Midterm Study Guide Flashcards
Maslow’s hierarchy of needs?
Physiological (food & shelter)
Safety ( personal & financial)
Love and belonging ( social & friendships)
Self esteem
Self actualization (personal growth)
After several therapeutic encounters with a suicidal patient, which thought by the nurse would be countertransference?
The nurses feels unusually happy when the patient’s mood begins to lift
A patient diagnosed with schizophrenia states “I saw two doctors in the hall taking. They are plotting against me.” The nurse knows this is:
Ideas of reference
A patient with schizophrenia taking fluphenazine has shuffle gait, drooling, mask like face. The nurse knows this is:
Pseudoparkinsonism
Haloperidol can cause you to feel these side effects:
Sedation and muscle stiffness
Patient with bipolar disorder tells other patients to get him a book and water. The nurse’s best therapeutic action is:
Distraction techniques: offer a snack
A person is making obscene gestures and directing traffic on a busy street, has not slept or eatened in days: what symptoms of mania are present:
Poor judgement and hyperactivity
A patient receiving risperidone reports severe muscle stiffness, then is diaphoretic, drooling and difficulty swallowing . What is the nurse best intervention?
Call the doctor STAT. Possible neuroleptic malignant syndrome
The nurse received a lab report indicating a patient’s lithium serum level is 1mEq/L. The patient’s last dose was 8 hours ago.
This lab value is within normal limits
Patient diagnosed with depressive disorder begins SSRI antidepressant therapy. The nurse should provide education on:
Report increased suicide ideation.
A nurse instructs a patient taking MAOIs to avoid certain foods (Tyramine) and drugs. What would be the risk for?
Hypertensive crisis due to high levels of Tyramine.
Tyramine restricted meal, what foods are ok?
Mashed potatoes
Ground beef
Corn
Green beans
Apple pie
Patient’s family reported that patient was taking antidepressants and started having chest pain after eating avocados and cheese. What antidepressants med would this be?
Isocarboxazid
The nurse understands that second generation antipsychotic (SGAs) atypical agents may cause which side effect?
Obesity
A patient who exhibits concrete thinking is unable to communicate in which manner?
Abstractly
Why should the nurse introduce the matter of a contract during the first session with a new patient?
To explain the participation and responsibilities of each party
Patient says “my marriage is great. My spouse and usually agree on everything.” The nurse observes the patients foot moving continuously
This is mixed communication
An anticonvulsant medication for bipolar disorder
Carbamazepine
Which information gathered from the ER patient requires crisis intervention?
New onset of hallucinations
Which side effect of antipsychotic medication therapy is not reversible?
Tardive Dyskinesia ( ex. pill rolling of hands) these are permanent
Which part of the nursing process is often neglected ?
Evaluation
Patient with bipolar disorder cusses while twirling, patient’s mood is what?
Labile and euphoric
Which nursing intervention demonstrates false imprisonment?
The nurse tells the patient to stay in their room until later
What assessment findings suggest patient may be hallucinating?
Darting eyes. Tilting head and mumbling to self
Which of the following supports the diagnosis of severely depressed patient?
Insomnia.
Flat affect
Substantial weight loss.
Reports “I don’t have anymore tears to cry”.
A client says “I’m all alone in the world, I have no reason to live’” which would encourage further communication?
You sound like you’re feeling lonely and frightened
A patient says she is Queen Elizabeth, what is this?
Grandiose Delusion
Which assessment is most important when evaluating s/s of mental illness?
The client’s social and cultural norms
A patient with MDD remains in his room and avoids others. According to Erickson, what describes his developmental task?
Isolation
True statements of neurotransmitters
- are responsible for essential functions in human emotions and behaviors
- targets or the mechanism of action of many psychotropic medications
Which function does the limbic system regulate?
Emotional experiences (flight or fight).
What is the nurse’s primary goal during the assessment phase of nursing process for a patient with depressive disorder?
To collect and organize information
Which nursing intervention would establish trust with a client experiencing concrete thinking?
Being consistent and adhering to unit guidelines
Behaviors of countertransference?
- the nurse defends the client’s inappropriate behavior to the psychiatrist
- the nurse subjectively appreciates the client’s feelings
- the nurse is uneasy when interacting with the client
Which determines the scope of practice for RN employed in a psychiatric inpatient facility?
State law, which may vary from state to state.
The right to determine one’s own destiny is to “autonomy” as the duty to benefit or promote the good of others is to:
Beneficence
Which client does not have the ability to refuse meds?
A client who is an imminent danger to him or herself
A patient says “my children are refusing to visit me. I feel like giving up.” Which Erickson’s stage is she in?
Integrity vs Despair
A client has been fired and says “imagine what I can do with all this time”. What defense mechanism is this?
Intellectualization
Examples of cognitive responses to mild levels of anxiety?
Increased concentration and heightened alertness
Example of behavior response to moderate levels of anxiety?
Restlessness
Example of physical response to a panic level of anxiety?
Dilated pupils
What are true about crisis?
- specific to an individual and cause may vary
- precipitated by specific identifiable event
- contains potential for psychological growth or deterioration
Which statement suggest podromal syndrome has occurred
Behaviors associated with podromol syndrome necessitate immediate action by the nurse .
Etiology of OCD from a biological theory perspective?
Abnormalities in various regions of the brain have been implicated in the cause of OCD.
Medications can be used for anxiety disorders
Buspirone
Alprazolam
Clonidine
Fluvoxamine
Which situations would Benzo be prescribed appropriately?
Short term treatment of general anxiety disorder (GAD), alcohol induced withdrawal and preop sedation
What symptoms are seen when client abruptly stops taking diazepam?
Tremor
Insomnia
Delirium
Which non therapeutic communication technique can make a person feel interrogated?
Excessive questioning
Which scenario is most urgent to act as a patient advocate?
A homeless adult with schizophrenia where a category 5 hurricane is.
What is the therapeutic level of lithium for treatment of bipolar?
0.4 to 1 mEq/L
A persecution delusion (false belief) with schizophrenia is what.
False belief that one is being singled out for harm by another .
What is serotonin syndrome?
Overaction of the central serotonin receptors due to high dose of SSRI
