HESI Flashcards
What is a life threatening Adverse reaction for antipsychotic medication
Neuroleptic malignant syndrome
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.
D - sign of NMS
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.
B
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 - 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.
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.
C
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.
D - These food are okay for this pt to eat because they do not contain thymine
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.
C
Acrophobia
Fear of heights
Agoraphobia
Fear of open spaces and crowds
Claustrophobia
Fear of closed in spaces
Hydrophobia
Fear of water
Thanatophobia
Fear of death
What medications are used for Tx of OCD
Anti-anxiety: Benzos, buspirone, Remelteon
SSRIs: “-ine”
Avolition
Lack of energy
Anhedonia.
Anhedonia is the inability, or decreased ability, to experience pleasure, joy, intimacy, and closeness.
Apathy.
Apathy is the lack of feelings, emotions, interests, or concerns
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.
D - Negative symptoms are characteristic of schizophrenia and include behaviors such as minimal eye contact, poor grooming and hygiene, and apathy.
positive symptoms
Hallucinations and delusions
Negative symptoms
alogia
avolition
anhedonia
Alogia
educed fluency and productivity of thought and speech
Word salad—
stringing together words that are not connected in any way
Referential thinking—
a belief that neutral stimuli have special meaning to the individual, such as a television commentator who is speaking directly to the individual
Neologisms—
words that are made up that have no common meaning and are not recognizable
Flight of ideas—
the topic of conversation changes repeatedly and rapidly, generally after just one sentence or phrase
Echolalia—
repetition of another’s words that is parrot-like and inappropriate
Tangentiality—
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
Loose associations—
absence of the normal connectedness of thoughts, ideas, and topics; sudden shifts without apparent relationship to preceding topics
Preservation
Repeating the same word to answer different questions
Blocking
Gap or interruption in speech due to absent thoughts
Schizophrenic pt. respond well to what type of thinking or statements
Concrete thinking and concrete statements
Anticholinergic drugs are administered for what?
To treat EPS symptoms from the 1st gen antipsychotics
Ex. Benztropine
Which herbal medicine used for Tx of anxiety can cause hepatotoxicity
Kava causes hepatotoxicity
What meds are given for Bipolar disorder
Lithium (mood stabilizer)
Antipsychotics
Sedatives
When should blood levels be drawn for assessment of lithium toxicity
12 hours after the last dose
Major red flag for suicide precautions
If the client has sudden change in mood from depressed to happy
Meds to Tx anorexia nervosa
Antidepressants - SSRIs
Pt. with anorexia nervosa withdrawals from SSRI, what precautions should the nurse put the pt. on?
Seizure precautions
Major characteristic of Boarderline personality disorder
Splitting
People are either all good or all bad
Personality disorders are characterized by ___ and __ behaviors
Personality disorders are characterized by anxious and fearful behaviors
Antipsychotic drug only prescribed for Tourettes syndrome
Pimozide (orap)
SE of 1st gen antipsychotics
EPS
Orthostatic hypotension
SE of 2nd gen antipsychotics
Clozapine - angranulocytosis
Drowsiness, dizziness
Neuroleptic malignant syndrome
Signs of serotonin syndrome
Rapid onset of altered mental status Agitation Myoclonus Hyperreflexia Fever Shivering Diaphoresis Ataxia Diarrhea
Major adverse reaction for Trazadone (antidepressant)
Priapism - erection lasting more than 4 hours
NDRIs lower ___ threshold so should not be used in pt with what disorders?
NDRIs lower SEIZURE threshold so should not be used in pt with EPILEPSY
Signs of hypertensive crisis: (Caused by MAOIs)
Severe hypertension Severe HA Chest pain Sweating Fever N/V
Food high in tyramine
Aged cheese Aged meats rRed wine Beer Beef and chicken Yeast Yogurt Soy sauce Chocolate Bananas
Warning signs for hypertensive crisis
Palpitations
HA
Increased BP
What antidepressant is lethal in overdose?
TCAs
What is the nurse’s priority after the pt. has received ECT?
Maintain the pt. airway
What should the nurse have in the room after the pt. has received ECT?
Crash cart
Suction
O2
CAGE assessment
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
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.
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.
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, 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.
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, B, D, E
___ may be used during withdrawal from alcohol to decrease agitation and discomfort
BENZOS may be used during withdrawal from alcohol to decrease agitation and discomfort
