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Mental Health ATI mastery, Study THIS ONE!

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Mental Health ATI mastery Test Bank/ Solution guide, Updated 2021/2022 Clinical finding of anorexia nervosa - Amenorrhea- what to look for? Clinical finding of bulimia - Tooth erosion, hand calluses, hypokalemia What causes parotid gland swelling - Increased serum amylase levels What lab value would you expect to see in a client with alcoholic cardiomyopathy - Increased CPK- enzyme released when tissue is damaged Common behavior associated with dependent personality disorder - Needing excessive external input from others to make everyday decisions Characteristic of avoidant personality disorder - Difficulty starting new relationships, unless he feels accepted. Are unwilling to get involved socially unless one feels accepted. What is part of healthy adolescent behavior - Exhibiting a realistic self-concept What age group displays an egocentric approach to problem solving - Pre schoolers What age group demonstrates distrust of others - Infants What is a common characteristic of autism spectrum disorder - Language delays What disorder is associated with fears of abandonment - Separation anxiety disorder What places a client with schizo at greatest risk of self-directed injury or harm to others - Command hallucinations Example of active listening - Attention to body language (identifying verbal and nonverbal communication) How much percentage of weight loss must occur in order for a pt to be required hospitalization - Over 30% within 6 months What clinical finding of a pt with anorexia nervosa requires hospitalization - Temp of 96.1 degrees - severe hypothermia due to loss of SQ tissue or dehydration How offer should a pt in seclusion be offered food? ( Prescribed haloperidol and seclusion, what should be included in plan of care?) - Every hour also document behavior every 15-30 min vitals every 1 to 2 hrs; keep communication w/client direct and brief; obtain written Rx from HCP ASAP, typically within 15-30 min; HCP should review Rx every 24 hr What is an early indication of depression - Decreased social involvement Signs of cocaine intoxication - Tachycardia, elevated BP, dilated pupils & agitation Signs of heroin intoxication - Constricted pupils & decreased BP Adverse effects of imipramine- for depression - Urinary retention, tinnitus, weight gain & tachycardia, Tricyclic -Anticholergic Effect Signs of PTSD & Priority action - Distressing dreams, difficulty concentrating & exaggerated startle response, (not delusions and compulsions). safety; making the client feel safe What is a sign of lithium toxicity? Side Effects that cause patients to stop taking it? - Coarse hand tremors- prevents them from doing ADLs. What lab does a nurse need to evaluate for a pt taking risperidine - Blood glucose- can cause DM to develop What kind of foods should a pt on tranyclopromine avoid - Foods high in tyramine, such as some cheeses, avocados, and bologna Clinical findings of mild anxiety - Restlessness, irritability, nail biting & fidgeting. Feels restless & irritable before taking exam. what level of anxiety? Clinical findings of moderate anxiety - Tension, palpitations, increased HR & diaphoresis Clinical findings of severe anxiety - Difficulty sleeping, light headedness, nausea, tremors & sense of impending doom Clinical findings of panic anxiety - Hyperactivity, severe tremors & uncoordinated impulsive behavior Indication of complicated grief - Difficulty carrying on normal activities following a loss. I feel so empty without my wife, its hard to get up every morning. What med should be prescribed to a pt experiencing alcohol withdrawals - Chlordiazepoxide What med should be prescribed to a pt to assist in alcohol abstinence - Disulfiram Taking tranylcypromine. What is good food choice? - Roasted chicken Hx of gambling dependence and participates in support group. What is the purpose of attending the group? - Provide assurance that others have similar problems Haloperidol what should be reported? - Shuffling gait Autonomy - The right of self goverment Discharged from inpatient detoxification program and plans to attend AA. What statement indicates understanding of teaching? - I will use peer support to maintain my abstinence Bereavement support group, one member is silent after several sessions. What should nurse do To encourage participation? - Divide the group into pairs to discuss topic, then summarize the discussion to the group Conduct disorder is being destructive , throwing things and kicking others. What intervention is highest? - Use a therapeutic holding technique. Exhibits anger, aggression and violent behavior, what is priority? - Create a large personal space Borderline personality disorder. Priority care goal? - The client will refrain form self mutilation. Situational crisis - The client recently lost grandparent in a MVA. unexpected event, changes that results when a person faces an event or situation that causes a disruption in his or her life. Code of ethics for RN - The right to treatment ensures individualized care Suspects abuse for an elderly client - Check the client for other sings and symptoms of abuse Valproic acid, what should be monitored to determine effectiveness of med? - The client has decreased episode of pressured speech. Decreased insomnia, grandiose thoughts, and hyperactivitiy. Bipolar client is bragging and dominating the conversion in group therapy. What should the nurse do? - Tell the client to calm down or he will be dismissed form the session. What is expected with chronc stress? - Viral infection Client wants to use herbals instead of pharmaceuticals. What classifications is the medicine practice? - Alternative medicine Client has lost 25lb in 3 months. She weighs 88lbs and states that she if fat. What is first priority? - Identify the client's nutritional status. Personality disorder and demonstrates manipulative behavior. What intervention should be included in plan of care? - Institute consequences for manipulative behavior. Clint is being d/c to nursing home. States why do I have to go to 'that place'? What is appropriate nursing response? - Did your doctor or anyone else talk to you about going to the nursing home? Client sits quietly and calmly after a traumatic assault. What behavior is this? - Denial What is appropriate to include in plan of care for client with schizophrenia? - Limit the number of questions asked during the assessment. Client becomes upset and breaks a chair. What should the nurse do first? - Administer an antianxiety medication Tertiary interventions for suicide. - I should provide counseling for the family following the suicide of a client Client was alert X3, but is now restless and confused. What interventions are appropriate? - Move the client to a room closer to the nurses station Client has delirium tremens. What actions should be done first? - Raise the bed side rails Hypochondriasis, what supports this? - Constant worry about the underdiagnosed presence of a terminal illness Continuous pacing at a rapid pace being treated for anxiety. What intervention is appropriate? - Talk calmly to the client Histrionic personally disorder. Priority intervention? - Promote appropriate behavior during group therapy session. Adjustment disorder. Expected finding? - Parents divorced two months ago Coronary artery disease. Afraid of dying form heart attack. Nursing response? - Tell me more about these fears of dying from a heart attack? Substance abuse program. Stated this is my entire wife's and boss' fault. - What defense mechanism is this? Projection Hypothyroidism meal planning? What should be added to diet? - Whole grains Autistic disorder. What should be included in plan of care? - Establish a reward system for positive behavior. signs of bulimia - tooth erasion Russell's sign= callused knuckles from self induced vomitting what lab value do you expect with alcohol cardiomyopathy - high CPK which PD- pt needs external input to make everyday decisions - dependent a client that demonstrates a dedication to his job that excludes time for leisure activitites - OCD adheres to a rigid set of rules - OCD toddler healthy behavior - requires literal explanations does an autistic kid have fear of abandonment - nope- a kid with separation anxiety does does an autistic kid have hostile behavior - no- a kid with oppositional defiant disorder does a pt is getting a new Rx of haldol- what symptom should you tell them to report - shuffling gait (dry mouth and blurred vision are common- also teach the client to stay out of sun) the nurse is caring for a client who has anorexia- which criteria requires hospitalization - weight loss of over 30% in 6 months hypothermia- less than 96.8 K less than 3 HR less than 40 a nurse is planning DC teaching to a family member of a pt newly diangosed with depression= what should the nurse teach about relapse - early identification of changes such as decreased social involvement is important is this true= medication compliance will prevent further need for inpatient hospitalization - not always intoxication of _____ HR 104 BP 152/94 dilated pupils - cocaine would a high BP and HR be common if intoxicated with inhalants - nope- these are depressants purpose of attending support group - provide assurance that others have a similar problem sign of delerium - sudden onset- rapid inappropriate speeach do clients with delerium have slow speech - no- rapid do clients with delerium have a flat affect - no-appropriate do they have normal moods? - no- mood swings can ECT increase risk of parkisnons - no how often does ECT happen - 2-3 times a week for 6 to 12 treatments so 4-6 weeks should you move a pt with depression to a private room - no- they are risk of self harm and isolated better to move the bipolor patient what lab should you do if patient is getting risperidone - glucose- can cause diabetes defense mechanism of conversion - uncosciously converting anxiety into physical symptoms transferring feeling about illness to another less threatening situations - displacement client demonstrates opposite action of what she is really feelings - reaction formation in the presence of low ____ levels renal excretion of lithium is reduced and client is at risk for toxicity - NA so less than 135 is bad what is tranylcypromine - MAOI is bologna okay to eat with MAOI - no- processed meet can you have avocodos - no can a client with MD make informed health desicions and give consent - yes who can not give consent - kids less than 18 intoxicated- blood alcohol level of .08 client with a dose of morphine what should you do to help encourage a silent group member to participate in group - divide the group into pairs to discuss a topic, then summarize the discussion to the group wht should you do if people try to monopolize the discussion - encourage the group that everyone should have a chance to participate ask the group to share observations of other group members (dont do this for the silent patient) what should you do if a patient exhibits demoralizing or negative behavior - focus on the group member and emphasize their helpfullness ___ increases the likelyhood of family violence - substance use "my son has a few drinks each night to unwind" is a sign clinical findings of mild anxeity - restless, irritable, nail biting, fidgeting sign that valporic acid is working - less pressured speech (remember for bipolar) less insmonia less gradiose a client was admitted as involuntary for substance abuse and is refusing the lorazepam- what do you do - dont give it- they still have the right to refuse treatment when the client maintains eye contact and leans forward - shows he trusts the nurse child with conduct disorder is behaving in a destructive manner- throwing things and kicking people- what is highest priority intervention 1. encourage kid to express feelings 2. promote attendance at an assertive training group 3. try relaxing breathing 4. use a therapeutic holding technique - 4- hold- need to maintain safety to establish a trusting nurse relationship th enurse should first - inform the client that her admission will be confidential (express confidentiality in the initial phase or relationships) what should you do in working phase - introduce clients to others in the day room assist the client to make behavioral changes determine coping strategies the client has used in the past dementia patient- useful to help orient them to reality - place a large calendar on the wall the tx plan is for a pt with schizo to gain autonomy from his parents. Prior to DC the nurse should plan to - schedule a family conference not stress to the client that he needs to be more independent in group a bipolar patient begins bragging and dominating the situation- what should the nurse do - tell the client to calm down or he will dismiss him from the group adventitious crisis - town hit by tornado external disaster maturational crisis - son leaves for college or fear of upcoming retirement natural life event a nurse is developing a plan of care for a patient who exhibits anger, aggression, and violent behavior, what is the priority nursing intervention - create a large personal space- this helps provide safety not use therapeutic communiciton (this only prevent escalation of agression and is a part of ongoing therapy) prupose of AA - to use peer support to maintain abstinence client in group gets angry and yells "listening to you people is making me worse. how do you respond - you sound angry and frustrated. tell us more about how you are feeling what drug should you give for alcohol withdwaral - chlordiazepocide (librium)- benzo does the code of ethics esure the right to tx and individualized care - yes the duty to protect third parties requires a nurse to testify about a client - no- only if she is given info regarding potential harm a nurse is caring for a client with a hx of agression, the client is playing cards and throws them at other patients- what should you do - ask the client how he is feeling (therapeutic cmcn) not take the cards away (this will increase aggression) explaining unit rules will not help either if you overhear another nurse talking bad about a client what should you do - do not confont that person directly report it to charge nurse anorexic client who needs to increase oral intake- what interventions should the nurse take - restrict caffiene - diuretic should you increase or decrease fiber - increase to prevent constipation should you offer rewards for the amt of weight gained - no- for the amt of calories taken in though can reward should you increase daily intake to 2500 cals - initial intake should not go below 1200 but 2500 may be too overwhelming (want small frequent meals) a nurse in a 24 hr mental health facility is planning DC for a client with a long history of alcohol use disorder- what postdischarge activity should the nurse plan to inlcude - attending a relapse prevention group several times each week like AA 12 steps is buprenorphine for alcohol - no- opioids- heroin is methadone for alcohol - no- heroin a client is experiencing alcohol withdrawal delerium- which roommate is most appropriate for this patient - one with depression- will allow client to rest pt with acl withdrawal needs uninterrupted rest why would a hypervigilant roommate not be good - this pt will not let the pt with alcohol withdrawal get the most rest he needs example of the displacement defese mechanism - the client critizises the nurse each med administration time (really mad about meds but taking it out on nurse) what defense mechanism is (the client reports a HA each day when group therpay is scheduled) - conversion what defense mech (client always talks about healthy eating habbits) - reaction formation defense mech (the pt complains about the taste of the food) - rationilization good statement that shows that suicide risk has decreased - "it is easier to talk about my feelings now" "im relieved now that my finanical affairs are in order" - more at risk when afairs are in order "thank you for taking such good care of me" - more at risk- people show an appreciation for loved ones when contemplating suicide who is at great risk for injury when doin gADLS - stage 6 alzheimers disease maintenanc ephase of schizo - calm and able to preform self care how can you help with OCD behaviors - assist the lcient to set limits of behaviors should the client with OCD monitor the number of times he has obsessive thoughts - no- this can be ven more time consuming how should you assess spirituality - discuss spiritual issues in a conversational manner not in a formal manner (this should be done by a pastor) a client is taking an SSRI like paroxetine- what should you tell the client to report to you if they notive - FEVER- Serotnonin syndrome not sex dysfunciton- this is normal priority assessment finding for a client taking valporic acid - pt has not slept in 24 hours not fine hand tremors (this is normal effect) highest priority intervention for a pt with OCD - help client id sources of anxiety not teach client focused relaxation techniques (good but not better that identifying sources of anxiety) could also use + reinforcement for nonritual behavior but not best admitting a pt experiencing alcohol withdrawal, is nauseas, shaking, and irritable- priority interventin - date and time of last drink (worst withdrawal 24-48 hrs after last drink) when client is unable to openly acknowledge nd express grief - disenfranchised grief exxaggerated grief - distorted grief what do you expect with masochism - fantasized being humiliated and bound recurrent, sex urges of being beaten, bound, and humiliated exhibitionism - exposing genitals to strangers fetishism - sex fantasies about non living objects frotteurism - urges to touch and rub against non consenting individuals exaple of enmeshed boundaries - children taking care of their younger siblings what do you say if a pt becomes verbally abuseive - i am leaving now but returning in a few minutes to see if you are calmer which label worries us with clozapine - WBC of 2500 intervention for patient with delerium - permit the client daily rituals to decrease anxiety dont keep lighting dim (want to be able to see invironment) dont give too man decisions because may get frustrated teach about light therapy for SAD - wear sunglasses when go outside- bc light therapy can cause eye strain and sensitivity to light (dont need to increase fluids bc will not cause dehydration) should you get a no suicide contract from a pt who recently attempted suicide and is angry over being admitted - no- should wait til pt is no longer angry and you can develop rapport first so what should you do with this patient (just attempted suicide and is angry about admission) - administer adntidepressant 1 to 1 observation a client says about ECT "I will be able to stop taking my antidepressants after the tx" - nope= sorry need maintenacne planning teaching about relapse prevention to a client who just began an outpatient substance use disorder tx program- what should you teach at the beginning - simple rules and objectives or program (pt still may have cog impairment RT detix) teach about resperidone - 1. may cause high blood sugar 2. mestrual irregularities may occur while on this med 3. you make experience dizziness while taking this med (no increase in hair or excess sexual desire) how do you use simple restitution as a behavior managment technique for a child with conduct disorder - make the child pick up books after he threw them all over the room "Im not going to my family reunion because no one asked me to help plan it" - sign of uselessness is a sign of depression refer families to a grief counselor following suicide - tertiary work with nurse to determine students at risk for suicide - primary (preventing suicide) establish a telephone hotline for individuals experiencing a suicide crisis - secondary review suicide precautions with nursing staff - secondary (involves treating a client during suicide crisis) an impotant consideration in promoting client adherence to treatment regiment - providing care to a clients physical health needs teach about buspar - dont take with grapefruit bc will intensify effects takes 3-4 weeks to work will not cause withdrawal early stage of grief= denial - "i think my labs got mixed up with someone elses" highest priority intervention for a kid with ADHD - remove unesarry stuff from childs surroundings cb greatest risk if injury to impulsive behabior not use + reinforcement when the pt gets a task done behavior that indicates that the client shoul dhave restraints removed - listens to nurses directions sign of recovery for someone who was sexually assulted - client expresses interest in intimate relationships signs of depression - flat affect anhedonia feeling hopeless which lab value of a pt on lithium should make you hold med and call dr - BUN of 45- lithium is hard on kidneys BUN normal is 6-20 primary prevention - promoting self esteem administering meds to minimize long term efects of violence - secondary what shoul dyou do if one pt is talking too much in group - ask the clients to discuss their feelings about the monopolizing behavior important teaching need for a pt on olonazpine - do not drive after initial doses- will make you drowsy and dizzy order the phases of the nurse client relationship - 1. pre-orientation= identify safety risks 2. orientation phase= set parameters 3. workin gphase= promote problem solving skills 4. summarize goals secondary dementia caused by thiamine def. - korsakoff's syndrome- be sure to help client with ambulation first action when you witness one client with dementia slap another - call team members for help do not try to go by self priority action by nurse to client just admitted with bipolar - provide frequent high calorie snacks voluntary admission- doing initial assessment and pt says "I've lost control of everything in my life" - are you having thoughts of killing yourself Imipramine - Antidepressant, structurally similar to phenothiazines but has no antipsychotic activity; parent compound to the tricyclic antidepressant. Can cause urinary retention and anticholinergic effects. Risperidone - Can cause diabetes mellitus to develop. Monitor blood glucose. Adventitious crisis - situational crisis is external crisis, maturational crisis deals with age related events, and natural disasters or 9/11 is an example of this crisis Creatine phosphokinase - Is a muscle enzyme released when muscle tissue is damaged, as in cardiomyopathy. Extrapyramidal side effects associated with typical antipsychotic medications - include lip smacking and tongue rolling Stay with the client and take them into a quiet room. - If the client is experiencing severe anxiety what should the nurse do first? After the attack has subsided to prevent further anxiety - When should the nurse establish an exercise routine or a relaxation technique or help identify triggers for anxiety? Compulsions - What do clients do to reduce anxiety? Haloperidol - While taking what drug should the nurse tell the patient to avoid activities until vision is clear? And wear sunglasses and limit sun exposure. Sip fluids and chew sugar less gum Sudden Onset Rapid Mood Swings Expression of Feelings Rapid inappropriate speech and language - What indication would let the nurse know that a patient is experiencing delirium? Sodium If levels are low then lithium excretion is low. - If lithium levels are high what other lab level are we worried about when giving lithium? Do not give it!! Allowing another nurse to try is going against the clients rights - When client rejects medications what do you do? To see that others have the same problems - What is the purpose for others attending a support group? The right to treatment ensures individualized care - When teaching about code of ethnics for nurses what should you include? Requires a nurse to take action if she is given information regarding potential harm to others - What is the duty to protect the third parties? Communication between clients and staff - Privileged communication protects who? Married, pregnant, Parents, or emancipated - Children younger than 18 can only give informed consent under what conditions? Benzo Intoxication - Just a decreased in BP are signs of what? Inhaled Substances - Patients who have CNS depression have what intoxication? Blood Glucose because this drug causes diabetes mellitus - Patients taking risperidone the nurse should monitor what? Hypertensive Crisis - If patient does take tyramine foods with a tranyclpromine what will happen? External disaster - What is an adventitious crisis? Natural life event ex. Son leaves for college, client is ambivalent about upcoming retirement - What is a maturational crisis? To prevent withdrawal symptoms of opioids - What is Methadone for? Patient taking responsibility - When patients are making lifestyle changes what do you look for in the questions? Inform the client that her admission will be confidential - To establish a nurse-patient relationship the nurse should do what first? Orientation Phase Assist client in facilitating behavioral changes Introduce other clients in the day room Determine coping strategies patient has used in the past - What happens during the working phase of the nurse-client relationship? Early identifications of changes such as decreased social involvement is important - What is important to education about relapse in a client who has depression? Offering self - What demonstrates genuine interest in the client? Silence - What demonstrates willingness to wait for the clients response? To encourage the client to acknowledge his feelings - Reflection of feelings is doing what with the client? A family member using alcohol - What shows signs of abuse in an elderly? Motor and verbal tics - A child who has Tourette's disorder will demonstrate what? Hostile Behavior - A child who has oppositional defiant disorder is most likely to demonstrate what? Tell client to calm down or he will be dismissed from the session - Bragging or dominating the conversation what do we do? Use a therapeutic holding technique - What do we do when a child has a conduct disorder? risk for harming others Schedule Family Conference - Autonomy from his parents, the nurse should plan what prior to discharge? Clock on the wall - What would you use to reorient the patient ? The patient is beginning to trust the nurse - If a patient leans forward and makes eye contact the nurse can observe that? Create a large personal space - A patient is angry and mad what is our first priority to do? Divide into pairs to discuss a topic then summarize the discussion to the group - If a patient is quiet and silent during group therapy what do we need to do? Suppression - Under a lot of stress and she doesn't want to talk about her problems Reaction Formation - Demonstrates opposite behavior of what she is really feeling ex. Talks about benefits of healthy eating habits Transference - Patients feelings towards nurse- I feel like you talk to me like my sister does. Countertransference - Nurse feelings toward patient 1. During the procedure I will have a cardiac monitor in place 2. I can expect to have two treatments a week for the next 4 to 6 weeks 3. Following the procedure the patient will have short term memory loss - Client undergoing ECT what do we need to inform the patient about? Requires literal explanations - What does a toddler require? Flat effect - What is an example of negative symptoms? Hallucinations Sensory perception that does not exist - What is an example of positive symptoms? Demonstration a dedication to his job that excludes time for leisure activities Rigid set of rules - OCD what does this patient need? or do? Russell's signs Calluses on knuckles Tooth Erosion - What occurs when someone performs self induced vomiting? Bereavement - What is it when a client is expressing preoccupation with the image of the dead one. And expressing anger and guilt Food - When client is on restraints what do we want to offer lots of every hour? 15 to 30 mins - How often do we nurses need to document when a patient is on restraints? A temperature lower than 98.6- severe hypothermia 30 % of weight loss in 6 months of total body weight HR less than 40 - What requires immediate hospitalization in patients who have anorexia nervosa? Rationalism - Complains about the taste of food Conversion - Unconsciously converts her anxiety into physical problems. Reports a headache every day when group therapy is scheduled Not Angry - Nurse should obtain a no suicide contract when a patient is? diazepam - Valium - benzodiazepine alprazolam - Xanax - benzodiazepine chlordiazepoxide - Librium - Benzodiazepine anxiolytic/sedative/hypnotic. clorazepate - Tranxene - benzodiazepine oxazepam - Serax - benzodiazepine clonazepam - Klonopin - benzodiazepine flumazenil - Romazicon - benzodiazepine toxicity antidote paroxetine - Paxil - SSRI zertraline - Zoloft - SSRI escitalopram - Lexapro - SSRI fluoxetine - Prozac - SSRI fluvoxamine - Luvox - SSRI duloxetine - Cymbalta - SSNRI buspirone - BuSpar - atypical anxiolytic buproprion - Wellbutrin, Zyban - atypical antidepressant, decrease craving/withdrawal from nicotine amitryptaline - Elavil - TCA imipramine - Trofranil - TCA doxepin - Sinequan - TCA nortriptyline - Aventyl - TCA amoxapine - Asendin - TCA trimipramine - Surmontil - TCA lithium - Lithane, Eskalith, Lithobid - Mood stabilizer carbamazepine - Tegretol - mood stabilizing anti-epileptic valproic acid - Depakote - mood stabilizing anti-epileptic *******************************CONTINUED***********************

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I know how frustrating it can get with all those assignments mate. 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Recent door jou bekeken

Waarom studenten kiezen voor Stuvia

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Betaal zoals je wilt, start meteen met leren

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Wat krijg ik als ik dit document koop?

Tevredenheidsgarantie: hoe werkt dat?

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Zit ik meteen vast aan een abonnement?

Is Stuvia te vertrouwen?