Term
| After 2 weeks of treamtnet, a severely depressed client suddenly begins to feel better and starts interacting appropriatley with other clients and staff. The nurse knows that this client has an increased risk for: |
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Definition
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Term
| What is the theory of depression that requires a client to change the way he thinks in order to alleviate feelings of depression? |
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Definition
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Term
| A 30 year old male client is admitted to the psychiatric unit with a diagnosis of bipolar disorder. For the last 2 months his family describes him as being "on the move," sleeping 3 to 4 hours nightly, spending lots of money, and losing approximately 10 lbs. During the initial assessment with the client, the nurse would expect him to exhibit which of the following? |
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Definition
| Exaggerated self importance |
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Term
| The nurse includes medication education in the discharge plans for a client diagnosed as having a bipolar disorder and taking lithium carbonate. The instructions are: |
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Definition
| Have serum lithium levels checked monthly |
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Term
| Janet is a 32 year old women admitted with a history of bipolor disorder. She was found in a bar claiming to be a millionaire, dressed provocatively and buying everyone drinks. On the unit she is irritable, has been running up and down the hall asking male patients if the will lay down with her. She has been entering other patients rooms intrusively. The nurse notes her bahavior reflect: |
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Definition
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Term
| A client with symptoms of mania frequently preys on clients for cigarettes and extra food. He flirts harmlessly with female clients and always gets to group 10 minutes late. The best reason for developing interventions to stop this behavior is: |
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Definition
| Tolerating manipulation supports the manic clients grandiose delusions |
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Term
| How does the role of the nurse differ when working with a client in crisis as opposed to other counseling situations? Working with a client in crisis the nurse is more: |
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Definition
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Term
| What is the expected outcome when working with a client who has experienced a crisis? |
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Definition
| Recovery from the crisis and return to pre-crisis level of functioning |
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Term
| Several members of a family are brought to the Emergency Department after four-car accient. The murse can use crisis intervention in this situation to: |
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Definition
| Provide immediate emotional support |
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Term
| Which is the best way to assess for suididal intent in a client? |
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Definition
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Term
| Some clients attempt suicide while they are in the hospital. The most common method of suicide attempt in the hospital is: |
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Definition
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Term
| A patient has been admitted to the inpatient unit for suicidal ideation with significant intent and a relistic plan. As the nurse in chage you develop a care plan disigned to macimize patient safety and minimize suicidal ideation. After introducing yourself to the client, which intervention should be instituted first? |
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Definition
| Assess client for the remove all harmful objects such as sharps, belts and shoelaces. |
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Term
| A patient was starting on an antidepressant medication. Antidepressants are thought to alleviate depression by which of the following actions? |
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Definition
| Increasing the activity of norepinephrine and serotonin |
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Term
| Defense mechanisms are universally employed to deal with anxiety. The defense mechanism seen most often in people with substance abuse problems is: |
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Definition
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Term
| In talking with a client about a physical attack she recently experienced in a parking lot after leaving work, the following response is an example of basic empathy: |
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Definition
| You're saying you are feeling afraid since your attack |
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Term
| For the client whose nursing diagnosis is "powerlessness" related to inability to control compulsive clenaing", the nurse recognizes that the primary gain associated with the cleaning rituals is |
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Definition
| Temporary anxiety reduction |
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Term
| A male client reveals that he is so anxious he can't "think straight" because his wife asked him for a divorce. What would the nurse say to assess the client's perception of the problem? |
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Definition
| Tell me what this divorce situation means to you? |
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Term
| The nurse approached her new client eager to establish good rapport. Which of the following statments by Sue would hinder a trust relationship and be a barrier to therapeutic communication? |
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Definition
| Dont worry, Mrs. Clark. Everything will be okay. |
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Term
| Patient: "Do you think I should leave home and get an apartment of my own?" Nurse: "I think you would be much better off away from your parents." The nurses response is an example of: |
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Definition
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Term
| The distraught parents of a 14 year old male esxorted their son to the emergency room because of his disrespectful and bizarra behavior. The client was admitted to the adolescnt unit. During the assessment interview, he cursed at the nurse and spit in her face. The best response by the nurse would be: |
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Definition
| I understand that youa re angry, I will not tolerate this behavior |
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Term
| A typical treatment goal for a client with mental illness being treated in a community setting is that they client will: |
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Definition
| Demonstrate optimal level of independent functioning |
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Term
| A client with behaviors of chronic sadness and despair wants to join a support group. He wonders what good might come from meeting with a "bunch of sad sacks." The answer that will give the client relevant information about the group is: |
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Definition
| People with a common problem provide mutual support |
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Term
| The genogram is an important assessment tool because it helps the nurse to: |
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Definition
| Find out about the past history of illness in the family of origin |
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Term
| Grief that follows a sudden and tragic event such as deaths from a house fire may be accompanied by exaggerated symptoms of anger and guilt. What types of nursing interventions are most appropriate from this type of situation? |
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Definition
| Provide support and safety so the client can move though grief work |
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Term
| As assessment question a nurse might ask to help identify secondary gains in a client with somatic disorder is? |
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Definition
| What cant you do now that you were formerly able to do |
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Term
| When the nurse has diagosed a patient as experiencing panic level anxiety, an interventon that should be implemented immediately is to |
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Definition
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Term
| A nursing diagnosis appropriate to consider for a patient with any of the personality disorders is: |
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Definition
| Impaired social interaction |
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Term
| The nurse working with a patient who has borderline personality disorder must consider advanced strategies for intervention in |
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Definition
| Mood shifts, impulsivity, and manipulation |
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Term
| If a patient developed extrapyramidal symptoms (EPS) the nurse would interpert this as resluting from: |
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Definition
| Dopamine depletion in response to antipsychotic medication administration |
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Term
| A patient smiles and giggles telling the nurse, "My mother died last week." The nurse can make the assessment that the patient is displaying |
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Definition
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Term
| A nurse who works in the post hospitalization clinic for clients with schizophrnia should assess each client for signs and symptoms of impending relapse such as |
|
Definition
| difficulty sleeping and feeling tense |
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Term
| A patient who is pedophile tells the nurse that he is feeling a huge amount of guilt and shame over molesting a child. He is concernd about the impact on his family and states that the family would be better off without him. The nurse should: |
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Definition
| Consider instituting suicide precautions |
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Term
| A 40 year old client diagnosed with schizophrenia is exhibiting muscle rigidity, fever, and confusion. The nurse assess that these may be symptoms of: |
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Definition
| Neuroleptic malignant syndome |
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Term
| High risk factors for childhood sexual abuse include: |
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Definition
| Parents who were sexually abused as children |
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Term
| When assessed within the context of the family system, the nurse determines that the identified patient is: |
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Definition
| The family member the other say is the problem |
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Term
| The DSM-IV-TR is a multiaxial system used to diagnose a client. On which axis would a nurse find the diagnosis of major depression? |
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Definition
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Term
| The nurse observes that a client is pacing in the hallway, talking rapidly, and gesturing dramatically. The nurse concludes that the client is beginning to demonstrate what kind of behavior? |
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Definition
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Term
| Three days ago a client is admitted with command auditory hallucinations, insomnia, anhedonia, anorexia, poor hygiene, and paranoid delusions. He initially refuses to take his Zyprexa (olanzapine) every morning, but consents on most days after lunch. After assessing for suicidal ideation what is the first thing the nurse should assess during morning rounds? |
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Definition
| How well the client is sleeping |
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Term
| A client if often seen mumbling to himself and batting at the air. He does not interact with others. What would best describe this behavior? |
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Definition
| Evidence of hallucinations |
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Term
| A client insists that she is coming close to developing a fuel made from hoursehold dust that will revolutionize the auto industry and make her a millionaire. She stays up late working on this project and refuses to go to sleep. What symptom does this client exhibit? |
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Definition
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Term
| Which of the following would the nurse include in documenting the effects of a medication? |
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Definition
| Theapeutic effects experienced by the client |
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Term
| An 18 year old male client, who has just begun taking Haldol, comes to the nurse complaining of severe muscle spasms. The nurse assesses the client and notes that his heart rate is 110, his blood pressure is 160/90, and his temperature is 102 degrees. Based on this data, which of the following actions should the nurse make? |
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Definition
Immediately call the physician and report the findings.
Neuroleptic malignant syndrome |
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Term
| Orders for a client with the diagnosis of schizophrenia include halopeidol (Haldol) 2 mg tab po STAT and then 1mg 1 tab pd bid; benztropine (Cogentin) 2 mg tabpo bid. Why is the Haldol ordered? |
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Definition
| To decrease psychotic symptoms |
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Term
| A patient is started on clozapine (Clozaril) for treatment of schizophrnia. Which lab valuse is the nurse most concerned about? |
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Definition
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Term
| While talking with a client diagnosed with schizophrenia, you notice the client loses eye contact with you and starts staring at the wall. The client is making facial grimaces. The most appropriate nursing intervention would be to: |
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Definition
| Ask the client directly, "What are you seeing on the wall?" |
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Term
| During report, a nurse learns that a newly admitted client is suffering from negative symptoms of schizophrenia. The nurse expects to find which of the following symptoms in this patient? |
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Definition
Anhedonia
Absence of something that should be present
EX. The absence of ability to feel joy |
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Term
| Which of the following staff behaviors is most provacative when working with clients who are predisposed to aggressive or violent behavior? |
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Definition
| Engaging in disputes over medication, supplies, or rules on the unit |
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Term
| A client presents herself to the ED accompanied by a friend. She is very frightened and her clothes are a mess; her hair is disheveled and she states that she has been raped on her way to her dorm and that her roommat brought her here. The priority nursing intervention for this client would be: |
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Definition
| To provide physical and emotional support during evidence collection |
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Term
| A client is on alprazolam (Xanax) for acute anxiety. Health teaching should include which of the following instructions? |
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Definition
| Avoiding alcoholic beverages |
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Term
| The nurse is assigned to preform an assessment for a client diagnosed as having paranoid personality disorder. When the interview is documented, the nurse is most likely to describe the client as: |
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Definition
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Term
| A client has been admitted to the psychiatric unit with a diagnosis of obsessiv compulsive disorder. She spnds many hours during the day and night washing her hands. The most likely reason she washes her hands so much is that it: |
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Definition
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Term
| Antipsychotics may produce anticholinergic side effects. On assessment, you would expect the client experiencing these to complain of: |
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Definition
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Term
| Which symptomes of schizophrenia are most amenable to treatment with both low and high potency antipsychotic medications? |
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Definition
| Hallucinations, delusions |
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Term
| Clients treated with Selective Serotonin Reuptake Inhibitors (SSRIs) frequently experience which of the following side effects? |
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Definition
| Decrease in libido; sexual duysfunction |
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Term
| Which of the following behaviors would suggest to the nurse that a patient might not be taking her lithium? |
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Definition
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Term
| A client taking Eskalith (lithium carbonate) is due for his 6 pm dose. His lithium level returns and is 1.8 mEq/L. The nurse most appropiate response would be: |
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Definition
| Hold the 6pm dose and notify the doctor |
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Term
| After several theraputic encounters with a client who recently attempted suicide, the behavior that would cause the nurse to consider the possibility of countertransference is that: |
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Definition
The nurse feels exceptionally happy when the clients mood begins to lift
Countertransference is redirection of feelings toward a client - a therapists emotional entanglement with a client |
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Term
| For the psychiatric nurse whose client care focus is holistic, awarness of which DSM-IV-TR axis is most important? |
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Definition
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Term
| The nurse making an admission assessment notes the client is profoundly depressed to the point of being mute and motionless. The client has refused to bathe and eat for a week, according to he parents. The nurse should code the clients Global Assessment of Functioning as |
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Definition
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Term
| The principle on which nursing intervention should be predicated when a clients aggression quickly escalates is |
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Definition
| Begin with the least restrictive measure possible |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
| Coming right out and saying it |
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Term
|
Definition
| Suggetive, not coming right out and saying it |
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Term
| What is a side effect of antipsychotic medication that has no known treatment? |
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Definition
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Term
|
Definition
Acute sustained contration of muscles, usually of the head and neck
Sometimes eyes roll back |
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Term
| What is pseudoparkinsonism? |
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Definition
| Tremors, reduced accessory movements, impaired gait, stiffening of muscles, cogwheeling, mask face |
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Term
| Prozac is what type of medication? |
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Definition
|
|
Term
| What do neurostansmitters do? |
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Definition
|
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Term
| What are some examples of neurotransmitters? |
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Definition
Norepinephrine
Epinephrine
Acetylcholine |
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Term
| If a person is hospitalized with severe depression, what drug do you think they will need education on? |
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Definition
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Term
| A pt is prescribed an SSRI and she says she was previously being treated with a MAOI and she doesnt want to take the MAOI she wants to try the SSRI. What do we need to tell her? |
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Definition
There needs to be a 2 week wash out period because this can cause adverse reactions
Severe hypertensive crisis, stroke |
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Term
| A mother comes to you and is tearful and upset bc she thinks she could have done something to prevent her daughter from getting the illness, how do you respond? |
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Definition
| It is a biological illness, it does have a genetic component like diabetes and heart disease, you are not to be blamed for your childs illness |
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Term
| A nurse sees the theory of Orem ... |
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Definition
| Promote self care activites |
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Term
| A nurse using paplow ... will plan interventions focusing on? |
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Definition
|
|
Term
| Generally what is schizophrenia? |
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Definition
| A Deteriorating personality |
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Term
| According to Maslow what is the first thing a nurse should be concerned with when a pt comes onto the usnit? |
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Definition
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Term
| When a pt asks you a personal questions what should you say? |
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Definition
"This time is about you"
Giving then a little is ok, but then redirect to talking about them |
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Term
| When the nurse remarks to a depressed client, and says, I see you are trying not to cry, tell me what is happening and there is no response, what should the nurse do? |
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Definition
| Wait quietly for the client to reply |
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Term
| What would you discuss duing termination with a client? |
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Definition
| Summarize goals and objectives and review clients plans for the future |
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Term
| What if you had a pt who recently has a suicide attemps and you wanted to make and empathic statement what would you say? |
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Definition
| "You must have been very upset to do what you did today" |
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Term
| When do you bring up termination? |
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Definition
| During the orientation phase |
|
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Term
| Who is at the highest risk for completing suicide? |
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Definition
| Single, white, male, age 79 |
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Term
| What is it if a pt uses a made up word such as "Vollmers" what is this called? |
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Definition
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
| What is the most commong hallucination? |
|
Definition
|
|
Term
| What is an appropriate suicide contract? |
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Definition
| In the next 24 hours I will not accidentally or for any reason kill myself |
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Term
| When a clients mood shifts suddenly from anger to laughter to irritability, the assessment can be made that the mood is? |
|
Definition
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Term
| A pt began treatment with Haldol, what teaching needs to be done on the strong dopaminergic effects? |
|
Definition
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Term
| The wife of a client with maina asks about genetic transmission of being bipolar, the nurse answer should be predicated on the knowledge that? |
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Definition
| The rate of bipolar in families is higher |
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Term
| Someone comes up to you and says that depression seems to be a problem with those over 60, what would you say? |
|
Definition
| Depression affects everyone children to the elderly |
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Term
| Someone is on antipsychotic meds for 6 weeks and comes to the clinic, her hallucinations are almost gone, but she says she is develoing the flu, with a fever and sore throat, what do we need to do? |
|
Definition
| Draw up a WBC (agranulocytosis) |
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Term
| A pt who is responding to auditory hallucinations, now he is approaching you and he shakes his fists at you and says back off bitch and goes into the day room and you follow him, what should you do? |
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Definition
| Make sure there is physical space between you and the pt |
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Term
| A pt with a mood disorder displays agitation, irritability, talkativeness ... nurse can begin care planning thinking that NP will be prescribing which type of mecidation? |
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Definition
|
|
Term
| Escalation of anger - emergency rooms are places where people can get increasingly irritable and agitated because we sometimes dont give family memebers enough info, interventions to prevent escalation of anger include (husbant waiting to hear news of wife): |
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Definition
| Update him about what is being done for his wife |
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Term
| What is the first line treatment to treat maina? |
|
Definition
|
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Term
| A pt is taking a tricyclic antidepressant and she says I dont think I can keep taking these pills, they make me dizzy, esp when I stand up. What do you say? |
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Definition
Side effects will lessen over time
Tell them to get up slowly |
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Term
| What is the only reason we can do an involuntary commitment? |
|
Definition
|
|
Term
| How would you describe a pt with avoidant personality disorder? |
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Definition
| Painfully shy and lacking in self confidence |
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Term
| Prodromal stage of schizophrenia: The symptoms that come before the full blown psychotic episode that would immediately alert the family that the person has schizophrenia - which are prodromal symptoms? |
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Definition
| Withdrawal, poor concertration, phobic or obsessive behavior, and oddities of speech |
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Term
| A pt has schizophrenia with auditory hallucinations telling them to do something, what would you ake them? |
|
Definition
| Ask specifically and directly what is the voice saying to you? |
|
|
Term
| What does a SSRI work on? |
|
Definition
|
|
Term
|
Definition
| Lake of knowledge/insight |
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