MENTAL_HEALTH_2.

MENTAL_HEALTH_2. 1. A nurse is teaching about deep-breathing exercises with a client who reports experiencing intense stress at work. Which of the following statements by the client indicates an understanding of the teaching? A. "I will hold my breath for 5 or 6 seconds each time." B. C. "I will focus on the causes of my stress during the exercise." D. "I will inhale through my mouth and exhale through my noise." 2. A nurse is caring for a client who has just received a terminal cancer diagnosis from his provider. Which of the following actions should the nurse take? A. Discourage the client forming new relationships B. Change the subject when the client becomes upset C. O*er the client advice about various treatment choices 3. A nurse is caring for a client who is seeking treatment for opioid use disorder. Which of the following actions should the nurse take? A. Initiate facility procedures for emergency commitment C. Request a prescription for varenicline from the client's provider D. Assess the client using the CAGE questionnaire 4. A nurse is caring for a school-age child who has conduct disorder and requires wrist restrains. Which of the following actions should the nurse take? A. Have the child perform range of motion exercises every 3 hr B. Obtain a prescription for the restraints within 2 hr of initiating them C. D. Ensure three fingers will fit between the child's wrist and the restraint 5. A nurse is reviewing the medical record of a client who is to begin taking aripiprazole. The nurse should identify that which of the following findings is a contraindication for aripiprazole therapy? A. Crohn's disease B. Hypothyroidism D. Asthma 6. A nurse is caring for a client who has schizophrenia and is taking clozapine. Which of the following findings is the priority for the nurse to report to the provider? A. Nausea B. Random blood glucose 130 mg/dL C D. Heart rate 104/min 7. A nurse is planning to conduct a supporting group for adolescents who have cancer. Which of the following actions should the nurse include during the orientation phase? B. Maintain the group's focus on identified issues C. Encourage the use of problem-solving skills D. Manage con=ict within the group 8. A nurse is conducting an education class for a group of clients who have schizophrenia and a new prescription for clozapine. Which of the following statements by a client indicates an understanding of the teaching? A. "I should discontinue the medication if I have adverse e*ects." B. "My symptoms will resolve in 4 days." D. "I can still take my St. John's work." 9. A nurse is providing teaching for a client who has a new prescription for a monoamine oxidase inhibitor. Which of the following foods should the nurse instruct the client to avoid? A. Grapefruit B. Yogurt C. Spinach D 10. A nurse is developing a behavior contract with a client who has antisocial personality disorder. Which of the following client goals should the nurse include in the contract? B. Use bargaining skill's for behavioral consequences C. Increase self-esteem D. Use projection during group therapy 11. A nurse is planning care for a newly admitted client who has anorexia nervosa. Which of the following interventions should the nurse include in the plan? A. Negotiate with the client how much weight she should gain each week C. Decrease the client's daily intake of fiber D. Weight the client weekly for the first month 12. A nurse is caring for a client who has alcohol use disorder and is experiencing withdrawal. The nurse should monitor the client for which of the following manifestations? A. Decreased blood pressure B. Decreased heart rate D. Hyperglycemia 13. A nurse is providing discharge teaching about medication administration to a client who has a prescription for lithium. Which of the following information should the nurse include in the teaching? A. "Take ibuprofen if you need to use a pain reliever." B. "You will need to decrease your sodium intake." C D. "You should have your lithium levels checked every year." 14. A nurse in a mental health facility is caring for a client who is being aggressive toward other clients. Which of the following actions is the priority for the nurse to take? A. Suggest the client make a list of things that make him angry B. Role model healthy ways to express anger D. Assist the client to explore techniques to reduce stress 15. A nurse in a provider's office is assessing a school-age child who has a spiral fracture. The parent of the child providers di*erent accounts of the cause of the injury. Which of the following actions should the nurse take first? B. Ask the child how the injury occurred C. Request that the parents leave the room while interviewing the child D. Report suspected abuse to child protective services 16. A nurse is caring for a client who has a new prescription for citalopram. The nurse should recognize that this medication can result in an adverse interaction when taken with which of the following over-the-counter supplements? A. Fish oil t C. Saw palmetto D. Glucosamine 17. A nurse is caring for a client who has a prescription for escitalopram. Which of the following statements by the client indicates that the medication is having the intended e*ect? A. "I am no longer having hallucinations." C. "I am gaining weight steadily." D. "My tremors have decreased significantly." 18. A nurse is caring for a client who has anorexia nervosa. Which of the following findings requires immediate intervention by the nurse? A. +2 edema of the lower extremities B. BUN 21 mg/dL D. Lanugo covering the body 19. A nurse is assessing a client who has delirium. Which of the following findings requires immediate intervention by the nurse? A. Rapid mood swings B. Impaired memory C. Inappropriate speech patterns 20. A nurse is caring for a client who has bordering personality disorder and has been engaging in self-mutilation. The nurse should encourage the client to participate in which of the following group? A. Co-dependents support group B. Desensitization therapy C. Dual diagnosis treatment group 21. A nurse is caring for a client who has Alzheimer's disease. Which of the following findings should the nurse expect? A. Rapid mood swings B. Excessive motor activity C. D. Altered level of consciousness 22. A charge nurse is discussing the care of a client who has a substance use disorder with a sta* nurse. Which of the following statements by the sta* nurse should the charge nurse identify as countertransference? A. "The client needs to accept responsibility for his substance use." B. "The client generally shares his feelings during group therapy sessions." D. "The client asked me to go on a date with him, but I refused." 23. A nurse is caring for a client who is undergoing electroconvulsive therapy. Which of the following tasks should the nurse delegate to assistive personnel? A. B. Give the client atropine 30 min before the procedure C. Assist the client to ambulate for the first time following the procedure D. Witness the client's signature on the consent for the procedure 24. 24. 25. A nurse is receiving change-of-shift report for four clients. Which of the following clients should the nurse see first? A. A client who has bipolar disorder and its speaking loudly B. A client who is taking lithium and reports weigh gain C. A client who has schizophrenia and is experiencing olfactory hallucinations 26. A nurse is assessing a client who has anorexia nervosa and began treatment 1 month ago. Which of the following findings indicates the client's adherence to the treatment plan? A. The client's potassium level is 3.2 mEq/L B. The client's current BMI is 14 D. The client reports following various cooking blogs 27. A nurse in a mental health facility is reviewing the laboratory results of a client who is taking lithium carbonate. Which of the following findings places the client at risk for lithium toxicity? A. WBC 6,000/mm3 C. Calcium 10.0 mg/dL D. Aspartate aminotransferase 40 units/L 28. A nurse manager is observing a newly licensed nurse preparing to administer an IM medication to a client who is manic and refuses the medication. Which of the following actions should the nurse manager take first? B. Demonstrate how to verbally de-escalate the situation C. Discuss the purpose of the medication with the client D. Assess the need for physical restrains 29. A nurse is assessing a client who has a history of substance use disorder and states, "People are out to get me." The client has tachycardia and hypertension. The nurse should suspect acute toxicity of which of the following substances? B. Alcohol C. Opium D. Heroin 30. A nurse is assessing a client who has anorexia nervosa. Which of the following findings should the nurse expect? (Select all that apply). A. Bradycardia C. Diarrhea E. Hypotension 31. A nurse is caring for a school-age child who has a new diagnosis of attention-deficit hyperactivity disorder. The nurse should anticipate a prescription for which of the following medications? A. Risperidone C. Valproate D. Lithium 32. 32. 33. A nurse is caring for a client who is taking citalopram. For which of the following adverse e*ects should the nurse monitor the client? A. Jaundice B. Bruising D. Urinary retention 34. A nurse is teaching a newly licensed nurse about contributing factors that can lead to the development of conduct disorder. Which of the following factors related to family dynamics should the nurse include in the teaching? A. The client's mother has asthma B. The client's father lives in the client's home C. The client is the oldest of their siblings 35. A nurse is caring for a client whose partner died 6 months ago. Which of the following findings is the nurse's priority? A. The client says he feels guilty about not spending more time with his partner C. The client frequently recalls negative experiences that occurred during his marriage D. The client relates that he is angry that the provider did not save his partner's life 36 37. A nurse is preparing for an interprofessional team meeting regarding a newly admitted client who has a major depressive disorder. Which of the following findings obtained during the initial assessment is the priority to report to other disciplines? B. Psychomotor retardation C. Markedly neglected hygiene D. Poor problem - solving skills 38. A nurse is providing counselling for a family that consists of two parents and their two adolescent children. Which of the following family members should the nurse identify in the role of monopolizer? A. The adolescent son who refuses to share personal feelings. B. C. The father who intervenes whenever the siblings argue. D. The mother who expresses hostility toward the spouse. 39. A nurse is caring for a client who states, "I am too embarrassed to tell anyone what I did last night." Which of the following responses should the nurse make? A B. "Lots of people feel ashamed to tell their secrets." C. "You shouldn't feel embarrassed to talk to me." D. "You will feel better if you tell me what you did last night." 40. A nurse is performing an admission assessment for a client who was transferred from another mental health facility. The nurse suspects negligence. Which of the following actions should the nurse take? A. Write a detailed accusation against the previous facility B. Notify the American Nurses Association of the occurrence. C D. Complete an incident report and include it in the client's medical record. 41. A nurse is leading a grief support group for bereaved clients. Which of the following client statements should the nurse report to the provider as an indication of clinical depression? A. "I don't know how I could cope if I didn't have my family's support." C. "it'll be a long time before I'm happy again." D. "I feel like I'm angry at the whole world right now." 42. A nurse is assessing a client who has bipolar disorder and is taking lamotrigine. Which of the following findings is the nurse's priority to report? A. ALT 20 units/L B. Platelets 200, 000/ mm3 C. Photosensitivity 43. A nurse is caring for a client who has borderline personality disorder. Which of the following actions should the nurse take? A. Demonstrate a sympathetic attitude toward the client when providing care. B. Encourage the use of countertransference for the client. D. Maintain consistency in assigning health care sta* for the client. 44. A nurse is providing teaching to a client who is prescribed methylphenidate for ADHD. Which of the following statements by the client indicates an accurate understanding of this medication's e*ects? A. "I'll take my medicine at bedtime because it will make me drowsy." B. "This medicine will help me relax and feel less anxious." C. D. "I need to tell my doctor if I start gaining weight." 45. A nurse is caring for a client who has bipolar disorder and is refusing to take prescribed medications. Which of the following ethical principles is the nurse displaying when he supports the client's refusal of medications? A. Veracity B. Justice C. Beneficence 46. A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed oral antianxiety medication. Which of the following actions should the nurse take? B. Implement consequences until the client takes the medication. C. Inform the client that he does not have the right to refuse the medication. D. Administrate the medication to the client via IM injection. 47. A nurse is caring for a client who has schizophrenia. The client's employer calls to discuss the client's condition. Which of the following is the appropriate nursing action? B. Consult the client's family C. Contact the facility legal department D. Contact the provider 48. A nurse is assessing a client who has schizophrenia. which of the following findings should the nurse document as positive symptoms of schizophrenia? (Select all that apply) C. Decreased motivation D. Impaired memory E 49. a nurse is assessing a client who recently experienced the loss of their partner. Which of the following questions is the priority for the nurse to ask during this situational crisis? B. "Who do you talk to when you need help?" C. "How do you think this event is a*ecting your life right now?" D. "What do you usually do to cope with problems in your life?" 50. a nurse is caring for a client in the emergency department who states that she was beaten and sexually assaulted by her partner. After a rapid assessment. Which of the following actions should the nurse plan to take next? A. Request a mental health consultation for the client B. Provide a trained advocate to stay with the client D. Conduct a pregnancy test. 51. A nurse is caring for a client who is admitted to a mental health facility after attempting suicide. Which of the following actions should the nurse take first? A. Ask the client to sign a no- suicide contract. B. Establish a rapport to foster trust C. Encourage the client to participate in group therapy 52. A charge nurse is making room assignments for new client admissions. Which of the following clients should the nurse place closest to the nurse's station? A. A client who has schizophrenia personality disorder A client who has moderate- stage Alzheimer's disease C. A client who has a history of dependent personality disorder D. A client who has a history of alcohol disorder. 53. A nurse on a mental health unit placed a client in mechanical restraints after the client assaulted another client. Which of the following actions should the nurse take? A. Request that the provider renew the prescription for restraints every 8 hr. B. Evaluate the client hourly while the restraints are applied. C. Obtain a prescription for restraints on as - needed basis. 54. A home health nurse is caring for a client who is in the continuation phase of major depressive disorder. The client states, "I feel unmotivated and don't feel like leaving my home." Which of the following recommendations should the nurse make to address the client's social isolation? A. Write in a journal daily B. Practice guided imagery each morning C. Join a low - impact exercise class 55. A nurse in an alcohol rehabilitation facility is creating a discharge plan for a client who has alcohol disorder. Which of the following recommendations should the nurse include in the plan? A. B. Teach the client to practice systematic desensitization C. Contact a close relative of the client to discuss the discharge plan D. Request a discharge prescription for buprenorphine for the client. 56. A charge nurse is educating a newly licensed nurse about various defense mechanisms. Which of the following examples should the charge nurse provide when discussing rationalization? A. B. A client whose partner died 5 years ago still talks about him in the present tense. C. A client who states she will worry about her grades after she finishes planning a party. D. A client who has stomach pain before presenting a project to his coworkers. 57. A nurse in an in- patient facility is caring for a client who has an anxiety disorder. Which of the following actions should the nurse take while the client is experiencing an acute panic attack? A. Encourage the client to watch television as distraction. B. Encourage the client to describe their feelings in a journal C. D. Administrate a dose of atomoxetine to the client 58. A nurse is reviewing the medication administration record of a client who has major depressive and a new prescription for selegiline. The nurse should recognize that which of the following client medications is contraindicated when taken with selegiline? A. Calcium carbonate B. Warfarin e D. Acetaminophen 59 60. A nurse in a long- term care facility is caring for a client. The nurse should identify that which of the following conditions places the client at an increased risk for developing delirium? A. Neuropathy B. Hypertension C D. BUN 16 mg/dl 61 62. A nurse is caring for a client who has a personality disorder and is using transference to cope. Which of the following behaviors should the nurse expect? B. Talking negatively about other stu* members C. Refusing to participate in group activities D. Expressing frustration regarding unit rules. 63. A nurse is caring for a client who receives lamotrigine daily for bipolar disorder and reports a rash on his arm. Which of the following actions should the nurse take? B. Apply hydrocortisone cream on the client's rash C. Ask the client about a recent change in laundry detergent D. Explain that the medication causes a temporary rash. 64. A nurse is caring for a client who was involuntarily committed and is scheduled to receive electroconvulsive (ECT). The client refuses the treatment and will not discuss why with the health care team. Which of the following actions should the nurse take? A. Ask the client's family to encourage the client to receive ECT. B. Tell the client he cannot refuse the treatment because he was involuntarily committed. C. Inform the client that ECT does not require client consent. 65. A nurse is caring for client who has been taking valproic acid. Which of the following is an expected outcome of the medication? A. The client reports absence of auditory hallucinations B. The client has decreased anxiety C D. The client reports improved short - term memory 66. A home health nurse visits a client who lost their partner 2 years ago. Which of the following behaviors by the client indicates a maladaptive grief response? A. The client expresses feelings of guilt. B. C. The client relocates from a house to an apartment D. The client gives away some of the partner's belongings. 67. A nurse is assessing a client who is restless and constantly mutters to himself. which of the findings should lead the nurse to suspect delirium? A. The client has a =at a*ect C. The client's speech is slow and repetitious D. The client is unable to recognize objects. 68. A nurse is reviewing the laboratory report of a client who has a panic disorder and is taking clonazepam. Which of the following laboratory report should the nurse report to the provider? B. WBC count 8, 000/ mm3 C. hemoglobin 16 g/dL D. RBC count 4.9 million/ mm3 69. A nurse is caring for a client who has depression following a recent job loss. Which of the following questions should the nurse ask to assess the client's personal coping skills? A. "Can you describe how you are currently feeling?" B. "How does this situation a*ect your life?" C. "Do you see yourself current situation a*ecting your future?" 70. A nurse on an acute care unit is caring for a newly- admitted client who has anorexia nervosa. When the nurse prepares to obtain a morning weight, the client becomes agitated. Which of the following statement should the nurse make? A. "You don't have to look at your current weight if you don't want to." B. "Why are you upset about us checking your weight today." D. "if you think you've gained too much weight, we can adjust your meal intake." 1. A patient is experiencing a panic attack a. Have them breathe in a paper bag 2. A patient is admitted with general anxiety disorder, what do you do first? a. Determine how she handles anxiety normally 3. Patient has advanced Alzheimer’s dementia, which would be a required safety? a. Lock is used for safety – but make sure it is out of reach; OR give police an updated picture 4. When giving Risperidone, what should be included in the teaching? a. Discontinue if they experience muscle rigidity 5. Patient has dementia, how should food be provided? a. Finger foods 6. Math a. 1.4 mL 7. What would be a sign that a patient with antisocial personality disorder has progressed? a. Treats others with respect 8. What would you add to the plan of care for a patient with schizophrenia displaying negative symptoms a. Personal own daily hygiene 9. Doxepin a. NO snack before bed, DOES NOT cause insomnia 10. A patient has a schizophrenic relapse a. Sleeps more than usual 11. Patient is admitted after attempting suicide, what should occur first? a. One on one observation 12. A patient has experienced intimate partner violence, what should the nurse obtain? a. Permission to take pictures 13. Which is considered a risk factor for schizophrenia? a. Environment (and genetics) 14. A new patient is admitted to the psych ward, how do you help them adapt to the health care setting? a. Community meetings 15. A child comes in with a broken arm, and bruises in varying stages, what is the first action the nurse should take? a. Ask the parent what happened 16. Which of these is an example of nonmaleficence? a. Withhold prescription causing adverse effects 17. A patient threatens to harm himself and others a. Restrain 18. A patient says I am spy for FBI, I, sky a. Clang associations (positive s/s of schizophrenia) 19. Which family member displays the roll of monopolizing? a. The daughter taking over the meeting 20. Involuntary movement scale for patient with which medication a. Haloperidol 21. The patient is beginning crisis intervention, what should occur first? a. Discuss confidentiality 22. A patient receiving Transcranial magnetic stimulation – what should the nurse expect? a. A headache after treatment 23. A patient taking MAOI’s should avoid tyramine in order to prevent what? a. Hypertensive crisis 24. Which assessment finding for an anorexic patient requires immediate attention? a. Blood pH of 7.6 25. What should be included in the plan of care for a patient with borderline personality disorder? a. Communicate needs 26. Confidentiality – what is not considered a breach of confidentially? a. Provider can alert intended victim that the client is planning to hurt them 27. Clinical psychologist a. Group therapy (the rest of the choices were different professions) 28. What is the difference between delirium and dementia? a. Manifestations develop suddenly in delirium 29. Which is an example of counter-transference? a. “this patient is just like my brother” 30. Which is an expected finding in an ETOH withdrawal patient? a. Insomnia 31. A patient is at risk for suicide, how should the bed be prepared? a. Hands on blankets when in bed 32. Which is an example of the ‘working phase’ a. Evaluate progress of goals 33. Patient with borderline personality disorder a. Implement measures to prevent self-injury 34. A bipolar patient is taking Lamotrigine, what should the nurse monitor for? a. Skin rash - SJS 35. Bulimic patient – what should be given a. 40 mEq of KCL IV (never push K but can be given slowly) 36. Anorexia a. Not decrease fiber – notify about designated meal times 37. A patient experiencing cocaine withdrawal with show which s/s? a. Rapid speech 38. Which is an example of a defense mechanism used well a. Student is upset with teacher, so writes a story about good student 39. The nurse is helping a patient suffering with auditory hallucinations, what should be included in plan of action a. Focus on reality-based activities 40. The UAP is showing signs of agitation with a patient who is depressed, what should be done a. Change their assignment 41. SATA – disulfiram a. Take once a day b. Avoid alcohol – mouthwash 42. A patient taking lithium should notify the provider if they experience what a. Diarrhea 43. Which of these patients should be reported? a. Borderline patient who wants to harm family 44. Which would be considered a form of advocacy a. Help get a referral 45. A patient experiencing manic episodes, what environmental change should the nurse perform a. Dim the lights 46. A patient states ‘I was fired because my boss does not like me’ a. Rationalization 47. Which patient is considered priority? a. Anorexia beginning to refeed 48. The nurse receives vitals on a patient with anorexia, which findings needs immediate hospitalization a. 93.1*F 49. A developmentally disabled patient is constantly stealing, which method should the nurse use for treatment a. Use positive reinforcement 50. Which is an example of transference a. The patient reacting to the nurse as mother 51. When caring for a bipolar patient that is manic, the nurse should a. Avoid power struggles – be neutral 52. What should be included in the plan of care for a patient with autism a. Initiates social interaction 53. A schizophrenia patient claims the FBI is monitoring my letters, how should the nurse respond a. ‘all letters are sealed, and that is unlikely’ 54. Patient does not want to be touched by another person a. Wear gloves 55. PTSD a. Response prevention 56. Which is an example of Maladaptive grieving a. Patient still will not go into work 57. A patient is sad hopeless and worthless after their son died, what should the nurse monitor for a. Harming themselves 58. clozapine should be withheld in a patient with which lab value a. WBC low 59. OCD care a. Thought stopping 60. A patient receiving electroconvulsive therapy might experience which side effects a. Short term memory 61. Neuro-malignant syndrome a. 104 fever 62. A patient is experiencing mania – what should be reported? a. Reports eating 2 in the past week 63. A patient refuses medication what should the nurse do a. Document 64. A client in a group is speaking badly about others – how should the ruse respond a. ‘you sound upset’