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A nurse is caring for an adolescent patient with an eating disorder. The patient is 64 inches tall and weighs 85lbs. upon assessment, which manifestations should the nurse recognize are consistent with the admitting diagnosis?
Amenorrhea; altered body image; bradycardia; over-exercising
A nurse is admitting a patient who has multiple trauma after a MVA. Shortly after admission, her husband arrives. He is distraught and blames himself for the accident. What is an appropriate nursing response?
Tell me more about your feelings about what happened with your wife.
A nurse is counseling a patient for the management of anxiety. The patient is consistently late for appointments and ignores household chores. The patient states, "I'm just too stressed. I need to be taken care of." The nurse identifies this behavior as an example of which defense mechanism?
A patient's serum lithium is 2.0mEq/L. What is the priority action?
Notify the provider of the toxic blood level.
A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a patient taking chlorpromazine (Thorazine). What is an example of EPS?
Muscle contractions of neck; fidgeting behavior; impaired gait
A patient with schizophrenia suddenly yells, "I am the devil. I am God. Open the gate for me!" Example of an inappropriate response is:
There is no gate.
A nurse is caring for a patient with acute psychosis, being treated with haloperidol (Haldol). The nurse should suspect tardive dyskinesia as an adverse reaction when the patient exhibits:
Tongue twisting/lip smacking; facial grimacing/eye blinking; repetitive, involuntary movement
What is a therapeutic environment for a patient who is cognitively impaired?
A quiet room with personal belongings.
A patient is involuntarily admitted after attacking a neighbor. The patient can be kept in the hospital after a 72-hour hold if patient:
Is a danger to herself/others.
A nurse is caring for a patient in the ED who has been on Haldol for the past 3 months. The patient's temp is 102, BP 150/110, and the patient is tachycardic. The nurse should know that these indicate a diagnosis of:
Neuroleptic Malignant Syndrome (NMS)
A patient taking chlorpromazine is going to a family event on a sunny day. What are important teachings about side effects:
Wear a hat and long-sleeved shirt.
A patient has paranoid schizophrenia. What should be in their plan of care?
Remove medications from the bedside.
A patient with schizophrenia has been taking fluphenazine for 12 months. the nurse observes fine, fasciculating tongue movements and associates these findings with:
Early signs and symptoms of tardive dyskinesia.
A nurse is caring for a patient with schizophrenia. The prior nurse reports that the patient will let the nurse in her house only if the nurse carries a public-health-issued blue bag and wears black pants. An appropriate action is:
Arrive carrying a blue bag and wearing black pants.
A patient begins making sexual advances toward a nurse. What's an appropriate statement by the nurse?
"I'm going to leave for 1 hour and come back."
A patient with schizophrenia is experiencing a variety of hallucinations. What type of hallucination is a priority concern?
In an adolescent with anorexia, what statement is a sign of cognitive distortion?
"If I eat 1 piece of candy, I may as well eat 10."
A nurse drives up to a patient's house. The patient is schizophrenic with manic episodes. On the 5th visit, the patient is on the front porch with a shotgun in his arms. What is the appropriate action?
A bipolar patient is being discharged on lithium. Lithium toxicity can occur if:
Patient engages in strenuous exercise.
A patient has traumatic injuries after an assault. She sits quietly and calmly in the exam room. What phase is the patient in?
What are the comorbidities associated with eating disorders?
Anxiety; OCD; depression
A nurse is observing a newly licensed nurse who is giving family therapy for a patient regarding relationship concerns with his spouse. What statement by the new nurse requires intervention?
"Try to see things from your wife's point of view."
A patient has anorexia and over-exercises. What is an appropriate intervention?
Establish a contract with the patient requiring her to talk to the nurse when she feels the urge to exercise.
What is most important for a new nurse who is learning about ECT to know?
Need informed consent from the patient.
A patient who has bipolar disorder is experiencing an acute depressive episode. What medication should be ordered?
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