a. teach the client strategies to decrease the hallucinations
b. check that the client is on antipsychotic meds
c. establish rapport with the client
d. explore what the voices are saying to the client
c. tardive dyskinesia
a. Move the client to a calm, nonstimulating environment.
b. Encourage expression of feelings.
c. Lower the client’s level of anxiety by offering medication.
d. Suggest the client engage in some automatic behavior, such as pacing, to reduce anxiety levels.
a. Chart observations and reassure the client that these manifestations are normal.
b. Administer diazepam (Valium) 5 mg PO (ordered PRN).
c. Encourage deep breathing and relaxation.
d. Administer benztropine Mesylate (Cogentin) 1 mg PO (ordered PRN).
a. “You will need to be careful of exposure to the sun and wear a sunscreen when outdoors.”
b. “While you are taking Seroquel, you will need to have weekly blood counts.”
c. “Weight gain is less common with Seroquel than with other atypical antipsychotics.”
d. “Seroquel is effective in managing rapid-cycling manic episodes.”
a. Carbamazepine (Tegretol)
b. Valproic acid (Depakote)
c. Paroxetine (Paxil)
d. Lithium (Lithane)
a. “You should increase your fluid intake to prevent dry mouth.”
b. “You should take this medication with food to prevent GI upset.”
c. “You will need to watch your caloric intake to prevent weight gain.”
d. “You will have to read food labels careful to eliminate tyramine from your diet.”
a. Flight of ideas
a. Sodium and fluid intake should be increased.
b. Fluid intake should not exceed 1000 mL per day.
c. Sodium intake should be restricted to 1200 mg per day.
d. An adequate daily intake of sodium and fluids should be maintained.
a. Method of reducing anxiety
b. Form of manipulation to avoid work
c. Strategy to get attention
d. Rationalization for avoiding social contact
a. Assess the client’s ability to communicate clearly.
b. Discourage the client from focusing on personal problems.
c. Reinforce the client’s identity as a homemaker.
d. Use the client’s personal strengths to build self-esteem.
a. Ask other clients to be more sympathetic of the complaining client.
b. Encourage the client to participate in group diversional activities.
c. Ask the client to stop talking about physical complaints.
d. Encourage the client to rest alone when upset.
a. Spaghetti and meat balls, salad, banana
b. Beef and vegetable stew, bread, vanilla pudding
c. Chicken nuggets, ear of corn, apple
d. Fish fillets, stewed tomatoes, cake
a. Increasing sodium intake
b. Mild exercise
d. Carbamazepine (Tegretol) therapy
a. Acetaminophen (Tylenol)
b. Ranitidine (Zantac)
c. Benztropine (Cogentin)
d. Pseudoephedrine (Sudafed)
a. “Thorazine is an antipsychotic that can cure your disorder.”
b. “Thorazine is a sedative that helps to calm you down.”
c. “Thorazine will help to control the symptoms of your illness.”
d. “Thorazine controls the side effects of antipsychotic drugs.”
a. Side effects include insomnia and seizures.
b. Valium can be habit forming.
c. This medication is administered solely by mouth.
d. It takes 2 to 3 weeks to reach full therapeutic effect.
a. Fine hand tremor
d. Urinary retention
a. Pinpoint pupils
a. should not be taken during pregnancy.
b. must be discontinued by gradual tapering over time.
c. is contraindicated for clients with asthma.
d. is a safe medication with no known adverse effects.
a. Jerky, choreiform movements of the upper extremities
b. Slow, involuntary athetoid movements of the arms and legs
c. Involuntary grimacing, lip smacking, and tongue protrusion
d. Tonic contractions of the neck and back
a. Clang association
c. Pressured speech
d. Word salad
a. Perception of reality
b. Ability to follow directions
c. Physical needs
d. Mental status
a. Skin rashes
b. Excessive sweating
d. Muscle breakdown
a. An illusion
d. Grandiose delusion
a. Aren’t you worried about the safety of your children?”
b. “Can you identify the situations that provoke your husband?”
c. “I am concerned about your safety.”
d. “I wouldn’t put up with this if I were you.”
a. Perception of the presenting problem
b. Description of hallucinations
c. Feelings about hospitalization
d. Relationship with the family
a. “I can’t leave you alone when you are this upset. Sit down, and try to relax.”
b. “Let’s go to your room, and you can tell me what is bothering you.”
c. “I will give you space as long as you control yourself. I’d like to know what is causing you to feel so tense.”
d. “I will leave you alone for a few minutes while you try to compose yourself.”
a. “How long were you married to your husband?”
b. “Remember? Your husband died five years ago.”
c. “You’ve forgotten that your husband is dead, haven’t you?”
d. “You miss your husband a lot, don’t you? “
a. Lock the doors to the unit and secure all windows so they cannot be opened.
b. Remove belts, glass objects, and sharp instruments from the client’s environment.
c. Have a staff member stay with the client at all times.
d. Provide a relaxed and accepting environment to develop trust.
a. “You should attend an Al-Anon meeting. The group can teach you how best to help him stay sober.”
b. “You have already done a great deal by getting him here. Now, it is up to him.”
c. “Are you feeling some responsibility for his drinking?”
d. “Tell me more about the kind of help you feel you are able to provide at this time.”
a. The client frequently argues with her parents.
b. The client is getting C’s in school because she is absent a lot.
c. The client smokes half a pack of cigarettes per day.
d. The client gave her favorite necklace to her best friend.
a. “I do not feel that you really believe that.”
b. “Everyone feels this way when depressed.”
c. “You sound upset. Are you thinking of hurting yourself?”
d. “You’ll feel better once your medications start working.”
a. “You are being unreasonable, and I will not call your therapist at 3:00 in the morning.”
b. “Why do you need to see your therapist tonight?”
c. “Calm down, go back to your room, and I’ll try to get in touch with your therapist right away.”
d. “You must be very upset about something to want to see your therapist in the middle of the night.”
a. “You may feel good now, but what about when you get depressed?”
b. “What do you like about being manic?”
c. “You feel better when you don’t take your medication?”
d. “You really should follow your provider’s orders if you want to be well.”
a. “You must be getting better. You look great!”
b. “Let’s go put some make-up on to make you look even better.”
c. Why did you get all dressed up today? Is it a special occasion?
d. “You look nice after your bath and shampoo.”
a. “Let’s discuss your feelings more after we finish admitting you.”
b. “I don’t think talking to you is a waste of time.”
c. “Why do you feel the way you do?”
d. “I think you are worthwhile, and I want to talk to you.”
a. “Everyone feels that way when they first start treatment.”
b. “You sound very discouraged and hopeless today.”
c. “You’ll feel so much better once you get up and into your own clothes.”
d. “Why do you say that you are too sick to bother?”
a. “At breakfast today everyone was talking about me. They were all staring at me.”
b. “I don’t feel like going to group therapy today. I don’t want to be with other people.”
c. “I have it all figured out. Everything is going to be okay now.”
c. “I don’t feel like showering or eating. I’d rather just stay in bed today.”
a. “Have you attempted suicide before?”
b. “What happened to make you so desperate?”
c. “How will you carry out your plan?”
d. “What will you accomplish by taking your life?”
a. “Did I say something wrong that made you feel tense?”
b. “Do you often feel tense when you are talking to a health care provider?”
c. “What were we discussing when you began to feel uncomfortable?”
d. “I sometimes feel tense, too, when I am talking to a stranger.”
a. “Tell me who would do such things to you?”
b. “You are mistaken. Nobody has told lies about you or tried to poison you.”
c. “Tell me more about your concerns about being poisoned.”
d. “You’re having very frightening thoughts.”
a. “Things will look brighter soon. Everyone feels down once in a while.”
b. “The staff here cares about you and wants to try to help you get better.”
c. “It is difficult for others to care about you when you repeatedly say negative things about yourself.”
d. “I’ll sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at 2:30 this afternoon.”
a. explain how to manage postural hypotension, and educate the patient that side effects go away after several weeks.
b. tell the patient that the side effects are a minor inconvenience compared with the feelings of depression.
c. withhold the drug, force oral fluids, and notify the health care provider to examine the patient.
d. teach the patient how to use pursed-lip breathing.
a. avoid exposure to bright sunlight.
b. report increased suicidal thoughts.
c. restrict sodium intake to 1 g daily.
d. maintain a tyramine-free diet.
a. monitors sodium intake and weight daily.
b. wears support stockings and elevates the legs when sitting.
c. consults the pharmacist when selecting over-the-counter medications.
d. can identify foods with high selenium content, which should be avoided.
a. “Go to the nearest emergency department immediately.”
b. “Do not to be alarmed. Take two aspirin and drink plenty of fluids.”
c. “Take one dose of the antidepressant. Come to the clinic to see the health care provider.”
d. “Resume taking the antidepressant for 2 more weeks, and then discontinue it again.”
a. hypotensive shock
b. hypertensive crisis.
c. cardiac dysrhythmia.
d. cardiogenic shock.
a. Distraction: “Let’s go to the dining room for a snack.”
b. Humor: “How much are you paying servants these days?”
c. Limit setting: “You must stop ordering other patients around.”
d. Honest feedback: “Your controlling behavior is annoying others.”
a. within therapeutic limits.
b. below therapeutic limits.
c. above therapeutic limits.
d. likely to be inaccurate.
a. Clonazepam (Klonopin)
b. Risperidone (Risperdal)
c. Lamotrigine (Lamictal)
d. Aripiprazole (Abilify)
a. Allow the patient to act out his or her feelings.
b. Set limits on the patient’s behavior as necessary.
c. Provide verbal instructions to the patient to remain calm.
d. Restrain the patient to reduce hyperactivity and aggression.
b. an antacid.
c. a large glass of juice.
d. an antiemetic medication.
a. maintain normal salt and fluids in the diet.
b. drink twice the usual daily amount of fluids.
c. double the lithium dose if diarrhea or vomiting occurs.
d. avoid eating aged cheese, processed meats, and red wine.
a. Decreasing physical activity
b. Increasing food and fluids
c. Meeting self-care needs
a. Pharyngitis, mydriasis, and dystonia
b. Alopecia, purpura, and drowsiness
c. Diaphoresis, weakness, and nausea
d. Ascites, dyspnea, and edema