Disorders
Defined as an unrealistic or inaccurate interpretation of physical symptoms or sensations, leading to a preoccupation with and fear of having a serious disease. This disease is related to Doctor Shopping.
Illness Anxiety Disorder
The nurse repeats the main idea expressed by the patient using different words to make sure the message was understood.
Restating
A person unconsciously attributes their own unacceptable feelings to another person.
Projection
What class of medication is commonly used to treat schizophrenia?
Antipsychotics
A patient says, “I don’t want to live anymore.”
What should the nurse do FIRST?
Assess for suicidal ideation, plan, intent, and access to means.
A Client has elevated mood, decreased need for sleep, pressured speech, grandiosity, and increased goal directed activity.
Mania or Manic Episode
Patient: “I’m really scared about what will happen to me.”
Nurse: “You’re feeling afraid about what might happen.”
What therapeutic technique is being used?
Reflection
A student is angry at their professor but goes home and yells at their younger sibling.
Displacement
_________ Hypothesis theory suggests that schizophrenia (or schizophrenia-like symptoms) may be caused by an excess of ___________-dependent neuronal activity in the brain.
Dopamine
Which patient should the nurse assess FIRST?
A) A depressed patient who refuses breakfast
B) A patient with schizophrenia who is quietly sitting alone
C) A patient hearing voices commanding them to kill themselves
D) A patient requesting a PRN medication
C) A patient hearing voices commanding them to kill themselves.
Mr. Yar is fabricating and embellishing his history and signs and symptoms of illness. He uses a wheelchair, undergoes unnecessary surgeries, and pretends to be terminally ill despite being physically healthy.
Munchausen Syndrome or Factitious Disorder
A patient says, “The voices are telling me that I’m worthless.”
What is the BEST response?
A) “Those voices aren’t real.”
B) “You need to ignore them.”
C) “I don’t hear the voices, but I understand that you hear them.”
D) “Why do you think you’re worthless?”
C) “I don’t hear the voices, but I understand that you hear them.”
A person who feels hostility toward someone behaves excessively kind toward that person.
Reaction Formation
A patient taking haloperidol develops muscle rigidity, high fever, altered consciousness, and autonomic instability.
What serious adverse reaction should the nurse suspect?
Neuroleptic Malignant Syndrome (NMS)
The priority nursing intervention before starting ECT therapy is to:
A) Take vital signs and record.
B) Have the patient void.
C) Administer succinylcholine.
D) Ensure that the consent form has been signed.
D) Ensure that the consent form has been signed.
Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder?
A) Insisting that others follow the rules of the unit
B) Wondering why others are being friendly to her
C) Having a tantrum if not getting enough attention
D) Getting others to make decisions for her
C) Having a tantrum if not getting enough attention
Nancy says to the nurse, “I worked as a secretary to put my husband through college, and as soon as he graduated, he left me. I hate him! I hate all men!” Which of the following is an empathetic response by the nurse?
A) “You are very angry now. This is a normal response to your loss.”
B) “I know what you mean. Men can be very insensitive.”
C) “I understand completely. My husband divorced me, too.”
D) “You are depressed now, but you will feel better in time.”
A) “You are very angry now. This is a normal response to your loss.”
A stressed adult begins behaving like a young child and asks their parents to do things they normally do independently.
Regression
A patient taking an antipsychotic develops lip smacking, tongue movements, and involuntary facial movements after long-term treatment.
What adverse effect is this?
Tardive Dyskinesia
A client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client?
A) Stay with the client and reassure of safety.
B) Administer a dose of diazepam.
C) Leave the client alone in a quiet room so that she can calm down.
D) Encourage the client to talk about what triggered the attack.
A) Stay with the client and reassure of safety.
A nursing student appears to cooperate with the group but does not complete agreed upon tasks at the appropriate time repeatedly and then display negativity. The nursing student may be showing signs of which personality disorder or behavior?
A) Paranoid
B) Borderline
C) Narcissistic
D) Passive-aggressive behavior
D) Passive-aggressive behavior
Nurse Mary has been providing care for Tom during his hospital stay. On Tom’s day of discharge, his wife brings a bouquet of flowers and box of chocolates to his room. He presents these gifts to Nurse Mary saying, “Thank you for taking care of me.” What is a correct response by the nurse?
A) “I don’t accept gifts from patients.”
B) “Thank you so much! It is so nice to be appreciated.”
C) “Thank you. I will share these with the rest of the staff.”
D) “Hospital policy forbids me to accept gifts from patients.”
C) “Thank you. I will share these with the rest of the staff.”
A student fails an exam and says, “The professor made the exam impossible. Anyone would have failed.”
What defense mechanism is MOST evident?
Rationalization
The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Why is chlorpromazine ordered?
A) To reduce extrapyramidal symptoms
B) To prevent neuroleptic malignant syndrome
C) To decrease psychotic symptoms
D) To induce sleep
C) To decrease psychotic symptoms
MOA: Chlorpromazine is a first-generation typical antipsychotic medication that works primarily by blocking dopamine receptors in the brain.
When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use first?
A) Provide large motor activities to relieve the client’s pent-up tension.
B) Administer a dose of prn chlorpromazine to keep the client calm.
C) Call for sufficient help to control the situation safely.
D) Convey to the client that his behavior is unacceptable and will not be permitted.
C) Call for sufficient help to control the situation safely.