Final Mental Health Exam Questions

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  • 1/44 Questions

    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

    • Level of involement and support by family and friends
    • Determination of whether the client's inability to walk has a physical cause
    • Client's potential for violence toward others
    • Client's ability to perform self-care activities
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About This Quiz

This Final Mental Health Exam assesses nursing responses to psychiatric conditions. It covers somatization, conversion disorders, dissociative disorders, and schizophrenia, focusing on diagnosis and care planning. Essential for nursing students specializing in psychiatric care.

Final Mental Health Exam Questions - Quiz

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  • 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?

    • The client is highly educated and has a high paying job

    • The client has no previous history of neurologic problems

    • The client is distressed and reports that one leg is deformmed

    • The client does not appear upset by the presence of symptoms

    Correct Answer
    A. The client does not appear upset by the presence of symptoms
    Explanation
    Conversion disorder symptoms are frequently accompanied by la belle indifference, a lack of concern about the symptoms. Level of education and income are not factors in conversion syndrome. The fact that there is no history of neurologic problems is not relevant. The client's report that one leg is deformed could be a sign of body dysmorphic disoder, but it does not relate to conversion disorder

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  • 3. 

    Dissociative disorders are often caused by

    • Alcohol or drug use

    • Insomnia

    • Witnessing extreme violence

    • Epileptic seizures

    Correct Answer
    A. Witnessing extreme violence
    Explanation
    Dissociative disorders are caused by exposure t extreme stress. Witnessing extreme violence is an event that can bring about the stress. While abusing drugs and alcohol can cause memory lapses, these lapses are not considered disssociative disorders according to the DSM-IV. Epileptic seizures can cause periods of amnesia concurrent with the seizure, but this type of amnesia is not considered dissociative. Insomnia usually does not cause amnesia, although it can cause memory impairment

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  • 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

    • Derealization

    • Rationalization

    • Depersonalization

    • Repression

    Correct Answer
    A. Depersonalization
    Explanation
    In depersonalization, the individual describes himself as seeming unreal. Derealization includes describing a familiar situation or event as unreal or strange. Rationalization is a defense whereby the individual justifes his behavior using faulty logic. In regression, the indivdual keeps threatening thoughts or feelings from coming to consciousness

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  • 5. 

    A client is in the acute stages of paranoid schizophrenia.  A nursing diagnosis always applicable in the stage is

    • Risk for others or self-directed violence

    • Noncompliance

    • Disturbed thought processes

    • Readiness for enhanced coping

    Correct Answer
    A. Disturbed thought processes
    Explanation
    The client is the acute stages of paranoid schizophrenia would have disturbed thought processes with active hallucinations and or delusions. A risk for violence is not universally present, although the nurse should assess for it. Noncompliance and disabled family coping are not necessarily present in clients with schizophrenia

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  • 6. 

    A client with schizophrenia has great difficulty with personal boundaries.  Which of the following are personal boundry problems?

    • Delusions of grandeur or persecution

    • Depersonalization or derealization

    • Visual or auditory hallucinations

    • Communication difficulties or social withdrawal

    Correct Answer
    A. Depersonalization or derealization
    Explanation
    Depersonaliztion (a feeling of being seperated from one's body) and derealization (a sensation of being in a strange environment) are examples of problems with personal boundaries. Delusions and hallucinations are positive symptoms of schizophrenia, but they are not personl boundary issues.

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  • 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?

    • Stop the interview at this point and resume later when the client is better able to concentrate

    • Ask the client "Are you seeing something on the ceiling"?

    • Tell the client, "You seem to be looking at something on the ceiling. I see something there too."

    • Attempt to distract the client from his hallucinations by continuing the interview without cmment on the client's behavior

    Correct Answer
    A. Ask the client "Are you seeing something on the ceiling"?
    Explanation
    The most appropriate intervention is to ask the client directly about his hallucinations, but avoid treating hallucinaions or delusions as if they were real. Stopping the interview until a later time may not be feasible since th client may experience hallucinations much of the time. Distraction can be helpful for working with a client with hallucinations; however, continusing the interview without commenting on this clien't hallucinations will not be an effective distraction

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  • 8. 

    Which of the following are associated with catatonic schizophrenia

    • Purposeless motor agitations

    • Tactile halluncinations

    • Word salad and flight of ideas

    • Eccentric behaviors or odd beliefs

    Correct Answer
    A. Purposeless motor agitations
    Explanation
    Catatonic schizophrenia is a subtype of schizophrenia characterized by abnormal motor behaviors and movements. Purposeless motor agitations, such as repetitive or stereotyped movements without any apparent reason or goal, are commonly associated with catatonic schizophrenia. This can include excessive motor activity, such as pacing, rocking, or grimacing. Other symptoms of catatonic schizophrenia may include immobility, mutism, echolalia (repeating others' words), and negativism (resistance or opposition to instructions or movements). Tactile hallucinations, word salad and flight of ideas, and eccentric behaviors or odd beliefs are not specifically associated with catatonic schizophrenia.

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  • 9. 

    True or False: A client with acute opioid overdose would be give the specific opioid antidote flumazentil (Romazicon) intravenously.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    False: Flumazenil (romazicon) is a specific antidote for benzodiazepine toxicity. An antidote for opioid toxicity is intravenous naloxone (Narcan)

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  • 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

    • True

    • False

    Correct Answer
    A. False
    Explanation
    False: The statement is an example of denial. Projection would occur if the client blamed someone else for her own unacceptable mistakes or shortcomings

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  • 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.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    True: Alcohol and benzodiazepines are cross-tolerant. Therefore, tolerance to one would mean that the client also has tolerance to the other.

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  • 12. 

    Which of the following is an antidote for benzodiazepine overdose or toxicity?

    • Busiprone (BuSpar)

    • Hydroxyzine (Vistaril)

    • Flumazenil (Romazicon)

    • Naloxone (Narcan)

    Correct Answer
    A. Flumazenil (Romazicon)
    Explanation
    Flumazenil (Romazicon) is the correct answer because it is an antidote specifically used for benzodiazepine overdose or toxicity. It works by blocking the effects of benzodiazepines on the central nervous system, reversing their sedative and respiratory depressant effects. Busiprone (BuSpar), Hydroxyzine (Vistaril), and Naloxone (Narcan) are not antidotes for benzodiazepine overdose or toxicity.

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  • 13. 

    A nurse knows that teaching has been effective if a client who is taking benzodiazepine for long-term treatment of anxiety says:

    • "I will ony take the medication at bedtime"

    • "I Cannot take this drug if I am using a pain medication"

    • "I will not stop taking the drug abruptly"

    • "I will need to take this medication the rest of my life"

    Correct Answer
    A. "I will not stop taking the drug abruptly"
    Explanation
    The correct answer is "I will not stop taking the drug abruptly". This statement indicates that the client understands the importance of gradually tapering off benzodiazepine instead of stopping it suddenly, which can lead to withdrawal symptoms and potential harm. It shows that the teaching has been effective in educating the client about the proper way to discontinue the medication.

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  • 14. 

    Buspirone is different from other antianxiety medications in that it

    • Has anticonvulsant effects

    • Has muscle relaxant effects

    • Will depress the central nervous system

    • Does not cause physical or psychological dependence

    Correct Answer
    A. Does not cause physical or psychological dependence
    Explanation
    Buspirone is different from other antianxiety medications because it does not cause physical or psychological dependence. This means that individuals who take buspirone do not develop a tolerance to the medication, nor do they experience withdrawal symptoms when they stop taking it. This is in contrast to other antianxiety medications, such as benzodiazepines, which can lead to dependence and withdrawal symptoms. The lack of dependence potential makes buspirone a safer option for long-term use in the treatment of anxiety disorders.

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  • 15. 

    When a client is admitted with a diagnosis of overdose of bupropion (wellbutrin), which of the following nursing diagnosis has the highest priority?

    • Alerteration in thought processes realted to confusion

    • Sleep pattern disturbances realted to depression

    • Potential for injury realted to seizure activity

    • Knowledge deficit of use and effects of antidepressants realted to denial

    Correct Answer
    A. Potential for injury realted to seizure activity
    Explanation
    The highest priority nursing diagnosis in this scenario is "Potential for injury related to seizure activity." This is because bupropion (Wellbutrin) is known to lower the seizure threshold, and overdose can significantly increase the risk of seizures. Seizures can cause harm to the client and require immediate medical intervention. Therefore, ensuring the client's safety and preventing injury from seizure activity is of utmost importance.

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  • 16. 

    A client is started on TCA for depression. Which of the following should be included in the teaching plan?

    • "Sit on the side of the bed before getting up; than stand up very slowly".

    • "Eat four to six small meals throughout the day".

    • "Be sure to eat foods high in potassium".

    • "Elevate your legs whenever yu sit down".

    Correct Answer
    A. "Sit on the side of the bed before getting up; than stand up very slowly".
    Explanation
    The correct answer is "Sit on the side of the bed before getting up; then stand up very slowly." This teaching plan is important because tricyclic antidepressants (TCA) can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. Sitting on the side of the bed before standing up allows the client to adjust to the change in position slowly, reducing the risk of dizziness or fainting.

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  • 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?

    • "I will need extra sleep while I am taking this medication".

    • " I have to drink extra fluid while I'm taking this medication".

    • "It will take about 4 weeks before I notice effects from this medcation".

    • "I will control my caloric intake and get lots of exercise".

    Correct Answer
    A. "I will control my caloric intake and get lots of exercise".
    Explanation
    The statement "I will control my caloric intake and get lots of exercise" indicates an understanding of the adverse effects of fluoxetine (Prozac). One of the common adverse effects of this medication is weight gain, so controlling caloric intake and exercising can help minimize this side effect. This statement shows that the client is aware of the potential impact on their weight and is taking proactive measures to mitigate it.

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  • 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?

    • "This is a common reaction with the first few doses of fluoxetine and will go away in a few hours"

    • "This is a very serious reaction to the drug. The drug must be stopped immediately"

    • "Your primary care provider will need to prescribe a MAOI to control these symptoms"

    • "We will need to increase the drug dosage to control these size efftects>

    Correct Answer
    A. "This is a very serious reaction to the drug. The drug must be stopped immediately"
    Explanation
    The client's symptoms of confusion, excessive sweating, and hallucinations indicate a serious reaction to fluoxetine. These symptoms may be indicative of serotonin syndrome, a potentially life-threatening condition caused by excessive serotonin levels. Therefore, it is important to stop the drug immediately and seek medical attention.

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  • 19. 

    A client is to be started on the MAOI phenelzine (Nardil). Which of the following should be monitored frequently?

    • Blood Pressure

    • Breath Sounds

    • Body Temperature

    • Blood Glucose

    Correct Answer
    A. Blood Pressure
    Explanation
    When starting a client on the MAOI phenelzine (Nardil), it is important to monitor their blood pressure frequently. MAOIs can cause a potentially dangerous increase in blood pressure, known as a hypertensive crisis. This can lead to symptoms such as severe headache, chest pain, palpitations, and even stroke. Therefore, monitoring blood pressure regularly is essential to ensure the client's safety and to detect any potential hypertensive crisis early on.

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  • 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?

    • "That is a good choice. Stronger analgesics would not be good for you"

    • "Regular aspirin would be a better choice, because Advil can raise your lithium level too high"

    • "You will have to stop taking lithium if you take any pain medication"

    • "The advil will make your lithium level fall too low, and your symptoms may come back"

    Correct Answer
    A. "Regular aspirin would be a better choice, because Advil can raise your lithium level too high"
    Explanation
    The nurse's best response is that regular aspirin would be a better choice because Advil can raise the client's lithium level too high. This is the correct answer because NSAIDs like Advil can interfere with the excretion of lithium, leading to increased levels of lithium in the blood. This can be dangerous and potentially toxic for the client. Regular aspirin is a safer alternative for pain relief in this case.

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  • 21. 

    A client is stared on vlproic acid (Depakote) for treatment of Bipolar Disorder. Which of the following laboratory studies should be monitored regularly?

    • AST/ALT and LDH

    • Creatinine and BUN

    • WBC and granulocyte counts

    • Serum sodium and potassium

    Correct Answer
    A. AST/ALT and LDH
    Explanation
    Valproic acid (Depakote) is known to have hepatotoxic effects, meaning it can cause damage to the liver. AST/ALT (aspartate aminotransferase/alanine aminotransferase) and LDH (lactate dehydrogenase) are liver function tests that can help monitor liver health and detect any potential liver damage caused by valproic acid. Regular monitoring of these laboratory studies is important to ensure the medication is not causing harm to the client's liver.

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  • 22. 

    Which of the following medications, if given concurrently with lithium, could produce a toxic effect?

    • Insulin

    • Prednisone

    • Digoxin (Lanoxin)

    • Furosemide (Lasix)

    Correct Answer
    A. Furosemide (Lasix)
    Explanation
    Furosemide (Lasix) is a loop diuretic that can cause dehydration and electrolyte imbalances, such as low sodium levels, when taken concurrently with lithium. Lithium is also known to cause dehydration and electrolyte imbalances, so combining it with furosemide can increase the risk of toxicity. This is why furosemide can produce a toxic effect when given concurrently with lithium. Insulin, prednisone, and digoxin do not have the same potential for interaction and toxicity with lithium.

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  • 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?

    • "If you watch your diet very closely, you may be able to discontinue the medication so that you can become pregnant"

    • "You should avoid becoming pregnant, because your chances of carrying the baby to term are very slight"

    • "There is an increased risk of birth defects if you become pregnant while taking this medication"

    • "Since you have bben on this medication for so long, your chances of having a healthy baby are excellent"

    Correct Answer
    A. "There is an increased risk of birth defects if you become pregnant while taking this medication"
    Explanation
    The nurse's best response is "There is an increased risk of birth defects if you become pregnant while taking this medication." This is the correct answer because valproic acid (Depakote) is known to be associated with an increased risk of birth defects, particularly neural tube defects, when taken during pregnancy. It is important for the client to be aware of this risk and to discuss alternative treatment options with her healthcare provider if she is planning to become pregnant.

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  • 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?

    • "You must contact your primary care provider right away, as this may indicate avery serious side effect of your medication"

    • "The flu is going around, so take plenty of fluids and call back if you don't feel better in a few days"

    • "Call your primary care provider to ask for a prescription for an antiemtic, because vomiting can cause toxicity of this drug"

    • "Stay home from work, get lots of rest, and drink ginger ale to help settle your stomach"

    Correct Answer
    A. "You must contact your primary care provider right away, as this may indicate avery serious side effect of your medication"
    Explanation
    The client's symptoms of nausea, vomiting, loss of appetite, and abdominal pain may indicate a serious side effect of Valproic acid. These symptoms could be signs of hepatotoxicity, which is a potential complication of taking this medication. It is important for the client to contact their primary care provider immediately to discuss these symptoms and determine the appropriate course of action.

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  • 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.

    • True

    • False

    Correct Answer
    A. False
    Explanation
    A serum lithium level above 1.5 is considered in the toxic range

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  • 26. 

    True or False: A client taking lithium is experiencing fine hand tremors, The client should stop taking her medication because the is experiencing a toxic effect

    • True

    • False

    Correct Answer
    A. False
    Explanation
    Fine hand tremors are an expected side efffect of lithium. This side effect may either subside or continue during lithium therapy. However, if the tremors begin to increase and become coarse, early lithium toxicity is a possibility

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  • 27. 

    A client with schizophrenia experiences blurred vision . Which of the following types of receptor blockade results in this adverse affect?

    • D2 Receptors

    • Muscarinic Receptors

    • Alpha 2 Receptors

    • H2 Receptors

    Correct Answer
    A. Muscarinic Receptors
    Explanation
    Schizophrenia is a psychiatric disorder characterized by hallucinations, delusions, and disorganized thinking. Antipsychotic medications are commonly used to treat schizophrenia, and these medications can cause various side effects. Blurred vision is one such side effect that can occur due to the blockade of muscarinic receptors. Muscarinic receptors are found in various parts of the body, including the eyes. Blockade of these receptors can lead to a decrease in the activity of the parasympathetic nervous system, resulting in blurred vision. Therefore, the correct answer is Muscarinic Receptors.

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  • 28. 

    Which of the following client statements indicates understanding of the nurse's teaching regarding antipsychotic medications?

    • "I will be able to stop taking the drug as soon as I feel better"

    • "If I feel sleepy, I will stop taking the drug and call my health provider"

    • "My symptoms can come back if I don't take the medication exactly as ordered"

    • "These drugs are highly addictive and must be withdrawn slowly"

    Correct Answer
    A. "My symptoms can come back if I don't take the medication exactly as ordered"
    Explanation
    The client statement "My symptoms can come back if I don't take the medication exactly as ordered" indicates understanding of the nurse's teaching regarding antipsychotic medications because it demonstrates awareness that adherence to the prescribed medication regimen is important for preventing symptom recurrence. This statement reflects knowledge of the potential consequences of not taking the medication as directed, suggesting that the client understands the importance of following the prescribed treatment plan for managing their condition effectively.

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  • 29. 

    A client who has been on an antipsychotic medication for several years begins to exhibit lip smacking, tongue protrusion, and facial grimices. Which of the following should the nurse suspect?

    • Parkinsonism

    • Tardive Dyskinesia

    • Antidrenergic Effects

    • Anticholingeric Effects

    Correct Answer
    A. Tardive Dyskinesia
    Explanation
    The client's symptoms of lip smacking, tongue protrusion, and facial grimaces are consistent with tardive dyskinesia, a side effect of long-term use of antipsychotic medication. Tardive dyskinesia is characterized by involuntary movements of the face and tongue and is more commonly seen in older adults who have been on antipsychotics for an extended period. Parkinsonism, antidrenergic effects, and anticholinergic effects do not match the client's symptoms and are not associated with tardive dyskinesia.

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  • 30. 

    Antianxiety medications such as benzodiazepines, produce a calming effect by

    • Depressing the CNS

    • Decreasing levels of norepinephrine and serotonin in the brain

    • Decreasing levels of dopamine in the brain

    • Inhibiting production of the enzyme MAO

    Correct Answer
    A. Depressing the CNS
    Explanation
    Antianxiety medications such as benzodiazepines produce a calming effect by depressing the CNS. This means that they slow down the activity of the central nervous system, which includes the brain and spinal cord. By doing so, they can reduce feelings of anxiety and promote relaxation.

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  • 31. 

    Nancy has a new diagnosis of panic disoder. Dr. S has written a PRN order for alprazolam (Xanax) for when Nancy is feeling anxious.  She says to the nurse, "Dr. S prescrbed Buspirone for my friend's anxiety, Why did he order something different for me? The nurses answer is based on which of the following?

    • Buspirone is not an antianxiety medication

    • Alprazolam and huspirone are essentialy the same medication, so either one is appropriate

    • Buspirone has delayed onset of action and cannot be used on a PRN basis

    • Alprazolam is the only medication that really works for panic disorder

    Correct Answer
    A. Buspirone has delayed onset of action and cannot be used on a PRN basis
    Explanation
    Buspirone has a delayed onset of action and cannot be used on a PRN (as needed) basis. This means that it takes time for the medication to start working, so it is not effective for immediate relief of anxiety symptoms. Alprazolam, on the other hand, is a fast-acting medication that can be taken as needed when feeling anxious. Therefore, it is more suitable for managing panic disorder symptoms in the moment.

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  • 32. 

    Education for the client who is taking MAOI should include which of the following?

    • Fluid and sodium replacement when appropriate, frequent drug blood levels, signs and symptoms of toxicity

    • Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks

    • Short term use, possible tolerance to beneficial effects, careful tapering of the drug at the end of treatment

    • Tyramine restricted diet, prohibitive concurrent use of over the counter medications without physician notifiication

    Correct Answer
    A. Tyramine restricted diet, prohibitive concurrent use of over the counter medications without physician notifiication
    Explanation
    The correct answer is to educate the client about a tyramine-restricted diet and the prohibition of concurrent use of over-the-counter medications without physician notification. This is because MAOIs (Monoamine Oxidase Inhibitors) can interact with certain foods and medications, leading to potentially dangerous hypertensive crises. A tyramine-restricted diet is necessary to avoid consuming foods high in tyramine, such as aged cheeses, cured meats, and fermented foods, as they can cause a sudden increase in blood pressure. Concurrent use of over-the-counter medications without physician notification should be avoided as they may contain substances that can interact with MAOIs and cause adverse effects.

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  • 33. 

    There is a very narrow margin between the therapeutic and toxic levels of lithium carbonate. Symptoms of toxicity are most likely to appear if the serum levels exceed

    • 0.12 mEq

    • 1.5 mEq

    • 15.0 mEq

    • 150 mEq

    Correct Answer
    A. 1.5 mEq
    Explanation
    Lithium carbonate is a medication used to treat bipolar disorder. However, it has a narrow therapeutic range, meaning that the difference between a therapeutic dose and a toxic dose is small. If the serum levels of lithium carbonate exceed 1.5 mEq, symptoms of toxicity are likely to appear. This suggests that levels above this threshold can lead to harmful effects and should be closely monitored to avoid potential complications.

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  • 34. 

    Initial symptoms of lithium toxicity include

    • Constipation, dry mouth, drowsiness, oliguira

    • Dizziness, thirst, dysuria, arrhythmias

    • Ataxia, tinnitus, blurred vision, diarrhea

    • Fatigue, vertigo, anuria, weakness

    Correct Answer
    A. Ataxia, tinnitus, blurred vision, diarrhea
    Explanation
    The initial symptoms of lithium toxicity include ataxia, tinnitus, blurred vision, and diarrhea. These symptoms may occur as a result of the toxic effects of lithium on the central nervous system and gastrointestinal tract. Ataxia refers to a lack of coordination and muscle control, tinnitus is the perception of ringing or buzzing sounds in the ears, blurred vision is the loss of sharpness and clarity in vision, and diarrhea is the frequent passage of loose or watery stools. These symptoms may indicate an overdose or accumulation of lithium in the body, which requires medical attention.

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  • 35. 

    Antipsychotic medications are thought to decrease psychotic symptoms by

    • Blocking reuptake of norepinephrine and serotonin

    • Blocking the action of dopamine in the brain

    • Inhibiting production of the enzyme MAO

    • Depressing the CNS

    Correct Answer
    A. Blocking the action of dopamine in the brain
    Explanation
    Antipsychotic medications are believed to reduce psychotic symptoms by blocking the action of dopamine in the brain. Dopamine is a neurotransmitter that plays a role in regulating mood, behavior, and cognition. Excessive dopamine activity has been linked to the development of psychotic symptoms such as hallucinations and delusions. By blocking dopamine receptors, antipsychotic medications help to normalize dopamine levels and alleviate these symptoms.

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  • 36. 

    Part of the nurse's continual assessment of the client taking antipsychotic medications is to observe for extrapyramidial symptoms. Examples include:

    • Muscular weakness, rigidity, tremors, facial spasms

    • Dry mouth, blurred vision,urinary retention, orthostatic hypotension

    • Amenorrhea, gynecomastia, retrograde ejaculation

    • Elevated blood pressure, severe occipital headache, stiff neck

    Correct Answer
    A. Muscular weakness, rigidity, tremors, facial spasms
    Explanation
    Extrapyramidal symptoms are side effects that can occur with antipsychotic medications. These symptoms affect the muscles and can include muscular weakness, rigidity, tremors, and facial spasms. These symptoms are important to watch for because they can be uncomfortable for the client and may indicate a need for a change in medication or dosage. Monitoring for these symptoms allows the nurse to provide appropriate care and support to the client.

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  • 37. 

    If the foregoing extrapyramidial symptoms should occur, which of the following would be a priority nursing intervention?

    • Notfy the physician immediately

    • Administer PRN trihexyphenidyl (Artane)

    • Withold the next dose of the antipsychotic medication

    • Explain to the client that these symptoms are only temporary and will disappear shortly

    Correct Answer
    A. Administer PRN trihexyphenidyl (Artane)
    Explanation
    Administering PRN trihexyphenidyl (Artane) would be a priority nursing intervention if extrapyramidal symptoms occur. Trihexyphenidyl is an anticholinergic medication that helps to reduce the symptoms of these side effects caused by antipsychotic medications. By administering this medication, the nurse can alleviate the symptoms and provide relief to the client. Notifying the physician may be necessary, but immediate intervention to relieve the symptoms should be the priority. Withholding the next dose of the antipsychotic medication or explaining that the symptoms are temporary may not address the immediate need for symptom relief.

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  • 38. 

    Doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed, The reason for this is

    • To prevent orthostatic hypotension

    • To preven seizures

    • To prevent hypertensive crisis

    • To prevent extrapyramidal symptoms

    Correct Answer
    A. To preven seizures
    Explanation
    The reason why doses of bupropion should be administered at least 4 to 6 hours apart and never doubled when a dose is missed is to prevent seizures. Bupropion is an antidepressant medication that can lower the seizure threshold, increasing the risk of seizures. By spacing out the doses and not doubling them when missed, the medication is more likely to maintain a consistent level in the body, reducing the likelihood of seizures.

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  • 39. 

    From which of the following symptoms might the nurse identify a chronic cocaine user

    • Clear, constricted pupils

    • Red, irritated nostrils

    • Muscle aches

    • Conjunctival redness

    Correct Answer
    A. Red, irritated nostrils
    Explanation
    The nurse might identify a chronic cocaine user based on the symptom of red, irritated nostrils. This is because cocaine can be snorted through the nose, which can cause damage to the nasal passages and result in inflammation and irritation. Chronic cocaine use can lead to persistent redness and irritation of the nostrils as a characteristic sign of drug abuse. The other symptoms listed, such as clear, constricted pupils, muscle aches, and conjunctival redness, may be associated with other conditions or drug use, but they are not specific to chronic cocaine use.

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  • 40. 

    An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal

    • Increased heart rate and blood pressure

    • Tremors, insomnia, and seizures

    • Incoordination and unsteady gait

    • Nausea and vomiting,diarrhea, and diaphoresis

    Correct Answer
    A. Nausea and vomiting,diarrhea, and diaphoresis
    Explanation
    When an individual is addicted to heroin and stops using it, they are likely to experience symptoms of withdrawal. These symptoms include nausea and vomiting, diarrhea, and diaphoresis (excessive sweating). These physical symptoms occur as the body tries to adjust to the absence of heroin and can be extremely uncomfortable for the individual going through withdrawal. The other options listed in the question, such as increased heart rate and blood pressure, tremors, insomnia, and seizures, and incoordination and unsteady gait, may also be present during heroin withdrawal, but the most common symptoms are nausea, vomiting, diarrhea, and diaphoresis.

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  • 41. 

    A polysubstance abuser make the statement, " The green and whites do me good after speed". How might the nurse interpret the statement

    • The client abuses amphetamines and anxiolytics

    • The client abuses alcohol and cocaine

    • The client is psychotic

    • The client abuses narcotics and marijuana

    Correct Answer
    A. The client abuses amphetamines and anxiolytics
    Explanation
    Based on the statement, "The green and whites do me good after speed," the nurse can interpret that the client is referring to amphetamines as "speed" and the combination of green and white pills as anxiolytics. This suggests that the client is abusing both amphetamines and anxiolytics.

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  • 42. 

    When would the first signs of alcohol withdrawal symptoms be expected to occur?

    • Within 12 hours after the last drink

    • Forty-eight to 72 hours after the last drink

    • Four to 5 days after the last drink

    • Six to 7 days after the last drink

    Correct Answer
    A. Within 12 hours after the last drink
    Explanation
    Alcohol withdrawal symptoms typically begin within 12 hours after the last drink. This is because alcohol is a depressant that affects the central nervous system. When a person abruptly stops consuming alcohol, their body goes into withdrawal as it tries to readjust to functioning without the depressant. Symptoms such as tremors, anxiety, sweating, and irritability can start to appear within the first 12 hours. It is important to seek medical assistance during alcohol withdrawal to manage symptoms and prevent complications.

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  • 43. 

    Symptoms of alcohol withdrawal include:

    • Euphoria, hyperactivity, and insomnia

    • Depression, suicidal ideation, and hypersomnia

    • Diaphoresis, nausea and vomiting, and tremors

    • Unsteady gait, nystagmus, and profound disorientation

    Correct Answer
    A. Diaphoresis, nausea and vomiting, and tremors
    Explanation
    Alcohol withdrawal refers to the physical and psychological symptoms that occur when a person abruptly stops or reduces their alcohol intake after prolonged and heavy use. Diaphoresis, which is excessive sweating, nausea and vomiting, and tremors are common symptoms of alcohol withdrawal. These symptoms are caused by the body's reaction to the sudden absence of alcohol, as it tries to readjust and regain balance. They can range in severity and may be accompanied by other symptoms such as anxiety, irritability, and increased heart rate. It is important to seek medical attention if experiencing alcohol withdrawal symptoms, as they can be potentially dangerous and require proper management.

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  • 44. 

    Which of the following medications is the physician most likely to order for Mr. White during his withdrawal syndrom?

    • Haloperidol (Haldol)

    • Chlordiazepoxide (Librium)

    • Propoxyphene (Darvon)

    • Phenytoin (Dilantin)

    Correct Answer
    A. Chlordiazepoxide (Librium)
    Explanation
    The physician is most likely to order Chlordiazepoxide (Librium) for Mr. White during his withdrawal syndrome because it is a benzodiazepine medication commonly used to manage alcohol withdrawal symptoms. It helps to reduce anxiety, agitation, and seizures that can occur during withdrawal. Haloperidol is an antipsychotic medication used for psychosis and not specifically for withdrawal. Propoxyphene is a pain medication and Phenytoin is an anticonvulsant, neither of which are typically used for withdrawal symptoms.

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Quiz Review Timeline (Updated): Mar 22, 2023 +

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  • Current Version
  • Mar 22, 2023
    Quiz Edited by
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  • May 12, 2010
    Quiz Created by
    Ladyicesk8

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