Mental health / illness
T or F: An individual is more likely to display mental illness when maladaptive responses to stress are coupled with interference in daily functioning.
True ... The DSM-5 indicates that in order to be diagnosed with a mental illness, daily functioning must be significantly impaired.
What class of medications can have the side effects of extrapyramidal symptoms?
Anti-psychotics
What is cross tolerance?
Cross-tolerance is exhibited when one drug results in a lessened response to another drug.
T or F: When thinking about MH clients, it is important to be self aware, self assess, and be willing to interact with MH clients.
True. The nurse should be willing to engage in meaningful relationships with people who have mental illnesses and addictions.
T or F: If a client is dysregulated and angry (throwing items), an appropriate intervention by nursing staff might be to explore why they are upset.
False. Exploring the source of anger may be more appropriate once the client has resolved the current emotion or is in a therapeutic group setting. It is hard to resolve these emotions when a person is "in the red"
What medication should the nurse anticipate administering to assist a client with maintaining abstinence from alcohol?
The nurse should expect to administer disulfiram to help the client maintain abstinence from alcohol.
T or F: Narcotic pain medication is contraindicated for all clients with active substance use disorders.
False. Narcotic pain medication should never be withheld (just) because a client has a substance abuse disorder.
A client is indicating that they would like care from a different nurse / CNA. What would be a therapeutic response?
"I can review the assignments and try to arrange for a different nurse to care for you."
In this therapeutic response, the nurse demonstrates empathy by endeavoring to meet the client's request for a different caregiver.
T or F: When initially talking to a MH client, it is a PRIORITY to identify the client's perception of their mental health status.
True. Assessment is the priority action when using the nursing process approach to client care. Identifying the client's perception of their mental health status provides important information about the client's psychosocial history.
What are at least 3 considerations with a client taking lithium?
Some examples: Consume adequate salt and fluids (can dehydrate easily); women should use contraception and discuss fertility concerns with their provider; take ibuprofen sparingly with lithium (NSAIDS can increase serum lithium levels); get labs often to monitor for therapeutic levels
What are at least 4 findings that indicate that the client is experiencing serotonin syndrome.
Give an example of the therapeutic communication technique of "exploring."
Tell me more about....
T or F: Depression can generate somatic symptoms that can mask actual physical disorders.
TRUE: The nurse should determine that a client with a diagnosis of major depressive disorder needs a full physical health assessment, because depression can generate somatic symptoms that can mask actual physical disorders. Many medical conditions, including endocrinological, neurological, nutritional, and metabolic disorders, often present with classic symptoms of depression.
A client recently started on an anti-depressant. What are at least 2 safety considerations?
1. The medication takes 4-8 weeks to fully work
2. Client may be more suicidal in the first few weeks due to more clarity, may need supervision
3. Interactions with other medications / foods
What is the first step of AA?
A client who takes responsibility for the consequences of substance use disorder or substance addiction is making positive progress toward recovery (admitting powerlessness over alcohol). This would indicate completion of the first step of a 12-step program (AA).
Is "giving reassurance" a therapeutic or non-therapeutic communication technique?
Giving reassurance is a nontherapeutic communication technique. Giving reassurance indicates to the client that there is no cause for anxiety, thereby devaluing the client’s feelings.
T or F: Decreased production of melatonin and less exposure to natural sunlight are two contributing factors to sadness and melancholia in winter time.
FALSE: The nurse should identify INCREASED production of melatonin as contributing to the etiology of the client’s symptoms. The client is experiencing major depressive disorder, recurrent with seasonal pattern, commonly called seasonal affective disorder (SAD).
The nurse should identify less exposure to natural sunlight as contributing to the etiology of the client’s symptoms. The client is experiencing major depressive disorder, recurrent with seasonal pattern, commonly called seasonal affective disorder (SAD).
Which 2 of the 4 are correct about sedative hypnotics:
1. decrease the production of needed liver enzymes
2. potentially addictive
3. lengthen necessary REM sleep
4. can be less effective over time
Sedative-hypnotics are potentially addictive, and their effectiveness will be compromised due to the development of tolerance.
Tell me about AA - who attends, how often, are medications prescribed there?
Alcoholics should attend these support meetings at least weekly to provide a support system. Many times they have sponsors to talk to when they are having cravings / difficulties, but these sponsors are not responsible to hold the alcoholic accountable. AA is a support group, so medications are not prescribed. Family members will be encouraged to attend Al-anon.
A nurse is caring for a client who states, "I plan to commit suicide." What should the nurse identify as the priority?
The priority assessment is to determine how lethal the method is, how available the method is, and how detailed the plan is.