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Mental Health Nursing Content Review Flashcards | StudBud
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Mental Health Nursing Content Review
Mental Health Nursing Content Review
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A review of Mental Health Nursing, designed for end of course.
Flashcards
92 cards
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Practice quiz
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Questions
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Answers
1
Dep. pt: "I can never do anything right!" Nurse can best address this cognitive distortion:
Is this why you think no one likes you?
Let's look at that, '"I can never do anything right"
Tell me things you think you are not able to do correctly
That is the most unrealistic thing I have ever heard.
2
What is a primary RN technique for managing manic behavior?
Reprimanding
Enforcing consequences
Clarifying
Distraction
3
A client is experiencing a manic episode. What should the nurse include in the plan of care?
Establish consistent limits
Provide flexible client behavior expectations
Use a relaxed approach with communication
Disregard client complaints
4
Manifestations of pseudoparkinsonism include:
SATA
shuffling gait
bradykinesia
fever
drooling
5
Pt takes SSRI and St. John's Wort daily. What should RN tell this pt?
Advise pt to drink several glasses of water daily.
Explain high possibility of adverse reaction.
Suggest using a sun lamp daily.
Agree that the two medications are very effective in tx dep.
6
Which side fx of those listed is least likely to be cause by a low pot. 1st gen antipsychotic?
dry mouth
tardive dyskinesia
drowsiness
constipation
7
Priority ND: Risk for self-directed violence. What is the priority outcome?
State absence of feelings of powerlessness
Refrain from self harm
Be placed on suicide precautions
Attend self-help group daily
8
Pt placed in seclusion with no exam or written order by physician. Which illegal act is this?
Battery
false imprisonment
assault
defamation of character
9
What is the #1 risk factor for Alzheimer's disease?
Gender
Cardiovascular disease
Diabetes
Age
10
How does Sullivan's Interpersonal theory view anxiety?
A sign of guilt in adults
The result of trying to go beyond experiences of guilt, pain
A painful emotion arising from social insecurity
An emotional experience felt after age 5
11
What can reduce the vulnerability of a child to development of psychopathology?
resilience
child abuse
having a depressed parent
malnutrition
12
SATA:
which of the following are anticholinergic symptoms?
constipation
dry mouth
blurred vision
urinary retention
13
SNRI given. What behavior demonstrates this medication is working?
Laughing at a joke.
Apologizing for being sarcastic.
Going to his room to "calm down".
Writing down his telephone number.
14
Polyuria is an expected side effect of lithium.
True
False
15
Which assessment demonstrates the effect of stress on the stimulation of the HPA axis?
Blood glucose levels
Heart rate
norepinephrine
triglycerides
16
A client is experiencing moderate anxiety. What is an appropriate nursing intervention?
ignore the client's anxiety so they will not be embarrassed
use a low pitched voice and speak slowly
Demonstrate calm manner and use simple and clear language
Reassure the client that everything will be okay
17
A client with schizophrenia is at greatest risk of injuring themselves or others when:
they experience command hallucinations
they lack motivation to perform daily tasks
they're unable to communicate with others
they feel worthless
18
Which medication affects primarily positive rather than negative symptoms of schizophrenia?
haloperidol
clozapine
ziprasidone
olanzapine
19
Which nursing intervention for schizophrenia is designed to prevent relapse?
Teach family/patient behaviors associated with relapse
Help pt and family adapt to stigma of diagnosis
Remind pt to return for periodic blood draws
Schedules group therapy that includes those who have relapse
20
What is a treatment option appropriate for all personality disorders?
ECT
lobectomy
psychotherapy
medication
21
Which would be an inappropriate nursing plan for a pt antisocial personality disorder?
Completing chores on unit
Discussing unit rules
Assigning to lead groups
Enforcing boundaries
22
Depressed pt: paces, pulls at clothes, wrings her hands. Behaviors demonstrate:
Hypertensive crisis
Psychomotor agitation
Central serotonin syndrome
Senile dementia
23
An MAOI client could have a dinner of:
Fried fish, rice, and caffeine free cola
Pepperoni pizza and beer
Chips and guacamole with sweet tea
Roast chicken, balsamic potatoes, and wine
24
Repeated suicide attempts, self harm, manipulation, frequent interpersonal relationship probs:
obsessive-compulsive personality disorder
Narcissistic personality disorder
Antisocial personality disorder
Borderline personality disorder
25
Acute dystonia is a crisis situation that requires rapid treatment. True or false?
True
False
26
Which side effect of antipsychotic medication is generally non-reversible?
Dystonic reaction
Tardive dyskinesia
Anticholinergic effects
Pseudoparkinsonism
27
Homeostasis is mediated by component of the nervous system?
The sympathetic nervous system
The central nervous system
The autonomic nervous system
The parasympathetic nervous system
28
Which nursing intervention demonstrates the theory behind operant conditioning?
Rewarding w/ a token for avoiding argument with another pt
Explaining the consequences of not following unit rules
Demonstrating deep breathing techniques to clients
Showing how to be assertive without being aggressive
29
Which assessment can the RN use to screen for EPS?
Body attitude test
AIMS test
PHQ-2
SAD scale
30
1st gen, high potency antipsychotic: which symptoms are most likely?
constipation
dry mouth
urinary retention
EPS
31
After formulating the nursing diagnosis for a new patient, what is a nurse’s next action?
Completing the spiritual assessment
Implementing the nursing plan of care
Determining the goals and outcome criteria
Designing interventions to include in the plan of care
32
The relaxation response to stress calls upon the initiation of what process?
Parasympathetic activation
Increased cortisol production by the adrenals
Sympathetic activation
Brainstem deactivation
33
The pt reports that she is hearing voices to "kill the doctor." What would you do next?
focus the client on reality
Initiate one to one observation of client
notify the provider of the client's statement
Assess if pt is able to resist commands
34
Technique shown by, "Please tell me what was happening that led to your hospitalization here?"
paraphrasing
Open- ended question
reflecting
using minimal encourager
35
A low potency antipsychotic is most likely to cause which side effects?
hypersalivation
tardive dyskinesia
drowsiness
urinary incontinence
36
What is the focus during clinical supervision?
Assisting the client to develop increased independence
Devising alternative strategies for client growth
Analysis of the client's motivation for transference
The nurse's behavior in the nurse/client relationship
37
Pt: depression, suicide attempt. Given 7 day script of amitriptyline at D/C. Why?
Amitriptyline is very expensive.
Amitriptyline is lethal in overdose
Pts should be evaluated for side effects after 7 days of use
Pts should be evaluated after 7 days to see if it is working
38
Which of the following is a negative symptom of schizophrenia?
Hostility
Agitation
Hallucinations
Anhedonia
39
Best room placement for patient in manic episode?
Shared room away from unit entrance
Single room near nurse's station
Single room near unit activities area
Shared room with pt with dementia
40
“I will always be alone because nobody could ever love me.” What cognitive-behavioral concept?
Aversion
Actualization
Emotional consequence
Schema
41
Which medication affects both positive and negative symptoms of schizophrenia?
aripiprazole
loxapine
trifluoperazine
haloperidol
42
Which client problem would be most suited to the use of interpersonal therapy?
Disturbed sensory perception
Medication noncompliance
Impaired sensory perception
Dysfunctional grieving
43
Which statement re: antidepressants in general can serve as a basis for pt/family teaching?
They often cause nocturnal urination.
They tend to be more effective for men.
Recent memory impairment is commonly observed
Onset of action: 2-3 weeks or longer
44
During schizophrenic psychosis, the pt may make up words. This is called:
Stilted language
Clang association
A neologism
Word salad
45
Which of the following behaviors supports a dx of dependent personality disorder?
The client is dedicated to a job that excludes leisure time
The client needs excessive external input to make decisions
The client adheres to a rigid set of rules
The client has difficulty starting new relationships
46
If a nurse left a suicidal pt unattended, her behavior violated what ethical principal?
Autonomy
Fidelity
Justice
Veracity
47
Lithium level: 1.8mEq/L. What should the nurse do?
Limit sodium intake for 24 hours
Limit fluids for 12 hours
Withhold lithium, call physician
Administer lithium as ordered
48
Which ethical principal refers to the individual's right to make his/her own decisions?
Fidelity
Autonomy
Beneficence
Veracity
49
Role-playing is associated with which type of psychotherapy?
Psychoanalysis
Modeling
Systematic desensitization
Operant conditioning
50
28 yr, bipolar pt, manic state. Which patient symptom has priority? Ref: Maslow
Lack of sleep
Grandiose thoughts
Rapid, pressured speech
Hyperactive behavior
51
Which statement best shows acceptance of a depressed, mute client?
I will spend time with you daily to improve your mood.
You should share with me; I can help evaluate your thinking.
Daily we will visit to talk about what's bothering you.
I will sit with you for 30 minutes daily.
52
Which intervention is appropriate when communicating with a pt who is depressed and withdrawn?
Avoid asking for the patient's preferences regarding care
Be prepared to wait for the client to respond
Give detailed explanations to maintain the pt's focus
Encourage the pt to use gestures if talking is difficult
53
Pt d/c'd with med with anticholinergic side fx.
SATA
- interventions to treat these fx.
Regular exercise
Fluid intake between 2-3L a day
Limiting calories in diet
Chewing sugarless gum
54
Possible side effects from risperidone include all but one of the following:
Heartburn
Weight gain
Sexual dysfunction
galactorrhea
55
A client has schizophrenia. Which statement indicates depersonalization?
" I am a superhero and am immortal"
"I feel monsters pinching me all over"
"I am no one, and everyone is me"
"I know that you are stealing my thoughts"
56
What is the first line drug to treat mania of bipolar?
carbamazepine
clonazepam
lamotrigine
lithium
57
Manifestations of neuroleptic malignant syndrome are?
SATA
Changes in BP, tachycardia, tachypnea
drooling
Sudden high fever
muscle rigidity
58
A client is giving away their possessions. The RN should:
Advise that giving away possessions is not therapeutic
Ask about vinyl record collection
Ask about suicidal ideation
Encourage to donate to charity
59
Pt with schizophrenia states voices are saying food is poisoned. How should the RN respond?
"You are safe here in the hospital."
I know the voices are very real to u, but I don't hear them.
"The voices are wrong."
"Other people are eating the food and they are okay."
60
1st gen anti-psychotics primarily work by blocking which neurotransmitter?
Serotonin
dopamine
glutamate
GABA
61
What should the nurse expect in a manic phase of a bipolar pt?
Agnosia
sedation
Pressured speech, racing thoughts, grandiosity
Anergia
62
Current information states what factor is associated with the most disabling mental disorders?
Biological influences
Learned ways of behaving
Psychological trauma
Faulty patterns of early nurturance
63
Which of the following meds would the RN administer to treat ETOH withdrawal sx?
Ativan
Paroxetine
Naltrexone
Disulfiram
64
Which would be a symptom of PTSD, not anxiety?
Re-experiencing trauma in dreams or flashbacks
Minimum interest in family or friends
Sleep disturbances
Avoiding situations
65
The patient has neg and pos sx of schizophrenia. Antipsychotic most likely to be ordered?
1st gen
anticonvulsant
lithium
2nd gen
66
The RN suspects neuroleptic malignant syndrome in her patient. Interventions?
SATA.
Administer dantrolene or bromocriptine
Stop antipsychotic meds
Increase fluid intake
Apply cooling blankets, give antipyretics
67
RN teaches pt a technique for examining neg thoughts and restating pos. What is this called?
Guided imagery
cognitive reframing
confrontational assertion
wishful thinking
68
A client who has OCD is applying, removing, and then reapplying makeup. What behavior is this?
adverse effect of antidepressant
fear of rejection
attempt to reduce anxiety
narcissistic
69
Initial RN intervention when pt expresses intent to hit another pt?
Prepare the client for seclusion
Initiate physical confrontation
Set verbal limits
Question the pt's motive
70
Altered thought & speech of pt w/ schizophrenia are r/t brain’s inability to do what?
Regulate conscious mental activity.
Regulate social behavior.
Retain and recall past experience.
Maintain homeostasis.
71
Which imaging technique can provide information about brain function?
Computed tomography (CT) scan
Magnetic resonance imaging (MRI) scan
Skull radiograph
Positron emission tomography (PET) scan
72
Pt is prescribed clozapine. Which is a priority nursing intervention?
monitoring daily weights
monitoring for cholinergic fx
monitoring I/O's
monitoring for s/s infection
73
The RN is caring for a hostile patient. What factor re: hostility should the RN keep in mind?
It's a sign pt is developing assertiveness and improving.
Pt may be projecting.
Pt may be experiencing transference.
Pt may be at high risk for self-harm
74
What statement is true regarding the civil rights of a mental health patient?
They are assured the same as those of any other citizen
Their rights are limited to provision of humane treatment
Their rights are always ensured by appointment of a guardian
Their rights are altered to prevent use of poor judgment
75
Which client behavior demonstrates the characteristic of resilience?
"My kid's happiness is worth any sacrifice I have to make."
"My mother made decisions about my husband's funeral."
"In spite of all the treatment, I know I'll never be healthy
"Losing my job was hard but I will get another one."
76
A client is experiencing a panic attack. What is an appropriate intervention?
Stay with the client and demonstrate deep breathing
Show the client how to change their behavior
Discuss relaxation techniques
Distract the client with television
77
How did Freud believe individuals cope with anxiety?
The superego
Security operations
Cognitive distortions
Defense mechanisms
78
Which of the following is an expected finding of ETOH withdrawal?
tremors
Bradycardia
hypotension
lethargy
79
Guidance on operate conditioning to a toddler's mom- temper tantrums are best handled by?
Ignoring the tantrum, giving attn with appropriate actions
Scolding the child when he/she has a tantrum
Giving the child what he/she wants
spanking the child at onset of tantrum
80
Your patient has these symptoms. What is the likely diagnosis?
acute dystonia
neuroleptic malignant syndrome
orthostatic hypotension
tardive dyskinesia
81
What is the main mechanism of action of 2nd and 3rd gen antipsychotic meds? SATA.
Potentiating dopamine
Blocking serotonin
Potentiating GABA
Blocking dopamine
82
The complication most likely from 2/3rd gen antipsychotic meds is:
hypertension
anticholinergic affects
metabolic syndrome
seizures
83
A nursing diagnosis serves what purpose with considering the plan of care?
Completing the medical diagnostic statement
Justifying the use of certain psychotropic medications
Providing data essential for insurance reimbursement
Framework for choosing appropriate interventions
84
An adult was molested at age 10, but can't remember it. What defense mechanism is in use?
Displacement
Projection
Repression
Reaction formation
85
Which medication requires the RN to monitor for the potential side fx of hypothyroidism?
Lithium
Fluoxetine
Imipramine
Buproprion
86
1st gen, high potency anti-psychotic: Which symptoms are least likely?
SATA
dry mouth
sedation
blurred vision
tardive dyskinesia
87
Phrase of the therapeutic relationship that may cause pt anxieties to reappear?
Termination
Preorientation
Orientation
Working
88
A cognitive therapist would help a client restructure the thought “I am stupid!” to what?
"Things usually go wrong for me."
"Things like this should not happen to anyone."
"I am not as smart as others."
"What I did was stupid."
89
A pt w/ depression distrusts staff,wants to go home. Initially what is the RN priority?
Making the client feel physically and emotionally safe
Identifying the client’s positive traits
Teaching the client effective coping skills
Focusing on preparing the client for a speedy discharge
90
Pt on clozapine 6 weeks reports fever and sore throat. Initial nursing intervention?
Tell MD to admit pt to hospital
Arrange for stat CBC for pt
Recommend change in medication
Advise antipyretic and extra rest
91
When treating mental illnesses with psychotropic drugs what is the focus of the treatment?
Regulating social behaviors.
Activating the body’s normal response to stress.
Altering brain neurochemistry.
Correcting brain anatomical defects.
92
Selective inattention is noted at what level of anxiety?
severe
moderate
Mild
panic
