MENTAL HEALTH FINAL EXAM 2023-2024 ACTUAL EXAM TEST BANK 300 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |AGRADE

MENTAL HEALTH FINAL EXAM 2023-2024 ACTUAL EXAM

TEST BANK 300 QUESTIONS AND CORRECT DETAILED

ANSWERS WITH RATIONALES (VERIFIED ANSWERS)

|AGRADE

A nurse is assigned to work with a client with borderline personality disorder. The

nurse will need to consider strategies for dealing with the client's

A. mood shifts, impulsivity, and splitting.

B. grief, anger, and social isolation.

C. altered sensory perceptions and suspicion.

D. perfectionism and preoccupation with detail. - ANSWER- A. mood shifts,

impulsivity, and splitting.

Rationale: Borderline personality disorder has the central characteristic of

instability in affect, identity, and relationships. Borderline individuals desperately

seek relationships to avoid feeling abandoned. But they often drive others away

with excessive demands, impulsive behavior, or uncontrolled anger. Their frequent

use of the defense of splitting strains personal relationships and creates turmoil in

health care settings.

A client with histrionic personality disorder winks at an attractive nurse and states,

"You and I should be able to turn those resident physicians into jelly if you'd wear

your skirts about two inches shorter." The nurse's reply should be based on the

understanding that the client's use of seductive behavior is

A. a response to stress.

B. based on a need to dominate.

C. seated in primitive rage.

D. callous disregard for others. - ANSWER- A. a response to stress.

Rationale: The histrionic person is impulsive and melodramatic and may act

flirtatious or provocative to get the spotlight in an attempt to reduce stress

When administering a mental status examination to a patient with delirium, the

nurse should

a. wait until the patient is well-rested.

b. administer an anxiolytic medication.

c. choose a place without distracting stimuli.

d. reorient the patient during the examination. - ANSWER- ANS: C-choose a place

without distracting stimuli.

Rationale: Because overstimulation by environmental factors can distract the

patient from the task of answering the nurse's questions, these stimuli should be

avoided. The nurse will not wait to give the examination because action to correct

the delirium should occur as soon as possible. Reorienting the patient is not

appropriate during the examination. Antianxiety medications may increase the

patient's delirium.

The nurse is administering a mental status examination to a 48-year-old patient

who has hypertension. The nurse suspects depression when the patient responds to

the nurse's questions with

a. "Is that right?"

b. "I don't know."

c. "Wait, let me think about that."

d. "Who are those people over there?" - ANSWER- ANS: B-"I don't know."

Rationale: Answers such as "I don't know" are more typical of depression than

dementia. The response "Who are those people over there?" is more typical of the

distraction seen in a patient with delirium. The remaining two answers are more

typical of a patient with mild to moderate dementia.

Which action will help the nurse determine whether a new patient's confusion is

caused by dementia or delirium?

a. Administer the Mini-Mental Status Exam.

b. Use the Confusion Assessment Method tool.

c. Determine whether there is a family history of dementia.

d. Obtain a list of the medications that the patient usually takes. - ANSWER- ANS:

B

Rationale: The Confusion Assessment Method tool has been extensively tested in

assessing delirium.

Education for the client who is taking MAOI's should include which of the

following?

A. Fluid and sodium replacement when appropriate, frequent drug blood levels,

signs and symptoms of toxicity.

B. Lifetime of continuous use, possible tardive dyskinesia, advantages of an

injection every 2 to 4 weeks.

C. Short-term use, possible tolerance to beneficial effects, careful tapering of the

drug at the end of treatment.

D. Tyramine-restricted diet, prohibitive concurrent use of over-the-counter

medications without physician notification. - ANSWER- D

Rationale: Tyramine can cause episodes of hypertensive crisis. Foods that contain

tyramine include:aged cheeses, raisins, fava beans, red wines, smoked and

processed meats, chicken of beef liver, soy sauce, meat tenderizer, chocolate.

There is a lot of medication interactions that occur with MAOI's so it is important

to consult your physician before taking any OTC meds.

In teaching a client about his antidepressant medication, fluoxetine, which of the

following would the nurse include? (Select ALL that apply)

A. Don't eat chocolate while taking this medication.

B. Keep taking this medication, even if you don't feel it is helping. It sometimes

take a while to take effect.

C. Don't take this medication with the migraine drugs "triptans".

D. Go to the lab each week to have your blood drawn for therapeutic levels of this

drug.

E. This drug causes a high degree of sedation, so take it just before bedtime. -

ANSWER- B, C

Rationale: A - chocolate is not something you would want your client to eat while

taking an MAOI

B - Antidepressants can take a few weeks before affects are felt.

C - serotonin syndrome may occur with concomitant use of SSRI fluoxetine and

"triptans"

D -

E - SSRI's can cause insomnia so it is important to take the dose early in the day.

A client with depression has just been prescribed the antidepressant phenelizine

(Nardil). She says to the nurse, " The doctor says I will need to watch my diet

while I'm on this medication. What foods should I avoid?" Which of the following

is the correct response by the nurse?

A. blue cheese, red wine, raisins