Exam 2023-2024 Final Exam Graded
A+
A client remains depressed even after an 8-week trial on several antidepressant
medications. A decision to initiate electroconvulsive therapy (ECT) is being considered
by the treatment team. Which condition is a contraindication to ECT?
Brain tumor
Type 1 diabetes
Hypothyroid disorder
Urinary tract infection - ANS---Brain tumour. ECT is contraindicated in the presence of
a brain tumor, because the treatment causes an increase in intracranial pressure. ECT
is not contraindicated in the presence of diabetes, hypothyroid, or urinary tract infection.
A nurse is assisting with the administration of electroconvulsive therapy (ECT) to a
severely depressed client. What side effect of the therapy should the nurse anticipate?
Loss of appetite
Postural hypotension
Total memory loss
Confusion immediately after the treatment - ANS---The electrical energy passing
through the cerebral cortex during ECT results in a temporary state of confusion after
treatment. Loss of appetite, postural hypotension, and total memory loss are not usual
or expected side effects. Memory loss is usually restored after a few months of
treatment.
,A nurse is monitoring a client with the diagnosis of schizophrenia who is experiencing
opposing emotions simultaneously. When providing a change-of-shift report, how
should the nurse refer to this emotional experience of the client?
Double bind
Ambivalence
Loose association
A client who was recently admitted to the psychiatric unit with the diagnosis of an
obsessive-compulsive disorder engages in a handwashing ritual. When the nurse
interrupts the ritual, the client becomes angry and acts out. What is the most probable
cause for this behavior? - ANS---The client is feeling overwhelmed in this situation. The
ritual reduces anxiety; when not permitted to complete the ritual, a client with an
obsessive-compulsive disorder will experience increased anxiety, frustration, and anger
and may act out. The client is experiencing anxiety not related to a personality clash,
the nurse's manner, or an aggressive personality.
The nursing staff is discussing the best way to develop a relationship with a new client
who has antisocial personality disorder. What characteristic of clients with antisocial
personality should the nurses consider when planning care? - ANS---Exhibits lack of
empathy for other. Self-motivation and self-satisfaction are of paramount concern to
people with antisocial personality disorder, and they have little or no concern for others.
Clients with obsessive-compulsive disorder, not antisocial personality disorder, engage
in rituals. Individuals with antisocial personality disorder are extremely dependent on
others; they count on others to extricate them from their problems. They are usually
charming on the surface and can easily con people into doing what they want.
Inappropriate affect - ANS---Ambivalence is the existence of two conflicting emotions,
impulses, or desires. Double bind is two conflicting messages, not emotions, in a single
communication. Loose associations are not two conflicting emotions but instead the
loosening of connections between thoughts. Inappropriate affect is the inappropriate
expression of emotions.
A nurse is caring for a young, hyperactive child with attention deficit-hyperactivity
disorder who engages in self-destructive behavior. What is the most important nursing
objective in the planning of care for this child?
Keeping the child from inflicting any self-injury
Helping the child improve communication skills
Helping the child formulate realistic ego boundaries
, Providing the child with opportunities to discharge energy - ANS---All nursing care
should be directed toward preventing injury, particularly with a self-destructive child.
Although improved communication skills, formulation of realistic ego boundaries, and
opportunities to discharge energy are all important, prevention of injury is the priority.
A nurse is preparing to care for a client who engages in ritualistic behavior. What is the
most appropriate intervention to include in the plan of care?
Redirecting the client's energy into activities to help others
Teaching the client that the behavior is not serving a realistic purpose
Administering antianxiety medications that block out the memory of internal fears
Helping the client understand that the behavior is caused by maladaptive coping with
increased anxiety - ANS---Helping the client understand that the behavior is caused by
maladaptive coping with increased anxiety. Helping clients understand that a behavior is
being used to control anxiety usually makes them more amenable to psychotherapy.
Treatment includes activities to help the client, not others. The client usually
understands already that the behavior is not serving a realistic purpose. Administering
antianxiety medications that block out the memory of internal fears will only mask
symptoms and will not get at the root of what is bothering the client.
A college student is brought to the mental health clinic by parents with a diagnosis of
borderline personality disorder. Which factors in the client's history support this
diagnosis? Select all that apply.
Impulsiveness
Lability of mood
Ritualistic behavior
Psychomotor retardation