PSYCHIATRIC NURSING GFC SET H

Prepared by: Jon Carlo C. Yalong, RN jcyalong_24@yahoo.com

Mood Disorders 1. A 52-year-old client who was admitted to the hospital 5days ago with major depression and suicidal ideations is now preparing for discharge. Which of the following statements for the client demonstrates she has met one of her outcome/evaluation measures When I go home: a. Ill finally get some sleep. c. I have a list of people that I can call if I start to b. Ill be able to take care of my plants again. feel poorly. d. Ill cook for myself. 2. Following suicide, the family needs help in expressing grief. In which way would the nurse be of LEAST assistance? a. Help them talk together about their individual feelings b. Allow them to relive some past experiences and identify how the adolescent may have masked true feelings c. Encourage them to allow siblings to talk about what happened d. Ask them what they think they did wrong in responding to the teenager 3. Which of the following statements should the nurse explain to a client newly diagnosed with bipolar disor der who doesnt understand why frequent blood work is necessary while he is taking lithium? a. Frequent lithium levels will help the primary care provider spot liver and renal damage early. b. Frequent lithium levels will demonstrate whether the client is taking a high enough dosage. c. Frequent lithium levels will indicate whether the drug passes through the blood-brain barrier. d. Frequent lithium levels are unnecessary if the client takes the drug as ordered. 4. Which of the following short-term goals would be given highest priority for a client with depression admitted to the inpatient unit because of attempted suicide? a. The client will seek out the nurse when feeling self-destructive. b. The client will identify and discuss actual and perceived losses. c. The client will learn strategies to promote relaxation and self-care. d. The client will establish healthy and mutually caring relationships. 5. A client in an acute psychiatric hospital unit tells a nurse about his plans for suicide. The priority nursing intervention is to : a. Allow the client time alone for reflection c. Follow agency protocol for suicide precautions b. Encourage client to use problem solving d. Stimulate the clients interest in activities 6. Client who is fighting against his restraints and shouting incoherently is brought by ambulance to the Emergency Department, accompanied by his girlfriend. She reports that he seemed fine until he took some pills that he had purchased that afternoon, but an hour later he went crazy. W hich of the following actions should the nurse take first? a. Take his vital signs c. Start intravenous (IV) fluids b. Check his orientation d. Administer sedative medication 7. Serotonin has been associated with depression because it plays which of the following roles? a. It plays a role in cerebral functioning. c. It is found widely in the hippocampus b. It has a proposed role in mood states. d. It regulates other neurotransmitters. 8. One day after being admitted with bipolar disorder, a client becomes verbally aggressive during a group therapy session. Which response by the nurse would be therapeutic? a. Youre behaving in an unacceptable manner, and you need to control yourself. b. If you continue to talk like that, no one will want to be around you. c. Youre disturbing the other clients. Ill walk with you around the patio to help you release some of your energy. d. Youre scaring everyone in the group. Leave the room immediately. 9. When approaching a client during a period of great over activity, it is essential to: a. Use a firm, warm, consistent approach b. Anticipate and physically control the clients hyperactivity c. Allow the client to choose the activities in which to participate. d. Let the client know the staff will not tolerate destructive behavior. 10. The plan of care for a client in the manic phase appropriately includes plans to: a. Arouse and focus the clients interest in reality b. Encourage the client to talk as much as needed c. Persuade the client to complete any task that has been started d. Provide constructive channels for re-directing the clients excess energy 11. A lack of dietary salt intake can have which of the following effects on lithium levels? a. Decrease c. Increase then decrease b. Increase d. No effect at all 12. A client who has been taking venlafaxine (Effexor) 25 mg PO, three times a day for the past 2 days states, This medicine isnt doing me any good. Im still so depressed. Which of the following responses by the nurse would be MOST appropriate? a. Perhaps well need to increase your dose. b. Lets wait a few days and see how you feel. c. It takes about 2 to 4 weeks to receive the full effects. d. Its too soon to tell if your medication will help you. 13. A nurse is obtaining an admission history on a 22-year-old man admitted for a major depressive episode and alcohol abuse. The nurse learns that a day for the last year and recently lost his job. His wife and 5-month-old son moved into her mothers home 2 weeks ago. In further discussing his alcohol abuse the client states: I wouldnt drink so much if my wife hadnt nagged me constantly about getting a better job, making more money. I was never good enough for her. The nurse recognizes that this statement most likely suggests: a. A dysfunctional family b. The client is in denial about his alcohol problem May God be with you always!-jcy,rn

PSYCHIATRIC NURSING GFC SET H

Prepared by: Jon Carlo C. Yalong, RN jcyalong_24@yahoo.com

c. The stressors were too much for this man d. The client will have a better prognosis if he remains separated from his wife 14. A client is receiving lithium carbonate. While this medication is being administered, it is important that the nurse: a. Test the clients urine weekly. d. Withhold the clients other medications for 1 b. Restrict the clients sodium intake. week. c. Monitor the clients blood level regularly. 15. Which of the following is NOT an effect of ECT? a. Permanent memory loss c. Dislocations and fractures b. Aspiration during treatment d. Confusion and anxiety 16. The Nurse is with the parents of a 16-year-old boy who recently attempted suicide. The nurse cautions the parents to be especially alert for which of the following in their son? a. Expression of a desire to date c. Giving away valued personal items b. Decision to try out for an extracurricular activity d. Desire to spend more time with friends Schizophrenia 17. Photosensitization is a side effect associated with the use of: a. Sertraline (Zoloft) c. Methylphenidate hydrochloride (Ritalin) b. Lithium carbonate (Lithane) d. Chlorpromazine hydrochloride (Thorazine) 18. A newly admitted patient can't take care of his personal needs, shows insensitivity to painful stimuli, and exhibits negativism, rigidity, and posturing. The nurse would suspect which diagnosis? a. Paranoid Schizophrenia c. Residual Schizophrenia b. Undifferentiated Schizophrenia d. Catatonic Schizophrenia 19. A client state: The nofas are coming. In response to this neologism, it would be best for the nurse to: a. Divert the clients attention to an aspect of reality. b. State that what the client is saying has not been understood and then divert attention to something that is realitybased. c. Acknowledge that the word has some special meaning to the client. d. Try to interpret what the client means. 20. An extrapyramidal symptom that is a potentially irreversible side effect of antipsychotic drugs is: a. Torticollis c. Tardive dyskinesia b. Oculogyric crisis d. Pseudoparkinsonism 21. A psychiatric client is to be discharged with orders for haloperidol (Haldol) therapy. When developing a teaching plan for discharge, the nurse should include cautioning the client against: a. Driving at night. c. Ingesting wines and cheeses. b. Staying in the sun. d. Taking medications containing aspirin. 22. A client has been admitted to the hospital with a diagnosis of paranoid schizophrenia. She believes that her employer is controlling her by invisible wires in her head and that the electricity is dangerous. The best approach to this client is to be: a. permissive and reassuring b. consistent and honest c. warm and nurturing d. friendly and emotionally detached 23. When the nurse is talking with a schizophrenic client, she suddenly says, Im frightened, do you hear that? Terrible things. Which initial response by the nurse would be most appropriate? a. I dont hear anything. b. Who is saying terrible things to you? c. I dont hear anything, but you do seem frightened. d. Why is someone saying to you? 24. Laboratory work is prescribed for a client who has been experiencing delusions. When the nurse approaches the client to obtain a specimen of the clients blood, the client begins to shout Youre all vampires. Let me out of here! The appropriate nursing response is which of the following? a. What makes you think that I am a vampire? b. Ill leave and come back later for your blood. c. I am not going to hurt you; I am going to help you. d. It must be frightening to think that others want to hurt you. 25. The client who is neatly dressed and clutching a leather briefcase tightly in his arms scans the adult inpatient unit on his arrival at the hospital and backs away from the window. The client requests that the nurse move away from the window. The nurse recognizes that doing as the client requested is contraindicated for which of the following reactions? a. The action will make the client feel that the nurse is humoring him. b. The action indicates nonverbal agreement with the clients false ideas c. The client will then think that he will have his way when he wishes. d. The nurse will be demonstrating a lack of composure over the situation.

May God be with you always!-jcy,rn