Psychiatric Nursing Interventions for Substance Use Disorders, Exams of Nursing

Download Psychiatric Nursing Interventions for Substance Use Disorders and more Exams Nursing in PDF only on Docsity! exam 2 chapter questions NR 326 QUESTIONS WITH CORRECT ANSWERS Recent research on the RAISE approach to the treatment of schizophrenia incorporates which of the following elements as important to improving outcomes? (Select all that apply.) a. Early intervention at the first episode of psychosis b. Support for employment or educational pursuits c. Rapid high-dose loading with antipsychotic medication d. Court-ordered sanctions for treatment e. Recovery-focused psychotherapy - CORRECT ANSWER_-a. Early intervention at the first episode of psychosis b. Support for employment or educational pursuits e. Recovery-focused psychotherapy Which of the following is the primary goal in working with an actively psychotic, suspicious client? a. Promote interaction with others. b. Decrease his anxiety and increase trust. c. Improve his relationship with his parents. d. Encourage participation in therapy activities. - CORRECT ANSWER_-b. Decrease his anxiety and increase trust. A client with schizophrenia has physician's orders for haloperidol (Haldol) 5 mg IM STAT and then 3 mg PO tid; 2 mg benztropine PO bid prn. Why is benztropine ordered? a. To treat extrapyramidal symptoms b. To prevent neuroleptic malignant syndrome c. To decrease psychotic symptoms d. To induce sleep - CORRECT ANSWER_-a. To treat extrapyramidal symptoms A client on the psychiatric unit tells the nurse that the CIA is looking for him and will kill him if they find him. The client's false belief is an example of a: a. Delusion of persecution. b. Delusion of reference. c. Delusion of control or influence. d. Delusion of grandeur. - CORRECT ANSWER_-a. Delusion of persecution. The primary focus of family therapy for clients with schizophrenia and their families is: a. To discuss problem-solving and adaptive behaviors for coping with stress. b. To introduce the family to others with the same problem. c. To keep the client and family in touch with the health-care system. d. To promote family interaction and increase understanding of the illness. - CORRECT ANSWER_-d. To promote family interaction and increase understanding of the illness. A client recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment and the police said I had to come with them." This is an example of what symptom of schizophrenia? a. Delusions of reference b. Loose association c. Anosognosia d. Auditory hallucinations - CORRECT ANSWER_-c. Anosognosia Which of the following assessments by the nurse would convey a need for prn benztropine? . The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. The patient's family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat since there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa. - CORRECT ANSWER_-a. The patient's family should be actively involved in each phase of treatment. A client has sought help for his concern that he is binge eating and feels like it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "Nothing can be done." b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "Medications can help with weight loss, but there are no medications effective for reducing binge eating." - CORRECT ANSWER_-b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors." Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia - CORRECT ANSWER_-c. Bradycardia, hypotension, hypothermia Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol) - CORRECT ANSWER_-c. Fluoxetine (Prozac) 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. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia - CORRECT ANSWER_-b. Binging, purging, normal weight, hypokalemia A 14-year-old client has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the priority nursing diagnosis for this client? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements. c. Interrupted family processes d. Anxiety (severe) - CORRECT ANSWER_-b. Imbalanced nutrition: Less than body requirements. 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? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice." - CORRECT ANSWER_-b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure you don't get too many calories in your diet." b. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you." - CORRECT ANSWER_-c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." 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. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. d. Client's weight is within the expected range. - CORRECT ANSWER_-a. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. b. Secure a verbal contract from the client that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with the client so that she will learn to relate to more than one person. - CORRECT ANSWER_-d. Rotate staff members who work with the client so that she will learn to relate to more than one person. A patient 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. "I'm married, but that's none of your business." b. "Let's talk about your love life instead." c. "Thank you so much for the compliment but I'm married." d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion." - CORRECT ANSWER_-d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion." A client with BPD reports to the nurse that she is having abdominal pain and is requesting pain medication. Which action by the nurse is a priority? a. Explore alternative pain management strategies. b. Confront the client about her manipulation to try to get drugs. c. Assess her pain in more detail. d. Set limits on her attempts to cling to the nurse. - CORRECT ANSWER_-c. Assess her pain in more detail. A male client with antisocial personality disorder was found in a female patient's room on her bed. 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 a female patient, 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. Reassure the client that he will have plenty of opportunities with women after he is discharged. b. Reinforce the rules of the treatment program that all clients are expected to follow. c. Escort the client to seclusion. d. Establish a trusting relationship by telling the client that you will make an exception just this once. - CORRECT ANSWER_-b. Reinforce the rules of the treatment program that all clients are expected to follow. An example of a treatable (reversible) form of NCD is one that is caused by which of the following? (Select all that apply.) a. Multiple sclerosis b. Huntington's disease c. Electrolyte imbalance d. HIV disease e. Folate deficiency - CORRECT ANSWER_-c. Electrolyte imbalance e. Folate deficiency A client has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? a. Multiple small brain infarcts b. Chronic alcohol abuse c. Cerebral abscess d. Unknown - CORRECT ANSWER_-d. Unknown Which of the following medications has been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? (Select all that apply.) a. Donepezil (Aricept) b. Rivastigmine (Exelon) c. Risperidone (Risperdal) d. Sertraline (Zoloft) e. Galantamine (Razadyne - CORRECT ANSWER_-a. Donepezil (Aricept) b. Rivastigmine (Exelon) e. Galantamine (Razadyne Which of the following factors is not associated with an increased incidence of neurocognitive disorder due to Alzheimer's disease? a. Multiple small strokes b. Family history of Alzheimer's disease c. Head trauma d. Advanced age - CORRECT ANSWER_-a. Multiple small strokes In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? (Select all that apply.) a. Personality b. Vision c. Speech d. Hearing e. Mobility - CORRECT ANSWER_-a. Personality c. Speech e. Mobility A client, who has neurocognitive disorder due to Alzheimer's disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? a. "Don't be silly. It's not Christmas, Mrs. G." b. "Today is Tuesday, October 21, Mrs. G. We will have supper soon, and then your daughter will come to visit." d. Unsteady gait, nystagmus, and profound disorientati - CORRECT ANSWER_-c. Diaphoresis, nausea and vomiting, and tremors. 3. Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Cannabidiol (Epidiolex) - CORRECT ANSWER_-b. Chlordiazepoxide (Librium) 4. A client who has been admitted to the chemical dependence treatment unit after being discliplined for drinking on the job states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know." Which defense mechanism is the client using? a. Denial b. Projection c. Displacement d. Rationalization - CORRECT ANSWER_-a. Denial A client who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job states to the nurse, "I don't have a problem with alcohol. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work." c. "Get real! You're an alcoholic and you know it!" d. "Why do you think your boss is a jerk?" - CORRECT ANSWER_-b. "You are here because your drinking was interfering with your work." A client who has been admitted to intensive outpatient treatment for substance use disorder arrives for group therapy and appears groggy with constricted pupils. The client denies using substances. Which of the following would be the best intervention at this time? a. Ask the client to empty his pockets. b. Smell his breath for evidence of alcohol. c. Conduct a drug screen to assess for presence of opioids. d. Discharge the client for failure to comply with treatment expectations. - CORRECT ANSWER_-c. Conduct a drug screen to assess for presence of opioids. A client admitted to the inpatient detoxification program for alcohol withdrawal approaches the nurse complaining of nausea and feeling shaky. The nurse notices that the client has hand tremors and appears diaphoretic. Which of these nursing interventions is a priority? a. Check the client's temperature. b. Send a urine sample to the laboratory for a random drug screen. c. Ask the client if there is anything that he is particularly stressed about. d. Administer prn benzodiazepine that was ordered for management of withdrawal symptoms. - CORRECT ANSWER_-d. Administer prn benzodiazepine that was ordered for management of withdrawal symptoms. A client comes into the emergency department stating that he is "crashing" and feels like he'd "be better off dead." Which of these nursing interventions is a priority? a. Instruct the client not to worry; these are temporary signs of withdrawal and should go away in a few days. b. Request an order for amphetamines to ease the client's withdrawal symptoms. c. Assess the client's risk for suicide. d. Instruct the physician that the client may need naloxone. - CORRECT ANSWER_-c. Assess the client's risk for suicide. A client is brought to the emergency department unconscious by a friend who says he was injecting heroin. The client is assessed to have a weak pulse. Which of these interventions are priorities? a. Administer naloxone and rescue breathing. b. IV benzodiazepines and continuous monitoring of vital signs. c. Ask the friend how much heroin he took and confirm with a laboratory drug screen. d. Initiate cardiopulmonary resuscitation and prepare to u - CORRECT ANSWER_-a. Administer naloxone and rescue breathing. 10. A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. After the nurse completes an assessment, the physician asks if there are any physical signs of long-term chronic alcohol abuse. Which of these findings should the nurse include in reporting to the physician? (Select all that apply.) a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count. - CORRECT ANSWER_-a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count.