Psychosocial Integrity FINAL

A nurse is assessing a client who has been taking thioridazine hydrochloride for several days. The clients reports drooling, hand tremors, and rigid extremities. Which of the following actions should the nurse take?

a. reassure the client that these effects are expected

b. administer diazepam

c. encourage deep breathing and relaxation

d. administer benztropine

d. administer benztropine

A nurse is helping a client who has an anxiety disorder select a nonpharmacological stress-reduction therapy for home use. Which of the following therapies engaged the insular cortex of the brain to allow the client to focus on a single thought that is important to the client in the present moment?

a. guided imagery

b. progressive relaxation

c. cognitive reframing

d. mindfulness

d. mindfulness

A nurse is assessing a client with conduct disorder. Which of the following findings should the nurse expect?

a. fearfulness of authority figures

b. flat affect

c. preoccupation with enforcing rules

d. aggressive behavior towards others

d.

A nurse is updating the plan of care for a patient who has major depression and a new prescription for amitriptyline. Which of the following adverse effects should the nurse monitor for?

a. hypertension

b. drowsiness

c. panic attacks

d. diarrhea

b. drowsiness

What is the defense mechanism that involves unconsciously transferring unacceptable feelings, thoughts, or traits from oneself onto another person?

projection

What is the defense mechanism that results in the client's compartmentalization of undesirable personal attributes?

dissociation

What defense mechanism involves an attempt to make up for an unacceptable action?

undoing

What defense mechanism involves an attempt to focus on a strength to compensate for a perceived weakness?

compensation

What defense mechanism is taking the characteristics of another person?

identification

What defense mechanism is adopting the values and beliefs of another person?

introjection

What defense mechanism is the conversion of unacceptable drives into socially sanctioned activities?

sublimation

Adventitious Crisis

unplanned and not a part of normal everyday life. could be a natural disaster, a national disaster, or crime of violence

What are three symptoms of cocaine intoxication?

elevated body temperature, elevated BP, and dilated pupils

What is important to monitor with use of lithium therapy for bipolar disorder?

They are more likely to gain weight, they need to ensure adequate sodium intake because they are at greater risk of hyponatremia, and they should avoid the use of NSAIDS while taking lithium because it increases the risk of toxicity. The patient should also take the medication with food or milk to avoid GI upset.

A nurse is caring for a client who has schizophrenia. The client states "Aliens came into my room last night and took a sample of my blood." Which of the following responses should the nurse make?

a. Aliens do not exist

b. Has your daughter had her baby?

c. Do you mean to say that lab came in and drew your blood last night?

d. That does not sound real.

d. that does not sound real

A nurse is establishing a therapeutic relationship with a client who has hallucinations. Which of the following actions should the nurse take in the orientation phase?

a. identify the client's perception of the reason for therapy

b. ask the client to provide a detailed prescription of the hallucinations

c. assist the client with development of problem-solving skills

d. explore the client's relationships with family members

a

What is apraxia?

The inability to accomplish once known tasks

A nurse is assessing a client with major depressive disorder. Which of the following should the nurse prioritize when speaking with the client?

A. Do you have any close friends?

B. Can you describe how you feel about what's happening?

C. Have you thought about hurting yourself?

D. How are you dealing with being away from family?

C.

A nurse is providing teaching to a client who has a new prescription for amitriptyline. The nurse should teach the client that which of the following over-the-counter medications can cause cardiac dysrhythmias when taken concurrently with amitriptyline?

a. acetaminophen

b. naproxen

c. famotidine

d. pseudoephedrine

d.

A nurse is caring for a client who is receiving treatment for alcohol detoxification. Which of the following medications should the nurse expect to administer during this phase of the client's care?

a. Buprenorphine

b. Diazepam

c. Varenicline

d. Rimonabant

b. diazepam

A nurse is assessing a client who has a history of alcohol use disorder and is experiencing alcohol withdrawal. Which of the following findings should the nurse identify as a manifestation of severe alcohol withdrawal?

a. decreased appetite

b. slurred speech

c. insomnia

d. hallucinations

d

A nurse is caring for a client with alcohol use disorder who has undergone detoxification. Which of the following medications should the nurse expect the provider to prescribe to assist the client with maintaining sobriety?

a. varenicline

b. clonidine

c. buprenorphine

d. disulfiram

d.

A nurse is caring for a newly admitted patient who is experiencing alcohol withdrawal. Which of the following findings should the nurse expect?

a. bradycardia

b. increased somnolence

c. slurred speech

d. headache

d. headache

What are 5 manifestations of alcohol withdrawal?

1. tachycardia

2. restlessness

3. insomnia

4. elevated temperature

5. muscle tremors

A nurse is reviewing lab reports for a pt who is taking risperidone. The nurse should identify that which of the following results indicates a potential adverse effect to the medication?

a. elevated blood glucose

b. elevated WBC

c. decreased platelet count

d. decreased aspartate transaminase

a. elevated blood glucose

What are 5 manifestations of neuroleptic malignancy syndrome?

elevated temperature, rigidity, fluctuating blood pressures, sweating, and dysrhythmias

A nurse is assessing a client prior to administering lithium. The client began taking lithium 1 week ago for the treatment of mania. For which of the following findings should the nurse hold the dose?

a. report of nausea with frequent episodes of emesis

b. weight gain of 4 lbs since the start of treatment

c. fine hand tremors in both hands

d. serum lithium level of 1.1

a.

What is the therapeutic range of serum lithium levels?

0.6-1.2

A nurse is caring for a patient with borderline personality disorder. Which of the following manifestations would the nurse expect?

a. self-mutilation

b. submission

c. exploitation of others

reclusive behavior

a. self-mutilation

What are 5 symptoms of physical dependence on amphetamines?

excessive eating, exhaustion, depression, prolonged sleep, and a craving for more

What two things are mania characterized by?

elevated mood and increased activity

What 5 findings are present in schizophrenia?

delusions, hallucinations, alteration in speech, paranoia, and withdrawn behavior

If a patient is experiencing hallucinations and delusions, should the nurse ask what the voices are saying?

No the nurse should not, but if they are command hallucinations, they should determine if they are being told to do something to harm themselves or others

What are 4 anticipated interventions for patients with delusions/hallucinations due to schizophrenia?

Decrease environmental stimuli, encourage the client to listen to music, use reality-based interventions, and administer a prescribed atypical antipsychotic.

what is an AIMS test?

a screening tool used to monitor for adverse effects of antipsychotic medications (specifically tardive dyskinesia)

A nurse is preparing to apply wrist restraints on a client who is threatening to harm others and has not responded to less invasive interventions. Which of the following actions should the nurse take?

a. obtain a PRN prescription for restraints from the clients provider

b. visually observe the client every 10 minutes until restraints are removed

c. ensure 3 fingers can fit between the restraint and the clients wrist

d. document the client's behavior every 15 minutes while restraints are in place

d.

What are two important things to remember when having a client in restraints?

They will need to have 1:1 observation and two fingers should be able to fit between the clients wrist and the restraint

A nurse is providing teaching to a client who has a new prescription for disulfiram for the management of alcohol dependence. Which of the following dietary items should the pt avoid?

a. peppermint candy

b. pure vanilla extract

c. salt

d. chocolate

b. because it is an alcohol based product

A nurse is providing teaching to a client who has social anxiety disorder and a new prescription for paroxetine. Which of the following statements should the nurse include in the teaching?

a. you can take this medication when needed

b. the medication takes a few weeks to build up in your system

c. you should plan to take this medication for 6 months

d. relapsing after withdrawing from this medication is rare

b.

What is an overt vs a covert suicidal statement?

Overt: shown plainly, done openly (There's no point in living any more)

Covert: not completely shown, slightly more hidden (Everything will be over soon; Soon no one will have to worry about me)

What category of medications are given to help with alcohol withdrawal symptoms?

benzodiazepines

A nurse in a mental health clinic is caring for a patient who has a history of mania. Which of the following indicates that they are having a relapse?

a. weight gain

b. ritualistic behavior

c. anhedonia

d. pressure speech

d. pressured speech

What is pressured speech?

speaking as if the words are being forced out, often rapidly

A patient with anxiety disorder was recently prescribed lorazepam. Which of the following statements should the nurse include?

a. taking an antacid with the medication will decrease stomach upset

b. expect the medication to cause insomnia for the first 1-2 weeks

c. drinking caffeinated beverages decreased the effectiveness of the medication

d. increase the dosage if the effectiveness of medication decreases

c

A nurse is caring for a client who spent the past several minutes mumbling about being "doomed to die" and is now pacing in an increasingly agitated and angry manner. Which of the following actions should the nurse take first?

a. administer PRN medication for agitation

b. attempt to reduce environmental stimuli

c. request a prescription for physical restraints

d. place the client in seclusion

b

When can delirium tremens occur from alcohol withdrawal?

Within the first 72 hours of abstinence

When do withdrawal seizures typically occur after alcohol abstinence?

12-24 hours after abstinence

A nurse is reviewing the medical record of a client with a new prescription for tranylcypromine, but the client is currently still on sertraline. Both of these medications taken together increases the risk of what adverse effect?

a. increased intracranial pressure

b. serotonin syndrome

c. acute kidney injury

d. hypertensive crisis

b. serotonin syndrome

What are 5 common adverse effects of SSRIs (paroxetine)?

weight gain, insomnia, sexual dysfunction, nausea, and headaches

A nurse is caring for a pt with bipolar disorder who was recently prescribed valproic acid. Which of the following actions should the nurse take?

a. monitor the clients liver function

b. avoid giving the medication with food or milk

c. counsel the client regarding medication dependency

d. limit intake of foods containing tyramine

a. valproic acid (valproate) is hepatotoxic

Methodone is a medication for patients with a substance use disorder involving what substances?

opiates

What is confabulation?

involves filling in gaps in the memory by fabrication. they unconsciously make up responses that are inaccurate to avoid the embarrassment of memory loss

What is the word for repetition of phrases or behavior and is most often exhibited by clients under stress?

Perseveration

What is the loss of purposeful movement in the absence of motor or sensory impairment, typically the clients cannot complete once-familiar tasks called?

apraxia

What is the loss of sensory ability to recognize objects called?

agnosia, typically they cannot recognize familiar sounds or people

A nurse is assessing a client with anxiety disorder who is on a benzodiazepine. What adverse effect should the nurse monitor for?

a. seizures

b. dizziness

c. polyuria

d. insomnia

b. dizziness

What medications can be given to reduce the craving for alcohol in people with alcohol use disorder?

naltrexone, disulfiram, and acamprosate

A nurse is caring for a pt who has alcohol use disorder. Following alcohol withdrawal, which of the following medications should the nurse expect to administer to the pt during maintenance?

a. naloxone

b. methadone

c. chloradiazepoxide

d. dilsuliram

d.

A nurse is caring for a client who has schizophrenia. Which of the following statements by the client indicates that the client is displaying cognitive symptoms?

a. I just feel so hopeless

b. the government have been watching my house

c. I am unable to remember to brush my teeth

d. i no longer enjoy the activities I used to love

c

What is vegetative depression?

when someone with depression is at high risk for altered sleep

What category of medication is chlordiazepoxide? What can it help with?

it is an anxiolytic (benzodiazepine) that reduces manifestations of alcohol withdrawal and can prevent seizures and delirium tremens

A nurse is caring for a patient who was brought to the emergency department by a friend. The friend stated they inhaled a large amount of cocaine. What finding would the nurse expect?

a. depressed mood

b. hallucinations

c. bradycardia

d. severe hypotension

b; cocaine is a stimulant

What is a neologism?

Inventing word that has no real meaning except for the person

What is akathsia?

sense of inner restlessness, pacing, rocking forward and backward in a chair, and constant foot tapping

A nurse is providing teaching to a client with schizophrenia who is taking quetiapine fumarate. Which of the following blood tests should be performed periodically?

a. uric acid

b. potassium

c. glucose

d. calcium

c; antispychotic medications can cause an increase in blood sugar

A nurse is teaching a client who has a prescription for a tricyclic antidepressant. Which of the following instructions should the nurse include in her teaching?

a. take this medication within 1 hour of waking each morning

b. limit alcohol to 2 drinks per week while taking this medication

c. it can take 6 weeks to reach full therapeutic effects of this medication

d. stop taking the medication if you experience dizziness

c

A nurse is reviewing the medications of a client who has bipolar disorder and has a new prescription for lithium. Which of the following medications may be administered safely while the patient is taking lithium?

a. ibuprofen

b. valproic acid

c. haloperidol

d. hydrochlorothiazide

b; the other three will increase the risk of lithium toxicity or tardive dyskinesia

A nurse is caring for a patient with schizophrenia and is experiencing negative symptoms. Which of the following would the nurse expect?

a. hallucinations

b. impaired memory

c. social discomfort

d. dysphoria

c; hallucinations are a positive symptom, impaired memory is a cognitive symptom, and dysphoria is an affective symptom

A nurse is caring for a client who has schizophrenia. Which of the following statements would the nurse identify as a persecutory delusion?

a. a tornado is going to wipe us out in 9 days

b. my brain is dead, and my body is slowly rotting away

c. the government is after me because I know top-secret information

d. the TV is purposely playing commercials that I don't like

c;

a is a nihilistic delusion

b is a somatic delusion

d is a referential delusion

What category of medications is first choice for treatment of PTSD?

SSRIs

A nurse is caring for a client who has schizophrenia. The clients spends a great deal of time repeating rhyming syllables such as me, see, bee, tree. The nurse recognizes that the client is experiencing what positive symptom of schiozphrenia?

Clang association

What is echolalia?

Repeats other's words or phrases

A nurse is providing teaching to a patient who recently started taking chlorpromazine. What type of medication is this? What is it used to treat?

this is an antipsychotic medication that helps to treat schizophrenia

What type of medications are amitriptyline and clomipramine?

tricyclic antidepressants

What are 5 symptoms of lithium toxicity?

blurry vision, clonic twitching, ataxia, severe hypotension, and polyuria

A nurse is caring for a client who has an alcohol use disorder and is currently undergoing alcohol detoxification. Which of the following interventions should the nurse provide at this time?

a. administer substitution therapy medications

b. teach the client about physical withdrawal symptoms

c. provide the client with information about a 12 step program

d. identify the causes of the client's alcohol use disorder

a.

A nurse is providing teaching to a client who has generalized anxiety disorder and a new prescription for buspirone. Which of the following is a common adverse effect of this medication?

a. confusion

b. dizziness

c. bradycardia

d. insomnia

b

A nurse is assessing a client with generalizes anxiety disorder who is taking buspirone. Which of the following findings should the nurse identify as an adverse effect of the medication?

a. arthralgia

b. photophobia

c. xerostomia

d. bradycardia

c xerostomia (dry mouth)

What is clonidine used for? What are 4 common adverse effects?

Hypertension, ADHD; somnolence, drowsiness, fatigue, and hypotension

A nurse is assessing a client who is receiving disulfiram for alcohol aversion therapy. The client is experiencing palpitations, nausea, headache, and extreme thirst. The nurse should identify that which of the following situations is occuring?

a. the client is experiencing mild acetaldehyde syndrome

b. the client is having delirium tremens

c. the client is experiencing disulfiram toxicity

d. the client is not having a therapeutic reaction to dilsulfarim

a

A nurse is caring for a client with schizophrenia. The client states "my internal organs have turned to stone" The nurse should document this finding as which of the following types of delusions?

a. somatic

b. reference

c. persecutory

d. grandiose

a.

Should a patient with suicide have a roommate? Where should their room be placed?

Yes suicidal patients should be placed with a roommate if they are deemed safe, their room should be near the nurses station so they can be closely monitored

Should a patient with bipolar disorder and schizophrenia have roommates? Where should their rooms be placed?

these patients should NOT have roommates unless necessary.

If the patient is experiencing paranoia and mania, we want them closer to the nurses station

What does benztropine treat?

Parkinson's disease and symptoms