Psychiatric Assessment for Psychiatric-Mental Health Nurse Practitioner Exam 4,5,6 Covered Weeks 3-4

Psychiatric Assessment for Psychiatric-Mental Health
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Nurse Practitioner dt




Exam 4,5,6 Covered Weeks 3-4
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1. A nurse on a mental health unit is caring for a client. Nurse's
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dt Notes

1300:

Client openly participated in group therapy and provided validating feedback to peers.
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dt Described a longstanding pattern of frequent changes in their life: changes in hobbies,
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dt employment, and in their friends. Reports a history of giving their best friends numerous
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dt gifts and constantly calling them every day,onlytosuddenlyignoreandbelittlethem,
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,followedbyregretfordoingso. Client also shared that they frequently feel "super nervous"
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dt and are restless for no known reason. Client reports that this anxiety makes sleeping and
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dt focusing on tasks difficult. dt dt dt




1530:

The client approached the nurse's station and attempted to interrupt a staff member who
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dt was talking on the phone.After noticing the staff member has a hearingimpairment,theclien
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loudlyyelled,"Areyoudeaforsomething?"and walked to their room. A couple of minutes
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dt later, th: When generating solutions while planning care for this client, the nurse should
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determine if the client is having thoughts of harming themselves or others.Clients whohave
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borderlinepersonalitydisorderoftenexhibitself-injuriousbehaviors,such as cutting or
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dt scratching.They also often experience suicidal ideation, even chroni- cally,andhave ahigher
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risk fordeathbysuicide.Feelingsofhostility andangerare also common with this disorder,
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dt increasing the risk for violence toward others. dt dt dt dt dt dt




The nurse should
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encourage the client to verbalize their feelings to diffuse frustration and other emo- tions.
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Clientswhohaveborderlinepersonalitydisorderexperienceemotionallability; therefore,
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dt verbalization of these emotions can decrease the impulsive behaviors often exhibited by dt dt dt dt dt dt dt dt dt dt dt




dt clients who have this disorder. dt dt dt dt

,The nurse should
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establish consequences for unacceptable behavior such as manipulation and im- pulsivity,
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dt which are manifestations of this disorder. Clearly communicate expected behaviors and the
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dt subsequent consequences when unacceptable behavior occurs.dt dt dt dt dt




The nurse should also
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provide clear boundaries for behaviors toward peers as clients who have this disorder can
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dt exhibit aggression and manipulation of others for their own benefit.
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The nurse should
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instruct the client on coping mechanisms and relaxation techniques. Clients who have
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dt borderline personality disorder also often have another mental illness, such asdepressionor
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anxietydisorder.Theclientverbalizedfeelinganxiousandrestless and that these feelings are
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dt disrupting their sleep and ability to focus.
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, Therefore,identifyingandpracticingcopingmechanismsandrelaxationtechniques are
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dt interventions that can decrease the client's anxiety. dt dt dt dt dt dt




2. Anurseiscaringforaclientwhoisexperiencingmanifestationsofanxiety. The nurse
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dt should recognize which of the following statements about the neurophysiologic
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dt manifestations of anxiety as correct? dt dt dt dt




The amygdala-centered (ACC) circuit of the brain is associated with feelings of panic.
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The amygdala-centered (ACC) circuit of the brain is associated with feelings of
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dt apprehension.

The cortico-striato-thalamo-cortical circuit (CSTC) of the brain is associated with phobias.
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The cortico-striato-thalamo-cortical circuit (CSTC) of the brain is associated with feelings
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dtof fear.:The amygdala-centered (ACC) circuit of the brain is associ- ated with feelings of panic.
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The ACC is associated with manifestations such as fear, panic, and phobia.
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3. Anursehassuccessfullycompletedadrugtreatmentprogramandisreturn- ing to work 3
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dt months later.Which of the following best describes a program designed for a nurse
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dt returning to work after treatment? dt dt dt dt