Psychiatrics - Ma'am Amee's Exam

A client with major depression tells the nurse, life isn’t worth living, I just want to die.

==“What do you mean by that statement?”==

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Why it is open ended statement that explores what the client means

An adolescent is observed to be irritable and increasingly withdrawn and getting low grades at school. He is brought to a psychiatrist for an evaluation.

Suicide

A client with mental disorder tells the nurse that I can make myself do all the things the president is doing.

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Nurse can say:

==“So what are those things you are referring to?”==

(Open ended statements)

What psychotic disorder is related to this?

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“A client with mental disorder tells the nurse that I can make myself do all the things the president is doing.”

Delusion of Grandeur (Grandoise Delusion)

A nurse at a psychiatric unit has 4 clients in the group therapy session. The nurse performs assessment during the session. ==Which out of the 4 clients is at risk of suicide?==

A bipolar client who is manic who has refused their medication because it feels good to be manic.

The nurse observes this risky behavior of a client with major depressive disorder and bipolar type 1 disorder.

Suicidal tendencies

A mental disorder encompasses by low self-interest and self pleasure.

Major depressive disorder

A client named Michael that has schizophrenia asks the nurse for medication because he is feeling nervous.

What is the nurse’s response?

“Let’s sit down for a while and let’s talk about your nervousness.”

For most nurses, the hardest part of nurse-client relationship is…

Developing an awareness of self and professional role in the relationship.

The client appears apprehensive.

Orienting the client to the environment

Linda, your client has delusion of persecution.

The priority nursing intervention is.

Establishing trust

A schizophrenic client with delusion tells the nurse, “There is a man wearing a black jacket who is coming after me.”

Which of the following would be the best response

This seemed to be troubling you

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(Nt. You can not argue with someone with delusions)

Another client with paranoid schizophrenia runs to the nurse and says, “Why are you poisoning me, I know you are working at..” As a nurse what will be your best response.

I am a nurse, you are a client in the hospital, I am not going to hurt you.

My job is that you are safe.

Which statement made by a schizophrenic patient will tell the nurse that he is at risk for self harm?

I have my sister’s voice telling me things.

Nurse Anna reviews her nursing care management about clients with bipolar 1 and major depressive disorder.

All but one best describe these two disorders.

Major depressive disorders can have mood swings.

Which statement is true about touching a client who is experiencing a feedback?

The nurse should touch the client only after recovering permission.

The nurse observes the client who is becoming increasingly upset, clenching his jaws, wringing his hands, his speech is high pitch and random.

Severe Panic attack

When assessing a client with anxiety the nurse’s question should be?

Specific and direct

The best goal with a client learning a relaxation technique.

Experience Anxiety without feeling overwhelmed.

Which of the four classes of medication is used for panic disorder low side effects?

SSRI

Best intervention of a client experiencing a panic attack.

Remain with the client.

A client with GAD (general anxiety disorder) the client states, “I have learned that I should forget my worries.”

How should the nurse evaluate that statement.

The client needs encouragement to speak worries.

The client is beginning a treatment with anti-anxiety agents.

Use of alcohol

A client with OCD is sent to the hospital due to ritualistic hand washing. The skin is red and cracked with minor bleeding.

What’s the goal of the client?

Decrease the time spent for hand washing.

Which should be an appropriate intervention for a client with OCD?

Structured schedule

Which statement of the client would indicate a positive response to the therapy?

I can tolerate anxiety caused by obsessive thinking.

The overall goal of psychiatric intervention.

Recovery from illness

When the client describes fear of leaving his apartment as well as the desire to hangout with his friends.

Ambivalence

Which of the following statements would indicate family teaching about schizophrenia had been effective?

Relief that we didn’t give our son schizophrenia

The nurse is teaching a client about clozapine. What is the teaching?

Go to the lab to get WBC (agrunolocytosis)

One of the most difficult tasks for the nurse is to develop one of these skills

Listener

Another client feels apprehensive caused by anticipation of danger. The nurse explains that’s it’s caused by

Anxiety

Nurse Ann noticed that her schizophrenia client repeats words of others

Echolalia

The best way to intervention a person with violence.

(Best way to handle clients with destructive behavior)

calm and firm

Which of the following to establish rapport and provide support to the client.

Listening to the clients concerns

The nurse learns that the client with bipolar disorder is pacing, talking random.

psychomotor agitation

Which signifies a person that is in acute mania?

flight of ideas

Best feed back to client

“I see you were sitting with others at lunch today”

Identify the serum lithium level for maintenance

0\.5-1.5

A client says to the nurse, “You are the best nurse I have ever met. I want you to remember me.”

Are thinking of suicide?

All but one describe panic disorder:

Can also go with ritualistic behavior

A disorder in which the individual displaced hypo manic and depressive but doesn’t meet MDD

Psychlothymic

Caring, most important…

Ascertain trust and rapport

A patient tells the nurse that people from Venus will take over the Earth.

“It must be terrifying for you. Can you tell me more about it?”

Two different conditions, schizophrenia and affective mood disorder

schizophrenic disorder

The nurse observed that the client is facing agitated behavior. Based on observation.

Provide safety to the client and other clients in the unit.

A client with mania begins dancing around the room, when she twirled it’s obvious she has no underwear. The nurse distracts her to get her to her room to get underwear.

Minimize the client’s embarrassment of present behavior.

What is the most common side effect of SSRI

Dizziness, dry mouth and drowsiness.

A late appearing side effect of anti-psychotic medication is tongue protrusion.

Tardive Dyskinesia

Photo kinetic sensitivity

Protective wear/sunscreen

Though ptsd and acute stress disorder the difference between the two is?

If the symptoms of ptsd occur for 3 months or more after the trauma, it is ==chronic==

The nurse is assessing a client with ptsd would expect the client to report? Except:

Wanting to sleep all the time

(They are actually hyper vigilant)

All but one could be our health education for clients with PTSD

Try to solve an important problem independently

Nursing interventions for clients with ptsd

Use of deep breathing relaxation technique

The nurse working with a client during flashback says “I know you are scared but…”

Grounding

Which intervention would be most beneficial for clients with difficulty expressing emotion.

journaling

Nurse Joan is taking care of a client with anxiety disorder.

Select one that does not apply:

Encourage the client to make choices (He is too anxious to make a good or realistic decision.)

The nurse is aware that during a panic attack her first and primary concern is:

Provide a safe environment

During a panic attack the client expressed himself to be unable to control himself. Which statement of the nurse is therapeutic?

John look around it is safe and I am here with you.

Client with panic disorder. Teach client:

Teaching the client to ignore any anxious feelings

You are working with moderate anxiety, you will be able to see.

Selective attention but can still process information

You are assigned to a client with OCD Common impulsive include:

counting steps

Your patient with BDD (body dysmorphia) preoccupied with an imagined defect and has goals for elective cosmetic surgery.

It is sought to fix the flaw

All but one nursing is experienced with OCD

Realistic thoughts

All but one, intervention of client with OCD

Interrupting the patient. (Do not interrupt)

Which of the following examples best illustrates the role of the nurse as a counselor

Clarifying reasons for admission with a client with poor reality

A client told a nurse that the music on the radio is played for him.

Ideas of reference

A client with schizophrenia. What medication for symptoms?

Atypical or second-generation antipsychotic.

Reasoning for the doctor’s response is:

(dopamine and serotonin antagonist)

Assigned to a delusional patient. What is your intervention?

Recognize client’s delusion is view of environment.

The nurse said how are you feeling today, the client said “invisible”.

“Can you explain that to me?”

Your client is so delusional that he is convinced the food is poisoned

“I have seen no evidence of that.”

While sitting with your client he says he is hearing voices:

“What are you hearing?”

Part of teaching the client and family with schizophrenia is to be aware of early signs of relapse. Select one that does not apply:

Effective management

You are now giving client and family about antipsychotics medication management.

Double dose is bad. Wait for next time.

The evaluation of schizophrenia is…

The client can carry out his daily life despite the symptoms.

Sometimes causes the clients to decrease or discontinue medication due to uncomfortable effects.

Diarrhea

Which underlying emotion is commonly seen in avoidant personality disorder?

Fear

Nurse Amy is taking care of a depressed client. What action shows that the client has an increased risk of suicide?

An improvement in mood

What would be your therapeutic response if your client with suicidal ideation tells you that “I want it to be all over”.

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“What it is you want to be specifically over?”

As a psychiatric nurse your goal in care for clients with suicidal ideation.

Select one that does not apply:

The client should be alone in their room.

Your client tells you that she has a drink very morning to call her nerves. You realize your client is at risk for:

Physical dependence

A client comes to day treatment intoxicated but says she is not. The client is experiencing:

Denial

Select one that does not apply to the myths of suicide.

Suicidal people often send out subtle and not so subtle messages of their suicide.

What is your therapeutic response when your client tells you, “I can’t stand the pain anymore?”

How do plan to end your pain?

You are taking care of a client with personality disorder. Maladaptive select on that does not apply.

Self-reliant

You are assigned to a client with substance abuse. Select one that does not apply:

Substance abuse is only alcohol (Not true)

There are many substance that can be used and abused. This type of drugs are synthetic substances may be altering medications:

Designer Drugs (club drugs)

This is an episode of ur client who is alcoholic but has no memory of his behavior:

Blackout

Treat of alcoholism 12 step in AA what is the key step that would reflect the program?

One day at a time

All but one are the drug of choice for personality disorder for aggression

SSRI

The nurses confronted to set limits with antisocial personality disorder except…

The nurse can respond angrily. (Nurse does not get mad.)

Another technique in Manipulative personality disorder what is the role of the nurse?

Remain neutral and matter of fact

PPD pervasive emotionally and attention seeking.

Histrionic Personality disorder

Joe has this personality disorder, need for admiration, grandiosity

Narcissistic Personality Disorder

Client personality disorder pervasive pattern of social discomfort, low self esteem, fearful, convinced make mistakes.

Avoidant personality disorder

Josey, has excessive need to be cared if she is clingy, obsessive and believe she cannot sustain herself without a relationship

Dependent Personality Disorder

This the synthetic opioid drug used for heroine:

Methadone (is used for withdrawal)

What are the drugs used for alcoholic withdrawal except:

Methadone

Narcissistic personality disorder

They feel they are entitled. (Entitlement)