Podcast
Questions and Answers
Ms. T. has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder?
Ms. T. has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder?
Which of the following is the most appropriate therapy for a client with agoraphobia?
Which of the following is the most appropriate therapy for a client with agoraphobia?
Facing her fear in gradual step progression
With implosion therapy, a client with phobic anxiety would be:
With implosion therapy, a client with phobic anxiety would be:
Presented with massive exposure to a variety of stimuli associated with the phobic object/situation
A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it:
A client with OCD spends many hours each day washing her hands. The most likely reason she washes her hands so much is that it:
Signup and view all the answers
The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions?
The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions?
Signup and view all the answers
A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate?
A client with OCD says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-ease with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate?
Signup and view all the answers
Annie has trichotillomania. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? (Select all that apply.)
Annie has trichotillomania. She is receiving treatment at the mental health clinic with habit-reversal therapy. Which of the following elements would be included in this therapy? (Select all that apply.)
Signup and view all the answers
A new client at the mental health clinic is diagnosed with body dysmorphic disorder. Which of the following nursing interventions is a priority?
A new client at the mental health clinic is diagnosed with body dysmorphic disorder. Which of the following nursing interventions is a priority?
Signup and view all the answers
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 client who is experiencing a panic attack has just arrived at the emergency department. Which is the priority nursing intervention for this client?
Signup and view all the answers
Janet has a diagnosis of generalized anxiety disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse?
Janet has a diagnosis of generalized anxiety disorder. Her physician has prescribed buspirone 15 mg daily. Janet says to the nurse, "Why do I have to take this every day? My friend's doctor ordered Xanax for her, and she only takes it when she is feeling anxious." Which of the following would be an appropriate response by the nurse?
Signup and view all the answers
Joanie is a new patient at the mental health clinic. She has been diagnosed with body dysmorphic disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie?
Joanie is a new patient at the mental health clinic. She has been diagnosed with body dysmorphic disorder. Which of the following medications is the psychiatric nurse practitioner most likely to prescribe for Joanie?
Signup and view all the answers
A client, who is a veteran of the war in Iraq, is diagnosed with PTSD. The client says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in the client?
A client, who is a veteran of the war in Iraq, is diagnosed with PTSD. The client says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in the client?
Signup and view all the answers
Which of the following treatment regimens would most appropriately be ordered for a client with PTSD?
Which of the following treatment regimens would most appropriately be ordered for a client with PTSD?
Signup and view all the answers
Which of the following may be influential in the predisposition to PTSD?
Which of the following may be influential in the predisposition to PTSD?
Signup and view all the answers
Which of the following is true regarding the diagnosis of adjustment disorder?
Which of the following is true regarding the diagnosis of adjustment disorder?
Signup and view all the answers
The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. This medication is intended to:
The physician orders sertraline (Zoloft) for a client who is hospitalized with adjustment disorder with depressed mood. This medication is intended to:
Signup and view all the answers
Trauma-informed care is a philosophical approach that includes which of the following principles? (Select all that apply.)
Trauma-informed care is a philosophical approach that includes which of the following principles? (Select all that apply.)
Signup and view all the answers
A client experiences a nightmare during their first night in the hospital and explains to the nurse that they were dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to:
A client experiences a nightmare during their first night in the hospital and explains to the nurse that they were dreaming about gunfire all around and people being killed. The nurse's most appropriate initial intervention is to:
Signup and view all the answers
A client who recently divorced after 10 years of marriage is admitted to the hospital with a diagnosis of adjustment disorder with depressed mood. The client acknowledges difficulty adjusting to an independent lifestyle and having thoughts of taking an overdose of acetaminophen. Which is the priority nursing diagnosis for this client?
A client who recently divorced after 10 years of marriage is admitted to the hospital with a diagnosis of adjustment disorder with depressed mood. The client acknowledges difficulty adjusting to an independent lifestyle and having thoughts of taking an overdose of acetaminophen. Which is the priority nursing diagnosis for this client?
Signup and view all the answers
A client, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the best response by the nurse?
A client, who is depressed following the breakup of a very stormy marriage, says to the nurse, "I feel so bad. I thought I would feel better once I left, but I feel worse!" Which is the best response by the nurse?
Signup and view all the answers
A client, age 16, has recently been diagnosed with diabetes mellitus. The client must watch their diet and take an oral hypoglycemic medication daily. The client has become very depressed, and the client's mother reports that they refuse to change their diet and often skips their medication. The client has been hospitalized for stabilization of their blood glucose level. The psychiatric nurse practitioner has been called in as a consultant. Which nursing diagnosis by the psychiatric nurse would be a priority for the client at this time?
A client, age 16, has recently been diagnosed with diabetes mellitus. The client must watch their diet and take an oral hypoglycemic medication daily. The client has become very depressed, and the client's mother reports that they refuse to change their diet and often skips their medication. The client has been hospitalized for stabilization of their blood glucose level. The psychiatric nurse practitioner has been called in as a consultant. Which nursing diagnosis by the psychiatric nurse would be a priority for the client at this time?
Signup and view all the answers
Some individuals with obesity take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with the use of amphetamines that makes this practice undesirable?
Some individuals with obesity take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with the use of amphetamines that makes this practice undesirable?
Signup and view all the answers
The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts?
The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts?
Signup and view all the answers
A client has sought help for their concern that they are binge eating and feels like it has "gotten out of control." The client asks the nurse what can be done to help them. Which of the following is the most accurate response?
A client has sought help for their concern that they are binge eating and feels like it has "gotten out of control." The client asks the nurse what can be done to help them. Which of the following is the most accurate response?
Signup and view all the answers
Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa?
Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa?
Signup and view all the answers
Which medication has been used with some success in clients with bulimia nervosa?
Which medication has been used with some success in clients with bulimia nervosa?
Signup and view all the answers
A client is hospitalized on the psychiatric unit with a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with this client's diagnosis?
A client is hospitalized on the psychiatric unit with a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with this client's diagnosis?
Signup and view all the answers
A 14-year-old client has just been admitted to the psychiatric unit for anorexia nervosa. The individual is emaciated and refusing to eat. What is the priority nursing diagnosis for this client?
A 14-year-old client has just been admitted to the psychiatric unit for anorexia nervosa. The individual is emaciated and refusing to eat. What is the priority nursing diagnosis for this client?
Signup and view all the answers
The nurse is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse?
The nurse is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse?
Signup and view all the answers
A hospitalized client with bulimia nervosa is discussing their need to vomit and tells the nurse they are afraid they will gain weight. Which is the most appropriate response by the nurse?
A hospitalized client with bulimia nervosa is discussing their need to vomit and tells the nurse they are afraid they will gain weight. Which is the most appropriate response by the nurse?
Signup and view all the answers
A client presents in the emergency department with complaints of suicidal ideation. The following information is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.)
A client presents in the emergency department with complaints of suicidal ideation. The following information is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.)
Signup and view all the answers
A client diagnosed with borderline personality disorder manipulates the staff in an effort to fulfill their own desires. All of the following may be examples of manipulative behaviors in the borderline patient except:
A client diagnosed with borderline personality disorder manipulates the staff in an effort to fulfill their own desires. All of the following may be examples of manipulative behaviors in the borderline patient except:
Signup and view all the answers
A client on the psychiatric unit has a diagnosis of antisocial personality disorder. Which of the following characteristics is consistent with this diagnosis?
A client on the psychiatric unit has a diagnosis of antisocial personality disorder. Which of the following characteristics is consistent with this diagnosis?
Signup and view all the answers
A nurse on the psychiatric unit documents that the client was attempting to use "splitting" behaviors with staff. This should be interpreted to mean that the client is exhibiting what behavior?
A nurse on the psychiatric unit documents that the client was attempting to use "splitting" behaviors with staff. This should be interpreted to mean that the client is exhibiting what behavior?
Signup and view all the answers
According to researchers, which of the following is a common theme in the health history of the client with borderline personality disorder?
According to researchers, which of the following is a common theme in the health history of the client with borderline personality disorder?
Signup and view all the answers
Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder?
Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder?
Signup and view all the answers
Which of the following behavioral patterns is characteristic of individuals with schizoid personality disorder?
Which of the following behavioral patterns is characteristic of individuals with schizoid personality disorder?
Signup and view all the answers
A client with a diagnosis of borderline personality disorder exhibits alternating clinging and distancing behaviors with the nurse who has been assigned to their care. Which is the most appropriate nursing intervention for the client with this type of behavior?
A client with a diagnosis of borderline personality disorder exhibits alternating clinging and distancing behaviors with the nurse who has been assigned to their care. Which is the most appropriate nursing intervention for the client with this type of behavior?
Signup and view all the answers
A client diagnosed with antisocial personality disorder approaches the nurse and says, "You're so cute, are you married?" Which of these is the most appropriate response by the nurse?
A client diagnosed with antisocial personality disorder approaches the nurse and says, "You're so cute, are you married?" Which of these is the most appropriate response by the nurse?
Signup and view all the answers
A client with borderline personality disorder reports to the nurse that she is having abdominal pain and is requesting pain medication. Which action by the nurse is a priority?
A client with borderline personality disorder reports to the nurse that she is having abdominal pain and is requesting pain medication. Which action by the nurse is a priority?
Signup and view all the answers
A male client with antisocial personality disorder was found on the bed in a female patient's room. When instructed to leave the room, the client states, "I'm sick of you telling me what I can or can't do. If I want to carry on a relationship with one of these ladies, it's my right. I'll do exactly as I please!" Which of these actions by the nurse is a priority at this point?
A male client with antisocial personality disorder was found on the bed in a female patient's room. When instructed to leave the room, the client states, "I'm sick of you telling me what I can or can't do. If I want to carry on a relationship with one of these ladies, it's my right. I'll do exactly as I please!" Which of these actions by the nurse is a priority at this point?
Signup and view all the answers
Study Notes
Agoraphobia
- Agoraphobia is characterized by avoiding places from which escape might be difficult or embarrassing.
- Gradual exposure therapy is the preferred treatment.
- Implosion therapy involves intense exposure to phobic stimuli.
Obsessive-Compulsive Disorder (OCD)
- OCD is driven by anxiety and relieved by compulsive behaviors.
- Initial care for a client with OCD includes structuring time for compulsive behaviors.
- Setting limits on compulsive behaviors is essential for treatment progress.
Trichotillomania
- Trichotillomania involves the urge to pull out one's hair.
- Habit-reversal therapy for trichotillomania includes awareness and competing response training.
- Social support is also crucial in habit reversal therapy.
Body Dysmorphic Disorder (BDD)
- BDD involves preoccupation with perceived flaws in appearance.
- Encouraging the client to explain their reasons for seeking treatment is a priority.
Panic Attacks
- Staying with the client and reassuring them is the initial priority in a panic attack.
- Nurses must help patients feel safe during the attack
Generalized Anxiety Disorder (GAD)
- GAD necessitates daily medication like buspirone for sustained effects, unlike occasional needs of other medications.
PTSD
- PTSD symptoms often include survivor's guilt, where individuals feel responsible for the deaths of others.
- Treatment for PTSD might include paroxetine and group therapy.
- Predisposition to PTSD is influenced by stressor severity and support systems.
Adjustment Disorder
- Symptoms of adjustment disorder often resolve once the individual adjusts to changes.
- Medication like sertraline helps boost mood and energy.
Trauma-Informed Care
- Nurses must recognize trauma's potential impact on clients.
- Protecting clients' physical, emotional, and psychological safety is crucial.
Suicidal Thoughts
- Risk for suicidal behavior is a priority nursing diagnosis for a client struggling with adjustment disorder and suicidal ideation.
Depression related to Relationship Changes
- Acknowledging the client's grief for the loss of a relationship is an essential step in providing care.
Medical Illness and Depression
- A priority nursing diagnosis for clients dealing with diabetes and depression involves intervening to address risk-prone health behaviors causing difficulty managing the illness.
Substance Use and Effects
- Tolerance is a potential adverse effect if amphetamines are used to suppress appetite.
Eating Disorders
- Anorexia Nervosa: Low body weight, bradycardia, hypotension, hypothermia are physical signs.
- Bulimia Nervosa: Binging, purging, normal weight, and hypokalemia may be symptoms.
- Treatment for anorexia involves restoring nutritional status, and a primary nursing diagnosis is imbalanced nutrition.
- Bulimia treatment might involve addressing purging behaviors and nutritional needs.
Personality Disorders
- Borderline Personality Disorder:
- Characterized by shifting behaviors between clinging and distancing.
- Early trauma is often a component of their history.
- Manipulative behaviours may include splitting (characterizing people as all good or all bad, or alternating).
- Treatment might involve rotating staff to help clients relate to multiple individuals.
- Antisocial Personality Disorder:
- Characterized by a lack of guilt.
- Narcissistic Personality Disorder: Characterized by excessive self-centeredness and exploitation of others.
- Schizoid Personality Disorder: Characterized by lifelong social withdrawal.
Additional Notes
- Nurses should reinforce treatment program rules when clients exhibit inappropriate behavior.
- Assessing pain is the priority when a client with a borderline personality disorder complains of pain.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Morgan, K. I., & Townsend, M. C. (2024). Davis advantage for Townsend's psychiatric mental health nursing (11th ed.). F.A. Davis.
- Chapter 27: Anxiety, Obsessive-Compulsive, and Related Disorders
- Chapter 28: Trauma- and Stressor-Related Disorders
- Chapter 30: Eating Disorders
- Chapter 31: Personality Disorders
