Psychiatric-Mental Health Nursing Review

Which characteristics suggest an individual is experiencing the prodromal phase of schizophrenia?

Displays unusual interest in numbers and specific topics, has increasingly unusual thoughts and uses words oddly, and demonstrates increasing difficulty with concentration.

Which nursing interventions are particularly well chosen for addressing a population at high risk for developing schizophrenia?

Teaching ways to cope and build resiliency, and educating about the risks of psychosis with marijuana use.

What condition must the nurse frequently assess for when providing care to a patient taking a second-generation antipsychotic?

Metabolic syndrome.

What information regarding signs and symptoms should the nurse provide to a patient prescribed a first-generation antipsychotic?

The patient should experience a reduction in hallucinations.

What characteristic presents the greatest risk for injury to others by a patient diagnosed with schizophrenia?

Paranoia.

Why do patients diagnosed with schizophrenia who suffer from anosognosia frequently refuse medication?

They believe that they are not actually ill.

A patient taking haloperidol presents stiff, mute, diaphoretic, with a blood pressure of $170/100$, pulse of $110$, and temperature of $104.2$. What are the priority nursing interventions for suspected neuroleptic malignant syndrome?

Hold his medication and contact his prescriber stat, and wipe him with a washcloth that has been wetted with cold water or alcohol.

In a patient with schizophrenia, self-medicating with excessive alcohol can represent an effort to achieve which effects?

Self-medicating for social discomfort, coping with anxiety, and enhancing mood.

What is an effective nursing response when a patient reports that "the voices are really bad today"?

Encouraging the patient to use competing auditory stimuli, such as humming or listening to music.

Which teaching points provide accurate information regarding bipolar disorder management to a patient and her support system?

Alcohol and caffeine can trigger symptom relapse; it is critical to notify the provider immediately if sleep is impaired; family understanding of management is helpful; and acute episodes of mania and depression tend to recur, requiring recognition of early symptoms.

Which statements demonstrate a patient's understanding of how to safely take newly prescribed lithium for bipolar mania?

"I have to keep reminding myself to consistently drink six 12- ounce glasses of fluid a day" and "I discussed the diuretic mu cardiologist prescribed with my psychiatric care provider."

Which early signs and symptoms of lithium toxicity should the nurse stress to a patient receiving lithium therapy?

Nausea and vomiting for no apparent reason, and shaky hands that make holding a cup difficult.

What is the initial nursing intervention when a patient calls to report a monthly lithium level of $1.7\,\text{mEq/L}$?

Instruct the patient to hold the next dose and contact the prescriber.

Which nursing interventions should be implemented when caring for a patient demonstrating manic behavior?

Provide frequent milkshakes and protein drinks, reduce the volume on the television and dim bright lights in the environment, and use a firm but calm voice to give specific, concise directions.

When emergency medical personnel respond to a home for a patient in acute mania, what are they commonly looking for and counting on the patient's desk?

Energy drink containers.

Which sleep-pattern complaint by an adolescent demonstrates a common symptom of major depressive disorder?

"I go to sleep by 11 p.m. but I’m always up by 3 a.m. and can’t go back to sleep."

Which assessment questions asked by a nurse evaluate comorbid mental health conditions associated with major depressive disorder?

"What do you do to manage anxiety?", "Do you have history of disordered eating?", and "Do you think you drink too much?"

Which nursing intervention addresses a common, critical characteristic of major depressive disorder in the older adult population?

Conducting routine suicide screenings at a senior center.

Which assessment findings support a diagnosis of disruptive mood dysregulation disorder (DMDD)?

Age of $7\,\text{years old}$ and a comorbid autism diagnosis.

For a patient diagnosed with major depressive disorder and secondary bulimia nervosa, which antidepressant is an appropriate alternative to consider?

Fluoxetine (Prozac).

When using therapeutic communication with a withdrawn, depressed patient, what is an effective method of managing silence?

Use the technique of making observations.

Which biological approach to treating depression utilizes electrodes surgically implanted into specific brain regions to stimulate underactive areas?

Deep brain stimulation.

Which statement made by a family member differentiates the onset of delirium from dementia?

"She was fine last night but this morning she was confused."

Which side effects should the nurse monitor for while caring for a patient taking donepezil (Aricept)?

Bradycardia, signs of dizziness, and reports of headache.

What underlying condition is most likely responsible when an $85\text{-year-old}$ individual abruptly presents with disheveled appearance, nonsensical words, and a strong odor of urine?

A urinary tract infection.

Since his wife's death $2\,\text{months}$ earlier, a $90\text{-year-old}$ male shows poor hygiene, reduced alertness, impaired concentration, disrupted sleep, and lack of energy, though he complies when reminded. What is the most appropriate action?