Psych Test 4 Test Answers – Flashcards
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A patient tells a nurse that she refuses to eat in a restaurant because she is afraid people will laugh at the way she eats. The nurse understands this behavior is associated with which condition?
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Avoidant personality disorder
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Since starting college, a client has been unrealistically worrying about his academic performance as well as his relationship with his girlfriend. He cannot sleep, commute, and concentrate because he cannot stop worrying about the numerous assignments and papers due over the course of the semester. He is irritable and on edge. Which three actions should be included in the plan of care?
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A client with OCD develops a number of washing rituals over the years. He tries to stop without success. When he is unable to complete the ritual it causes distress or anxiety. The nurse understands that the client's behavioral rituals serve to what for this person?
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perfectionism, anxiety relief
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Which statement for the treatment of panic disorder is inaccurate? In the book-what treatments are accurate for patients with panic disorder?
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cognitive- behavioral techniques, deep breathing and relaxation, and medications such as benzos, SSRI's, Tricyclics, and antihypertensives such as catapres, inderal
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In treating a client with OCD, the nurse should allow the patient ----amount of time in starting treatment ---- and then later in treatment?
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more, less
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Patient is admitted to the ER having a panic attack. The client asks the nurse if I am going crazy. What is the most appropriate nursing response?
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the nurse can let them know that the nurse is in control until the pt regains control
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After receiving treatment for panic attack what can be done about this disorder? The patient wants better information. A teaching plan was created for the patient, which is inappropriate for teaching plan for panic disorder?
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The nurse is conducting a psycho-education group about anxiety. Which teaching by the nurse is accurate about anxiety?
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deep breathing exercises, guided imagery, exercise regularly.
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A nurse therapist is using systematic desensitization to address a client's severe anxiety. How would the nurse describe the process to the client?
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the therapist progressively exposes the pt to the threatening object in a safe setting unitl the pt anxiety decreases.
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A patient with a diagnosis for OCD, folding/unfolding clothes, arranging her closet. Why is she engaging in this activity? What purpose do the rituals serve for patients with OCD?
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A nurse is caring for a client with OCD. She has been on the unit for several days; she is becoming more comfortable and beginning to interact with others. What change, if any, should the nurse make to her initial plan of care? Which nursing intervention should be utilized to decrease OCD behavior?
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When caring for a patient who is experiencing a panic attack, which two nursing interventions are most appropriate?
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provide safe enviroment and to ensure pt privacy
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A nurse is discussing treatment options with a client whose life has been negatively impacted by claustrophobia. Which two behavioral therapies are most commonly used?
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systematic desensitization, flooding (positive reframing and assertiveness training)
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A nurse is caring for a military veteran with PTSD. When planning inpatient care, which goal would be inappropriate for the client's plan of care?
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A nurse has been caring for a client with generalized anxiety disorder, the nurse should evaluate that the care has been effective when the client is able to do what?
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A nurse is caring for a client being evaluated for panic attacks. Which symptom does not support diagnosis?
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A nurse is caring for a patient with Schizophrenia; the nurse observes the client is exhibiting the following: avolution, alogia, anhedonia. Which type of schizophrenic symptoms is the patient experiencing?
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negative or soft symptoms
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A nurse is caring for 17 yo paranoid schizophrenic who has been hospitalized following a suicide attempt. The patient's parents describe the patient's condition as depression and frequently mention that the child will be going off to a wonderful college. How should the nurse analyze the behavior of the adolescent's parents? select all that apply PS vs depression
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A nurse is caring for a 25 yo with paranoid schizophrenia. The client is experiencing command hallucinations to harm others. The patient believes the voice of God told him to jump from a second floor window. The client's parents ask what causes our son to hear the voices. What is the most appropriate response by the nurse?
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it the positive or hard symtpoms of the disease causes distorted thoughts and behavior
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Which statement should a nurse recognize as accurate about schizophrenia?
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Which manifestations should a nurse assess as positive symptoms of schizophrenia?
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ambivalence, delusions, echopraxia, flight of ideas, hallucinations, ideas of reference, perserveration
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A patient hears the word-match, replies-a match, I like matches, they are the light of the world, God will light the world, let your light shine. Which term best describes this patient?
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perservation
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A schizophrenic approaches the nurse with a look of concern of his face. He asks the nurse can you hear him. It's the devil, he is telling me I'm going to hell. Which is the most appropriate response by the nurse?
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Which factor should a nurse recognize as influential in establishing a trusting relationship with a schizophrenic? What is considered most important when establishing a relationship with a schizophrenic?
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telling the pt ones name and calling the pt by name
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To effectively manage a client's hallucinations, which therapeutic nursing interventions are appropriate? Select the best answer.
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A nurse interviews a patient with delusions. Which statement does not demonstrate a delusional disorder? Be able to tell the difference between a delusion, hallucination and an illusion.
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A HCP prescribes 100mg of thorazine BID, 2 mg Cogentin PRN for Paranoid schizophrenia. Under what condition would a nurse give PRN dose of Cogentin?
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Dystonic reactions
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A 48 yo woman is admitted after trying to shoot herself in the head. Her husband reports that she seems despondent since her youngest child left for college. What is a priority intervention for this client?
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A 24 yo man recently diagnosed with bipolar disorder is brought to the hospital by the police. On the unit, he is agitated; he paces about, and speaks to unseen others (internal stimuli). His mood fluctuates from fits of laughter to outbursts of yelling. He has not slept in 3 days and has lost 12 pounds in two weeks. What is the most appropriate priority intervention for this client?
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In the initial stages of caring for a client that is experiencing acute manic episode. Which is priority nursing diagnosis? What happens during an acute manic episode?
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A nurse is performing a suicide assessment on newly admitted client. Which components is part of a suicide assessment?
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A client demonstrates manic behavior and becomes demanding and active. Which is the most appropriate nursing intervention for this patient?
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How should a nurse rank outcomes for a manic client in order of priority when planning care. The following nursing diagnosis in priority maintains nutritional status, interacts appropriately with peers, free from injury and self-harm, remains reality-oriented without psychosis.
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free from injury and self harm
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Which factor should be identified as the most important contributing factor in the diagnosis of bipolar disorder? What causes the disorder?
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A Home health nurse is caring for a client that has recently lost his wife to cancer. He is concerned about this patient as he depressed. Which statement about suicide among the elderly is most accurate? What elderly suicide risk is accurate?
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A nurse is caring for a client that has threatened suicide by hanging himself. The nurse understands that which statement regarding suicide is accurate?
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A patient is diagnosed with Bipolar type I-current episode is depressed. A psychiatrist prescribes Paxil. The client is encouraged to participate in unit activities and express her feelings. Despite all efforts the client's depression becomes profound. The medication is not effective and the client's depression is worsening. The psychiatrist obtains consent to perform ECT. What is the rationale behind this treatment for profound depression? Why is it used, only one circumstance.
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A client who has been hospitalized for mania in the past is laid off from her job. She becomes very depressed and refuses to look for another job. She stays in her room, eats very little and neglects her personal hygiene. The patient is found unconscious but still breathing with an empty bottle of sertraline/Zoloft beside her. She is admitted and stabilized in the ED. Then admitted to the psych unit, diagnosed bipolar type I-current episode depressed. Which is the priority diagnosis for this patient? She just tried to kill herself, what is the priority diagnosis?
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Risk for suicide
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A patient with a diagnosis of bipolar type I-current episode- manic. Tells the HCP she does not want to take Lithium carbonate because gained weight. She tells the HCP she will stop taking her lithium. The HCP decides to change her medication so she will be more compliant. Which medication should the nurse anticipate the HCP will choose for this client? What class of medication is lithium?
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either tegretol, depakote, neurontin, klonopin
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A nurse is caring for a client with Major Depressive Disorder; the client is also experiencing delusions. The nurse understands that this is an example of what type of MDD? What kind of features would this disorder have? Blank disorder with blank features.
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A nurse is caring for a client with MDD; the client is experiencing lack of movement and stupor. The nurse understands that this is example of which type of MDD? What kind of additional features would this patient have?
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A Patient with Antisocial Personality Disorder. The patient comes to the nurses' station at 11pm to place a call to his lawyer. The unit rules states that there are to be no phone calls placed after 9pm. He needs to speak to his lawyer about filing a divorce action immediately. Which is the most appropriate response by the nurse?
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The unit rules are no calls after 9pm
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A 34 yo with Borderline Personality Disorder is angry that the night shift staff will not let her have a cup of coffee at 3am. She brings this up at a community meeting and develops a following of clients that demands access to the kitchen at all hours. Which nursing action prevents staff splitting?
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ongoing communication is necessary to remain firm and consistent
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A BPD is admitted because of a suicide attempt, anxiety and depression. Which nursing intervention reflects the best understanding of this disorder?
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A patient's husband of 10 years has died of a heart attack. She reports he was abusive husband and controlling. She was never allowed to learn how to drive or handle the bills. The patient feels lost and helpless without him. She asks the others in group to tell her what to do. One month she has enter another relationship with a controlling man. Which personality disorder should the nurse suspect this patient has? Major hint is she feels lost and helpless.
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dependent personality disorder
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A nurse is planning care for a patient with Narcissitic personality disorder-which is not an appropriate outcome for this patient?
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A nurse is caring for a client with BPD. Which suicidal behavior should the nurse anticipate? Example of BPD engage is suicidal gestures to bring about a certain response? They are trying to get something out of this behavior.
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A patient in a day treatment program is referred by probation officer for treatment after being arrested for DUI, multiple arrests for assault, grand larceny and other serious crimes and has served two prison sentences. He is diagnosed with ASPD. Which comment should the nurse anticipate about behavior? What do you think he will say about his behavior?
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does not feel guilt
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A 27 yo client has been married and divorced four times. She is diagnosed with BPD. Which pattern should the nurse anticipate when caring for this patient? Specific criteria for borderline personality disorder.
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Which attribute is not characteristic of a patient with borderline personality disorder?
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(unstable and intense relationships, labile mood, irritablity, lack of insight, unstable self image, fear of abandomnet)
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The nurse observes a client who is becoming increasingly upset, rapidly pacing, hyperventilating, clinching his jaw, wringing his hands, his voice is high pitched and trembling he seems preoccupied with his thoughts, he is pounding his fist with the other hand. The nurse recognizes his anxiety level as? Which type of anxiety?
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severe
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When a nurse is assessing a client with anxiety, the nurse's question should be?
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During the assessment, the client tells the nurse she cannot stop worrying about her appearance and often removes old makeup and reapplies new makeup every hour or two. The nurse identifies this behavior as?
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OCD
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Which of the following statements would indicate that the family teaching about Schizophrenia has been effective teaching
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When the client describes a fear of leaving his apartment and the desire to get out and meet others it is called?
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agoraphobia
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The client that hesitates 30 seconds before responding is called?
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latency of response
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When administering an antidepressant to a particular client contemplating suicide it is most important for the nurse to? Why is assessment for suicide important?
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watch for suicidal tendencies, bc this is a side effect of the medication
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Which of the following adverse reactions would the nurse anticipate with a client taking amitryptilline
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dizziness, orthostatic hypotension, tachycardia, sedation, headache, tremor, constipation, sweating
