RNSG 2363 ATI Mood and Affect Quiz 2020 _ San Antonio College | RNSG2363 ATI Mood and Affect Quiz 2020 _ Grade A

RNSG 2363 ATI Mood and Affect Quiz 2020 _ San Antonio College Mobility level II Clinicals ATI Mood and Affect Quiz 1. A nurse in an acute care mental health facility is caring for a client who has depression. After 3 days of treatment, the nurse notices that the client suddenly seems cheerful and relaxed and there are no longer signs of depressive state. Which of the following interventions is appropriate to include in the plan of care? a. Encourage family to take the client out of the facility for short periods of time b. Reward the client for her change in behavior c. Monitor the client’s whereabouts at all times d. Ask the client why her behavior has changed *Clients who have depression and exhibit a sudden change in behavior are at a risk and suicide precautions should be included in the plan of care. Antidepressant medications generally take 1 to 3 weeks before improvement is seen. A cheerful mood with nosigns of depressive state 3 days after treatment begins might indicate that the client has made a decision to commit suicide. 2. A nurse is reviewing the medical record of a client who has schizophrenia and is receiving olanzapine. Which of the following findings should the nurse identify as an adverse effect of olanzapine? a. Weight gain of 3 lbs in 2 weeks *Weight gain is a common adverse effect of olanzapine b. Delusions of grandeur c. Heart rate 60/min d. Oral candidiasis 3. A nurse is teaching a client who has a new prescription for lithium to treat bipolar disorder. The nurse should instruct the client to ensure an adequate intake of which of the following dietary elements? a. Sodium Lithium is a salt. If Sodium level falls, the client will retain lithium and have an increased risk for lithium toxicity. b. Potassium c. Vitamin K d. Vitamin C4. A nurse is caring for a client following a suicide attempt. The client has a history of depression, substance abuse and anorexia nervosa. Which of the following actions is the nurse’s priority? a. Reviewing the client’s toxicology laboratory report b. Making a contract with the client for eating behavior c. Initiating suicide precautions *Client safety is the nurse’s priority. Therefore, the first action the nurse should take for this client is to initiate suicide precautions. d. Administering the Hamilton Depression Scale 5. A nurse is caring for a client 3 days after admission for treatment of depression. The client leaves her current activity, approaches the nurse and states, “There’s no reason to go on living. I just want to end it all.” Which of the following actions should the nurse take? a. Ask the client if she has a plan to commit suicide *The nurse should take seriously all statements regarding suicide. Asking the client if she has a suicide plan is a specific question that the nurse should include when assessing a client who has possible suicide ideation. b. Recognize the attempt at manipulation and escort the client back to her activity c. Assist the client to her room and allow her to rest before resuming activity d. Notify the client’s family and request a visitor to stay with the client until thoughts of suicide are gone.6. A nurse is discussing postpartum depression with a newly licensed nurse. Which of the following statements indicates an understanding of this disorder? a. “Postpartum depression usually begins 48 hours after childbirth.” b. “It’s common for clients who have postpartum depression to exhibit psychotic behavior.” *Psychotic behavior is a common finding in clients who have postpartum psychosis. c. “The most common manifestation of postpartum depression is harming the infant.” d. “Postpartum depression is most often seen in women who have a history of depression.” 7. A nurse in an acute care mental health facility is preparing to administer morning medication for a client who has been taking lithium for 2 weeks and has a current lithium level of 1.0 mEq/L. Which of the following actions should the nurse take? a. Prepare for gastric lavage due to an extremely elevated lithium level b. Administer the morning dose of lithium *The nurse should administer the lithium dose since a lithium level of 1.0 meq/L is within the expected initial therapeutic range of 0.8- 1.3 mEq/L. At a therapeutic level the client might demonstrate adverse effects of lithium, such as a fine had tremor, thirst, and mild nausea and the nurse should note if any of these manifestations are present. The nurse should continue to monitorfor adverse effects and signs of toxicity, which usually occur at levels of 1.5 mEq/L or higher. c. Check the client’s medication record to assess whether the client has been refusing her lithium d. Hold the medication and assess for early manifestations of toxicity 8. A nurse is caring for a client who has been hospitalized for the treatment of bipolar disorder and will be discharged with a prescription 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 *Lithium is used to treat the manic stage of bipolar disorder. Toxicity occurs when the level of lithium in the blood becomes too high. A low sodium levels, or factors which result in a low sodium level, (such as dehydration, diarrhea, sweating, excess exercise in hot weather, diuretic use, a low sodium diet) increases the lithium level because the kidney processes sodium and lithium in the same way. If sodium levels fall, the body conserves the lithium, causing lithium levels to rise. b. Exercising moderately c. Increasing sodium intake d. Drinking green tea 9. 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 0300demanding 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 hour.” 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 emergency.” d. “You must be very upset about something.” *This therapeutic response allows the nurse to show empathy for the client’s feelings. The response is also open-ended, which allows for further communication and encourages the client to clarify the situation. 10. A nurse on a crisis hotline is speaking to a client who says, “I just took an entire bottle of amitriptyline.” Which of the following responses should the nurse take? a. “I’m glad you called, and I want to send an ambulance to help you.” *Amitriptyline, a tricyclic antidepressant, is used to treat depression. This therapeutic statement shows the nurse’s concern for the client’s safety and responds to the client’s priority need. Maslow’s hierarchy of needs states that the client’s physical and safety needs come first. Therefore, the client needs to be evaluated immediately. b. “You must have been feeling pretty depressed to do that.” c. “Do you know how many pills were in the bottle?” d. “Were you trying to kill yourself by taking an overdose?”11. A nurse is caring for a client who is in a manic phase of bipolar disorder. The client is running around the unit trying to organize competitive games with the clients. Which of the following is an appropriate intervention? a. Recommend a game of table tennis with another client b. Suggest the client exercise on a stationary bike c. Take the client outside for a walk *Clients who are experiencing mania are at a risk for physical exhaustion; therefore, the nurse should redirect the client to a different activity that will decrease stimulation and slow the client’s physical activity expenditure. d. Praise the client’s efforts to engage in social interaction 12.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 outside every afternoon *Strenuous exercise in outdoor heat, which can lead to dehydration, puts the client at risk for lithium toxicity. Mild to moderate exercise will not lead to lithium toxicity, but if the client engages in strenuous exercise during hot weather, she should take care to replace any water and sodium that have been lost through profuse sweating. This also applies to other factors that can causethe client to become dehydrated, such as having diarrhea or taking diuretics. b. The client drinks 2 liters of fluid daily c. The client eats 2 to 3 gm of sodium-containing foods daily d. The client eats foods high in tyramine 13.A nurse in an acute mental health unit is admitting a client who has bipolar disorder. Which of the following findings support the admitting the diagnosis of acute mania? a. The client’s spouse reports that the client has recently gained weight b. The client is dressed in all black c. The client responds to questions with disorganized speech *Clients who are experiencing acute mania exhibit disorganized speech such as flight of ideas. d. The client reports that voices are telling her to write a novel 14.A nurse asks a client who is suicidal to make a safety contract, but the client declines. Which of the following actions should the nurse identify as the priority? a. Lock the doors to the unit and secure windows so they cannot be opened b. Provide the client with plastic eating utensils for meals c. Remove any objects from the client’s environment that could be used for selfharm d. Assign a staff member to stay with the client at all times *The greatest risk to this client is self-injury during unsupervised time; therefore, the nurse should identify the priority action is toassign a staff member to stay with the client at all times. The staff member can monitor all of the client’s behaviors and actions and prevent the client from harming herself. 15.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 this way. c. “Why do you feel you are worthless?” d. “You’ve been feeling that your life has no meaning.” *This open-ended statement uses the communication tool of empathy and addresses the client’s feeling of worthlessness. This therapeutic response communicates to the client that the nurse was listening, and it will encourage the client to talk further about personal feelings. 16.A nurse is reviewing medications for a newly admitted client who has bipolar disorder and is experiencing mania. Which of the following client prescriptions should the nurse realize is expected to reduce the client’s mania? a. Fluvastatin b. Carbamazepine*Carbamazepine, an anti-seizure medication and a mood stabilizer, is prescribed to treat and prevent mania in clients who have bipolar disorder. c. Lorazepam d. Propranolol 17.A nurse is caring for a client who has bipolar disorder and has been taking lithium for 1 year. Before administering the medication, the nurse should check to see that which of the following tests have been completed? a. Thyroid hormone assay *Thyroid testing is important because long-term use of lithium may lead to thyroid dysfunction. b. Liver function tests c. Erythrocyte sedimentation rate d. Brain natriuretic peptide 18.A nurse is collecting data from an adolescent. Which of the following should the nurse identify as the greatest risk for suicide? a. Availability of firearms b. Family conflict c. Homosexuality d. Active psychiatric disorder *An active psychiatric disorder represents the greatest risk for suicide. An active psychiatric disorder is present in 90% of those who complete suicide.19.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 *Pancreatic, hepatic dysfunction and thrombocytopenia are serious adverse effects occasionally associated with valproate. Liver function tests should be monitored periodically to check for hepatic failure d. High serum sodium levels can cause toxic levels of valproate 20. A nurse in an emergency department is caring for an adolescent following a suicide attempt. After reviewing the client’s history, the nurse should determine that which of the following is the priority risk for suicide completion? a. Active psychiatric disorder b. Previous suicide attempt *A prior suicide attempt is found in as many as half of the adolescents who attempt suicide. c. Loss of a parent d. History of substance abuse