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HURST Review: Psychiatric Nursing|250 Questions and Answers (Latest Update 2023/2024) Solutions
Typology: Exams
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Depression: Signs/Symptoms - Correct answer -loss of interest in life's activities -negative view of the world -anhedonia -usually related to loss -poor kept appearance Depression Signs/Symptoms: What is anhedonia? - Correct answer loss of pleasure in usually pleasurable things Depression Signs/Symptoms: In mild depression there is _____________ while there is ______________ in severe depression - Correct answer weight gain; weight loss Depression Signs/Symptoms: There are crying spells with ________________ and no more tears with ___________________ - Correct answer mild to moderate depression; severe depression Depression Signs/Symptoms: It is commons for client's to experience - Correct answer sleep disturbances Depression Signs/Symptoms: These clients have slow thoughts so we need to - Correct answer speak slowly to them and use the therapeutic communication technique of silence (give them time to process) Depression Signs/Symptoms: Clients who are depressed can have ___________________ and _________________ - Correct answer delusions; hallucinations Depression Treatment: They may need help with - Correct answer their self-care
Depression Treatment: Prevent _________________ because _______________________ makes the client feel better - Correct answer isolation; interacting with others Depression Treatment: Help them experience - Correct answer accomplishments Depression Treatment: Be careful with _______________ as they may make the client _________________ - Correct answer compliments; feel worse Depression Treatment: If severely depressed, ________________________________ may be the best thing you can do. It's a _______________________________ - Correct answer sitting with client and making no demands; self-esteem thing Depression Treatment: As they feel better, encourage them to _____________________. Let the client know that _________________________________________ - Correct answer describe their feelings; you understand they are in pain and feel powerless Depression Treatment: Help them set - Correct answer accomplishable goals Depression Treatment: If they are capable, activities such as _________________________________________ will help with depression - Correct answer walking, running, weight lifting Depression Treatment: Assess for - Correct answer suicide risk Depression Treatment: As depression lifts, what happens to suicide risk? - Correct answer the risk goes up Depression Treatment: Observe clients when they start taking antidepressants because - Correct answer their risk for suicide just went up (increase in SSRIs and energy)
Depression Treatment: A sudden change in mood towards the better may indicate - Correct answer that the client has made the decision to kill themselves Depression Treatment: Culturally, ____________________ have a higher suicide rate - Correct answer American Indians Depression Treatment: ___________ clients are particularly at risk for suicide - Correct answer Elderly Depression Treatment: ______________________ tend to be very successful because they generally use ______________________ - Correct answer Elderly men; very lethal methods Depression Treatment: When assessing suicide risk, ask clients 3 very important questions - Correct answer 1. do they have a plan?
-safe-proofing the room -getting a signed contract to postpone suicide Depression Treatment: A signed contract post poning suicide is done in hope that - Correct answer the client will develop coping mechanisms during this time Mania: One pole is __________ and the other is ________________ - Correct answer mania; depression Mania: Signs/Symptoms - Correct answer -continuous high -labile emotions (periods of extremes) -flight of ideas -delusions -constant motor activity -no inhibitions -altered sleep patterns -poor judgment -manipulation Mania: Delusions are just - Correct answer a false idea Mania: Types of delusions can include - Correct answer -delusions of grandeur (ex. client thinks they are Jesus) -delusions of persecution Mania: Constant motor activity leads to - Correct answer exhaustion
Mania: Lack of inhibition can include - Correct answer -inappropriate dress -hyper-sexual behaviors (an attention-seeking mechanism) Mania: Manipulation makes these clients - Correct answer feel secure and powerful Mania Treatment: Decrease - Correct answer the stimuli Mania Treatment: Don't ___________ or __________________ - Correct answer argue; try to reason Mania Treatment: Do you talk a lot about the delusion? - Correct answer no Mania Treatment: Let the client know you ____________________________, but that you ___________________ - Correct answer accept that they need the belief or delusion; do not believe it Mania Treatment: Look for the - Correct answer underlying need in the delusion Mania Treatment: The underlying need with delusions of persecution is the - Correct answer need to feel safe Mania Treatment: The underlying need with delusions of grandeur is the - Correct answer need to feel good about self Mania Treatment: Set ___________ and be ______________ - Correct answer limits; consistent Mania Treatment: They feel most secure in - Correct answer one-on-one relationships
Mania Treatment: Remove - Correct answer hazards (no cigarettes-1 or 2 then monitor) Mania Treatment: Stay with the client as - Correct answer anxiety increases Mania Treatment: These clients need - Correct answer a structured schedule Mania Treatment: Provide _______________ to replace _____________________________ - Correct answer activity; non-purposeful activity Mania Treatment: Supply __________________ because they are _________________________ - Correct answer finger foods; too busy to stop and eat Mania Treatment: Walk with client during - Correct answer meals Mania Treatment: Don't forget about ________________ because this client can become ____________________________________ - Correct answer fluids; dangerously dehydrated Mania Treatment: Make sure dignity is - Correct answer maintained Mania Treatment: ECT treatment can induce - Correct answer a tonic clonic seizure Mania Treatment: ECT treatment is used for clients with - Correct answer severe depression Mania Treatment: Prior to ECT treatment, what needs to happen? - Correct answer -client needs to be NPO -client needs to void -atropine is given (prevent aspiration) -consent is signed
-succinylcholine (Anectine) is given (relax muscles) Mania Treatment: ECT treatments are given in a - Correct answer series of treatments depending on the client's response Mania Treatment: Following ECT treatment, what must be done? - Correct answer -position client on side (prevent aspiration) -stay with the client -reorient them repeatedly -return to day-to-day activities ASAP Mania Treatment: What is expected post ECT treatment? - Correct answer temporary memory loss IMPORTANT TO REMEMBER: With psych patients, - Correct answer get people involved and active!! Schizophrenia: Signs/Symptoms - Correct answer -focus is inward (they create their own world) -inappropriate affect, flat affect, or blunted affect -disorganized thoughts (looseness of associations) -ineffective communication skills -concrete thinking (don't say "clean your plate") -religiosity -delusions -hallucinations Schizophrenia: What is one of their biggest problems? - Correct answer communication
Schizophrenia: What specific communication problems do they have? - Correct answer - echolalia -neologism -word salads Schizophrenia: What is echolalia? - Correct answer hearing a word and repeating it Schizophrenia: What is neologism? - Correct answer making up new words that have special meaning to the client, but NOT to the nurse Schizophrenia: What should you do when client expresses neologism? - Correct answer seek clarification (ex. I don't understand) Schizophrenia: With neologism, what do these words mean? - Correct answer nothing Schizophrenia: What are the most common hallucinations that these clients have? - Correct answer auditory Schizophrenia: Treatment includes - Correct answer -decreasing stimuli -frequent observation -frequent orientation -reality based conversation -observing for hallucinations Schizophrenia Treatment: When observing, make sure - Correct answer you don't look suspicious (physically go in the room-no peeking) Schizophrenia Treatment: With frequent orientation, it's important to remember that - Correct answer although client may know person, place, and time, delusions may still occur
Schizophrenia Treatment: When observing for hallucinations, make sure you - Correct answer warn them before touching them Schizophrenia Treatment: When observing for hallucinations, make sure you don't - Correct answer refer to the voices as "they" because this makes the hallucinations seem real Schizophrenia Treatment: Pertaining to hallucinations, let the client know that you - Correct answer do NOT share the perception Schizophrenia Treatment: Hallucinations are connected to - Correct answer times of anxiety Schizophrenia Treatment: Get these patients - Correct answer involved in an activity Schizophrenia Treatment: Elevate - Correct answer the head of the bed Schizophrenia Treatment: Turn off - Correct answer the TV Schizophrenia Treatment: You should offer reassurance because - Correct answer the client is frightened Schizophrenia Treatment: The nurse should observe for command hallucinations, these are - Correct answer auditory hallucinations that command the client to hurt themselves or others Schizophrenia Treatment: Command hallucinations are often frightening for the client and can signal - Correct answer a psychiatric emergency Paranoid Personality Disorder: Signs/Symptoms - Correct answer -always suspicious for no reason
-distrust of others -can't explain away their delusions or false beliefs -pathologic jealousy -hypersensitive to comments or actions -can't relax -no humor -unemotional -abnormal anger response, responds w/rage when provoked Paranoid Personality Disorder: Treatment includes - Correct answer -being reliable (do what you say to build trust!) -being honest -consistent nurses and brief visits -being matter-of-fact -respecting personal space -being careful with touch -don't mix medications -may need to give sealed foods -restraints Paranoid Personality Disorder Treatment: Brief visit example - Correct answer four 15 minute visits better than two 30 minute visits Paranoid Personality Disorder Treatment: Regarding touch, a paranoid person cannot - Correct answer handle a touchy, feely nurse (no whispering either) Paranoid Personality Disorder Treatment: Medications should be - Correct answer ID'd
Paranoid Personality Disorder Treatment: Why would these clients need to eat sealed foods? - Correct answer they think they are being poisoned Paranoid Personality Disorder Treatment: Restraints may be used when - Correct answer the nurse assesses that the client is a danger to themselves or others Paranoid Personality Disorder Treatment: Restraints are used as a - Correct answer last resort Paranoid Personality Disorder Treatment: Regarding restraints, make sure - Correct answer clients are getting something to eat, drink and use of the bathroom (remember hydration, nutrition, and elimination) Paranoid Personality Disorder Treatment: The client could ____________________________ while in restraints, so the need for accurate monitoring of this client cannot be overstated! - Correct answer be harmed or die RESTRAINTS-Joint Commission Standards: The client must be _______________________ within ____________________ of restraint - Correct answer evaluated in-person by a primary healthcare provider; 1 hour RESTRAINTS-Joint Commission Standards: Orders must be renewed every _________________ for adults - Correct answer 4 hours RESTRAINTS-Joint Commission Standards: Orders must be renewed every _________________ for ages 9-17 - Correct answer 2 hours RESTRAINTS-Joint Commission Standards: Orders must be renewed every _________________ for less than 9 years of age - Correct answer hour Anxiety: ____________________ has it - Correct answer everybody
Anxiety Signs/Symptoms: It is a - Correct answer universal emotion Anxiety Signs/Symptoms: It becomes a disorder when - Correct answer it interferes with daily functioning Anxiety Signs/Symptoms: It ________________________ at mild levels and ________________________ at high levels - Correct answer increases performance; decreases performance Anxiety Signs/Symptoms: Client may not need _______________ in mild anxiety; however, the nurse should _____________________________ - Correct answer the nurse's presence; stay with the highly anxious client Anxiety Signs/Symptoms: The client who is highly anxious needs - Correct answer step-by-step directions Generalized Anxiety Disorder (GAD) Signs/Symptoms: It is - Correct answer chronic anxiety Generalized Anxiety Disorder (GAD) Signs/Symptoms: Called the - Correct answer "worry" disease Generalized Anxiety Disorder (GAD) Signs/Symptoms: Client lives with it - Correct answer daily Generalized Anxiety Disorder (GAD) Signs/Symptoms: Fatigued d/t ______________________________ and always - Correct answer constant activity and muscle tension; uncomfortable Generalized Anxiety Disorder (GAD) Signs/Symptoms: Always seek - Correct answer help
Generalized Anxiety Disorder (GAD) Treatment: Short-term use of - Correct answer anxiolytics Generalized Anxiety Disorder (GAD) Treatment: Relaxation techniques including - Correct answer -deep breathing -imagery -deep muscle relaxation -meditation Generalized Anxiety Disorder (GAD) Treatment: Journaling over time may - Correct answer help to gain insight into anxiety, peaks and valleys, and triggers Generalized Anxiety Disorder (GAD) Treatment: Re-channel anxiety through - Correct answer exercise Generalized Anxiety Disorder (GAD) Treatment: With exercise, make sure you pick - Correct answer the most exerting exercise (ex. punching bag, NOT the long walk around the lake) Generalized Anxiety Disorder (GAD) Treatment: Stay calm, because - Correct answer anxiety is contagious Panic Disorders Signs/Symptoms: Onset of panic attack starts - Correct answer in the late 20s Panic Disorders Signs/Symptoms: These attacks can be as frequent as _____________________, or spread out, like _____________________ - Correct answer weekly; monthly Panic Disorders Signs/Symptoms: The client may present in the ED with classic symptoms of - Correct answer an MI, but it will be a panic attack
Panic Disorders Signs/Symptoms: They may be ___________________________and think _________________________ so, _____________________ - Correct answer frightened; they are dying; stay with them Panic Disorders Treatment: Speak with the client in a _______________________. Give them ______________________. Don't add to _____________________. Make them feel ____________________. - Correct answer non-threatening way; space, and be calm; the anxiety; secure Panic Disorders Treatment: If they are hyperventilating, - Correct answer slow down their breathing and breathe with them Panic Disorders Treatment: Use simple _______________________ when talking. They cannot _________________________________. - Correct answer words or messages; understand complex messages Panic Disorders Treatment: Teach ways to - Correct answer stop anxiety Panic Disorders Treatment: Teach that symptoms should peak within ________________________ and be gone within __________________ - Correct answer 10 minutes; 20-30 minutes Panic Disorders Treatment: Journaling to - Correct answer help manage the anxiety Panic Disorders Treatment: Use ___________________ techniques - Correct answer relaxation Phobias: The object the client fears often - Correct answer does not present a danger Phobias Treatment: Must develop - Correct answer a trusting relationship with the client
Phobias Treatment: What is the key to recovery? - Correct answer desensitization, and it must occur over time Phobias Treatment: Do NOT - Correct answer talk about the phobia a lot Phobias Treatment: It is ____________________________ that causes people to have a phobia
- Correct answer unconscious anxiety Phobias Treatment: ____________________________ haven't worked and for some reason, _____________________ may help them cope better - Correct answer Normal coping mechanisms; this fear Obsessive-Compulsive Disorder (OCD): Signs/Symptoms - Correct answer -obsession is a recurrent thought -compulsion is a recurrent act they cannot stop -it comes from an unconscious conflict/anxiety Obsessive-Compulsive Disorder (OCD) Treatment: They need a - Correct answer structured schedule Obsessive-Compulsive Disorder (OCD) Treatment: We give them - Correct answer time for their rituals Obsessive-Compulsive Disorder (OCD) Treatment: Why do we give them time for their rituals? - Correct answer their anxiety level goes up if they cannot perform their ritual Obsessive-Compulsive Disorder (OCD) Treatment: What do we do with the amount of time used for their ritual? - Correct answer decrease the amount of time for performing the ritual and increase the amount of time between the ritual
Obsessive-Compulsive Disorder (OCD) Treatment: NEVER - Correct answer take away the ritual without replacing it with another coping mechanism such as anxiety reduction techniques Obsessive-Compulsive Disorder (OCD) Treatment: Provide ______________________________ to distance themselves from the anxiety producing thoughts - Correct answer distraction techniques Obsessive-Compulsive Disorder (OCD) Treatment: Teach - Correct answer relaxation techniques like meditation Anorexia Nervosa: Signs/Symptoms - Correct answer -distorded body image -pre-occupied with food, but won't eat -menses stop d/t malnourishment -decreased sexual development -weight loss -hypothermia -low BP & low HR Anorexia Nervosa Signs/Symptoms: What might these clients have on their skin? - Correct answer lanugo Anorexia Nervosa Signs/Symptoms: Why do they have hypothermia? - Correct answer loss of SQ tissue Anorexia Nervosa Signs/Symptoms: Why do they have low BP and HR? - Correct answer dehydration and electrolyte imbalances Anorexia Nervosa Treatment: Increase weight - Correct answer gradually
Anorexia Nervosa Treatment: How should we weigh them? - Correct answer in their underwear (otherwise they will manipulate their weight) and with their back to the numbers Anorexia Nervosa Treatment: Monitor the client's - Correct answer exercise routine Anorexia Nervosa Treatment: Acknowledge the difficulty of - Correct answer the client's situation Anorexia Nervosa Treatment: Teach healthy - Correct answer eating and exercise Anorexia Nervosa Treatment: Allow _____________________ into choosing healthy food items for meals - Correct answer client's input Anorexia Nervosa Treatment: Monitor for - Correct answer suicidal thoughts Bulimia Nervosa Signs/Symptoms: They overeat and then - Correct answer vomit Bulimia Nervosa Signs/Symptoms: Teeth have - Correct answer erosion of enamel (dentist may be the first one to pick up on it) Bulimia Nervosa Signs/Symptoms: Use of - Correct answer laxatives and diuretics Bulimia Nervosa Signs/Symptoms: Strict dieters; they - Correct answer fast, exercise and binge Bulimia Nervosa Signs/Symptoms: Binges are - Correct answer alone and secret Bulimia Nervosa Signs/Symptoms: Binges are pleasurable intially, but after consuming - Correct answer thousands of calories, intense self-criticism may occur
Bulimia Nervosa Signs/Symptoms: Normal - Correct answer weight (lower end of normal) Bulimia Nervosa Treatment: Sit with the client at meals and - Correct answer observe for 1 hour after eating (make sure they don't throw up) Bulimia Nervosa Treatment: Allow __________________ for meals - Correct answer 30 minutes Bulimia Nervosa Treatment: Take focus away from - Correct answer the food Bulimia Nervosa Treatment: Intense ______________________ is usually needed because the cause is usually __________________________ - Correct answer family therapy; family problems Bulimia Nervosa Treatment: What is important for these clients? - Correct answer self-esteem building Clients with bulimia and anorexia nervosa feel in control as long as they are - Correct answer eating what they want Post-Traumatic Stress Disorder (PTSD): Signs/Symptoms - Correct answer -relives the experience, nightmares, and flashbacks -emotionally numb -difficulty with relationships -isolate themselves Post-Traumatic Stress Disorder (PTSD) Treatment: First goal - Correct answer establish a sense of safety Post-Traumatic Stress Disorder (PTSD) Treatment: Engage client in - Correct answer learning new coping skills
Post-Traumatic Stress Disorder (PTSD) Treatment: Get them involved in - Correct answer support groups Alcohol Use Disorder: Individuals are considered to have a substance use disorder when - Correct answer the use of the substance interferes with the ability to fulfill obligations such as work, school, or home Alcohol Use Disorder: Alcohol is - Correct answer a depressant Alcohol Use Disorder Treatment: Keep the - Correct answer light on (clients are very scared) Alcohol Use Disorder Treatment: Encourage a close friend or family member to - Correct answer stay with them Alcohol Use Disorder Treatment: Provide a - Correct answer quiet environment (will help with agitation seen in stages 1 & 2) Alcohol Use Disorder Treatment: Walk and - Correct answer talk to them Alcohol Use Disorder Treatment: ___________ the client frequently - Correct answer Orient Alcohol Use Disorder Treatment: _________________ illusions - Correct answer Clarify Alcohol Use Disorder Treatment: What precautions should they be put on? - Correct answer seizure Alcohol Use Disorder Treatment: Don't be afraid to give them - Correct answer anxiolytics
Alcohol Use Disorder Treatment: What is an anxiolytic that is frequently used for outpatient detox? - Correct answer chlordiazepoxide (Librium) Alcohol Use Disorder Treatment: Remember that the client has a tolerance to _____________________ and a cross-tolerance to ___________________________ - Correct answer alcohol; other CNS depressants Alcohol Use Disorder Treatment: Sedatives like ________________________ are used because they not only sedate, but have _____________________________________ - Correct answer benzodiazepines; anticonvulsive qualities Alcohol Use Disorder Treatment: Other examples of medications with anticonvulsive qualities - Correct answer -chlordiazepoxide (Librium) -diazepam (Valium) -lorazepam (Ativan) Alcohol Use Disorder Treatment: Keep the clients well - Correct answer hydrates and replace electrolytes Alcohol Use Disorder Treatment: Clients usually have low __________________________________________ because alcoholics don't eat or drink well - Correct answer -thiamine -magnesium -calcium -potassium -phosphorus Alcohol Use Disorder Treatment: Replacement with _________________________________________ may be required during detox - Correct answer multi-vitamins, electrolyte solutions and thiamine injections
Alcohol Use Disorder Treatment: Thiamine deficiency can lead to the chronic conditions of - Correct answer Wernicke's Encephalopathy and Korsakoff's Psychosis Alcohol Use Disorder Treatment: What should be prevented? - Correct answer alcohol induced delirium tremens Wernicke's Encephalopathy is - Correct answer the most serious form of thiamine deficiency in alcoholics Wernicke's Encephalopathy: Symptoms - Correct answer -paralysis of the ocular muscles -diplopia -ataxia -somnolence -stupor Wernicke's Encephalopathy: What will happen without thiamine injections? - Correct answer death will occur Korsakoff's Psychosis is - Correct answer syndrome of confusion and loss of recent memory Korsakoff's Psychosis: Often seen when the client is - Correct answer coming out of Wernicke's What is is called when Wernicke's Encephalopathy and Korsakoff's Psychosis occur together? - Correct answer Wernicke-Korsakoff syndrome Alcohol Use Disorder Treatment: CIWA-Ar is - Correct answer an assessment tool that guides alcohol withdrawal medication dosing
Alcohol Use Disorder Treatment: With CIWA-Ar, treatment frequently begins when scores reach
- Correct answer 8-10 Alcohol Use Disorder Treatment: With CIWA-Ar, clients may be transferred to ICU for scores - Correct answer over 20 Alcohol Use Disorder: How many stages of withdrawal are there? - Correct answer 3 Alcohol Use Disorder: Stage 1 of withdrawal is - Correct answer minor withdrawal Alcohol Use Disorder: Stage 1 of withdrawal starts within - Correct answer 4-12 hours of drinking cessation Alcohol Use Disorder: During stage 1 of withdrawal, clients will experience - Correct answer - mild tremors -nervousness -nausea -insomnia -H/As -palpitations Alcohol Use Disorder: During stage 1 of withdrawal, clients are - Correct answer oriented to time, place, and person Alcohol Use Disorder: Stage 2 of withdrawal is - Correct answer moderate to severe withdrawal Alcohol Use Disorder: During stage 2 of withdrawal, clients will experience - Correct answer - increased tremors -confusion
-hyperthermia -hyperactiveness -nightmares -increased BP -increased respirations -hallucinations -illusions Alcohol Use Disorder: During stages 1 and 2 of withdrawal, we must ________________________________________ to prevent the client from progressing to _____________________________________ - Correct answer carefully assess and provide treatment; delirium tremens Alcohol Use Disorder: Stage 3 of withdrawal is ___________________________ and is AKA _______________________ - Correct answer the most dangerous withdrawal; delirium tremens Alcohol Use Disorder: Stage 3 of withdrawal is considered - Correct answer a medical emergency Alcohol Use Disorder: What is most common during stage 3 of withdrawal? - Correct answer kinesthetic DTs (clients feel things crawling on them) Alcohol Use Disorder: What becomes possible during stage 3 of withdrawal? - Correct answer tonic clonic seizures Alcohol Use Disorder: Observe for the use of - Correct answer defense mechanisms Alcohol Use Disorder: The major defense mechanisms in alcoholism are - Correct answer denial and rationalization
Alcohol Use Disorder: What medication is a deterrent to drinking? - Correct answer disulfiram (Antabuse) Alcohol Use Disorder: Before disulfiram (Antabuse) is given, the client must - Correct answer sign a consent Alcohol Use Disorder: While on disulfiram (Antabuse), the client must stay away from - Correct answer any form of alcohol including cough syrup, aftershave, colognes, and chemicals such as varnish Alcohol Use Disorder: Must have _________________ once detox is over - Correct answer support Alcohol Use Disorder: What usually emerges once the alcoholic is sober? - Correct answer family issues (family therapy is important for all family members) Alcohol Use Disorder: What is effective in supporting these individuals following their detox? - Correct answer 12-step program Opioid Abuse: This can start in one of two ways - Correct answer 1. A prescription from a primary provider that is intended to treat a legitimate problem
Opioid Abuse: Signs/Symptoms of an addiction - Correct answer -client needs more drugs and needs them more often because of built-up tolerance -drug seeking is no longer an option (it is survival) Opioid Intoxication: Signs/Symptoms are present as - Correct answer a triad Opioid Intoxication: Signs/Symptoms are - Correct answer 1. pinpoint pupils