mental health final all review combined

What are examples of different types of abuse?

physical sexual emotional neglect and economic

What is conduct disorder?

• Persistent behavioral problems

• Examples:

  • Fighting

  • Rule-breaking

  • Repeated misconduct

  • Getting in trouble (school, authority)

A nurse is discussing suicide interventions. Which action is an example of SECONDARY intervention?

Perform life-saving measures during a suicide attempt

What should a nurse do when caring for a patient with suicidal thoughts?

• Place on 1:1 observation (constant monitoring)

• Remove harmful objects from environment

• Assess for plan (ask directly)

• Ensure safety at all times

A nurse is caring for 4 patients in an urgent care center. Which patient should the nurse suspect has been physically abused?

9-month-old infant with near drowning after climbing into tub and turning on hot water

depression plan of care

ensure patient safety, remove hazards, structural sleep schedule

suicide interventions

• Stay with the patient (1:1 observation)

• Do NOT leave the patient alone

• Priority = safety

Suicide / Mental Health Actions

• Focus on safest action FIRST

• Ignore distractions in answers → choose safety-based intervention

• Includes:

  • History of depression/substance use

  • Crisis situations

types of crisis

• Developmental crisis (life stages/maturation)

• Situational crisis (unexpected events)

• Adventitious crisis (traumatic/disaster events)

alcohol withdrawal

• Focus: nursing interventions

• No heavy medication focus

• Support patient through withdrawal

Conduct Disorder

acting out/physical

autism

• Routine/schedule is critical

• Do NOT disrupt routine

• Prefer same caregivers

• Use reward system (positive reinforcement)

adhd symptoms

inattention impulsivity and restlessness

Intellectual Developmental Disorder

• Expected behaviors

• Learning limitations

intellect is delayed

Grief (Kubler-Ross + Types)

Know stages:

• Denial

• Anger

• Bargaining

• Depression

• Acceptance

adaptive grief

open expression

maladaptive grief

• Denial, avoidance, not processing reality

• Example: “I’m fine, nothing is wrong”

patient wants to die dos

DO:

• Report to appropriate professionals

• Involve:

  • Psychiatric team

  • Social worker

• Provide resources

patient wants to die don'ts

• Do NOT:

  • Handle alone

  • Make decisions like involuntary hold yourself

Maladaptive vs Uncomplicated Grief

• Uncomplicated grief:

  • Normal reactions (anger, sadness)

• Maladaptive grief:

  • Not coping properly

  • Denial, dysfunction

grief stage

immediate response: denial

maladaptive grief

incorrect coping behaviors: avoidance, substance abuse, and social withdrawal

cancer

accepting the diagnosis

Being angry

uncomplicated grief

Indications of depression

feelings of worthlessness, trouble concentration, and suicidal thoughts

autism

know that the do things ritualization, like the same people, must be on a

schedule, reward system

A patient with schizophrenia asks, “What is this medication supposed to do?”
Which response should the nurse make?

“This medication will help clear your thinking.”

A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder. Which of the following instructions should the nurse include?

Wait up to 3 weeks to see the full effects of the medication.

A nurse is reinforcing teaching with a client who has a new prescription for lithium carbonate to treat bipolar disorder. The nurse should make sure the client understands that he must maintain consistency in his intake of which of the following dietary elements?

sodium

A nurse is collecting data from a client admitted to an inpatient mental health unit and has a new prescription for disulfiram. Which of the following information is most important for the nurse to obtain before administering this medication?

when client last drank alc

A nurse is caring for a client who has schizophrenia and is receiving clozapine. For which of the following findings should the nurse monitor to determine if the medication is havingla therapeutic effect?

decrease auditory hallucinations

A nurse is collecting data from a client who is taking alprazolam. For which of the following adverse effects should the nurse closely monitor?

inability to recall events

A nurse is collecting data from a client who is to begin taking alprazolam. Which of the following findings should the nurse identify is a contraindication to this medication?

alc use disorder

A nurse is reinforcing teaching with a client who has a prescription for lithium carbonate to treat bipolar disorder. Which of the following instructions should the nurse include?

wait 3 weeks for effects

A nurse is collecting data from a client who is taking chlorpromazine. Which of the following findings should the nurse identify as extrapyramidal symptoms (EPS)? (Select all that apply.)

Muscle contractions of the neck
Fidgeting behavior
Impaired gait

A nurse is reinforcing teaching with a client who has alcohol use disorder and is taking disulfiram. Which of the following statements should the nurse include in the teaching?

Avoid alcohol for 2 weeks after discontinuing the medication."

A nurse is reviewing the morning laboratory report for a client who has bipolar disorder and recently started taking lithium. The client's current lithium level is 1.2 mE/L. Which of the following actions should the nurse plan to take?

administer regular dose

A nurse is caring for a client who has schizophrenia and taking haloperidol. The nurse observes that the client has developed a stooped posture and shuffling gait. The nurse should document these findings as which of the following extrapyramidal side effects of haloperidol?

pseudoparkisonism

A nurse is caring for a client who has a prescription for alprazolam 0.25 mg PO every 8 hr PRN anxiety. For which of the following situations should the nurse administer the alprazolam?

heart is beating out of chest

A nurse is caring for a client who is taking clozapine for the treatment of schizophrenia. The nurse should monitor the client for which of the following potential adverse effects of clozapine?

dry mouth

A nurse is reinforcing discharge teaching for a client who will continue to take lithium carbonate at home to manage bipolar disorder. Which of the following instructions should the nurse include when reinforcing the teaching?

Withhold dose if having a fine hand tremor.

tardive disksenia

fuphanazine early symptoms

antipsychotic medications do what?

reduce hallucinations and delusions, but NOT mood or anxiety

A nurse is caring for a group of patients in a mental health facility.
Which patient should the nurse recommend the provider see first?

Patient taking clozapine who has a sore throat and fever

A nurse is collecting data from patients with anxiety disorders taking psychotropic medications.
Which patient has an increased risk for suicide?

Patient with OCD taking Prozac (SSRI)

ssris can increase what?

suicidal thoughts

ssris are responsible for?

sexual and emotional behaviors

A nurse is collecting data from a patient taking an antipsychotic.
Which findings should be identified as extrapyramidal symptoms (EPS)?

• muscle contraction of the neck

• impaired gait

snri can be remembered as?

flight or fight

ssri side effects?

shivering, sweating, dizziness, sexual dysfunction, and WEIGHT GAIN

ssri medications

escitalpram, altalopram, fluoxetine, paroxetine, & setasine

generic ssri med names

prozac, lexapro, celexa, pexeva, & zoloft

ssris must be what?

tapered off

stopping ssri meditations abruptly can cause

serotonin syndrome

what is serotonin syndrome?

overload of serotonin

sero. syndrome causes what?

the loss of functions and possibly organs

what can’t be taken together?

maois and ssris, leads to serotonin syndrome

snri medications

devenlatine, dudexetine, womilnacipran, & vanlafaxine

generic snri meds

pristiq, cymbalta, fatzima, & effexor XR

wait how long after to take ssris from maois

2 weeks

angranulochtosis

clozapine

quetipine is a?

antipsychotic and causes drowsiness

clozapine has?

anticholineegetic effects, causes a person to dry out, “i can’t see”

clozapine is contradicted in patients who have?

bone marrow pts

clozapine causes?

bone marrow problems and depression

haldol is used for

schizo patients (antipsychotic) causes hardive and dyskinesia

maois can have?

cottage cheese and regular bananas

lithium toxicity level?

0.6-1.2

wjat’s the rule to have while on lithium

do not restrict water, maintain sodium, and don't diet

how long does it take to check lithium

3-5 days

atypical medication

buripron, miratapizine, nafazadone, trazadone, viazadone, & vorioxtine

A nurse is collecting data from a patient whose husband died during a hurricane 1 year

ago. The patient reports having nightmares about the hurricane persistent through

blaming herself for her husband'

s death and has stopped participating in her usual

activities. The nurse should identify that the patient is experiencing which of the

following disorders ?

PTSD

speak in?

a respectful tone

bipolar when maniac has?

grandiosity

The medication they use for Bipolar disorder

Lithium

What is the best food to give to someone who is manic

High calorie high protein finger food

As part of a plan of care for a pt with BPD, the nurse reviews the day schedule with him

each morning while doing so the pt states

“Why dont u shut up already I can read it

myself cant you see

”

. Which of the following is the appropriate nursing response

I

expect you to speak to me in a civil ton

A nurse is interviewing a patient who has personality disorder. The nurse and the pt had

agreed for an interview time but the patient resisted discussing her feelings until 5

minutes prior to the end of the session and then asked for additional time. Which of the

following actions should the nurse take

End at the scheduled time and tell the patient

they can continue at the next scheduled sessio

A nurse is assisting with the admission of an older adult who is confusing. Which of the

following statements by the patient indicate that the patient may be experiencing

delirium

Her behavior changed so quickly and I wasn

't sure what happened.

A nurse is collecting data from a pt who is experiencing alcohol withdrawal delirium.

Which of the following findings should the nurse expect? Select all that appl

Visual

hallucination, paranoid delusion, trimmers

Gradual change with

BPD and schizophrenia

A nurse is assisting the charge nurse to prepare for an in service with nursing staff to

discuss substance use disorder. Which of the following should the nurse include as an

etiological factor of addicted disorder ? Select all that apply.

Low self esteem, family

history of addiction, lack of support system, poor educational resource

A nurse is collecting data from an adolescent patient that has anorexia nervosa . Which

of the following findings should the nurse expect ? Select all that apply.

Amenorrhea,

altered body image and hypokalemia

Conversion disorder?

Involuntary loss of sensory function

A nurse is collecting data from a patient that has conversion disorder. Which of the

following should the nurse expect ?

Involuntary loss of sensory function

Conversion disorder can be caused by

PTSD

Schizophrenia ?

You have to open food in front of them

A nurse is contributing to the plan of care for a patient who has paranoid schizophrenia.

Which of the following interventions should the nurse recommend to be included in the

plan of care ?

Serve food family style rather than individual plates

What should a nurse do when caring for a patient involuntarily admitted for depression?

The patient has the right to refuse medication.

is caring for a patient who has dementia when performing MSE (mental status

examination) the nurse includes which of the following? Select all that apply

ability to perform, level of consciousness, level of orientation

A nurse in a long term facility performs a MSE for a newly admitted patient who has

dementia. Which of the following data should the nurse include? Select all that apply.

grooming, long term memory, and affect

A nurse is discussing group therapy with a patient who has depressive disorder. Which

of the following benefits of group therapy should the nurse include? Select all that apply

decreasing feeling of isolation and getting support from other members

What must be determined to keep a patient in the hospital after the initial 72-hour hold?

Whether the patient is going to harm themselves or others.

If a patient has trouble following a medical regimen, what should the nurse say?

Let's work together to create a schedule.

What mechanism is demonstrated by a patient who does not remember anything after a street fight?

Dissociation.

What level of anxiety is indicated by loud and rapid speech and repeating 'I don't know why my wife left me'?

Severe anxiety.

Which pain scale should be used for a 3-month-old infant?

FLACC (infant - 7 years).

What statement indicates a need for further teaching about ECT?

My memory loss will last several minutes after treatment.

What elements should be included in a mental status examination for a patient with dementia?

Ability to perform calculations, level of consciousness, presence of suicidal thoughts, long term memory, level of orientation.

What additional data should be included in a MSE for a patient with dementia?

Grooming, long term memory, support system, affect, presence of pain.