Management of patients with various mental disorders
Time: 15:00
A client is admitted to an inpatient unit in the manic phase of bipolar disorder. Which nursing intervention is most appropriate to include in the plan of care?
[a] Encourage participation in large, competitive group activities.
[b] Assign the client to be the leader of a community meeting to foster self-esteem.
[c] Provide a structured schedule and a low-stimulation environment.
[d] Allow the client to set their own limits to promote autonomy.
A nurse is teaching a client who is starting a selective serotonin reuptake inhibitor (SSRI) for major depressive disorder. What is the most important information to convey?
[a] The medication's full therapeutic effect may not be felt for several weeks.
[b] This medication is highly addictive and should be used with caution.
[c] All foods containing tyramine must be strictly avoided.
[d] It may take several weeks for the medication to reach its full therapeutic effect.
What is the priority nursing diagnosis for a client admitted with schizophrenia who is experiencing command auditory hallucinations to harm others?
[a] Disturbed sensory perception.
[b] Impaired verbal communication.
[c] Ineffective coping.
[d] Risk for other-directed violence.
A client with Borderline Personality Disorder tells one nurse, "You're the only one who understands me," and tells another, "You're terrible and I hate you." This behavior is known as:
[a] Transference.
[b] Splitting.
[c] Projection.
[d] Countertransference.
A client taking a first-generation antipsychotic medication develops muscle rigidity, a high fever, and altered mental status. The nurse should suspect which medical emergency?
[a] Serotonin syndrome.
[b] Tardive dyskinesia.
[c] Neuroleptic Malignant Syndrome (NMS).
[d] Agranulocytosis.
What is the primary goal for a client admitted with anorexia nervosa who has a body weight of 75% of the ideal?
[a] To explore family dynamics.
[b] To restore nutritional status and normal body weight.
[c] To improve self-esteem and body image.
[d] To develop effective coping skills.
A client is experiencing a severe panic attack. What is the nurse's most therapeutic initial action?
[a] Encourage the client to discuss the source of their anxiety in detail.
[b] Leave the client alone in a quiet room to calm down.
[c] Stay with the client and speak in a calm, reassuring voice.
[d] Immediately teach the client progressive muscle relaxation techniques.
A client with Obsessive-Compulsive Disorder (OCD) has a compulsion to wash their hands 50 times a day. An appropriate initial nursing intervention is to:
[a] Forbid the client from performing the ritual to extinguish the behavior.
[b] Tell the client that their behavior is irrational.
[c] Allow the ritual but work with the client to set limits on the time spent.
[d] Ignore the behavior completely, as it is harmless.
Which class of medications is most commonly used to manage the acute symptoms of alcohol withdrawal?
[a] Antipsychotics.
[c] Benzodiazepines.
[b] Antidepressants.
[d] Mood stabilizers.
A primary intervention for a client with Antisocial Personality Disorder is:
[a] Showing sympathy for their difficult past to build rapport.
[b] Setting firm, clear, and consistent limits on behavior.
[c] Allowing them to bend unit rules to avoid confrontation.
[d] Focusing on building a close, trusting friendship.
A client taking clozapine (Clozaril) must be monitored for which potentially fatal blood disorder?
[a] Thrombocytopenia.
[b] Anemia.
[c] Agranulocytosis.
[d] Polycythemia.
A client with severe depression suddenly appears energetic and says, "I've finally figured it all out." The nurse should assess this as a potential sign of:
[a] Spontaneous remission of the depression.
[b] Increased risk for suicide.
[c] The beginning of a manic episode.
[d] A positive response to antidepressant medication.
Which intervention is most appropriate for managing "sundowning" in a client with advanced dementia?
[a] Increase stimulation in the late afternoon to keep the client awake.
[b] Encourage a long nap in the early afternoon.
[c] Maintain a well-lit environment and provide a calm, quiet routine.
[d] Administer a strong sedative at noon to prevent agitation.
A key nursing intervention for a client with bulimia nervosa immediately after meals is to:
[a] Encourage vigorous exercise.
[b] Observe the client for 1-2 hours.
[c] Provide a large glass of water to promote fullness.
[d] Allow the client private time in their room to digest.
A client is prescribed lithium carbonate for bipolar disorder. The nurse should teach the client that it is important to maintain an adequate intake of:
[a] Potassium and Vitamin C.
[b] Calcium and Vitamin D.
[c] Sodium and fluids.
[d] Iron and protein.
Which therapeutic approach is considered a first-line treatment for Post-Traumatic Stress Disorder (PTSD)?
[d] Supportive therapy that avoids discussing the trauma.
A client taking an MAOI (monoamine oxidase inhibitor) must be educated to avoid which of the following?
[a] Foods high in sugar, like candy and cake.
[b] Green, leafy vegetables high in Vitamin K.
[c] Dairy products like milk and yogurt.
[d] Aged cheeses, cured meats, and red wine.
A client with somatic symptom disorder complains of severe abdominal pain, but a full medical workup is negative. A therapeutic nursing response is:
[a] "The doctors can't find anything wrong; it must be in your head."
[b] "I understand you are in pain. Let's talk about how you are feeling emotionally."
[c] "You should stop focusing on your body so much."
[d] "We need to refer you to another specialist to find the cause."
Which of the following describes a key symptom of tardive dyskinesia?
[a] Severe muscle rigidity and high fever.
[b] Involuntary, repetitive movements of the face and tongue.
[c] A subjective feeling of inner restlessness.
[d] A shuffling gait and tremors at rest.
A client is scheduled for electroconvulsive therapy (ECT) in the morning. The nurse's pre-procedure care includes:
[a] Administering the morning dose of anticonvulsant medication.
[b] Ensuring the client remains NPO (nothing by mouth) for 6-8 hours.
[c] Encouraging a high-carbohydrate breakfast for energy.
[d] Informing the client that they will be awake during the procedure.
What is the most effective behavioral therapy for specific phobias, such as a fear of flying?
[a] Psychoanalytic therapy.
[b] Systematic desensitization.
[c] Aversion therapy.
[d] Milieu therapy.
A client is prescribed disulfiram (Antabuse) for alcohol use disorder. The nurse must emphasize that if the client consumes alcohol, they will experience:
[a] A euphoric high.
[b] A reduction in cravings.
[c] A severe, unpleasant reaction including nausea, vomiting, and palpitations.
[d] No significant effect.
A client with schizophrenia is experiencing negative symptoms such as avolition and anhedonia. A helpful nursing intervention is to:
[a] Insist the client join a loud, competitive group game.
[b] Allow the client to remain isolated in their room.
[c] Assist the client in starting a simple, short-term task.
[d] Plan a complex, multi-step craft project for the client.
A client taking valproic acid (Depakote) should be monitored for which potential adverse effect?
[a] Renal failure.
[b] Hepatotoxicity.
[c] Agranulocytosis.
[d] Hypertensive crisis.
In dialectical behavior therapy (DBT), a primary focus for clients with BPD is:
[a] Analyzing unconscious childhood conflicts.
[b] Learning skills for mindfulness, emotion regulation, and distress tolerance.
[c] Undergoing exposure therapy for past traumas.
[d] Receiving positive reinforcement for all behaviors.
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