A client has abruptly stopped taking a CNS depressant, and is experiencing withdrawal symptoms. Which symptoms should the nurse expect to see?
A. Hypothermia, psychosis, seizures, decreased heart rate, increased blood pressure, and panic anxiety
B. Fever, euphoria, headache, increased heart rate, and fatigue
C. Fever, psychosis, seizures, increased heart rate, decreased blood pressure, panic, and anxiety
D. Euphoria, fever, tremor, relaxation, and coma
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Terms in this set (56)
A nurse taking an admission history from a client suspects that the physician will diagnose major depression. For the physician to make this diagnosis, the client will have to demonstrate specific symptoms. What are some of these symptoms? Select all that apply.
excessive guilt
disruption in sleep
disruption in
appetite
disruption in concentration
obsessive desire to exercise
excessive guilt
disruption in sleep
disruption in appetite
disruption in concentration
Family education concerning the safe care of a client with a history of suicide attempts includes what? Select all that apply.
List of emergency service telephone numbers
Information regarding the stressors that trigger the client's suicidal
ideations
Techniques to help the client cope with known triggers
Information on how to determine if the threat of suicide is legitimate
Signs and symptoms that indicate a mood change that could indicate the client is suicidal
List of emergency service telephone numbers
Information regarding the stressors that trigger the client's suicidal ideations
Techniques to help the client cope with known triggers
Signs and symptoms that indicate a mood
change that could indicate the client is suicidal
A client comes to the clinic for an evaluation of headache, fatigue, and an overall feeling of being "down." When assessing the client, which statement by the client would alert the nurse to suspect possible suicide? Select all that apply.
"I've been drinking about three or four more beers every night."
"I'm so tired that all I ever want to do is sleep all the time."
"I've been going out
with my friends about once or twice a week."
"Most times, I feel like I'm trapped with no way out."
"I'm looking for a new job because my job is so stressful."
"I've been drinking about three or four more beers every night."
"I'm so tired that all I ever want to do is sleep all the time."
"Most times, I feel like I'm trapped with no way out."
When conducting a focused assessment on a newly
admitted client who attempted suicide, which question should the nurse include to ensure the client's safety? Select all that apply.
"Do you still have a plan to harm yourself?"
"Have you ever tried to hurt yourself before?"
"Are you willing to tell us if you plan to harm yourself again?"
"Did you really want to kill yourself?"
"Is there a history of depression in your family?"
"Do you still have a plan to harm yourself?"
"Have you ever
tried to hurt yourself before?"
"Are you willing to tell us if you plan to harm yourself again?"
When assessing risk of suicide, which are important assessment components? Select all that apply.
seriousness of suicidal ideation
degree of hopelessness
previous attempt
lethality of method
Unemployment
seriousness of suicidal ideation
degree of hopelessness
previous attempt
lethality of
method
Which must be present in a client diagnosed with serotonin syndrome? Select all that apply.
Agitation
Hyporeflexia
Diaphoresis
Constipation
Ataxia
Fever
Agitation
Diaphoresis
Ataxia
Fever
A client with bipolar disorder is prescribed divalproex sodium as part of the treatment plan. Before administering the medication, which tests
should be done? Select all that apply.
Liver function tests
Complete blood count
Platelet count
Urinalysis
Blood glucose concentration
Liver function tests
Complete blood count
Platelet count
A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply.
Flight of ideas
Obsessive
rumination
Hypersomnia
Widespread shopping sprees
Difficulty concentrating
Obsessive rumination
Hypersomnia
Difficulty concentrating
A client diagnosed with bipolar disorder and experiencing mania is admitted to the inpatient psychiatric setting. During the acute phase of mania, which medication(s) would the nurse expect to administer? Select all that apply.
Lithium
carbonate
Carbamazepine
Fluoxetine
Paroxetine
Divalproex sodium
Lithium carbonate
Carbamazepine
Divalproex sodium
A client has just been diagnosed with a major depressive disorder following recent problems with the client's mood, work performance, and sleep quality. When planning this client's care, the nurse should anticipate what interventions? Select all that apply.
Administration of a
sustained serotonin reuptake inhibitor (SSRI)
Administration of a monoamine oxidase inhibitor (MAOI)
Phototherapy
Cognitive therapy
Repetitive transcranial magnetic stimulation (rTMS)
Administration of a sustained serotonin reuptake inhibitor (SSRI)
Cognitive therapy
A nurse suspects that a client has overdosed on the prescribed tricyclic antidepressant. Which assessment finding would support this
suspicion? Select all that apply.
Confusion
Hallucinations
Agitation
Orthostatic hypotension
Headache
Confusion
Hallucinations
Agitation
Pharmacotherapy is essential to the management of the client with bipolar disorder. The nurse understands that the goals for such therapy are what? Select all that apply.
Cure of the disorder
Rapid control of symptoms
Prevention of future
episodes
Decreased severity of manic episodes
Decreased frequency of manic episodes
Rapid control of symptoms
Decreased frequency of manic episodes
Prevention of future episodes
Decreased severity of manic episodes
Although its therapeutic mechanism of action is unknown, electroconvulsive therapy (ECT) is effective treatment for severe depression in some clients. The nurse is aware that ECT would
be contraindicated in which of the following clients? Select all answer choices that apply.
Patients with recent cerebrovascular accidents (CVAs)
Patients with recent retinal detachment
Patients with increased intracranial pressure
Patients who had recent myocardial infarctions (MIs)
Patients who had acute renal failure
Patients at risk for complications of anesthesia
Patients with recent cerebrovascular accidents (CVAs)
Patients with
recent retinal detachment
Patients with increased intracranial pressure
Patients who had recent myocardial infarctions (MIs)
Patients at risk for complications of anesthesia
A client taking a monoamine-oxidase inhibitor (MAOI) for depression should be instructed to avoid which of the following when taking the medication? Select all that apply.
Spinach
Red wine
Aged cheese
Red meat
Beer
Red
wine
Aged cheese
Beer
A client taking an antidepressant has experienced a 12 pound weight gain in 1 month as a side effect of the medication. Which of the following are nursing interventions to help this patient with this problem? Select all that apply.
Advocate with the physician to change the medication.
Recommend daily exercise.
Reassure the patient that the weight gain is not that significant.
Recommend a nutritionally
balanced diet.
Remind the patient that weight gain is better than feeling depressed.
Advocate with the physician to change the medication.
Recommend daily exercise.
Recommend a nutritionally balanced diet.
When assessing a child with major depression, which of the following would the nurse need to keep in mind? Select all that apply.
The risk for suicide is less in children than adults.
Children
have more interaction with their peers than adults do.
Mood may be more irritable than sad.
Children more often have anxiety symptoms
Somatic complaints are rarely noted.
Mood may be more irritable than sad.
Children more often have anxiety symptoms
A nurse is preparing an education plan for the family members of a client who has been diagnosed with bipolar disorder. After teaching them about
potential indicators for relapse, the nurse determines that the education was effective when the family members identify which as suggesting mania? Select all that apply.
Avoiding people
Reading several books at once
Being hungry all the time
Talking faster than usual
Sleeping more than usual
Being hungry all the time
Talking faster than usual
Reading several books at once
A nurse suspects
that a client has overdosed on the prescribed tricyclic antidepressant. Which assessment finding would support this suspicion? select all that apply
headache
blurred vision
warm dry skin
orthostatic hypotension
agitated delirium
blurred vision
warm dry skin
agitated delirium
A nursing instructor is teaching about mood disorders and informs the class that bipolar disorder is divided into
several groups. Those groups include what? Select all that apply.
Bipolar I
Bipolar I
Bipolar III
Bipolar mixed
Bipolar IV
Bipolar I
Bipolar II
Bipolar mixed
The client's family is questioning the nurse about bipolar disorder. Which statements about the etiology of bipolar disorder do most psychoanalytical theories subscribe to? Select all that apply.
Norepinephrine levels may be
increased in mania.
Manic episodes are a "defense" against underlying depression.
Acetylcholine seems to be implicated in mania.
The id takes over the ego and acts as an undisciplined hedonistic being (child).
Manic episodes are a "defense" against underlying depression.
The id takes over the ego and acts as an undisciplined hedonistic being (child).
The client presents to the Emergency Department
with a flat affect. The family is concerned about the lack of family involvement with the client. Which variables represent the highest risk for developing major depressive disorder? Select all that apply.
Mood disorder in first-degree relatives
Male gender
Older adult age group
Divorced
Substance abuse
Mood disorder in first-degree relatives
Substance abuse
Divorced
A client is being
discharged on lithium. The nurse encourages the client to follow which health maintenance recommendations? Select all that apply.
Weigh self weekly at the same time of day.
Drink a 2-L bottle of decaffeinated fluid daily.
Do not alter dietary salt intake.
See the doctor if you get the flu.
Restrict involvement in intense exercise.
Drink a 2-L bottle of decaffeinated fluid daily.
Do not alter dietary salt intake.
See the doctor if you get
the flu.
Which time periods during antidepressant therapy are persons most likely to commit suicide? Select all that apply.
After starting antidepressant therapy but not having reached the therapeutic level
After having reached the therapeutic level of antidepressants and maintained it for several years
If the client has made a choice to discontinue antidepressant therapy without medical supervision and is becoming gradually more
depressed
If the client does not adhere to the medication regimen and takes antidepressant medications irregularly
Prior to initiating antidepressant therapy but before the depression results in lack of energy
After starting antidepressant therapy but not having reached the therapeutic level
If the client has made a choice to discontinue antidepressant therapy without medical supervision and is becoming gradually more depressed
If the client does
not adhere to the medication regimen and takes antidepressant medications irregularly
Prior to initiating antidepressant therapy but before the depression results in lack of energy
Which may contribute to a staff person being less effective in dealing with a person who is at increased risk for suicide? Select all that apply.
Negative societal view of suicide
Feeling inadequate and anxious about suicide and/or his or her own
mortality
Having personally considered suicide but decided against it and not having dealt with the associated anxiety
Being unaware of his or her own feelings and beliefs about suicide
Implementing nursing interventions to decrease the risk of suicide
Negative societal view of suicide
Feeling inadequate and anxious about suicide and/or his or her own mortality
Having personally considered suicide but decided against it and not having dealt
with the associated anxiety
Being unaware of his or her own feelings and beliefs about suicide
The nurse who is developing a suicide prevention strategy would need to ensure which step is included? select all that apply
Following up with interventions to prevent suicide in the future
Consulting with family members about risk for suicide
Using assertive interventions if there is a threat of suicide
Figuring out who is at risk for
suicide
Determining imminent risk of suicide
Figuring out who is at risk for suicide
Determining imminent risk of suicide
Using assertive interventions if there is a threat of suicide
Following up with interventions to prevent suicide in the future
When talking with the spouse of a client who attempted suicide, the psychiatric nurse demonstrates understanding of the priority areas of assessment by
asking which questions? Select all that apply.
"Has your spouse attempted to kill himself or herself by injuring him- or herself."
"Has your spouse ever been psychiatrically unstable before?"
"Who will be responsible for getting your spouse to weekly hospital therapy sessions?"
"Does your spouse harm himself or herself physically when stressed?"
"Looking back on it, did your spouse give you any clue that he or she was suicidal?"
"Does your
spouse harm himself or herself physically when stressed?"
"Has your spouse attempted to kill himself or herself by injuring him- or herself."
A client who is prescribed a tricyclic antidepressant is brought to the emergency department with a suspected overdose. Which would the nurse assess to support this suspicion? Select all that apply.
headache
diarrhea
blurred vision
pale, moist skin
urinary retention
urinary retention
blurred vision
A client with major depressive disorder is prescribed new drug therapy. To best the client's adherence to this therapy, which information would the nurse include in the teaching plan for the client? Select all that apply.
The possibility that two or more drugs will be prescribed
A detailed description of possible side effects
The social barriers against psychiatric treatments
The
length of time treatment is anticipated
The importance of staying in touch with mental health care provider
The possibility that two or more drugs will be prescribed
The length of time treatment is anticipated
A detailed description of possible side effects
The importance of staying in touch with mental health care provider
A client with bipolar disorder has a plasma lithium concentration of 2.7
mE/L. Which finding would a nurse most likely assess in this client? Select all that apply.
Incoordination
Tinnitus
Fasciculations
Nystagmus
Seizures
Fasciculations
Nystagmus
Seizures
The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room? Select all that apply.
The room should have pens or pencils.
The room should not have
any sharp objects.
The room should not have locked doors.
The room should have a bed that is bolted to the floor.
The room should have facility for direct visual monitoring.
The room should not have any sharp objects.
The room should have a bed that is bolted to the floor.
The room should have facility for direct visual monitoring.
When administering and monitoring antidepressant therapy in a
client, what would be most appropriate for the nurse to do? Select all that apply.
Observe the client for cheeking of medications.
Assess orthostatic vital signs before beginning therapy.
Ask the client about the use of any herbal supplements.
Obtain liver function studies once a week
Check plasma drug concentrations 1 hours before the next dose
Observe the client for cheeking of medications.
Assess orthostatic vital signs before beginning
therapy.
Ask the client about the use of any herbal supplements.
A differential diagnosis for older clients is critical because symptoms of depression in this age group can be confused with symptoms related to which condition? Select all that apply.
Dementia
Cerebrovascular accident (CVA)
Pneumonia
Urinary tract infection
Dehydration
Dementia
Cerebrovascular accident (CVA)
When talking with the spouse of a client who attempted suicide, the psychiatric nurse shows an understanding of the priority areas of assessment when asking which of the following questions? Select all that apply.
"Does your wife harm herself physically when she's stressed?"
"Looking back on it, did your wife give you any clue that she was suicidal?"
"I understand your wife attempted to kill herself by cutting her wrists."
"Who will be responsible
for getting your wife to her daily hospital therapy sessions?"
"Has your wife ever been psychiatrically unstable before?"
"Does your wife harm herself physically when she's stressed?"
"I understand your wife attempted to kill herself by cutting her wrists."
"Who will be responsible for getting your wife to her daily hospital therapy sessions?"
For a client in crisis, assessment of the psychological
domain focuses on which of the following? Select all that apply.
Capability of the community to respond in a supportive way
Emotions
Disturbances in sleep patterns
Coping strengths
Disturbances in nutrition
Emotions
Coping strengths
A nurse is reading a journal article about bipolar disorder and common comorbidities. The nurse demonstrates understanding of the article by identifying which
condition as a common comorbidity? Select all that apply.
Anxiety disorders
Substance use
Personality disorders
Schizophrenia
Eating disorders
Anxiety disorders
Substance use
A nurse is reviewing information about the drug, lithium carbonate. The nurse demonstrates understanding of the info by identifying which situation as a potential cause of lithium toxicity? Select all that
apply.
diarrhea
hot climate
strenuous exercised
vomiting
hypernatremia
diarrhea
hot climate
strenuous exercised
vomiting
A nurse is reviewing the medical record of a client prescribed lithium carbonate. The nurse would be alert for possible increases in serum lithium concentrations based on the client's use of which substance?
Select all that
apply.
fluoxetine
ibuprofen
alcohol
furosemide
haloperidol
fluoxetine
ibuprofen
alcohol
A nurse is working with a client diagnosed with bipolar disorder and his family on relapse prevention. Which information would the nurse encourage the family to include in their emergency plan? Select all that apply.
information about other health problems
treatment preferences
past meds
taken
self-care strategies
list of emergency contacts
information about other health problems
treatment preferences
list of emergency contacts
A client is being diagnosed with major depressive disorder based on reports of depressed mood, insomnia, loss of pleasure, extreme fatigue, and poor concentration. To confirm this diagnosis, which condition related to the client's report of symptoms must be
present? Select all that apply.
Issues must be among the recognized symptoms for
this disorder
Symptoms cause a noticeable negative effect on the client's ability to function
Symptoms interfere with the client's ability to maintain social and employment relationships
The client's symptoms are unrelated to an underlying medical condition
Symptoms have been observed over a minimum of 4 weeks
Issues must be among the recognized symptoms
for
this disorder
Symptoms cause a noticeable negative effect on the client's ability to function
Symptoms interfere with the client's ability to maintain social and employment relationships
The client's symptoms are unrelated to an underlying medical condition
The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When teaching the client about this procedure, which of the following would the
nurse include? Select all that apply.
You will receive a short-acting anesthetic to relax you.
You will be awake and alert during the procedure.
You will be awake and alert during the procedure.
We will need to shave your scalp at the area where the magnet is placed.
You might feel a moderate amount of stinging at the site.
"You will be awake and alert during the procedure." "You can resume your normal activities right after the treatment."
Which of the following side effects of lithium are frequent causes of noncompliance?
select all that apply.
A) Metallic taste in the mouth
B) Weight gain
C) Acne
D) Thirst
E) Lethargy
Weight Gain
Lethargy
A nurse is administering an MAO to a client with depression. The nurse must be aware of what effects this drug can
have?
select all that apply.
hypertensive crisis if food with tyramines are ingested
interaction with other MAO's and antidepressants
diminished thoughts of suicide in depressed clients
decreased sedation and anticholinergic effects
can be given safely with meperidine
hypertensive crisis if food with tyramines are ingested
interaction with other MAO's and antidepressants
decreased sedation and anticholinergic effects
Which time periods during antidepressant therapy are persons most likely to commit suicide? select all that apply.
A) After starting antidepressant therapy but not having reached the therapeutic level
B) After having reached the therapeutic level of antidepressants and maintained it for several years
C) If the client has made a choice to discontinue antidepressant therapy without medical supervision and is becoming gradually more depressed
D) If the
client does not adhere to the medication regimen and takes antidepressant medications irregularly
E) Prior to initiating antidepressant therapy but before the depression results in lack of energy
After starting antidepressant therapy but not having reached the therapeutic level
If the client has made a choice to discontinue antidepressant therapy without medical supervision and is becoming gradually more depressed
If the client does not adhere to
the medication regimen and takes antidepressant medications irregularly
Prior to initiating antidepressant therapy but before the depression results in lack of energy
Which may contribute to a staff person being less effective in dealing with a person who is at increased risk for suicide? select all that apply
A) Negative societal view of suicide
B) Feeling inadequate and anxious about suicide and/or his or her own mortality
C) Having
personally considered suicide but decided against it and not having dealt with the associated anxiety
D) Being unaware of his or her own feelings and beliefs about suicide
E) Implementing nursing interventions to decrease the risk of suicide
Negative societal view of suicide
Feeling inadequate and anxious about suicide and/or his or her own mortality
Having personally considered suicide but decided against it and not having dealt with the
associated anxiety
Being unaware of his or her own feelings and beliefs about suicide
Which of the following would indicate an increased suicidal risk?
Select all that apply.
An abrupt improvement in mood-
Calling family members to make amends-
Statements such as, "Everything will be better soon"
Crying when discussing sadness
Feeling overwhelmed by simple daily tasks
Statement such as "I'm such a burden for
everyone"
An abrupt improvement in mood-
Calling family members to make amends-
Statements such as, "Everything will be better soon"
A client taking lithium for bipolar disorder comes to the clinic and reports symptoms which the nurse interprets as consistent with moderate lithium toxicity. Which action should the nurse perform? Select all that apply.
Withhold additional doses of lithium.
Obtain a
blood sample for lithium level.
Perform a 12-lead electrocardiogram.
Push fluids.
Contact the physician.
Push fluids.
Withhold additional doses of lithium.
Contact the physician.
Obtain a blood sample for lithium level.
The nurse educator is teaching a class on the biologic theories underlying suicide. Teaching has been effective when students identify which factor as playing a biologic role in
suicide? Select all that apply.
serotonin dysfunction
low levels of dopamine
childhood trauma
low thyroid stimulating hormone
low serum iron levels
serotonin dysfunction
low levels of dopamine
childhood trauma
The nurse is facilitating a support group for people who have lost a family member or friend to suicide. When discussing strategies for coping with grief, which should the nurse
include? Select all that apply.
take anti-anxiolytic medications as often as possible
encourage time spent in solitude
writing out the events leading up to the loved one's suicide
completing a daily journal entry before bedtime
cognitive behavioral therapy
completing a daily journal entry before bedtime
writing out the events leading up to the loved one's suicide
cognitive behavioral therapy
The
nurse is assisting the family of a client to develop an individualized plan for suicide prevention. Which intervention should the nurse include? Select all that apply.
Train a family member to conduct a risk assessment
Practice a mantra that helps with instilling hope
Listen to music when feeling overwhelmed
Using a journal to express gratitude daily
Continuing to attend a spiritual group meeting weekly
Continuing to attend a spiritual group
meeting weekly
Using a journal to express gratitude daily
Listen to music when feeling overwhelmed
Practice a mantra that helps with instilling hope
The nurse is seeing a client who has a diagnosis of schizophrenia with episodic depression. The nurse should be concerned that the client's risk for completing suicide is higher if what factors are present? Select all that apply.
The client has mobility problems
The client has been
hearing voices more often
The client experiences anxiety before seeing a support worker
The client has been drinking alcohol
The client is a female
The client has been drinking alcohol
The client has been hearing voices more often
A nurse is developing a plan of care for a client with bipolar disorder. When preparing to administer medications, which agent would the nurse anticipate as being
prescribed as the mainstay of pharmacotherapy? Select all that apply.
Lamotrigine
Carbamazepine
Divalproex
Fluoxetine
Lithium carbonate
Lithium carbonate
Divalproex
Carbamazepine
Lamotrigine
A client who has been prescribed fluoxetine for depression and has just had the dosage increased comes to the emergency department. The nurse suspects serotonin syndrome based on which assessment?
Select all that apply.
Ataxia
Constipation
Diaphoresis
Hyporeflexia
Change in mental status
Fever
Change in mental status
Ataxia
Diaphoresis
Fever
A client on a medical unit has a comorbid diagnosis of depression and has been taking mirtazapine for several months prior to the current admission. When providing care to the client, which action would be most appropriate for the nurse to
do? Select all that apply.
Assess the client's mood immediately prior to administration and 30 minutes after.
Ensure that the client adheres to the necessary dietary modifications.
Ensure that the client is not cheeking or stockpiling the medication.
Monitor the client's mood and affect over the course of the admission.
Monitor the client for hypertensive crises.
Monitor the client's mood and affect over the course of the admission.
Ensure
that the client is not cheeking or stockpiling the medication.
Because of the lag period before monoamine oxidase inhibitors (MAOIs) are effective, adequate washout periods of which time frame are recommended between the time that the MAOI is discontinued and another class of antidepressants is started?
5 to 6 weeks
1 to 2 weeks
7 to 8 weeks
3 to 4 weeks
5 to 6 weeks
A nurse is developing an education plan for a client who is prescribed escitalopram. Which side effect would the nurse include in this plan? Select all that apply.
weight gain
urinary retention
sedation
decreased sexual interest
blurred vision
Dry mouth
weight gain
decreased sexual interest
Dry mouth
A nursing instructor is teaching about mood disorders and informs the
class that bipolar disorder is divided into types/groups related to demonstrated characteristics. What are these groups/types? Select all that apply.
Bipolar I
Bipolar mixed
Bipolar III
Cyclothymic
Bipolar II
Bipolar I
Bipolar II
Cyclothymic
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