The nurse describes a client as anxious. Which of the following statement about anxiety is true?
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Solution
Anxiety is a response to a threat
Option D: Anxiety is a response to a threat arising from internal or external stimuli.
A client with depression has been hospitalized for treatment after taking a leave of absence from work. The client’s employer expects the client to return to work following inpatient treatment. The client tells the nurse, “I’m no good. I’m a failure”. According to cognitive theory, these statements reflect:
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Solution
Faulty thought processes that govern behavior
Option C: The client is demonstrating faulty thought processes that are negative and that govern his behavior in his work situation – issues that are typically examined using a cognitive theory approach.
Option A: Issues involving learned behavior are best explored through behavior theory, not cognitive theory.
Option B: Issues involving ego development are the focus of psychoanalytic theory.
Option D: This is incorrect because there is no evidence in this situation that the client has conflictual relationships in the work environment.
A nurse who explains that a client’s psychotic behavior is unconsciously motivated understands that the client’s disordered behavior arises from which of the following?
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Solution
Internal needs
Option C: The concept that behavior is motivated and has meaning comes from the psychodynamic framework. According to this perspective, behavior arises from internal wishes or needs. Much of what motivates behavior comes from the unconscious.
Options A, B, and D: The remaining responses do not address the internal forces thought to motivate behavior.
A client with depressive symptoms is given prescribed medications and talks with his therapist about his belief that he is worthless and unable to cope with life. Psychiatric care in this treatment plan is based on which framework?
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Solution
Cognitive framework
Option B: Cognitive thinking therapy focuses on the client’s misperceptions about self, others and the world that impact functioning and contribute to symptoms. Using medications to alter neurotransmitter activity is a psychobiologic approach to treatment.
Options A, C, and D: The other answer choices are frameworks for care, but hey are not applicable to this situation.
Which of the following best explains why tricyclic antidepressants are used with caution in elderly patients?
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Solution
Cardiovascular system effects
Option B: The TCAs affect norepinephrine as well as other neurotransmitters, and thus have significant cardiovascular side effects. Therefore, they are used with caution in elderly clients who may have increased risk factors for cardiac problems because of their age and other medical conditions.
Options A, C, and D: The remaining side effects would apply to any client taking a TCA and are not particular to an elderly person.
The nurse understands that the therapeutic effects of typical antipsychotic medications are associated with which neurotransmitter change?
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Solution
Decreased dopamine level
Option A: Excess dopamine is thought to be the chemical cause for psychotic thinking. The typical antipsychotics act to block dopamine receptors and therefore decrease the amount of neurotransmitter at the synapses.
Options B, C, and D: The typical antipsychotics do not increase acetylcholine, stabilize serotonin, stimulate GABA.
A client refuses to remain on psychotropic medications after discharge from an inpatient psychiatric unit. Which information should the community health nurse assess first during the initial follow-up with this client?
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Solution
Reason for refusal to take medications
Option D: The first are for assessment would be the client’s reason for refusing medication. The client may not understand the purpose for the medication, may be experiencing distressing side effects, or may be concerned about the cost of medicine. In any case, the nurse cannot provide appropriate intervention before assessing the client’s problem with the medication.
Options A and B: The patient’s income level, living arrangements, and involvement of family and support systems are relevant issues following determination of the client’s reason for refusing medication.
Option C: The nurse providing follow-up care would have access to the client’s medical record and should already know the reason for inpatient admission.
Important teaching for women in their childbearing years who are receiving antipsychotic medications includes which of the following?
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Solution
Continuing previous use of contraception during periods of amenorrhea
Option C: Women may experience amenorrhea, which is reversible while taking antipsychotics. Amenorrhea doesn’t indicate cessation of ovulation thus, the client can still be pregnant.
Discharge instructions for a male client receiving tricyclic antidepressants include which of the following information?
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Solution
Don’t consume alcohol
Option B: Drinking alcohol can potentiate the sedating action of tricyclic antidepressants. Dry mouth and blurred vision are normal adverse effects of tricyclic antidepressants.
Nurse Fred is assessing a client who has just been admitted to the ER department. Which signs would suggest an overdose of an antianxiety agent?
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Solution
Emotional lability, euphoria, and impaired memory
Option D: Signs of anxiety agent overdose include emotional lability, euphoria, and impaired memory.