Final Mental Health Exam Questions
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- 1.A nurse is performing an assessment on a client who has many past reports of physical problems and is now reporting an inablity to walk. A possible medical diagnosis is somatization disorder. Which of the following is least relevant when planning care for the client with somatization disorder
- A.
Level of involement and support by family and friends
- B.
Determination of whether the client's inability to walk has a physical cause
- C.
Client's potential for violence toward others
- D.
Client's ability to perform self-care activities
- 2.A nurse assess a client in the emergency department who says that he is suddenly unable to move his legs. Which of the following should cause the nurse to suspect that this client might be experiencing a conversion disorder?
- A.
The client is highly educated and has a high paying job
- B.
The client has no previous history of neurologic problems
- C.
The client is distressed and reports that one leg is deformmed
- D.
The client does not appear upset by the presence of symptoms
- 3.Dissociative disorders are often caused by
- A.
Alcohol or drug use
- B.
Insomnia
- C.
Witnessing extreme violence
- D.
Epileptic seizures
- 4.A client discribes himself by saying "I feel like I'm floating in the air looking down at myself, but it's not really me". This situation describes
- A.
Derealization
- B.
Rationalization
- C.
Depersonalization
- D.
Repression
- 5.A client is in the acute stages of paranoid schizophrenia. A nursing diagnosis always applicable in the stage is
- A.
Risk for others or self-directed violence
- B.
Noncompliance
- C.
Disturbed thought processes
- D.
Readiness for enhanced coping
- 6.A client with schizophrenia has great difficulty with personal boundaries. Which of the following are personal boundry problems?
- A.
Delusions of grandeur or persecution
- B.
Depersonalization or derealization
- C.
Visual or auditory hallucinations
- D.
Communication difficulties or social withdrawal
- 7.A nurse is speaking with a client with schizophrenia when he suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to himself. The most appropriate intervention by the nurse at this time would be to?
- A.
Stop the interview at this point and resume later when the client is better able to concentrate
- B.
Ask the client "Are you seeing something on the ceiling"?
- C.
Tell the client, "You seem to be looking at something on the ceiling. I see something there too."
- D.
Attempt to distract the client from his hallucinations by continuing the interview without cmment on the client's behavior
- 8.Which of the following are associated with catatonic schizophrenia
- A.
Purposeless motor agitations
- B.
Tactile halluncinations
- C.
Word salad and flight of ideas
- D.
Eccentric behaviors or odd beliefs
- 9.True or False: A client with acute opioid overdose would be give the specific opioid antidote flumazentil (Romazicon) intravenously.
- A.
True
- B.
False
- 10.True or False: A client in a rehabilitation facility due to chronic heroin abuse tells the nurse, "I have used heroin, but it doesn't affect me and I could stop any time I really wanted". This is an example of the defense mechanism projection
- A.
True
- B.
False
- 11.True or False: A client who has developed tolerance for alcohol would likely need a larger than usual dose of benzoiazepine to obtain a therapeutic effect.
- A.
True
- B.
False
- 12.Which of the following is an antidote for benzodiazepine overdose or toxicity?
- A.
Busiprone (BuSpar)
- B.
Hydroxyzine (Vistaril)
- C.
Flumazenil (Romazicon)
- D.
Naloxone (Narcan)
- 13.
- A.
"I will ony take the medication at bedtime"
- B.
"I Cannot take this drug if I am using a pain medication"
- C.
"I will not stop taking the drug abruptly"
- D.
"I will need to take this medication the rest of my life"
- 14.Buspirone is different from other antianxiety medications in that it
- A.
Has anticonvulsant effects
- B.
Has muscle relaxant effects
- C.
Will depress the central nervous system
- D.
Does not cause physical or psychological dependence
- 15.When a client is admitted with a diagnosis of overdose of bupropion (wellbutrin), which of the following nursing diagnosis has the highest priority?
- A.
Alerteration in thought processes realted to confusion
- B.
Sleep pattern disturbances realted to depression
- C.
Potential for injury realted to seizure activity
- D.
Knowledge deficit of use and effects of antidepressants realted to denial
- 16.A client is started on TCA for depression. Which of the following should be included in the teaching plan?
- A.
"Sit on the side of the bed before getting up; than stand up very slowly".
- B.
"Eat four to six small meals throughout the day".
- C.
"Be sure to eat foods high in potassium".
- D.
"Elevate your legs whenever yu sit down".
- 17.A nurse has completed medication teaching regarding fluoxetine (Prozac) with a client. Which of the following statements made by the client indicated an understanding of the adverse affects?
- A.
"I will need extra sleep while I am taking this medication".
- B.
" I have to drink extra fluid while I'm taking this medication".
- C.
"It will take about 4 weeks before I notice effects from this medcation".
- D.
"I will control my caloric intake and get lots of exercise".
- 18.A client has taken two doses of fluoxetine for treatment of depression. A family member call the clinic to tell the nurse the client is very confused, sweating a lot, and "seeing things" Which of the following should the nurse communicate to the family member?
- A.
"This is a common reaction with the first few doses of fluoxetine and will go away in a few hours"
- B.
"This is a very serious reaction to the drug. The drug must be stopped immediately"
- C.
"Your primary care provider will need to prescribe a MAOI to control these symptoms"
- D.
"We will need to increase the drug dosage to control these size efftects>
- 19.A client is to be started on the MAOI phenelzine (Nardil). Which of the following should be monitored frequently?
- A.
Blood Pressure
- B.
Breath Sounds
- C.
Body Temperature
- D.
Blood Glucose
- 20.A client who has been on lithium therapy for 6 months has recently developed symptoms of mild arthritis. He tells the nurse that he wants to start taking the NSAID ibuprofen (Advil) for his pain. Which of the following is the nurses best response?
- A.
"That is a good choice. Stronger analgesics would not be good for you"
- B.
"Regular aspirin would be a better choice, because Advil can raise your lithium level too high"
- C.
"You will have to stop taking lithium if you take any pain medication"
- D.
"The advil will make your lithium level fall too low, and your symptoms may come back"
- 21.A client is stared on vlproic acid (Depakote) for treatment of Bipolar Disorder. Which of the following laboratory studies should be monitored regularly?
- A.
AST/ALT and LDH
- B.
Creatinine and BUN
- C.
WBC and granulocyte counts
- D.
Serum sodium and potassium
- 22.Which of the following medications, if given concurrently with lithium, could produce a toxic effect?
- A.
Insulin
- B.
Prednisone
- C.
Digoxin (Lanoxin)
- D.
Furosemide (Lasix)
- 23.A client with bipolar I disorder has been well controlled wil valproic acid (Depakote). She wants children and asks the nurse if she could become pregnant. Which of the following is the nurse's best response?
- A.
"If you watch your diet very closely, you may be able to discontinue the medication so that you can become pregnant"
- B.
"You should avoid becoming pregnant, because your chances of carrying the baby to term are very slight"
- C.
"There is an increased risk of birth defects if you become pregnant while taking this medication"
- D.
"Since you have bben on this medication for so long, your chances of having a healthy baby are excellent"
- 24.A client who has been taking Valoproic acid for 2 years calls the nurse and reports flu-like symptoms for the past 4 to 5 days. He says he has nausea, some vomiting, does not feel like eating, and has constant abdominal pain. Which of the following should the nurse communicate to the client?
- A.
"You must contact your primary care provider right away, as this may indicate avery serious side effect of your medication"
- B.
"The flu is going around, so take plenty of fluids and call back if you don't feel better in a few days"
- C.
"Call your primary care provider to ask for a prescription for an antiemtic, because vomiting can cause toxicity of this drug"
- D.
"Stay home from work, get lots of rest, and drink ginger ale to help settle your stomach"
- 25.True or False: For a client with bipolar I disordr who is taking lithium, a serium lithium level of 1.8 is within normal limits.
- A.
True
- B.
False
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