Exam 4

Question 1

What is the goal of crisis intervention?

Answer 1

To return to the level of function before the crisis and to resolve the crisis.

Question 2

What should the nurse ask to assess the person’s perception of the precipitating stressor?

Answer 2

What was happening before you felt this way?

Question 3

What are signs that a persistently mentally ill (PMI) person might soon experience a crisis?

Answer 3

Anxiety increases, coping skills are mobilized, including defense mechanisms, that are unsuccessful and person perceives there is nothing he/she can do.

Question 4

What would be a reason a homeless person would not be allowed to stay at a shelter?

Answer 4

They are actively using substances

Question 5

What can shelter provide for the homeless?

Answer 5

A chance for social interaction, safety and support.

Question 6

How soon after the last drink do withdrawal symptoms occur?

Answer 6

Six to eight hours after.

Question 7

What should the nurse do when the person who has been admitted for alcohol abuse, develops high blood pressure?

Answer 7

They need more sedation–administer benzodiazepines and be careful of fluid overload.

Question 8

What is an appropriate goal for initial detox phase?

Answer 8

Have and maintain stable vital signs.

Question 9

How can “recovery” be described?

Answer 9

Lifelong process that is accomplished day by day.

Question 10

What is an expected outcome for a person completing a substance abuse program?

Answer 10

Recognize powerlessness over substances and recognize that recovery is a lifelong process

Question 11

How can success be measured for the person in recovery?

Answer 11

Number of drug free days

Question 12

What is a nursing diagnosis of high priority for the intoxicated person?

Answer 12

High risk for injury

Question 13

What is the most effective way to deal with denial in a person who abuses substances?

Answer 13

Have the person describe the effect that substance abuse has had on their life

Question 14

What is the most important question to ask an alcoholic on admission?

Answer 14

When did you have your last drink?

Question 15

What should parents observe for if they suspect their child of abusing substances?

Answer 15

Observe for behavioral changes (dropping grades, truancy, lack of interest, poor hygiene, and night sweats)

Question 16

What should the nurse do if s/he suspects a co-woker is addicted to substances?

Answer 16

Document objectively (dates & times) and report to supervisor

Question 17

How does methadone work

Answer 17

Used for withdrawal treatment but it is also addictive in substitution therapy

Question 18

What are symptoms of amphetamine use?

Answer 18

Decreased growth, appetite suppression, insomnia

Question 19

What are symptoms of of LSD use?

Answer 19

Depression, suicicidal ideation, fatigue

Question 20

What are s/s of sedative/hypnotic withdrawal?

Answer 20

Similar to alcohol, carefully withdrawal (slowly reduce dose)

Question 21

What are s/s of LSD use?

Answer 21

Synesthesia, alteration in sensations (see sounds), psychosis; bad trip - paranoia, anxiety, terror, suicide attempts, violence

Question 22

What nursing intervention should be used in caring for a person who is withdrawing from a psychostimulant drug?

Answer 22

One to one supervision, low stimulation, seizure precautions, orient PRN, maintain adequate nutrition, fluids, administer medication, monitor for other substance abuse

Question 23

What is the nurses legal responsibility if abuse is suspected?

Answer 23

Report it and the nurse does not investigate, rather they take care of the person

Question 24

What are s/s of physical neglect?

Answer 24

Not providing a child’s basic needs, unkempt hygiene, and not going to doctor’s appointments

Question 25

What is the reason children usually don't report their abuse?

Answer 25

Fear of retaliation

Question 26

What is emotional abuse?

Answer 26

Belittling, rejecting, ignoring, and blaming a child for things they cannot control

Question 27

Which phase of the battering cycle makes it difficult for people to leave an abusive situation?

Answer 27

Honeymoon Phase

Question 28

When a person who has been abused is assessed, what should take priority?

Answer 28

Physical injuries and document by photo of injuries

Question 29

If a person decides to return to the abusive situation, what referral information should the nurse provide?

Answer 29

Encourage to develop a safety plan (have money stashed, an ID, and a place to go)

Question 30

If person has been abused, what should be included in documentation?

Answer 30

Photos of the injury

Question 31

When a person who has been raped calls a crisis hotline, what information should the nurse give?

Answer 31

Provide information so the victim can make decisions and encourage the victim to go to the hospital

Question 32

What information should be given ton discharge to the person who has been raped?

Answer 32

Arrange for supportive follow-up care and provide verbal and written instructions

Question 33

What should the nurse be able to do when providing patient care regarding sexuality?

Answer 33

Screen for sexually transmitted disorders, screen for sexual dysfunction, and give information related to the person’s concerns about sexual issues

Question 34

What is the reason a person with a sexual disorder would refuse to participate in his or her care?

Answer 34

They are in denial

Question 35

What is the most important characteristic for a nurse working with persons with sexual dysfunctions?

Answer 35

Self awareness

Question 36

How should a sexual history interview be conducted?

Answer 36

Use a nondirective approach geared towards the person’s concern

Question 37

What would indicate a child has separation anxiety?

Answer 37

Anxiety continues long after parent is gone and bed wetting

Question 38

What is a crisis?

Answer 38

Overwhelming emotional reaction to an event

Question 39

IF a child is unable to express him/herself verbally, how might s/he communicate needs?

Answer 39

They are likely to act out their feelings

Question 40

What are s/s of autism?

Answer 40

Impaired communication, relationships, and imaginative abilities, and stereotypical hand movements

Question 41

What are s/s of ADHD?

Answer 41

Impulsive, easily frustrated and have social interaction problems

Question 42

What are side effects of atomoxetine (Straterra)?

Answer 42

Dysrhythmia, angina, HTN, mood swings, changes in affect

Question 43

What nursing interventions would be used for a patient with a diagnosis of conduct disorder?

Answer 43

Be aware of behaviors that indicate a person is ready to act out and enforce rules and boundaries

Question 44

What is the most important nursing intervention to use then a person is in crisis?

Answer 44

Stay with them

Question 45

What are characteristics of co-dependency?

Answer 45

Being over responsible

Question 46

What is the most likely cause of Autism?

Answer 46

Abnormalities in brain structures and functions

Question 47

What would indicate a person has developed tolerance for alcohol?

Answer 47

They need increasing amounts to achieve the high/effect

Question 48

What would be included in patient education about disulfiram (Antabuse)?

Answer 48

This drug inhibits impulsive drinking because it causes an unpleasant reaction with alcohol; must avoid all alcohol; effects last 5-14 days after last dose

Question 49

Describe AA

Answer 49

Alcoholics anonymous – group therapy. First step is recognition of powerlessness over substance and recognize recovery is a lifelong process. The goal is to improve life and maintain sobriety.

Question 50

What is the most frequent result of growing up in an alcoholic family?

Answer 50

Substance abuse

Question 51

What is one of the purposes of having a PMI person come to the community mental health center?

Answer 51

To build long-term relationships with peers and mental health workers

Question 52

What is a safety plan?

Answer 52

A way to escape from home (money, ID, and place to go)

Question 53

When a person who has been raped comes into the ED, what should the nurse do?

Answer 53

Physical injuries are priority. Document by photos and treat physical injuries. Ask, “How did this happen?” Refer to a shelter. Encourage a safety plan, group therapy, and assertiveness training, and be nonjudgmental.

Question 54

What are characteristics of fetishism?

Answer 54

In denial. Rarely seek treatment. Sexual arousal involving non-living objects (shoes, underwear).

Question 55

What are side effects of methylphenidate?

Answer 55

Decrease in growth and insomnia

Question 56

What type of program would be most helpful for the person who has been addicted to narcotics and has relapsed several times?

Answer 56

Therapeutic community

Question 57

What symptoms will be seen after someone injects heroin?

Answer 57

Drowsiness, constricted pupils, slurred speech, constipation, euphoria, and pain relief

Question 58

What are the s/s of heroin withdrawal?

Answer 58

N/V/D, diaphoresis, flu-like symptoms (yawning, body aches, runny nose, insomnia, chills)

Question 59

Describe oppositional defiant disorder (ODD)?

Answer 59

Negative hostile defiant passive aggressive behavior that typically begins at the age of eight

Question 60

What is the reason that thiamine is given to a person who is an alcoholic?

Answer 60

Develop thiamine deficiency that causes ataxia, abnormal eye movements, and somnolence

Question 61

What classification of drugs is used to treat ADHD?

Answer 61

Amphetamines

Question 62

What are interventions that are used for clients with sexual dysfunction (not disorders)?

Answer 62

Anxiety reduction techniques, systematic desensitization, hormones, and permission giving

Question 63

If a patient's family is involved in crisis with him/her, what other intervention might be necessary?

Answer 63

Outsider with a neutral perspective

Question 64

What is one factor associated with homeless population that makes it difficult for the nurse to provide follow-up care?

Answer 64

Very mobile – difficult to track and help

Question 65

What is one reason an elderly person would be reluctant to admit to being abused in the home?

Answer 65

Fear that they will be removed from the home

Question 66

What drug is used for narcotic overdose?

Answer 66

Narcan

Question 67

What do you know about the drug that is given for narcotic overdose?

Answer 67

Quickly reverses CNS depression, but the narcotic has a longer span of action than the antagonist

Question 68

What drug is used for benzo overdose?

Answer 68

Flumazenil

Question 69

What is known about how the decision to leave an abusive situation is made?

Answer 69

Usually the person is severely hurt or they fear for their own life/life of their kids. Needs some sort of outside support because leaving increases the dangers.

Question 70

What might the nurse do during mental status examination of a child who is suspected of having autism?

Answer 70

Try engaging the child in meaningful conversation or reciprocal imaginative play

Question 71

What is most important for the child with autism in the school setting?

Answer 71

Structure

Question 72

What is the most appropriate nursing diagnosis for the child who is developmentally delayed?

Answer 72

Be as dependent as possible (ADLs)

Question 73

What drugs are used for alcohol abstinence? (other than antabuse)

Answer 73

Acamprosate and naltrexone

Question 74

How is hepatic encephalopathy treated?

Answer 74

Abstain from drinking, eliminate protein, neomycin, lactulose or flagyl

Question 75

What is one treatment for pathological gambling?

Answer 75

Gamblers anonymous and SSRI antidepressants