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100
Inpatient hospitalization for persons with mental illness is generally reserved for patients who: present a clear danger to self or others. are noncompliant with medication at home. have limited support systems in the community. develop new symptoms during the course of an illness.
What is present a clear danger to self or others
100
The patients below were evaluated in the emergency department. The psychiatric unit has one bed available. Which patient should be admitted? The patient: feeling anxiety and a sad mood after separation from a spouse of 10 years. who self-inflicted a superficial cut on the forearm after a family argument. experiencing dry mouth and tremor related to taking haloperidol (Haldol). who is a new parent and hears voices saying, “Smother your baby.”
What is who is a new parent and hears voices saying, “Smother your baby.”
100
Which patient would be most appropriate to refer for assertive community treatment (ACT)? A patient diagnosed with: a phobic fear of crowded places. a single episode of major depression. a catastrophic reaction to a tornado in the community. schizophrenia and four hospitalizations in the past year.
What is schizophrenia and four hospitalizations in the past year.
100
Consider these three anticonvulsant medications: divalproex (Depakote), carbamazepine (Tegretol), and gabapentin (Neurontin). Which medication also belongs to this classification? clonazepam (Klonopin) risperidone (Risperdal) lamotrigine (Lamictal) aripiprazole (Abilify)
What is lamotrigine (Lamictal)
100
When alprazolam (Xanax) is prescribed for a patient who experiences acute anxiety, health teaching should include instructions to: report drowsiness. eat a tyramine-free diet. avoid alcoholic beverages. adjust dose and frequency based on anxiety level.
What is avoid alcoholic beverages?
200
A patient was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the case manager learned that the patient received a notice of eviction immediately prior to admission. Select the case manager’s most appropriate action. Postpone the patient’s discharge from the hospital. Contact the landlord who evicted the patient to further discuss the situation. Arrange a temporary place for the patient to stay until new housing can be arranged. Determine whether the adverse medication reaction was genuine because the patient had nowhere to live.
What is Arrange a temporary place for the patient to stay until new housing can be arranged.
200
A suspicious, socially isolated patient lives alone, eats one meal a day at a local shelter, and spends the remaining daily food allowance on cigarettes. Select a community psychiatric nurse’s best initial action. Explore ways to help the patient stop smoking. Report the situation to the manager of the shelter. Assess the patient’s weight; determine foods and amounts eaten. Arrange hospitalization for the patient in order to formulate a new treatment plan.
What is Assess the patient’s weight; determine foods and amounts eaten.
200
A newly admitted patient diagnosed with major depression has gained 20 pounds over a few months and has suicidal ideation. The patient has taken an antidepressant medication for 1 week without remission of symptoms. Select the priority nursing diagnosis. Imbalanced nutrition: more than body requirements Chronic low self-esteem Risk for suicide Hopelessness
What is risk for suicide
200
A nurse assesses a patient who takes lithium. Which findings demonstrate evidence of complications? Pharyngitis, mydriasis, and dystonia Alopecia, purpura, and drowsiness Diaphoresis, weakness, and nausea Ascites, dyspnea, and edema
What is Diaphoresis, weakness, and nausea
200
A hospitalized patient diagnosed with an alcohol abuse disorder believes the window blinds are snakes trying to get in the room. The patient is anxious, agitated, and diaphoretic. The nurse can anticipate the health care provider will prescribe a(n): narcotic analgesic, such as hydromorphone (Dilaudid). sedative, such as lorazepam (Ativan) or chlordiazepoxide (Librium). antipsychotic, such as olanzapine (Zyprexa) or thioridazine (Mellaril). monoamine oxidase inhibitor antidepressant, such as phenelzine (Nardil).
What is sedative, such as lorazepam (Ativan) or chlordiazepoxide (Librium).
300
Select the example of tertiary prevention. Helping a person diagnosed with a serious mental illness learn to manage money Restraining an agitated patient who has become aggressive and assaultive Teaching school-age children about the dangers of drugs and alcohol Genetic counseling with a young couple expecting their first child
What is Helping a person diagnosed with a serious mental illness learn to manage money
300
A nurse surveys medical records. Which finding signals a violation of patients’ rights? A patient was not allowed to have visitors. A patient’s belongings were searched at admission. A patient with suicidal ideation was placed on continuous observation. Physical restraint was used after a patient was assaultive toward a staff member.
What is A patient was not allowed to have visitors
300
A nurse provided medication education for a patient diagnosed with major depression who began a new prescription for phenelzine (Nardil). Which behavior indicates effective learning? The patient: monitors sodium intake and weight daily. wears support stockings and elevates the legs when sitting. can identify foods with high selenium content that should be avoided. confers with a pharmacist when selecting over-the-counter medications.
What is confers with a pharmacist when selecting over-the-counter medications.
300
Which medication to maintain abstinence would most likely be prescribed for patients with an addiction to either alcohol or opioids? Bromocriptine (Parlodel) Methadone (Dolophine) Disulfiram (Antabuse) Naltrexone (ReVia)
What is Naltrexone (ReVia)
400
A patient diagnosed with schizophrenia had an exacerbation related to medication noncompliance and was hospitalized for 5 days. The patient’s thoughts are now more organized, and discharge is planned. The patient’s family says, “It’s too soon for discharge. We will just go through all this again.” The nurse should: ask the case manager to arrange a transfer to a long-term care facility. notify hospital security to handle the disturbance and escort the family off the unit. explain that the patient will continue to improve if the medication is taken regularly. contact the health care provider to meet with the family and explain the discharge rationale.
What is explain that the patient will continue to improve if the medication is taken regularly.
400
Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting? Resolve the crisis with the least restrictive intervention possible. Swift intervention is justified to maintain the integrity of a therapeutic milieu. Rights of an individual patient are superseded by the rights of the majority of patients. Patients should have opportunities to regain control without intervention if the safety of others is not compromised.
What is Resolve the crisis with the least restrictive intervention possible.
400
A patient diagnosed with major depression has lost 20 pounds in one month, has chronic low self-esteem, and a plan for suicide. The patient has taken an antidepressant medication for 1 week. Which nursing intervention has the highest priority? Implement suicide precautions. Offer high-calorie snacks and fluids frequently. Assist the patient to identify three personal strengths. Observe patient for therapeutic effects of antidepressant medication.
What is implement suicide precautions
400
A nurse instructs a patient taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of: hypotensive shock. hypertensive crisis. cardiac dysrhythmia. cardiogenic shock.
What is hypertensive crisis.
400
A patient diagnosed with borderline personality disorder has a history of self-mutilation and suicide attempts. The patient reveals feelings of depression and anger with life. Which type of medication would the nurse expect to be prescribed? Benzodiazepine Mood stabilizing medication Monoamine oxidase inhibitor (MAOI) Serotonin norepinephrine reuptake inhibitor (SNRI)
What is Mood stabilizing medication
500
A nurse inspects an inpatient psychiatric unit and finds that exits are free of obstructions, no one is smoking, and the janitor’s closet is locked. These observations relate to: coordinating care of patients. management of milieu safety. management of the interpersonal climate. use of therapeutic intervention strategies.
What is management of milieu safety.
500
Clinical pathways are used in managed care settings to: stabilize aggressive patients. identify obstacles to effective care. relieve nurses of planning responsibilities. streamline the care process and reduce costs.
What is streamline the care process and reduce costs.
500
A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. To prepare teaching materials, which drug should the nurse anticipate will be prescribed? phenytoin (Dilantin) clonidine (Catapres) risperidone (Risperdal) carbamazepine (Tegretol)
What is carbamazepine (Tegretol)
500
A patient experiences a sudden episode of severe anxiety. Of these medications in the patient’s medical record, which is most appropriate to give as a prn anxiolytic? buspirone (BuSpar) lorazepam (Ativan) amitriptyline (Elavil) desipramine (Norpramin)
What is lorazepam (Ativan)
500
A nurse plans health teaching for a patient with generalized anxiety disorder who begins a new prescription for lorazepam (Ativan). What information should be included? Select all that apply. Caution in use of machinery Foods allowed on a tyramine-free diet The importance of caffeine restriction Avoidance of alcohol and other sedatives Take the medication on an empty stomach
What is Caution in use of machinery, The importance of caffeine restriction, and Avoidance of alcohol and other sedatives
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