NUR 2488 NU239 NUR2488 Mental Health Nursing Exam 2 updated

played All Answers, Submitted Answers, Feedback  Question 1 1 out of 1 points You are the nurse responsible for assessing for extrapyramidal side effects in a patient who has been taking chlorpromazine. Which of the following may be side effects for this medication? (Select all that apply.) Akathisia Acute dystonia Tardive Dyskinesia Answer s: Amenorrhea Akathisia Acute dystonia Tardive Dyskinesia Response Feedback: Extrapyramidal side effects of the central nervous system include involuntary motor movements, resulting in possible dystonia, akathisia or dyskinesia. Amenorrhea is a possible side effect of chlorpromazine, but is not an extrapyramidal side effect.  Question 2 1 out of 1 points An adult with depression has been treated with medication and cognitive behavioral therapy. The patient now verbalizes that being passive and letting others make decisions for her contributed to the depression. What referrals could the nurse make to help this patient prevent recurrence of depression? Selected Answer: Social skills training Answers: Social skills training Use of complementary therapy Relaxation training classes Learning desensitization techniques Response Feedback : Social skills training is helpful in treating and preventing the recurrence of depression. Training focuses on assertiveness and coping skills that lead to positive reinforcement from others. Use of complementary therapy refers to adjunctive therapies such as herbals. Assertiveness would be of greater value than relaxation training because passivity has been identified as a concern. Desensitization is used in treatment of phobias  Question 3 1 out of 1 points A patient with suicidal impulses is placed on the highest level of suicide precautions. Which measures should be incorporated into the plan of care by the nurse caring for the patient? (Select all that apply.) Selected Answers: Maintain arm’s-length distance, institute one-on-one nursing observation around the clock Allow no glass or metal on meal trays Remove all potentially harmful objects from the patient’s possession Answers: Maintain arm’s-length distance, institute one-on-one nursing observation around the clock Allow no glass or metal on meal trays Keep patient within visual range while awake, but only check every 15 to 30 minutes while the patient is sleeping Only check the patient’s whereabouts every 15 minutes and make frequent verbal contacts. Remove all potentially harmful objects from the patient’s possession Response Feedback : One-on-one observation is necessary for anyone who has limited control over suicidal impulses. Plastic dishes on trays and the removal of potentially harmful objects from the patient’s possession are measures included in any-level suicide precautions. The remaining options are used in less stringent levels of suicide precautions.  Question 4 0 out of 1 points Which statement indicates a patient with major depression’s most likely outlook on life during the acute phase of the illness? Selected Answer: “If I ignore this, it will go away.” Answers: “It’s just a matter of time and I’ll be well.” “I deserve to be this way.” “I can fight this and get better.” “If I ignore this, it will go away.” Response Feedback: Patients with depression feel worthless and often believe they deserve to have “bad” things happen. Patients with depression are usually hopeless and would not respond optimistically. Patients with depression usually feel helpless and unable to fight.  Question 5 0 out of 1 points The nurse knows that sedation is a side effect of many antipsychotics. Which of the following medications should the nurse question if ordered for a patient taking antipsychotics? Selected Answer: hydrochlorothia zide Answers: hydrochlorothia zide diphenhydrami ne acetaminophen verapamil Response Feedback: Diphenhydramine is an antihistamine that is likely to cause drowsiness and enhance the sedative effect of an antipsychotic. Hydrochlorothiazide (diuretic), acetaminophen (antipyretic and pain reliever) and verapamil (antihypertensive) do not cause sedation.  Question 6 1 out of 1 points The nurse is caring for a patient who experiences orthostatic hypotension related to taking chlorpromazine. The nurse should suggest which of the following interventions for managing this side effect? Selected Answer: Sit on the side of the bed before standing up. Answers: Stay in bed for an hour after taking the medication. Sit on the side of the bed before standing up. Stand quickly, then wait a moment before walking. Take the medication with milk or food. Response Feedback : Sudden position changes lead to dizziness associated with postural hypotension, so arising slowly from sitting or lying down is a good suggestion. It’s not necessary to stay in bed for an hour after taking the medication. The patient should not stand quickly, as this can lead to a sudden drop in blood pressure. Taking the medication with milk or food will not affect blood pressure.  Question 7 1 out of 1 points The nurse is evaluating the