Exam 2: Suicide Prevention, Addiction, and Anxiety Disorders

A client has been successfully treated on the psychiatric mental health unit following a suicide attempt. In preparation for discharge, the nurse should prioritize what action?

Documenting the client's psychiatric advance directive

Communicating with the pharmacy where the client will obtain prescribed medications

Ensuring that the client has created a commitment to treatment statement

Ensuring a plan is in place for the client's community-based care

D

The nurse assesses an adult client who presents with depression. Which question does the nurse include in the health history interview to determine if the client is at risk for suicide? Select all that apply.

"Were you subjected to any type of abuse when you were a child?"

"Have you experienced the loss of a job recently?"

"Do you have a history of alcohol use disorder?"

"Do you have any physical illnesses?"

"Has anyone in your family ever attempted self-harm?"

ABCDE

A client who lost a child as a result of an automobile accident by an impaired driver is seen by the nurse in an outpatient mental health clinic. The client is exhibiting signs of depression in the context of complicated grief. During the session, the nurse should recognize which of the following as a priority?

Assessing the client for suicidal ideations

Encouraging the client to become an activist in organizations such as Mothers Against Drunk Driving (MADD)

Assessing the client for feelings regarding the driver responsible for the death

Expressing condolences over the loss of the child

A

A nurse determines that a client is at imminent risk for suicide. Which priorities are most appropriate to include in the client’s plan of care? Select all that apply.

using cognitive interventions to foster hope

listening intently and nonjudgmentally

instituting strict restriction on the client’s activity

validating the client’s feelings and experience

ensuring safety

BDE

The nurse is facilitating a support group for people who have lost a family member or friend to suicide. When discussing strategies for coping with grief, which should the nurse include? Select all that apply.

writing out the events leading up to the loved one's suicide

take anti-anxiolytic medications as often as possible

completing a daily journal entry before bedtime

encourage time spent in solitude

cognitive behavioral therapy

ACE

A client with a diagnosis of depression tells the nurse that the client's mood was especially bad this morning but that the client pushed through it to attend a support group. How can the nurse best validate the client?

"You really showed that you're able to rise above your fear and anxiety."

"Many people who are battling depression find that support groups are beneficial."

"Excellent! This shows that you're nearly recovered from your depression."

"That shows an admirable level of perseverance on your part. Well done!"

D

A nurse is conducting a client interview on a psychiatric–mental health unit. Which statement made by the nurse would indicate the need for immediate intervention by the nurse manager?

“What brought you in here?”

“This is a safe place; I am here to listen.”

“Are you having current thoughts of harming yourself?”

“I will keep our conversation private.”

D

A community support group is presented virtually for persons who have lost loved ones to coronavirus disease 2019 (COVID-19) by a community health nurse as an outreach project. The nurse will present information on the negative impact COVID-19 has had. The nurse must include which statement(s)? Select all that apply.

"Now that COVID-19 is on the decline, those effected should feel better."

"The impact on family is worse than that of health care workers."

"Unpaid caregivers for adults are likely to report increased substance use disorders."

"All of those affected have multiple adverse mental and behavioral conditions."

"The full impact of COVID-19 will not be fully realized for quite some time."

CE

The parent of a suicidal adolescent is concerned that "only crazy people commit suicide." When helping the parent understand a child's suicidal behavior, the nurse would explain what?

Analysis of suicide notes reveals that most people who commit suicide are extremely unhappy.

Suicide attempts are very common in teenage children.

Fifty percent of all suicides occur as a result of major psychoses.

Suicidal tendencies are inherited.

A

A client on the psychiatric mental health unit completed suicide. A nurse who cared for the client has been experiencing insomnia and anxiety attacks since the event. What is the nurse's first action?

Take a leave of absence until the symptoms have stopped

Dialogue with a trusted colleague about these feelings

Confide in one of the psychiatrists who gives care on the unit

Interact with other clients in order to witness improvements in their condition

B

Less than ____% of high school seniors reported binge drinking.

20

Why is substance abuse a common comorbidity in individuals with mental disorders?

Some disorders are a byproduct of long-term substance use while others are predisposed due to substance abuse.

Nurses should be aware that patients who abuse substances often have ______.

A. Psychotic disorders

B. Anxiety disorders

C. Mood disorders

D. Personality disorders

A,B,C,D

What is Fetal Alcohol Syndrome (FAS) is one of the leading causes of _______.

Irreversible mental retardation

What is AUDIT?

Alcohol Use Disorders Identification Test

_______-induced amnestic disorders leads to Wernicke's encephalopathy, Korsakoff's amnestic syndrome, and Wernicke-Korsakoff syndrome.

A. Alcohol

B. Amphetamine

C. Cannabis

D. Opioids and Morphine Derivatives

E. Inhalants

F. Steroids

A

What is the drug of choice for alcoholism and narcotic dependence?

Naltrexone (Relistor)

Which substances cause euphoria, increased energy, sexual arousal, mood swings, distractibility, forgetfulness, and confusion?

A. Alcohol

B. Amphetamine

C. Cannabis

D. Opioids and Morphine Derivatives

E. Inhalants

F. Steroids

F

Which substances increase the risk for MI, stroke, blood clots, cholesterol changes, HT, depressed mood, fatigue, restlessness, loss of appetite, insomnia, reduced libido, muscle and joint pain, and severe liver problems?

A. Alcohol

B. Amphetamine

C. Cannabis

D. Opioids and Morphine Derivatives

E. Inhalants

F. Steroids

F

_______ is the name for synthetic substances related to the male sex hormones (androgens).

Anabolic steroids

During cocaine intoxication, after 10-20 minutes the individual experiences an intense letdown effect with irritability and _______.

A. Depression​

B. Anxiety​

C. Craving​

D. Mental alertness

A

Synthetic cathinones, Krokodil, and synthetic hallucinogens are chemically similar to _____.

Methamphetamines and MDMA

N-bomb (synthetic hallucinogens) are sold as substitutes for ______ or _____.

LSD, mescaline

LSD stands for _______.

d-lysergic acid diethylamide

Side effects of N-bomb are:

Seizures, heart attack, respiratory arrest, and death

_______ are examples of non-substance-related addictive disorders?

Gambling, internet, sex, food

_________ is/are used as maintenance therapy/treatment.

A. Methadone​

B. L-acetyl-alpha-methadol​

C. Naloxone​

D. Buprenorphine

A,B,D

What is the priority of care for a person with substance-related disorders?

Whether the person will be withdrawing

What is stupor?

Near unconsciousness or insensibility

MDMA falls under ______.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

A,C

Prolonged used of _______ leads may cause weight loss/malnutrition and susceptibility to infectious diseases.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

A

Prolonged used of _______ can lead to "flashbacks," HPPD, and organic brain syndromes with recurrent psychotic behavior which can last up to 6 months after not using the drug.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

D

Prolonged used of _______ can lead to numerous psychiatric hospitalizations and police arrests.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

D

Prolonged used of _______ can lead to criminal behavior to get money for drugs.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

E

Prolonged used of _______ can lead to risk of infection related to needle use (HIV, endocarditis, hepatitis, abscesses).

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

E

Prolonged used of _______ can lead to hepatic/renal failure.

A. Stimulants

B. Cannabis

C. Hallucinogens

D. PCP

E. Opioid

F. Inhalants

F

Withdrawal symptoms of _______ include: abdominal cramps, rhinorrhea, watery eyes, dilated pupils, yawning, "goose flesh," diaphoresis, nausea, diarrhea, anorexia, insomnia, fever

A. Alcohol/Inhalants

B. Stimulants

C. Hallucinogens

D. Opioids

E. Nicotine

F. Caffeine

D

Withdrawal symptoms of _______ include: mood changes (e.g., craving, anxiety) and physiologic changes (e.g., poor concentration, sleep disturbances, headaches, gastric distress, and increased appetite)

A. Alcohol/Inhalants

B. Stimulants

C. Hallucinogens

D. Opioids

E. Nicotine

F. Caffeine

E

Withdrawal symptoms of _______ include: headache, drowsiness, fatigue, craving, impaired psychomotor performance, difficulty concentrating, yawning, nausea

A. Alcohol/Inhalants

B. Stimulants

C. Hallucinogens

D. Opioids

E. Nicotine

F. Caffeine

F

HPPD could be triggered by the use of ______.

Hallucinogens or psychedelics

Suicide is the second leading cause of death among those aged ___________.

10 to 34

Suicide is the fourth leading cause of death among those aged ___________.

35 to 54

A nurse is engaged in case finding. Which activity would be involved?

A. Identifying those at risk

B. Assessing for suicidal ideation

C. Ascertaining for a suicide plan

D. Determining the severity of the intent

A

A nurse is engaged in risk assessment. Which activity would be involved?

A. Identifying those at risk

B. Assessing for suicidal ideation

C. Ascertaining for a suicide plan

D. Determining the severity of the intent

B,C,D

________ is the uncomfortable feeling of apprehension or dread in response to internal or external stimuli.

Anxiety

Which anxiety disorder is the extreme, overwhelming form of anxiety often experienced when an individual is placed in a real or perceived life-threatening situation?

A. Panic disorder

B. Generalized anxiety disorder (GAD)

C. Phobias

A

Which anxiety disorder has a moderately high lifetime prevalence in the general population?

A. Panic disorder

B. Generalized anxiety disorder (GAD)

C. Phobias

A

Which anxiety disorder is associated with being female, middle aged, of low socioeconomic status, widowed, separated, or divorced?

A. Panic disorder

B. Generalized anxiety disorder (GAD)

C. Phobias

A

Which anxiety disorder is related to the HPA Axis that activates stress hormones (ex: cortisol)

A. Panic disorder

B. Generalized anxiety disorder (GAD)

C. Phobias

A

If there is too much GABA, it increases the risk of _________.

Seizures

Panic is considered abnormal regardless of the situation and degree of threat.

A. True

B. False

B

Panic symptoms in early adolescence predict high risk for late adolescent ________ and ________.

Depression, suicide ideation

Which anxiety disorder is characterized by excessive worry and anxiety (apprehensive expectation) for at least 6 months.

A. Panic disorder

B. Generalized anxiety disorder (GAD)

C. Phobias

B

Which agent would a nurse least likely expect to administer to a patient experiencing panic disorder? ​

A. Fluoxetine​

B. Sertraline ​

C. Imipramine​

D. Buspirone

D

Which agent(s) is/are used to treat a patient experienced generalized anxiety disorder? ​

A. Fluoxetine​

B. Sertraline ​

C. Imipramine​

D. Buspirone

D