a patient diagnosed with major depression disorder began taking citalopram 5 days ago. the patient now says, "this medicine isn't working." the nurse's best intervention would be to..
explain the time lag before antidepressants relieve symptoms
a nurse conduction group therapy on the eating-disorder unit schedules the sessions immediately after meals for the primary purpose of
promoting processing of anxiety associated with eating
which nursing response demonstrates accurate information that should be discussed with a female patient diagnoses with bipolar disorder and her support system?
it is critical to let you healthcare provider know if you're not sleeping well
remember that alcohol and caffeine can trigger a relapse of your symptoms
is your family prepared to be actively involved in helping manage this disorder?
the symptoms tend to come and go and so you need to be able to recognize the early signs
caring for patients who are terminally ill require the nurse to focus on communication, and of presence and symptom management. art of present includes 2 essential skills. these skills are
listening and observing
a patient being treated for an eating disorder is prescribed refeeding. which outcomes are the primary reasons a patient receiving this treatment is closely monitored by the nursing staff?
fluid-tolerance abnormalities
hypokalemia
abnormal glucose metabolism
(ALTERNATE Q) a patient being treated for an eating disorder is prescribed refeeding. which outcomes are the primary reasons a patient receiving this treatment is closely monitored by the nursing staff?
no physical signs or symptoms of an electrolyte imbalance are observable
four teenagers died in an automobile accident. six months later, which behavior by the parents best demonstrates acceptance of the tragedy?
the parents who establish a fund for a teenage safe driving course
(alternate) creates a scholarship fund at their child's high school
a patient referred to the eating disorders clinic has lost 35 pounds in 3 months. which physical manifestations of anorexia nervosa would a nurse likely find?
peripheral edema, constipation, hypotension, lanugo
when teaching a patient with depression about foods to avoid while taking the MAOI phenelzine (nardil), which of the following would the nurse in charge include?
salami
an adolescent comes to the crisis clinic and reports sexual abuse by an uncle. the adolescent told both parents about the uncles behavior, but the parents did not believe the adolescent. what type of crisis exists?
situational
during the initial interview at the crisis center, a patient says, I've been served with divorce papers. i'm so upset and anxious that i can't think clearly" which commment should the nurse use to assess personal coping skills?
in the past, how have you handled difficult or stressful situations?
an outpatient diagnose with bipolar disorder is prescribed lithium. the patient telephones the nurse to say. I've had severe diarrhea for 4 days. i feel very weak and unsteady when i walk. my usual hand tremor has gotten worse. what should i do? the nurse will advise the patient to
have someone bring the patient to the clinic immediately
the mother of a teenager is concerned that her teenaged daughter may be anorexic. which report of the teenagers behavior is support of such diagnosis?
peculiar handling of food, cutting into small bits
although she has grown 3 inches, she has gained no weight
hasn't had no menstrual period in the last 2 years
which measure would be considered a form of primary prevention for suicide?
helping school children learn to manage stress and be resilient
a patient has blindness related to conversion disorder but is unconcerned about this problem. which understanding should guide the nurses planning for this patient?
the patient's anxiety is relieved through the physical symptom
a patient tells the nurse, "i'm ashamed of being bipolar. when i'm manic, my behavior embarrasses everyone. even if i take my medication, there are no guarantees. i'm a burden to my family." these statements support which nursing diagnoses?
powerlessness
chronic low self-esteem
when considering protective factors related to risk of suicide, these include
access to effective mental healthcare and strong connection to family or friends
as death approaches, a patient diagnosed with AIDs says, "i do not have enough energy for many visitors anymore and i am embarassed about how i look. i only want to see my parents and sister." which actions should the nurse take?
assist family to inform the patients family of the request
support the patient to share the request with the parents and sister
the dying patient with a neurocognitive disorder such as alzeheimers disease is especially challenging to provide care for. they may have symptoms or pain that they are unable to adequately describe or define. reversible conditions that respond to treatment may affect level of consciousness, anxiety, or agitations include
distended bladder, constipation or nausea
disturbed body image is a nursing diagnosis established for a patient diagnosed with an eating disorder. which outcome indicator is most appropriate to monitor?
patient expressed satisfaction with the body appearance
a patient diagnosed with bipolar disorder becomes hyperactive after discontinuing lithium. the patient threatens to hit another patient. which comment by the nurse is appropriate?
do not hit anyone. if you are unable to control yourself, we will help you
a patient comes to the mental health clinic with insomnia, irritability, increased tension, and headaches. the symptoms began 1 week ago after the patient was laid off from work. the patient expresses concern that this will result in a relocation that will be hard on the entire family. the patient is most likely experiencing:
a situational crisis
an adults says to the nurse, "the cancer in my neck spread in only 2 months. i've been cursed my whole life. maybe if i had been more generous with others....." considering the stages of grief described by kubler-ross, which stage is evident?
bargaining
physical assessment of a patient diagnosed with bulimia often reveals:
prominent parotid glands
what precipitating emotional factor has been associated with an increased incidence of cancer?
feelings of hopelessness, despair from depression and prolonged intense stress
priority interventions for a patient diagnosed with major depressive disorder and feelings of worthlessness hould include
careful unobtrusive observation around the clock
substance abuse is often present in people diagnosed with bipolar disorder. the 28 year old patient drinks alcohol instead of her prescribed medications. the nurse caring for this patient recognizes
alcohol used as a form of self-medication for bipolar symptoms
(ALTERNATE) alcohol ingestion is a form of self-medication
which of the following statements about non-suicidal self-injury is incorrect?
patient who engage in NSSI are not necessarily suicidal, even when their injuries become life threatening (this is a correct answer not an incorrect one)
a patient is seen in the ER for cuts on both wrists that are minimal. patient paces and sobs but after few minutes, the patient is calmer. the nurse attempts to determine the patients perception of the precipitating event by asking
what was happening when you started feeling this way?
a team of nurses report to the community after a category 5 hurricane devastates many homes and businesses. the nurses provide emergency supplies of insulin to the persons with diabetes and help transfer patients in skilled nursing facilities to sites that have electrical power. which aspects of disaster management have theses nurses fulfilled?
response
mitigation
a nurse interacts with an outpatient who has a history of multiple suicide attempts. select the most helpful response for a nurse to make when the patient states, "i am considering committing suicide"
bringing up these feelings is very positive action on your part
a patient experiencing moderate anxiety says, "i feel undone" an appropriate response for the nurse would be
"im not sure i understand. give me an example"
a woman who is 5'7, 160lbs, and wears a size 8 shoe. she says, "my feet are huge. i've asked three orthopedists to surgically reduce my feet." this person tries to buy shoes to make her feet look smaller and, in social settings, conceals both feet under a table or chair. which health problem is likely
body dysmorphic disorder
serotonin syndrome is believed to be related to over activation of the central serotonin receptors. which of the following are true about serotonin syndrome?l
it is commonly associated with the use of tricyclic antidepressants
cyproheptadine is used as part of treatment
a patient with a new diagnosis of cancer says, "my father died of pancreatic cancer. i took care of him during his illness, so i know what is ahead for me" which nursing diagnosis applies?
anticipatory grieving
which actions by a nurse are most appropriate when caring for a hospice patient?
giving choices
offering interventions that convey respect
fostering personal control
supporting the patients spirituality
a patient diagnoses with anorexia nervosa is resistant to weight gain. what is the rationale for establishing a contract with a patient to participate in measures designed to produce a specific weekly weight gain?
patient involvement in decision making increases sense of control and promotes adherence to the plan of care
when counseling patients diagnosed with major depressive disorder an advanced practice nurse will address the negative thought patterns by using
cognitive behavioral therapy
a patient is experiencing psychomotor agitation associated with major depressive disorder. which observation would the nurse associate with the symptom? the patient
paces aimlessly around the room
a medical-surgical nurse works with a patient diagnosed with an illness anxiety disorder. care planning is facilitated by understanding that the patient will most likely (alternate somatic symptom disorder)
be resistant to accepting psychiatric help
in the current healthcare environment with constant advances in technology and dying has become more complex. this adds to difficult decision patients and loved ones face at the end of life. in the united states this is correlated with
it is our ethical duty to try as many treatments as available
patient with a somatic symptom disorder has the nursing diagnosis, "interrupted family processes related to patients disabling symptoms as evidenced by spouse and children assuming roles and tasks that previously belonged to patient" an appropriate outcome is that the patient will
demonstrate performance of former roles and tasks
the plan of care for a patient in the manic stage of bipolar disorder should include which interventions?
provide a structured environment for the patient
ensure that the patients nutritional needs are met
which medication should the nurse be prepared to educate patients on when they're prescribed a selective serotonin reuptake inhibitor for panic attacks
fluoxetine (prozac)
a patient was diagnosed with anorexia nervosa. the history shows the patient virtually stopped eating 5 months ago and lose 25% of body weight. the serum....? currently 2.7 mf/dl. which diagnosis applies?
imbalanced nutrition, less than body requirements related to reduced oral intake as evidenced by loss of 25% of body weight and hypokalemia
the columbia protocol, also known as the columbia-suicide severity rating scale, supports suicide risk assessment through a series of simple questions...which of the following is correct about the CSSRS?
ask whether and when they attempted suicide or began a suicide attempt that was either interrupted by another person or stopped of their own volition
includes actions they have taken and when to prepare for suicide
asks if they have had thoughts about suicide
an imbalance of certain transmitters are thought to disrupt specific brain regions that contribute to various anxiety disorders. these neurotransmitters are
serotonin, GABA, norepinephrine
(book states, epinephrine, norepinephrine, dopamine, serotonin and GABA)
which question would be a priority when assessing for symptoms of major depression?
you look really sad. have you ever thought of harming yourself