramidal side effects of Haldol |
| Tricylclic antidepressants canb produce anticholinergic side effects. Which of the following is a common anticholinergic side effect | Dry mouth |
| client has a lithium level of 1.o mEq/L. Which of the following interventions by the nurse is indicated | No intervention is necessary at this time. |
| The nurse is assessing a client who is taking haloperidol (Haldol) 2 mg po BID. The nurse must monitor for what common side effect of this drug | Extgrapyramidal symptoms |
| A client iwth severe and persistent mental illness will be starting to take clzapine (Clozaril). In teaching about this medication, the nurse must caution that: | Blood work will be required regularly |
| THe nurse is working with a client who doesn' take prescribed medication once he is discharged from the hospital. The clinet states. :There's nothing wrong with me. I don't need medication." This is an example of: | Denial |
| When teaching a client about taking lithium, the nurse must include the necessity of maintaining an adequate diet, especially the importance of: | Salt |
| A college student decides to go to a party the night before a major exam instead of studying. After receiving a low score on the exam, the student tells a fellow "I have to work too much and don't have time to study" The defense mechanism is: | Rationalization and Projection |
| A client hates her mother, who ignored her while she was growing up. The clent uses the defense mechanism of reaction formation. Which of the following statements is an example of this defense mechanism? | "I have a wonderful mother whom I love very much" |
| A client is supplsed to be ambulating ad lib, Instead, he refuses to geot out of bed, asks for a bed bath, amd makes manyh demands of the nurses. He also yells that they are lazy an incompetent. The clients'behavior is an example of whichl | Projection |
| A client begins to take stock of his life and look into the future. The nurse assesses that this client is in which of Eridson's developmental stages? | Integrity versus despair |
| According to Maslow's hierarchy of needs, the most basic need is : | Safety |
| Linda frequently conducts comprehensive assessment interview with patients within the first 24 hours after admission. This in integral to what phase of the therapeutic relationshp? | Orientation Phase |
| Laura is a nurse on an inpatient psychiatric unit. Much of her time is spent observing patient activity, talking with patients, and intervening to maintain or restore order on the unit when patients become disruptive. This intervention step of the NP: | Milieu therapy |
| Carol had made an appointment to see her primary care provider because of increased anxiety. She sees anurse practitioner who does a physical examination, takes a detailed hx, and diagnoses Carol with Anxiety Disorder. Anticipated Medication | Diazepam (Valium) or |
| Anitanziety drugs are thought to produce their effect because of their action on which of the following neurochemicals? | Gamma_aminobutyric acid (GABA) |
| Peter's primary care physician has prescribed imipramine (Tofranil) and Thoraxine. What information specifically related to the class of medication to which imipramine belongs is important ot include as patient educaiton in the plan of intervetion? | The medication may cuase photosensitivity. |
| The class of antidepresasnts known as SSRI's affect the balance of which of the following neurochemicles? | Serotonin |
| Methypphenidate (ritalin) is one medicaiton presribed for Attention Deficit Hperacitvity Disorder. WHich of the followng medicaiton b elongs to the sme broad group of psychotropic medications? | Dextroamphetamine sulfate (Dexedrine). |
| Adherence to a drug regimen is often difficult for people whi psychotic disorders. WHich of the following antipsychotic medications provides a method of dosing that minimzed this problem? | Fluphenazine (Prolixin) |
| Placing a client in restraints before using other methods of intervetionVIOLATES the clents' right to: | Recieve treatment in the least restrive inviroment |
| It is appropraite and legal to restrain a patient if: | The client is a danger to self-and/or others |
| What source states the criteria for psychotic disorders? | DSM IV-R |
| Mary, a nurse on the inpatient psych unit, observes taht a patient named john is sitting with his dead cocked to one side and mumbling. A therapeutic response for Mary would be to: | Approach John and ask him if he is hearing voices. |
| As a psychiatric diagnosis, mental retardation woulbe be placed on | Axis II |
| The nurse on the psych unit realizes that Mary, a patient is starting to hallucinate. It is important for the nurse to assess for: | Command hallucinations |
| Mary, a 23yo college student. is preparing to take her final exam for a ver difficult course. She has started to exhibit symptoms of systhymia (low grade depression), experience migraine h/a, and state "I just don't have time to study because I work" | Mary's anxiety level is Moderate |
| John a known diabetic, eats chocolate candy on a daily basis. He stilld oes not understand why his blood sugar level continuees to remain high. A defense mechanism used by John may be: | Denial |
| Josh, once agian, has forgotten his wedding anniversary. A week later he surprises his wife with two tickets to a Caribbean cruise. This is an example of : | Undoing |
| Michael, an electical engineer, is performing poorly at work an a consistent asis. When his supervisor cals him in and asks for an explanation regarding his behvior. Michael stste "Its my wife's fault. She is always nagging at met. This is an example: | Projection |
| Tom is a small boy who is 5'5 tall. He tries out for the basketball team but fails. "make it". Thereafter, he concentrates his efforts on has acedemic studies and recieves "A's" in all of his subjects. Tom is using the defense mechanism of: | Compensation |
| The nurse is teaching a clent takng MAOI antidepressant about foods with tyramine that should be avoided. Which of the following statements would indicate that further teaching is needed? | I'm so glas I can have pizza as long as I don't have pepperoni" |
| Building trust is important in; | The orientation phase of the relationship |
| When the client says " I met Joe at the dance last week." what is the best way for the nurse to ask the clent to describe hedr relationship with Joe? | Tell me about you and Joe |
| "Good afternnon, Mr Hollick. My name is John Toth and I am a student nurse from Ocean College Nursing Department. i will be your nurse today from 3 to 10:30 pm. This statement is made for the purpose of : | Giving recognition and providing self: offering both first and last name so the client can choose a comfortalbe way to address the nurse and settting the limits of the relationship |
| Affect many be described as : | An immediately expessed and observed emotion. A feeling state becomes an affect when it is observalbe. Common e.g. are: euphoria, anger, and sadness |
| John, a 39 yo client, is admitted with a diagnosis of schizophrenia, is experiencing derealization. John is having: | Sensation of unreality concerning onese;f, parts of oneself or one's environment. (Extremity changes in size, looking at self from a distance. |
| Agens, 42wo was admitted to the psych unit for an eval. The nursing hx reveals that Agnes is consistently anxious and worries about everything, especially her family. Agnes reports that this uncomfortable feeling has been present for years. DX: | Generalized anxiety disorder |
| Cam is a new client at the mental health clinic. In the nursing hx, the nn that Cam in c/o sever anxiety. Cam reports becomning so anxious that at times his thinkin is disorganized and he feels absolute terror and helplessness, Cam is describing: | Panic attack |
| Barclay is a new client in an outpatient MH clinic. Barclay c/o he keeps having thoughts about shutting off the coffee port. Barclay know he has shut it off, but he cannot get the thought out of his head. Barclay is suffering from: | Obsessive disorder |
| Andy is a nurse caring for a client with OCD. Andy's client feels compelled to get in an out of chair four times in response to some intrusive thought. Designing POC so that the clent maintains a sense of control. Taking away the clents control will: | Increase the clients anxiety |
| Alcia is 20yo student in college,m who is having problems with class presentations. Alicia is paralyzed by fear when she must stand up in front of others and do any form of public speaking. Alicia is duffering fro a | Social Phobia |
| Freiga 29yo who was robbed at gunpoint, resisted and was beaten. She has recovered from physical injuries. She is hyperalert, constantly searches the environment, and aggresivve upon approach. She is aware of these problems and has isolated herself: | Post traumatic stress disorder |
| Lupe 30yo female , hospitalized with facial conerns since being a teen. Lupe beleived her skin is flawed/pitted not visible to others. She is spending hours in front of the mirror. Lupe is suffering from: | Somatofor Disorder |
| The nurse must be aware that the side effects of alprazola (Xanax) include which of the following? | Dependency |
| Which of the following statements regarding crisis is true? | A crisis occurs because of specific , identifiable events. |
| Carol had made an appointment to see her PCC because of increased anxiety. She sees a nurse practitioner who does a PE, takes a detailed hx, and Dx Carol with Anxiety Disorder. Which is an axiety medication? | Diazepam (Valuim} orKlonopin |
| Antianxiety drugs are thought to produce their effect because of their action on which of the foloowing neurochemicals? | Gamma-aminobutyric acid (GABA) |
| In working with a patient experiencing a crisis, it is important to: | Assess the clients' level of crisis and support systems |
| The following is ture in relationship to thenurse reporting sexual abuse: | Required by law in every state |
| The nurse is caring for a 16o boy with a hx of sexual abuse. The nurse might expect this adolescent tl: | Experience nightmares and flashbacks |
| Which stage of development, according to Erikson, is most affected for the clent who is a victim of family violence? | Trust vs Mistrust |
| Which of the following interventions is the prority for a clent with painc-level anxiety? | Provide for the clients safety |
| The clent has an order fro an anxioltyic agent. Loraxepam (Ativan). Which of the following statemnts by the client would indicate that client education about this medicaztion has been effective? | "This medication will relax me so I can focus on problem-solving |
| Acxiety can best be described as ? | A vague, uneasy feeling that occures when self-concept is threatened |
| While completing the PE of a clent being admitted for surgery, the nurse obs that the clent is experiencing a naorowed perceptual field and focuses only on immediated concerns, but can follow directions with assistance. The nurse asses level of anxiety: | Moderate |
| Which of folliwng is an approprate interventin for the nurse to implement with the clent with obsesseive-compulsive disorder? | Assist the client to practice relaxation |
| A client with panic disorder is learing to counter negative thoughts of "I'm going to die:, wiht "This is only anxiety, and it will pass. The client id using which therapeutic apprach | Cognitive restructuring |
| When working with a clent experiencing a painc attack, the nurse should do wich of the following? | Stay with the clinet while allowing adequate personal space |
| The client asks the nurse. "What does \having psychosomatic symptoms mean? The best reply by the nurse is: | Stress and/or emotions are causing your symptoms |
| A clent with recurrent h/a has been told by the Dr. that the cuase is likely physcosomatic. The client recalls the conversation with the nurse and says. This cannot be true". My head hurts so bad sometimes it makes my stomach sick: Nsg Response | "the pain in your head is very real" |
| Distorted perceptions, loss of rational thinking, and failure to perceive potential harm are characteristic of which level of anxiety | Panic |
| Nursing interventions that are appropriate for all clients with anxiety disorders are to reduce anxiety and | devleiop alternative responses to anxiety-provoking situations |
| Which if the following is an example of effective limit-setting for the client who performs, ritualistic complusions? | "You may wash your hands before group therapy, but not during group therapy |
| Which nursing intervention is effective for severly anxious clients? | Give information concretely |
| When a client is experiencing severe anxiety, which of the following is the Priority intervention? | Move the cleint to a quiet environment |
| A client is learning to cope wih5t anxiety and stress What is the expected outcome? The client will: | Change reactions to stressors |
| The nurse enters the client's room and finds the client anxiously pacing the floor. The client begins shouting at the nurse "Get out of my room!" The best interventions by the nurse would be to | Stand at the doorways and "You seem upset" |
| During a panic attack, the client runs tot he nurse and reports breathing difficulty, chest pains, and palitations. The client is pale and his mouth is wide ipen. What should the nurse do first? | Assist the client with deep breathing into a paper bag |
| Before eating a meal, a client with OCD must wash her hands for 14 minutes , comg her hair for 114 strokes, and switch the light off and on 44 times. What is themost important treatment goal for this client? | Gradually decrease the amount of time spent performing rituals |
| In a clinet w/OCD, the purpose of the ritualistic behavior is to | releive anxiety |
| Which of the following statements by the client indicates and understanding of somatization disorder? | "How I handle stress and emotions can affect my physical health" |
| In planning care for clients who somatize, an appropriate long-term outome for treatment would be the client will | develop alternative coping mechanisms |
| Which of the follwing is an example of a factitious disorder | Malingering |
| Anne 40yo housewife, is being eval at a community outpaitent clinic for the following symptoms: feeling keyed up, tired, irratible, dec. concentrations, and tense muscles. What meds might be ordered | Klonipin 0.5 mg 1 tab tid |
| a client diagnosed with schizophrenia is laughing and talking while sitting aline. WHich of the following is the best repsonse by the nurse | Tell me what is happening. |
| a college freshman is admitted to the hsop. with a dx of schizophrenia. Friends reporte dthat she had been in her toom for two days in a trance-like stae, not eating or seaking to anyone. The highest priority for this client is | assessing fluid intake and output |
| The nurse is working with a client w/schizophrenia, disorganize type. It is time for the client to get up and eat breakfast. WHich of the following statemnts by the nurse would be th most effective in helping her prepare for breakfast | "Its time to put on your dress now" |
| The nurse enter the room of a client wq/ schizophrenia the day after he has been admitted to an inpatient setting and syas "i would like to spend some time talking w/you. The client stares straight ahead and remains silent. The best response by the nurse | "You don not need to talk right now. I'll just sit here for a few minutes" |
| One evening, a client w/schizophrenia leaves his room and begins marching in the hall. When approached by the nurse, the client syas, "God syas I'm supposed to guard the area." The best response woiuld be | "I understand you hear a voice. You and I are the only ones in the hall and I don't hear a voice. |
| A client w/schizophrenia paranoid type, yells at the nurse. "They're all trying to destroy me. You're all par tof it, aren't you? The best response form the nurse would be | "Thinking people are out to destroy you must be very frightening" |
| A cline w/ schizophrenia is having difficulty maintaining personal hygiene. The nurse should plan to | break hygient tasks into a series of small steps |
| A client diagnosed w/wchizophrenia is having auditory hallucinations commanding him to kill himslef. The most therapeutic interventions would be | Spend time with him at regular intervals |
| A client w/mania is demonstrating hypersexual behavior. blowing kisses to other clients, amking suggetive remarks, and removing some articles of clothing. The intervention would be | accompany th elcient to her room to get dressed |
| The afore mentiond client with maia is prescribed lithium. Until the lithium stabilizes the patient, the doctor may also start the patient on | Ativan |
| In the event the mania patient was prescribed Haldol, an antipsychotic, and started ecperiencing stiff neck and posturing, the nurse would inform the doctor that the patient is experiencing | dystonia: give prn benadryl |
| The manic client refuses to eat, stating, "I have to much to do." The best response is | HEre is a sandwhich for you to eat |
| The client w/mania attempts to hit the nurse. The best responmse is | "Do no swing at me again. If you cannot control yourself, we will help you. |
| At 1 am , the clien tw/amaia rushes to the nurses stations and demands the psytchiatrist come to the unit now to write an order for a pass to go home. The mos therapeutic response is | "I cannot call the psy. Now, but you and I can talk about your request for a pass" |
| The nurse is concerned ab out the lack of food and fluid intake of a client w/mania. WHich of the followng foods should the nurse select that would best meet the client's nurtitional needs? | Peanut butter sandwich and milk` |
| A client w/amia is in the dining room at lunch time and is observed taking food from other client's tryas. The nurses intervetion should be based on which rationale | other clients need to be protected from the intrusive behavior |
| Which of the following activites would th enurse select to provide distraciton for a client w/ maic behavior. | Going for a walk |
| The client who is maic tells the nurse "this is no way to treat the future queen. I could have your job you know!" The best response would be | You and I can woak down to the dining room for dinner now. |
| The nurse observes a client sitting alone at a table. looking sad and preoccupied. The nuse sits down and says "I saw you sitting alone and thought I might kkep you company." The client utrns away from the nuse. The most therapeutic response would be | Move to a chair a little furhter away and say, "We can just sit together quielty" |
| A client with bipolar disorder is admitted to the psych. unit. The client is talking loudly and rapidsly walking back adn forth and exhibits a short attention span. WHich of the following would the nurse do first? | Decrease the client's environmental stimuli |
| The nuse has just completed admission assessment for a client eith depression, obtaining the following data: 20 lbs wgt loss/6 weeks, fatifue, trouble sleeping, overwheming sadness, disheveled, no eye contact, hasn't showered or shaved x2 days. Outcomes: | Eat at least 50% of meals and snacks in two days |
| A client with depression is observed pacing in the hallway, muttering about how hopeless life is. WHich of the following interventions is most appropriate at this time? | Walk with the client as he paces in the hallway. |
| A dpressed client states "I'm such a burden toeveryone. I'm not worth all the trouble." The best response by the nurse would be | "I care aobut you and want to work with you" |
| j, 20yo economics major became severly depressed after failing to exams. J cried x 2hours, then called her parents who live in a neighboring state, planning to ask if she could return home. J gave her roommate expensive sweaters . Later J unconscous/pi | Giving away her sweaters |
| J a college student, attempted suicide via overdose. She was treated in the ED and because she had no available social supports, the decision was made to hospitilize her. Identify a short-tern goal r/t J's increased risk for suicide J will: | Make a no suicide contract with the nurse covering the next 24 hours. |
| A cleint is admitted to the psychiatric unit after an overdose of antidepresasnts. The client was treates with gastric lavage in the emergency room. The client states, I'm sorry I didn't succedd this time." The priority for this client is: | assessing suicidal potential |
| E is a manic client who became hyperactive after d/c her lithium. SHe has not eaten or slept in three day.s If E attempts to hit anouther client or a staff member. Which is the best response? | "E, do not hit him/her/me. If you are unable to control yourself we will help you. |
| The family members of a client who is to receive ECT asks the nurse what to expect when they visit the clinic after treatment. WIch of the follwong is the most accurate response the nurse could make? | There will probably be loss of memory for recent events` |
| Which of the followng statements to a family member of an elderly man receiving ECT on an outpatient basis is accurate? | "Allow your father to take a nap today, and give him Tylenol if he has a headache" |
| In response to a client's manipulative behavior, the nurse should provide | consistent limits |
| When assessing a client to demonstrate whoch of the followng | Grandiose and superior self-concept |
| The nuse workes the B. paranoid schizophrenia, and his family to help understand importance of reg. meds. Be contiues to say he doesn't like taking pills. Family is helpless in compliance. Tx strategy? | Use of an antipsychotic decanoate preparation. |
| N. court after jail, and battery of wife. At arraignment, he told the judge how sorry he was and wanted psych help. His hx reveals adolescent and adult arrest. What statements would be antisocial behavior | "i hit her because she nags at me. SHe deserves it, whenever I beat her up." |
| M. borderline personality disorder tells nurse. "You used to care about me. I though you were wonderful. This outburst can be assessed as use of | Splitting |
| When planning care for a client with passive aggressive PD, the nurse will need to include interventions for which of the following behaviors? | Procrastination and intentional inefficiency. |
| Which of the follwing would the nurse expect to administer for the tx of Wernicke-Korsakoff Syndrome? | Thiamine (viamin B1) |
| Symptoms of alcohol withdrawel include which of the following | Diaphoresis, nausea, vomiting. tremors |
| T. a client undergoing rehab. , decides he will take disulfiram (Antabuse) to help him avoid impulsively responding to drinking cues. Discharge teaching for T shoulc include the need to | read labels of all liquid medication for ones that contain alcohol |
| Wich of the following medications might be prescribed to prevent delirium tremeor (DT's) | Librium |
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