Question 1

A client is taking fluoxetine (Prozac) and wonders if adding St. John's wort would help. Knowing that St. John's wort acts similar to selective serotonin reuptake inhibitors (SSRIs), you are concerned that by taking both your client may develop:

Accepted Answer

St. John's wort acts similar to SSRIs by increasing serotonin levels in the brain. Taking both Prozac and St. John's wort together can lead to a dangerous condition called serotonin syndrome, which can cause symptoms such as agitation, confusion, rapid heart rate, high blood pressure, and dilated pupils. Therefore, it is not recommended to combine these two medications without consulting a healthcare professional.

Question 2

Which statement would have the best potential to obtain assessment data from a client about possible use of complementary and alternative practices or products?

Accepted Answer

This open-ended question encourages the client to discuss all health-related practices, including complementary and alternative methods, without feeling restricted to only prescribed medications.

Question 3

A client who has hallucinations is no longer benefiting from medication. The client's wife has heard that repetitive transcranial magnetic stimulation (rTMS) might be helpful. The nurse knows that rTMS may be promising for this client because it:

Accepted Answer

Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive procedure that does not cause pain and does not require anesthesia, making it a promising option for clients who are not benefiting from medication. Unlike ECT, rTMS does not involve electrical currents to induce seizures and is considered less invasive.

Question 4

There are a variety of techniques available to clients, their families, as well as healthcare professionals that serve to alleviate muscle tension, anxiety, fatigue, headaches, and more. The technique that is specifically identified as adjunctive treatment for sinus headaches is:

Accepted Answer

Alternate-nostril breathing has been shown to alleviate sinus headaches by increasing airflow and oxygenation to the sinuses. It can also reduce anxiety and promote relaxation. Guided imagery and passive progressive relaxation may help alleviate muscle tension and anxiety but have not been specifically identified as effective for sinus headaches. Tai chi may help with overall relaxation and stress reduction but has not been specifically identified as effective for sinus headaches either.

Question 5

The nurse is caring for an older client with depression who has begun having trouble sleeping. In addition to antidepressants, a safe, nonpharmacologic and potentially effective adjunctive treatment for insomnia in persons with a diagnosis of depression is:

Accepted Answer

Progressive relaxation has been shown to be effective in reducing symptoms of insomnia in individuals with depression. Medical meditation and alternate-nostril breathing may also be helpful, but may not be appropriate for all individuals. Watching TV before bed can actually worsen sleep quality.

Question 6

Which of the following reflects the concepts of crisis intervention?

Accepted Answer

The answer of Which of the following reflects the concepts...

Question 7

Which of the following are risk factors that may continue to promote disequilibrium?

Accepted Answer

Poverty, abuse, and pre-existing psychiatric disorders are all risk factors that can contribute to ongoing disequilibrium. Coping skills and strong self-esteem can help mitigate these factors, but they are not risk factors themselves. Sudden experiences and communication with others can be both positive and negative influences and do not necessarily contribute to ongoing disequilibrium.

Question 8

The caregiving team may also need support to process traumatic events in the community or in the care setting. Critical Incident Stress Debriefing (CISD) is a model of effective group crisis intervention. This group intervention:
Select all that apply.

Accepted Answer

The answer of The caregiving team may also need support...

Question 9

Which of the following statements by a client would reflect a turning point?

Accepted Answer

Option D shows personal growth and reflection, indicating that the client has overcome a challenge and developed new skills. This statement can be considered a turning point in the client's perspective and behavior. The other options show blame or acceptance of negative circumstances without a desire for change or growth.

Question 10

A client describes being depressed, out of control, and unable to make decisions. Upon assessment, the nurse determines that the client has recently experienced a fire at home in which many important files as well as family mementos were destroyed. Many things that were not totally burned were water damaged. The nurse knows that identifying the origin of the crisis:

Accepted Answer

Identifying the origin of the crisis can help the nurse understand the client's situational stressors and develop interventions specific to the client's needs, increasing the likelihood of effectiveness.

Question 11

Identify which of the following would be detrimental for the nurse desiring to manage stress when working with a client/family in crisis.

Accepted Answer

Maintaining a consistent work assignment might limit exposure to varied situations and reduce the ability to adapt to different stressors, potentially increasing stress in dynamic or crisis situations. It could lead to burnout due to monotony or lack of challenge.

Question 12

A new nurse is being oriented to work on the psychiatric unit. Which of the following statements reflect general principles for maintaining unit safety?
Select all that apply.

Accepted Answer

The answer of A new nurse is being oriented to...

Question 13

Staff have made several verbal attempts to de-escalate a client, however, the client's level of agitation continues to increase and it becomes necessary to administer a fast-acting pharmacological intervention. Which medication would the nurse most likely provide?

Accepted Answer

Haloperidol (Haldol) is a fast-acting antipsychotic medication commonly used to quickly reduce agitation and aggression in clients. Amitriptyline (Elavil) is a tricyclic antidepressant and not typically used for acute agitation. Methylphenidate (Ritalin) is a stimulant medication used for attention deficit hyperactivity disorder (ADHD) and would not be appropriate for aggressive or agitated behavior. Lithium carbonate (Lithobid) is a mood stabilizer used for bipolar disorder and would not be fast-acting enough for immediate intervention in an escalating situation.

Question 14

A client is being admitted to the inpatient psychiatric unit. Which actions would be appropriate for the nurse to assess the client's risk of violence?
Select all that apply.

Accepted Answer

Reviewing past records and obtaining information from the family can provide insights into the client's history and potential risk factors. Asking direct questions about past violent behavior can help assess the client's risk of violence.

Question 15

A client who is a construction supervisor has a history of becoming violent when the client's workers do not complete their work within the established deadline. Police have been called to the worksite multiple times for behaviors including loud shouting and destruction of property. The most appropriate expected outcome related to resolving this problem would be for the client to:

Accepted Answer

The most appropriate expected outcome for this client would be for them to identify alternative methods for expressing anger. This would address the underlying issue of the client's violent behavior by providing them with more constructive ways to handle their anger and frustration. The other options (A, C, and D) are also important outcomes to work towards, but they do not specifically address the issue of the client's violent behaviors at work.

Question 16

An inpatient psychiatric unit has been operating at an unusually high acuity level over the past week resulting in numerous incidents of seclusion or restraint. A review of each violent event reveals that appropriate crisis management strategies were implemented and unit policy followed. What action is most appropriate?

Accepted Answer

The answer of An inpatient psychiatric unit has been operating...

Question 17

Which of the following is part of the ongoing nursing assessments of the client on psychiatric medications?
Select all that apply.

Accepted Answer

Ongoing nursing assessments of clients taking psychiatric medications should include monitoring for side effects, evaluating the effectiveness of the medication in managing symptoms, assessing the client's cultural beliefs about illness and medication, and determining the client's readiness to learn about the medication and its management. Asking about the client's favorite activities is not directly related to the assessment of psychiatric medication.

Question 18

The client has been taking fluvoxamine (Luvox) for years, has been symptom-free for one year, and is now considering taking a drug holiday. What nursing teaching is necessary?

Accepted Answer

It is important to educate the client that abruptly stopping fluvoxamine can lead to discontinuation symptoms, including dizziness, nausea, headaches, and others. Therefore, a drug holiday should be avoided without discussing it with the prescribing healthcare provider. The healthcare provider will determine if the client can safely discontinue the medication, and if so, create a plan for gradually tapering off the medication to minimize potential withdrawal symptoms.

Question 19

There are several ways to encourage clients and their families to become educated consumers of CAM practices and products by gathering information about advantages, disadvantages, or risks related to CAM. Such information might be gained through:
Select all that apply.

Accepted Answer

The answer of There are several ways to encourage clients...

Question 20

A nurse is asked to provide a brief presentation comparing and contrasting the modalities within one category of complementary and alternative therapies, as identified by NCCAM. The nurse chooses to speak about Whole Medical Systems; therefore, the presentation would include:
Select all that apply.

Accepted Answer

Whole Medical Systems are distinct approaches to healthcare that have evolved separately from conventional Western medicine. They include Homeopathic medicine, Naturopathic medicine, Ayurveda, and Traditional Chinese medicine. Herbal products, while often used within these systems, are considered part of the "Biologically Based Practices" category rather than Whole Medical Systems themselves.

Quiz 4: Vulnerable Populations

A client is taking fluoxetine (Prozac) and wonders if adding St. John's wort would help. Knowing that St. John's wort acts similar to selective serotonin reuptake inhibitors (SSRIs) , you are concerned that by taking both your client may develop:

Which statement would have the best potential to obtain assessment data from a client about possible use of complementary and alternative practices or products?

A client who has hallucinations is no longer benefiting from medication. The client's wife has heard that repetitive transcranial magnetic stimulation (rTMS) might be helpful. The nurse knows that rTMS may be promising for this client because it:

There are a variety of techniques available to clients, their families, as well as healthcare professionals that serve to alleviate muscle tension, anxiety, fatigue, headaches, and more. The technique that is specifically identified as adjunctive treatment for sinus headaches is:

The nurse is caring for an older client with depression who has begun having trouble sleeping. In addition to antidepressants, a safe, nonpharmacologic and potentially effective adjunctive treatment for insomnia in persons with a diagnosis of depression is:

Which of the following reflects the concepts of crisis intervention?

Which of the following are risk factors that may continue to promote disequilibrium?

The caregiving team may also need support to process traumatic events in the community or in the care setting. Critical Incident Stress Debriefing (CISD) is a model of effective group crisis intervention. This group intervention: Select all that apply.

Which of the following statements by a client would reflect a turning point?

Identify which of the following would be detrimental for the nurse desiring to manage stress when working with a client/family in crisis.

A new nurse is being oriented to work on the psychiatric unit. Which of the following statements reflect general principles for maintaining unit safety? Select all that apply.

Staff have made several verbal attempts to de-escalate a client, however, the client's level of agitation continues to increase and it becomes necessary to administer a fast-acting pharmacological intervention. Which medication would the nurse most likely provide?

A client is being admitted to the inpatient psychiatric unit. Which actions would be appropriate for the nurse to assess the client's risk of violence? Select all that apply.

Which of the following is part of the ongoing nursing assessments of the client on psychiatric medications? Select all that apply.

The client has been taking fluvoxamine (Luvox) for years, has been symptom-free for one year, and is now considering taking a drug holiday. What nursing teaching is necessary?

There are several ways to encourage clients and their families to become educated consumers of CAM practices and products by gathering information about advantages, disadvantages, or risks related to CAM. Such information might be gained through: Select all that apply.

A nurse is asked to provide a brief presentation comparing and contrasting the modalities within one category of complementary and alternative therapies, as identified by NCCAM. The nurse chooses to speak about Whole Medical Systems; therefore, the presentation would include: Select all that apply.