Psychiatric and Mental Health Nursing D449
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Free Psychiatric and Mental Health Nursing D449 Questions
When assessing a female client who has been taking an antipsychotic medication for the past year, the nurse observes that the client demonstrates involuntary foot tapping while both feet are flat on the floor. The nurse plans to report the observation to the healthcare provider. Which additional action should the nurse take?
- Assist the client in recognizing her manifestations of anxiety.
- Prepare to initiate seizure precautions for the client's safety.
- Advise the client that she has developed tolerance to the medication.
- Document the finding on the Abnormal Involuntary Movement Scale.
Explanation
Explanation
Long-term use of antipsychotic medications can cause tardive dyskinesia, which presents as involuntary repetitive movements. The Abnormal Involuntary Movement Scale (AIMS) is used to assess and document these symptoms. Recording the findings using this standardized tool helps monitor severity and progression of the movement disorder.Correct Answer Is:
D. Document the finding on the Abnormal Involuntary Movement Scale.The nurse is teaching a client about the initiation of a prescribed abstinence therapy using disulfiram. Which information should the client provide to acknowledge understanding?
- Completely abstain from heroin or cocaine use.
- Admit to others that he is a substance abuser.
- Attend monthly meetings of Alcoholics Anonymous.
- Remain alcohol free for 12 hours prior to the first dose.
Explanation
Explanation
Disulfiram is used to support abstinence in individuals with alcohol use disorder. Alcohol must be avoided before starting the medication because combining disulfiram with alcohol can cause a severe reaction, including flushing, nausea, vomiting, and hypotension. Clients should remain alcohol free for at least 12 hours before the first dose.Correct Answer Is:
D. Remain alcohol free for 12 hours prior to the first dose.An adult female client with bipolar disorder is seen in the outpatient psychiatric clinic and tells the nurse that she is thinking of harming her sister. Which action is most important for the nurse to take?
- Notify the healthcare provider of the threat.
- Inform the sister of the client’s threat.
- Report the threat to the healthcare team.
- Document the threat in the medical record.
Explanation
Explanation
When a client expresses a threat of harm toward another person, the nurse has a duty to protect potential victims and ensure immediate intervention. The priority action is to notify the healthcare provider so that appropriate safety measures and further evaluation can occur. Documentation and team communication are important but notifying the provider is the most urgent step.Correct Answer Is:
A. Notify the healthcare provider of the threat.A male client arrives at the mental health clinic and asks the nurse for more lithium and the antidepressant amitriptyline that he uses to help him sleep. After reviewing the assessment findings with the healthcare provider, a serum creatinine is obtained. Which information supports the reason for this laboratory test?
- The effects of amitriptyline can promote and potentiate the risk of lithium toxicity.
- Lithium is excreted by the kidneys and creatinine is related to kidney functioning.
- The combination of lithium and amitriptyline may need to be changed if creatinine is high.
- Creatinine can measure how the body is metabolizing the lithium in the liver.
Explanation
Explanation
Lithium is primarily excreted through the kidneys. Measuring serum creatinine helps evaluate kidney function, which is important because impaired renal function can lead to lithium accumulation and toxicity. Monitoring kidney function is therefore essential for clients receiving lithium therapy.Correct Answer Is:
B. Lithium is excreted by the kidneys and creatinine is related to kidney functioning.A client is admitted to the mental health unit and sits in the corner of the day room. When the nurse begins the admission assessment interview, the client is guarded, suspicious, and resists talking. Which action should the nurse implement?
- Document the client's paranoid behavior.
- Ask another nurse to talk with the client.
- Postpone the client interview until the next day.
- Attempt to ask the client simple questions.
Explanation
Explanation
When a client appears guarded and suspicious, the nurse should use simple, nonthreatening communication to build trust and encourage interaction. Asking simple questions allows the client to respond at their comfort level and helps establish rapport. Postponing the interview or transferring responsibility to another nurse does not promote therapeutic communication, and documentation alone does not address the client's immediate needs.Correct Answer Is:
D. Attempt to ask the client simple questions.The nurse is providing teaching to a client and family about schizophrenia before discharge from an inpatient facility. The nurse should instruct the family to notify the healthcare provider when which behavior is observed?
- Changes in appetite.
- Decreased attention to detail.
- Fear of large dogs.
- Social withdrawal.
Explanation
Explanation
Social withdrawal is an early warning sign of relapse in clients with schizophrenia. It may indicate worsening negative symptoms or the return of psychotic symptoms. Early recognition and reporting allow the healthcare provider to adjust treatment and prevent further deterioration.Correct Answer Is:
D. Social withdrawal.A client who has agoraphobia (a fear of crowds) is beginning desensitization with the therapist, and the nurse is reinforcing the process. Which intervention has the highest priority for this client's plan of care?
- Encourage deep breathing when anxiety escalates in a crowd.
- Establish trust by providing a calm, safe environment.
- Encourage substitution of positive thoughts for negative ones.
- Progressively expose the client to larger crowds.
Explanation
Explanation
Establishing a calm and safe environment is the priority because clients with severe anxiety or phobias need to feel secure before engaging in therapeutic interventions. Building trust helps reduce anxiety and increases the client's willingness to participate in treatments such as desensitization and gradual exposure.Correct Answer Is:
B. Establish trust by providing a calm, safe environment.A client with schizophrenia is demonstrating echolalia, which is becoming annoying to other clients on the unit. Which intervention is best for the nurse to implement?
- Escort the client to a private area.
- Administer a PRN sedative.
- Isolate the client from other clients.
- Avoid recognizing the behavior.
Explanation
Explanation
Echolalia is the repetition of another person’s words and is common in schizophrenia. Escorting the client to a private area helps reduce stimulation and prevents disruption to other clients while maintaining dignity. Isolation or sedation is unnecessary unless safety concerns exist.Correct Answer Is:
A. Escort the client to a private area.The mental health unit nurse completes the admission assessment for a depressed adolescent client with suicidal ideation. The client reports becoming angry with a sibling, so the client took a handful of pills. Which goal is most important for the nurse to establish with this client?
- Identify three effective ways to cope with feelings.
- Attend at least 2 group sessions daily on the unit.
- Verbally express anger towards family.
- Interact positively with the staff on the unit.
Explanation
Explanation
The client attempted self-harm after becoming angry, indicating difficulty managing emotions. The priority goal is to help the client develop healthy coping strategies for dealing with intense feelings. Learning effective coping methods can reduce impulsive behaviors and decrease the risk of future self-harm.Correct Answer Is:
A. Identify three effective ways to cope with feelings.A client at the mental health center reports difficulty concentrating at work, feeling very tired during the day, and sleeping 4 to 5 hours at night. To further assess for depression, which question is most important for the nurse to ask?
- “Do you often feel sad?”
- “What foods do you like to eat?”
- “Have you experienced sleep changes?”
- “Have you experienced recent stresses?”
Explanation
Explanation
A persistent depressed or sad mood is a primary symptom of major depressive disorder. Asking directly about feelings of sadness helps determine whether the client is experiencing one of the core indicators of depression. The client has already reported sleep problems and fatigue, so assessing mood is the most important next step.Correct Answer Is:
A. “Do you often feel sad?”How to Order
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