Mental Health & Therapeutic Communication

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Questions and Answers

A patient taking lithium exhibits severe diarrhea, blurred vision, and muscle weakness. Which action should the nurse prioritize?

  • Administer an anti-diarrheal medication.
  • Encourage the patient to increase fluid intake.
  • Immediately assess the patient for lithium toxicity. (correct)
  • Administer medication to help with blurred vision.

A patient is prescribed alprazolam for anxiety. Which instruction is most important for the nurse to emphasize to the patient?

  • Discontinue the medication immediately if side effects occur.
  • Take the medication on an empty stomach to enhance absorption.
  • Increase the dosage if anxiety symptoms worsen.
  • Avoid consuming alcohol while taking this medication. (correct)

A child with ADHD is prescribed methylphenidate. Which potential side effect should the nurse educate the parents about?

  • Excessive salivation and frequent urination.
  • Decreased blood pressure and drowsiness.
  • Weight loss, increased blood pressure, and insomnia. (correct)
  • Increased appetite and weight gain.

A nurse is caring for a patient experiencing homelessness. According to Maslow's hierarchy of needs, which intervention should the nurse prioritize?

<p>Providing the patient with a nutritious meal and a warm blanket. (A)</p> Signup and view all the answers

A physician orders haloperidol 0.5 g in 50 mL to be administered intravenously over 30 minutes. The IV tubing drop factor is 20 gtt/mL. What is the correct flow rate in drops per minute (gtt/min)?

<p>33 gtt/min (C)</p> Signup and view all the answers

A nurse is assessing a client's cognitive function. Which assessment findings would be the MOST indicative of impaired cognitive function?

<p>The client is oriented to person, place, and time but cannot recall three common objects after 5 minutes. (B)</p> Signup and view all the answers

A client states, "I feel completely hopeless, like nothing will ever get better." Which nursing response BEST demonstrates therapeutic communication?

<p>&quot;Tell me more about what you are feeling and what makes you say that.&quot; (D)</p> Signup and view all the answers

A client being treated for depression states, "My doctor says I'm doing better, but I feel worse than ever." What is the MOST appropriate nursing response?

<p>&quot;It sounds like you're feeling worse. Tell me more about what's going on.&quot; (A)</p> Signup and view all the answers

A client in an inpatient psychiatric unit threatens to harm another patient. According to legal and ethical guidelines, what is the nurse's MOST appropriate action?

<p>Notify the client that their confidentiality will be breached due to the threat. (B)</p> Signup and view all the answers

A client is involuntarily admitted to a psychiatric unit due to being a danger to self. Which of the following rights does the client RETAIN?

<p>The right to refuse treatment unless a court order has been obtained. (C)</p> Signup and view all the answers

A nurse observes a client pacing, shouting, and making threatening gestures toward staff. What is the FIRST action the nurse should take?

<p>Ensure the safety of the client, other patients, and staff. (A)</p> Signup and view all the answers

A client taking phenelzine (Nardil), an MAOI, is instructed to avoid tyramine-rich foods. Which meal choice indicates that the client understands these dietary restrictions?

<p>Grilled chicken salad with a vinaigrette dressing and apple juice (B)</p> Signup and view all the answers

A client has been prescribed fluoxetine (Prozac) for depression. What information is MOST important for the nurse to include in client education regarding this medication?

<p>The medication may take 4-6 weeks to reach its full therapeutic effect. (B)</p> Signup and view all the answers

A patient taking haloperidol begins to exhibit muscle rigidity and a shuffling gait. Which of the following is the MOST likely cause of these symptoms?

<p>Extrapyramidal symptoms (EPS) (D)</p> Signup and view all the answers

A patient is prescribed zolpidem for insomnia. What instruction should the nurse emphasize to the patient regarding its use?

<p>Take the medication immediately before bed. (A)</p> Signup and view all the answers

A nurse is caring for a patient with multiple needs. According to Maslow's Hierarchy of Needs, which of the following should the nurse address FIRST?

<p>Ensuring adequate hydration and nutrition (A)</p> Signup and view all the answers

A physician orders haloperidol 2 g in 200 mL to be administered intravenously over 60 minutes. The IV tubing drop factor is 15 gtt/mL. What is the correct flow rate in drops per minute (gtt/min)?

<p>50 gtt/min (D)</p> Signup and view all the answers

A patient taking methylphenidate for ADHD reports difficulty sleeping and decreased appetite. What is the MOST appropriate nursing intervention?

<p>Educate the patient about potential side effects and strategies to manage them such as taking the medication earlier in the day. (C)</p> Signup and view all the answers

A nurse is assessing a client who is exhibiting a flat affect. Which of the following observations BEST describes this symptom?

<p>The client exhibits minimal facial expression and a monotone voice. (B)</p> Signup and view all the answers

A patient being treated for depression begins cognitive behavioral therapy (CBT). What is the primary goal the nurse should emphasize when educating the patient about CBT?

<p>To identify and change negative thought patterns. (C)</p> Signup and view all the answers

During a mental health assessment, a nurse asks the client to repeat a series of numbers and recall them a few minutes later. Which cognitive function is the nurse primarily assessing?

<p>Immediate and Short-term Memory (A)</p> Signup and view all the answers

A patient taking tricyclic antidepressants (TCAs) is being discharged. What potential side effect should the nurse prioritize when teaching the patient about home safety?

<p>Orthostatic hypotension (C)</p> Signup and view all the answers

Which nursing action constitutes false imprisonment?

<p>Restraining a patient against their will without a doctor's order when they are not an imminent threat to themselves or others. (D)</p> Signup and view all the answers

A client receiving inpatient psychiatric care states, "I want to leave now, but the doctor won't let me." Under what circumstances can a client be held against their will?

<p>If the client is an imminent danger to self or others. (D)</p> Signup and view all the answers

A client taking phenelzine (Nardil) is invited to a party. Which food item should the nurse advise the client to avoid to prevent a potential adverse reaction?

<p>Aged cheddar cheese (A)</p> Signup and view all the answers

A nurse observes a patient rapidly pacing, speaking loudly, and clenching their fists. Which intervention is the MOST appropriate FIRST step?

<p>Speak to the patient in a calm, non-threatening manner and attempt to de-escalate the situation. (C)</p> Signup and view all the answers

Flashcards

Mood Stabilizers

Medications used primarily to manage bipolar disorder.

Extrapyramidal Symptoms (EPS)

Medication (like Haloperidol) that can cause muscle rigidity or shuffling gait.

Anxiolytic Risks

Medications like alprazolam carry these risks.

Maslow's Hierarchy in Nursing

Basic needs must be met before addressing higher-level needs.

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Dose Calculation Formula

Ordered dose divided by available dose, multiplied by volume.

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Cognitive Function Assessment

Assesses memory, orientation, attention, and ability to follow commands.

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Mental Status Assessment

Encompasses appearance, behavior, cognition, and thought processes.

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Affect vs. Mood

Outward expression of emotion vs. sustained emotional state.

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Right to refuse treatment

Patients can refuse treatment unless court-ordered.

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Duty to Warn, False Imprisonment, Battery and Assault

Duty to warn of threats; unjustified restraint; touching w/o consent; threat of harm

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Cognitive Behavioral Therapy (CBT)

Focuses on changing negative thought patterns.

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Handling Aggression

Ensure safety, de-escalate, avoid confrontation.

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Documentation

Nurses must always use objective, factual instead of judgmental language.

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Lithium Monitoring

A mood stabilizer that requires monitoring for toxicity; signs include severe diarrhea, blurred vision and muscle weakness.

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Alprazolam Risks

Alprazolam carries a risk of dependency, and should not be stopped suddenly. Avoid alcohol to prevent CNS depression.

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Methylphenidate (ADHD stimulant) Side Effects

Medication used for ADHD that can cause weight loss, increased blood pressure, and insomnia.

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Sedative-Hypnotics Instructions

Medications used for insomnia that should be taken right before bed, can cause daytime drowsiness.

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Ordered 250mg, Available 500mg/5mL

To give 2.5 mL. (250 mg / 500mg) x 5mL

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Open-Ended Questions

Asking questions that encourage detailed responses, not just 'yes' or 'no'.

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Active Listening

Actively listening to understand and respond to a patient's communication.

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Reflection (Communication)

Restating a patient's feelings to show understanding.

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Summarization (Communication)

Brief recap of main points.

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Therapeutic Milieu

Using a structured environment to support patient recovery.

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Psychobiological Interventions

Medications that address mental health symptoms.

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Emergency Admission

Only when a patient is at risk to themselves or others.

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Crisis Management

Actions taken to ensure safety and de-escalation.

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Study Notes

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