2.Malou is diagnosed with majordepressionspends majority of the day lying in bed with the sheet pulled over his head.Which of the following approaches by the nurse would be the most therapeutic?a.Question the client until he respondsb.Initiate contact with the client frequentlyc.Sit outside the clients roomd.Wait for the client to begin the conversation4.When teaching Mario with a typical depression about foods to avoid while taking phenelzine(Nardil), which of the following would the nurse in charge include?a.Roasted chickenb.Fresh fishc.Salamid.Hamburger5.When assessing a female client who is receiving tricyclic antidepressant therapy, which of the following would alert the nurse to the possibility that the client is experiencing anticholinergic effects?a.Urine retention and blurred visionb.Respiratory depression and convulsionc.Delirium and Sedationd.Tremors and cardiac arrhythmias6.For a male client with dysthymic disorder, which of the following approaches would the nurse expect to implement?a.ECTb.Psychotherapeutic approachc.Psychoanalysisd.Antidepressant therapy7.Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, Where is my daughter?I love Louis.Rain, rain go away.Dogs eat dirt.The nurse interprets these statements as indicating which of the following?a.Echolaliab.Neologismc.Clang associationsd.Flight of ideas10.Jun has been hospitalized for major depression and suicidal ideation.Which of the following statements indicates to the nurse that the client is improving?a.Im of no use to anyone anymore.b.I know my kids dont need me anymore since theyre grown.c.I couldnt kill myself because I dont want to go to hell.d.I dont think about killing myself as much as I used to.12.When developing the plan of care for a client receiving haloperidol, which of the following medications would nurse Monet anticipate administering if the client developed extra pyramidal side effects?a.Olanzapine (Zyprexa)b.Paroxetine (Paxil)c.Benztropine mesylate (Cogentin)d.Lorazepam(Ativan)14.A client is suffering from catatonic behaviors.Which of the following would the nurse use to determine that the medication administered PRN have been most effective?a.The client responds to verbal directions to eatb.The client initiates simple activities without directionc.The client walks with the nurse to her roomd.The client is able to move all extremities occasionally16.When planning care for Dory with schizotypal personality disorder, which of the following would help the client become involved with others?a.Attending an activity with the nurseb.Leading a sing a long in the afternoonc.Participating solely in group activitiesd.Being involved with primarily one to one activitie17.Which statement about an individual with a personality disorder is true?a.Psychotic behavior is common during acute episodesb.Prognosis for recovery is good with therapeutic interventionc.The individual typically remains in the mainstream of society, although he has problems in social and occupational rolesd.The individual usually seeks treatment willingly for symptoms that are personally distressful.18.Nurse John is talking with a client who has been diagnosed with antisocial personality about how to socialize during activities without being seductive.Nurse John would focus the discussion on which of the following areas?a.Discussing his relationship with his motherb.Asking him to explain reasons for his seductive behaviorc.Suggesting to apologize to others for his behaviord.Explaining the negative reactions of others toward his behavior19.Tina with a histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner.Nurse Trish would recommend which of the following activities for Tina?a.Baking classb.Role playingc.Scrapbook makingd.Music group20.Joy has entered thechemical dependencyunit for treatment of alcohol dependency.Which of the following clients possession will the nurse most likely place in a locked area?a.Toothpasteb.Shampooc.Antiseptic washd.Moisturizer21.Which of the following assessment would provide the best information about the clients physiologic response and the effectiveness of the medication prescribed specifically for alcoholwithdrawal?a.Sleeping patternb.Mental alertnessc.Nutritional statusd.Vital signs22.After administering naloxone (Narcan), an opioid antagonist, Nurse Ronald should monitor the female client carefully for which of the following?a.Respiratory depressionb.Epilepsyc.Kidney failured.Cerebral edema24.A female client is brought byambulanceto the hospital emergency room after taking an overdose of barbiturates is comatose.Nurse Trish would be especially alert for which of the following?a.Epilepsyb.Myocardial Infarctionc.Renal failured.Respiratory failure26.Jose is diagnosed withamphetaminepsychosis and was admitted in the emergency room.Nurse Ronald would most likely prepare to administer which of the following medication?a.Libriumb.Valiumc.Ativand.Haldol35.The primary nursing diagnosis for a female client with a medical diagnosis of major depression would be:a.Situational low self-esteem related to altered roleb.Powerlessness related to the loss of idealized selfc.Spiritual distress related to depressiond.Impaired verbal communication related to depression36.When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic episode) nurse Ron should plan to?a.Isolate his gym timeb.Encourage his active participation in unit programsc.Provide foods, fluids and restd.Encourage his participation in programs

41. When asking the parents about the onset of problems in young client with the diagnosis of schizophrenia, Nurse Linda would expect that they would relate the clients difficulties began in:

a. Early childhood

b. Late childhood

c. Adolescence

d. Puberty47.Nurse John recognizesthat paranoid delusions usually are related to the defense mechanism of:a.Projectionb.Identificationc.Repressiond.Regression49.Nurse Gerry is aware that the defense mechanism commonly used by clients who are alcoholics is:a.Displacementb.Denialc.Projectiond.CompensationAnswers:2. B. The nurse should initiate brief, frequent contacts throughout the day to let the client know that he is important to the nurse. This will positively affect the clients self-esteem.4. C. Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be avoided because when they are ingested in combination with MAOIs a hypertensive crisis will occur.5. A. Anticholinergic effects, which result from blockage of the parasympathetic (craniosacral) nervous system including urine retention, blurred vision, dry mouth & constipation.6. B. Dysthymia is a less severe,chronic depressiondiagnosed when a client has had a depressed mood for more days than not over a period of at least 2 years. Client with dysthymic disorder benefit from psychotherapeutic approaches that assist the client inreversingthe negative self image, negative feelings about the future.7. D. Flight of ideas is speech pattern of rapid transition from topic to topic, often without finishing one idea. It is common in mania.10. D. The statement I dont think about killing myself as much as I used to. Indicates a lessening of suicidal ideation and improvement in the clients condition.12. C. The drug of choice for a client experiencing extra pyramidal side effects from haloperidol (Haldol) is benztropine mesylate (cogentin) because of its anti cholinergic properties.14. B. Although all the actions indicate improvement, the ability to initiate simple activities without directions indicates the most improvement in the catatonic behaviors.16. C. Attending activity with the nurse assists the client to become involved with others slowly. The client with schizotypal personality disorder needs support, kindness & gentle suggestion to improve social skills & interpersonal relationship.17. C. An individual with personality disorder usually is not hospitalized unless a coexisting Axis I psychiatric disorder is present.18. D. The nurse would explain the negative reactions of others towards the clients behaviors to make the clients aware of the impact of his seductive behaviors on others.19. B. The nurse would use role-playing to teach the client appropriate responses to others and in various situations. This client dramatizes events, drawn attention to self, and is unaware of and does not deal with feelings. The nurse works to help the client clarify true feelings & learn to express them appropriately.20. C. Antiseptic mouthwash often contains alcohol & should be kept in locked area, unless labeling clearly indicates that the product does not contain alcohol.21. D. Monitoring of vital signs provides the best information about the clients overall physiologic status during alcoholwithdrawal& the physiologic response to the medication used.22. A. After administering naloxone (Narcan) the nurse should monitor the clients respiratory status carefully, because the drug is short acting & respiratory depression may recur after its effects wear off.24. D. Barbiturates are CNS depressants; the nurse would be especially alert for the possibility of respiratory failure. Respiratory failure is the most likely cause of death from barbiturate over dose.26. D. The nurse would prepare to administer an antipsychotic medication such as Haldol to a client experiencingamphetaminepsychosis to decrease agitation & psychotic symptoms, including delusions, hallucinations & cognitive impairment.35. D. Depressed clients demonstrate decreased communication because of lack of psychic or physical energy.36. C. The client in a manic episode of the illness often neglects basic needs, these needs are a priority to ensure adequate nutrition, fluid, and rest.41. C. The usual age of onset ofschizophreniais adolescence orearly childhood.47. A. Projection is a mechanism in which inner thoughts and feelings are projected onto the environment, seeming to come from outside the self rather than from within.49. B. Denial is a method of resolving conflict or escaping unpleasant realities by ignoring their existence.