agrees to take SSRI antidepressant as suggested by NP - additional teaching needed when ....

i prefer to have gastric bypass rather than this plan

inpatient tx for eating disorder would be warranted when what assessment data is observed?

has systolic BP less than 90 mmHg

supports anorexia nervosa

i am terrified of gaining weight

Which behavior would be characteristic of a client during a manic episode?

going rapidly from one activity to another

hospitalized for acute manic episode - nurse suspects lithium toxicity, which findings?

ataxia, severe hypotension, large volume of dilute urine

16 yr old - weighs 80 lbs & eats one tiny meal daily and engages in rigorous exercise program - which nursing diagnosis?

imbalanced nutrition: less than body requirements

current theory - which statement regarding eating disorders is accurate?

possibly influenced by sociocultural factors

What action should the nurse take on learning that a manic client’s serum lithium level is 1.8 mEq/L?

withhold the medication and notify the physician

pts often appear at a normal weight

evaluating eating disorder - what physical criterion for hospital admission would you consider?

a daytime HR of less than 50 bpm

LEAST useful for accurate measurement of weight - diagnosed with anorexia nervosa

weigh fully clothed before breakfast

partner of manic client asks about genetic transmission of bipolar disorder, the nurse’s answer should be predicated on

rate of bipolar disorder higher in relatives of people w/ bipolar disorder

mealtime difficulties that resolve spontaneously with or without caregiver support and education

avoidant/restrictive food intake

“Bud.Crud.Dud. I’m a real stud! You’d like what I have to offer. Let’s go to my room.” What is the best initial approach

distracting the client by suggesting "its time to work on your art project"

pt with anorexia nervosa orients to room for her stay - after getting settled, nurse says

i need to go through your belongings you have brought

bulimia nervosa uses enemas and laxatives to purge to maintain weight - physiological outcome of this patient?

disruption of fluid and electrolyte balance

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MH Exam 2 - Part 2

80 termsStudBud Administration7 plays

Ch 18 Ch 13

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Questions 80

Answers

1
16 yr old - anorexia - prescribed medication to reduce compulsive behaviors regarding food now that ideal weight reached
anxiolyics
antidepressants
atypical antipsychotics
mood stabilizers
2
most common eating disorder
bulimia
anorexia
binge-eating
3
agrees to take SSRI antidepressant as suggested by NP - additional teaching needed when ....
my comorbid conditions may improve with weight loss
i prefer to have gastric bypass rather than this plan
psychotherapy will be part of my treatment
i am willing to admit tht i am depressed
4
inpatient tx for eating disorder would be warranted when what assessment data is observed?
has systolic BP less than 90 mmHg
HR less than 60 bpm
weighs 10% below ideal weight
K+ of 3mEq/L or greater
5
supports anorexia nervosa
i am terrified of gaining weight
i wish i had a good friend to talk to
ive been told that i dirnk way too much alcohol
i dont get much pleasure out of life anymore
6
Which side effects of lithium can be expected at therapeutic levels?
nausea and thirst
fine hand tremor and polyuria
ataxia and hypotension
coarse hand tremor and GI upset
7
anorexia - mild when BMI is
17 or more
16-17
15-16
less than 15
8
bulimia is prevalent in children younger than 12 and adults older than 40
False
True
9
full manic episode - family calls EMS, medic is most likely counting what?
fast food wrappers
empty soda cans
energy drink containers
hypodermic needles
10
anorexia is an ego-syntonic disorder
False
True
11
expect a client demonstrating typical manic behavior to be attired in clothing that includes with characteristics?
compulsively neat and clean
dark colored and modest
colorful and inappropriate
ill-fitted and ragged
12
biological theorists suggest that the cause of eating disorders may be related to which factor?
dopamine excess
normal weight phobia
body image disturbance
serotonin imbalance
13
should reintroduce foods/nutrients slowly to avoid potentially lethal refeeding syndrome for pts with anorexia nervosa
True
False
14
An acute phase nursing intervention aimed at reducing hyperactivity is demonstrated by which intervention?
writing in a diary
directing unit activites
exercising in the gym
orienting a new client to the unit
15
Which behavior would be characteristic of a client during a manic episode?
taking frequent rest periods and naps during the day
going rapidly from one activity to another
being unwilling to leave home to see other people
watching others intently and talking little
16
hospitalized for acute manic episode - nurse suspects lithium toxicity, which findings?
ataxia, severe hypotension, large volume of dilute urine
GI distress, thirst, nystagmus
electroencephalographic changes, chest pain, dizziness
SOB, GI distress, chronic cough
17
16 yr old - weighs 80 lbs & eats one tiny meal daily and engages in rigorous exercise program - which nursing diagnosis?
ineffective denial
death anxiety
imbalanced nutrition: less than body requirements
disturbed sensory perception
18
current theory - which statement regarding eating disorders is accurate?
rarely comorbid w/ other mental health disorders
psychotic disorders in which pts experience body dysmorphic disorder
possibly influenced by sociocultural factors
frequently misdiagnosed
19
What action should the nurse take on learning that a manic client’s serum lithium level is 1.8 mEq/L?
withhold the medication and notify the physician
advise the client to curtail salt intake for 24 hrs
advise the client to limit fluids for 12 hours
continue to administer medication as ordered
20
hospitalized w/ anorexia nervosa has weight that is 65% of normal - realistic short-term goal for the first week?
develop a pattern of normal eating behavior
discuss fears and feelings about gaining weight
gain max of 3 lbs
verbalize awareness of the sensation of hunger
21
true of bulimia
pts often appear at a normal weight
pts severely restrict their food intake
one sign is lanugo
pts eat but do not engage in compensatory measures
22
the condition demonstrated by a person who has numerous hypomanic and dysthymic episodes over a two-year period?
seasonal affective disorder
bipolar I disorder
cyclothymia
bipolar II disorder
23
while no FDA approved meds for anorexia, psychotropic meds have been used to treat associated symptoms and comorbidities
False
True
24
evaluating eating disorder - what physical criterion for hospital admission would you consider?
a daytime HR of less than 50 bpm
systolic BP greater than 130 mmHg
an oral temp of 100 degrees or more
90% of ideal body weight
25
LEAST useful for accurate measurement of weight - diagnosed with anorexia nervosa
weigh fully clothed before breakfast
permit no oral intake before weighing
weigh 2 times daily first week, then 3 times weekly
do not reweight when client requests
26
partner of manic client asks about genetic transmission of bipolar disorder, the nurse’s answer should be predicated on
highly creative people tend toward development of the disorder
rate of bipolar disorder higher in relatives of people w/ bipolar disorder
much depends on the socioeconomic class of individuals
no research exists to suggest genetic transmission
27
mealtime difficulties that resolve spontaneously with or without caregiver support and education
avoidant/restrictive food intake
rumination
pica
28
buproprion (Wellbutrin) is contraindicated for bulimia due to risk of seizures
False
True
29
most common form of child abuse is neglect
False
True
30
there are no FDA approved medications for bulimia
False
True
31
undigested food being returned to the mouth then rechewed, swallowed, or spit out - diagnosed after 1 month of symptoms
avoidant/restrictive food intake
pica
rumination
32
lithium for 11 months - now ready for maintenance therapy, how will the dosage be adjusted
once a week dosing
different drug
higher dosage
lower dosage
33
on a secret mission for President of the United States, “I am the only one he trusts, because I am the best!” What term?
flight of ideas
grandiosity
unpredictability
rapid cycling
34
What is the first-line drug used to treat mania?
Clonazepam
Carbamazepine
Lithium carbonate
Lamotrigine
35
after stabalization of symptoms, what is primary focus of tx for client diagnosed w/ anorexia nervosa?
changing family interaction patterns
weight restoration
learning effective coping methods
improving interpersonal skill
36
initially, patients with bulimia appear to be physically ill
False
True
37
bipolar client: "I have the finest tenor voice in the world" - what term should nurse use to identify this behavior?
limit testing
grandiosity
flight of ideas
distractibility
38
When a hyperactive manic client expresses the intent to strike another client, what is the initial nursing intervention?
prepare the client for seclusion
set verbal limits
initiate physical confrontation
question the clients motives
39
only FDA approved medication for bulimia nervosa
MAOI
SSRI
tricyclic antidepressants
benzodiazepines
40
overweight all of her life - now has health problems - seeking weight-loss assistance - suprised when NP suggests
removing snack foods from home
medication tx for HTN
SSRI antidepressant therapy
mild exercise to start, increasing in intensity over time
41
bulimia exhibits which characteristic vs anorexia nervosa
doing more rigorous exercising
purging to keep weight down
maintaining normal weight
holding a distorted body image
42
anorexia is more prevalent in LGBTQ community
False
True
43
effective care of suspected bulimia nervosa - which assessment?
inspection of oral cavity
ROM assessment
inspection of body cavities
body fat analysis
44
What is the priority nursing diagnosis for a hyperactive manic client during the acute phase of treatment?
impaired verbal communication
risk for other-directed violence
ineffective role performance
risk for injury/suicide
45
72 w/ parkinson's disease demonstrating anxiety&several falls lately but reluctant to take meds - HCP orders lorazepam
may become addicted faster than younger clients
should be treated with cognitive therapies because of his advanced age
client at risk for falls
hx of nonadherence w/ medications
46
subjective symptom of anorexia nervosa
fear of gaining weight
lanugo
25-lb weight loss
hypotension
47
“Bud.Crud.Dud. I’m a real stud! You’d like what I have to offer. Let’s go to my room.” What is the best initial approach
distracting the client by suggesting "its time to work on your art project"
reprimand by stating "what an offensive thing to suggest"
enforcing consequences by responding "lets walk down to seclusion"
clarifying nurse-client relationship "i dont have sex with clients"
48
pt with anorexia nervosa orients to room for her stay - after getting settled, nurse says
the daily structure is based around your desire to eat
you will be eating 5x a day
you can use the scale in the back room when you need to
i need to go through your belongings you have brought
49
bulimia nervosa uses enemas and laxatives to purge to maintain weight - physiological outcome of this patient?
increase in RBC count
disruption of fluid and electrolyte balance
elevated serum Na+ level
elevated serum k+ level
50
only FDA SSRI antidepressant approved for tx of bulimia nervosa
escitalopram (Lexapro)
sertraline (Zoloft)
fluoxetine (Prozac)
alprazolam (Xanax)
51
When a client experiences four or more mood episodes in a 12-month period, which term is used to describe this behavior?
dyssynchronous
rapid cycling
incongruent
cyclothymic
52
Ted diagnosed with bipolar I disorder 8 yrs ago - hx:IV drug use, now Hep C - takes lithium on schedule - to treat mania
Fluoxetine (Prozac)
Lurasidone (Latuda)
Electroconvulsive therapy (ECT)
Clonazepam (Klonopin)
53
FDA approved for treatment of anxiety in children?
duloxetine
sertraline
fluoxetine
clomipramine
54
induces vomiting as often as a dozen times a day - assessment finding to support which electrolyte imbalance?
hypernatremia
hypokalemia
hypercalcemia
hypolipidemia
55
can help families develop effective coping mechanisms by implenting which interventions?
stressing need to suppress overt conflict w/in the family
encouraging family to use their usual social behaviors at meals
urging family to demonstrate greater caring for the client
teaching family about the disorder and clients behaviors
56
educating client w/ bulimia nervosa about medication fluoxetine - include which info ?
there are a variety of meds to preseibe if it proves ineffective
long-term management of symptoms is best achieved w/ tricyclic antidepressa
it will be prescribed at a higher than typical dose
it will reduce the need for cognitive therapy
57
psychotic relapse - being discharged home to family. Which topic is important to address when teaching pt and family
increased appetite
increased attention to bodily function
decreased sleep
decreased social interaction
58
Which room placement would be best for a client experiencing a manic episode?
a shared room with a client w/ dementia
a shared room away from the unit entrance
a single room near the nurses station
a single room near the unit activities area
59
assosciated with diagnosis of pica?
nothing could make me drink milk
i havent eaten a green veggie since i was 3
i regurgitate and rechew my foodafter almost every meal
im ashamed of it, but i eat my hair
60
there are no drugs approved by FDA for treatment of anorexia
True
False
61
which intervention will promote independence in pt being treated for bulimia nervosa?
encourage to use behavior modification techniques to promote weight gain
have pt monitor daily caloric intake and I&O of fluids
allow pt to make limited choices about eating and exercise as gain progress
ask for daily log, record feelings and circumstances related to urge purge
62
neglect - basic physical, emotional, educational needs not met - not protected from harm -medical/dental neglect
act of ommission
act of commission
63
What is a desired outcome for the maintenance phase of treatment for a manic client?
take meds more than 50% of the time
use alcohol to moderate occasional mood "highs"
adhere to follow-up appointments
exhibit optimistic, energetic, playful behavior
64
anorexia is more prevalent in men than woman
False
True
65
anorexia is associated with purging
False
True
66
obesity can be end result of binge-eating disorder - best treatment option
coping strategies
avoidance of public eating
bariatric surgery
appetite supression medications
67
17yr old w/ bulimia coming to outpatient clinic for counseling - which indicate appropriate outcome that tx has been met
I purge when I am alone so im not a bad role model for my sister
I am a hard worker and am very compassionate toward others
I purge only once a day not instead of twice
I am alot calmer, just like when i used to eat 4-5 burgers
68
anorexia is more prevalent in athletes (gymnastics, running, figure skating)
False
True
69
something improper that is done to a child - deliberate, intentional - physical, sexual, emotional abuse
act of ommission
act of commission
70
lithium causes an upset stomach, the nurse should make which suggestion associated with taking the medication?
2 hours after meals
with meals
30 minutes before meals
with an antacid
71
ingestion of substances that have no nutritional value - paint, dirt, hair
pica
rumination
avoidant/restrictive food
72
substance use/disorders are often present in people diagnosed with BD - laura, 28, drinks alochol instead of taking meds
she is using alcohol because she is depressed
anxiety may be present
she is lacking a sufficient number of neurotransmitters
alcohol ingestion is a form of self-medication
73
anorexia - moderate when BMI is
17 or more
15-16
less than 15
16-17
74
anorexia - severe when BMI is
17 or more
16-17
15-16
less than 15
75
given priority for client diagnosed w/ bulimia nervosa?
chronic low self-esteem
ineffective coping: impulsive responses to problems
risk for injury: electrolyte imbalance
disturbed body image
76
which coping mechanism used excessively by clients diagnosed with bulimia nervosa to cope w/ obsession of body image?
projection
humor
altruism
denial
77
bariatric surgery is generally unsuccessful for tx of obesity due to binge-eating disorder
True
False
78
anorexia - extreme when BMI is
17 or more
less than 15
15-16
16-17
79
lanugo is associated with
anorexia
binge eating
bulima
80
three stages of violence : tension-building, acute battering, honeymoon
False
True

MH Exam 2 - Part 2 Flashcards | StudBud