question

sign of anorexia

answer

amenorrhea

question

signs of bulimia

answer

tooth erasion Russell's sign= callused knuckles from self induced vomitting

question

what lab value do you expect with alcohol cardiomyopathy

answer

high CPK

question

which PD- pt needs external input to make everyday decisions

answer

dependent

question

a client that demonstrates a dedication to his job that excludes time for leisure activitites

answer

OCD

question

adheres to a rigid set of rules

answer

OCD

question

a client who has trouble starting new relationships unless he feels accepted

answer

avoidant personality disorder

question

healthy adolescnet behavior

answer

realistic self concept

question

healthy preschool behavior

answer

displays an egocentric apprach to problem solving

question

toddler healthy behavior

answer

requires literal explanations

question

who displays mistrust of others

answer

an infant

question

what should you teach parents about autism spectrum disorder

answer

language delay

question

does an autistic kid have fear of abandonment

answer

nope- a kid with separation anxiety does

question

does an autistic kid have hostile behavior

answer

no- a kid with oppositional defiant disorder does

question

what demonstrates active listening

answer

attention to body language (identifying verbal and nonverbal communication)

question

a pt is getting a new Rx of haldol- what symptom should you tell them to report

answer

shuffling gait (dry mouth and blurred vision are common- also teach the client to stay out of sun)

question

the nurse is caring for a client who has anorexia- which criteria requires hospitalization

answer

weight loss of over 30% in 6 months hypothermia- less than 96.8 K less than 3 HR less than 40

question

how often should you offer the client food in seclusion

answer

every hour also document behavior every 15-30 min

question

a nurse is planning DC teaching to a family member of a pt newly diangosed with depression= what should the nurse teach about relapse

answer

early identification of changes such as decreased social involvement is important

question

is this true= medication compliance will prevent further need for inpatient hospitalization

answer

not always

question

intoxication of _____ HR 104 BP 152/94 dilated pupils

answer

cocaine

question

intoxication of _____ constricted pupils low BP

answer

heroin

question

would a high BP and HR be common if intoxicated with inhalants

answer

nope- these are depressants

question

SE of imipramine (4)

answer

mild tachycardia (not brady) urinary retention increased appetite and wt gain tinnitus

question

signs of PTSD

answer

distressing dreams difficulty concentrating exaggerated startle response (not delusions and compulsions)

question

purpose of attending support group

answer

provide assurance that others have a similar problem

question

sign of delerium

answer

sudden onset- rapid inappropriate speeach

question

do clients with delerium have slow speech

answer

no- rapid

question

do clients with delerium have a flat affect

answer

no-appropriate

question

do they have normal moods?

answer

no- mood swings

question

can ECT increase risk of parkisnons

answer

no

question

how often does ECT happen

answer

2-3 times a week for 6 to 12 treatments so 4-6 weeks

question

should you move a pt with depression to a private room

answer

no- they are risk of self harm and isolated better to move the bipolor patient

question

what lab should you do if patient is getting risperidone

answer

glucose- can cause diabetes

question

defense mechanism of conversion

answer

uncosciously converting anxiety into physical symptoms

question

transferring feeling about illness to another less threatening situations

answer

displacement

question

client demonstrates opposite action of what she is really feelings

answer

reaction formation

question

priority goal for a client with borderline personality disorder

answer

client will refrain from self mutiliation

question

in the presence of low ____ levels renal excretion of lithium is reduced and client is at risk for toxicity

answer

NA so less than 135 is bad

question

what is tranylcypromine

answer

MAOI

question

is bologna okay to eat with MAOI

answer

no- processed meet

question

can you have avocodos

answer

no

question

can a client with MD make informed health desicions and give consent

answer

yes

question

who can not give consent

answer

kids less than 18 intoxicated- blood alcohol level of .08 client with a dose of morphine

question

what should you do to help encourage a silent group member to participate in group

answer

divide the group into pairs to discuss a topic, then summarize the discussion to the group

question

wht should you do if people try to monopolize the discussion

answer

encourage the group that everyone should have a chance to participate ask the group to share observations of other group members (dont do this for the silent patient)

question

what should you do if a patient exhibits demoralizing or negative behavior

answer

focus on the group member and emphasize their helpfullness

question

___ increases the likelyhood of family violence

answer

substance use "my son has a few drinks each night to unwind" is a sign

question

clinical findings of mild anxeity

answer

restless, irritable, nail biting, fidgeting

question

moderate anxiety

answer

tensions, palpitation, increase heart rate, sweating

question

severe anxiety

answer

trouble sleeping light headed nausea tremors sense of impending doom

question

panic

answer

hyperactive severe tremors uncoordinated impulsive behavior

question

sign that valporic acid is working

answer

less pressured speech (remember for bipolar) less insmonia less gradiose

question

a client was admitted as involuntary for substance abuse and is refusing the lorazepam- what do you do

answer

dont give it- they still have the right to refuse treatment

question

when the client maintains eye contact and leans forward

answer

shows he trusts the nurse

question

child with conduct disorder is behaving in a destructive manner- throwing things and kicking people- what is highest priority intervention 1. encourage kid to express feelings 2. promote attendance at an assertive training group 3. try relaxing breathing 4. use a therapeutic holding technique

answer

4- hold- need to maintain safety

question

to establish a trusting nurse relationship th enurse should first

answer

inform the client that her admission will be confidential (express confidentiality in the initial phase or relationships)

question

what should you do in working phase

answer

introduce clients to others in the day room assist the client to make behavioral changes determine coping strategies the client has used in the past

question

what indicates a risk for complicated grief (cmplicated when it affects daily functioning)

answer

when a client has trouble carrying on normal activities after a loss "I feel so empty without my wife, its hard to get up every morning"

question

dementia patient- useful to help orient them to reality

answer

place a large calendar on the wall

question

the tx plan is for a pt with schizo to gain autonomy from his parents. Prior to DC the nurse should plan to

answer

schedule a family conference not stress to the client that he needs to be more independent

question

in group a bipolar patient begins bragging and dominating the situation- what should the nurse do

answer

tell the client to calm down or he will dismiss him from the group

question

example of situational crisis

answer

lost a grandparent in a motor vehicle crash an unexpected even

question

adventitious crisis

answer

town hit by tornado external disaster

question

maturational crisis

answer

son leaves for college or fear of upcoming retirement natural life event

question

a nurse is developing a plan of care for a patient who exhibits anger, aggression, and violent behavior, what is the priority nursing intervention

answer

create a large personal space- this helps provide safety not use therapeutic communiciton (this only prevent escalation of agression and is a part of ongoing therapy)

question

prupose of AA

answer

to use peer support to maintain abstinence

question

client in group gets angry and yells "listening to you people is making me worse. how do you respond

answer

you sound angry and frustrated. tell us more about how you are feeling

question

what drug should you give for alcohol withdwaral

answer

chlordiazepocide (librium)- benzo

question

does the code of ethics esure the right to tx and individualized care

answer

yes

question

the duty to protect third parties requires a nurse to testify about a client

answer

no- only if she is given info regarding potential harm

question

a nurse is caring for a client with a hx of agression, the client is playing cards and throws them at other patients- what should you do

answer

ask the client how he is feeling (therapeutic cmcn) not take the cards away (this will increase aggression) explaining unit rules will not help either

question

SE of lithium that causes them to stop takin it

answer

hand tremors- prevents them from doing ADLs

question

if you overhear another nurse talking bad about a client what should you do

answer

do not confont that person directly report it to charge nurse

question

anorexic client who needs to increase oral intake- what interventions should the nurse take

answer

restrict caffiene - diuretic

question

should you increase or decrease fiber

answer

increase to prevent constipation

question

should you offer rewards for the amt of weight gained

answer

no- for the amt of calories taken in though can reward

question

should you increase daily intake to 2500 cals

answer

initial intake should not go below 1200 but 2500 may be too overwhelming (want small frequent meals)

question

a nurse in a 24 hr mental health facility is planning DC for a client with a long history of alcohol use disorder- what postdischarge activity should the nurse plan to inlcude

answer

attending a relapse prevention group several times each week like AA 12 steps

question

is buprenorphine for alcohol

answer

no- opioids- heroin

question

is methadone for alcohol

answer

no- heroin

question

a client is experiencing alcohol withdrawal delerium- which roommate is most appropriate for this patient

answer

one with depression- will allow client to rest pt with acl withdrawal needs uninterrupted rest

question

why would a hypervigilant roommate not be good

answer

this pt will not let the pt with alcohol withdrawal get the most rest he needs

question

example of the displacement defese mechanism

answer

the client critizises the nurse each med administration time (really mad about meds but taking it out on nurse)

question

what defense mechanism is (the client reports a HA each day when group therpay is scheduled)

answer

conversion

question

what defense mech (client always talks about healthy eating habbits)

answer

reaction formation

question

defense mech (the pt complains about the taste of the food)

answer

rationilization

question

good statement that shows that suicide risk has decreased

answer

"it is easier to talk about my feelings now"

question

"im relieved now that my finanical affairs are in order"

answer

more at risk when afairs are in order

question

"thank you for taking such good care of me"

answer

more at risk- people show an appreciation for loved ones when contemplating suicide

question

who is at great risk for injury when doin gADLS

answer

stage 6 alzheimers disease

question

maintenanc ephase of schizo

answer

calm and able to preform self care

question

how can you help with OCD behaviors

answer

assist the lcient to set limits of behaviors

question

should the client with OCD monitor the number of times he has obsessive thoughts

answer

no- this can be ven more time consuming

question

how should you assess spirituality

answer

discuss spiritual issues in a conversational manner not in a formal manner (this should be done by a pastor)

question

a client is taking an SSRI like paroxetine- what should you tell the client to report to you if they notive

answer

FEVER- Serotnonin syndrome not sex dysfunciton- this is normal

question

priority assessment finding for a client taking valporic acid

answer

pt has not slept in 24 hours not fine hand tremors (this is normal effect)

question

highest priority intervention for a pt with OCD

answer

help client id sources of anxiety not teach client focused relaxation techniques (good but not better that identifying sources of anxiety) could also use + reinforcement for nonritual behavior but not best

question

admitting a pt experiencing alcohol withdrawal, is nauseas, shaking, and irritable- priority interventin

answer

date and time of last drink (worst withdrawal 24-48 hrs after last drink)

question

when client is unable to openly acknowledge nd express grief

answer

disenfranchised grief

question

exxaggerated grief

answer

distorted grief

question

what do you expect with masochism

answer

fantasized being humiliated and bound recurrent, sex urges of being beaten, bound, and humiliated

question

exhibitionism

answer

exposing genitals to strangers

question

fetishism

answer

sex fantasies about non living objects

question

frotteurism

answer

urges to touch and rub against non consenting individuals

question

exaple of enmeshed boundaries

answer

children taking care of their younger siblings

question

what do you say if a pt becomes verbally abuseive

answer

i am leaving now but returning in a few minutes to see if you are calmer

question

which label worries us with clozapine

answer

WBC of 2500

question

intervention for patient with delerium

answer

permit the client daily rituals to decrease anxiety dont keep lighting dim (want to be able to see invironment) dont give too man decisions because may get frustrated

question

teach about light therapy for SAD

answer

wear sunglasses when go outside- bc light therapy can cause eye strain and sensitivity to light (dont need to increase fluids bc will not cause dehydration)

question

should you get a no suicide contract from a pt who recently attempted suicide and is angry over being admitted

answer

no- should wait til pt is no longer angry and you can develop rapport first

question

so what should you do with this patient (just attempted suicide and is angry about admission)

answer

administer adntidepressant 1 to 1 observation

question

a client says about ECT "I will be able to stop taking my antidepressants after the tx"

answer

nope= sorry need maintenacne

question

planning teaching about relapse prevention to a client who just began an outpatient substance use disorder tx program- what should you teach at the beginning

answer

simple rules and objectives or program (pt still may have cog impairment RT detix)

question

teach about resperidone

answer

1. may cause high blood sugar 2. mestrual irregularities may occur while on this med 3. you make experience dizziness while taking this med (no increase in hair or excess sexual desire)

question

how do you use simple restitution as a behavior managment technique for a child with conduct disorder

answer

make the child pick up books after he threw them all over the room

question

"Im not going to my family reunion because no one asked me to help plan it"

answer

sign of uselessness is a sign of depression

question

refer families to a grief counselor following suicide

answer

tertiary

question

work with nurse to determine students at risk for suicide

answer

primary (preventing suicide)

question

establish a telephone hotline for individuals experiencing a suicide crisis

answer

secondary

question

review suicide precautions with nursing staff

answer

secondary (involves treating a client during suicide crisis)

question

an impotant consideration in promoting client adherence to treatment regiment

answer

providing care to a clients physical health needs

question

teach about buspar

answer

dont take with grapefruit bc will intensify effects takes 3-4 weeks to work will not cause withdrawal

question

early stage of grief= denial

answer

"i think my labs got mixed up with someone elses"

question

highest priority intervention for a kid with ADHD

answer

remove unesarry stuff from childs surroundings cb greatest risk if injury to impulsive behabior not use + reinforcement when the pt gets a task done

question

behavior that indicates that the client shoul dhave restraints removed

answer

listens to nurses directions

question

sign of recovery for someone who was sexually assulted

answer

client expresses interest in intimate relationships

question

signs of depression

answer

flat affect anhedonia feeling hopeless

question

which lab value of a pt on lithium should make you hold med and call dr

answer

BUN of 45- lithium is hard on kidneys BUN normal is 6-20

question

primary prevention

answer

promoting self esteem

question

administering meds to minimize long term efects of violence

answer

secondary

question

what shoul dyou do if one pt is talking too much in group

answer

ask the clients to discuss their feelings about the monopolizing behavior

question

important teaching need for a pt on olonazpine

answer

do not drive after initial doses- will make you drowsy and dizzy

question

order the phases of the nurse client relationship

answer

1. pre-orientation= identify safety risks 2. orientation phase= set parameters 3. workin gphase= promote problem solving skills 4. summarize goals

question

secondary dementia caused by thiamine def.

answer

korsakoff's syndrome- be sure to help client with ambulation

question

first action when you witness one client with dementia slap another

answer

call team members for help do not try to go by self

question

priority action by nurse to client just admitted with bipolar

answer

provide frequent high calorie snacks

question

voluntary admission- doing initial assessment and pt says "I've lost control of everything in my life"

answer

are you having thoughts of killing yourself

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