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Final Exam Review Psych
Terms in this set (55)
A nurse asks a patient diagnosed with schizophrenia, "What is meant by the old saying, 'You can't judge a book by looking at the cover?'" Which response by the patient indicates concrete thinking?
"The table of contents tells what the book is about."
The nurse anticipates that the physician will order which medication for a client who is concerned about his/her recent excessive weight gain?
The health teaching for a client taking lithium will include:
Signs and symptoms of toxicity, dietary sodium issues, and frequent blood levels
When working with the client taking lithium, what should the nurse instruct the client and family to do?
Keep sodium intake stable and drink at least 8 glasses of water per day
A client is admitted to the unit with a diagnosis of mania. He is placed on lithium carbonate 300 mg PO TID. He has developed a fine tremor in both hands. The response to this is based on the knowledge that:
This is a toxic side effect of lithium and the next dose should be held
A client comes to crisis center. She is anxious, fearful, and convinced she is dying. She described having an attack of rapid heartbeat, trouble breathing, nausea, lightheadedness, and sense of impending doom while shopping in the grocery store. She states that this has happened before, but she is otherwise healthy, employed, and taking no medications. The drugs of choice for the preceding target symptoms are:
Diazepam and alprazolam
A patient diagnosed with schizophrenia approaches the nurses and says, "I'm cold. Ice cream is cold. Freezers keep ice cream cold." This speech pattern can be assessed as:
A patient has been admitted to inpatient for recent manic episodes. As the mania intensifies, the patient begins experiencing delusions, hallucinations, and dramatically disturbed thoughts. This is a clinical picture for which disorder?
Bipolar I disorder
A client who was recently started on chlorprozamine (Thorazine) began having tonic muscle spasms of the neck and shoulders. This side effect is:
Acute dystonic reaction
Which assessment findings mark the prodromal stage of schizophrenia?
Withdrawal, misinterpreting, poor concentration, and preoccupation with religion
A nurse observes a catatonic patient standing immobile, facing the wall with one arm extended in the air. The patient remains immobile in this position for 15 minutes, moving only when the nurse gently lowers the arm. What is the name of this phenomenon?
During a manic episode, a client talks about self-harm. The nurse must plan care so that the client:
Has constant supervision until the risk for suicide is ruled out
A patient being treated for severe depression shows resistance to involvement in the nurse-patient relationship by being withdrawn and unresponsive. There is also preoccupation with guilt and hopelessness. When interacting with the patient, which response would have the greatest therapeutic effect?
"Let's explore the origins of your pessimis
After one week of therapy on haloperidol (Haldol) 5mg PO, the patient begins to display worm-like movement of the mouth. What the nurse suspect this reaction is?
A patient with depression recently lost 8 pounds. After only a few bites of the meal, the patient refuses to eat more, saying, "I'm full. All that food makes me sick just to look at." The best intervention for the nurse to help increase the patient's dietary intake would be to:
Serve six, small calorie-dense meals daily
The treatment team is discussing changing the medications for a client diagnosed with anxiety disorder from diazepam to some other drug with less sedating and dependence side effects. What is the drug most likely to be chose?
A patient has been instructed to use crutches in order to rest an injured foot. At a follow-up appointment, the patient admits to beginning a walking program. A nurse can assess this behavior as evidence the patient is employing:
The nurse assesses for which common anxiety disorder among children?
Separation anxiety disorder
A community mental health nurse wants to establish a relationship with a very withdrawn patient diagnosed with schizophrenia. The patient lives at home with a supportive family. Select the nurse's best plan.
Visit the patient daily for 4 days, then every other day for 1 week; stay with the patient for 20 minutes, accept silence, state when the nurse will return.
A client has manifestations similar to those of schizophrenia, but the duration is from 1 to 6 months and social/occupational dysfunction may or may not be present. Which disorder is correct?
A patient's spouse asks the nurse, "Why are they wasting money doing all these tests on my spouse? The hallucinations make the mental illness obvious!" The best reply would be:
"Physical illness can cause psychiatric symptoms. We must be sure of what we are treating."
A patient diagnosed with schizophrenia begins to talk about "macnabs" hiding in the school. The term "macnabs" should be documented as:
Avolition, alogia, and anhedonia are considered to be what subtype of symptoms of:
A patient with severe depression and suicidal ideation has not improved after trials with SSRIs and tricyclics. Which treatment option can a nurse expect the healthcare provider will now consider?
What is the most useful strategy for helping a patient with schizophrenia prevent a potential relapse?
Teach the patient and family about behaviors that indicate impending relapse
A nurse is caring for a client who is experiencing MODERATE anxiety. Which of the following is an appropriate nursing intervention when trying to give necessary information to the client?
Demonstrate a calm manner while using simple and clear language
A patient reports that "the government has implanted a device in my head." What outcome would the nurse identify as being appropriate for the patient to achieve within 1wk of admission?
Reporting feeling less anxious about having the government listening to interior thoughts
A patient calls the community mental health center and shares, "For the past 6 months, whenever I even think about leaving my house, my heart pounds, my body shakes, and I cry and feel dizzy. There's no reason for me to feel this way, but I do." These symptoms can be assessed as being most consisted with:
Panic disorder with agoraphobia
A patient diagnosed with major depression received six ECT therapy sessions and aggressive doses of antidepressant medication. The patient owns a small business and was counseled not to make major decisions for a month. Selected the correct rationale for this counseling.
The patient may experience temporary memory impairments with ECT therapy
The purpose of a screening tool for depression is to:
Diagnose the type of depression (?)
A nurse observes a client with OCD repeatedly applying, removing, and then reapplying makeup. Repetitive behavior in a client with OCD is due to which of the following?
Attempt to reduce anxiety
A nurse is caring for a client who is experiencing a panic attack. Which oft he following is an appropriate nursing intervention?
Stay with the client, and remain quiet
A patient with a history of depression reports not feeling well rested in recent weeks. Before making the assumption that the complaint is related to depression, a nurse should investigate whether the patient has had any recent changes in:
Work schedule that affects hours of sleep
What, if any, treatment is indicated for a client experiencing neuroleptic malignant syndrome?
Withdrawal of antipsychotic medications
What effect, if any, could strenuous exercise and sweating have on the blood lithium levels of clients being treated for bipolar disorder?
Increased blood lithium level
A client receiving lithium complains of vomiting and diarrhea. The nurse notes a coarse hand tremor, slurred speech, and ataxia. Vital signs show an elevated temperature, decrease in BP, and irregular pulse. Initially the nurse would:
Hold her next scheduled dose of medication and get a blood serum level
When the nurse checks the lithium level of a client on the unit, it is 2.0 mEg/L. What would the interpretation/action by the nurse be?
The level is high. The client should be assessed for toxicity and notify the physician.
A 68 year-old being treated for depression has a history of suicide at age 29. When the patient reports feelings of uselessness related to selling the family business and retiring, the nurse should initially:
Ask the patient if is he experiencing any suicidal ideations, including any plans to hurt himself
A client is on pyschotropic medication and is exhibiting smacking, twitching of the mouth, and a "fly catcher's tongue." What is this type of reaction called?
The primary distinction between suppression and repression is that suppression is:
Conscious denial of a disturbing situation or feeling
Note that sudden improvements in one's state of depression could indicate:
Plan to commit suicide (should be watched carefully_
A nurse recognizes that her client with paranoid schizophrenia is acute disturbed and agitated. Which would be helpful in providing an appropriate environment for the assessment interview?
Providing sufficient personal space so the client's boundaries are not invaded
A 36 year-old divorced female has been diagnosed with major depression, severe with psychotic features. The nurse is completing the admission assessment in the inpatient psychiatric unit. The client talks about feeling depressed and the nurse is unable to elicit a contract for safety at this time. What is the correct intervention?
Place on one-to-one staff observation
A client develops a temperature of 104, extreme muscle rigidity, and rapid deterioration in mental status. The nurse suspects what complication of antipsychotic therapy?
Neuroleptic malignant syndrome
After 3 days of taking fluphenazine (Prolixin), a client shows inability to sit still, increased motor restlessness, fidgeting, and is pacing around the unit. What is the client experiencing?
When lithium use is contraindicated in a client with bipolar disorder, what alternate drug would be indicated?
A client is having difficulty finishing a task and is beginning to experience diaphoresis and palpitations. At what level is the client's anxiety correctly assessed?
A teenage girl had a short telephone conversation with her former boyfriend, and a few minutes later, she bursts into tears about breaking a fingernail. Which coping mechanism is she using?
Which clinical manifestation is an example of a dystonic reaction associated with the use of first-generation antipsychotic medications?
Which medication is used to treat the EPS associated with the use of antipsychotic medications?
What foods should avoided if a patient is taking MAOIs?
Foods high in tyramine such as aged cheeses, pickled/smoked fish, beer or wine
This anxiety disorder is the most common one in children
Separation anxiety disorder
Phobias are characterized by a:
Persistent, irrational fear of a specific object, activity, or situation that leads to a desire for avoidance or actual avoidance of the object, activity, or situation
Triggering situations in social anxiety disorders include:
Fear of saying something that sounds foolish in public, not being able to answer questions in a classroom, looking awkward while eating or drinking in public, or performing badly on stage
Fear of __________________ is the most common manifestation of social anxiety disorder.
This set is often in folders with...
Chapter 17-Bipolar and Related Disorders
Chapter 24 - Children & Adolescents
MH Exam #3 - Ch 23
Townsend - Chapter 24: Schizophrenia Spectrum and…
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