When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that they:

Increase availability of norepinephrine and serotonin

admin risperidone to a client dx w/schizo. Which following client symp would decease becuz of therapeutic effect. SATA

Somatic delusions, Gustatory hallucinations, Clang associations

A client says, “I’m tired of living. My family would be better off without me.” Which is the nurse’s priority response?

“Have you thought about killing yourself?”

Lab results reveal low levels of prolactin in a client dx w/schizo. Which symptoms expect to observe? SATA

Anhedonia, Social withdrawal, Apathy

The purpose of developing a family genogram is to:

Explore generational family patterns.

Which client statement reflects understanding of circadian rhythms in psychopathology?

"I'm a morning person. I get my best work done before noon."

Patient on lithium for 3 weeks has symptoms: tremor, diarrhea, vomiting, lethargy, and confusion. Whats priority action?

Obtain a stat lithium level; hold lithium

Client w/ schizophrenia.Physician orders haloperidol 50 mg bid, benztropine 1 mg prn, which behavior warrant benztropine

Restlessness and muscle rigidity

Which client statement indicates a low-risk level for suicide?

“I don’t want to live anymore but have no plan.”

After taking chlorpromazine for 1 month, a client presents in ED with severe muscle rigidity, tachycardia, temp 105*F

Neurleptic mligant syndrm treat by discont Thorazine & administer dantrolen

60-year-old w/ schizophrenia presents in ED w/uncontrollable tongue movements, stiff neck, dysphagia. What treatment exp

Tardive dyskinesia treated by discontinuing antipsychotic medications

Which individuals would the nurse recognize as being at increased risk for suicide? (Select all that apply.)

History of previous suicide attempt, History of substance abuse, Elderly white male, Recent divorcee

Client w/ schizo states, My psychiatrist is out to get me. Im sad that the voice is telling me to stop him. What symptom

Command hallucinations; warn the psychiatrist.

which of the following components shld a nurse recog as an integral part of rehab when plan of care 4 client dx w/schizo

Medication management, Group therapy, Supportive family therapy, Social skills training

Which patient outcome would be most applicable for a patient taking benzodiazepines?

Avoids alcohol while on medication.

To educate a patient regarding what to expect, the nurse must understand that benzodiazepines:

Have a rapid onset of peak action

Which statement about healthy family functioning is correct?

Healthy families foster open communication.

Which nursing behavior will enhance the establishment of a trusting relationship with a client with schizophrenia?

Being reliable, honest, and consistent during interactions

Which interventions are appropriate for a suicidal client? (Select all that apply.)

Maintain close observation., Maintain safe environment., Remove potentially dangerous objects., Encourage expression of feelings.

Which finding requires immediate intervention by the nurse?

Client starts giving away prized possessions.

Parents ask how they should reply when their child, w/ schizophrenia, tells them that voices command him to harm others.

Focus on the feelings generated by the hallucinations and present reality.

Causes of anorexia nervosa include:

Growth hormone abnormalities, Gonadotropin abnormalities

Patient prescribed alprazolam for anxiety says, “I’m scared about getting off this medication.” Whats the best response?

Rapid brain absorption/distribution makes withdrawal harder to manage.

Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further instruction?

I usually order liver and onions when my wife and I eat out.

A client states, "I have a chemical imbalance. I have no control over my behavior. Medications are my only hope to feel

Medications treat biology; environment and relationships matter too.

A patient with rapid cycling bipolar disorder is not responding well to lithium. The nurse should suggest:

“Another drug, valproic acid, is proving effective.”

Client diagnosed with schizoaffective disorder, admitted for social skills training. What should be included in teaching

How to make eye contact when communicating

Paranoid client presents with bizarre behaviors, neologisms, and thought insertion. How to maintain client safety?

Note escalating behaviors and intervene immediately.

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Psychiatric Nursing Quiz

98 termsStudBud Administration1 play

Test your knowledge on various topics related to psychiatric nursing, including neurotransmitters, brain structures, and psychiatric disorders.

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Questions 98

Answers

1
When asked how tricyclic antidepressants affect neurotransmitter activity, the nurse should respond that they:
Make available increased amounts of monoamine oxidase
Decrease available dopamine
Increase availability of norepinephrine and serotonin
Increase the effects of the chemical gamma-aminobutyric acid (GABA)
2
admin risperidone to a client dx w/schizo. Which following client symp would decease becuz of therapeutic effect. SATA
Somatic delusions
Gustatory hallucinations
Social isolation
Clang associations
3
According to Bowen, which concept describes when a person becomes emotionally fused to another to avoid anxiety?
Triangulation
Emotional cutoff
Fusion
Differentiation of self
4
Decreased norepinephrine levels play a role in:
Generalized anxiety disorder
Bipolar mania
Major depressive episode
Schizophrenia
5
A client says, “I’m tired of living. My family would be better off without me.” Which is the nurse’s priority response?
“You sound very upset.”
“Think about how this will affect your family.”
“Try to stay positive.”
“Have you thought about killing yourself?”
6
Lab results reveal low levels of prolactin in a client dx w/schizo. Which symptoms expect to observe? SATA
Anhedonia
Social withdrawal
Apathy
Auditory hallucinations
7
The purpose of developing a family genogram is to:
Explore generational family patterns.
Measure stress levels.
Identify dysfunctional members.
Assign blame to family members.
8
Which part of the nervous system plays a major role during stressful situations?
Sympathetic nervous system
Somatic nervous system
Peripheral nervous system
Parasympathetic nervous system
9
Which is the most significant risk factor for a client to commit suicide?
Alcohol and substance use
The existence of a plan
Family history of depression
Diagnosis of schizophrenia
10
A withdrawn client with schizophrenia expresses little emotion. What altered component is responsible?
Neurotransmitters
Axons
Dendrites
Synapses
11
Memory deficits and decreased motor function are correlated with decreased levels of:
Dopamine
Serotonin
Norepinephrine
Acetylcholine
12
Which cerebral structure is called the emotional brain?
Cortex
Cerebellum
Limbic system
Left temporal lobe
13
Which client statement reflects understanding of circadian rhythms in psychopathology?
"Every February, I feel sad."
"I get irritable during my menstrual cycle."
"I'm a morning person. I get my best work done before noon."
"When I dream about my mother's accident, I become hysterical."
14
Patient on lithium for 3 weeks has symptoms: tremor, diarrhea, vomiting, lethargy, and confusion. Whats priority action?
Provide reassurance that symptoms are transient
Obtain a stat lithium level; hold lithium
Administer prn Cogentin
Assist patient to decrease sodium intake
15
A client with catatonic schizophrenia has elevated levels of which neurotransmitter?
Dopamine
Serotonin
GABA
Histamine
16
A client diagnosed with major depressive disorder asks, "What part of my brain controls my emotions?"
Occipital lobe
Parietal lobe
Medulla
Limbic system
17
Client w/ schizophrenia.Physician orders haloperidol 50 mg bid, benztropine 1 mg prn, which behavior warrant benztropine
Tactile hallucinations
Reports of hearing disturbing voices
Restlessness and muscle rigidity
Tardive dyskinesia
18
Which client statement indicates a low-risk level for suicide?
“I already have the pills to take.”
“I plan to drive my car off the bridge tonight.”
“I hear voices telling me to hurt myself.”
“I don’t want to live anymore but have no plan.”
19
After taking chlorpromazine for 1 month, a client presents in ED with severe muscle rigidity, tachycardia, temp 105*F
Nurleptic mligant syndrm trt by incrs Thorazine dsage & minister antiaxiety
Dystonia treated by administering trihexyphenidyl
Neurleptic mligant syndrm treat by discont Thorazine & administer dantrolen
Dystonia treated by administering bromocriptine
20
A nurse observes that one family member consistently assumes responsibility for another's problems. This is:
Enabling
Enmeshment
Fusion
Scapegoating
21
Client w/ schizophrenia. Nurse asks the client, Do you receive special messages from sources, such as the tv?
Thought insertion
Magical thinking
Delusions of reference
Paranoid delusions
22
60-year-old w/ schizophrenia presents in ED w/uncontrollable tongue movements, stiff neck, dysphagia. What treatment exp
Agranulocytosis treated by administration of clozapine
Tardive dyskinesia treated by discontinuing antipsychotic medications
Extrapyramidal symptoms treated by administration of benztropine
Neuroleptic malignant syndrome treated by discontinuing antipsychotics
23
Which individuals would the nurse recognize as being at increased risk for suicide? (Select all that apply.)
History of previous suicide attempt
History of substance abuse
Elderly white male
Recent divorcee
Member of supportive faith community
24
The nurse would assess for neuroleptic malignant syndrome (NMS) if a patient on haloperidol (Haldol) develops a:
Temperature reading of 104°F
30 mm Hg decrease in blood pressure reading
Pulse rate of 70 beats per minute
Respiratory rate of 24 respirations per minute
25
Client w/ schizo states, My psychiatrist is out to get me. Im sad that the voice is telling me to stop him. What symptom
Magical thinking; administer an antipsychotic medication.
Persecutory delusions; orient the client to reality.
Command hallucinations; warn the psychiatrist.
Altered thought processes; call an emergency treatment team meeting.
26
which of the following components shld a nurse recog as an integral part of rehab when plan of care 4 client dx w/schizo
Medication management
Group therapy
Supportive family therapy
Social skills training
27
Which patient outcome would be most applicable for a patient taking benzodiazepines?
Can return to work while on medication.
Understands how to increase dosage.
Avoids alcohol while on medication.
There are specific foods to avoid.
28
To educate a patient regarding what to expect, the nurse must understand that benzodiazepines:
Have a rapid onset of peak action
Generally diminish the activity of GABA
Interact with serotonin to increase availability
Reduce availability of GABA
29
Which person with mania is the least likely candidate to receive lithium?
Displaying postpartum depression
Taking hormone replacement therapy
Six weeks pregnant
Recovering from hysterectomy
30
Which statement about healthy family functioning is correct?
Healthy families avoid conflict entirely.
Healthy families foster open communication.
Healthy families rely on rigid roles.
Healthy families suppress emotional expression.
31
A nurse working with a family recognizes clear roles, flexible boundaries, and appropriate communication. This indicates
Pseudomutual family system
Co-dependent family system
Dysfunctional family system
Healthy family system
32
Which nursing behavior will enhance the establishment of a trusting relationship with a client with schizophrenia?
Sharing limited personal information
Sitting close to the client to establish rapport
Establishing personal contact with family members
Being reliable, honest, and consistent during interactions
33
Which neurotransmitter is associated with the fight-or-flight response?
Serotonin
Norepinephrine
Dopamine
Acetylcholine
34
Which interventions are appropriate for a suicidal client? (Select all that apply.)
Maintain close observation.
Provide a private room.
Maintain safe environment.
Remove potentially dangerous objects.
Encourage expression of feelings.
35
Which finding requires immediate intervention by the nurse?
Client starts giving away prized possessions.
Client avoids family phone calls
Client refuses to attend group therapy.
Client remains quiet and withdrawn
36
Parents ask how they should reply when their child, w/ schizophrenia, tells them that voices command him to harm others.
Tell him to stop discussing the voices.
Present objective evidence that the voices are not real.
Focus on the feelings generated by the hallucinations and present reality.
Ignore what hes saying, while attempting to discover the underlying cause.
37
Causes of anorexia nervosa include:
Growth hormone abnormalities
Gonadotropin abnormalities
ADH abnormalities
Oxytocin abnormalities
Prolactin abnormalities
38
Patient prescribed alprazolam for anxiety says, “I’m scared about getting off this medication.” Whats the best response?
Long elimination half-life will result in a manageable withdrawal plan.
Sensitivity of the reticular activating system makes addiction unlikely.
Combination with antidepressant improves withdrawal.
Rapid brain absorption/distribution makes withdrawal harder to manage.
39
The assessment tool used to assess suicide risk is called the sad persons scale.
True
False
40
Which of these statements made by a patient taking the MAOI phenelzine (Nardil) would warrant further instruction?
I should not use over-the-counter cold medications.
I need to restrict the amount of sodium in my diet.
I usually order liver and onions when my wife and I eat out.
I often forget to wear sunscreen when I go outside.
41
A client states, "I have a chemical imbalance. I have no control over my behavior. Medications are my only hope to feel
Environmental factors show the most influence on depression development.
Biological factor are the cause of depression medication will improve mood.
Researchers been unable to demonstrate a link between nature and nurture.
Medications treat biology; environment and relationships matter too.
42
A patient with rapid cycling bipolar disorder is not responding well to lithium. The nurse should suggest:
“Another drug, valproic acid, is proving effective.”
“Sometimes you like being high.”
“You’re feeling discouraged.”
“If your kidneys hold out, lithium will eventually work.”
43
After IM ziprasidone (Geodon), monitor primarily for:
Tardive dyskinesia
Orthostatic hypotension
Anticholinergic effects
Pseudoparkinsonism
44
Client diagnosed with schizoaffective disorder, admitted for social skills training. What should be included in teaching
How to be a leader
Deep breathing techniques to decrease stress
The side eects of medications
How to make eye contact when communicating
45
A patient taking chlorpromazine (Thorazine) shows drooling, tremors, and a shuffling gait. These behaviors indicate:
Neuroleptic malignant syndrome
Tardive dyskinesia
Pseudoparkinsonism
Akinesia
46
To evaluate outcomes for schizophrenia on typical antipsychotics, monitor:
Cognitive functioning
Self-care activities
Affective mobility
Positive symptoms
47
Six months after a tragic accident, a clients diagnosed with ulcerative colitis. This validates which study perspective?
Psychoimmunology
Neurophysiology
Diagnostic technology
Neuroendocrinology
48
A client refuses to discuss painful family experiences and cuts o family contact. Which term describes this behavior?
Differentiation
Emotional cutoff
Fusion
Triangulation
49
Paranoid client presents with bizarre behaviors, neologisms, and thought insertion. How to maintain client safety?
Interpret attempts at communication.
Assess triggers for bizarre, inappropriate behaviors.
Note escalating behaviors and intervene immediately.
Assess for medication nonadherance.
50
A family maintains superficial harmony while underlying conflict exists. What term describes this pattern?
Pseudomutuality
Triangulation
Fusion
Differentiation of self
51
Which nursing diagnosis takes priority in a dysfunctional family system?
Ineffective family coping
Dysfunctional grieving
Risk for suicide
Impaired parenting
52
A parent tells a child, “Don’t tell your father about what happened today.” This is an example of:
Triangulation
Fusion
Emotional cutoff
Pseudomutuality
53
Which factor is associated with an increased risk for suicide?
Unemployment
Age 25-35
Absence of psychiatric illness
Married status
54
Which describes the scapegoat role in a dysfunctional family?
The problem child
The lost child
The lost child
The family hero
55
A patient taking fluphenazine complains of dry mouth and blurred vision. What would the nurse assess as likely symptoms?
Cholinergic blockade
Decreased dopamine at receptor sites
Blockade of histamine
Adrenergic blocking
56
Patient diagnosed with schizophrenia is not taking prescribed oral haloperidol; which intervention promotes compliance?
Writing instructions in detail for the patient to follow
Changing haloperidol to an atypical antipsychotic
Instructing the patient to have friends monitor his medications
Beginning administration of haloperidol decanoate
57
What intervention will the nurse request for GI side effects related to valproate therapy?
Mild laxative
Low-fat diet
Histamine-2 antagonist
Oral antacid
58
Why is an SSRI like sertraline chosen for patients with symptoms of major depression
Good side-effect profile
Increase in medication compliance
Rapid rate of absorption from the GI tract
Less expense for the patient
59
In Bowen’s family systems theory, what happens when unresolved emotional issues persist across multiple generations?
Multigenerational transmission occurs.
Problems get better with time.
Anxiety decreases
Dierentiation of self improves.
60
Abnormal secretion of growth hormone may play a role in:
Acute mania
Alzheimer's disease
Schizophrenia
Anorexia nervosa
61
The study of biological foundations of emotional, cognitive, and behavioral processes is called Psychobiology
True
False
62
Which adoption studies provide useful information for the psychiatric community?
Monozygotic twins raised together
Mentally healthy biological parents with mentally ill adoptive parents
Mentally ill biological parents with mentally healthy adoptive parents
Monozygotic twins raised separately
63
A patient’s lithium level is 1.9 mEq/L. The nurse should immediately:
Restrict sodium and fluid intake
Transfer to ICU
Notify physician immediately
Assess for signs of toxicity
64
Client experiencing a flat affect, delusions, anhedonia, anergia, neologisms, echolalia. positive and negative symptoms
Delusions, anhedonia, and anergia are positive symptoms of schizophrenia.
Delusions, neologisms, echolalia are positive symptoms of schizophrenia.
Delusions, flat aect, and anhedonia are negative symptoms of schizophrenia.
Delusions, anergia, and echolalia are negative symptoms of schizophrenia.
65
Which information about suicide should the nurse identify as correct?
Most people who commit suicide do not give any warning signs.
The risk of suicide is lowest after initiation of antidepressant therapy.
Suicide occurs most often in response to a sudden unexpected event.
The risk of suicide is highest after improvement in mood.
66
Which characteristics are found in healthy family systems? (Select all that apply.)
Suppressed conflict
Rigid boundaries
Supportive emotional climate
Open communication
Appropriate roles
67
Which factor would the nurse identify as a protective factor for suicide?
Substance use
Lack of social support
Feelings of hopelessness
Effective problem-solving skills
68
An aging client diagnosed with schizo takes an antipsychotic and a beta-adrenergic blocking agent for hypertension.
Wear sunscreen and try to avoid midday sun exposure.
Make sure you concentrate on taking slow, deep, cleansing breaths.
Rise slow when u change position from lyin to sittin or sitting to standing
Watch your diet and try to engage in some regular physical activity.
69
How do neurotransmitters return to the presynaptic neuron?
Reuptake
Recycling
Retransmission
Regeneration
70
Symptoms associated with increased TSH include:
Mania
Depression
Hyperexcitability
Increased libido
Fatigue
71
Which intervention takes priority in the care of a suicidal client?
Reassure the client that things will get better
Establish a written no-suicide contract.
Remove all potentially harmful objects.
Discuss positive aspects of life
72
A grieving client is encouraged to talk, eat properly, and exercise. Why?
Stress increases susceptibility to illness
Neurotransmitter alteration
Interpersonal therapy
Routine practice
73
Which statement by a patient with generalized anxiety disorder taking lorazepam (Ativan) suggests proper understanding?
“I’ll take my dose to help me sleep instead of worrying.”
“I’m embarrassed to take this medication.”
“I may have to take this for life.”
“I can talk with my therapist easily after my medication takes effect.”
74
A client diagnosed with schizop is prescribed clozapine. Which client symptoms, related to the side effects
Dry mouth and urinary retention
Akathisia and hypersalivation
Akinesia and insomnia
Sore throat, fever, and malaise
75
Which of the following are common dysfunctional family roles? (Select all that apply)
Peacekeeper
Enabler
Hero
Scapegoat
Lost child
76
Assess that a client dx with schizo has allergy to penicillin, prochloperazine, and bee stings. Which med contraindicati
Clozapine (Clozaril), because it is incompatible with desipramine
Risperidone (Risperdal), because it exacerbates symptoms of depression
Thioridazine (Mellaril), because of cross-sensitivity among phenothiazines
Haloperidol (Haldol), because it is used only in older patients
77
Suicide risk is at its lowest when the client has both the intent and the means to act.
True
False
78
Increased dopamine activity plays a role in:
Body dysmorphic disorder
Schizophrenia spectrum disorder
Parkinson's disease
Major depressive disorder
79
A graphic representation of multiple generations used for family assessment is called a genogram
True
False
80
Which family assessment tool is most helpful in identifying generational patterns?
Family APGAR
The Mini-Cog
Mental status exam
Genogram
81
Patient with poststroke depression receives an SSRI. Whats the rationale for giving medication at breakfast and midday?
Prevent insomnia
Prevent toxic reactions
Decrease afternoon sleepiness
Closely monitor behavior
82
Which patient complaint should receive priority from a patient who is taking the MAOI tranylcypromine (Parnate)?
I get a headache when I drank several cups of coffee.
My legs get stiff when I sit in the chair for any length of time.
I haven’t had a bowel movement in 2 days.
Will you take my temperature? I feel too warm.
83
A nurse teaches family members about the importance of problem-solving and clear communication. This is an example of:
Family fusion
Codependency
Psychoeducation
Psychoeducation
84
Client w/ schizophrenia takes an antipsychotic agent daily. Which assessment finding should a nurse prioritize?
Respirations of 22 beats/minute
Excessive salivation
Temperature of 104F (40C)
Weight gain of 8 pounds in 2 months
85
The psychiatric nurse explains to the new nurses how typical antipsychotics differ from atypical ones. Which is correct?
Remain in the system longer
Produce fewer extrapyramidal effects
Act more quickly to reduce delusions
Are risk free for neuroleptic malignant syndrome (NMS)
86
Client w/ schizophrenia states, Cant you hear him? Its the devil. He telling me Im going to hell. Which is appropriate
The devil only talks to people who are receptive to his influence.
Voices must be scary the devil isnt talking to u. It part of your illness.
You are not going to hell. You are a good person
Did you take your medicine this morning?
87
Which displayed behavior by a patient on typical antipsychotics would be characteristic of tardive dyskinesia (TD)?
Falling asleep in the chair and refusing to eat lunch
Having excessive salivation and drooling
Grimacing and lip smacking
Experiencing muscle rigidity and tremors
88
assessing a client dx with SIPD. What would differentiate this clients symptoms from the symptoms of a client dx BDP?
Catatonic features associated w SIPD, wherea BPD has no catatonic features.
Client w BPD experience hallucinations, where clients diagnosed w SIPD dont
Catatonic features associated w BPD, where SIPD has no catatonic features
Clients w SIPD experience delusions, whereas clients diagnosed w BPD dont.
89
Adolescent with schizophrenia experiences command hallucinations. The clients parents ask where the voices come from?
Your childs hallucinations are caused by medication interactions.
Your child has little serotonin in brain, causing delusions/hallucinations.
Childs abnormal hormonal changes have precipitated auditory halucinations.
Your child has a chemical imbalance of brain; leads to altered perceptions.
90
A client has been assign an admission dx of brief psycho disorder. Which assess inform would alert the nurse to dx
The client has experienced confusion for 3 weeks.
The client has experienced auditory hallucinations for the past 3 hours.
The client has experienced bizarre behavior for 1 day.
The client has experienced impaired reality testing for a 24-hour period.
91
Which patient statement about lithium suggests more teaching is needed?
When I get home, I may go on a salt-free diet.
I will have my blood work done regularly.
I have learned not to restrict my intake of water.
I understand some people gain weight on lithium.
92
Which statement made by a client should alert a nurse to a warning sign of suicide?
“I'm feeling much better.”
“I’ve decided to give my dog away to a good home.”
“I’m finally at peace with everything.”
“I’ve been sleeping much better lately.”
93
After 24 hours of haloperidol, a patient feels jittery and restless. This indicates:
Neuroleptic malignant syndrome
Dystonia
Serotonin syndrome
Akathisia
94
Which intervention would be appropriate when caring for acute agitated paranoid client with schizophrenia?
Provide neon lights and soft music.
Provide personal space to respect the clients boundaries.
Maintain continual eye contact throughout the interview.
Use therapeutic touch to increase trust and rapport.
95
Which nursing diagnosis takes priority for a suicidal client?
Dysfunctional grieving
Dysfunctional grieving
Ineffective coping
Risk for suicide
96
Client with schizo tells a nurse about voices commanding him to kill the president. Which is the priority nurse diagnosi
Altered thought processes
Disturbed sensory perception
Risk for violence: directed toward others
Risk for injury
97
A severely depressed patient has been prescribed clomipramine. Which medication side effects should be monitored?
Muscle rigidity and restlessness
Excess salivation and drooling
Orthostatic hypotension and constipation
Polyuria and coarse hand tremors
98
Decreased prolactin hormone levels are associated with:
Major depressive episode
Schizophrenia
Alzheimer’s disease
Anorexia nervosa

Psychiatric Nursing Quiz Flashcards | StudBud