HESI RN Mental Health Exam Prep Questions & Knowledge Review ALL ANSWERS 100% VERIFIED CORRECT GUARANTEED GRADE A+

HESI RN Mental Health Exam Prep Questions & Knowledge Review ALL ANSWERS 100% VERIFIED CORRECT GUARANTEED GRADE A+ A married male client with three children has lost his job and states that he feels useless. He is tearful, upset, and embarrassed. What is an appropriate objective of care for this client? 1. Limiting tearfulness 2. Increasing self-esteem 3. Controlling feelings of sadness 4. Promoting acceptance by others 2. Increasing self-esteem The loss of a job can precipitate negative feelings about the self and decrease self-esteem. Feelings should be expressed, not limited; attempting to decrease a client's crying often ends up worsening it. Crying is not necessarily an expression of sadness; other feelings are involved. The focus should be on the client's self-acceptance, not acceptance by others. A 44-year-old client has been unable to function since her husband asked for a divorce 2 weeks ago. She is brought to the crisis intervention center by a friend. What type of crisis is this situation? 1. Social 2. Situational 3. Maturational 4. Developmental 2. Situational Situational crises involve an unanticipated loss, such as a divorce, that is threatening to the client. Social crises involve multiple losses such as those occurring during major disasters. Maturational crises occur in response to stress experienced as one struggles with developmental tasks. Developmental (maturational) crises are associated with developmental tasks; divorce is not a developmental task. A resident in a nursing home recently immigrated to the United States from Italy. How does the nurse plan to provide emotional support? 1. By offering choices consistent with the client's heritage 2. By ensuring that the client understands American beliefs 3. By assisting the client in adjusting to the American culture 4. By correcting the client's misconceptions about appropriate health practices 1. By offering choices consistent with the client's heritage Adherence to a plan of care is enhanced by the nurse's providing choices consistent with the client's cultural beliefs and practices. The nurse's cultural or personal beliefs and biases should not influence or interfere with the implementation of appropriate care. Helping the client adjust to the American culture is not the priority at this time; care should be adapted to the client's needs and culture. The person's cultural practices should not be addressed unless they are detrimental to the person's health. A nurse should reassess an older adult client's needs and current plan of care when the client's behavior indicates the development of what symptom? 1. Confusion 2. Hypochondriasis 3. Additional complaints 4. Increased socialization 1. Confusion The development of confusion indicates that the client's ability to maintain equilibrium has not been achieved and that further disequilibrium is occurring. Hypochondriasis and additional complaints do not indicate that the plan needs to be changed unless the client's history demonstrates no prior use of these defenses. Increased socialization is a positive response to the plan of care that does not require reassessment. An injured child is brought to the emergency department by the parents. While interviewing the parents, the nurse begins to suspect child abuse. Which parental behaviors might support this conclusion? Select all that apply. 1. Demonstrating concern for the injured child 2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 4. Asking questions about the injury and the child's prognosis 5. Giving an explanation of how the injury occurred that is not consistent with the injury 2. Focusing on the child's role in sustaining the injury 3. Changing the story of how the child sustained the injury 5. Giving an explanation of how the injury occurred that is not consistent with the injury The child is often made the scapegoat in the situation; the parents blame the child because they have unrealistic expectations of the child. Discrepancies or inconsistencies in the history result from attempts to present a story that is not based in fact. Discrepancies between the parental explanation for the child's injuries and the physical findings or discrepancies in the history that each parent gives are common because the information that is being provided is not based in fact. Abusive parents usually do not ask questions about the injury or prognosis and demonstrate little or no interest in their child's well-being. A nurse is planning to teach a client about self-care. What level of anxiety will best enhance the client's learning abilities? 1. Mild 2. Panic 3. Severe 4. Moderate 1. Mild Mild anxiety motivates one to action, such as learning or making changes. Higher levels of anxiety tend to blur the individual's perceptions and interfere with functioning. Attention is severely reduced by panic. The perceptual field is greatly reduced with severe anxiety and narrowed with moderate anxiety. A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems? Select all that apply. 1. Dementia 2. Multiple losses 3. Declines in health 4. A milestone birthday 5. An injury requiring hospitalization 2. Multiple losses 3. Declines in health Depression in the older adult is most often associated with the loss of family members and friends (e.g., death, relocation) and declines in mobility, health, and income. A decline in health, particularly when associated with a chronic illness, frequently precipitates depression in older adults. Dementia is a cognitive problem. Research does not correlate the onset of depression with a milestone birthday in older adults. A traumatic injury does not precipitate the onset of depression in the older adult as often as does a chronic illness. The nurse observes biting, rocking, sucking, and lags in intellectual development in a child. She also concludes the child is suffering from sleep disorders. What could be the reason for the child's condition? 1. Physical neglect 2. Sexual abuse 3. Physical abuse 4. Emotional abuse 4. Emotional abuse The child may be neglected if the parent is having a mental illness such as psychosis. Sleep disorders, feeding disorders, biting, rocking, sucking, and lags in intellectual development are behavioral findings associated with emotional abuse. Physical neglect, sexual abuse, and physical abuse manifest in different sets of signs and symptoms. Which emotional condition may be apparent in a client with an addiction? 1. Insomnia 2. Social isolation 3. Acute confusion 4. Functional urinary incontinence 2. Social isolation Social isolation is an emotional condition that may be apparent in a client with an addiction. Insomnia, acute confusion, and functional urinary incontinence are physical, not emotional, conditions that may be apparent in clients with addiction. A client who has been battling cancer of the ovary for 7 years is admitted to the hospital in a debilitated state. The healthcare provider tells the client that she is too frail for surgery or further chemotherapy. When making rounds during the night, the nurse enters the client's room and finds her crying. Which is the most appropriate intervention by the nurse? 1. Sit down quietly next to the bed and allow her to cry. 2. Pull the curtain and leave the room to provide privacy for the client. 3. Explain to the client that her feelings are expected and they will pass with time. 4. Observe the length of time the client cries and document her difficulty accepting her impending death. 1. Sit down quietly next to the bed and allow her to cry. Sitting down quietly next to the bed and allowing her to cry demonstrates acceptance of the client's behavior and provides an opportunity for the client to verbally express feelings if desired. Pulling the curtain and leaving the room to provide privacy for the client may make the client feel that the behavior is wrong or is annoying others. Also, it abandons the client when support is needed. Explaining to the client that her feelings are expected and they will pass with time closes off communication and does not provide an opportunity for the client to talk about feelings. Also, it provides false reassurance. The length of time she cries is unimportant at this time. Assuming that she is having difficulty accepting her impending death is a conclusion without enough information. Which of these are symptoms of depression commonly observed in older adults? Select all that apply. 1. Fatigue 2. Sadness 3. Agitation 4. Increased sleep 5. Increased appetite 1. Fatigue 2. Sadness 3. Agitation Symptoms of depression that are often observed in older adults include fatigue, sadness, and agitation. Insomnia is more likely than increased sleep to occur in depressed older adults. Anorexia, rather than increased appetite, is more likely to occur in depressed older adults. A nurse is aware that after the administration of alprazolam (Xanax) is started, it is important to observe the client for side effects. What is the nurse's initial action? 1. Measuring the client's urine output 2. Examining the client's pupils daily 3. Checking the client's blood pressure 4. Monitoring the abdomen for distention 3. Checking the client's blood pressure Orthostatic hypotension is a common side effect of alprazolam (Xanax) that occurs early in therapy. Central nervous system depression is not an early side effect, but it may occur after prolonged use. An alteration in urine output is not a common side effect, but it may occur after prolonged use. Distention is not a common side effect, but distention from constipation may occur after prolonged use. A nurse is administering medications to clients on a psychiatric unit. What does the nurse identify as the reason that so many psychiatric clients are given the drug benztropine or trihexyphenidyl in conjunction with the phenothiazine-derivative neuroleptic medications? 1. They reduce postural hypotension. 2. They potentiate the effects of the neuroleptic drug. 3. They combat the extrapyramidal side effects of the neuroleptic drug. 4. They ameliorate the depression that may accompany schizophrenia. 3. They combat the extrapyramidal side effects of the neuroleptic drug. Benztropine and trihexyphenidyl control the extrapyramidal (parkinsonian) manifestations associated with the neuroleptics and are classified as antiparkinsonian drugs. These drugs do not reduce postural hypotension, nor do they potentiate phenothiazine derivatives or have an effect on depression. At night an older client with dementia sleeps very little and becomes more disoriented. How can the nurse best limit this confusion resulting from sleep deprivation? 1. Shutting the client's door during the night 2. Applying a vest restraint when the client is in bed 3. Leaving a dim light on in the client's room at night 4. Administering the client's prescribed as-needed sedative medication 3. Leaving a dim light on in the client's room at night A small light in the room may prevent misinterpretation of shadows, which can heighten fear and alter the client's perception of the environment. A disoriented and confused client should be closely observed, not isolated. Restraints are a last resort; less restrictive interventions should be used first. Sedatives should be used sparingly in older adults, because they may cause further confusion and agitation. An older client with the diagnosis of dementia of the Alzheimer type is admitted to a long-term care facility. What should the nurse keep in mind regarding confusion when planning care for this client? 1. Confusion occurs with a transfer to new surroundings. 2. Confusion will be unchanged despite reality orientation. 3. Confusion is a common finding and is expected with aging. 4. Confusion results from brain changes that make interventions futile. 1. Confusion occurs with a transfer to new surroundings. A change in environment and introduction of unfamiliar stimuli precipitate confusion in clients with dementia-type disorders; with appropriate intervention, including frequent reorientation, confusion can be reduced. Reality orientation can reduce confusion when these clients are confronted with unfamiliar surroundings. The assertions that reality orientation is ineffective, that confusion is an expected finding in aging, and that brain changes in dementia make interventions futile are all untrue. A nurse is caring for a client who is angry and agitated. What is the best approach for the nurse to use with this client? 1. Confronting the client about the behavior 2. Turning on the television to distract the client 3. Maintaining a calm, consistent approach with the client 4. Explaining to the client why the behavior is unacceptable 3. Maintaining a calm, consistent approach with the client Consistency ensures an approach that is known and less frightening than the unknown. A calming approach can decrease agitation. Confronting the client about the behavior may escalate the client's anger and agitation. Environmental stimulants should be decreased, not increased. An agitated client is not capable of comprehending logical explanations; the nurse must avoid criticisms and arguments with the client. A depressed client has been receiving venlafaxine (Effexor) 25 mg three times a day by mouth. The health care provider increases the dose to 37.5 mg three times a day by mouth. The pharmacy supplies scored 25-mg tablets of Effexor. How many tablets should the nurse administer? Record your answer using one decimal place. _________ tablets Solve the problem by using ratio and proportion. Desire 37.5 mg x tablets ------------------- = --------- Have 25 mg 1 tablet 25x = 37.5 x = 37.5 ÷ 25 x = 1.5 tablets. What is the nurse's specific responsibility when the rights of a client on a mental health unit are restricted by the use of seclusion? 1. Informing the client's family 2. Monitoring pharmacological interventions 3. Completing a denial-of-rights form and forwarding it to the administrative officer 4. Documenting both the client's behavior and the reason that specific rights were denied 4. Documenting both the client's behavior and the reason that specific rights were denied Seclusion and restraints are special procedures for dealing with aggressive acting-out behavior for the protection of the client and others; clear documentation is essential when the client's rights are restricted. Informing the client's family is not necessary because the use of seclusion or restraints is included in the general consent form that is signed on admission. Pharmacological intervention should be monitored for all clients. There is not a typical form; however, documentation is required to justify the need for seclusion or the use of restraints. Which drugs are considered neuroleptics? Select all that apply. 1. Asenapine 2. Lurasidone 3. Aripiprazole 4. Thioridazine 5. Chlorpromazine 4. Thioridazine 5. Chlorpromazine First-generation antipsychotic drugs are also known as neuroleptics. Thioridazine and chlorpromazine are neuroleptics. Asenapine, lurasidone, and aripiprazole are second-generation drugs, which are considered as atypical antipsychotic drugs. Which disorders are complications associated with alcoholism? Select all that apply. 1. Rhinitis 2. Sinusitis 3. Delirium tremens 4. Korsakoff psychosis 5. Wernicke encephalopathy 3. Delirium tremens 4. Korsakoff psychosis 5. Wernicke encephalopathy Delirium tremens, Korsakoff psychosis, and Wernicke encephalopathy are associated with alcoholism. Rhinitis and sinusitis are associated with chronic abuse of cocaine by snorting. An executive, busy at work, receives a phone call from a friend relating bad news. The woman makes a conscious effort to put this information out of her mind and continues to work at the task at hand. The next day she remembers that her friend telephoned her but is unable to recall the message. Which defense mechanism does this behavior represent? 1. Regression 2. Suppression 3. Passive aggression 4. Reaction formation 2. Suppression Suppression is the voluntary exclusion from awareness of anxiety-producing feelings, ideas, and situations. In regression, a person returns to an earlier and more comfortable developmental level. Passive aggression is the use of behaviors such as passivity, procrastination, and inefficiency that negatively affect others. Reaction formation is a conscious behavior that is the opposite of an unconscious feeling. What is the most important tool a nurse brings to the therapeutic nurse-client relationship? 1. The self and a desire to help 2. Knowledge of psychopathology 3. Advanced communication skills 4. Years of experience in psychiatric nursing 1. The self and a desire to help The nurse brings to a therapeutic relationship the understanding of self and basic principles of therapeutic communication; this is the unique aspect of the helping relationship. Knowledge of psychopathology, advanced communication skills, and years of experience in the field all support the psychotherapeutic management model, but none is the most important tool used by the nurse in a therapeutic relationship. Which addictive drug may cause the dependent user to think that he or she has the ability to fly? 1. Cocaine 2. Hallucinogens 3. Amphetamines 4. Opioid analgesics 2. Hallucinogens Hallucinogens affect various parts of the brain, altering perception and thinking; a chronic user of these drugs may think he or she has the ability to fly. Use of the other drugs has other results. Chronic overdose of cocaine may lead to cardiorespiratory distress and seizures. Amphetamines strongly stimulate the central nervous system and may induce hallucinations and paranoia. Acute opioid overdose may cause severe respiratory depression, pinpoint pupils, and stupor or coma. Two 20-year-old female clients on the psychiatric unit have become very much attached to each other and are found in bed together. They become angry and sarcastic when the nurse asks one of them to return to her own bed. How can the nurse best address this situation? 1. By asking the health care provider to transfer one of the clients to another unit 2. By limiting their privileges for several days because their behavior is undesirable 3. By adopting a matter-of-fact, nonjudgmental attitude and setting limits on the behavior 4. By supervising them carefully and separating them when possible throughout the day and always at night 3. By adopting a matter-of-fact, nonjudgmental attitude and setting limits on the behavior Everyone has the right to his or her sexual orientation and preferences, but limits must be set on acting-out behavior on a psychiatric unit. Helping clients deal with their sexuality in a more appropriate manner is more therapeutic than continuous separation by the staff. Punishment is inappropriate. A client with newly diagnosed multiple myeloma asks, "How long do you think I have to live?" What is the most appropriate response by the nurse? 1. "Let me ask your primary healthcare provider for you." 2. "I can understand why you are worried." 3. "Tell me about your concerns right now." 4. "It depends on whether the tumor has spread." 3. "Tell me about your concerns right now." The response "Tell me about your concerns right now" encourages the client to review facts and provides an opportunity to talk about feelings. The response "Let me ask your primary healthcare provider for you" suggests the nurse does not want to discuss the subject; it abdicates the nurse's responsibility to explore the issue with the client. Although it is an empathic answer, the response "I can understand why you are worried" does not encourage the client to explore feelings; it may increase anxiety. Although the statement "It depends on whether the tumor has spread" is true, the response does not encourage the client to examine feelings. A client with cancer is told by a health care provider that the cancer has metastasized to other organs and is untreatable. The client tells the nurse, "I think they made a mistake. I don't think I have cancer. I feel too good to be dying." Which stage of grief does the nurse conclude that the client is experiencing? 1. Anger 2. Denial 3. Bargaining 4. Acceptance 2. Denial The client has difficulty accepting the inevitability of death and attempts to deny the reality of it. In the anger stage the client strikes out with statements such as "Why me?" and "How could God do this to me?" The client is angry at life and is still angrier to be removed from it by death. In the bargaining stage the client attempts to bargain for more time; the reality of death is no longer denied, but the client tries to manipulate and extend the remaining time. In the acceptance stage the client accepts the inevitability of death and quietly awaits it. A client with schizophrenia is taking benztropine (Cogentin) in conjunction with an antipsychotic. The client tells a nurse, "Sometimes I forget to take the Cogentin." What should the nurse teach the client to do if this happens again? 1. Take 2 pills at the next regularly scheduled dose. 2. Notify the health care provider about the missed dose immediately. 3. Take a dose as soon as possible, up to 2 hours before the next dose. 4. Skip the dose, then take the next regularly scheduled dose 2 hours early. 3. Take a dose as soon as possible, up to 2 hours before the next dose. Taking a dose as soon as possible is the advised intervention when a dose is missed; interruption of the medication may precipitate signs of withdrawal such as anxiety and tachycardia. Taking 2 pills at the next regularly scheduled dose will provide an excessive amount of the medication at one time. Notifying the health care provider about the missed dose immediately is unnecessary. Skipping a dose is not advised if the next regularly scheduled dose is due within 2 hours. A nurse encourages a client to join a self-help group after being discharged from a mental health facility. What is the purpose of having people work in a group? 1. Support 2. Confrontation 3. Psychotherapy 4. Self-awareness 1. Support Members of a self-help group share similar experiences and can provide valuable understanding and support to one other. Although confrontation and self-awareness may occur, these are not the primary purposes of self-help groups. Self-help groups provide an opportunity for people to interact, not to engage in professional psychotherapy. A nurse is counseling a client who abuses cocaine. The nurse recognizes that this drug is representative of which drug category? 1. An opioid 2. A stimulant 3. A barbiturate 4. A hallucinogen 2. A stimulant Cocaine is classified as a stimulant. It is inhaled in its powdered form or smoked as crack; its use creates experiences similar to but more intense than those experienced with the amphetamines, and its withdrawal results in a deeper crash. Opioids and barbiturates are central nervous system depressants. Hallucinogens produce cerebral excitation that can yield a state similar to psychosis. A client who has been taking the prescribed dose of zolpidem for 5 days returns to the clinic for a follow-up visit. When interviewing the client, the nurse identifies that the medication has been effective when the client makes which statement? 1. "I have less pain." 2. "I have been sleeping better." 3. "My blood glucose is under control." 4. "My blood pressure is coming down." 2. "I have been sleeping better." Zolpidem is a sedative-hypnotic that produces central nervous system depression in the limbic, thalamic, and hypothalamic areas of the brain. Zolpidem is not an analgesic, antidiabetic, or antihypertensive medication. When communicating with a client with a psychiatric diagnosis, the nurse uses silence. How should clients feel when silence is used in therapeutic communication? 1. Unhurried to answer 2. It is their turn to talk 3. The nurse is thinking about the interaction 4. The nurse expects that further communication is unnecessary 1. Unhurried to answer Silence is a tool employed during therapeutic communication that indicates that the nurse is listening and receptive; it allows the client time to collect thoughts, gain control of emotions, or speak without hurrying. Silence should be comfortable and should not create pressure to talk. The client should feel that he or she has an opportunity to think about the interaction. The client's perception that the nurse expects that further communication is unnecessary will close communication. We have an expert-written solution to this problem! A client with the diagnosis of schizophrenia, paranoid type, has been receiving a phenothiazine drug. When the psychiatric daycare center plans a fishing trip, it will be important for the nurse to take which action? 1. Provide the client with sunscreen. 2. Caution the client to limit exertion during the trip. 3. Give the client an extra dose of medication to take after lunch. 4. Take the client's blood pressure before allowing participation in the outing. 1. Provide the client with sunscreen. Phenothiazines commonly cause a photosensitivity that can be controlled with sunscreen. Limiting activity is not a necessary precaution when phenothiazines are prescribed. The medication must be administered as prescribed. Participating in the outing should not negatively affect the client's blood pressure. A client is agitated and threatening staff and other clients with physical harm. The nurse prepares to administer the prescribed PRN haloperidol (Haldol) after other means to deescalate the behavior have failed. The prescription calls for the administration of 5 mg of haloperidol intramuscularly PRN for severely agitated/aggressive behavior. The haloperidol is available in a vial labeled "2 mg/mL." How many milliliters of solution should the nurse administer? Record your answer rounding to one decimal place. __________ mL Use ratio and proportion to solve this problem. Desire 5 mg x mL ---------------- = ------- Have 2 mg 1 mL 2x = 5 x = 5 ÷ 2 x = 2.5 mL A nurse counseling a female client on the inpatient psychiatric unit responds to a statement made by the woman by stating, "I'm confused about exactly what is upsetting you. Would you go over that again, please?" What is the nurse using? 1. Clarifying 2. Structuring 3. Confronting 4. Paraphrasing 1. Clarifying Clarifying is an attempt to better understand the message intended by the client. It is utilized to gain a clearer understanding of what another person has stated. Structuring is an attempt to create order and thereby allow a client to become aware of problems. Confronting examines a discrepancy between what a person is saying and what a person does. It requires careful attention to nonverbal communication, as well as the discrepancies between the nonverbal and verbal message. Paraphrasing allows the speaker to share how one person perceives and hears another's information. The nurse is not paraphrasing but instead is attempting to better understand the client. A nurse enters the room of an agitated, angry client to administer the prescribed antipsychotic medication. The client shouts, "Get out of here!" What is the nurse's best approach? 1. Say, "I'll be back in 15 minutes, and then we can talk." 2. Get assistance and give the medication by way of injection 3. Explain why it is necessary to comply with the practitioner's order 4. Tell the client, "You have to take the medicine that's been prescribed for you." 1. Say, "I'll be back in 15 minutes, and then we can talk." Saying, "I'll be back in 15 minutes, and then we can talk" allows the agitated, angry client time to regain self-control; telling the client that the nurse will return will decrease possible guilt feelings and implies to the client that the nurse cares enough to come back. Getting assistance and giving the medication by way of injection does not respect the client's feelings; it may decrease trust and increase feelings of anger, helplessness, and hopelessness. An agitated, angry client will not be able to accept a logical explanation. Continued insistence may provoke increased anger and further loss of control. Which medication may be used to encourage abstinence in a client with alcoholism? 1. Disulfiram 2. Lorazepam 3. Methadone 4. Chlordiazepoxide 1. Disulfiram Rehabilitation helps an alcoholic client abstain from alcohol abuse. Disulfiram is a medication that may be administered to the alcoholic client to encourage abstinence. During detoxification of alcoholic clients, lorazepam and chlordiazepoxide are used to treat tremors, nervousness, and restlessness, but they are not used to promote abstinence. Methadone is a synthetic opioid that helps suppress withdrawal symptoms in clients addicted to morphine or heroin. A client who has been attending a day treatment facility for 1 month with the diagnosis of major depression is to be discharged in a week. Because the nurse and the client are aware of this, what is the most appropriate comment by the nurse? 1. "We have just a few sessions left. I'm really pleased at your progress." 2. "Your discharge date has been set for next week. That's wonderful news." 3. "We have five sessions remaining. We need to start making plans to end our sessions." 4. "I understand that your discharge is set for next week. I'm wondering how you feel about that." 4. "I understand that your discharge is set for next week. I'm wondering how you feel about that." Plans for termination that take emotional needs into account are best made after exploration of the client's thoughts and feelings about discharge. Noting that there are just a few sessions left and expressing pleasure at the client's progress acknowledges the future termination but focuses on the nurse's, not the client's, feelings. Noting that the client's discharge date has been set for next week and calling this wonderful news acknowledges the future termination but suggests that the client should feel wonderful about the discharge, which may or may not be true. Although noting that the client and nurse have five sessions remaining and that the two need to start making plans to end the sessions acknowledges the future termination, plans for termination should be made after a discussion of the client's emotional response to the pending discharge. Which type of caregiver is the most frequent abuser of older adults? 1. Adult child 2. Spouse 3. Family friend 4. Nonrelated professional caregiver 2. Spouse Caregivers are most often the clients' spouses, and spouses are frequently the perpetrators when an older adult is the victim of abuse. A client's adult child, family friend, or nonrelated professional caregiver may perpetrate abuse as well, but this occurs less often. What drug should a nurse anticipate that the health care provider will prescribe for a client demonstrating clinical manifestations associated with an opioid overdose? 1. Naloxone 2. Methadone 3. Epinephrine 4. Amphetamine 1. Naloxone Naloxone is a narcotic antagonist that displaces opioids from receptors in the brain, thereby reversing respiratory depression. Methadone is a synthetic opioid that causes central nervous system depression; it will add to the problem of overdose. Epinephrine and amphetamine will have no effect on respiratory depression related to opioid overdose. A young female client admitted to the trauma center after being sexually assaulted continues to talk about the rape. Toward what goal should the primary nursing intervention be directed? 1. Getting her involved with a rape therapy group 2. Remaining available and supportive to limit destructive anger 3. Exploring her feelings about men to promote future relationships 4. Providing a safe environment that permits the ventilation of feelings An older adult client is talking to the nurse about his Vietnam experiences and shares that he still has flashbacks. While assessing him the nurse notes that he is jumpy and exhibits startle reactions and poor concentration. With which mental health disorder does the nurse associate these symptoms? 1. Delusions 2. Hallucinations 3. Posttraumatic stress disorder (PTSD) 4. Obsessive-compulsive disorder (OCD) 3. Posttraumatic stress disorder (PTSD) PTSD is a syndrome characterized by the development of symptoms after an extremely traumatic event. Symptoms include helplessness, flashbacks, intrusive thoughts, memories, images, emotional numbing, loss of interest, avoidance of any place that reminds the affected person of the traumatic event, poor concentration, irritability, startle reactions, jumpiness, and hypervigilance. Delusions are beliefs that guide one's interpretation of events and help make sense of disorder. Common delusions among older adults involve being poisoned, having their assets taken by their children, being held prisoner, and being deceived by a spouse or lover. Hallucinations are visual or auditory perceptions of nonexistent objects and sounds. Older adults with hearing and vision deficits may hear voices or see people who are not actually present. OCD is characterized by recurrent and persistent thoughts, impulses, and urges of ritualistic behaviors that improve the affected person's comfort level. The grieving spouse of a client who has just died says to the nurse, "We should have spent more time together. I always felt that my work came first." What should the nurse conclude that the spouse is experiencing? 1. Displaced anger 2. Feelings of guilt 3. Shame for past behavior 4. Ambivalent feelings about the spouse 2. Feelings of guilt The spouse is expressing the typical feelings of guilt associated with the death of a loved one; often there is initial guilt over what might have been. No evidence supports the displaced anger conclusion. The spouse is expressing guilt, not shame. No evidence supports the ambivalent feelings about the spouse conclusion. A 17-year-old client is found to have anorexia nervosa. The psychiatrist, in conjunction with the client and the parents, decides to institute a behavior modification program. What does the nurse recall is a major component of behavior modification? 1. Rewarding positive behavior 2. Reducing necessary restrictions 3. Deconditioning fear of weight gain 4. Reducing anxiety-producing situations 1. Rewarding positive behavior In behavior modification, positive behavior is reinforced, and negative behavior is neither reinforced nor punished. Reducing the number or complexity of necessary restrictions, deconditioning the fear of weight gain, and reducing the number of anxiety-producing situations may all be part of the program, but none is a major component. Which statement about addiction needs correction? 1. Alcoholism is an example of addiction. 2. Addiction is excessive use or abuse of a substance. 3. A person can have only a single addiction at one time. 4. Addiction can be characterized by a display of psychological disturbance 3. A person can have only a single addiction at one time. A person can have more than one addiction at the same time. The other statements are correct: Alcoholism is an example of addiction. Addiction is excessive use or abuse of a substance, and it can be characterized by a display of psychological disturbance. Which qualities are traits of an addictive personality? Select all that apply. 1. Confusion 2. Illogical thinking 3. Negative self-image 4. Feelings of insecurity 5. Low tolerance for stress 3. Negative self-image 4. Feelings of insecurity 5. Low tolerance for stress Negative self-image, feelings of insecurity, and low tolerance for stress are traits of the addictive personality. Confusion and illogical thinking are alcohol withdrawal symptoms. A client with schizophrenia is started on a regimen of chlorpromazine. After 10 days a shuffling gait, tremors, and some rigidity are apparent. Benztropine mesylate 2 mg by mouth daily is prescribed. What does the nurse remember when administering these medications together? 1. Both medications are cholinesterase inhibitors. 2. Both medications have a cholinergic-blocking action. 3. The antipsychotic effects of chlorpromazine will be decreased. 4. The synergistic effect of these medications will cause drooling. 2. Both medications have a cholinergic-blocking action. Both medications block central acetylcholine receptors. Neither medication inhibits cholinesterase; neostigmine (Prostigmin) acts in this manner. Although benztropine mesylate can cause mental confusion when given in large doses, it does not reduce the antipsychotic effect of chlorpromazine. Both medications cause dry mouth. A nurse has been assigned to work with a depressed client on a one-on-one basis. The next morning the client refuses to get out of bed, saying, "I'm too sick to be helped, and I don't want to be bothered." What is the best response by the nurse? 1. "You won't feel better unless you make the effort to get up and get dressed." 2. "I know you'll feel better again if you just make an attempt to help yourself." 3. "Everyone feels this way in the beginning as they confront their feelings. I'll sit with you." 4. "I know you don't feel like getting up, but you might feel better if you did. Let me help you get started." 4. "I know you don't feel like getting up, but you might feel better if you did. Let me help you get started." The statement "I know you don't feel like getting up, but you might feel better if you did. Let me help you get started" acknowledges the client's feelings, offers hope, and helps the client to a higher level of function. The statement "You won't feel better unless you make the effort to get up and get dressed" ignores the client's feelings and may not be true. The statement "I know you'll feel better again if you just make an attempt to help yourself" denies the client's feelings, and feeling better cannot be guaranteed. The statement "Everyone feels this way in the beginning as they confront their feelings. I'll sit with you" minimizes the client's feelings; also the client is not interested in how others feel. A client comes to the mental health clinic for a monthly intramuscular 37.5 mg fluphenazine decanoate injection. Fluphenazine decanoate is available 25 mg/mL. How many milliliters of solution should the nurse administer? Record your answer using one decimal place. __________ mL Use the "desired over have" formula of ratio and proportion. Desire 37.5 mg x mL ------------------- = ------ Have 25 mg 1 mL CONTINUED..