Exam (elaborations) NURS 2510 AD Quiz Psychosis

Exam (elaborations) NURS 2510 AD Quiz Psychosis A client with schizophrenia is given an antipsychotic drug. The nurse recalls all the extrapyramidal effects associated with this type of medication and anticipates that the drug will be discontinued if which occurs? 1 Akathisia Correct2 Tardive dyskinesia 3 Parkinsonian syndrome 4 Acute dystonic reaction Tardive dyskinesia is characterized by protrusion and vermicular movements of the tongue, chewing and puckering movements of the mouth, and a puffing of the cheeks. These adverse effects may or may not be reversible when the antipsychotic medication is withdrawn. Motor restlessness (akathisia), parkinsonian symptoms, or an acute dystonic reaction can be treated with an antiparkinsonian or anticholinergic drug while the antipsychotic medication is continued. 67%of students nationwide answered this question correctly. 9 Confidence: Just a guess Stats Issue with this question? 2. The primary healthcare provider prescribes a neuroleptic drug to a client diagnosed with schizophrenia. On what basis would the primary healthcare provider choose the drug? 1 Symptoms Correct2 Side effects 3 Therapeutic effects NURS 2510 AD Quiz Psychosis 4 Underlying pathology First-generation antipsychotic drugs are also known as neuroleptics. The selection of these drugs is primarily based on side effects rather than therapeutic effects. Because all symptoms respond equally to antipsychotic drugs, the drug selection may not be based on symptoms. Because these drugs do not alter the underlying pathology, the selection may not be based on underlying pathology. 34%of students nationwide answered this question correctly. 1 Confidence: Just a guess Stats Issue with this question? 3. On the afternoon of admission to a psychiatric unit, an adolescent boy with the diagnosis of schizophrenia exposes his genitals to a female nurse. What should the nurse’s immediate therapeutic response be? 1 Ignoring the client at this time Correct2 Stating that this behavior is unacceptable 3 Moving him to his room for a short time-out 4 Telling the client to come to the office later to discuss the behavior When clients enter a new milieu, limits should be set on unacceptable behavior and acceptable behavior should be reinforced. Neither clients nor unacceptable behavior should ever be ignored. Moving the client to his room for a short time-out is punishment. Unacceptable attention-getting behavior must be addressed immediately; also, the focus should be on appropriate behavior. Test-Taking Tip: If the question asks for an immediate action or response, all of the answers may be correct, so base your selection on identified priorities for action. 82%of students nationwide answered this question correctly. 6 Confidence: Just a guess Stats Issue with this question? 4. Despite repeated nursing interventions to improve reality orientation, a client insists that he is the commander of an alien spaceship. What is the client experiencing? 1 Illusion Correct2 Delusion 3 Confabulation 4 Hallucination A delusion is a fixed false belief. An illusion is a false sense interpretation of an external stimulus. Confabulation is the client's attempt to fill gaps in memory with imaginary events. A hallucination is a false sensory perception with no external stimulus. Test-Taking Tip: Read every word of each question and option before responding to the item. Glossing over the questions just to get through the examination quickly can cause you to misread or misinterpret the real intent of the question. 83%of students nationwide answered this question correctly. 4 Confidence: Just a guess Stats Issue with this question? 5. A client with the diagnosis of schizophrenia who has been hospitalized on a mental health unit for 2 weeks is to be discharged home. The client is vacillating between being happy and sad about going home. What term best describes these conflicting emotions? 1 Double bind Correct2 Ambivalence 3 Loose association 4 Inappropriate affect The simultaneous existence of two conflicting emotions, impulses, or desires is known as ambivalence. A single communication containing two conflicting messages is known as a double-bind message. A lack of connections between thoughts is known as loose associations. Inappropriate affect is not two conflicting emotions but instead the inappropriate expression of emotions. 65%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 6. Which medication is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD)? 1 Clonidine 2 Guanfacine 3 Atomoxetine Correct4 Methylphenidate Methylphenidate is the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD). Clonidine, guanfacine, and atomoxetine are nonstimulants used to treat ADHD; these medications are less effective than methylphenidate. 72%of students nationwide answered this question correctly. 5 Confidence: Just a guess Stats Issue with this question? 8. The night nurse reports that a young client with paranoid schizophrenia has been awake for several nights. The day nurse reviews the client’s record and finds that this client did not have an interrupted sleep pattern disorder before transfer from a private room to a four-bed room 3 days ago. What factor should the nurse identify as most likely related to the client’s sleeplessness? Correct1 Fear of the other clients 2 Concern about family at home 3 Watching for an opportunity to escape 4 Trying to work out emotional problems Because the client has paranoid feelings that other people are out to do harm, assignment to a four-bed room may be threatening. Concern about family at home seems unlikely, because the disruption appears to have started with the transfer to a four-bed room. Watching for an opportunity to escape is possible but unlikely; planning an escape is usually not part of a schizophrenic pattern of behavior. Trying to work out emotional problems is possible but not likely; clients with schizophrenia have difficulty solving problems. 92%of students nationwide answered this question correctly. 2 Confidence: Just a guess Stats Issue with this question? 9. Which condition is contraindicated for St. John’s wort herbal therapy? 1 Anxiety 2 Seizures Correct3 Dementia 4 Cardiac disease Dementia is contraindicated for St. John’s wort herbal therapy; this herbal therapy is used to treat anxiety. Seizures are contraindicated for bupropion therapy. Cardiac disease is contraindicated for valerian (Valeriana Officinalis). 31%of students nationwide answered this question correctly. 5 Confidence: Just a guess Stats Issue with this question? 10. A male client with a history of schizophrenia comes to the emergency department, accompanied by his wife. What is the emergency department nurse’s priority intervention? Correct1 Observing and evaluating his behavior 2 Writing a plan of care for the mental health team 3 Obtaining a copy of the client’s past medical records 4 Meeting separately with his wife and exploring why he came to the hospital The client and his needs are the priority, and assessment is the first step of the nursing process. Writing a plan of care for the mental health team is done after a thorough assessment is completed. The nurse must deal with the present, not the past. Although meeting separately with the wife should be done, it is not the priority. 72%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 11. 3 A healthcare provider prescribes aripiprazole 15 mg by mouth once a day for a client with the diagnosis of schizophrenia. The hospital pharmacy sends aripiprazole 5 mg/tablet. How many tablets will the nurse administer? Record your answer as a whole number. ____ tablet(s) Solve the problem using ratio and proportion. 2 Which medications are used to treat generalized anxiety disorder (GAD)? Select all that apply. Correct1 Duloxetine Correct2 Venlafaxine 3 Clonazepam Correct4 Escitalopram 5 Clomipramine Duloxetine, venlafaxine, and escitalopram are antidepressants approved for the treatment of generalized anxiety disorder (GAD). Clonazepam and clomipramine are used to treat panic disorders. 24%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 13. Which atypical antipsychotics are approved for long-term use to prevent the recurrence of mood episodes in clients with bipolar disease? Select all that apply. Correct1 Olanzapine 2 Quetiapine Correct3 Ziprasidone 4 Risperidone Correct5 Aripiprazole Olanzapine, ziprasidone, and aripiprazole are atypical antipsychotics approved for long-term use to prevent recurrence of mood episodes. Quetiapine and risperidone are atypical antipsychotics approved for use in bipolar disease but are not approved for long-term use to prevent the recurrence of mood episodes. 13%of students nationwide answered this question correctly. 2 Confidence: Just a guess Stats Issue with this question? 14. After assessing a client, the nurse suspects that the client has shift-work sleep disorder (SWSD). Which medication would be prescribed to the client? 1 Caffeine Correct2 Modafinil 3 Atomoxetine 4 Methylphenidate Modafinil is a unique nonamphetamine stimulant used to treat shift-work sleep disorder (SWSD). This drug promotes wakefulness in clients suffering from excessive sleepiness associated with SWSD. Caffeine is a central nervous stimulant used to promote wakefulness, but this drug is not as effective in the treatment of SWSD. Atomoxetine is a nonstimulant used to treat attention deficit hyperactivity disorder (ADHD). Methylphenidate is considered the first choice drug for the treatment of attention deficit hyperactivity disorder (ADHD). 63%of students nationwide answered this question correctly. 8 Confidence: Just a guess Stats Issue with this question? 15. Which toxic effect would the nurse find in a client who has overdosed on isocarboxazid? 1 Mydriasis 2 Bradycardia 3 Hypothermia Correct4 Circulatory collapse The clinical symptoms of monoamine oxidase inhibitors (MAOIs) generally appears after 12 hours of ingestion. Circulatory collapse is associated with MAOI toxicity. Mydriasis, bradycardia, and hyperthermia are not associated with an isocarboxazid overdose. 51%of students nationwide answered this question correctly. 9 Confidence: Just a guess Stats Issue with this question? 16. A client with paralysis of the legs is found to have somatoform disorder, conversion type. What must the nurse consider when formulating a plan of care for this client? Correct1 The illness is very real to the client and requires appropriate nursing care. 2 Although the client believes that there is an illness, there is no cause for concern. 3 There is no physiological basis for the illness; therefore only emotional care is needed. 4 Nursing intervention is needed even though the nurse understands that the client is not ill. Individuals who have somatoform disorders are really ill; they need care in a nonthreatening environment. The client requires physiological and emotional care for treatment of motor or sensory functional deficits. 65%of students nationwide answered this question correctly. 7 Confidence: Just a guess Stats Issue with this question? 17. Which adverse effect is least likely to occur in a client who is prescribed clozapine? 1 Seizures 2 Sedation 3 Akathisia Correct4 Myocarditis Clozapine is a second-generation antipsychotic drug. Myocarditis is a very rare side effect caused by clozapine. Seizures, sedation, and akathisia are common side effects of clozapine. 47%of students nationwide answered this question correctly. 4 Confidence: Just a guess Stats Issue with this question? 18. A client tells the nurse, "I’m a terrible, evil person. The voices are telling me that God needs to punish me." What is the most therapeutic initial response by the nurse? 1 "God is loving and won’t punish you." 2 "Those voices you’re hearing are a fantasy." Correct3 "Tell me what you’re thinking about yourself." 4 "You aren’t wicked—both God and I love you." Encouraging the client to focus on the self will facilitate communication and foster self-perception. Stating that God will not punish the client denies the client’s feelings and provides false reassurance. Stating that the voices are fantasy denies the client’s experience. Stating that the client is not wicked denies the client’s feelings and provides false reassurance. 90%of students nationwide answered this question correctly. 4 Confidence: Just a guess Stats Issue with this question? 19. A client who has been admitted with a diagnosis of schizophrenia says to the nurse, "Yes, it's March. March is Little Women. That's literal, you know." What do these statements illustrate? 1 Echolalia 2 Neologisms 3 Flight of ideas Correct4 Loosening of associations Loose associations are thoughts that are presented without the logical connections that are usually necessary for the listener to interpret the message. Echolalia is the purposeless repetition of words spoken by others or repetition of overheard sounds. Neologisms are new meaningless words coined by the client or new, unique meanings given to old words. Flight of ideas is the rapid skipping from one thought to another; these thoughts usually have only superficial or chance relationships. Test-Taking Tip: Do not panic while taking an exam! Panic will only increase your anxiety. Stop for a moment, close your eyes, take a few deep breaths, and resume review of the question. 57%of students nationwide answered this question correctly. 0 Confidence: Just a guess Stats Issue with this question? 20. When being admitted to a mental health facility, a young male adult tells the nurse that the voices he hears frighten him. The nurse knows that clients tend to hallucinate more vividly at what point in their routine? 1 Before meals Correct2 After going to bed 3 During group activities 4 While watching television Auditory hallucinations are most troublesome when environmental stimuli are diminished and there are few competing distractions. Before meals, during group activities, and during television watching are all times of relatively high, competing environmental stimuli. 62%of students nationwide answered this question correctly. 4 Confidence: Just a guess Stats Issue with this question? 22. A client with schizophrenia is speaking made-up words that have no meaning to other people. What term should the nurse use to document these verbalizations? 1 Avolition 2 Echolalia 3 Anhedonia Correct4 Neologisms Neologisms are unique words with personal meanings only to the client. Avolition is the lack of motivation associated with a reduced emotional expression (flat affect). Echolalia is parrotlike echoing of spoken words or sounds. Anhedonia is the loss of enjoyment of things that were formerly enjoyed. Which statement is true regarding antipsychotic drugs? 1 All first- and second-generation antipsychotics are equally effective. 2 Second-generation antipsychotics pose a risk of extrapyramidal symptoms. Incorrect3 First-generation antipsychotics pose a significant risk of metabolic side effects. Correct4 Clozapine is more effective than other second-generation antipsychotics. Clozapine is a second-generation antipsychotic drug that is more effective than other second-generation antipsychotics. Most (but not all) first- and second-generation antipsychotics are equally effective. Second-generation antipsychotics may cause metabolic side effects such as diabetes and dyslipidemia. First-generation antipsychotics may cause extrapyramidal side effects. 31%of students nationwide answered this question correctly. 2 Confidence: Just a guess Stats Issue with this question? 21. Which antidepressant drug is a selective monoamine oxidase-B inhibitor? Correct1 Selegiline 2 Phenelzine Incorrect3 Isocarboxazid 4 Tranylcypromine Selegiline is a selective monoamine oxidase-B inhibitor. Phenelzine, isocarboxazid, and tranylcypromine are nonselective monoamine oxidase-A and monoamine oxidase-B inhibitors. 50%of students nationwide answered this question correctly. 6 Confidence: Just a guess Stats Issue with this question? 23. A nurse is monitoring a client with the diagnosis of schizophrenia who is experiencing opposing emotions simultaneously. When providing a change-of-shift report, how should the nurse refer to this emotional experience of the client? Incorrect1 Double bind Correct2 Ambivalence 3 Loose association 4 Inappropriate affect Ambivalence is the existence of two conflicting emotions, impulses, or desires. Double bind is two conflicting messages, not emotions, in a single communication. Loose associations are not two conflicting