8/12/2019 A 15 Year Old Client Comes in With the Diagnosis of Anorexia Nervosa

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1. A 15 year old client comes in with the diagnosis of Anorexia Nervosa. The nurse recognizes thatthis problem is most likely caused by: an issue of control

2. Nursing intervention for anorexia will most likely include focus on proper nutrition.3. Symptoms of Anorexia include Bradycardia, lanugo, and amenorrhea.4. Mrs. Arrow is a 30 year old woman who was in an automobile accident and she now has to

wear leg braces. Since the nursing staff discussed her prognosis with her, she is vacillatingbetween periods of depression and anger. The most likely explanation of her reaction is anormal grief reaction to a change in body image.

5. Mrs. Phillips husband is a heroin addict and she has accompanied her husband to a detox unit ofthe local general hospital. When the nurse is interviewing Mrs. Phillips, the wife asks what shecan do to help her husband with his addiction. The nurses best response is: Tell me more aboutyour understanding of your husbands addiction

6. Mrs. Style is 75 years of age and in a nursing home with a diagnosis of dementia. She is oftenagitated and was placed Haldol 5mg. TID and prn for agitation. The nurse enters her room andfinds that she appears comatose, feverish with muscle rigidity. Her rectal temperature was 103F.The nurses best understandin g of these findings is as follows: This is a symptom of neurolepticmalignant syndrome.

7. Ms. Page is a 24 year old woman admitted to the psychiatric hospital with the diagnosis ofpsychotic depression. She cut herself over several areas of her body and attempted suicide onseveral occasions. She has displayed hallucinations and delusions. You are walking down thecorridor with Ms. Page when she stops and says I dont want to be here. What is the nursesbest response? I am not sure I understand what you mean by not wanting to be here.

8. Mr. Jones is a 50 year old man who has been depressed and was placed on a tricyclicantidepressant. The most serious side effect of this medication is: Orthostatic hypotension anddizziness.

9. Mr. Jones has made a serious suicide attempt by gunshot wound and was hospitalized. He saysto the nurse Everybody here must think I am really crazy. Your best response would be: Youare concerned about what others will think of you.

10. Mr. Williams is an 18 year old schizophrenic who says to you Dont make me move my finger. IfI move my finger I will blow this whole place up. This is an example of omnipotent delusion.

11. What is the best response to Mr. Williams in the previous question? Are you feeling as if youhave no control over what s happening to you in the hospital?

12. Side effects of the antidepressant Tofranil (Imipramine) include Urinary retention.13. A client has been taking Tofranil (Imipramine) for five days and tells the nurse it is not helping

her and she doesn't want to take it. The best responses of the nurse would be to: explain thatone usually has to take the medication for ten days to achieve beginning effects.

14. The client is still extremely depressed and her physician changes her medication from Tofranil(Imipramine) to Nardil (Phenelzine). She asks the nurse what the medication will do. The nurse'sbest responses would be: The medication will help increase your appetite and make you feelbetter.

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15. A client does not respond to the antidepressant drugs. The physician decides to administer aseries of electroconvulsive treatments. The preparation for this treatment includes: - Select allthat apply. A thorough physical examination. NPO after midnight. Careful explanation.Succinylcholine prior to the treatment.

16. Succinylcholine chloride (Anectine) is administered to a client before she receives ECT. Thenurse should observe for Respiratory difficulties.

17. Persons receiving any of the MAO inhibitors should be cautioned about avoiding specific foodsubstances as they can precipitate Hypertensive crisis.

18. A client who is taking imipramine (Tofranil) should not take: Nardil (Phenelzine)19. The most commonly used medication order for an assaultive patient in physical restraints is: -

Check all that apply: Haldol (Haloperidol 2mg IM), Risperidal (Risperidone 4mg PO).20. The side effects of Thorazine (Chlorpromazine) are Photosensitivity.21. A patient has received Haldol (Haloperidol) for a long time. He is noted to have a parkinsonian-

like gait. What measure would most likely be taken? Giving the patient Cogentin (Benztropine)or Artane (Trihexyphenidyl).

22. While a patient receives Clozapine (Clozaril), it is recommended that which of the followingobservations are the most important to be made? White blood cell count.

23. Which of the following statements about tardive dyskinesia is incorrect? It can be successfullytreated with antiparkinsonian drugs.

24. Zyprexa (Olanzapine) is prescribed for a client. He is going home on a weekend pass. The nurseinforms him that he should not drink any alcoholic beverages while he is taking this medication.

25. The client with schizophrenia on antipsychotic medication returns from the weekend pass andthe nurse notices that his sclera look yellow. The nurse's initial action should be to Hold themedication and notify the M.D.

26. The medication usually prescribed to prevent an alcoholic who is withdrawing from experiencingdelirium tremens is: Ativan (Lorazepam) or Serax (oxazepam).

27. An alcoholic patient will be discharged with the drug disulfiram (Antabuse). The nurse shouldcaution the patient to avoid: Elixirs and liniments

28. A patient is receiving lithium. The nurse knows that the desired therapeutic lithium blood level is0.9 to 1.0 meq/liter.

29. Side effects of lithium (below 1.5 mEq/liter level) include: hand tremors and diarrhea.30. A patient receiving lithium carbonate complains of diarrhea, tremors, and drowsiness. The nurse

should withhold the medication, notify the MD, and get a blood lithium level.31. A patient is to be discharged on a regimen of lithium carbonate. What information about this

drug should be included in the teaching plan for discharge? (Check all that apply). Advise her tomaintain a normal diet with adequate salt and fluid, stop taking her diuretics, encourage her tohave her blood levels checked as ordered.

32. Aripiprazone (Abilify) is a major tranquilizer.33. The side effects of Haldol for which the nurse should be observant are amenorrhea.34. Dry mouth, photosensitivity, and susceptibility to sunburn may occur in patients receiving:

(Check all that apply): Haloperidol (Haldol), Fluphenazine (Prolixin), Prochlorperazine(Compazine).

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35. All of the following are potential side effects of antipsychotic phenothiazine medication exceptNausea.

36. Which of the following groups of foods should be avoided by patients who are takingantidepressants of the MAO inhibitor type? Chocolate, Cheddar cheese, Chianti wine.

37. The most appropriate assignment in a psychiatric unit for a new nursing student would be apatient with panic attacks who abuses alcohol to medicate these attacks.

38. Which statement is correct? The RN is the person ultimately responsible for the nursing processand overseeing that the plan of care is implemented.

39. Which of the following tasks should the RN delegate to a nursing assistant/ Activities of DailyLiving and morning care for patients on the unit.

40. A newly admitted resident in a nursing home is confused at times. Which intervention would bemost appropriate nursing assistant to implement? Encourage family and friends to bring objectsfrom the residents home.

41. Bernice Bowan is brought to the emergency room by the police and paramedic team becauseshe has been raped. Appropriate care for the nursing assistant to perform should includeinstructing Mrs. Bowan on how to obtain a clean catch urine specimen.

42. A psychiatric patient is scheduled for Electro-convulsive therapy. The nursing assistant istransporting the patient to the area where the procedure will be performed. On the way, thepatient says Im so frightened about having these treatments. I think Im going to die. I dontthink I want to go through it. The nursing assistants responsibility would be to inform thenurse in charge.

43. A medical nurse is floated to the psychiatric unit to help out for the day. Which is the mostappropriate assignment for the nurse? A patient detoxing from drugs.

44. Elavil (Amitriptyline) Tricyclic antidepressant45. Haldol (Haloperiodol)- Major tranquilizer46. Cogentin (Benztropine)- Antiparkinson agent47. Artane (Trihexyphenidyl)- Antiparkinson agent48. Parnate (Tranylcypromine)- MAO inhibitor antidepressant49. Lithium carbonate is monitored by blood levels.50. Imipramine (Tofranil) and Lithium carbonate have therapeutic effects in several weeks.51. Chlorpromazine (Thorazine) is related to tardive dyskinesia.52. Diazepam (Valium) may be habit forming.53. Chlorpromazine (Thorazine) is related to photosensitivity.

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