Unit 1 Study Test (mental) Flashcards
1
Q
What are some symptoms of lithium toxicity?
A
Confusion
Blurred Vision
Diarrhea
Tinnitus
Slurred speech
Convulsions
Excessive urination
Excessive thirst
Tremors/ ataxia
2
Q
How does lithium Toxicity occur?
A
Dehydration
Hyponatremia
Old age & Kidney failure
3
Q
A patient is taking lithium for Bipolar Depression the nurse should advise to monitor what during treatment?
A
Lithium Levels
NA levels
4
Q
What should the nurse educate a patient taking Lithium carbonate?
A
Monitor Serum Lithium levels
Drink plenty of water 2-3l a day
DO NOT decrease salt diet.
Carry id showing that you are taking medication.
5
Q
What is the therapeutic range of Lithium?
A
0.6-1.2
6
Q
What are some first generation antipsychotic medication?
A
Chlorpromazine
Haloperidol
Loxapine
7
Q
First generation antipsychotic are at higher risk of?
A
EPS ( Extrapyramidal symptoms)
8
Q
What are the types of EPS ?
A
Tardive Dyskinesia
Dystonia’s
9
Q
Later onset involuntary movement disorders primarily the tongue, lips and jaw are signs of what?
A
Tardive Dyskinesia
10
Q
Muscle spasms, that can be life threatening and are Parkinson like are signs of what ?
A
Dystonia’s
11
Q
What medications are used to treat acute EPS ?
A
Anticholinergics
Antihistamines
Dopaminergic Agents
12
Q
Amantadine (symmetril) is a ?
A
Dopaminergic Agent
13
Q
Benztropine (cogentin) are what?
A
Anticholinergics
14
Q
What other drugs can be used to counteract EPS ?
A
Anti Parkinson Drugs
Ex:
Procyclidine
Levodopa
Orphenadrine
15
Q
pretending the truth is not reality to manage unpleasant, anxiety causing thoughts or feelings is a sign of what defense mechanism?
A
Denial
16
Q
Attributing one’s unacceptable thoughts and feelings onto another who does not have them is a sign of what defense mechanism?
A
Projection
17
Q
Shifting feelings related to an object, person , or situation to another less threatening object, person or situation is a sign of what defense mechanism?
A
Displacement
18
Q
Performing an act to make up for prior behavior (commonly seen in children) is a sign of what defense mechanism ?
A
Undoing
19
Q
When a person directs their feeling about one person onto someone else is a sign of what defense mechanism ?
A
Transference
20
Q
At what point is ECT considered ?
A
After a trial therapy of antidepressants are unsuccessful.
21
Q
What therapy is An induction of grand mal seizures through the application of electrical current of the brain ?
A
ECT (Electroconvulsive Therapy)
22
Q
The course of ECT is ?
A
2-3 times a week for a total of 6-12 treatments.
23
Q
What should be obtained before the start of ECT ?
A
Consents
24
Q
What medication will be given 30 min before the procedure to decrease secretions that could cause aspiration?
A
Glycprrolate (IM)
25
What medication is given before the procedure (ECT) that causes the muscles to paralyze ?
Succinylcholine
26
Apart from medication during ECT what other interventions will be needed?
O2
EEG
BP
Vitals
Cardiac hx
Eeg consent
27
How long after the procedure (ECT) is completed should the patient become alert ?
15 mins after
28
An alteration in mood that is expressed of sadness, despair and pessimism. Loss of interest in usual activities are signs of what ?
Depression
29
What medications are used to treat depression?
SSRI’s
Mood stabilizer
SNRI’s
TCA’s
MAOI’S
30
A single episode or recurrent episodes of unipolar depression resulting in significant changes in clients formal functioning followed with at least 5 findings are symptoms of
Major Depressive disorder
31
Patients can expierence clinical findings of depression within ?
The first 2 months after a significant loss
32
This disorder is depression to mania with periods of normalcy?
BPD
33
The nurse should offer what to patients with mania?
Energy and protein dense foods
Finger foods !
34
What are some considerations for BPD?
Safe environment
Set limits for manipulative behavior
Provide finger foods and fluids
DECREASE stimuli
Re-channel energy for physical activity
35
What are some Pharmacological treatments for BPD ?
Lithium carbonate
Anticonvulsant
Antidepressants
Antipsychotic
Anti anxiety
36
Abnormally elevated mood, which can also be described as expansive or irritable
Usually requires hospitalization
Are signs of what?
Mania
37
Less severe episodes that last 4 days accompanied by 3 or more manifestations
Hospitalization is not required
Are signs of ?
Hypomania
38
Four or mor episodes of hypomania or acute mania within 1 year and associated with increase of recurrent rate and resistance? Signs of
Rapid cycling
39
What is the number one priority with those struggling with depression?
Safety
(Higher risk of Suicide)
40
Depression that occurs seasonally is what and what is the treatment ?
Seasonal affective disorder (SAD)
TTMT: Light therapy
41
What are some non pharmacological treatments for depression?
Physical activity
Self care
Supportive relationships
Identify coping methods and teach alternatives
Individual therapy, support groups, peer support
Light therapy
St. John worts
42
A patient exhibits uncontrollable, excessive worrying that last for at-least 6 months and can cause impairment in one or more areas of functioning are signs of ?
generalized anxiety disorder (GAD)
43
Which level of anxiety allows patient to have sharp focus and problem solve?
Symptoms include nail-biting, tapping, foot jitters
Mild Anxiety
44
What level of anxiety does is the thinking ability impaired, sharp focus and problem solving can still happen at a lower level.
GI upset, headache and voice shakiness can occur
Moderate anxiety
45
What level of anxiety can cause focus and problem solving not possible and feelings of doom may be felt?
Dizziness, headache, nausea, sleepiness, hyperventilation can occur
Severe Anxiety
46
What level of anxiety does instability and patient becomes not in touch with reality
Pacing, yelling, running, and hallucinations can occur?
Panic anxiety
47
Persistent thoughts or urges that cause anxiety through compulsive or obsessive behaviors are signs of what
OCD
48
Low weight BMI, low BP, Low HR, Low sexual development, Hypothermia, low period regularity, Amenorrhea, refusal to eat, Lanugo, restricts from eating dehydrations are sign of what disorder
Anorexia Nervosa
49
What are some interventions for Anorexia nervosa ?
Increase weight slowly
Monitor exercise
50
What is A potential complication when fluids, electrolytes and carbs are introduced to quickly to a malnourished patient?
Refeeding syndrome
51
What should be done to avoid refeeding syndrome?
Introduce foods SLOWLY to avoid syndrome.
52
Binge eating followed by purging, normal BMI to over weight BMI, teeth erosion, bad breath , patient may use laxatives/ diuretics are signs of what disorder?
Bulimia Nervosa
53
What interventions should be done with a patient experiencing bulimia nervosa?
Monitor client during and after meals for acts of purging
54
Tend to be overweight, this disorder is not followed by purging, second caused such as depression, hatred and shame can be factors what disorder is this?
Binge eating
55
What is the treatment/intervention for binge eating?
Therapy (group, Individual, Family )
Maintain trust
Teach coping skills
56
Manifestations that are not normally present in a patient can include delusions, hallucinations, disorganized thinking, abnormal motor behavior are signs of what?
Positive Schizophrenia Symtpoms
57
Affect, Alogia, Anergia, Anhedonia, Avolition are signs of what?
Negative Schizophrenia Symptoms
58
What are some possible causes to schizophrenia ?
Increased dopamine
Illicit substance abuse
Environmental (malnutrition, toxins, viruses during pregnancy)
Genetics
59
What are some nursing considerations with patients who are experiencing schizophrenia?
Establish trust
Encourage compliance with medication
Promote self care
Encourage group activity
Therapeutic communication
60
What does a nurse address hallucinations in a patient experiencing schizophrenia?
Do not address hallucinations ( “i don’t see monkeys but i see you are scared “)
Be compassionate
Bring conversation back to reality
DO NOT argue with patient
PROVIDE safety for staff& client (give space)
61
What are some pharmacological treatments for Schizophrenia?
Antipsychotic meds
Antidepressants
Mood stabilizers
Benzodiazepines
62
What are some non pharmacological treatments for schizophrenia?
Therapy
Exercise
63
A group of symptoms not specific to a disease but may advance to am major NGD are signs of what ?
Dementia
64
A short term/ sudden change of impairment usually caused by an underlying issue are signs of what
Delirium
65
Disorganization, loss of memory, anxiety ,agitation delusional thinking can range from lethargic to hyper vigilance usually caused by Hospitalization, ICU, old age , stroke, infection, electrolyte imbalance are signs of ?
Delirium
66
What are some Interventions for delirium?
Safety
Avoid restrains
Provide physical needs (water, food, sleep)
Anti-anxiety/ antipsychotic medications
67
Can delirium be reversible ?
Yes, if prompt treatment is initiated
68
A decline of function over months or years usually caused by genetics, head injury, advanced age, cardiovascular disease or lifestyle factors and comes in stages are signs of
Alzheimer disease
69
What stage of Alzheimer’s disease is where it is not noticeable to others but can experience memory lapse, misplacing items, difficulty focusing, still accomplish own ADLS ?
Mild (early Stage )
70
What stage of Alzheimer’s is noticeable to others but patient can experience forgetfulness, short term memory loss, personality changes, gets lost or wander, unable to do some of ADL and self care?
Moderate ( Middle Stage )
71
What stage of Alzheimer’s disease requires full assistance with ADLs, loss of physical skills, may result in death or coma?
Severe ( Late Stage)
72
What are some interventions for Alzheimer’s disease ?
Help families in planning for extended care
Monitor nutrition, weight and fluids status
Maintain a quiet environment do decrease stimuli
73
What are some considerations when using communication with a Alzheimer’s patient
Speak slowly
Give one direction at a time
Don’t ask complex or open ended questions
Ask simple , direct questions
Face client when speaking
74
What medications will be given to a patient with Alzheimer’s disease?
Donepezil (Aricept)
Galantamine (Razadyne)
Rivastigmine (Exelon)
75
Donepezil , galantamine, rivastigimine are what type of medications
Cholinesterase Inhibitors
76
When giving medication ( cholinesterase inhibitor) to a patient with Alzheimer’s disease can it cure the disease ?
True or False
False
77
What is the main consideration with patients who have Alzheimer’s disease ?
Safety
78
Who are more risk for completing suicide ?
Men
79
Who attempt suicide more often but do not accomplish to complete?
Women
80
Patient who are IVC’d can leave AMA? T/F
False
81
Patients who are admitted IVC/d can refuse medications/ttmt ?
True or False
True
82
“There is no reason for me to keep going”
“ Everything is looking very grim for me”
“Everything is going to be okay when i get home’
Are all signs of ?
Warning Signs of Suicide
83
The nurse should screen patient who have _____ due to a high risk of suicide ?
Depression
84
A nurse observes a client who has OCD repeatedly applying removing and then reapplying make up. the nurse identifies that repetitive behavior and client who has OCD is due to which of the following underlying reason?
A. Narcissistic behavior
B. Fear of rejection from staff
C. Attempts to reduce anxiety
D. Adverse effect of antidepressants medication?
C. Attempts to reduce anxiety
85
A nurse is caring for a client who is experiencing a panic attack. Which of the following action should the nurse take?
A. Discuss new relaxation techniques.
B. show the client how to change the behavior.
C. Distract the client with television show.
D. Stay with the client and remain quiet.
D. Stay with the client and remain quiet.
86
A nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect select all that apply
A.Excessive worry for six months.
B. Impulsive decision making.
C. Delayed reflexes
D. Restlessness
E. Sleep disturbances
A.Excessive worry for six months.
D. Restlessness
E. Sleep disturbances
87
A nurse is planning care for a client who has body dysmorphic disorder. Which of the following action should the nurse plan to take first?
A. Assess the client risk for self harm.
B. And still hope for positive outcomes.
C. Encouraged the client to participate in group therapy session.
D. Assist the client to participate in treatment decisions.
A. Assess the clients risk for self harm .
88
A nurse is caring for a client who has generalized anxiety disorder and is experiencing severe anxiety which of the following statements action. Should the nurse make?
A. “Tell me about how you were feeling right now”
B. “ you should focus on the positive things in your life to decrease your anxiety”
C. “Why do you believe you are experiencing this anxiety”
D.” let’s discuss the medication is your provider is prescribing to decrease your anxiety”
A. Tell me about how you were feeling right now”
89
A nurse is caring for a client who has major depressive disorder. Which of the following should the nurse identify as a risk for depression select all that apply.
A. Male sex
B. History of chronic bronchitis
C. Recent death in clients family
D. Family history of depression
E. Personal History of depression
B. History of chronic bronchitis
C. Recent death in clients family
D. Family history of depression
E. Personal History of depression
90
A nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following action is the nurses priority?
A. Placing the client on one to one observation
B. Assisting a client to perform ADLs.
C. Encouraging the client to participate in counseling.
D. Teaching a client about Medication Adverse effect.
A. Placing the client on one to one observation
91
A nurse is teaching a client who has a new diagnosis of premenstrual dysphoric disorder. Which of the following statements by the client indicates understanding of the teaching.
A. “ I can expect my problems with PMDD to be worse when Im menstruating”
B.” I should avoid exercise when I am feeling depressed”
C. “ I am aware that my PMDD causes me to have rapid mood swings”
D. “ I should increase my caloric intake with a nutritional supplement when my PMDD is active”
C. “ I am aware that my PMDD causes me to have rapid mood swings”
92
A charge nurse is discussing the care of a client who has major depressive disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse, indicates an understanding of the teaching?
A.” Here during the continuation face focuses on treating continued manifestations of MDD”
B.” the treatment of MDT during the maintenance face list for 6 to 12 weeks.”
C. “ the client is at greatest risk for suicide during the first weeks of an MDD episode.”
D.” Medication and psychotherapy are most effective during the cute face of MDD”
C. “ the client is at greatest risk for suicide during the first weeks of an MDD episode.”
93
A nurse is interviewing a client who has a new diagnosis of persistent depressive disorder which of the following findings should the nurse expect?
A. Wide fluctuations in mood.
B. Report of a minimum of five clinical findings of depression.
C. Presence of manifestations for at least two years.
D. Inflated sense of self esteem.
C. Presence of manifestations for at least two years.
94
A nurse is planning care for a client who has bipolar disorder and is experiencing a manic episode which of the following intervention should the nurse include in the plan of care select all apply
A. Provide flexible client behavior expectation.
B. Offer concise explanations.
C. Establish consistent limits.
D. Disregard client concerns
E. Use a firm approach with communication
B. Offer concise explanations.
C. Establish consistent limits.
E. Use a firm approach with communication
95
A nurse is teaching a newly licensed nurse about the use of electro convulsive therapy for the treatment of bipolar disorder. Which of the following statements by the newly licensed nurse indicates understanding?
A. “ ECT is the recommended initial treatment for bipolar disorder”
B “ ECT is contradicted for clients who have suicidal ideation”
C “ ECT is effective for clients who are experiencing severe mania”
D “ ECT is prescribed to prevent relapse of bipolar disorder”
C “ ECT is effective for clients who are experiencing severe mania”
96
A nurse is caring for a client who has bipolar disorder, which of the following is the priority for the nursing action?
A. Set consistent limits for expected Client behavior
B. Administer prescribe medication as scheduled.
C. Provide the client with step-by-step instructions during hygiene activities.
D. Monitor the client for escalating behavior
D. Monitor the client for escalating behavior
97
A nurse is caring for a client who has bipolar disorder. The client states “I am very rich and I feel I must give my money to you” which of the following responses to the nurse make?
A. “ why do you think you feel the need to give money away?”
B “ I am here to provide care and cannot accept this from you”
C “ I can request that your case manager discusses appropriate charity options with you”
D. “ you should know that giving away your money is inappropriate”
B “ I am here to provide care and cannot accept this from you”
98
A nurse is discussing relapse prevention with a client who has bipolar disorder. Which of the following information should the nurse include in the teaching select all that apply.
A. Use caffeine in moderation to prevent relapse.
B. Difficulty sleeping can indicate a relapse.
C. Begin taking your medication’s as soon as relapse begins.
D. Participating in psychotherapy can help prevent relapse.
E. Anhedonia is a clinical manifestation of depressive relapse.
B. Difficulty sleeping can indicate a relapse.
D. Participating in psychotherapy can help prevent relapse.
E. Anhedonia is a clinical manifestation of depressive relapse.
99
The nurse is caring for a client who has substance induced psychotic disorder and is experiencing auditory hallucinations. The client states the voices won’t leave me alone which of the following statement should the nurse make select all that apply
A. ”when did start hearing these things “
B. “The voices are not real or else we would both hear them “
C. “ It must be scary to hear voices”
D.” Are the voices you hear telling you to hurt yourself”
E. “ why are the voices only talking to you “
A. ”when did start hearing these things “
C. “ It must be scary to hear voices”
D.” Are the voices you hear telling you to hurt yourself”
100
A nurse is competing an admission assessment for a client who has schizophrenia. Which of the following symptoms would the nurse document as positive symptoms? SATA
A.Auditory hallucinations
B. Lack of motivation
C. Use of Clang associations
D. Delusion of persecution
E. Constantly waving arms
F. Flat affect
A.Auditory hallucinations
C. Use of Clang associations
D. Delusion of persecution
E. Constantly waving arms
101
A Nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization?
A. “ I am a superhero and am Immortal”
B. “ I am no one and everyone is me”
C. “ i feel monsters pinching me all over”
D.. “ I know that your are stealing my thoughts “
B. “ I am no one and everyone is me”
102
A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are stating “ kill your doctor” which of the following actions should the nurse take first?
A. Encourage the client to participate in group therapy on the unit
B. Initiate one to one observation of the client
C. Focus the client on reality
D. Notify the provider of clients statement
B. Initiate one to one observation of the client
103
A Nurse is speaking with a client who has schizophrenia when the client suddenly seems to stop focusing on the nurses questions, and begins looking at the ceiling and talking to themselves. Which of the following action should the nurse take?
A. Stop the interview at this point and resume later when the client is better able to concentrate.
B. As the client “are you seeing something on the ceiling”
C.Tell the client “ you seem to be looking at something on the ceiling i see something there too”
D. “ continue the interview without comment on the clients behavior”
B. As the client “are you seeing something on the ceiling”
104
A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates understanding of the teaching?
A. “ I can promote my clients sense of control by establishing a schedule”
B. “ I should encourage clients who have a schizoid personality disorder to increase socialization”
C. “ I should practice limit-setting to help prevent client manipulation”
D. “ i should implement assertiveness training with clients who have antisocial personality disorder”
C. “ I should practice limit-setting to help prevent client manipulation”
105
A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder?
A. “ im scared that you’re going to leave me “
B. “ ill go to group therapy if you’ll let me smoke”
C. “ I need to feel that everyone admires me”
D. “ I sometimes feel better if i cut myself”
A. “ im scared that you’re going to leave me “
106
A nurse is caring for a client who has borderline personality disorder. The client says “ the nurse on the evening shift is always nice! You are the meanest nurse ever” the nurse should recognize the clients statement as an example of high of the following defense mechanism?
A. Regression
B. Splitting
C. Undoing
D. Identification
B. Splitting
107
A nurse is assisting with a court ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect? SATA
A. Demonstrates extreme anxiety when placed in a social situation
B. Often engages in magical thinking
C. Attempts to convince other clients to relinquish thier belongings
D. Becomes agitated if personal area is not neat and orderly
E. Blames others for personal past and current problems
C. Attempts to convince other clients to relinquish thier belongings
E. Blames others for personal past and current problems
108
A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching? SATA
A. Difficulty in getting along with other members of a group
B. Belief in the ability to become invisible during times of stress
C. Display of defense mechanism when routines are changed
D. Claiming to be more important than other persons
E. Difficulty understanding why it is inappropriate to have personal relationships with staff
A. Difficulty in getting along with other members of a group
C. Display of defense mechanism when routines are changed
E. Difficulty understanding why it is inappropriate to have personal relationships with staff
109
A nurse is caring for a client who has early stage Alzheimer’s disease and a new prescription for donezepil . The nurse should include which of the following statements when teaching the client about this medication?
A.”You should avoid taking over the counter acetaminophen while on Donepezil”
B.” You should take this medication before going to bed at the end of the day”
C. “ you will be screened for underlying kidney disease prior to starting Donepezil”
D. “ you should stop taking Donepezil if you experience nausea or diarrhea “
B.” You should take this medication before going to bed at the end of the day”
