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Mental Health Ch 2
Terms in this set (72)
A client has bipolar disorder and has just begun a regimen of lithium, 600 mg tid. Which is the most critical management issue for the client during the first 2 weeks of treatment?
Ensuring the client's blood levels reach a therapeutic and safe dose
Which correctly describes the primary effect of a selective serotonin reuptake inhibitor (SSRI) antidepressant drug?
Its ability to block the reuptake of serotonin
A client is seen in an outpatient mental health clinic for complaints of involuntary tongue movement, blinking, and facial grimacing. This syndrome would be identified correctly as what?
Dietary modifications are most likely necessary when a client is being treated with which antidepressant?
Monoamine oxidase inhibitors (MAOIs)
Which client is most likely to benefit from treatment with an antiparkinsonism agent?
A client who has a medication-induced movement disorder
A client is prescribed medication for a psychiatric disorder. After 3 days, the client reports being constipated. Which instruction would the nurse give the client?
"You need to eat more fruits and vegetables and drink more water
During the stabilization phase of drug therapy for a client who is hospitalized with a psychiatric disorder, which action would be most appropriate?
Assessing the client for target symptoms and side effects
A nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the client will have difficulty in what area?
A client presents to the mental health clinic with reports including lack of focus, lethargy, and inattention. The nurse talks about the different neurotransmitters and what each neurotransmitter does. How would you elaborate on the type of symptoms this client is demonstrating?
"Lack of norepinephrine in the body produces symptoms such as obesity, fibromyalgia, and panic attacks."
Norepinephrine has been shown to play a role in a person's mood and ability to concentrate. Which are disease processes seen with low levels of norepinephrine? Select all that apply.
Several neuroimaging techniques are available for researchers and practitioners. What value does this technology have in diagnosing disorders of the brain?
It provides data about the structures of the brain correlated with their activity.
The nurse is caring for a mental health client who has developed difficulty with balance and muscle tone after a car accident that involved a head injury. Based on this information, what area of the brain was most likely injured in the accident?
Which side effect is associated with selective serotonin reuptake inhibitors (SSRIs)?
The mental health nurse instructs a client prescribed phenelzine to avoid aged foods, such as wine and cheese. For which reasons are these instructions important for client safety?
The foods contain tyramine, which may provoke hypertensive crisis.
After teaching a client who is prescribed imipramine about the drug, the nurse determines that the education was effective when the client states:
"I need to be careful because the drug can make me sleepy."
A college student wakes up and notices a racing heart and dilated pupils. The student is scheduled to write an exam later that morning. Which system is responsible for this physiological response?
Sympathetic nervous system
A client in the operating room goes into malignant hyperthermia due to an abnormal reaction to the anesthetic. The nurse knows that the area of the brain that regulates body temperature is what?
A client with Parkinson's disease is hospitalized on a medical unit. The nurse would be correct in identifying which neurotransmitter decreased in this disease?
The nurse is caring for a client diagnosed with Parkinson's disease. How would the nurse explain which transmitter is increased by taking antiparkinson's medication?
A client is brought to the emergency department with reports of slurred speech, spasms, and jerky movements. The significant other shows the nurse a pill bottle and states that the client has been taking antipsychotic medications for "awhile". The nurse notices that an "improper dose" is ordered on the prescription bottle. How would the nurse explain what system is causing the movements?
Dysfunction of the extrapyramidal motor track can manifest serious neurologic symptoms including dystonia, pseudoparkinsonism, and akathisia"
All but which are currently used neuroimaging techniques?
When a client who is generally pleasant and cooperative begins to show aggressive behavior toward most clients in a community care facility, the nurse suspects the client has experienced cerebral trauma. Which brain structure is responsible?
Which medication classification blocks serotonin reuptake?
Which client would not be able to undergo a magnetic resonance imaging scan (MRI)?
A client with a pacemaker
Which is considered the first-line treatment for bipolar disorder?
Excess tyramine caused by monoamine oxidase inhibitors (MAOIs) can result in what?
Neurotransmission is important in the function of the CNS. For neurotransmission to occur, how do neurons communicate with other cells?
A client exhibiting an uncoordinated gait has presented at the clinic. The nurse knows that what brain structure has the function of balance and coordination?
The nurse is working with a client that has not been diagnosed yet. The client is aggressive, unable to control anger, and violent at times. The client was brought to the emergency deparment by local police. The nurse selects what system as the etiology for the clients' behavior? Classify the symptoms according to origin in the body.
The client presents to the mental health clinic with reports of mood swings, inability to handle stress, and forgetfulness.The nurse talks about the different neurotransmitters and what each neurotransmitter does. How should the nurse elaborate on the type of symptoms this client is demonstrating?
Lack of dopamine in the body produces symptoms such as depression, fatigue, and lack of motivation."
When caring for an older adult taking a psychotropic medication, the psychiatric nurse must be aware that older adults:
usually require a lower dose of these medications than do younger counterparts.
Which is the most commonly seen adverse side effect of typical antipsychotics?
Extrapyramidal symptoms and tardive dyskinesia
Which reason do clients cite most frequently as the cause for self-discontinuation of medication?
Intolerable side effects
Which is a major difference between the atypical antipsychotics (such as clozapine) and the typical antipsychotics (such as haloperidol)?
Atypical antipsychotics block both serotonin and dopaminergic receptors.
Which are anticholinergic side effects that may occur with the use of antipsychotic drugs? Select all that apply.
A client is being seen in the mental health clinic. The client has been on haloperidol for 8 months and is now exhibiting tongue protrusion, lip smacking, and rapid eye blinking. A nurse would document this chronic syndrome as:
A client receiving an antipsychotic agent develops acute extrapyramidal symptoms. Which response by the nurse would be most appropriate?
These are the results of the drug and can be treated; your illness is not getting worse."
A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter?
The client presents to the mental health clinic with reports of fibromyalgia, migranes, and GI distress. The nurse talks about the different neurotransmitters and what each neurotransmitter does. How would you elaborate on the type of symptoms this client is demonstrating?
Lack of serotonin in the body produces symptoms such as irritability, sleep disturbances, and compulsiveness."
One of the most common ways in which neurotransmitters are deactivated within the nervous system at the neuronal level is:
enzymatic degradation, primarily by monoamine oxidase (MAO).
In the discharge instructions for a client who is taking alprazolam, the nurse should include what?
Sudden cessation of alprazolam can cause rebound insomnia and nightmares.
A client with a diagnosis of schizophrenia lacks insight into the illness. The client presents with significantly declined function and is consistently nonadherent with medications. Which medication administration route is best suited for optimal treatment of this client's condition?
What part of the brain would be responsible for activities such as walking and dancing?
A professional boxer has suffered several concussions while boxing. Since retirement, the client has experienced periods of depression and suffers from short-term memory loss. Which provides the best explanation for the neurological basis of the client's symptoms?
Damage to the hippocampus
Which culture would the nurse expect to be disproportionately diagnosed as having schizophrenia when compared to other groups?
The student nurse is working with a client that presents to the mental health clinic with reports of loss of appetite, weight loss, and anhedonia. The student nurse discusses with the instructor that lack of a neurotransmitter may be affecting the client. How would the student explain what neurotransmitters do?
"Molecules that control the opening/closing of ion channels"
The client has difficulty with motor coordination and walks with an unsteady gait. Of the following brain structures, which is most likely affected in the client's brain?
Benzodiazepines work by the following mechanism of action:
They act directly on GABA receptors and are thought to increase the amount of GABA available.
The psychiatric-mental health nurse needs to have a basic understanding of information that is unique to individual medications. Which factors that affect pharmacokinetics should the nurse know? Select all that apply.
Indications for use
Food and drug interactions
A client has been started on an antipsychotic medication and is exhibiting muscle stiffness of the arms, slowness of gait, and tremors. Which extrapyramidal syndrome (EPS) is the client displaying?
The nurse is administering a sedative drug to a client before the magnetic resonance imaging (MRI) procedure. What are the possible reasons for which the nurse had to sedate the client? Select all that apply.
The client may have claustrophobia.
The client may have severe anxiety.
The client cannot remember anything before an accident yesterday. Which brain structure might be injured?
A drug that is an antagonist functions to do what?
Prevent natural or other substances from activating cell function
The function of the thalamus and the hypothalamus is to coordinate
internal and external responses.
An older adult resident of a group home has been receiving treatment for schizophrenia for several decades. The nurse who oversees care at the facility believes that the resident may be developing tardive dyskinesia. What assessment findings would support this suspicion? Select all that apply.
The client often smacks lips when at rest
The client makes repetitive movements with the fingers
The brain stem consists of which structure?
When describing the various neurotransmitters, which would a nurse identify as the primary cholinergic neurotransmitter?
A 46-year-old client sustained a closed-head injury 4 hours ago. The client now presents to the emergency department because the client is having difficulty breathing. This is a result of swelling surrounding which brain structure?
A client is returning from military service and has been diagnosed with post-traumatic stress disorder (PTSD). Dysfunction in which brain structure contributes to the rage and fear experienced in PTSD
A client with schizophrenia is erratic in adhering to the antipsychotic regimen. What action best addresses this client's lack of adherence?
Changing the client's medication route to intramuscular depot
A client brings a spouse to the mental health clinic with reports that the spouse has been exhibiting a tendency to self-mutilate, experiences fits of intense rage, and is increasingly aggressive toward others. How should the nurse elaborate on the type of symptoms this client is demonstrating?
"Lack of serotonin in the body produces symptoms such as aggression, hostility, and compulsiveness."
What is the difference between traditional and atypical antipsychotics?
Atypical antipsychotics work on dopamine-receptor and serotonin-receptor blockade, whereas traditional antipsychotics work on dopamine-receptor blockade.
Clients diagnosed with myasthenia gravis have a decrease in which receptor?
Benzodiazepines increase which neurotransmitter function?
A client receives the first dose of fluphenazine. The next day, during the follow-up appointment, the nurse finds the client is confused and the client's temperature is 103°F, pulse rate is 116 beats per minute, respirations are 34 breaths per minute, and blood pressure is 100/50 mmHg. The nurse should investigate further for which condition?
The nurse caring for the client taking clozapine should advocate for monitoring using which diagnostic test?
White Blood cell coment
A nursing assessment of a client who has been diagnosed with neuroleptic malignant syndrome (NMS) would most likely reveal which signs?
Hyperpyrexia, severe hypertension, and diaphoresis
A nurse observes an older adult client who has been taking antipsychotic medications for 8 months. The nurse sees the client's lips smacking and eyes blinking rapidly. The nurse also observes a protruding tongue. Which action by the nurse would be most appropriate?
A client who has been taking clozapine for 6 weeks visits the clinic reporting fever, sore throat, and mouth sores. The nurse notifies the client's physician because the nurse suspects
A 36-year-old client has been receiving a selective serotonin reuptake inhibitor for treatment of depression. The client is exhibiting manifestations of serotonin syndrome. The nurse should be aware of which symptom of this syndrome?
A client has been prescribed clozapine for treatment of schizophrenia. Which would the nurse include in the education plan for this client and family?
"You may experience noticeable weight gain while taking this medication."
The nurse is preparing to orient a graduate nurse to the mental-health unit. When teaching the new nurse about general principles related to psychoimmunology/psychoneuroimmunology the nurse includes what information? Select all that apply.
inflammatory bowel disease
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