Mental Health Final Exam

Nurse on a care unit with anxiety disorder, phone call upset, pacing, what do you think best action would be

walk with them at gradually slower pace

PTSD question

dreams about combat, all i can see are wounded soldiers trying to grab me

SSRIs

explain antidepressants take several weeks to be affective

client who is in the manic phase of bipolar, hyperavtivity to do something to let out activity

walking with nurse in courtyard (gives nurse time to use therapeutic communication)

New client, suicidal declining to make a safety contract with you, what is the priority

monitor for safety, assign a staff member to stay with client at all times

Depressed sitting alone crying, go in and ask what is wrong, feeling down and dont want to talk

“I will sit here with you for a few minutes then”

pt. admitted recently domestic abuse incident, does not want a male nurse

arrange for a female nurse to care for him

Newly depressed pt. refusing to be in group activites, brush teeth, bathe

I will assist you in getting out of bed and getting dressed

Nurse is reviewing schedule woth client in morning, client starts to yell shut up already

let them know i dont like it when you address me in this way or tone voice

indications of depression in teenagers

persistent anger, social withdrawal, poor school performance, lack of enthusiasm, and changes in sleep or appetite

client who is hospitalized for treatment of depression

spend more time sitting with client

Major depressive disorder attempted suicide, expressing they feel they should have died, feel worthless

respond with open ended statements so they can elaborate

legal expectations client provider nurse confidentiality

provoders should warn individauls if someone threatens to harm them

client committed suicide in facility, what should staff do

identify cues in bahvior that could have warned them

Nurse caring for a client who attacked one of her friends, admitted to psychiatric unit

set behavioral limits for cleint

Nurse in acute mental facility has histrionic personaility disorder

promote appropriate behavior in group therapy sessions

pt comes to voluntary admission

still need to give informed consent forms

Manic behavior

prevent self directed violence

pt has moderate anxiety, pacing mumbling screaming end of rope cant take it anymore in front of other pt.

direct him to go into a quite area away from other patients

client recent suicide attempt

inspect clients personal belongings

priority pt

anyone who is verbally abusing another peer

know symptoms of depersonalization disorder

a persistent feeling of being detached from one's own body, thoughts, or feelings

depersonalization disorder

(has and not diagnosed= meet with psychiartrist for diagnosis)  

dissociation serves to

isolate painful events so that primary self is protected

pt with antiscoial personality curing spitting not answering questions

undestand you are angry but this behavior is not going to be tolerated

paranoid personality disorder, violent on unit

use clear calm statements and confident physiacl stance

avoidant personality disorder

desire intimacy but fears it, …… someone prefers to be alone

always maintain consistency of care to

avoid staff manipulation with who???

major depressive disorder

adhere to structure schedule limited choices of activities

priority

provide self and client with safe environemnt

nurse providing teaching about stress with client statement made to let

certain practices can increase my awareness of stress

anxiety high level

use deep breathing exercises, use slow and deep breaths using muscles

generalized anxiety disorder

a mental health condition characterized by persistent, excessive, and uncontrollable worry about daily life events for at least six months

cognitive behavioral therapy

help me figure out how to live woth the loss of my…

acute stress can last between 3 days and 1 month

????

First line treatment ptsd

sertraline

therapist

helps you face trauma ????

factitious disorder

a serious mental health condition where a person acts as if they have an illness, or causes injury, to assume the "sick role" for attention or sympathy, without external incentives

suicide plan

safety number one

secondary prevention strategies

arranging counseling sessions for family members

delusions

unshakable, false beliefs firmly held despite clear evidence to the contrary

what are things that put you at risk for lithium toxicity

dehydration (4miles outdoors) (2-3L perr day is ideal) (client who runs can become dehydrated)

adolescent reports being sexually assualted

ask client to describe what happned

client with OCD

plan schedule to allow time for rituals

if lithium level is 1

give lithium (normal=0.6-1.2) (within rnage)

pt. with OCD

decrease anxiety to a tolerable level

know some meds to treat bipolar

lithium, valporate, carbamazepine, paroxetine

pt. who is bipolar in manic phase

make sure they have a private room and quiet location on unit

pt is threatening, homicidal ideas, victim he is going to harm

need to warn victim

abuse

is mandatory reporting, any suspicions of abuse you must report immediately

client has difficulty sleeping pacing the floor

remain with client

schizophrenia hallucinations

can trigger relapse

active negativism

a behavioral symptom where an individual, often due to psychiatric conditions like catatonia or developmental stages (toddlerhood/adolescence), does the opposite of what is requested or suggested

dependant personality disorder

positive feedback when client is assertive with staff or other clients

person experiencing acute alcohol withdraw

perform neurological exam

pt. experiencing acute manifestations of withdraw alcohol

administer benzodiazepam (diazepam)

withdrawing from opioids what med do you administer

methadone

soem signs that indicate alcohol withdraw

tachycarida, vomiting, hypertension

pt. who says when i look in the mirror all i see is horrible complexion

body dismorphia

assessments require immediate follow up

HR of 50 (bradycardia), potassium level of 3.0, bp of 8-/48, body temp of 96.8

anorexia

provide them with small frequent meals, monitor daily weight, sit with client during meals and for 1 hour after, offer special privelages with weight gain

new anorexia diagnosis

will be bradycardic

clients who have anorexia

demonstrate a high interest preparing food but not eating it (searching for new recipes)

client who repeatedly says im stupid what shows progression when he says sometimes i do stupid things

progression

explore clients feelings about delusions

??

common symptoms of grief

common symptoms do not indicate mental illness

always continue professional attempts for positive working relationships

??

feel like mother doesnt want you to come back home

restate question

someones hearing voices

i know it migth seem real to you but im not hearing voices

primary prevention for suicide

helping school; children learn to manage stress and be resilient

strongest clue of impending suicide attempt

giving away personal items

client tells you they are considering suicide

bringin up feeling is a positive action on their part

highest ris for violent behavior toward others

client having????

acute mania

clear room of all other clients

outburst on unit

get them away from everyone else go somewhewre else

feelings of loss of pleasure (when used to have pleasure)

anhedonia

what illness is anxiety disorder

?? generalized anxiety disorder

family describes client as shy and lacking self confidence dont want to be around work members

avoidant personality disorder

repsect clients needs for

periods of social isolation

3 year old continuously rocks in place for 30 minutes sign of

autism

child talks all the time constant motion

adhd

signs of schizophrenia

associative loose somehting

hearing voices

what are the voices telling you

neuroleptic malignant syndrome

a rare, life-threatening neurological emergency often caused by an adverse reaction to antipsychotic (neuroleptic) medications

assess client to idnetify triggers of binge eating disorder

???

cleint with oppositional defiant disorder, running around in residnet treatmewnt, cursing at nurse

take to gym and have them do activity

oppositional defiant disorder

a childhood behavioral condition characterized by a persistent pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness lasting at least 6 months

know med is usually not prescribed for ODD, it usually

discussing behavioral strategies to use

teen run away from home 6 times, shoplifting physically abusing to mom defiant with dad

conduct disorder

client has alcohol use disorder

assist client to achieve physiological stability

denial when it comes to alcohol abuse disorder

will go to extreme lengths to hide their drinking habits

sobriety solves problems new ones may

emerge as you adjust to living without alcohol

delerium

a sudden, temporary state of acute confusion and cognitive impairment, often triggered by underlying medical issues like infection, dehydration, or drug withdrawal

delirium (question)

something careful observation and supervision ???

admitted with UTI having delirium

confusion will get better as you treat the infection