Mental Health Nursing Test IV - Set A

Risperidone is an antipsychotic medication that is used to treat certain mental/mood disorders. Alcohol can enhance the sedative effects of risperidone and increase the risk of drowsiness, dizziness, and impaired judgment. Therefore, it is important for the nurse to inform the client that alcoholic beverages should not be consumed while taking this medication.

The correct answer is "Probably associated with toxic levels of lithium." This is because the symptoms described, such as nausea, slurred speech, and ataxic gait, are commonly associated with lithium toxicity. When lithium levels in the blood become too high, it can lead to adverse effects on the central nervous system, resulting in these symptoms. It is important for healthcare providers to monitor lithium levels regularly to ensure that it remains within the therapeutic range and prevent toxicity.

Lorazepam (Ativan) is a benzodiazepine medication that is commonly used during detoxification to reduce the anxiety-tremor state and prevent more serious withdrawal symptoms. Benzodiazepines have sedative and anxiolytic properties, which help to alleviate symptoms of delirium tremens such as anxiety, tremors, and agitation. By reducing these symptoms, lorazepam can prevent the progression to more severe withdrawal symptoms and potentially dangerous complications. It does not specifically quiet the client or encourage cooperation, enable better sleep, or prevent physical injury during seizures.

The nurse anticipates that the physician will prescribe Benztropine mesylate (Cogentin) to limit the extrapyramidal symptoms observed in the client. Benztropine is an anticholinergic medication that is commonly used to treat these symptoms, which can include muscle stiffness, tremors, and involuntary movements. By blocking the effects of acetylcholine, Benztropine helps to restore the balance of neurotransmitters in the brain and reduce these side effects. Dantroline is a muscle relaxant that is not typically used for extrapyramidal symptoms, while Hydroxyzine is an antihistamine and Zolpidem is a sedative, neither of which would be effective in addressing these symptoms.

The correct answer suggests that a compulsive act is one that seems absurd to others but is necessary to the person carrying out the act. This implies that the act may not have any logical or practical purpose, but the person feels compelled to perform it due to their obsessive-compulsive personality disorder. The nurse's anxiety may stem from the understanding that the client's behavior may be difficult to comprehend or rationalize for others, but it is essential for the client's own sense of relief or satisfaction.

Naloxone is the correct answer for this question because it is a medication used to reverse the effects of an opiate overdose. It works by blocking the effects of opiates in the body and can quickly restore normal breathing and consciousness in individuals experiencing an overdose. Amphetamine, epinephrine, and methadone are not used to treat opiate overdose and do not have the same mechanism of action as naloxone.

When working with a client diagnosed with antisocial personality disorder, it is important for a nurse to provide clear boundaries and consequences. This is because individuals with this disorder often have difficulty understanding and respecting social norms and boundaries. By establishing clear boundaries and consistently enforcing consequences for inappropriate behavior, the nurse can help the client understand the expectations and consequences of their actions. This can promote a safer and more structured environment for both the client and the nurse.

The client's statement of not being able to sit still and feeling jittery indicates that they may be experiencing akathisia. Akathisia is a common side effect of haloperidol, which is characterized by restlessness, an inability to sit still, and a feeling of inner restlessness. It is important for the nurse to recognize and assess for this side effect as it can be distressing for the client and may require intervention such as medication adjustment or discontinuation.

The physician orders routine lithium levels to monitor the therapeutic range of the medication. It is important to obtain the blood specimen at the right time to accurately assess the levels. The correct answer is 8 to 12 hours after the last dose of lithium. This timeframe allows for adequate time for the medication to be absorbed and distributed throughout the body, ensuring an accurate measurement of the lithium levels in the blood.

If the client fails to adhere to the dietary restrictions while receiving tranylcypromine (Parnate), they may experience a hypertensive crisis. Tranylcypromine is a monoamine oxidase inhibitor (MAOI) that works by increasing the levels of certain chemicals in the brain. When certain foods or beverages containing tyramine are consumed while taking MAOIs, it can cause a sudden increase in blood pressure, leading to a hypertensive crisis. Therefore, it is important for the nurse to teach the client about the dietary restrictions to prevent this potentially dangerous complication.

The statement "I must be careful to check over-the-counter medications" indicates that the client has been educated about the potential interactions between disulfiram and other medications. This shows that the medication has been effective in helping the client understand the importance of avoiding certain medications while taking disulfiram.

People with antisocial personality disorder have difficulty relating to others because they have never learned to empathize with others. Empathy is the ability to understand and share the feelings of others, and individuals with this disorder often lack this capacity. This inability to empathize makes it challenging for them to form meaningful connections and relationships with others, as they struggle to understand and respond to the emotions and needs of those around them.

Fluphenazine decanoate (Prolixin decanoate) is the most appropriate medication for Joselito because it is a long-acting injectable antipsychotic medication. Given that he is noncompliant and suspicious, a long-acting medication can help ensure consistent treatment and improve medication adherence. Additionally, since Joselito has schizophrenia, an antipsychotic medication like fluphenazine decanoate can help manage his symptoms effectively. Fluphenazine hydrochloride (Prolixin) is also an antipsychotic medication, but it is not long-acting like fluphenazine decanoate. Tranylcypromine (Parnate) and amitriptyline (Elavil) are not appropriate for treating schizophrenia.

A client with an antisocial personality disorder is generally unable to postpone gratification. This means that they struggle with delaying immediate needs or desires in order to achieve long-term goals. They often prioritize immediate pleasure or satisfaction over considering the consequences or impact on others. This impulsivity and inability to delay gratification can lead to impulsive and risky behaviors, as well as difficulties in maintaining relationships or fulfilling responsibilities.

The nurse should emphasize the use of sunscreen for all outdoor activities on a year-round basis because Fluphenazine decanoate (Prolixin decanoate) can increase the client's sensitivity to sunlight. This medication belongs to the class of antipsychotic drugs known as phenothiazines, which can cause photosensitivity reactions. Therefore, it is important for the client to protect their skin from the harmful effects of the sun by using sunscreen regularly.

Malingering refers to the act of intentionally pretending or exaggerating an illness or symptoms for personal gain or to avoid responsibility. This behavior is different from using conversion defenses, which involve unconsciously converting psychological distress into physical symptoms. Malingering does not indicate being out of contact with reality or being psychotic, as it is a deliberate and conscious action rather than a symptom of a mental disorder.

The nurse explained that methadone is useful in the treatment of narcotic addiction because it has an effect of longer duration. This means that methadone stays in the body for a longer period of time compared to other drugs, which helps to reduce withdrawal symptoms and cravings. By providing a longer-lasting effect, methadone can help individuals in their recovery process by stabilizing their opioid dependence and allowing them to focus on other aspects of their treatment, such as counseling and therapy.

Conversion refers to a defense mechanism where a person unconsciously converts their anxiety or psychological distress into physical symptoms. Instead of dealing with the underlying emotional issues, the person expresses their anxiety through physical manifestations such as pain, paralysis, or other physical symptoms. This allows them to avoid confronting the emotional distress directly. Hypochondriasis refers to excessive worry about having a serious illness, regression is a defense mechanism where a person reverts to childlike behaviors, and projection involves attributing one's own unwanted thoughts or emotions onto others.

Clients with paraphiliac sexual disorder often experience other covert or overt emotional problems. Paraphiliac sexual disorder refers to an intense and persistent sexual interest or behavior that involves non-consenting individuals, suffering or humiliation, or children. These individuals often have underlying emotional issues such as low self-esteem, anxiety, depression, or trauma, which may contribute to the development of their paraphilic interests or behaviors. Therefore, the presence of other emotional problems is a common finding in clients with paraphiliac sexual disorder.

To prevent life threatening complications from the administration of chlorpromazine, it is important for the nurse to monitor the client's vital signs. Chlorpromazine is a neuroleptic drug that can cause various side effects, including changes in blood pressure, heart rate, and body temperature. By closely monitoring the client's vital signs, the nurse can identify any abnormalities or adverse reactions early on and take appropriate actions to prevent further complications. This ensures the client's safety and well-being during the administration of the drug.

The nurse's response of "I like you, but our relationship is professional" is the best because it acknowledges the patient's feelings while also maintaining professional boundaries. It shows empathy and understanding, but also clearly communicates that a romantic relationship is not appropriate in their professional context.

In psychophysiologic disorder, there is an actual tissue change. This means that there is a physical alteration or abnormality in the body's tissues or organs. This is in contrast to somatoform disorders, where there may be physical symptoms but no identifiable tissue change or organic pathology. The presence of an actual tissue change suggests that there is a tangible physiological basis for the disorder, distinguishing it from somatoform disorders where the symptoms are primarily psychological in nature.

Haloperidol (Haldol) is an antipsychotic medication that is commonly used to treat symptoms of psychosis, such as hallucinations, delusions, and disorganized thinking. It works by blocking certain neurotransmitters in the brain, which helps to reduce overactivity and control impulsive behaviors. Therefore, haloperidol is most effective in managing overactive behavior in clients.

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When caring for a client with schizotypal personality disorder, it is important for a nurse to respect the client's need for social isolation. People with this disorder often have difficulty forming and maintaining relationships, and may prefer to be alone. Respecting their need for solitude can help them feel more comfortable and reduce their anxiety. It is important for the nurse to create a supportive and non-judgmental environment that allows the client to have control over their social interactions.