NUR 2459 Rasmussen Mental Health Exam 2. Questions & Correct Answers. Graded A+. 100%

NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 1 / 59 usion, a le cramping 1. B. Dilated pupils: A nurse in an emergency department is assessing a client for suspected cocaine intoxication.Which of the following findings should the nurse expect? A. Nystagmus B. Dilated pupils C. Hypersomnia D. Depression Mod 4 post quiz 2. A. "The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss.": A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make? A. "The main side effects are temporary, and may include mild conf headache, and short-term memory loss." B. "Most clients have no adverse effects to this treatment, but musc may result from the induced seizure." C. "Some clients have been known to have a myocardial infarction, but we will monitor your spouse closely to be certain this does not happen." D. "The most common side effects are directly related to the use of anesthesia." Mod 4 post quiz 3. C. "I don't see any bugs, but you seem very frightened.": A nurse is caring for a client who has a history of alcohol use disorder and has been hospitalized for detoxification.The nurse enters the room and finds the client shouting in a terrified voice, "Get these bugs off of me!" Which of the following responses by the nurse is appropriate? A. "I'm sure that the bugs you see will not harm you." B. "Tell me more about the bugs that you see in your room." C. "I don't see any bugs, but you seem very frightened." D. "I do not see anything. This is part of the withdrawal process." Mod 4 post quizNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 2 / 59 4. B. Slowed breathing: A nurse is teaching a community education course about the physical complications related to substance use disorder. Which of the following findings should the nurse include in the discussion as a health risk of heroin use? A. Acute pancreatitis B. Slowed breathing C. Nasal septum perforation D. Permanent short-term memory loss Mod 4 post quiz 5. B. Personal history of alcohol use disorder.: A nurse is collecting a health history on a client who has a diagnosis of Wernicke-Korsakoff syndrome. Which of the following is an expected finding? A. Family history of Alzheimer's disease. B. Personal history of alcohol use disorder. C. Undergoing current treatment for HIV. D. Current rehabilitation for opiate addiction Mod 4 post quiz 6. A. Methadone: A nurse is caring for a client who is withdrawing from opioids. Which of the following medications should the nurse prepare to administer? A. Methadone B. Disulfiram C. Risperidone D. Lithium carbonate Mod 4 post quiz 7. A. Tremors: A nurse is assessing a client who is experiencing acute cocaine toxicity. Which of the following findings should the nurse expect? A. Tremors B. Hypothermia C. Hypotension D. Respiratory depression Mod 4 post quizNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 3 / 59 e family 8. D. Talk the client through tasks one step at a time.: A nurse on a long-term care unit is creating a plan of care for a client who has Alzheimer's disease. Which of the following interventions should the nurse include in the plan? A. Rotate assignment of daily caregivers. B. Provide an activity schedule that changes from day to day. C. Limit time for the client to perform activities. D.Talk the client through tasks one step at a time. Mod 4 post quiz 9. D. Forgetfulness gradually progressing to disorientation: A community health nurse is providing teaching to the family of a client who has primary dementia. Which of the following manifestations should the nurse tell th to expect? A. Decreased auditory and visual acuity B. Decreased display of emotions C. Personality traits that are opposite of original traits D. Forgetfulness gradually progressing to disorientation Mod 4 post quiz 10. A. Grooming B. Long-term memory D. Affect: A nurse is performing a mental status examination (MSE) on a client who has a new diagnosis of dementia. Which of the following components should the nurse include? (Select all that apply.) A. Grooming B. Long-term memory C. Support systems D. Affect E. Presence of pain Mod 4 post quiz 11. A. Dysrhythmias: A nurse is caring for a client who has severe manifestations of schizophrenia and is medicated PRN for agitation with haloperidol. The nurse should assess the client for which of the following adverse effects?NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 4 / 59 you." g, and muscle ect? A. Dysrhythmias B. Cataracts C. Pancreatitis D. Bleeding Mod 5 post quiz 12. B.Tongue thrusting and lip smacking D. Facial grimacing and eye blinking E. Involuntary pelvic rocking and hip thrusting movements: A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol. The nurse should suspect that the client may be experiencing tardive dyskinesia when the client exhibits which of the following? (Select all that apply.) A. Urinary retention and constipation B. Tongue thrusting and lip smacking C. Fine hand tremors and pill rolling D. Facial grimacing and eye blinking E. Involuntary pelvic rocking and hip thrusting movements Mod 5 post quiz 13. B. "You seem to be having very frightening thoughts.": A nurse is caring for a client who has schizophrenia and tells the nurse, "They lie about me all the time and they are trying to poison my food." Which of the following statements should the nurse make? A. "You are mistaken. Nobody is lying about you or trying to poison B. "You seem to be having very frightening thoughts." C. "Why do you think you are being lied about and poisoned?" D. "Who is lying about you and trying to poison you?" Mod 5 post quiz 14. B. Neuroleptic malignant syndrome: A nurse in an emergency department is assessing a client who has been taking haloperidol for 3 months.The client has a temperature of 39.5° C (103.4° F), blood pressure of 150/110 mm H rigidity. Which of the following complications should the nurse susp A. Agranulocytosis B. Neuroleptic malignant syndromeNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 5 / 59 he following usion, a le cramping treats which C. Akathisia D.Tardive dyskinesia Mod 5 post quiz 15. C. Ideas of reference: A nurse is conducting a group therapy session for several clients. The group is laughing at a joke one of the clients told, when a client who is schizophrenic jumps up and runs out of the room yelling, "You are all making fun of me!" The nurse should identify this behavior as which of t characteristics of schizophrenia? A. Magical thinking B. Delusions of grandeur C. Ideas of reference D. Looseness of association Mod 5 post quiz 16. A. "The main side effects are temporary, and may include mild confusion, a headache, and short-term memory loss.": A nurse is caring for a client who has major depressive disorder and is scheduled for electroconvulsive therapy (ECT). The client's spouse asks the nurse about the possible side effects of the ECT. Which of the following responses should the nurse make? A. "The main side effects are temporary, and may include mild conf headache, and short-term memory loss." B. "Most clients have no adverse effects to this treatment, but musc may result from the induced seizure." C. "Some clients have been known to have a myocardial infarction, but we will monitor your spouse closely to be certain this does not happen." D. "The most common side effects are directly related to the use of anesthesia." Mod 5 post quiz 17. B. Vegetative depression: A nurse is teaching about electroconvulsive therapy (ECT) with a newly licensed nurse. The nurse should identify that the newly licensed nurse understands the teaching when she states that ECT of the following disorders? A. Narcotic addiction B. Vegetative depressionNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 6 / 59 C. Personality disorder D. Eating disorder Mod 5 post quiz 18. A. Affective flattening: A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom? A. Affective flattening B. Bizarre behavior C. Illogicality D. Somatic delusions Mod 5 post quiz 19. C. Command hallucination: A nurse is caring for a client who has schizophrenia and is experiencing a variety of hallucinations. Which of the following hallucinations is the priority for the nurse to address? A. Visual hallucination B. Gustatory hallucination C. Command hallucination D.Tactile hallucination Mod 5 post quiz 20. A. Seizures B. Illusions C. Tremors: A nurse is teaching a newly-admitted client about the possible physical effects of alcohol withdrawal. Which of the following manifestations should the nurse include in the teaching? (Select all that apply.) A. Seizures B. Illusions C. Tremors D. Polyphagia E. Nystagmus Mod 5 post quizNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 7 / 59 t's talk about ophrenia is s 21. A. "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way.": A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following statements should the nurse make? A. "You said that you feel guilty about your daughter's diagnosis. Le what is causing you to feel this way." B. "You should not feel guilty about your daughter's diagnosis. Schiz unpreventable." C. "I'm sure your daughter's diagnosis is very difficult to deal with, but everything will be all right once she receives the proper treatment." D."Your provider has explained the causes of schizophrenia.Why do you feel guilty about your daughter's diagnosis?" Mod 5 post quiz 22. A. A private room in a quiet location on the unit: A nurse is admitting a client who is in the manic phase of bipolar disorder. The nurse should plan to make which of the following room assignments for the client? A. A private room in a quiet location on the unit B. A semi-private room with a roommate who has a similar diagnosi C. A private room close to the nursing station D. A seclusion room until the client's activity level becomes more subdued. Mod 6 post quiz 23. A. The client runs 4 miles outdoors every afternoon.: A nurse is providing discharge teaching to a client who has bipolar disorder and will be discharged with a prescription for lithium. The nurse should teach the client that which of the following factors puts her at risk for lithium toxicity? A. The client runs 4 miles outdoors every afternoon. B. The client drinks 2 liters of liquids daily. C. The client eats 2 to 3 gm of sodium-containing foods daily. D.The client eats foods high in tyramine Mod 6 post quizNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 8 / 59 our." cy." 24. B. Explain that antidepressants often take several weeks to be fully effective.: A nurse is caring for a client who has major depressive disorder and was prescribed citalopram 2 weeks ago with a planned dosage increase 1 week ago. The client reports having an improved appetite, but still feels very depressed and is still having trouble sleeping. Which of the following actions should the nurse take? A. Speak to the provider about adding an MAOI to the current medication regimen. B. Explain that antidepressants often take several weeks to be fully effective. C. Tell the client that the provider will need to change citalopram to a different medication. D. Recommend a sleep study be done on the client Mod 6 post quiz 25. D. "You must be very upset about something.": A nurse who works in a psychiatric unit is caring for a client who has bipolar disorder. The client comes to the nurse's station at 0300 demanding that the nurse call the provider immediately. Which of the following responses by the nurse is appropriate? A. "You are being unreasonable, and I will not call your doctor at this h B. "Go back to your room, and I'll try to get in touch with your doctor." C. "I can't call a doctor in the middle of the night unless it's an emergen D. "You must be very upset about something." Mod 6 post quiz 26. C. "I see you have done some grooming today.": A nurse caring for a client who has depression observes the client comes to breakfast freshly bathed, wearing clean clothes, and with combed and styled hair. Which of the following responses by the nurse is therapeutic? A. "Everyone feels better after showering." B. "You must be getting better.You look great!" C. "I see you have done some grooming today." D. "Why are you all dressed up today? Is it a special occasion?" Mod 6 post quiz 27. A. Experiencing diarrhea: A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescriptionNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 9 / 59 ith others. for lithium. The nurse's discharge teaching should include information cautioning against which of the following factors that may cause lithium toxicity? A. Experiencing diarrhea B. Exercising moderately C. Increasing sodium intake D. Drinking green tea Mod 6 post quiz 28. C. Determine the client's need for assistance with grooming.: A nurse is planning care for a client newly admitted with major depressive disorder. Which of the following actions should the nurse plan to take? A. Ask the client to create her own schedule of daily activities. B. Teach the client to use passive communication when interacting w C. Determine the client's need for assistance with grooming. D. Limit the client's involvement in unit activities. Mod 6 post quiz 29. C. Liver function tests must be monitored.: A nurse is caring for a client who has bipolar disorder and a new prescription for valproate. Which of the following instructions should the nurse give the client about the use of this medication? A. Thyroid function tests should be performed every 6 months. B. A pretreatment electroencephalogram (EEG) will be done. C. Liver function tests must be monitored. D. High serum sodium levels can cause toxic levels of valproate. Mod 6 post quiz 30. A. "I will assist you in getting out of bed and getting dressed.": A nurse is caring for a client who is depressed and refuses to participate in group therapy or perform activities of daily living. Which of the following statements should the nurse make to the client? A. "I will assist you in getting out of bed and getting dressed." B. "You can remain in bed until you feel well enough to join the group." C. "The unit rules state that you may not remain in bed." D. "If you don't participate in your care, you will not get better."NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 10 / 59 rse expect? onal decline in nd psychologg and behavMod 6 post quiz 31. A. Irritability C. Insomnia D. Low self-esteem F. Chronic pain: A nurse is caring for an adolescent who is experiencing indications of depression. Which of the following findings should the nu (Select all that apply.) A. Irritability B. Euphoria C. Insomnia D. Low self-esteem F. Chronic pain Mod 6 post quiz 32. D. "You've been feeling that your life has no meaning.": A nurse is caring for a client who has major depressive disorder and attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." Which of the following responses should the nurse make? A. "You have a great deal to live for." B. "It's not unusual for depressed people to feel that way." C. "Why do you feel you are worthless?" D. "You've been feeling that your life has no meaning." Mod 6 post quiz 33. dementia: is a mental disorder involving a functi multiple cognitive areas, including memory, along with behavioral a ical symptoms Mod 4 Lesson Content 34. an overabundance of plaques and tangles that no longer allow short-term and long-term memory to occur.They also effect problem solvin ior.: What structural changes in the body contribute to dementia? Mod 4 Lesson ContentNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 11 / 59 eginning to e used to ed, becomome comwith the 36. Alzheimer's Disease: most common form of dementia Ch 22 37. Stage I: Name this stage of Alzheimer's *No apparent symptoms* - There is no apparent decline in memory despite changes that are b occur in the brain. A positron emission tomography (PET) scan can b detect these changes. Mod 4 Lesson Content Ch 22 38. Stage II: Name this stage of Alzheimer's *Forgetfulness/Very Mild Changes* - Losses in short term memory are frequent. The individual begins to lose things or forget names of people. - The individual is aware of the intellectual decline and may feel asham ing anxious and depressed, which in turn may worsen the symptoms. - Maintaining organization with lists and a structured routine provides s pensation. - These symptoms often are not noticed by others and do not interfere individual's ability to work or live independently. Mod 4 Lesson Content Ch 22 39. Stage III: Name this stage of Alzheimer's *Mild cognitive decline* - In this stage, there is interference with performance, and this becomes noticeable to others. There is difficulty recalling names or words. A downturn is *noticeable to family and close associates.* - The individual may get lost when driving his or her car. 35. Impaired memory Self-care deficit: Typical nursing diagnoses for dementia J.A. prerecorded lectureNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 12 / 59 his or her s shopping news events. elatives. in knowledge - Concentration may be interrupted. There is difficulty recalling names which becomes noticeable to family and close associates. - A decline occurs in the ability to plan or organize. Mod 4 Lesson Content Ch 22 40. Stage IV: Name this stage of Alzheimer's *Mild to Moderate cognitive decline* - The individual may forget significant events in history, experience a declining ability to perform tasks. He/she may deny a problem exists by covering memory loss with *confabulation*. - The individual may forget major events in personal history, such as child's birthday; experience declining ability to perform tasks, such a and managing personal finances; or be unable to understand current - Depression and social withdrawal are common. At this stage, the individual requires some assistance to maintain safety. Mod 4 Lesson Content Ch 22 41. Stage V: Name this stage of Alzheimer's *Moderate cognitive decline* - At this stage, individuals *lose the ability to independently perform some ADLs*, such as hygiene, dressing, and grooming, and require some assistance to manage these tasks on an ongoing basis. - They may forget addresses, phone numbers, and names of close r - They may become disoriented about place and time, but they mainta about themselves. - Frustration, withdrawal, and self-absorption are common. Mod 4 Lesson Content Ch 22 42. Stage VI: Name this stage of Alzheimer's *Moderate to severe cognitive decline* - Disorientation to surroundings is common and may not know the day, season, or or words,NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 13 / 59 hat one must mbers. He/she cur. eimer's? nce they are year. - The person is also *unable to manage ADLs without assistance.* Urinary and fecal incontinence are common. - Psychomotor symptoms include wandering, agitation, and aggression. Symptoms seem to worsen in late afternoon and evening (*sundowning*). - At this stage, individuals may be unable to recall the name of their spouse or may misidentify people (e.g., thinking a child is their spouse). - Delusions often become apparent, such as maintaining the belief t go to work even though the person is no longer employed. - Sleeping becomes a problem. - Communication becomes more difficult, with increasing loss of language skills. Institutional care is usually required at this stage. Mod 4 Lesson Content Ch 22 43. Stage VII: Name this stage of Alzheimer's *Severe cognitive decline* - In the end stages, the individual is unable to recognize family me most commonly confined to bed and aphasic. - Problems of immobility, such as decubiti and contractures, may oc Mod 4 Lesson Content Ch 22 44. - Mini mental status exam - plaques and tangles seen on MRI: How do we assess for Alzh J.A. prerecorded lecture 45. - medication to slow progression...does not CURE or STOP progression- : How do we treat Alzheimer's? J.A. prerecorded lecture 46. Stage IV: At what stage of Alzheimer's can meds be stopped si no longer effective? J.A. prerecorded lecture 47. - Maintaining function that they have as long as we can. - Continually orient them, use large pictures and symbols, provide emotionalNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 14 / 59 iety and o the client. s too extenor write. support - Promoting client dignity: Don't feed them or wash their face if they can do it. Let them do it. - Keep the environment as safe as possible to prevent injury. - Assist the client with ambulation and ADL's. - Remain calm and undemanding and avoid pressing the client when he/she is refusing. - Dance and movement therapy has been shown to reduce anx aggressiveness. - Music of the client's past has also been shown to be calming t *low stimulation environment*: What's our top nursing intervention for Alzheimer's patients? J.A. prerecorded lecture ATI Ch 17 Mod 4 Lesson Content 48. Agnosia: the inability to recognize familiar objects. ATI Ch 17 49. Amnesia: An inability to recall important personal information that i sive to be explained by ordinary forgetfulness. Ch 17 50. Aphasia: loss of language ability Ch 17 51. Agraphia: The diminished ability and eventual inability to read Mod 4 Lesson ContentNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 15 / 59 p. or a client the following 52. Apraxia: the inability to carry out purposeful motor activities despite intact motor function and the inability to use objects properly, may develo Ch 17 53. D. I am your nurse. Let's walk together to your room.: A nurse in a long term care facility is caring for a client who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following statements should the nurse make? A.You have forgotten that this is your home. B.You cannot go outside without a staff member. C. Why would you want to leave? Aren't you happy with your care? D. I am your nurse. Let's walk together to your room. ATI Ch 17 Application Exercises 54. A. Install childproof door locks. D. place the client's mattress on the floor. E. Install light fixtures above stairs.: A home health nurse is making a visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following suggestions should the nurse make to decrease the client's risk for injury? (Select All That Apply) A. Install childproof door locks. B. Place rugs over electrical cords. C. Mark cleaning supplies with colored tape. D. place the client's mattress on the floor. E. Install light fixtures above stairs. ATI Ch 17 Application Exercises 55. B. Family report of personality changes C. Hallucinations E. Restlessness: A nurse is performing an admission assessment f who has delirium related to an acute urinary tract infection. Which of findings should the nurse expect? (Select All That Apply) A. History of gradual memory loss B. Family report of personality changes C. HallucinationsNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 16 / 59 lcohol: - hdrawal D. Unaltered level of consciousness E. Restlessness ATI Ch 17 Application Exercises 56. coarse tremor of hands, tongue, or eyelids nausea or vomiting malaise or weakness tachycardia sweating elevated blood pressure anxiety depressed mood or irritability transient hallucinations or illusions headache insomnia: Signs & Symptoms of Alcohol Withdrawal Ch 23 57. 6-8 hrs after last drink. alcohol withdrawal delirium can occur 2-3 days after cessation of a When do alcohol withdrawal symptoms begin? ATI Ch 18 58. *Benzodiazepines* Keep environment quiet (decrease stimulus) If necessary, one to one observation (family and/or staff) Fall precautions Seizure precautions Suicidal precautions Frequently orient to reality and surroundings Monitor vital signs Follow the medication regime: Nursing Interventions for Alcohol Wit Mod 4 Lesson Content Ch 23 59. addiction: A compulsive or chronic requirement. The need is so strong as to generate distress (either physical or psychological) if left unfulfilled.NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 17 / 59 table to the ental state of panies the lower dose. 60. intoxication: A state of disturbance in cognition, perception, behavior, level of consciousness, judgment, and other functions that is directly attribu effects of a psychoactive drug. It may be marked by a physical and m exhilaration and emotional frenzy or lethargy and stupor. Ch 23 61. withdrawal: The physiological and mental readjustment that accom discontinuation of an addictive substance. Ch 23 62. tolerance: The need for increasingly larger or more frequent doses of a substance in order to obtain the desired effects originally produced by a Ch 23 63. psychomotor retardation drowsiness slurred speech altered mood impaired memory and attention bradycardia hypotension hypothermia meiosis (pinpoint pupils) intense drowsiness coma "everything is LOW": Signs & Symptoms of Opioid Intoxication Mod 4 Lesson Content Ch 23NUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 18 / 59 ication ethargic. It is wal 64. tachycardia rhinorrhea (runny nose) muscle spasms bone and muscle pain anxiety abdominal cramps vomiting & diarrhea hypertension hypothermia mydriasis (enlarged pupils) diaphoresis increased respiratory rate: Signs & Symptoms of Opioid Withdrawal (6-8 hrs after last dose) Mod 4 Lesson Content 65. - hydration - ventilator - Methadone (for withdrawal)/Narcan (for overdose): Nursing Interventions for Opioid Withdrawal J.A. prerecorded lecture Mod 4 Lesson Content 66. Elation Euphoria Sensitive, anxious, tense, hypervigilant and angry Psychotic and aggressive: Signs & Symptoms of Stimulant Intox Mod 4 Lesson Content 67. In the initial phase, the individual feels agitated and anxious with intense cravings for the drug. Following the initial phase, the individual feels depressed and l often called "crashing.": Signs & Symptoms of Stimulant Withdra Mod 4 Lesson Content 68. - treated with antidepressants - suicide preventionNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 19 / 59 hdrawal cted to occur? - medical detox program: Nursing Interventions for Stimulant Wit J.A. prerecorded lecture Mod 4 Lesson Content 69. B. Fine tremors of both hands D. Vomiting E. Restlessness: A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following is an expected finding? (Select all that apply.) A. Bradycardia B. Fine tremors of both hands C. Hypotension D.Vomiting E. Restlessness ATI Ch 18 Application Exercises 70. C. Implement seizure precautions.: A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following is the priority nursing intervention? A. Orient the client frequently to time, place, and person. B. Offer fluids and nourishing diet as tolerated. C. Implement seizure precautions. D. Encourage participation in group therapy sessions. 71. a. Several hours after the last drink: A client is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for several years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expe a. Several hours after the last drink b. 2 to 3 days after the last drink c. 4 to 5 days after the last drink d. 6 to 7 days after the last drink Ch 23 questionsNUR 2459 Rasmussen Mental Health Exam 2 Mental Health - Exam 2 20 / 59 tory drug drawal and l symptoms. 72. c. Diaphoresis, nausea and vomiting, and tremors.: Symptoms of alcohol withdrawal include: a. Euphoria, hyperactivity, and insomnia. b. Depression, suicidal ideation, and hypersomnia. c. Diaphoresis, nausea and vomiting, and tremors. d. Unsteady gait, nystagmus, and profound disorientation. Ch 23 questions 73. a. Administer naloxone and rescue breathing.: A client is brought to the emergency department unconscious by a friend who says he was injecting heroin. The client is assessed to have a weak pulse. Which of these interventions are priorities? a. Administer naloxone and rescue breathing. b. IV benzodiazepines and continuous monitoring of vital signs. c. Ask the friend how much heroin he took and confirm with a labora screen. d. Initiate cardiopulmonary resuscitation and prepare to use an external defibrillator. Ch 23 questions 74. c. Assess the client's risk for suicide.: A client comes into the emergency department stating that he is "crashing" and feels like he'd "be better off dead." Which of these nursing interventions is a priority? a. Instruct the client not to worry; these are temporary signs of with should go away in a few days. b. Request an order for amphetamines to ease the client's withdrawa c. Assess the client's risk for suicide. d. Instruct the physician that the client may need naloxone. Ch 23 questions 75. d. Administer prn benzodiazepine that was ordered for management of withdrawal symptoms.: A client admitted to the inpatient detoxification program for alcohol withdrawal approaches the nurse complaining of nausea and feeling shaky.The nurse notices that the client has hand tremors and appears diaphoretic. Which of these nursing interventions is a priority?Mental Health - Exam 2 Study online at 21 / 59 bout. of withdrawal a. Check the client's temperature. b. Send a urine sample to the laboratory for a random drug screen. c. Ask the client if there is anything that he is particularly stressed a d. Administer prn benzodiazepine that was ordered for management symptoms. Ch 23 questions 76. c. Conduct a drug screen to assess for presence of opioids.: A client who has been admitted to intensive outpatient treatment for substance use disorder arrives for group therapy and appears groggy with constricted pupils. The client denies using substances. Which of the following would be the best intervention at this time? a. Ask the client to empty his pockets. b. Smell his breath for evidence of alcohol. c. Conduct a drug screen to assess for presence of opioids. d. Discharge the client for failure to comply with treatment expectations. Ch 23 questions 77. a. Personality c. Speech e. Mobility: In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (Select all that apply.) a. Personality b.Vision c. Speech d. Hearing e. Mobility Ch 22 questions 78. b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit.": A client, who has neurocognitive disorder due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response?Mental Health - Exam 2 Study online at 22 / 59 a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G.We will have supper soon, and then your daughter will come to visit." c. "Who is your date with, Mrs. G.?" d. "I think you need some more medication, Mrs. G. I'll bring it to you now." Ch 22 questions 79. d. Ensure that the client gets regular physical exercise during the day.: A client who has NCD due to Alzheimer's disease has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in this client? a. Ask the doctor to prescribe flurazepam (Dalmane). b. Ensure that the client gets an afternoon nap so she will not be overtired at bedtime. c. Make the client a cup of tea with honey before bedtime. d. Ensure that the client gets regular physical exercise during the day. Ch 22 questions 80. c. "This is the patio door. Are you looking for the bathroom?": The night nurse finds a client with Alzheimer's disease wandering the hallway at 4 a.m. and trying to open the door to the side yard. Which of the following is the best initial response by the nurse? a. "That door leads out to the patio. It's nighttime.You don't want to go outside now." b. "You look confused. What is bothering you?" c. "This is the patio door. Are you looking for the bathroom?" d. "Are you lonely? Perhaps you'd like to go back to your room and talk for a while." Ch 22 questions 81. b. Ensuring that the environment is safe to prevent injury: A client with neurocognitive disease due to Alzheimer's disease is admitted to the hospital. Which of the following actions by the nurse is a priority? a. Ensuring that she receives food she likes to prevent hunger b. Ensuring that the environment is safe to prevent injury c. Ensuring that she meets the other patients to prevent social isolationMental Health - Exam 2 Study online at 23 / 59 red thought likely to be ns isturbance d. Ensuring that she takes care of her own ADLs to prevent dependence Ch 22 questions 82. c. Assist her with step-by-step instructions. e. Encourage her and give her plenty of time to perform independently as many of her ADLs as possible.: Which of the following interventions is most appropriate in helping a client with Alzheimer's disease with ADLs? (Select all that apply.) a. Perform ADLs for her while she is in the hospital. b. Provide her with a written list of activities she is expected to perform. c. Assist her with step-by-step instructions. d. Tell her that if her morning care is not completed by 9 a.m., it will be performed for her by the nurse's aide so that she can attend group therapy. e. Encourage her and give her plenty of time to perform independently as many of her ADLs as possible. Ch 22 questions 83. Schizophrenia: A group of mental health problems that is characterized by psychotic features such as hallucinations and delusions, disorde processes and disrupted interpersonal relationships. J.A. prerecorded lecture 84. Impaired reality testing: decreased ability to determine what is real and what is not; often contributes to hallucinations and delusio 85. fragmentation it's very similar to flight of ideas: is a form of thought d which occurs as pieces of sentences flocked together J.A. exam review 86. thought blocking: sudden cessation of a thought in the middle of a sentence; they truly cannot finish the thought and they become extremely agitated as well as fearfulMental Health - Exam 2 Study online at 24 / 59 apidly from nd illogical ent trol a isible to tual events to 87. Associative looseness (loose association): unconscious *inability to concentrate on a single thought.* Can progress to flight of ideas in which the client's speech moves so r one thought to another that it is incoherent. Ideas that do not connect to each other and are expressed in garbled a speech. ATI Ch 15 88. echoalia: the client repeats words spoken to him ATI Ch 15 89. neologism: Make-up words that have meaning only to the cli ATI Ch 15 90. magical thinking: believes their actions or thoughts are able to con situation or affect others, such as wearing a certain hat makes them inv others ATI Ch 15 91. confabulation: the creation of stories or answers in place of ac maintain self-esteem ATI Ch 15 J.A. prerecorded lectureMental Health - Exam 2 Study online at 25 / 59 icance to the elligence or of obvious ortant, like lved with belief i.e. being talks about oing this." 93. delusion: false personal beliefs not consistent with a person's int cultural background. The individual continues to have the belief in spite proof that it is false and/or irrational Ch 24 94. Delusion of grandeur: believes that they are all powerful and imp a god ATI Ch 15 95. delusion of jealousy: believes that their partner is sexually invo another individual even though there is not any factual basis for this ATI Ch 15 96. delusion of persecution: feels singled out for harm by others ( hunted down by the FBI) ATI Ch 15 97. - ask patient to describe the delusion (*paranoid delusions can result in violence/safety issue*) - focus conversation on reality - do not ever argue and try to convince people that it's wrong; try to reorient to reality and pull them back in. - validate if some of that delusion is real...Anything that the client that's real - respond in reality "Look over there there's a person d That person IS there but they are not doing what they think. ex: let them touch the stethoscope to show them it's not a snake: Nursing interventions for delusions J.A. prerecorded lecture 92. word salad: words jumbled together with little meaning or signif listener ATI Ch 15Mental Health - Exam 2 Study online at 26 / 59 98. - set firm limits and firm directions ex: "We are going to talk about what it's like to be Queen for the next 15 minutes and then I don't want to hear about the queen of England for the rest of the day.": Nursing interventions for a patient that continues to believe a delusion and obsesses over it J.A. prerecorded lecture 99. - ask them about the hallucinations Questions to include: What do you hear? Are you hearing a voice that is telling you to do something? Do you believe what you hear is real? - avoid reacting to the hallucination as if it's real - make it very clear you understand it's real for them, "You are seeing a spider on the wall. But I don't see it." "Present reality" and recognize the feelings observed. Example: "I understand you are frightened, but there is no one here to harm you.": Nursing interventions for hallucinations J.A. prerecorded lecture Mod 5 Lesson Content 100. - need 1:1 observation - do not touch them - encourage them to express their feelings - do not judge or joke - make sure you attempt to engage their attention in concrete activities (get them to color or draw...anything to get them distracted and to focus on something else).: Nursing interventions for significant active hallucinations J.A. prerecorded lecture 101. - Auditory hallucinations - Visual hallucinations - Command hallucinations - Delusions - Associative loosenessMental Health - Exam 2 Study online at 27 / 59 chizophrenia ctions - Disorganized speech - Bizarre behavior: List the positive symptoms of Schizophrenia *manifestation of things that are normally not present* Mod 5 Lesson Content ATI Ch 15 102. - Affect - blunted or flat - Alogia - poverty of thought or speech (*mumbling*) - Anergia - lack of energy - Anhedonia - lack of pleasure or joy - Avolition - lack of motivations in activities and hygiene - Withdrawn (Asociality) - Expresses feelings of rejection/loneliness - Talks about self as bad/no good: List the negative symptoms of S *absence of things that are normally present* Mod 5 Lesson Content ATI Ch 15 103. Anergia: abnormal lack of energy, passivity 104. avolition: decreased engagement in purposeful, goal-directed aMental Health - Exam 2 Study online at 28 / 59 verty of obbies, and nication 105. Alogia: A decrease in speech or speech content; Also known as po speech. 106. Anhedonia: loss of pleasure and lack of interest in activities, h sexual activity ATI Ch 14 107. mutism: Inability or the refusal to speak (positive symptom) 108. pressured speech: rapid, frenzied, or loud, disjointed commu 109. NEED AT LEAST 2 OFTHE FOLLOWING, AND 1 OFTHEM MUST BE ONE OF THE FIRST THREE: *1. Delusions* *2. Hallucinations* *3. Disorganized speech* 4. Grossly disorganized or catatonic behavior 5. Negative symptoms ( i.e., diminished emotional expression, lack of motivation and a sociality): What is the criteria to diagnose Schizophrenia? Mod 5 Lesson Content 110. premorbid phase: *Name this phase of Schizophrenia:* Signs occur prior to clear evidence of an illness: - shy & withdrawn - poor peer relationships - doing poorly in schoolMental Health - Exam 2 Study online at 29 / 59 111. prodromal phase: *Name this phase of Schizophrenia:* Period between premorbid phase and the onset of psychosis (average length 2-5 years) Signs of cognitive impairment - deterioration in functioning *client experiences negative symptoms* Mod 5 Lesson Content ATI Ch 15 112. psychotic phase: *Name this phase of Schizophrenia:* - Psychotic symptoms are prominent *client experiences negative and positive symptoms* Mod 5 Lesson Content 113. residual phase: *Name this phase of Schizophrenia:* Usually follows the active phase of the illness, symptoms of active phase no longer prominent - flat affect - impairment in functioning *client can experience both negative and positive symptoms* Mod 5 Lesson Content 114. dopamine theory of schizophrenia: the theory there is an excess of the neurotransmitter, dopamine and too many dopamine receptors throughout the brain. It has now been determined that there is excess dopamine in the limbic system of the brain, but a decrease of dopamine in the prefrontal cortex. - passive - introverted *client experiences negative symptoms* Mod 5 Lesson ContentMental Health - Exam 2 Study online at 30 / 59 tial delusions. unctioning. e symptoms e the same as ere is a major Mod 5 Lesson Content 115. significant stressors like developmental (going off to college) or family stress: What triggers Schizophrenia? Mod 5 Lesson Content Ch 15 116. delusional disorder: *Delusion(s) have lasted 1 month or longer.* The general theme includes grandiose, persecutory, somatic and/or referen They are usually not severe enough to impair occupational or daily f Mod 5 Lesson Content 117. brief psychotic disorder: Sudden onset of at least one of the following: delusions, hallucinations, disorganized speech or catatonic behavior. Th must last more than 1 day and less than 1 month. Mod 5 Lesson Content 118. schizophreniform disorder: This disorder has features that ar Schizophrenia, but last *less than 6 months.* Mod 5 Lesson Content 119. schizoaffective disorder: The symptoms meet the criteria for schizophrenia and the individual also has an uninterrupted period during which th depressive, manic or mixed episode of behavior. Mod 5 Lesson Content 120. Atypical/Second-generation antipsychotic medications *they control both positive and negative symptoms and have fewer adverse effects*: What is the first choice medication for Schizophrenia? J.A. prerecorded lecture vs ATI 121. *Anticholinergic effects* - dry mouth - blurred vision/photosensitivity - constipation - urinary retention *Orthostatic hypotension*Mental Health - Exam 2 Study online at 31 / 59 easures *Sedation* *Fatigue* *Gynecomastia (men)* *Amenorrhea (women)* *EPS symptoms* Pseudoparkinsonism Akinesia- muscular weakness Akathisia- restlessness or the urgent need for movement Dystonia- involuntary movements of the face, arms, legs and neck Oculogyric crisis- involuntary deviation and fixation of the eyeballs, usually upward: Side effects of traditional/first-generation antipsychotic medications Mod 5 Lesson Content 122. Abnormal Involuntary Movement Scale (AIMS): The m involuntary movements associated with tardive dyskinesia. Mod 5 Lesson Content 123. Cogentin (benztropine) it's in the anticholinergic drug class this is given in conjunction with 1st generation anti-psychotics: What drug do we use to control the negative side effects and EPS effects of FGAs? J.A. prerecorded lecture 124. Neuroleptic Malignant Syndrome: Rare but potentially fatal. Can be caused by typical or atypical antipsychotic. Side effects: muscle rigidity very high fever-hyperpyrexia tachycardia fluctuations in blood pressure diaphoresis stupor-comaMental Health - Exam 2 Study online at 32 / 59 Mod 5 Lesson Content 125. - discontinue Rx - monitor vitals - antipyretics - fluids - transfer to Critical Care unit for cardiac monitoring - dantrolene (Dantrium) and bromocriptine (Parlodel): Treatment for NMS Mod 5 Lesson Content 126. *agranulocytosis* - CBC drawn every week to check WBC count - infection control measures (wash hands!): What do we need to monitor when a patient is on clozapine (Clozaril)? Note this is a SGA. J.A. prerecorded lecture 127. - Treat both positive and negative symptoms - Decrease in affective symptoms (depression and anxiety) - Fewer or no EPS (less dopamine blockage) - Fewer anticholinergic side effects- (Except for clozapine) - Less relapse - Tolerated well: What are the advantages to taking second-generation antipsychotics? Mod 5 Lesson Content 128. b. Decrease his anxiety and increase trust.: Which of the following is the primary goal in working with an actively psychotic, suspicious client? a. Promote interaction with others. b. Decrease his anxiety and increase trust. c. Improve his relationship with his parents. d. Encourage participation in therapy activities. Ch 24 Questions 129. a.To treat extrapyramidal symptoms: A client with schizophrenia has physician's orders for haloperidol (Haldol) 5 mg IM STAT and then 3 mg PO tid; 2 mg benztropine PO bid prn. Why is benztropine ordered?Mental Health - Exam 2 Study online at 33 / 59 a. To treat extrapyramidal symptoms b.To prevent neuroleptic malignant syndrome c. To decrease psychotic symptoms d. To induce sleep Ch 24 Questions 130. a. Delusion of persecution.: A client on the psychiatric unit tells the nurse that the CIA is looking for him and will kill him if they find him. The client's false belief is an example of a: a. Delusion of persecution. b. Delusion of reference. c. Delusion of control or influence. d. Delusion of grandeur. Ch 24 Questions 131. d. To promote family interaction and increase understanding of the illness.: The primary focus of family therapy for clients with schizophrenia and their families is: a. To discuss problem-solving and adaptive behaviors for coping with stress. b.To introduce the family to others with the same problem. c. To keep the client and family in touch with the health-care system. d. To promote family interaction and increase understanding of the illness. Ch 24 Questions 132. c. Anosognosia: A client recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment and the police said I had to come with them." This is an example of what symptom of schizophrenia? a. Delusions of reference b. Loose association c. Anosognosia d. Auditory hallucinations Ch 24 QuestionsMental Health - Exam 2 Study online at 34 / 59 133. d. Muscle spasms: Which of the following assessments by the nurse would convey a need for prn benztropine? a. Increased level of agitation b. Complaints of a sore throat c. A yellowish cast to the skin d. Muscle spasms Ch 24 Questions 134. d. "I know you believe that, but it's really hard for me to believe.": A client on the psychiatric unit has been diagnosed with schizophrenia. He tells the nurse that the CIA is looking for him and will kill him if they find him. The most appropriate response by the nurse is: a. "That's ridiculous. No one is going to hurt you." b. "The CIA isn't interested in people like you." c. "Why do you think the CIA wants to kill you?" d. "I know you believe that, but it's really hard for me to believe." Ch 24 Questions 135. c. Ask the patient if he is hearing something or someone other than the nurse's voice.: The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in midsentence, and listens intently. Which of the following is the most appropriate follow-up assessment based on this information? a. Ask the patient if he is experiencing loose associations. b. Ask the patient if he needs more medication. c. Ask the patient if he is hearing something or someone other than the nurse's voice. d. Ask the patient if his neck is stiff. Ch 24 Questions 136. b. Evaluate the client's foot to rule out physical causes for his complaint.: A client reports to the nurse that his foot is on fire and he thinks the demons are trying to burn off his flesh. The priority nursing intervention for this symptom is to:Mental Health - Exam 2 Study online at 35 / 59 n. exhibits a cription of a. Administer prn haloperidol as ordered. b. Evaluate the client's foot to rule out physical causes for his complaint. c. Administer prn benztropine as ordered. d. Ask the client if he would like to speak with a chaplain. Ch 24 Questions 137. c. Call for adequate help to control the situation safely.: When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first? a. Provide large motor activities to relieve the client's pent-up tensio b. Administer a dose of prn haloperidol to keep the patient calm. c. Call for adequate help to control the situation safely. d. Convey to the client that his behavior is unacceptable and will not be permitted. Ch 24 Questions 138. b. Assess his safety toward himself and others.: A client has been diagnosed with schizophrenia. He has been socially isolated and is hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. The initial nursing intervention for Josh is to: a. Give him an injection of haloperidol. b. Assess his safety toward himself and others. c. Place him in restraints. d. Order him a nutritious diet. Ch 24 Questions 139. C. Risperidone (Risperdal) this is the prototype drug for SGAs. SGAs treat both positive and negative symptoms.: A nurse is caring for a client who has schizophrenia and lack of grooming and a flat affect. The nurse should anticipate a pres which of the following medications? A. Chlorpromazine (Thorazine) B. Thiothixene (Navane) C. Risperidone (Risperdal) D. Haloperidol (Haldol)Mental Health - Exam 2 Study online at 36 / 59 ll that apply.) ng for a ncing auditory Which of the ATI Ch 24 Application Exercises 140. A. Auditory hallucinations C. Delusions of grandeur D. Severe agitation: A charge nurse is discussing manifestations of schizophrenia with a newly licensed nurse. Which of the following should the charge nurse identify as being effectively treated by conventional antipsychotics? (Select a A. Auditory hallucinations B. Withdrawal from social situations C. Delusions of grandeur D. Severe agitation E. Anhedonia ATI Ch 24 Application Exercises 141. B. Drooling C. Involuntary arm movements E. Continual pacing: A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EPS)? (Select all that apply.) A. Decreased level of consciousness B. Drooling C. Involuntary arm movements D. Urinary retention E. Continual pacing ATI Ch 24 Application Exercises 142. A. "When did you start hearing the voices?" C. "It must be scary to hear voices" D. "Are the voices telling you to hurt yourself?": A nurse is cari client who has substance-induced psychotic disorder and is experie hallucinations. The client states, "The voices won't leave me alone!" following statements should the nurse make? (SATA) A. "When did you start hearing the voices?" B. "The voices arrant real, or else we would both hear them." C. "It must be scary to hear voices"Mental Health - Exam 2 Study online at 37 / 59 ake first? he client. nd talking to better able D. "Are the voices telling you to hurt yourself?" E. "Why are the voices talking only to you?" ATI Ch 15 Application Exercises 143. A. Auditory hallucination C. Use of clang associations D. Delusion of persecution E. Constantly waving arms: A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? (SATA) A. Auditory hallucination B. Lack of motivation C. Use of clang associations D. Delusion of persecution E. Constantly waving arms F.Flat affect ATI Ch 15 Application Exercises 144. B. Initiate one-to-one observation of the client: A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are telling her to "kill your doctor." Which of the following actions should the nurse t A. Use therapeutic communication to discuss the hallucination with t B. Initiate one-to-one observation of the client C. Focus the client on reality D. Notify the provider of the client's statement. ATI Ch 15 Application Exercises 145. B. Ask the client, "Are you seeing something on the ceiling?": A nurse is speaking with a client who has schizophrenia when he suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling a himself. Which of the following actions should the nurse take? A. Stop the interview at this point, and resume later when the client is to concentrate B. Ask the client, "Are you seeing something on the ceiling?" C. Tell the client, "You seem to be looking at something on the ceiling. I seeMental Health - Exam 2 Study online at 38 / 59 oes on. Or ar subject eight over something there, too." D. Continue the interview without comment on the client's behavior. ATI Ch 15 Application Exercises 146. diurnal variation: patients may feel better at a certain periods of time in the day. Ex: feeling well first thing in the morning and gets worse as the day g vice versa. J.A. prerecorded lecture 147. rumination: persistent thinking and discussions of a particul J.A. prerecorded lecture 148. Criteria for diagnosis, need to have at least 5 of them and must occur almost every day for a minimum of 2 weeks and last most of the day: 1. Depressed/irritable mood (subjectively or objectively reported) 2. Difficulty sleeping or excessive sleeping (fatigue or loss of energy) 3. Indecisiveness 4. Decreased ability to concentrate 5. Suicidal ideation 6. Increase or decrease in motor activity (change in activity level) 7. Inability to feel pleasure or interest in activities. 8. Increase or decrease in weight of more than 5% of total body w 1 month or change in appetite: Name the criteria to be diagnosed with major depressive disorder (MDD) J.A. prerecorded lecture ATI Ch 13 149. *Nutrition* - monitor nutrition intake (I&O) - stay with them during meals and assess what they are eating and promote their eating - give Boost or Ensure, mac and cheese, eggs, soups, etc. since they don't take much energy to eat *ADLs and Self Care*Mental Health - Exam 2 Study online at 39 / 59 and they - hygiene takes a significant amount of energy for them; take it slow - getting dressed takes a significant amount of energy for them; they don't care if their outfit matches, etc. They are just tired and don't care. - encourage self-care and ADLs. *Activities* - they need 1:1 activity.They don't do well in groups. - 1:1 activity should be short, so they have time to process and regroup. - gross motor activities like walking is good. - activities need to be ones they can achieve success in (don't use huge puzzles). *Self-Harm/Suicide Risk* - if there's a risk you must make sure they are safe at all costs!That over anything else. - if they are expressing anger make sure it is in a therapeutic way aren't going to harm themselves - implement appropriate safety precautions *Communication* - make time to be with the client, even if they do not speak - make observations rather than asking direct questions. - give directions in simple, concrete sentences - give the client sufficient time to respond - do not push decision making, they can't do it.You'll only make them feel worthless. - encourage patient to express their feelings - encourage independence as much as possible - hang out with client so they feel their worth; reminisce on what made them happy.: Nursing interventions for major depressive disorder (MDD) J.A. prerecorded lecture ATI Ch 13 150. Depression/Suicidal patients - helps with anger and agitation - patients who aren't responding to medication - patients who need rapid response (catatonia, suicidal, homicidal) Manic patents is priorityMental Health - Exam 2 Study online at 40 / 59 atients? herapy is the onin. insomnia, - when lithium has not worked: ECT is good for which type of p J.A. prerecorded lecture ATI Ch 14 151. seasonal affective disorder (SAD): A form of depression that occurs seasonally, usually during the winter, when there is less daylight. Light t first-lie treatment. Light therapy inhibits nocturnal secretion of melat J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 13 152. Persistent Depressive Disorder (Dysthymia) *considered moderate depression*: A milder form of depression that usually has an early onset (in childhood or adolescence) and lasts *at least 2 years* for adults (1 year for children). It contains *at least 3 clinical findings of depression* and can, later in life, become major depressive disorder (MDD). ex: depressed for 5/7 days a week for at least 2 years This may be a diagnosis made in children and adolescents: early onset -before age 21 late onset - 21 or older J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 13 153. premenstrual dysphoric disorder: A depressive disorder associated with the luteal phase (*week prior to menses*) of the menstrual cycle. Emotional manifestations include mood swings, irritability, depression, anxiety, feeling overwhelmed and difficulty concentrating. Physical manifestations include lack of energy, overeating, hyper-or breast tenderness, aching, bloating, and weight gain. Treatment includes exercise, diet, and relaxation therapy.Mental Health - Exam 2 Study online at 41 / 59 or depressive upational n a 12-month J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 13 154. Bipolar I Disorder: Most severe form of bipolar disorder. The client has *at least one episode of mania* alternating with maj episodes. J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 14 155. Bipolar II Disorder: The client has *one or more hypomanic episodes* alternating with major depressive episodes. Hypomania is a milder form of mania. Symptoms are excessive hyperactivity, but not severe enough to cause marked impairment in social or occ functioning. J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 14 156. cyclothymic disorder: In this form of bipolar disorder, the client will have symptoms of *hypomania* alternating with symptoms of *mild to moderate depression.* This individual tends to have irritable hypomanic episodes. Some experience *rapid cycling* and may have at least 4 episodes i period. J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 14 157. Check their speech, their behavior, their mood. Assess them for alcohol and drug use. Assess for delusions of grandeur and cognitive function with impulse control (might run out to street and get hit by a car)Mental Health - Exam 2 Study online at 42 / 59 he acute equences ing Interven- *focus is on safety and maintaining physical health, especially in t phase*: Nursing Assessment for mania J.A. prerecorded lecture 158. - Use a firm and calm approach - Use short and concise explanations - Be consistent in approach and expectations and limit-setting - Identify expectations in simple and concrete terms with cons - Avoid power struggles - Hear and act on legitimate complaints - Redirect energy into more appropriate behavior/actions: Nurs tions for mania: communication J.A. prerecorded lecture Mod 6 Lesson Content 159. - Low level stimulus - Provide structured/solitary activities (assist as needed) - Provide high calorie fluids - Provide outlets for physical activity - Encourage rest periods - Redirect aggressive behavior - Store valuables until rational judgement returns - Use least restrictive measures to ensure safety - Encourage adequate diet - Finger foods may be necessary - Check for medications (make sure they didn't pocket any): Nursing Interventions for mania: therapeutic milieu J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 14 160. - sleep disturbance - alcohol - caffeine: What factors precipitate a mania relapse?Mental Health - Exam 2 Study online at 43 / 59 q/L) 161. 0.6-1.2 mEg/L: Lithium normal range Mod 6 Lesson Content ATI Ch 23 162. Taking more than the prescribed dose Anything that causes decreased sodium: - Sweating profusely - Fever - Diuresis Low sodium diet: How do lithium levels become toxic? J.A. prerecorded lecture ATI Ch 23 163. - mental confusion - sedations - coarse tremors - barred vision - ataxia (poor coordination) - tinnitus GI distress: - nausea and vomiting - severe diarrhea: Symptoms of mild lithium toxicity (1.5-2.0 mE J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 23 164. Same side effects of mild: - mental confusion - tremors - blurred vision ATI Ch 14Mental Health - Exam 2 Study online at 44 / 59 ty (2.0-2.5 Eq/L) et. - ataxia (poor coordination) - tinnitus Plus: - polyuria of dilute urine - giddiness - muscular irritability/jerking movements - seizures - severe hypotension - psycho motor retardation: Symptoms of moderate lithium toxici mEq/L) J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 23 165. - impaired consciousness - nystagmus - seizures - coma - oliguria/anuria - arrhythmias - myocardial infarction *coma and death*: Symptoms of severe lithium toxicity (> 2.5 m J.A. prerecorded lecture Mod 6 Lesson Content ATI Ch 23 166. - Teach patients about s/s of toxicity and they need to call their provider and get a blood level drawn. - Teach patients to stay hydrated and have a normal sodium di - Avoid NSAIDs: Patient education for lithium toxicity J.A. prerecorded lecture ATI Ch 23 167. Mood Stabilizers (lithium) for the mania/depression Anticonvulsants for the mania (prevent relapses)Mental Health - Exam 2 Study online at 45 / 59 aceuti