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Ati nurs 120 mental health psychiatric proctored exam
Ati nurs 120 mental health psychiatric proctored exam
Total Questions : 35
Showing 10 questions Sign up for moreA nurse is assessing an adolescent client who has attention deficit hyperactivity disorder (ADHD). Which of the following findings should the nurse expect?
Explanation
Choice A reason: Emotional numbing is more commonly associated with post-traumatic stress disorder (PTSD) or depressive disorders rather than ADHD. ADHD is characterized by hyperactivity, inattention, and impulsivity, not emotional blunting.
Choice B reason: Elevated mood is typically seen in bipolar disorder during manic episodes. ADHD does not present with sustained elevated mood; instead, it involves distractibility, restlessness, and impulsive behavior.
Choice C reason: Impulsivity is a hallmark symptom of ADHD. Adolescents with ADHD often act without considering consequences, interrupt conversations, and struggle with self-control. This symptom directly aligns with the diagnostic criteria for ADHD.
Choice D reason: Anxiety can co-occur with ADHD but is not a defining feature. While some adolescents with ADHD may experience anxiety due to difficulties in school or social situations, it is not a primary symptom of the disorder.
A nurse is preparing a client who has chronic anxiety for discharge from the psychiatric unit. Which of the following instructions should the nurse include in the client's discharge plan?
Explanation
Choice A reason: Identifying anxiety-producing situations is a key strategy in managing chronic anxiety. Recognizing triggers allows the client to develop coping mechanisms, practice relaxation techniques, and use problem-solving skills to reduce anxiety.
Choice B reason: Eliminating stress and anxiety completely from daily life is unrealistic. Stress is a normal part of life, and attempting to eliminate it entirely may lead to frustration and worsen anxiety.
Choice C reason: Repressing feelings of anxiety is maladaptive. Suppression can intensify symptoms and lead to unhealthy coping behaviors. Effective management involves acknowledging and addressing anxiety, not ignoring it.
Choice D reason: Contacting a crisis counselor once a week is not a standard discharge instruction for chronic anxiety. Crisis counselors are typically contacted during acute episodes, not as routine weekly follow-up.
A patient on lithium therapy presents to the emergency department. When should you hold the lithium medication and notify the healthcare provider?
Explanation
Choice A reason: A lithium level of 0.9 mEq/L is within the therapeutic range (0.6–1.2 mEq/L). This does not require holding the medication.
Choice B reason: Dry mouth and increased thirst are common side effects of lithium due to its mild diuretic effect. These do not indicate toxicity and do not require holding the medication.
Choice C reason: Mild hand tremors are a common side effect of lithium and are not usually dangerous. They can be managed but do not warrant stopping the medication.
Choice D reason: Nausea, vomiting, diarrhea, and coarse tremors are signs of lithium toxicity. These symptoms indicate dangerous accumulation of lithium in the body, requiring immediate discontinuation and notification of the healthcare provider.
A nurse is caring for a client who has schizophrenia and is taking haloperidol. The nurse should monitor for which of the following adverse effects of haloperidol?
Explanation
Choice A reason: Fever can occur in rare cases of neuroleptic malignant syndrome, but it is not the most common adverse effect of haloperidol.
Choice B reason: Intractable hiccups are not associated with haloperidol use. They are not a recognized adverse effect of this medication.
Choice C reason: Excessive salivation is more commonly linked to medications like clozapine, not haloperidol.
Choice D reason: Extrapyramidal symptoms (EPS) are the most common adverse effects of haloperidol. These include dystonia, akathisia, parkinsonism, and tardive dyskinesia. EPS result from dopamine blockade in the nigrostriatal pathway and require close monitoring and management.
A nurse is teaching a client who has a depressive disorder about fluoxetine (Prozac). Which of the following information should the nurse include in the teaching?
Explanation
Choice A reason: Fluoxetine, a selective serotonin reuptake inhibitor (SSRI), is commonly associated with sexual dysfunction, including decreased libido, delayed orgasm, or erectile difficulties. This is an important teaching point because it can affect adherence to therapy if the client is not prepared for this side effect.
Choice B reason: Drooling is not a typical side effect of fluoxetine. Excessive salivation is more commonly seen with antipsychotics such as clozapine, not SSRIs.
Choice C reason: Improvement in depressive symptoms with fluoxetine usually takes 2 to 4 weeks, not 2 to 3 days. Clients should be counseled to continue taking the medication consistently and not expect immediate relief.
Choice D reason: Appetite changes can occur with SSRIs, but decreased appetite is not a primary or consistent side effect of fluoxetine. Some clients may experience weight changes, but sexual dysfunction is more characteristic.
A nurse is providing dietary teaching for a client who has a new prescription for a monoamine oxidase inhibitor (MAOI). When the client develops a sample lunch menu, which of the following items requires intervention by the nurse?
Explanation
Choice A reason: Bologna is a processed meat that contains tyramine. Clients taking MAOIs must avoid foods high in tyramine because they can precipitate a hypertensive crisis. Processed meats, aged cheeses, and fermented products are particularly dangerous.
Choice B reason: Sliced apples are safe for clients taking MAOIs. Fresh fruits do not contain tyramine and do not pose a risk.
Choice C reason: Cheese, especially aged varieties, is high in tyramine. This would also require intervention. Since the question asks for the item requiring intervention, both bologna and cheese are problematic, but bologna is the clearest example of a food to avoid.
Choice D reason: Whole milk is safe for clients on MAOIs. It does not contain tyramine and does not interact with the medication.
A nurse is caring for a newly admitted client who has obsessive-compulsive disorder (OCD). Which of the following actions should the nurse take first?
Explanation
Choice A reason: Providing a structured activity schedule is helpful for clients with OCD, but it is not the first priority. Before structuring activities, the nurse must understand what triggers the client’s compulsions.
Choice B reason: Relaxation techniques are useful for managing anxiety, but they are not the initial intervention. Identifying precipitating factors is necessary before teaching coping strategies.
Choice C reason: Identifying precipitating factors for ritualistic behaviors is the first step in managing OCD. Understanding what triggers compulsions allows the nurse to tailor interventions, reduce exposure to triggers, and help the client develop healthier coping mechanisms.
Choice D reason: Discussing alternative coping strategies is important, but it comes after identifying the triggers. Without knowing what causes the ritualistic behaviors, alternative strategies cannot be effectively implemented.
Which of the following medications is most commonly associated with the development of agranulocytosis?
Explanation
Choice A reason: Clonidine is an antihypertensive medication that works as an alpha-2 adrenergic agonist. It is not associated with agranulocytosis.
Choice B reason: Haloperidol, a typical antipsychotic, can cause extrapyramidal symptoms and tardive dyskinesia but is not commonly linked to agranulocytosis.
Choice C reason: Clozapine, an atypical antipsychotic, is strongly associated with agranulocytosis, a potentially life-threatening reduction in white blood cells. Clients taking clozapine require regular monitoring of complete blood counts to detect this adverse effect early.
Choice D reason: Lithium is a mood stabilizer used in bipolar disorder. Its adverse effects include tremors, polyuria, hypothyroidism, and toxicity symptoms, but agranulocytosis is not a common risk.
A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for 0.25 mg PO every 8 hr PRN anxiety. For which of the following client statements should the nurse consider administering alprazolam?
Explanation
Choice A reason: Visual hallucinations such as seeing bugs crawling on the wall are symptoms of schizophrenia, not anxiety. Alprazolam is a benzodiazepine used for acute anxiety relief, not for treating hallucinations.
Choice B reason: Delusional thinking, such as believing one is a government agent, is a psychotic symptom of schizophrenia. Alprazolam does not treat delusions; antipsychotic medications are required.
Choice C reason: A pounding heart is a classic manifestation of acute anxiety or panic. Alprazolam is indicated for short-term relief of acute anxiety symptoms, making this the appropriate situation for administration.
Choice D reason: Fatigue and lack of motivation are common in schizophrenia and depression, but alprazolam is not indicated for these symptoms. Administering it in this case would not address the underlying issue.
A nurse is caring for a client who has schizophrenia and generalized anxiety disorder. The client has a prescription for 0.25 mg PO every 8 hr PRN anxiety. For which of the following client statements should the nurse consider administering alprazolam?
Explanation
Choice A reason: Visual hallucinations such as seeing bugs crawling on the wall are symptoms of schizophrenia, not anxiety. Alprazolam is a benzodiazepine used for acute anxiety relief, not for treating hallucinations.
Choice B reason: Delusional thinking, such as believing one is a government agent, is a psychotic symptom of schizophrenia. Alprazolam does not treat delusions; antipsychotic medications are required.
Choice C reason: A pounding heart is a classic manifestation of acute anxiety or panic. Alprazolam is indicated for short-term relief of acute anxiety symptoms, making this the appropriate situation for administration.
Choice D reason: Fatigue and lack of motivation are common in schizophrenia and depression, but alprazolam is not indicated for these symptoms. Administering it in this case would not address the underlying issue.
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