Mental Health Exam 2 Flashcards

Questions and Answers

Which nursing interventions are particularly well chosen for addressing a population at high risk for developing schizophrenia? (Select all that apply)

Forming a support group for females aged 25 to 35 who are diagnosed with substance use disorders.

Teaching ways to cope and build resiliency. (correct)

Educating about the risk of psychosis with marijuana use. (correct)

Screening 15- to 25-year-olds for early symptoms. (correct)

What should the nurse frequently assess for in a patient taking a second-generation antipsychotic?

Metabolic syndrome

What information should the nurse provide to a patient prescribed a first-generation antipsychotic medication regarding signs and symptoms?

She should experience a reduction in hallucinations.

Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia?

Paranoia Signup and view all the answers

Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is hallucinations? (Select all that apply)

"I know you say you hear voices, but I cannot hear them." Signup and view all the answers

When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that:

They are not actually ill. Signup and view all the answers

What is the priority nursing intervention for a patient on haloperidol who is diaphoretic and unresponsive?

Wipe him with a washcloth that has been wetted with cold water or alcohol. Signup and view all the answers

What can self-medicating with excessive alcohol provide for a patient with schizophrenia?

Enhance mood. Signup and view all the answers

Which helpful nursing response could be used when a patient reports that 'the voices are really bad today'?

Encouraging the patient to use competing auditory stimuli, such as humming or listening to music. Signup and view all the answers

What question should the nurse ask initially when attempting to help a patient de-escalate moderate anxiety?

Can you identify what was happening when your anxiety began to increase? Signup and view all the answers

Which patients are at increased risk for the development of anxiety and will require frequent assessment? (Select all that apply)

Exacerbation of asthma signs and symptoms Signup and view all the answers

Which medication should the nurse prepare to educate patients on when prescribed an SSRI for panic attacks?

Fluoxetine (Prozac) Signup and view all the answers

Which statements show effective use of relaxation therapy for anxiety management? (Select all that apply)

"I've given you written descriptions of the various relaxation exercises for you to review." Signup and view all the answers

Which lifestyle practice should the nurse discourage for a patient recently prescribed an antianxiety medication?

Buying a large coffee with sugar and extra cream each morning on the way to work. Signup and view all the answers

What is a likely contributor to the extremely shy behavior of the 8-year-old girl in the context of parental involvement?

The inherited shyness trait. Signup and view all the answers

What effective teaching about mild anxiety can be recognized when a patient states?

Mild anxiety is okay because it helps me to focus. Signup and view all the answers

What drug facilitates the action of gamma-aminobutyric acid (GABA)?

Benzodiazepines Signup and view all the answers

Which test should be ordered for a patient using kava, which inhibits P450?

Liver enzymes Signup and view all the answers

What is the medic most likely counting while talking with Luc and his family?

Energy drink containers Signup and view all the answers

What assessment findings would indicate lithium toxicity in Tatiana?

Ataxia, severe hypotension, large volume of dilute urine Signup and view all the answers

What dosage adjustment is the psychiatric nurse practitioner likely to prescribe for a patient ready to enter maintenance therapy?

A lower dosage Signup and view all the answers

What treatment may the psychiatric nurse practitioner recommend for Ted to reduce his mania?

Electroconvulsive therapy (ECT) Signup and view all the answers

What does the nurse recognize about Laura, who drinks alcohol instead of taking prescribed medications?

Alcohol ingestion is a form of self-medication. Signup and view all the answers

What should the nurse instruct the patient with a lithium level of 1.7 mEq/L to do?

Instruct the patient to hold the next dose of medication and contact the prescriber. Signup and view all the answers

What nursing diagnosis is most appropriate for a patient expressing hopelessness?

Hopelessness Signup and view all the answers

Why is psychotherapy important for a patient preparing for discharge?

Psychotherapy will help you cope with stressors that present after discharge. Signup and view all the answers

What treatment option acts quickly for a patient with severe paranoia and refuses to eat?

Electroconvulsive therapy (ECT) Signup and view all the answers

What medication presents a high risk for a patient with bipolar disorder and epilepsy?

Lithium Signup and view all the answers

What medication should be anticipated for a manic patient who is highly agitated?

Clonazepam Signup and view all the answers

What education should be provided to a patient prescribed valproate and risperidone?

Valproate will help to control your mood while risperidone will help your mind to think clearly. Signup and view all the answers

Which is a characteristic of bipolar II?

Excessive involvement in pleasurable activities Signup and view all the answers

The onset of bipolar II typically occurs around what age?

25 Signup and view all the answers

Which statement regarding generalized anxiety disorder (GAD) is true?

The individual's worrying experienced with GAD becomes a coping mechanism. Signup and view all the answers

Which treatment would the team most likely choose to understand specific anxiety-provoking situations?

Systematic desensitization Signup and view all the answers

Which intervention should the team initiate first for a patient with GAD?

Provide a supportive environment Signup and view all the answers

What statement made by a patient indicates an understanding of cognitive behavioral therapy?

I no longer believe that my mistakes will result in catastrophic outcomes. Signup and view all the answers

What education does the nurse anticipate providing for a patient taking a benzodiazepine with an added antidepressant?

The benzodiazepine must be slowly tapered off. Signup and view all the answers

Why does the psychiatric nurse practitioner suggest discontinuing the patient's herbal remedy?

Herbal remedies can delay diagnosis of major depression or anxiety disorders. Signup and view all the answers

What assessment finding requires immediate action by the nurse for a patient with severe anxiety?

The patient states that severe anxiety symptoms have been present for days. Signup and view all the answers

What intervention is appropriate for a patient exhibiting moderate levels of anxiety?

Ask the patient to identify the cause of anxiety. Signup and view all the answers

What nursing intervention will help a patient with panic levels of anxiety to participate in psychotherapy?

Tell the patient to take a walk. Signup and view all the answers

Which question should the nurse ask to determine if a patient with GAD is exercising regularly?

What type of exercise are you doing, how frequently are you exercising, and how long are you exercising? Signup and view all the answers

Which statement regarding obsession is true?

Obsession is characterized by persistent thoughts. Signup and view all the answers

Which intervention is most appropriate for a patient diagnosed with OCD who hasn't responded positively to treatment?

Deep brain stimulation Signup and view all the answers

What medication would be beneficial for a patient recently diagnosed with OCD experiencing increased anxiety?

Sertraline Signup and view all the answers

What is the definition of Isocarboxazid?

C Signup and view all the answers

Which possible side effect is most important for the interdisciplinary health care team to monitor in a patient prescribed an SSRI?

Suicidal ideation Signup and view all the answers

Which nursing diagnosis is most appropriate for a patient with OCD who has decreased anxiety but continues organizing belongings?

Social isolation Signup and view all the answers

Which patient outcome best demonstrates adherence to the treatment plan for a patient with OCD?

Patient goes to the gym three times a week. Signup and view all the answers

Which statement made by the nurse to a patient diagnosed with OCD is most therapeutic?

It is great that you are drawing the connection between your feelings of anxiety and the need to pray every few minutes. Signup and view all the answers

Which statement made by the patient indicates an understanding of OCD and its treatment?

I need to work on being more proactive in cooking meals, showering, and going to bed at a decent hour. Signup and view all the answers

Which statement regarding panic disorder is true?

The diagnosis of panic disorder does not include panic attacks caused by substance withdrawal. Signup and view all the answers

Which type of therapy is recommended to help a patient understand the connection between feelings of impending doom and difficulty breathing?

Cognitive behavior therapy Signup and view all the answers

Which medication is recommended for a patient with several complex medical conditions experiencing anxiety from public speaking?

Propranolol Signup and view all the answers

Which statement by the patient indicates understanding of systematic desensitization therapy?

This therapy teaches me how to relax when exposed to stimuli that provoke anxiety. Signup and view all the answers

Which assessment tool is most effective for evaluating a patient with panic disorder?

Mental status exam Signup and view all the answers

Which nursing diagnosis requires immediate intervention in a patient with an anxiety disorder?

Stress overload Signup and view all the answers

Which nursing intervention is most effective for a patient with social phobia?

Suggest the patient join an online chat group Signup and view all the answers

Which observations indicate medication effectiveness for a patient's positive symptoms of schizophrenia?

After two days, less response to auditory hallucinations. Signup and view all the answers

Which medication is suitable for a non-compliant patient with schizophrenia?

Haloperidol decanoate Signup and view all the answers

Which patient teaching scenario is most effective for a patient diagnosed with a thought disorder?

The nurse provides written education and answers questions. Signup and view all the answers

Which statement made by the nurse is most therapeutic for a patient with schizophrenia claiming royal lineage?

That's an interesting observation. Signup and view all the answers

Which observations suggest a therapeutic relationship has been established between the nurse and patient?

Nurse approaching a patient showing behavioral changes. Signup and view all the answers

Which communication principle should the nurse use when caring for an agitated patient with schizophrenia?

Be calm when talking to the patient. Signup and view all the answers

Which nursing intervention is most appropriate for a withdrawn patient?

Place chairs in groups. Signup and view all the answers

Which best describes milieu therapy?

Where the patient learns about themselves. Signup and view all the answers

Which patient has the lowest risk for developing schizophrenia?

A 40-year-old female being treated for depression. Signup and view all the answers

What should the nurse's best response be to a mother asking about the cause of her daughter's schizophrenia?

It's related to many genetic, environmental, and psychosocial issues. Signup and view all the answers

Which developmental theorist explains a patient's disorder as an outcome of failing to learn trust in infancy?

Erikson Signup and view all the answers

Which assessment finding would confirm suspicion of delusions in a patient diagnosed with schizophrenia?

Patient believes the Japanese mafia is after him. Signup and view all the answers

Which part of this patient's history supports a diagnosis of schizophrenia?

Having hallucinations and delusions for the past month. Signup and view all the answers

How should the nurse respond to a mother asking why her daughter doesn't talk or engage?

Experiencing negative symptoms, including anergia. Signup and view all the answers

Which information should the nurse provide regarding neurotransmitters related to schizophrenia?

Positive symptoms relate to excess dopamine in the mesolimbic area. Signup and view all the answers

How should the nurse document a patient's auditory hallucination where they hear someone say, 'You are horrible'?

Patient is having auditory hallucinations. Signup and view all the answers

How should the nurse explain a patient appearing distractible and in their own world?

Experiencing a symptom known as autism. Signup and view all the answers

How should the nurse document a patient's affect changing from happy to sad to angry?

Patient has a labile affect. Signup and view all the answers

Which behavior observed by the nurse would support a conclusion of delusions?

Patient thinks the FBI wants him killed. Signup and view all the answers

Which question would be most appropriate for assessing subjective symptoms of schizophrenia?

Do you feel like your thoughts are slowed or blocked? Signup and view all the answers

Which characteristics suggest a man is experiencing the prodromal phase of schizophrenia?

Increased anxiety and social withdrawal. Signup and view all the answers

Study Notes

Bipolar Disorder and Treatment

Full manic episodes often lead to emergency medical intervention; energy drink containers may be present during assessments.
Indicators of lithium toxicity include ataxia, severe hypotension, and a large volume of dilute urine.
Maintenance therapy for bipolar I disorder typically involves dosage adjustments to lower levels of lithium after stable functioning.
Electroconvulsive therapy (ECT) is recommended for patients with severe mania and paranoia impeding essential functions like eating.
Substance use disorders are prevalent in bipolar disorder; self-medication with alcohol may occur.
Nursing interventions for manic patients include monitoring vital signs, providing protein drinks, and offering calm, clear instructions.

Lithium Monitoring and Education

A lithium level of 1.7 mEq/L is toxic; instruct patients to hold doses and contact their providers.
Early signs of lithium toxicity include nausea and tremors; patients should understand these symptoms.
Effective lithium management includes hydration, monitoring diuretic interactions, and arranging for outpatient lithium level checks.

Patient Education and Support

Understanding the link between alcohol/caffeine and symptom relapse is crucial; patients must communicate sleep patterns and changes in health.
Medication education emphasizes that antidepressants are rarely combined with bipolar treatment due to potential manic triggers.
Family support and awareness of the disease's cyclical nature aid in managing bipolar disorder.

Nursing Diagnoses and Interventions for Bipolar Disorder

Hopelessness is a critical concern; nursing diagnoses may include risk for injury and ineffective coping during depressive episodes.
Engaging patients in psychotherapy helps manage stressors following stabilization from acute mania.
Paranoia in manic patients necessitates rapid interventions, often involving ECT for quick action.

Anxiety Disorders

Generalized anxiety disorder (GAD) involves persistent worry impacting function; evidence suggests both environmental and hereditary factors contribute.
Effective interventions for anxiety include positive interaction, inclusion in care plans, and early recognition of escalating behavior.
Cognitive-behavioral therapy is informed by the acknowledgment of irrational catastrophic thinking patterns.

Obsessive-Compulsive Disorder (OCD)

Neurological evidence for OCD includes dysfunction in the basal ganglia and altered serotonin function; increased anxiety can lead to compulsive behaviors.
Patients with OCD often grapple with feelings of shame and loneliness; intervention strategies may involve deep brain stimulation for those unresponsive to treatment.
SSRIs combined with benzodiazepines can effectively manage OCD symptoms; monitoring for suicidal ideation is essential.

Key Characteristics and Considerations

Hypomania features impulsivity, distractibility, and risky behavior but does not severely impair global functioning.
Bipolar II disorder is often characterized by excessive involvement in pleasurable activities, with typical onset around 25 years of age.
Nursing strategies for managing anxiety or OCD should focus on maintaining supportive environments and encouraging healthy coping mechanisms.### Panic Attack Symptoms
Common feelings during a panic attack include impending doom, separation from self, and disorganized surroundings.
Lack of impulse control and intense fear of a specific object or place are less typical.

Panic Disorder Insights

A diagnosis of panic disorder requires persistent worry for longer than three months.
Panic attacks related to substance withdrawal are excluded from the diagnosis.

Effective Therapies

Cognitive behavioral therapy (CBT) is recommended to understand connections between feelings of doom and physical symptoms.
Systematic desensitization therapy helps patients learn relaxation techniques in response to anxiety-provoking stimuli.

Medication for Anxiety and Phobia

Propranolol is recommended for patients facing anxiety related to public speaking.
Patients diagnosed with specific phobias benefit from supportive interventions like engaging in online chat groups.

Nursing Assessments and Diagnostics

The mental status exam is crucial for assessing panic disorders.
Immediate intervention is required for patients experiencing stress overload.

Therapeutic Relationships

Establishing a therapeutic relationship is supported by active listening and appropriate responses to patient behavior.

Patient Safety and Communication

Calm communication is essential when interacting with agitated patients.
Direct and respectful communication is necessary for paranoid schizophrenia patients, avoiding unnecessary pressure or touch.

Knowledge of Schizophrenia

Patients with schizophrenia may show both positive symptoms (like hallucinations) and negative symptoms (like lack of motivation).
Expectation of weight gain and understanding of medication side effects are important educational components for patients and families.

Risk Factors and Development

Heritability of schizophrenia is significant, with a 70-90% estimated risk for those with a family history.
Prenatal exposure to toxins or complications is linked to an increased risk of developing schizophrenia.

Challenging Behaviors and Symptoms

Delusions, like false beliefs of being targeted, indicate active psychosis in patients with schizophrenia.
Symptoms like labile affect demonstrate rapid emotional changes, necessitating careful nursing documentation.

Coping Mechanisms and Self-medication

Patients often self-medicate with alcohol to cope with social discomfort and anxiety, impacting their mental health.

Priority Nursing Interventions

For patients experiencing severe reactions to antipsychotics, immediate nursing actions include holding medication and contacting a prescriber.

Effective Communication Techniques

Therapeutic responses to hallucinations should acknowledge patient experiences while gently steering towards reality.

General Understanding

Schizophrenia is complex, warranting ongoing support and tailored interventions to address individual patient needs.### Patient Care and Anxiety Management
Encouragement of competing auditory stimuli like humming or music can aid patients in managing anxiety.
When addressing moderate anxiety, a pertinent question for the nurse is, "Can you identify what was happening when your anxiety began to increase?" This helps in understanding triggers.
Patients at heightened risk of anxiety include individuals with exacerbated asthma, chronic obstructive pulmonary disease (COPD), unstable angina pectoris, or a history of traumatic brain injury.

Medications and Treatment

Selective serotonin reuptake inhibitors (SSRIs), such as Fluoxetine (Prozac), are recommended for treating panic attacks.
The effectiveness of relaxation therapy is indicated by statements like, "Muscle relaxation promotes the relaxation response," and showing patients deep breathing techniques.
Lifestyle changes are crucial; for example, purchasing large amounts of coffee with added sugar is discouraged for patients on antianxiety medications.

Behavioral Observations

A profoundly shy child may exhibit traits learned from parents; inherited shyness is a significant factor.
Students with mild anxiety, such as a straight-A student experiencing test anxiety, may understand the positive aspect of anxiety as it helps them focus.

Pharmacodynamics

Gamma-aminobutyric acid (GABA) plays a critical role in slowing neural activity; benzodiazepines enhance the effect of GABA, aiding in anxiety control.
Long-term use of herbal kava can inhibit P450 enzymes, necessitating liver enzymes testing for patients self-medicating with this substance.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on mental health concepts with these flashcards for Exam 2. This quiz covers various scenarios and questions related to manic episodes and other mental health topics. Challenge yourself and enhance your understanding of critical mental health issues.