Upgrade to remove ads
Chapter 17 Mental Health
Terms in this set (63)
Which would be the priority diagnosis for the client in the manic phase of bipolar disorder who is exhibiting aggressive behavior?
Risk for other-directed violence
To care for an acutely suicidal client, which is the most effective initial mode of treatment?
The nurse is caring for a client with major depressive disorder who has been admitted to a psychiatric-mental health facility. After assessing the client, the nurse has developed a nursing diagnosis of "risk for violence toward others related to agitation and low tolerance level." Which would be an appropriate intervention for this client?
Remove all dangerous items from the client's room.
The nurse is assessing a 42-year-old client who is experiencing depression. The client's mother died by suicide 20 years ago. Which statement regarding this client's risk for suicide is correct?
The client has a greater risk for suicide than the general population.
After assessing a client, the nurse identifies that the client is at risk for suicide. Which would be the nurse's priority intervention?
Remove means of suicide from the client's access.
After being diagnosed with a chronic disease, a client has been feeling depressed. Which diagnosis has the strongest association with an increased suicide risk?
Acquired immunodeficiency syndrome
A client is receiving lithium carbonate for the treatment of mania. The nurse would reinforce which teaching component regarding lithium treatment?
Schedule bloodwork for lithium levels.
The nurse is caring for a client diagnosed with bipolar disorder. During a manic episode, which takes priority?
A nurse is caring for a client diagnosed with bipolar disorder who has been prescribed divalproex. The nurse knows that the client should have which test completed before initiation of drug therapy?
A nurse is caring for a white, 30-year-old man whose wife has recently died. The client has been diagnosed with clinical depression and is demonstrating insufficient coping skills. Which action by the nurse would be most important?
Ask the client whether he is thinking about killing himself.
A nurse is providing a presentation about suicide for a group of health professionals. Which would the nurse address as a major contributing factor to the rising suicide rate among men?
A client was admitted to the psychiatric unit 3 days ago because of suicidal ideation. The client's suicidal risk has lessened considerably, and the client currently denies having any desire to kill himself or herself. In addition, the client is able to identify reasons why the client wants to be alive. Which nursing intervention would be most appropriate at this time?
Developing a personal plan for managing suicidal thoughts when they occur
A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which would the nurse include?
Depression in one family member affects the entire family.
A nurse maintains a safe environment for a client who is suicidal by ...
observing the client frequently.
In response to a change in the community health nurse, a client has recently discontinued use of lithium. As a result of the discontinuation of the medication, the client has began to exhibit early signs of mania. The client is brought to the emergency department at the hospital for assessment. Which is the best nursing approach for this client?
Setting limits, providing a low-stimulation environment, and maintaining a neutral attitude
The nurse working on a mental health unit is teaching a nursing student. The student asks the nurse about what constitutes a diagnosis for major depressive disorder. What is the nurse's best response?
"The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present."
A client who has just been prescribed lithium for bipolar disorder is being given education from the nurse about this medication. Which is important for the nurse to include in teaching?
The higher the sodium level, the lower the lithium level will be.
Before a client became depressed, the client was an active, involved parent with three children, often attending their school functions and serving as a volunteer. The client is hospitalized for a major depressive episode and now reveals that the client feels like an unnecessary burden on the client's family. Which nursing diagnosis is most appropriate?
Situational low self-esteem
A client has been successfully treated on the psychiatric mental health unit following a suicide attempt. In preparation for discharge, the nurse should prioritize what action?
Ensuring a plan is in place for the client's community-based care
The nurse is planning the inpatient care of a client who has been admitted with major depression. The client's plan of care includes regular exercise, but the client is reluctant to participate due to a lack of energy and motivation. What is the nurse's best action?
Collaborate with the client to choose a manageable amount of exercise and acknowledge the client's subsequent effort
The nurse is working with a 50-year-old client admitted for a major depressive episode. The client has remained isolated and withdrawn since admission and is reluctant to speak. Which therapeutic communication skill is most likely to encourage the client to verbalize the client's feelings?
Silence and active listening
Which client is most likely to benefit from electroconvulsive therapy (ECT)?
A client whose major depression has not responded appreciably to antidepressants
When teaching prevention to the parents of a 15-year-old client who recently attempted suicide by taking an overdose of alprazolam, the nurse describes which behavioral clue?
Giving away valued personal items
A 30-year-old woman has been brought to the emergency department after causing a disturbance. She is wearing a pair of tight, pink yoga pants, high heels, a sports bra, and a bright-colored hat. The woman's care providers would recognize that the woman's dress may suggest what?
A client with major depression is scheduled to receive electroconvulsive therapy. The nurse understands that this treatment is typically used in which situation?
The client is experiencing catatonia.
When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what in a client?
Which individual has the highest number of risk factors for the development of depression?
A 50-year-old woman who just lost her spouse and has a family history of depression
The nurse is seeing a 26-year-old client and the client's family. The client's family describes the client as being "very, very different." The family describes a history of periods of unpredictable behavior and disregard for consequences occurring a few times each year. The client has recently been diagnosed with bipolar I disorder, a condition that is characterized by what?
An elevated mood that lasts for at least 1 week
Which sleep pattern is suggestive of a manic episode?
A client stays awake for several days and nights before "crashing" and sleeping for a long period.
A 29-year-old first-time mother has been diagnosed with postpartum psychosis after her partner reported the client was hearing voices and told the partner she "saw someone trying to steal the baby." In the planning of this client's care, which outcome should the nurse prioritize?
The client will demonstrate the ability to differentiate between perceptual disturbances and reality.
A client comes to the emergency department reporting a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and the client's pulse is racing. The client states that the client is being treated for depression with an MAOI. Which question by the nurse would be most important to ask at this time?
"What have you had to eat or drink today?"
Trying to kill oneself and surviving the ordeal is identified as what?
A client who has experienced the recent loss of an infant child and recent immigration to the United States is admitted to the inpatient psychiatric unit with severe symptoms of depression. The client has expressed thoughts of suicide. Which is the nurse's priority intervention for this client?
Ensuring that the client is not permitted to use anything that would be potentially dangerous.
A nurse is caring for a client diagnosed with bipolar disorder. The client is experiencing a manic episode. The nurse would be especially alert for signs indicating what?
A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to the client's feelings of sadness and hopelessness, the nurse would expect to assess what?
Which is a true statement regarding depressive disorders?
Norepinephrine, dopamine, and serotonin have been implicated.
The major difference between bipolar I and bipolar II disorder is what?
Clients with bipolar II disorder do not have symptoms of mania that interfere enough to cause marked functional disturbances.
When conducting a suicide risk assessment, the nurse understands that which method has the least lethality?
Which biogenic amines have been implicated in depression?
Norepinephrine and serotonin
While caring for a client in the hospital, the nurse becomes concerned that the client may be having thoughts of suicide. Which statement would be most therapeutic?
"I've noticed something is bothering you. Please share you thoughts with me."
Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension?
A nurse taking an admission history from a client suspects that the physician will diagnose major depression. For the physician to make this diagnosis, the client will have to demonstrate specific symptoms. What are some of these symptoms? Select all that apply.
disruption in sleep
disruption in appetite
disruption in concentration
A client is prescribed a selective serotonin reuptake inhibitor (SSRI) as treatment for depression. Which would the nurse most likely administer?
A nurse is reviewing the medical record of a young client to determine the client's risk for suicide. Which factor would alert the nurse to an increased risk for this client?
experiencing unemployment that has lasted a year
Which is an anticonvulsant used as a mood stabilizer?
Police officers bring a client to the mental health unit for admission. The client had been directing traffic on a busy city street, shouting rhymes such as "to work, you jerk, for perks" and making obscene gestures at cars that came close to the client. When the client's spouse is contacted at work, the spouse reports that the client stopped taking lithium 3 weeks ago and has not slept or eaten for 3 days. With which two features characteristic of the manic phase of bipolar disorder can the nurse identify?
Poor judgment and hyperactivity
A client has experienced a first episode of major depression and has received medication and treatment, which has led to a complete remission of the symptoms. The client asks the nurse, "How much longer will I need to take the medication?" Which response by the nurse would be most appropriate?
"You'll need to continue the medication for about 6 to 12 months to see how things go."
After educating a class on the etiology of bipolar disorders, a nursing instructor determines that the education was successful when the class describes the kindling theory as involving what?
Exposure to repetitive subthreshold stressors at vulnerable times
When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate?
Thyroid function tests
The nurse is assessing a client who has presented to the emergency department in emotional distress. What client data represents the greatest risk for suicide?
The client overdosed on pills 2 years earlier
The nurse is interviewing a client with a diagnosis of depression and the client states, "Honestly, I know my family would be a lot better off if I wasn't around to be a burden on them. That's just between you and me, though, okay?" What is the nurse's best response?
"I'm obliged to share what we talk about with the other people on your care team."
Which medication classification is considered first-line drug therapy for bipolar disorder?
Which statement regarding depression and gender is correct?
Depressive disorders are more common in women than men.
A mental health nurse has identified a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. Which outcome would be most appropriate for this nursing diagnosis?
The client will reframe negative thoughts in a more positive way.
During an interview, the nurse has asked a client with depression about any hopes or plans for the future. In response, the client silently made a gesture of drawing the index finger from one side of the client's throat to the other. The nurse has informed the client that this must be communicated to the care team. What is the main rationale for the nurse's action?
Ensuring the client's safety
The policies and procedures at a community psychiatric-mental health center include an emphasis on case finding. How can a nurse at the center best perform case finding?
Assessing all clients carefully to identify those at risk for suicide
A 46-year-old client comes to the community mental health center because the client thinks they might be suffering from depression. When assessing this client, which symptom would the nurse identify as being necessary for the diagnosis of major depressive disorder to be made?
A loss of interest or inability to derive pleasure for previously enjoyed activities
A 56-year-old client who suffers from seasonal affective disorder is being assessed by the nurse in an outpatient mental health clinic. The nurse is aware which treatment is the most effective type of treatment for this condition?
A client has been diagnosed with major depressive disorder. The clinical symptom that would be included when the clinician makes this diagnosis is what?
A significant decrease in appetite
A client comes to the clinic for an evaluation of headache, fatigue, and an overall feeling of being "down." When assessing the client, which statement by the client would alert the nurse to suspect possible suicide? Select all that apply.
"I've been drinking about three or four more beers every night."
"I'm so tired that all I ever want to do is sleep all the time."
"Most times, I feel like I'm trapped with no way out."
After teaching a group of nursing students about major depression, the instructor determines that the education was successful when the group identifies which information is accurate?
Depression is twice as common in women than in men
The nurse is conducting an interview with an adult client who is being treated for major depression. What question should the nurse prioritize in an effort to determine the client's risk for suicide?
"Do you ever feel like your situation is hopeless?"
The nurse is assessing a client with depression and a colleague suggests that the client be encouraged to sign a no-suicide contract. What is the nurse's best response to the colleague?
"There's no demonstrated benefit of no-suicide contracts, though they're not believed to be harmful."
THIS SET IS OFTEN IN FOLDERS WITH...
PrepU Mental Health Assignment 14
CH 24- Depression Boyd/prep U
Psychiatric - Chp 17
Mental: Ch 19 Addiction
YOU MIGHT ALSO LIKE...
Mood Disorders and Suicide
PrepU Chapter 17 (Mental Test II)
PN120 PrepU Chapter 17
3660 Mood PrepU
OTHER SETS BY THIS CREATOR
Ch 21 Mental Health
Mental Health Chapter 12
Mental Health Ch 2
Mental Health Ch 5