HESI Flashcards

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1
Q

What is a life threatening Adverse reaction for antipsychotic medication

A

Neuroleptic malignant syndrome

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2
Q

The nurse should withhold the next scheduled dose of a client’s haloperidol (Haldol) based on which assessment finding?

a. ) Dizziness when standing.
b. ) Shuffling gait and hand tremors.
c. ) Urinary retention.
d. ) Fever of 102 F.

A

D - sign of NMS

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3
Q

The nurse is assessing the parents of a nuclear family who are attending a support group for parents of adolescents. According to Erikson, these parents who are adapting to middle adulthood should exhibit which characteristic?

a. ) Loss of independence.
b. ) Increased self-understanding.
c. ) Isolation from society.
d. ) Development of intimate relationships.

A

B

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4
Q

The nurse observes a female client with schizophrenia watching the news on television. She begins to laugh softly and says, “Yes, my love, I’ll do it.” When the nurse questions the client about her comment she states, “The news commentator is my lover and he speaks to me each evening. Only I can understand what he says.” What is the best response for the nurse to make?

a. ) What do you believe the news commentator said to you?
b. ) Let’s watch news on a different television channel.
c. ) Does the news commentator have plans to harm you or others?
d. ) The news commentator is not talking to you.

A

A - it is imperative that the nurse determine what the client believes she heard. The idea of reference may be to hurt herself or someone else, and the main function of the psychiatric nurse is to maintain safety. The other responses are not the priority.

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5
Q

The parents of a 14-year-old boy bring their son to the hospital. He is lethargic, but responsive. The mother states, “I think he took some of my pain pills.” During initial assessment of the adolescent, what information is most important for the nurse to obtain from the parents?

a. ) If he has seemed depressed recently.
b. ) If a drug overdose has ever occurred before.
c. ) If he might have taken any other drugs.
d. ) If he has a desire to quit taking drugs.

A

C

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6
Q

Which diet selection by a client who is depressed and taking the MAO inhibitor tranylcypromine sulfate (Parnate) indicates to the nurse that the client understands the dietary restrictions imposed by this medication regimen?

a. ) Hamburger, French fries, and chocolate milkshake.
b. ) Liver and onions, broccoli, and decaffeinated coffee.
c. ) Pepperoni and cheese pizza, tossed salad, and a soft drink.
d. ) Roast beef, baked potato with butter, and iced tea.

A

D - These food are okay for this pt to eat because they do not contain thymine

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7
Q

An adult female client is admitted to the psychiatric unit for evaluation. Her husband states that she has been reluctant to leave home for the last six months. The client has not gone to work for a month and has been terminated from her job. She has not left the house since that time. Which condition is this client likely manifesting?

a. ) Claustrophobia.
b. ) Acrophobia.
c. ) Agoraphobia.
d. ) Post-traumatic stress disorder.

A

C

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8
Q

Acrophobia

A

Fear of heights

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9
Q

Agoraphobia

A

Fear of open spaces and crowds

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10
Q

Claustrophobia

A

Fear of closed in spaces

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11
Q

Hydrophobia

A

Fear of water

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12
Q

Thanatophobia

A

Fear of death

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13
Q

What medications are used for Tx of OCD

A

Anti-anxiety: Benzos, buspirone, Remelteon

SSRIs: “-ine”

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14
Q

Avolition

A

Lack of energy

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15
Q

Anhedonia.

A

Anhedonia is the inability, or decreased ability, to experience pleasure, joy, intimacy, and closeness.

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16
Q

Apathy.

A

Apathy is the lack of feelings, emotions, interests, or concerns

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17
Q

The nurse understands that schizophrenia can be differentiated from psychosis by which assessment?

a. ) Disorganized speech.
b. ) Disorganized behavior.
c. ) Auditory hallucinations.
d. ) Negative symptoms.

A

D - Negative symptoms are characteristic of schizophrenia and include behaviors such as minimal eye contact, poor grooming and hygiene, and apathy.

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18
Q

positive symptoms

A

Hallucinations and delusions

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19
Q

Negative symptoms

A

alogia
avolition
anhedonia

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20
Q

Alogia

A

educed fluency and productivity of thought and speech

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21
Q

Word salad—

A

stringing together words that are not connected in any way

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22
Q

Referential thinking—

A

a belief that neutral stimuli have special meaning to the individual, such as a television commentator who is speaking directly to the individual

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23
Q

Neologisms—

A

words that are made up that have no common meaning and are not recognizable

24
Q

Flight of ideas—

A

the topic of conversation changes repeatedly and rapidly, generally after just one sentence or phrase

25
Q

Echolalia—

A

repetition of another’s words that is parrot-like and inappropriate

26
Q

Tangentiality—

A

the topic of conversation is changed to an entirely different topic that is a logical progression but causes a permanent detour from the original focus

27
Q

Loose associations—

A

absence of the normal connectedness of thoughts, ideas, and topics; sudden shifts without apparent relationship to preceding topics

28
Q

Preservation

A

Repeating the same word to answer different questions

29
Q

Blocking

A

Gap or interruption in speech due to absent thoughts

30
Q

Schizophrenic pt. respond well to what type of thinking or statements

A

Concrete thinking and concrete statements

31
Q

Anticholinergic drugs are administered for what?

A

To treat EPS symptoms from the 1st gen antipsychotics

Ex. Benztropine

32
Q

Which herbal medicine used for Tx of anxiety can cause hepatotoxicity

A

Kava causes hepatotoxicity

33
Q

What meds are given for Bipolar disorder

A

Lithium (mood stabilizer)
Antipsychotics
Sedatives

34
Q

When should blood levels be drawn for assessment of lithium toxicity

A

12 hours after the last dose

35
Q

Major red flag for suicide precautions

A

If the client has sudden change in mood from depressed to happy

36
Q

Meds to Tx anorexia nervosa

A

Antidepressants - SSRIs

37
Q

Pt. with anorexia nervosa withdrawals from SSRI, what precautions should the nurse put the pt. on?

A

Seizure precautions

38
Q

Major characteristic of Boarderline personality disorder

A

Splitting

People are either all good or all bad

39
Q

Personality disorders are characterized by ___ and __ behaviors

A

Personality disorders are characterized by anxious and fearful behaviors

40
Q

Antipsychotic drug only prescribed for Tourettes syndrome

A

Pimozide (orap)

41
Q

SE of 1st gen antipsychotics

A

EPS

Orthostatic hypotension

42
Q

SE of 2nd gen antipsychotics

A

Clozapine - angranulocytosis
Drowsiness, dizziness
Neuroleptic malignant syndrome

43
Q

Signs of serotonin syndrome

A
Rapid onset of altered mental status
Agitation
Myoclonus
Hyperreflexia
Fever
Shivering
Diaphoresis
Ataxia
Diarrhea
44
Q

Major adverse reaction for Trazadone (antidepressant)

A

Priapism - erection lasting more than 4 hours

45
Q

NDRIs lower ___ threshold so should not be used in pt with what disorders?

A

NDRIs lower SEIZURE threshold so should not be used in pt with EPILEPSY

46
Q

Signs of hypertensive crisis: (Caused by MAOIs)

A
Severe hypertension
Severe HA
Chest pain
Sweating
Fever
N/V
47
Q

Food high in tyramine

A
Aged cheese
Aged meats
rRed wine
Beer
Beef and chicken
Yeast
Yogurt
Soy sauce
Chocolate 
Bananas
48
Q

Warning signs for hypertensive crisis

A

Palpitations
HA
Increased BP

49
Q

What antidepressant is lethal in overdose?

A

TCAs

50
Q

What is the nurse’s priority after the pt. has received ECT?

A

Maintain the pt. airway

51
Q

What should the nurse have in the room after the pt. has received ECT?

A

Crash cart
Suction
O2

52
Q

CAGE assessment

A

C - ever felt like you need to cut down on drinking
A - ever felt annoyed when someone tells you you are drinking too much
G - ever felt guilty
E - eye opener

53
Q

If it is determined that Matt is dependent on alcohol, which information should the nurse obtain in order to predict the onset of withdrawal symptoms?

a. ) The frequency with which the client drinks alcohol.
b. ) The last time the client consumed an alcoholic beverage.
c. ) The quantity of alcohol the client usually drinks.
d. ) Past withdrawal symptoms the client has experienced.

A

B - This information is important, and the answer can help the nurse predict the onset of withdrawal symptoms, which can begin as early as 4 to 6 hours after substance use.

54
Q

Which items can the nurse allow Matt to keep in his room? Select all that apply

a. ) Unlaced tennis shoes.
b. ) Aftershave lotion.
c. ) Electronic book reader.
d. ) An electronic cigarette.
e. ) A personal photo.

A

A, C, E - Aftershave lotion contains alcohol, and this is contraindicated for the client. The client may keep his electronic book reader, but it cannot connect to the internet. The client must keep the battery’s charging cord at the nurse’s desk and the staff may charge the battery for him as needed.

55
Q

What are some of the ramifications of drinking alcohol while taking disulfiram (Antabuse)? Select all that apply

a. ) Severe headache.
b. ) Nausea and vomiting.
c. ) Hypertension.
d. ) Chest pain.
e. ) Hypotension.

A

A, B, D, E

56
Q

___ may be used during withdrawal from alcohol to decrease agitation and discomfort

A

BENZOS may be used during withdrawal from alcohol to decrease agitation and discomfort