Mental Health Flashcards
A client in an inpatient psych unit has been diagnosed with posttraumatic stress disorder. They will be starting a first-line pharmacological treatment. Which medication should the nurse prepare to administer?
A. Methylphenidate
B. Dantrolene
C. Sertraline
D. Quetiapine
C. Sertraline
Sertraline is a selective serotonin reuptake inhibitor, which works to increase levels of serotonin in the brain.
An adolescent female client is brought to the pediatrician’s office by her mother due to concerns about an eating disorder. While the nurse is with the client and her mother performing a review of allergies and medical history, the client turns to her mother and states, “I only made myself throw up one time, this is not a big deal.” How should the nurse document this interaction?
A. Client has bulimia nervosa
B. Client has an attention-seeking mentality
C. Client states she “made [herself] throw up one time.”
D. Client does not take her condition seriously
C. Client states she “made [herself] throw up one time.”
Documenting exact quotes from a client can help portray objective and accurate information without the nurse making assumptions. The nurse documenting that the client made herself throw up one time is significant because it indicates the potential for maladaptive behaviour that could indicate the start of an eating disorder.
A nurse in the behavioural health emergency department is receiving handoff reports for several clients who are being treated for depression. Which client should the nurse assess first?
A. A client prescribed duloxetine complaining of a 6/10 dull headache and light sensitivity
B. A client taking venlafaxine reporting worsening depression with no suicidal ideation
C. A client prescribed sertraline reporting weight gain of 3 kg over the last 3 months
D. A client taking escitalopram with a temperature of 38.5℃ (101.3℉)
D. A client taking escitalopram with a temperature of 38.5℃ (101.3℉)
Elevated temperature in a client taking an selective serotonin reuptake inhibitor (SSRI), like escitalopram, may be a sign of serotonin syndrome.
A client in the emergency department with a history of schizophrenia is experiencing acute agitation. The healthcare provider prescribes an intramuscular (IM) ziprasidone 10 mg once STAT. Per manufacturer directions, the nurse preparing the medication obtains ziprasidone 20 mg powder and reconstitutes the medication with 1.2 mL of normal saline. How many mL should the nurse draw up to administer?
0.6 mL
The nurse is caring for a client on the cardiac unit admitted for chest pain with a history of substance use disorder. Which client statement supports diagnosis of substance use disorder?
A. “I take my Percocet every day as prescribed.”
B. “I have a beer on Friday nights after work.”
C. “I have to smoke marijuana or I won’t be able to sleep.”
D. “I tried cocaine a few times in college, but I didn’t like how it made me feel.”
C. “I have to smoke marijuana or I won’t be able to sleep.”
Substance use disorder is a condition in which an individual is unable to control their use of legal or illegal substances, such as hallucinogens like cannabis or marijuana. Since the client reports they are unable to sleep without the substance, it indicates they cannot control their use of it.
A client is scheduled to meet with a psychiatrist to rule out obsessive-compulsive (OCD) disorder. To assess the client’s risk factors for this condition, which question is most appropriate for the nurse to ask?
A. Which physician do you see for primary care?
B. What are your average meals like?
C. Have you ever been prescribed antacids?
D. Do you have a family member with OCD?
D. Do you have a family member with OCD?
Which medication(s) should the nurse expect to administer to a client diagnosed with acute anorexia nervosa and major depressive disorder? Select all that apply.
A. Ibuprofen
B. Olanzapine
C. Docusate sodium
D. Cobalamin
E. Fluoxetine
B. Olanzapine
C. Docusate sodium
D. Cobalamin
E. Fluoxetine
A client with anxiety disorder comes to the outpatient clinic and tells the nurse, “I have a very strong fear of talking to strangers and the thought of being around groups of people makes me feel panicked.” What type of anxiety is this client most likely experiencing?
A. Post traumatic stress disorder (PTSD)
B. Social anxiety disorder (social phobia)
C. Obsessive compulsive disorder (OCD)
D. Generalized anxiety disorder (GAD)
B. Social anxiety disorder (social phobia)
A nurse is caring for a client who is brought to the emergency department after a suspected overdose on illicit substances. The client is obtunded, and it is not clear what substances were used by the client. Which pharmacological treatment should the nurse prepare to administer for an opiate overdose?
Naloxone
A client is prescribed an antipsychotic medication to treat symptoms of schizophrenia. Which medication is an example of an antipsychotic?
A. Fluticasone
B. Spironolactone
C. Risperidone
D. Trazodone
C. Risperidone
A female client was admitted to the inpatient behavioral health unit after a panic attack. Which nursing diagnosis should the nurse identify as the priority for this client?
A. Ineffective coping related to the inability to manage stress
B. Risk for self-directed violence related to hopelessness
C. Risk for spiritual distress related to feelings of despair
D. Failure to thrive related to impaired grieving processes
A. Ineffective coping related to the inability to manage stress
Clients with anxiety disorders have an inability to cope with stressful situations and may make unsound decisions to address the situations. Clients often lack the coping mechanisms to adequately manage stress. Per Maslow’s hierarchy of needs, physiological needs should be ranked first, followed by psychological needs.
The nurse is caring for a client newly admitted to the psychiatric unit with major depressive disorder with psychotic features. Which is the nurse’s priority intervention?
A. Assess the client for suicidal ideation
B. Assess the client for self-care deficits
C. Implement the use of de-escalation techniques
D. Encourage the client to discuss coping skills
A. Assess the client for suicidal ideation
A client who started taking fluvoxamine one-week-ago calls the nurse and says, “I am feeling like I just want to die.” Which is the best response by the nurse?
A. “Don’t worry, that will get better with time.”
B. “Continue to take the medication as this is an expected side effect.”
C. “This is an emergency. Please have someone drive you to a hospital now.”
D. ”There is no reason to worry unless you also experience homicidal ideation.”
C. “This is an emergency. Please have someone drive you to a hospital now.”
A client with anorexia nervosa is being treated at an outpatient clinic. The nurse obtains height and weight and draws an electrolyte panel. What question is appropriate to ask to determine adherence to the treatment regimen?
A. “Do you still think you are overweight?”
B. “What feelings do you have about your caloric intake?”
C. “How do you feel about your therapist?”
D. “Have you determined why you have this disease?”
B. “What feelings do you have about your caloric intake?”
A nurse in the emergency department is caring for a client brought in by ambulance after a suicide attempt. The nurse is reviewing the client’s previous records and notes that a mental health provider diagnosed the client with a psychotic disorder. Which definition best describes this type of disorder?
A. Lack of interest in activities that were once pleasurable
B. Persistent feelings of anxiousness in social situations
C. A change in thinking or behaving that leads to an altered sense of reality
D. Aggressive behaviors towards others and threats of self-harm
C. A change in thinking or behaving that leads to an altered sense of reality
The nurse in the family medical practice is assessing a five-week-old infant brought in by their mother due to uncontrollable crying. The infant appears stable but unsettled in their car seat and cries loudly. The mother is known to the practice and was recently diagnosed with postpartum depression. Which observation should the nurse report to the healthcare provider?
A. The mother attempts to put a pacifier in the infant’s mouth
B. The mother asks if she can have her partner on the phone. At the same time, the nurse speaks with her
C. The mother removes the infant from their carrier and rocks them
D. The mother does not respond to the infant’s cries
D. The mother does not respond to the infant’s cries
A triage nurse in the emergency department is preparing to deliver care to four clients in the waiting room. Which client is at highest risk for posttraumatic stress disorder?
A. A 21-year-old presenting with shortness of breath after a house fire
B. A 65-year-old presenting for a check-up after falling in their house
C. A 30-year-old presenting with a hand laceration sustained while doing yard work
D. An 80-year-old presenting with gastrointestinal bleeding
A. A 21-year-old presenting with shortness of breath after a house fire
A client asks the nurse, “Can you please explain to me what mood disorders are?” Which is the best response by the nurse?
A. “Mood disorders are mental health conditions that affect a client’s emotional state.”
B. “Mood disorders are mental health conditions that affect a client’s ability to communicate their feelings.”
C. “Mood disorders are mental health conditions that affect a client’s ability to process information received from others.”
D. “Mood disorders are mental health conditions that affect a client’s ability to separate reality from fantasy.”
A. “Mood disorders are mental health conditions that affect a client’s emotional state.”
The nurse is developing a teaching plan for a client diagnosed with an anxiety disorder. Which statement should the nurse include in the education session?
A. “Drinking caffeine will not affect your anxiety level.”
B. “Your therapy sessions only last for two weeks.”
C. “Take your antidepressants only when you feel you need them.”
D. “When you feel anxious, you should take a walk or exercise.”
D. “When you feel anxious, you should take a walk or exercise.”
A client prescribed amitriptyline for treatment of depressive symptoms explains to the nurse that they are considering discontinuing the medication due to its side effects. The client has been experiencing a severe dry mouth and constipation. Which is the best response by the nurse?
A. “This medication does not typically cause these side effects.”
B. “These side effects should resolve on their own.”
C. “You are experiencing a cholinergic crisis and should go to the emergency department immediately.”
D. “Have you tried drinking more water during the day?”
D. “Have you tried drinking more water during the day?”
Tricyclic antidepressants (TCAs) like amitriptyline are known to cause anticholinergic side effects like dry mouth and constipation. The nurse should suggest lifestyle modifications to help relieve these symptoms, such as frequent sips of water or the use of sugar free chewing gum or hard candy to help with a dry mouth.
The nurse has provided education to a client diagnosed with bipolar disorder. Which client statement indicates further teaching is required?
A. “After I take my medication, I will take a 20-minute walk.”
B. “If I feel like hurting myself, I will call my doctor’s office.”
C. “Even if I don’t feel better right away, I should continue to take my medicine.”
D. “I have contacted a local support group to see if the meetings will be helpful.”
B. “If I feel like hurting myself, I will call my doctor’s office.”
Clients who feel they may hurt themselves or someone else should be instructed to immediately call the national suicide prevention lifeline, call for emergency services, or go to the nearest emergency department.
Two nurses in the inpatient mental health unit discuss the mechanism of action of antipsychotic medications. Which statement made by the nurse is true regarding the mechanism of action of antipsychotics?
A. “Norepinephrine is increased by antipsychotics, decreasing the symptoms associated with psychosis.”
B. “Antipsychotics target and block epinephrine in the brain, which lowers the level of serotonin.”
C. “Antipsychotics alter dopamine and serotonin in the brain by blocking D2 receptors to decrease symptoms.”
D. “Dopamine and serotonin levels in the brain are increased, thus increasing endorphins and decreasing symptoms.”
C. “Antipsychotics alter dopamine and serotonin in the brain by blocking D2 receptors to decrease symptoms.”
A client with bulimia nervosa has been receiving cognitive behavioral therapy (CBT). Which statement by the client indicates therapy has been effective?
A. “I feel frustrated with my body when it doesn’t look the way I want it to.”
B. “Every time I cheat on my diet, I just binge the rest of the day since I already blew it.”
C. “I am a broken person as a result of my illness.”
D. “I should be able to overcome my condition without any help.”
A. “I feel frustrated with my body when it doesn’t look the way I want it to.”
A client who is admitted to a voluntary behavioral health unit for depression and heroin misuse tells their nurse they are anxious about experiencing withdrawal symptoms but would like to stop using heroin. Which instruction should the nurse ensure the client understands about their plan of care?
A. “You will be given an intravenous narcotic to prevent withdrawal symptoms.”
B. “You will be given alprazolam to prevent withdrawal symptoms.”
C. “You will be given methadone to prevent withdrawal symptoms.”
D. “You will be permitted to use heroin to prevent withdrawal symptoms.”
C. “You will be given methadone to prevent withdrawal symptoms.”
A client newly diagnosed with bipolar disorder is prescribed lithium for home use. The discharge nurse provides the client education about proper medication administration. Which client statement indicates that the teaching was successful?
A. “I need to take this medication on an empty stomach.”
B. “After I’ve been on this medication for two months, I won’t need to have my lithium levels checked anymore.”
C. “I shouldn’t crush or chew my medicine.”
D. “I can stop taking this medicine when I start feeling better.”
C. “I shouldn’t crush or chew my medicine.”
A client with a history of schizophrenia is brought to the emergency department after bystanders called emergency services when the client was shouting in a nearby grocery store. When the nurse asked the client to recount the event, the client states “I am the owner of that grocery store. I own every grocery store in this country.” The client appears disheveled, in dirty clothes, with no shoes on. The client asks the nurse, “Don’t you know that I own every grocery store in this country?” What is the best response by the nurse?
A. “I understand this is how you see things now.”
B. “Can you tell me how you became so successful?”
C. “Are there voices in your head telling you that?”
D. “No, you do not; you’re imagining things.”
A. “I understand this is how you see things now.”
This client is likely experiencing a delusion, and cannot distinguish the difference between their delusion and reality. The nurse should assist them by avoiding disagreeing or arguing with them about their delusion and not asking them to describe their delusion in more detail. Instead, the nurse should say something like, “I understand this is how you see things now,” and encourage them to talk about their anxiety or fears that are underlying the delusion.
MS assessment using the ‘BOTAMI’ formation is a useful nursing assessment tool because it tells you?
A. Whether or not a client has a mental illness
B. Details about an individual’s feeling state and cognitive functioning
C. Whether a mental illness is organic or functional in origin
D. The history of a clients symptoms and his response to stress
B. Details about an individual’s feeling state and cognitive functioning
A person with an acute psychotic illness have most difficulty in?
A. Meeting dependency needs
B. Maintaining grooming and personal hygiene
C. Distinguishing between reality and unreality
D. Displaying personal feelings
C. Distinguishing between reality and unreality
People who have a personality disorder tend to?
A. Frequently progress to a psychotic illness
B. Become psychotic under severe stress
C. Be known as borderline personalities
D. Have ongoing difficulties in relating to others
D. Have ongoing difficulties in relating to others
Memory loss associated with old age
A. Has a sudden onset and affects both long term and short term memory
B. Has a gradual onset and affects mainly long term memory
C. Has a gradual onset and affects mainly short term memory
D. Has a sudden onset and affects mainly short term memory
C. Has a gradual onset and affects mainly short term memory
Asocial factor contributing to the incidence of eating disorders is?
A. Economic disadvantage
B. Educational disadvantage
C. Gender stereotyping
D. Unemployment
C. Gender stereotyping
The most common features of chronic organic psychosis are
A. Fluctuating confusion and disorientation
B. Persistent elated mood and hyperactivity
C. Thought blocking and concrete thinking
D. Social withdrawal and paranoid ideation
D. Social withdrawal and paranoid ideation
A phobia is best described as?
A. A fear related to an identifiable traumatic event in ones life
B. An irrational fear of a specific situation or object
C. A series of repetitive behaviours designed to relieve anxiety
D. A general sense of impending doom
B. An irrational fear of a specific situation or object
The most appropriate treatment for phobias is
A. Anxiolytic drugs
B. Cognitive restructuring
C. Relaxation exercises
D. Systematic desensitisation
D. Systematic desensitisation
