CBRC Psychiatric Mental Health

74問 • 3年前

問題一覧

The scope of psychiatric nursing encompasses primary to tertiary level of prevention. Secondary level of prevention in mental health and psychiatric nursing encompasses all of the following except:

Assisting the community to better understand basic emotional needs

The nurse is aware that according to Erikson, a young child's increase vulnerability to anxiety in response to separation for pending separation from significant others result from failure to complete the developmental task called:

Trust

No single, universal definition of mental health exists. Generally a person’s behavior can provide clues to his or her mental health.After lecturing about the characteristics of a mentally healthy person according to Marie Jahoda, Mr. David asked his students to identify which client can be categorized as mentally healthy:

Cherrie, 21, recent passer of engineering board exam, mother of a 4 year old girl

Mang Kepweng has been diagnosed to have bipolar disorder. He is now being discriminated by the community and is labeled as "Baliw" because of his illness. This is an example of?

Hidden burden

One of the character in the video, Mr. Clay, 64, was observed to have course hand tremors, Festinating gait, and slowed body movements. Students correctly identify the cause of these signs or symptoms?

An imbalance in dopamine and acetylcholine

And emergency psychiatric client presents with amnesia, hyperthermia and unexplained loss of appetite. Accompanying family members state that the client suffered a head injury while falling from a ladder several days previously. The nurse concludes that the clients symptoms are consistent with trauma to which area of the brain?

Hypothalamus

Nurse Miriam enters Renato’s room for the first time and says, “Renato, I’m Miriam, the nurse. I’ll help you get settled.” Renato responds, “ I want another nurse. I don’t like you. Your are always mean to me.” Nurse Miriam recognizes that Renato’s response is an example of:

Transference

Under the psychoanalytic model of Freud, the ego functions include all of the following except:

Operate on the pleasure principle to reduce tension or discomfort

A newly admitted patient tells the nurse that he had a fight with his wife 2 days ago and that yesterday, on his way home from work, he decided it would be thoughtful to buy her the emerald ring she always wanted. Which defense mechanism is this patient using? a. Undoing Denial Substitution Sublimation

Undoing

Margaux was very kind to Celyn, her intelligent twin sister, but deep inside had hostile feelings towards her. Margaux is manifesting what type of ego defense mechanism?

Reaction Formation

A mental health client who experiences a brief psychotic reaction was treated as an inpatient for one week and then discharged to an outpatient day hospital program for follow-up treatment. The nurse explains to the client’s family that the outpatient treatment setting approach is based on the principle of providing:

Mental health care in the least restrictive setting possible

You ask Nurse Ramba “to whom should healthcare providers obtain the written consent of mentally ill clients? Nurse Ramba answers:

Parents or legal guardian

A voluntary client in a facility decides to leave the unit before treatment is complete. To detain the client, you refuse to return the client's personal effects. Nurse Ramba will tell you that you are committing?

False imprisonment

A client who has been admitted with a diagnosis of schizophrenia says to the nurse, “Yes, it is raining. You nurses better cook rice. For the concrete is soft and elephants are dancing at the casino.” These statements illustrate:

Loose of associations

How should the nurse respond to Juan when he states “The voices told me to do bad things.”

“What bad things are these voices telling you to do?”

A client who has been hospitalized with schizophrenia tells the nurse, “My heart has stopped and my veins have turned to glass!” The nurse recognizes this an example of:

Somatic delusions

A male client tells the nurse that he used to believe that he was God, but know he knows that this is not true. The nurse’s best response would be:

“What caused you to think you were God?”

The family of Nathan related that one day the client looked at shadow of the streetlight and thought it was a ghost. The nurse recognizes that this was:

Illusion

A client is admitted with a history of extremely elevated and irritable mood for almost a week now. Upon assessment, the nurse notes grandiosity, flight of ideas and insomnia and agitation. The nurse sets a priority short term goal: the client will demonstrate:

Adequate nutrition and rest Stability of mood

Which method would a nurse use to determine a client’s risk for suicide?

Observe client’s behavior for cues of suicide ideation

The nurse knows that sadness typically accompanies grief and depression. Which changes indicate major depressions?

Withdrawal, negative attitude, no eye contact

Which information is most essential in the initial teaching session for the family of a young adult with diagnosed with schizophrenia?

The distressing symptoms of schizophrenia can respond to treatment and medications.

Some researchers believe that an abnormally high level of dopamine may be related to the occurrence of:

Schizophrenia

Andy is pacing up and down the hall rapidly and muttering in an angry manner and had several verbal outbursts but not violent since admission. What is the initial nursing action for Andy diagnosed with paranoid type of schizophrenia?

Observe the client’s behavior and approach in a non-threatening manner.

Which of the following outcomes related to delusional perceptions of the client would the nurse establish first to a client with paranoid type of schizophrenia?

The client will demonstrate realistic interpretation of daily events in the unit.

The parents of a client with schizophrenia express feelings of responsibility and guilt for their son’s problems. How can the nurse best educate the family?

Explain the biological nature of schizophrenia.

Nurse Laika visited her client, Byron during breakfast one morning, Byron verbalized, I just want to stay in bed. I not in the mood for breakfast today.” Nurse Laika should respond initially by saying:

“Byron, it’s time for you to eat.”

In planning for the initial care for a client with acute schizophrenia, the nurse must appropriately emphasize:

Assign the same staff members to work with the client each day.

There is no cure for AD. One of the goals for treatment is to slow the progression of the disease, although it is difficult to do. Which nursing intervention is most appropriate for a client with AD who has frequent episodes of emotional ability?

Reduce environmental stimuli to redirect client’s attentions

Researchers theorize that hunger, a drop in BP after a meal (which temporarily takes away oxygen from the brain), or changes in glucose levels in the blood from eating in people with diabetes may bring on agitation and confusion. In the clients with cognitive impairment, the phenomenon of increased confusion in the early evening hours is called:

Sundown syndrome

Individuals who confabulate are generally very confident about their recollections, despite evidence contradicting its truthfulness. An 87 year-old client with dementia of the Alzheimer’s type and confabulates. The nurse understands that this client will:

Fills in memory gaps with fantasy

The most common types of cognitive problems due to are disturbances of attention, language, memory and executive function. Executive function is the ability to analyze, interpret, plan, organize, and execute complex instructions. Which if the following will the nurse use when communicating with a client with cognitive impairment?

Short words and simple sentences

Dementia is a loss of brain function that occurs with certain diseases. Alzheimer's disease (AD), is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior. Nurse Love enters the room of Lola Raquel, a client with cognitive impairment and asks what day of the week it is; the date, month and year are and where the client is. Nurse Love is attempting to assess Lola Raquel’s:

Orientation

The body does not metabolize lithium. It is completely absorbed by the gastrointestinal tract and excreted via the kidneys.Care plan for Bipolar patients in the manic phase prescribed with Lithium Carbonate should include all of the following except:

Any diuretic can be given for toxicity since lithium is excreted through the kidneys

The physician has ordered Imipramine (Tofranil), 75mg TID, for a client. An appropriate nursing action in giving this drug is to:

Provide instructions to watch out for symptoms of glaucoma.

Theories say that Endogenous Depression is caused by imbalances in serotonin and ____________. It is best treated with Anti-Depressants.When the nurse is working with patients prescribed with anti-depressants, it is crucial that the nurse informs the patients about:

Informing patients who are taking Isocarboxacid (Marplan) to refrain from eating foods such as organ meats, processed foods, avocado

Chlorpromazine (Thorazine) is classified as a _____-generation antipsychotic. Antipsychotics can also be used to manage acute manic symptoms. Mang Noli has been taking fluophenazine for 2 weeks now.He suddenly complains of muscle spasm, his neck appears twisted and his eyes appear to roll back in the sockets. The nurse anticipates to administer which of the following drug?

Benadryl IM

Antipychotics are also known as major-tranquilizers. They are most commonly used in the treatment of ____________. The psychiatric nurse is also involved in devising and evaluating health teaching plans for all the patients in the psychiatric unit. The health teaching plan for patients taking Chlorpromazine is satisfactory if it includes teaching the patient to:

“Apply sunblock when going out on a sunny day.”

Antipsychotics can be classified based on their generation (i.e. first generation, 2nd generation and 3rd generation).They can also be classified based in their __________ (i.e. high or low) Anti-psychotics can also be used to manage psychosis in patients with alzheimer’s disease. Which among the following antipsychotics is appropriate for a 73 year old patient with alzheimer’s disease who also has a history of cardiovascular disease?

Haloperidol (Haldol)

The nurse is asking a client in the psychiatric crisis unit specific questions about recent substance use. Which assessment finding could indicate to the nurse that the client is experiencing mild to moderate delirium?

Time and place disorientation

Remy is experiencing a conversion disorder “paralysis” of the legs. What is the best response by the nurse?

“Tell me what you plan to do when you return home.”

The nurse is preparing a care plan for a client experiencing hypochondriasis. What is the most appropriate nursing diagnosis for this client?

Risk for situational low self-esteem related to feelings of worthlessness

Nurse Rita is teaching a student nurse about somatoform disorders. Which of the following statements by Nurse Rita would be the most accurate in describing somatoform disorders?

Individuals experience physical symptoms without an organic cause

Which nursing diagnosis is most appropriate for a client with acute schizophrenic reaction?

Social isolation related to impaired ability to trust

A client approaches a nurse and tells her that he hears voices telling him that he’s evil and deserves to die. Which response by the nurse is most appropriate?

“I don’t hear any voices, but I understand that you do.”

What is the best nursing action to assist a client with posttraumatic stress disorder and his family to handle interpersonal conflict at home?

Have the family discuss how to change dysfunctional family patterns.

The nurse suspects a client may have posttraumatic stress disorder. It would be most important for the nurse to assess the client for which of the following?

Suicide

Which of the following nursing diagnoses would be appropriate for a client with an avoidant personality disorder?

Anxiety related to fear of criticism, disapproval and rejection

Betong, a client with paranoid personality disorder is discussing current problems with a nurse. What is the most important intervention for the nurse to implement?

Have the client clarify thoughts and beliefs about an event

The nurse is assessing a new client who was just admitted to the psychiatric unit. Which of the following assessment questions by the nurse would determine if the client has a schizotypal personality disorder? 1. “Do you feel that people often want to reject you or that they find you odd?” 2. “Does anxiety make you want to self-mutilate?” 3. “Do people of the opposite sex frequently find you attractive?” 4. “Do you feel that other people take advantage of you?” 5. “Have you ever felt like you had some special powers or some sort of magical influence over other?” 6. “Do you tend to stay by yourself, even though you would like to be with others?” 7. “Have you ever been arrested or pulled over by the police?”

1, 5 and 6

Which of the following behaviors can a nurse expect to see in a client with a personality disorder? 1. Compliance with the rules of the unit 2. Tendency to provoke interpersonal conflict 3. Inflexibility 4. Maladaptive responses to stress 5. Trouble in social and professional relationships 6. Personal boundaries are blurred

All except 1

The home health nurse is consulting with a family about making changes in their home in order to create a safe environment for a person who has Alzheimer’s disease. What is the most important information for the nurse to provide? 1. Keep all household cleaning products in a locked cabinet 2. Supervise the client when cooking or fixing a snack 3. Place all matches and cigarette lighters in a safe place 4. Install locks on places where garden equipment is kept 5. Monitor the use of stoves, ovens and heating appliances 6. Mount heat sensors or smoke detectors in each room

1, 2, 3, 4, 5

The nurse is providing care to a client with Alzheimer’s type dementia. Which nursing intervention is most important?

Control the environment by providing structure and consistent boundaries

A client who is experiencing a manic episode as been admitted to the unit. What is the most important intervention by the nurse to provide adequate nutrition for the client?

Give the client foods to be eaten while he’s active

A nurse is assigned a client with anxiety disorder. What is the most appropriate intervention by the nurse to demonstrate caring?

Verbalize concern about the client

The nurse is developing a plan of care for a client with a risk of suicide. What is the most important nursing intervention for the nurse to include?

Establishing suicide contract to ensure his safety

Susan, a client diagnosed with major depression has been admitted to an inpatient unit. Susan’s family members are upset and tell the nurse they do not understand what is wrong. What is the best response by the nurse?

Explain that depression is an illness and can be treated

A nurse is caring for a client who reports that he thinks about suicide every day. The nurse anticipates that the client’s care will include which of the following?

Intensive inpatient treatment

The nurse is developing a plan of care for a client with depression who has been admitted to the inpatient unit because of an attempted suicide. What is the priority goal for this client?

The client will seek out the nurse when feeling self-destructive

What is the nursing intervention most appropriate for an individual experiencing symptoms of depression?

Encourage the client to take a warm bath before retiring

The first nursing intervention in cases of severe level of anxiety would be to

Stay physically close to the client.

Prior to entering the classroom for the NLE, the examinee started to have feelings that he will have a difficult time answering the exam questions. While waiting for the proctor, he sits rigidly at one corner having scattered thoughts while ritualistically looking at his watch. The nurse would assess the examinee’s level of anxiety as:

Severe level

A client with generalized anxiety disorder is refusing the prescribed benzodiazepine medication. What is the most likely explanation by the client for his response?

“I want to solve my problems on my own.”

A client with panic disorder is taking Alprazolam (Xanax) 1 mg PO three times daily. The nurse understands that this medication is effective in blocking the symptoms of panic because of its specific actions on which of the following neurotransmitters?

GABA

Lola Kalimutera , 72, stage II alzheimer’s disease patient, was prescribed to take Donezepil (Aricept). The patient’s daughter asks the nurse “How long will my mama take this expensive drug before she gets cured?”. The nurse’ best answer should be?

The drug cannot cure your mother’s disease, it functions by treating or masking the symptoms

All but which of the following interventions should the nurse include in planning the care for a patient who is to undergo ECT?

Reorient the client frequently during post treatment care.

Part of the treatment for ADHD are ______________. They minimize the child’s behavioral manifestation. After searching information on the internet, the mother of Eddie H. Dee asked the nurse about the possible actions to counteract growth supression as a side-effect of Ritalin. The competent nurse correctly answers:

Give the drug except on holidays

Nurse Gela is a certified specialist in psychiatric nursing, as such he is well versed in different therapeutic modalities in Psychiatric nursing. 3. The ________________ is an environment that is structured and maintained as an ideal, dynamic setting in which to work with clients. Milieu therapy promotes personal growth and client interactions. Nurse Gela discusses therapeutic millieu with the client. As part of the milieu therapy, the client has the freedom to do which of the following?

Express feelings in a socially acceptable manner

Accoding to Reichmann, the Goal of individual therapy is to alleviate patient’s emotional difficulties in living and the elimination of symptomatology. One of Nurse Gela’s colleague is assisting clients involved in a psychotherapy to identify the the client’s problematic thoughts and work towards changing the identified thoughts in order to influence their problematic behaviors. Nurse Jlin identifies that his colleague is utilizing which framework of psychotherapy?

Cognitive-behavioral framework

Electroconvulsive therapy is use of electric shock to induce grandmal seizure. The treatment is thought to be effective if it induces a ____________ seizure. Priority nursing intervention for client’s undergoing ECT is:

Protecting the client

Cardiovascular diseases are one of the common contraindications of ECT. Several contraindications to ECT were cited when it was first introduced in 1938. Dr. Orval ordered ECT for Zeny, a patient with major depression, acutely suicidal. Referral from the obstetrician reads that she is pregnant and there is no other complication. The psychiatric nurse should:

Administer ECT as ordered

The psychiatric nurse is also responsible for providing safe and effective electroconvulsive therapy for psychiatric patients. Nurse Calma is working at the Mariveles Mental Hospital, Bataan. One of her responsibilities is to provide safe and effective electroshock therapy for the psychiatric patients. 7. _________________ known as electroshock therapy, which is a pejorative term nowadays. ECT can be used to treat clients with depression, schizophrenia, mania, and clients at risk for suicide.Zeny is undergoing ECT for the first time. Which of the following instructions is appropriate for the nurse to teach Zeny?

Refraining from food and fluids for at least 8 hours before treatment

One of the most effective treeatment for alcoholism is the utilization of ___________ therapy. A popular self help group is Alcoholics anonymous. Nurse Melvin also works with alcoholic patients. In a group therapy meeting with the alcoholics, which of the following patient statements needs no correction from nurse melvin?

“Once a person is sober, he or she remains at risk to drink alcohol”

Nurse Melvin has been working as a psychiatric and mental health nurse in Bayonne, New Jersey and he is well versed in the use of different therapies in psychiatric nursing. 5. Eating disorders include anorexia nervosa and bulimia nervosa. The most common used treatment for patient’s eating disorders is ____________ _____________. One of Nurse Melvin’s patient is Anna, 23, a patient diagnosed to have anorexia nervosa. She has shown improvement in her psychopathologic behavior. Nurse Melvin utilized behavior modification therapy to change her problematic behavior, this therapy is best exemplified by:

Giving Anna privileges which are important to her everytime she exhibits weight gain

Pathognomonic sign

Castle Aranza · 60問 · 3年前

Pathognomonic sign