APEA Psychiatric-Mental Health Nursing|200+ Psychiatric Exam Questions and Verified Answers| Graded A+|Brand New! |

The nurse is preparing to administer methylphenidate to an older adult with apathy and depression. Which would the nurse include in the assessment to monitor for complications? Select all that apply. One, some, or all responses may be correct. - Answer Vision, Weight, Heart Rate Rationale: When methylphenidate is administered to older adults, the nurse will monitor the client's vision for signs of glaucoma, as well as their weight, heart rate, and blood pressure. Skin turgor and bowel sounds are not affected by methylphenidate. A client with schizophrenia who is receiving an antipsychotic medication begins to exhibit a shuffling gait and tremors. The primary health care provider prescribes the anticholinergic medication benztropine, 2 mg daily. The nurse should inquire about which symptom when assessing the client? - Answer Constipation Rationale: The anticholinergic activity of each medication is magnified, and adverse effects such as paralytic ileus may occur. Hypotension, not hypertension, occurs with anticholinergic medications. Dryness of the mouth, not increased salivation, occurs with anticholinergic medications. Decreased, not increased, perspiration occurs with anticholinergic medications A client with a diagnosis of schizophrenia is prescribed an antipsychotic medication. The nurse understands which side effect of antipsychotic medications may be irreversible? - Answer Tardive Dyskinesia Rationale: Tardive dyskinesia, an extrapyramidal response characterized by vermicular movements and protrusion of the tongue, chewing and puckering movements of the mouth, and puffing of the cheeks, is often irreversible, even when the antipsychotic medication is withdrawn. Akathisia (motor restlessness), parkinsonian syndrome (a disorder featuring signs and symptoms of Parkinson's disease such as resting tremors, muscle weakness, reduced movement, and festinating gait), and dystonia (impairment of muscle tonus) usually can be treated with antiparkinsonian or anticholinergic medications while the antipsychotic medication is continued. Donepezil is prescribed for a client who has mild dementia of the Alzheimer type. Which information would the nurse include when discussing this medication with the client and family? - Answer Blood tests that reflect liver function will be performed routinely. Rationale: Donepezil may affect the liver because alanine aminotransferase (ALT) is found predominantly in the liver; most ALT increases indicate hepatocellular disease. Clients taking this medication should have regular liver function tests and report light stools and jaundice to the primary health care provider. Fluids should not be limited, because a side effect of donepezil is constipation. A side effect of constipation is expected; therefore, fluids, high-fiber foods, and exercise should be recommended to help keep the stools soft. The client should not increase or decrease the dosage abruptly; donepezil should be taken exactly as prescribed. . A client has just been admitted with the diagnosis of borderline personality disorder. There is a history of suicidal behavior and self-mutilation. The nurse remembers that the main reason that clients use self-mutilation is to: - Answer Express anger or frustration A depressed client is admitted to the mental health unit. What factor should the nurse consider most important when evaluating the client's current risk for suicide? - Answer Impending anniversary of the loss of a loved one The parents of an overweight 12-year-old bring their child to the mental health clinic. One parent says, "You've got to do something to help us—just look how huge he is." The child tells the nurse, "I hate school. The other kids tease me about my weight. I'm always last when they pick teams in gym." What is the most therapeutic response by the nurse? - Answer "That hurts a lot when you want to be liked." A nurse is assigned to care for a college student who has been talking to unseen people and refusing to get out of bed, go to class, or participate in daily grooming activities. What is the nurse's initial effort toward helping this client? - Answer Attempting to establish a meaningful relationship with the client A depressed client is very resistive and complains about inabilities and worthlessness. The best nursing approach is to: - Answer Involve the client in activities in which success can be ensured The nurse is caring for a client with vascular dementia. What does the nurse identify as the cause of this problem? - Answer Disruptions in cerebral blood flow, resulting in thrombi or emboli A nurse is interacting with a depressed, suicidal client. What themes in the client's conversation are of most concern to the nurse? (Select all that apply.) - Answer Loneliness Hopelessness What is the greatest difficulty for nurses caring for the severely depressed client? - Answer quality of depression A psychologist has been a client on a mental health unit for 3 days. The client has questioned the authority of the treatment team, advised other clients that their treatment plans are wrong, and been disruptive in group therapy. What is the most appropriate nursing intervention? - Answer Accepting that the client is unable to control this behavior and setting appropriate limits A client with schizophrenia who is being admitted to a psychiatric hospital for evaluation refuses to remove dirty clothing. What should the nurse do to best meet the client's needs? - Answer Allow the client to undress when ready to help maintain identity A nurse is caring for a client with the diagnosis of somatoform disorder, conversion type. What type of affect does the nurse expect this client to exhibit? (Select all that apply.) - Answer Calm Matter-of-fact (In their head) A client who is hallucinating actively approaches the nurse and reports, "I'm hearing voices that are saying bad things about me." What should the nurse do? - Answer Reply, "I'll stay with you for a while because you seem frightened." A client who is hallucinating actively approaches the nurse and reports, "I'm hearing voices that are saying bad things about me." What should the nurse do? - Answer Recognizing that the behavior is part of the illness but setting limits on it During a routine yearly physical an older adult says to a nurse, "I haven't had sex lately because I can't get an erection anymore!" What should the nurse's initial response be? - Answer "Let's discuss this concern a little more." A nurse is caring for several clients with the diagnosis of bulimia nervosa. What primary feeling does the nurse anticipate that these clients experience after an episode of bingeing? - Answer Guilt What should be the nurse's first intervention in the care of a client with a generalized anxiety disorder? - Answer Removing as many stimuli from the client's environment as possible A male client with the diagnosis of a bipolar disorder, depressed episode, is found lying on the floor in his room in the psychiatric unit. He states, "I don't deserve a comfortable bed; give it to someone else." The best response response by the nurse is: - Answer "Everyone has a bed. This one is yours." A client confides to the nurse, "I've been thinking about suicide lately." What conclusion should the nurse make about the client? - Answer The client is fearful of the impulses and is seeking protection from them. One day the nurse and a young adult client sit together and draw. The client draws a face with horns and says, "This is me. I'm a devil." What is the best response by the nurse? - Answer "When I look at you I see a person, not a devil." A widow who is hospitalized for a medical problem has dementia of the Alzheimer type and is no longer able to live alone. The client is to be transferred from the hospital to a long-term care facility. When should the staff begin preparation for the transfer? - Answer Immediately after the client's admission to the hospital A nurse is caring for a preschool-aged child with a history of physical and sexual abuse. What type of therapy will be the most advantageous for this child? - Answer Play A nurse has been caring for a suicidal client for 3 weeks on an inpatient unit. One morning the client greets the nurse cheerfully and states, "Everything is looking up. I'm not going to have problems for very long." What does the client's behavior and statement indicate? - Answer Increased risk of suicide...