Bipolar Disorder
Suicide prevention
Crisis Intervention
Behavior &
Substance Use/Addictive Disorders
The Bereaved Individual
Somatic Symptom/
Dissociative Disorders
What should I do?

An alteration in mood that may be expressed by feelings of elation, inflated self-esteem, grandiosity, hyperactivity, agitation, racing thoughts, and accelerated speech.

What is mania?


Risk factors for suicide

Pain, presence of suicide ideation, lack of connectedness 


Patient reports being "down in the dumps" for over 2 years and has low self esteem and hopelessness 

What is dysthymia


Places crisis intervention can take place (very generally speaking).

Where are inpatient settings, outpatient settings, and in the community?


These two therapies are typically used in conjunction with each other to help a client make appropriate choices for dealing with situations that may arise.

What is Cognitive & Behavioral Therapy?


Abbreviation for alcohol use when documenting in a client's medical record

What is ETOH?


When people face an imminent loss begin to grapple with the very real possibility of the loss or death in the near future.

What is Anticipatory Grief?


Syndrome of multiple symptoms which cannot be explained medically

What is Somatic Symptom Disorder?


The nurse is working on an in-patient psychiatric unit.  Which client situation would require priority intervention?

Answer choices:  A client who:

a. is disturbed that family can be seen only during visiting hours?

b. exhibits hostile and angry behaviors toward another client.

c. states, "I have no one who cares about me."

d. states, "I have never met my career goals."


Maintaining a safe environment is a priority intervention because, according to Maslow, safety and security needs must be met before any other needs, with the exception of physiological ones.  When a client exhibits hostile/angry behaviors towards another client, the nurse must always focus on safety.


Characterized by bouts of major depression with episodic occurrence of hypomania. Has never met criteria for full manic episode

Bipolar II disorder

Tenth leading cause of death overall



Depressed mood for more than two weeks that impacts function

Major depressive disorder


Psychological resolution of the individual's immediate crisis and restoration to at least the level of functioning that existed before the crisis period.

What is the Minimum Therapeutic Goal of crisis intervention?


An association is made between a behavior and a consequence (whether negative or positive) for that behavior

What is Operant Conditioning?


A client presents with constant, severe epigastric pain, nausea, vomiting, and abdominal distention, and you overheard him talking to his friend who brought him to the ED that he went to "an epic party and got totally wasted over the weekend."  The client is most likely experiencing this.

What is Acute pancreatitis?


Elizabeth Kubler-Ross' model grieving

What are Denial, Anger, Bargaining, Depression, and Acceptance?


Treatment modalities for Somatic Syndrome Disorder

What are Individual or group psychotherapy, cognitive behavior therapy, and psychopharmacology.


A parent calls a crisis line and tells the nurse her 15-yr old daughter ran away from home and the parent seems emotionally distraught.  Which of the following questions should the nurse ask first?

a. "Would you like to join a parent support group for dealing with teen issues?

b. "Is this the first time your child has run away?"

c. "How have you handled similar problems?"

d. "Do you have a good parenting relationship with the father?"


Assesses and helps with developing coping strategies and support


A disturbance of mood (depression or mania) that is considered to be the direct result of the physiological effects of a substance (e.g., ingestion of or withdrawal from a drug of abuse or a medication or other treatment)

What is substance-induced bipolar?


What to assess in client with a suicide plan?

Details; time, place, means to do it.


Life-threatening syndrome resulting from too much serotonin 

What is serotonin syndrome?


Skills that focus on managing the feelings provoked by the even and help maintain a reasonable balance.

What are Affective skills?


Creating SMART goals, using guided discovery and questioning, journaling, and reframing thoughts are examples of this.

What is Cognitive Therapy?


Pain, burning, tingling or prickly sensations of the extremities.

What is Peripheral Neuropathy?


Delayed/Inhibited grief, exaggerated/distorted grief response, and chronic/prolonged grief

What is Maladaptive Responses to Loss?


Experiencing when he or she is unable to recall important personal information that is too extensive to be explained by ordinary forgetfulness.

What is Dissociative Amnesia?


A nurse is pulled from a medical-surgical floor to the psychiatric unit.  Which of the following clients would the nurse manager assign to this nurse?  Select all that apply.

a. an chronically depressed client

b. an actively psychotic client

c. a client experiencing paranoid thinking

d. a client diagnosed with narcissistic personality disorder

e. a client diagnosed with generalized anxiety disorder

Who are a and e?


Average age of onset of bipolar disorder 

What is early 20's?


Do more men or women commit suicide?

More women attempt and more men succeed. 


These medications should not be taken with foods high in tyramine 

What is MAOI?

These skills help the individual find meaning in and understand the personal significance of an unexpected event.

What are Spiritual Skills?


For cognitive therapy to be successful, the client must be willing to do this.

What is talk openly about fears/feelings?


A client presents to the ED with tremors in her hands, nausea, general malaise, tachycardia, diaphoresis, elevated blood pressure, irritability, and transient hallucinations.  It is most likely this client is experiencing this...

What is Alcohol Withdrawal?


May openly express anger; experiences a mixture of good and bad days; may express guilty feelings over some aspect of the loss

What are Signs of Normal Grieving?


Syndrome of fabricating symptoms for emotional gain, whether to oneself or to another person

What is Munchausen Syndrome?

The nurse has just received the evening report.  Which client would the nurse need to assess first?

a.  a newly admitted client with a history of panic attacks

b. a client who has slept 2 to 3 hours last night because of flashbacks

c.  a client pacing the halls and stating his anxiety is an 8 out of 10

d.  a client diagnosed with generalized anxiety disorder awaiting discharge

Who is c?


Medication frequently given for bipolar disorder that requires serum monitoring every 1-2 months

What is lithium?


Priority with client admitted with suicidal ideation

What is monitoring for patient safety?


True/False: SSRI and MAOI are safe and effective when taken together.

False: May lead to serotonin syndrome


These skills help the client in coping temporarily and in long-term resolution of the crisis.

Example:  Denial may be temporarily effective to prevent feeling of being overwhelmed.  Another example is to redefine the unexpected event to reshape into something more favorable.

What are Cognitive Skills?


Behavior that can be changed through conditioning with external or environmental conditions or stimuli.

What is Classical Conditioning?


Name 4 common complications of Cirrhosis of the Liver.

What are Portal HTN, Ascites, Esophageal varices, and Hepatic Encephalopathy?


Experiencing multiple losses in a short time can result in this.

What is Bereavement Overload?


Unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to a preoccupation and fear of having a serious disease.

What is Illness Anxiety Disorder?


In which condition could the nurse support the use of ECT?

a. a 67 yo client with dementia

b. a 45 yo client with depression who is resistant to medication

c. a 52 yo client who lives in a long-term care facility

d. a 37 yo client undergoing a stressful life change

e. 24 yo client having recurrent suicidal thoughts despite medication

Who are b and e?

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