Question 1 A patient with a history of cocaine use reports a concurrent history of using other drugs in order to counteract the effects of cocaine. Which drug is this patient likely to have abused? Selecte d Answer : Alcohol Answers: PCP Alcoh ol Methylphen i date Caffeine Respons e Feedbac k: Alcohol is a depressant which can neutralize the effects of cocaine, which is a stimulant. Caffeine, methylphenidate (used to treat ADHD) and the illegal drug PCP are also stimulating and would only exacerbate the effects of cocaine. • Question 2 A patient is admitted with a heart rate of 53 bpm, respirations 6/min, temp 96.8 and pinpoint pupils. Based on these clinical manifestations, what substance did this patient most likely overdose on? Selecte d Answer : Marijuana Answers: Opioids Alcohol Marijuan a Amphetam ine Respons e Feedbac k: Opioids include prescribed medications such as oxycodone and morphine, and the illegal substance heroin. The above symptoms are typical of opioid overdose, but are not typically seen with marijuana, alcohol or amphetamines. • Question 3 An elderly client with cognitive impairment is combative and pulled out a nasogastric tube, intravenous line, and indwelling urinary catheter. What can the nurse anticipate that the health care provider will most likely prescribe? Selected Answer: A a selective serotonin reuptake inhibitor s m a l l d o s e o f NUR2488 Mental Health Nursing Exam 3 Answers: A small dose of a selective serotonin reuptake inhibitor A large dose of a benzodiazepine A maintenance dose of buspirone A small dose of an atypical antipsychotic Respons e Feedbac k : Aggressive behavior can be safely managed by antipsychotic medication. Initial dosing should be small and raised cautiously until behavior is controlled. Selective serotonin reuptake inhibitors are not indicated for aggressive behavior. If a benzodiazepine is used, the initial dose should be low. Buspirone is not effective if given on an as-needed basis. It is administered in small divided doses daily to control agitation. • Question 4 A nursing care plan contains the intervention “monitor for complications of refeeding syndrome.” Which body system should a nurse most closely monitor for clinical manifestations of dysfunction? Selecte d Answer : Centra l nervou s Answers: Renal Centra l nervou s Endocrine Cardiovasc u lar Respons e Feedbac k: Refeeding resulting in too-rapid weight gain can overwhelm the heart, resulting in cardiovascular collapse; thus focused assessment becomes a necessity to ensure patient physiological integrity. The other body systems are not initially involved in the refeeding syndrome. • Question 5 Which of the following is the best example of all-or-nothing thinking, a common cognitive distortion of patients with an eating disorder? Selected Answer