Communication
Nursing Interventions
Pharmacology
More Pharm :)
Misc.
100

A client states that life isn't worth living anymore. How should the nurse respond?

"Are you having thoughts of harming yourself?"

100

Describe nursing interventions appropriate for a client experiencing mania.

Decrease stimulation - private room, quiet location, seclusion if necessary, frequent rest

Monitor nutrition - daily weights, high calorie and high protein foods

Structured activities - not group

Frequent vital signs

Calm neutral attitude

100

Patient education for the client who is prescribed valproate to decrease mania in bipolar disorder should include information about common side effects. Identify the common side effects of this medication.

Dizziness, drowsiness, tremors, visual disturbances, N/V, weight gain, alopecia, makes oral contraceptives ineffective, can cause liver disease (monitor LFTs)

100

What dietary restriction is required for a client who is prescribed phenelzine?

Tyramine-rich foods (can cause severe HA, palpitations, neck stiffness, N/V, HTN, stroke, death).

AVOID aged cheeses and meats, beer, red wine

100
The nurse should promise the client that all information provided will be kept strictly confidential in order to maintain trust within the therapeutic relationship - True/False

False.

*Double points if you explain the exception to patient confidentiality in mental health!

200

A client is experiencing delusions and reports that "everyone is out to get him." 

Which response by the nurse is the most therapeutic?

1. "Who is out to get you?"

2. "You seem to be very frightened."

3. "What makes you think that?"

4. "Nobody is out to get you."

2. "You seem to be very frightened."

200

Place these patient concerns in order of highest priority:

Psychoeducation

Signs of malnutrition

Suicidal ideation

Reports of <2 hours of sleep for past 3 nights


1. Suicidal ideation

2. Reports of <2 hours of sleep for past 3 nights

3. Signs of malnutrition

4. Psychoeducation

200

Identify symptoms of tardive dyskinesia

Involuntary movements of the mouth, face, and tongue - lip smacking, tongue thrusting, facial grimacing, blinking

Also includes trunk and extremities - rocking or hip thrusting

200

A client is taking amitriptyline and is experiencing dizziness when standing up. What education should be provided to the client to address this side effect?

Stand up or change positions slowly, take the medication at night

200

A client is prescribed lithium 12 mEq BID. The pharmacy provides a solution containing 8mEq/5mL. How many mL should the nurse administer per dose?

7.5mL

300
A client is complaining about staff stating "The night shift nurse is awful, the daylight nurse is the best!"

This is an example of which defense mechanism/coping style?

Splitting

300

Describe the nursing care of a client receiving ECT.

Witness consent, EKG, NPO, loose clothing, remove anything from the mouth, monitor VS, explain about common side effects (hypo/HTN, brady/tachycardia, arrhythmias, HA, muscle pain, nausea, memory loss or confusion)

300

Your client is prescribed lithium to treat bipolar disorder. Identify the following:

1. Therapeutic trough levels

2. Signs of toxicity

3. Patient teaching regarding sodium levels

1. 0.4-1.0 mEq/L for maintenance, 0.8-1.4 mEq/L for mania

2. AMS, N/V/D, muscle weakness, myoclonic twitches, nystagmus, EKG changes, seizures, syncope, coma, death

3. Salt and lithium have an inverse relationship. Drink same amount of water each day. Vomiting, diarrhea, diaphoresis, and diuresis can alter lithium retention.

300

Identify signs of neuroleptic malignant syndrome (NMS), a rare complication of antipsychotic medication.

Hyperthermia, muscle rigidity, HTN, mental status changes, tachycardia

300

Describe the difference between a voluntary admission versus an involuntary commitment. 

How long can a patient remain hospitalized for a 201 or a 302?

Voluntary admission - patient is voluntarily admitted, must remain for 72 hours after notification of plan to leave. Involuntary commitment - patient is determined to be a harm to self or others and is committed against their will to the inpatient psychiatric unit.

201 - no time limit

302 - 5 days 

400

Identify and describe 4 symptoms of schizophrenia.

Hallucinations

Delusions

Ambivalence

Anhedonia

Disorganized thinking

Disorganized Behavior

400

A client is being disruptive on the unit, making up stories about other clients and trying to cause drama between them. How should the nurse handle it?

1. Place them in seclusion.

2. Discuss the issues during group therapy.

3. Set limits on the client's behavior.

4. Tell the client if they continue this behavior, they will lose privileges on the unit.

3. Set limits on the client's behavior.

400

Identify 4 side effects of trazodone.

Drowsiness, weight gain, dry mouth, GI upset, dizziness, HA, muscle aches, loss of libido, Black Box warning for risk of suicide in kids, adolescents, and young adults, risk of serotonin syndrome.

400

Explain serotonin syndrome and identify symptoms of the complication.

Also called serotonin toxicity, occurs when dosages are increased or multiple drugs are used (SSRIs plus triptans to treat migraines, MAOIs). 

Symptoms = fever, HTN, GI symptoms, restlessness, confusion, tachycardia, dilated pupils, muscle rigidity or twitching

400

What signs in a client would indicate to the nurse that the client is under the influence of cocaine?

Euphoria, perspiration, tremors, dilated pupils, hypervigilance, increased energy, grandiosity
500
Describe 5 therapeutic communication techniques (i.e. open-ended questions).

Avoid self-disclosure

Avoid giving advice

Active listening

Observation

Silence

Validation

Avoid judgmental questions (why?)

And many more...

500

Identify signs of alcohol withdrawal, name the scale we use to rate the severity of symptoms, and identify the treatment used.

Tachycardia, HTN, diaphoresis, anxiety, restlessness, tremors, hallucinations, seizures.

CIWA Scale

Ativan PRN

500

A client is prescribed clozapine. What lab value indicates a complication from this medication? What should you do if the lab values are abnormal?

Agranulocytosis - WBC < 3.5 (normal range 5-10).

Hold the medication, notify the provider immediately, watch for signs/symptoms of infection.

500

Identify 5 side of effects of risperidone and interventions to help manage them.

Orthostatic hypotension - change positions slowly

Constipation - increase fluid and fiber

Weight gain - nutrition and exercise

Extrapyramidal symptoms - add an anticholinergic medication

Sexual dysfunction - lower the dose, try a different medication, add an erectile dysfunction medication

500

Identify 5 clinical manifestations of Major Depressive Disorder.

Feelings of sadness or hopelessness

Anhedonia

Decrease in libido

Negative self-worth

Irritability

Insomnia or hypersomnia

Somatic symptoms

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