Deck 46: Care of Patients With Anxiety, mood, and Eating Disorders

Question 1

After having refused lunch and dinner because her "regular" chair was occupied at breakfast,the resident in a long-term care facility asks for a snack.The nurse should take this opportunity to sit down with the resident and say:

A)"You are hungry now. Is there something else you could have done besides refuse to eat?"
B)"Here is your snack. Maybe you won't be so quick to refuse meals the next time you don't get your way."
C)"Refusing meals is not the answer. You must eat."
D)"Why in the world did you leave the dining room without eating?"

Answer 1

"You are hungry now. Is there something else you could have done besides refuse to eat?"

Question 2

The night nurse finds a patient who broke both legs in a car accident 2 weeks ago awake and crying at 2:00 AM.When the nurse asks if she wants a sedative to sleep,the patient confesses that she relives the accident in her dreams and is fearful to go to sleep.The nurse recognizes signs of:

A)post-traumatic stress disorder (PTSD).
B)phobic disorder.
C)obsessive-compulsive disorder (OCD).
D)panic level of anxiety.

Answer 2

post-traumatic stress disorder (PTSD).

Question 3

Antidepressant therapy has been effective and the suicidal patient verbalizes that he feels better.The nurse is aware that at this time,the:

A)risk of self-harm increases.
B)patient gains insight to his previous desire for suicide.
C)suicidal precautions can be relaxed.
D)antidepressive medication doses can be reduced.

Answer 3

risk of self-harm increases.

Question 4

A patient who has been on lithium for 5 days walks up the hall singing loudly and gaily greets everyone he sees.He is a little unsteady in his walker.He asks for more ice water saying he is very thirsty and complaining of insomnia.The nurse would report the observation of:

A)manic behavior.
B)unsteady gait.
C)thirst.
D)insomnia.

Question 5

The nurse takes into consideration that when a depressed person presents herself as "sad" the term takes on the meaning of being:

A)fatigued and gloomy.
B)physically unclean.
C)hopeless and worthless.
D)suicidal.

Question 6

The nurse reminds the patient who has just been prescribed diazepam (Valium)to use it with caution as this drug can cause:

A)dependency.
B)urine retention.
C)severe dehydration.
D)hallucinations.

Question 7

The nurse clarifies that anxiety disorders differ from normal anxiety in that anxiety disorders:

A)develop into suicidal tendencies.
B)are seldom controlled.
C)interfere with effective functioning.
D)make maintenance of relationships impossible.

Question 8

A resident in a long-term care facility who has generalized anxiety disorder (GAD)enters the dining room on her walker and discovers that her regular place has been taken by a visitor.The resident becomes agitated and says,"I need my place so I can eat! I can't eat unless I am in my place!" The nurse's most effective intervention would be to say:

A)"Go sit with Mrs. Smith right now. There is no one else at her table now."
B)"We'll eat over here for lunch and at your regular place for supper."
C)"Don't be silly! That chair is no different from any other chair in the room."
D)"If you don't eat, you will be hungry."

Question 9

The patient suspected of having bulimia should be assessed for the classic behavior of this disorder,which is:

A)bingeing and purging.
B)refusal to eat.
C)excessive exercising.
D)hiding food to make it appear it was eaten.

Question 10

The nurse lists the signs and symptoms of a general anxiety disorder (GAD),which include: (Select all that apply.)

A)heart rate of over 100 beats/min.
B)restlessness.
C)urinary retention.
D)fatigue.
E)muscular tension.

Question 11

The nurse encourages the patient with generalized anxiety disorder (GAD)that buspirone (BuSpar)has the benefit of:

A)less time to reach therapeutic level.
B)decreased risk of dependence.
C)increased sedation.
D)inhibiting serotonin reuptake.

Question 12

A resident in the long-term care facility has been in a manic stage for 2 days.He has not slept and cannot focus long enough to eat a meal.The nurse can enhance his nutrition by:

A)insisting he sit down and eat at the table at regular mealtimes.
B)spoon-feeding him at the table at regular mealtimes.
C)handing him small glasses of high-protein drinks every hour.
D)making up a game about who can finish a meal first.

Question 13

The nurse is aware that chlorpromazine (Thorazine)is given along with lithium carbonate because:

A)lithium takes up to 2 weeks to reach therapeutic level.
B)Thorazine reduces the threat of lithium toxicity.
C)Thorazine lowers blood pressure.
D)Thorazine synergizes the lithium.

Question 14

An older adult resident in a long-term care facility has come to the desk for the fourth time in an hour with various minor complaints.He continues to wander about aimlessly.The nurse examines the patient's chart and finds the newly prescribed drug that may explain his anxious behavior,which would be:

A)Tylenol 32 mg PO every 4 hours for pain.
B)theophylline 100 mg bid for asthma.
C)bisacodyl tabs 2 prn for constipation.
D)lisinopril 10 mg bid for hypertension.

Question 15

The depressed patient who has been taking amitriptyline (Elavil)for the past 2 weeks complains of still feeling depressed and wants to abandon the drug.The nurse's most helpful response would be:

A)"All drugs don't work for all people. I will talk to the physician about a new order for a different drug."
B)"You probably should quit taking Elavil if it is not helping you."
C)"Sometimes drinking a small glass of wine with meals helps."
D)"These drugs take several weeks to become effective."

Question 16

While the nurse is helping the dialysis patient dress to go to her dialysis treatment,the patient bursts into tears and says,"I can't go! I can't stand another day in that awful place.I will die if I have to go!" The nurse's best intervention would be to:

A)stop the dressing process, sit down, and calmly ask, "Let's talk about how you are feeling."
B)continue to dress the patient and say, "You'll feel better after you have had your dialysis treatment."
C)stop the dressing process and ask, "Are you aware that you can get sicker if you don't go?"
D)continue dressing the patient and say, "We'll have to hurry if you are to eat breakfast before you go."

Question 17

The nurse is aware that unless effective intervention occurs for demonstrated anxiety disorders,the anxiety will:

A)be self-limiting.
B)force the person to seek medical intervention.
C)develop into a full-blown psychosis.
D)return at a greater level of severity.

Question 18

The nurse is aware that the basic drive behind the patient's anorexia nervosa is to:

A)be sexually desirable by staying slender.
B)be involved with preparation of food, but not eating it.
C)punish self by denial of adequate nutrition.
D)gain a sense of control by limiting food intake.

Question 19

The nurse observes a coworker who is always behind because he checks and rechecks the accuracy of his medication dosages.Even after being reassured his dosages are correct,he checks them again.The nurse suspects her coworker to be suffering from:

A)perfectionism.
B)phobic disorder.
C)obsessive-compulsive disorder (OCD).
D)general anxiety disorder.

Question 20

The nurse is caring for a patient admitted with a diagnosis of serotonin syndrome.Which will most likely be included in the plan of treatment?

A)Antihypertensive medications
B)Intravenous therapy
C)Large doses of antianxiety medications
D)Sedatives

Question 21

The nurse assesses the patient for the signs and symptoms that characterize a major depressive disorder,which are: (Select all that apply.)

A)euphoria.
B)psychomotor retardation.
C)indecisiveness.
D)sleep disturbances.
E)suicidal ideation.

Question 22

The nurse outlines the treatment for a person with anxiety disorders,which include: (Select all that apply.)

A)anxiolytic medication.
B)education about disorder.
C)individual therapy.
D)relaxation techniques.
E)stress management.
F)None of the above.

Question 23

The nurse points out that a persistent irrational fear of a specific object or situation that causes anxiety that interferes with responsibilities is a(n)_________.

Question 24

The nurse takes into consideration that it is estimated that _____% of the population will have some form of anxiety disorder.

Question 25

The nurse assesses data about a depressed patient that increase the probability of his being suicidal,which are: (Select all that apply.)

A)owning a gun collection.
B)living with wife and three children.
C)being an active member of the local church.
D)having a plan to shoot himself in a motel.
E)having a brother that recently committed suicide.

Question 26

The nurse reviews the nursing considerations related to the administration of lithium,which include: (Select all that apply.)

A)drug should be taken on an empty stomach.
B)fluids should be restricted to 1000 mL daily.
C)ensure frequent blood levels are drawn.
D)encourage contraception to avoid pregnancy while on drug.
E)avoid caffeine.

Question 27

A patient is considering having electroconvulsive therapy to treat his severe depression.Which statements indicate the patient has an understanding of the procedure? (Select all that apply.)

A)"My treatment plan will include treatments once every other month."
B)"The shock will cause me to have a short seizure."
C)"This treatment is often more successful than medications."
D)"I will have to be hospitalized the day before and after the treatments for observation."
E)"The treatments will be performed in the early morning hours."

Question 28

The nurse is reviewing the medical history of a patient who is being evaluated for anorexia nervosa.Which characteristic(s)would be consistent with the condition? (Select all that apply.)

A)Loss of 2 to 3 pounds in the past month
B)Binge eating
C)Frequent mood changes
D)Absence of three consecutive menstrual periods
E)Body weight less than 85% of what is expected for height and weight