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170 Cards in this Set

  • Front
  • Back
Symptom most likely present in a preschooler who is depressed?
social withdrawl
A patient with depression is sudedenly happy, and active on the unit, what is the nurses response to this behavior?
Reassess for suicial potential

The pt is exhibiting warning s/s of potential suicide therefore needs to be reassessed
It is most important to evaluate a pt who is manic in which area?
nutritional status

*if the pt is dehydrated or malnourished, along with poor judgement the pt will be at risk for injury.
Proper teaching to parents of a school age child with ADHD, who is recieving CNS stimulant?
give medication early in the day
At which age will a child with autism show signs of the disease?
as early as 4 months;

but definitivley diagnised by age 3
low levels of seratonin are associated with_____________?
which diagnostic tool is used to determine structural and biochemical abnormaities associated with mental illness?

*Positron Emission Tomography
A pt admitted with Bipolar begins to sing and dance during a group meeting, the best nurses response is too?
take patient to a quieter location

*pt requires assistance to provide external controls on destructive behavior and to maintain saftey
what synptoms woud the nurse expect to find in a pt with neuroleptic malignant syndrome?
high fever and muscle ridgidity; which are s/s of a potential fatal side effect of antipshychotic meds
Tegretol dosage should be maintained at a blood serum level of__________?
6-8 mg/L
A person with borderline personality would most likely engage in self-destructive behavior if faced with what stressor?
Rejection or threat of separation
Which nursing measure is most important for a pt who is experiencing acute phase of mania?
Preventing physical exhaustion would be priority.
What info is given to an outpatient prior to recieving ECT (electroconvulsive therapy)
You make feel groggy and confused upon awakening.
Regular engagment in what activity will most likely lower the anxiety of a person dealing with chronic acute anxiety?
Regular physical exercise
What Symptom is associated with PTSD?
persistant feelings of detachment from others
a nearly continuous flow of rapid speech that jumps from topic to topic, usually based on discernible associations, distractions, or plays on words, but in severe cases so rapid as to be disorganized and incoherent. It is most commonly seen in manic episodes but may also occur in other mental disorders such as in manic phases of schizophrenia
Flight of Ideas
A thought or communication pattern disorder characterized by loose or odd connections between ideas. A person having this disorder is unable to express a set of well-structured, logically related ideas. In effect, the person expresses a rather diffuse, vague, confusing, and without clear logic and connections between one idea to the next.


For example: I like to dance; all people have hands.
Loose associations
During a family therapy session, which statment is the nurse most likley to hear onr family member to the other if the family boundries are enmeshed?
"you should of known what i really meant when i said that"

The best candidate for short-term dynamic pshycho-therapy would be?
pt suffering from PTSD

* best option for pt who is relitivley well functioning who has a specific area of difficulty
What is most imortant to consider when makeing a care plan for a person with unresolved anger?
"when anger is turned inward, it may turn into depression"
True or False

Imbalanced nutrition is priority for a person suffering from major depression
A patient taking Litium may need to be monitored for?
-N/V-dehydration may rise lithium levels causing toxicity
-Monitor NA levels; low NA intake casues lithium retention causing toxicity
-Monthly Lithium Levels
-Avoid OTC
A behavior that indicates impaired impulse control?
An adult rapildy loses temper when traffic signal turns yellow.
Somatization disorder
is a long-term (chronic) condition in which a person has physical symptoms that are caused by psychological problems, and no physical problem can be found.
Social isolation and loss in interest in usual activities in a teenager may be a sign of___________?
Suicidal thoughts
Antipshycotic med used to treat the positive signs of schitzophrenia, such as dilusions, hallucinations, disordered thinking and paranoia?
Antipshycotic meds used to treat the negative signs of schitzophrenia, such as flat affect, social withdrawl, lack of motivation ?
Olanzapine, Risperidone or Clozapine
Setting limits with a pt who is manipulative, benefits the pt in which way?
gaining self-empowerment in relationships with others
A pt admitted for substance abuse treatment says, " I am only here to save my marriage, i can stop anytime i want" would most likely have what nursing diagnosis?
ineffeective denial
Most appropriate outcome for a person suffering from depersonalization disorder who has a nursing diagnosis of social isolation?
the pt will express satisfaction with interaction with others
Which action should be the focus of therapy for a nurse working with a family witha pt with anorexia nervousa?
improve communication among family members
A patient taking Lithium for 2 weeks, has a serum level of 1.2 mEq/L; what would be an expected behavior?
modulation of mood and ability to solve problems
Lithium maintenence levels
0.4 Meq/L -1.3 Meq/L
Which manifestations of an 18 month old are clinical manifestations of Autism?
preoccupation with objects, self stimulating behaviors, absence of attachment
______________-is the development of change of behavior, that is externally controlled, to behavior that is controlled by internal standards and principles
Which Nursing measure should be used to address the vegetative signs of depression?
monitor eating and sleeping
To date which disorder has the strongest evidence of genetic involvment?
During the nurses cognitive assessment the pt repeativley says "What is this why am i here? this is an example of what behavior?
Preservation- which involves repeated behavior esp. when stressed
What nursing measure should a nurse perform for a pt with ascites?
check abd girth daily
Uses of Pancrease:
Pancrease is used to treat pancreatic enzyme deficiency.
Pancrease is also used for people who have had all or part of their stomach surgically removed (gastrectomy)
It is also used for surgical removal of the pancreas (pancreatectomy).
For Cystic fibrosis.
What is the rationale for using Ideral (propranolol hydrochloride) in managment for a patient with cirrhosis of the liver
to prevent bleeding from esophageal varicies
Which clinical manifestation is most indicative of impending hepatic encephalopathy in a pt with liver failure?
diorientation is the most early sign
Which nursing intervention will most likely achieve the goal of improving respiratory function for a pt with acute pancreatitis?
Keep pt in Semi-Fowlers position to keep pressure of the diaghram; caused by distended stomach.
Which form of Vitamin A, D and E, should be administered to a pt suffereing from Steatorrhea?
water-soluble due to malabsorbtion
Which co-existing condition should a nurse recognize as a problem with a pt with acute pancreatitis?
pluerel effusion
While reviewing a patients orders, with pancreatitis, you come across an order for Demoral. your initial response should be to__________?
Seek clarification. Demerol causes CNS irritability and even SZ
Which type of medication should the nurse question in the order for a patient with end stage hepatic dysfunction?
Sedatives- precipitate hepatic encephalopathy, should be used sparingly
Which test provides the most information when diagnosing chronic pancreatitis?
ERCP (Endoscopic Retrograde Cholangiopancreatography
ERCP (Endoscopic Retrograde Cholangiopancreatography
-patient will be given sedative
-followed by oral insertion of scope into the GI tract
What is the rationale for incorparating massage into a patient suffering with impaired liver function?
to promote mobilization of edema
Warning signs of Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)?
Blood sugar level over 600 mg/dl
Dry, parched mouth
Extreme thirst (although this may gradually disappear)
Warm, dry skin that does not sweat
High fever (over 101 degrees Fahrenheit, for example)
Sleepiness or confusion
Loss of vision
Hallucinations (seeing or hearing things that are not there)
Weakness on one side of the body
If you have any of these symptoms, call someone on your health care team.
Approx. wht % of food should be Carbohydrates for a pt suffering from Diabetes Mellitus?
Pt is admitted with Dx of cirrhosis of the liver r/t ETOH abuse, presents with classis manifestation of the disease; the nurse should formulate what nursing dx for the patient?
fluid volume excess
A pt with hyperparathyroidism is encouraged to remain as physically active as possible to b/c decreased mobility may cause what problem?
Kidney involvement is a common threat in hyperpraythyroidism; this coupled with excessive Calcium Secretion and immobility put the patient at risk for Renal Calculi
What clinical manifestation may a nurse expect to find in a pt with decreased erythropoietin production secondary to end stage renal disease. (ESRD)
decreased erythropoietin production secondary to end stage renal disease would result in SOB
What is Pheochromocytoma ?
Pheochromocytoma is a rare tumor of the adrenal gland that causes too much release of epinephrine and norepinephrine -- hormones that regulate heart rate and blood pressure.

Abdominal pain
Chest pain
Increased appetite
Rapid heart rate
Severe headache
Weight loss
Other symptoms that can occur with this disease:

Hand tremor
High blood pressure
Sleeping difficulty
Following a thyroidectomy, it is most important for the nurse to ask the patient which question to assess for bleeding?
Ask about a feelingof fullness; this may lead to acute respiratory obstruction
What finding should the nurse expect to find in a pt with hyperparathyroidisn?
Fatigue is common due to Calcium build up in the bloodstream.
What finding should the nurse expect to find in a pt with Graves DX, (hyperthyroidism)
Nervousness is the most common problem associated with Graves
Caring for a pt with edema associated with nephrotic syndrome, the nurse must carefully monitor use of diuretics b/c?
reduced plasma volume may precipitate Acute renal failure
A patient with Renal calculi should be advised to __________ taking multi-vitamins and minerals?
stop; to prevent further sone formation
What is the expected effect of epoetin alfa in a pt with chonic renal failure?
Epoetin alfa is used to treat anemia in CRF pts therefore an increase in HCT should be expected.
(also called exophthalmia or proptosis) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease)
Older pts with hyperthyroidism commonly present with what clinical manifestation?
diffuse pruitis (itching) is common; in younger population with hyperthyroidism present with moist flushed skin
A pt with thyroid storm has a nursing dx of altered body temp; the nurse should give priority to what intervention?
apply hypothermia blanket
pt with adrenal insufficiency is dizzy,and experiencing neuromuscular irritability and confusion; the nurse should associate these findings with what laboratory finding?
What is the physiological effect of Thyroxine (T4)
-increase basal metabolic rate
-increase neuromuscular response
A patient with hypothyroidism is being taught about Synthroid, and asks how long will it take to have a full effect?
10 days
The nurse should monitor_______________ in a pt with hyperthyroidism taking Inderal?
pule and B/P
a pt with hypothyroidism is taking HRT (hormone replacement therapy) what health problem my they be at risk for?
Hyperglycemia-Thyroid hormones increase blood sugar levels
Thyroid Hormones effect on Potassium levels?
No effect
What is an appropriote expected outcome for a 5 y/o child who is autistic with a nursing dx of social isolation. The child will?
make attempts to offer toys to peers
Theraputic level of Lithium, a patient would feel, fine hand tremors and slight thirst and the serum lithium level would be?
0.4 Meq/L- 1.0Meq/L
Which charachteristic is most common in successful resolution of the grief response. The person who is grieving?
has a healthy self-esteem
Which disorder is associated with an excesse of neurotransmitter dopamine?
Which behavior is charachteristic of all types of personality disorders?
inflexible response to stress
What behavioral charachteristic would you see in a patient who is narccisistic?
Lack of empathy
What behavioral charachteristic would you see in a patient who is anti-social personality disorder?
Lack of Remorse
what is cognitive therapy?
Cognitive therapy seeks to help the patient overcome difficulties by identifying and changing dysfunctional thinking, behavior, and emotional responses
Sublimination is
transforming impulses into something constructive

*For example, a person experiencing extreme anger might take up kick boxing as a means of venting frustration
Displacement is
moving an impulse from one target object to another

*Rather than express our anger in ways that could lead to negative consequences (like arguing with our boss), we instead express our anger towards a person or object that poses no threat (such as our spouses, children, or pets).
Which child behavior who is emotionally disturbed is most indicitive of a severe problem?
unresponsive to the enviroment would be a severe behavior
What is the goal of family therapy as a component for treatment with a pt with schizophrenia?
Reduce familys stress level
A pt who has anorexia nervosa is likely to experience difficulty with which developmental achievment?
establishing individual autonomy
Which lab test does a nurse need to evaluate for apatient recieving Valproic Acid therapy for Bipolar disorder?
baseline liver functions should be tested
Which daignostic criterion is specific for anorexia nervosa, but not for bulemia nervosa?
Amennorhea can only occur with Aorexia Nervosa
What is the Primary focus of Cognitive Therapy?
Current problems
According to pshychodynamic theory, a person who places high value on self-control, is most likey going to experience which initial response when that control is threatened?
Which are vegetative signs of depression?
A set of signs in depression which includes loss of appetite, sleep disorder, loss of sexual drive, loss of weight, and constipation. May also indicate an eating disorder.
What is Conversion disorder ?
Conversion disorder is a condition in which a person has blindness, paralysis, or other nervous system (neurologic) symptoms that cannot be explained.

Symptoms of a conversion disorder include the loss of one or more bodily functions, such as:

Inability to speak
A patient recieving tricyclic antidepressants, the nurse should abserve for which side effect?
Orthostatic hypotension
The most important nursing intervention when a pt c/o hearing voices is to?
Ask the patient what the voices are saying to him

*this may give insight to any violence or harm, so precautions can be taken
Agnosia is?
Inability to recognize objects or people.
Reminiscence therapy is?
Reminiscence therapy is used to counsel and support older people, and is an intervention technique with brain-injured patients. This form of therapeutic intervention respects the life and experiences of the individual with the aim to help the patient maintain good mental health.
Delirium is?
Delirium involves a quick change between mental states (for example, from lethargy to agitation and back to lethargy).
Referral for homecare for a pt recovering from acute pancreatitis, what nursing interventtion would be priority to maintain?
maintian importance of fluid and nutritional intake
Dietary needs of a pt recovering from Pancreatitis?
Avoid Caffiene-b/c it increases pancreratic and gastric juices

-High Carb, low-Protien, Low Fat
Clay colored stool after choledochostomy is?
NO BUENO... may indicate complications
A pt with diabetes mellitus type I, is experiencing poor glycemic control, other than poor dietary managment, what else may be the cause?
Lypodystrophy-the localized reaction to the injections may cause scar tissue and impede absorption of the insulin
A patient with thrombocytopenia is at risk for?
bleeding and petechiae
A patient with diabetes mellitus is at risk for?
Precose is?
-a medication that should be take with first biteof every meal.

-delays absorbtion of glucose in the intestinal tract
Glucotrol(Glipizide), Micronase(Glybubride) and Dymelor(Acetohexamide) act by ?
directly stimulating Pancrease to excrete insulin
A patient with thrombocytopenia is at risk for?
bleeding and petechiae
A patient with diabetes mellitus is at risk for?
A pt displaying the clinical manifestations of cholecystitis should be questioned about the recent ingestion of what medication?
Erythromycin Estolate(Ilosone)-the most common side effect of this drug mimics cholecystiys
A patient with pancreatic dysfucntion may exhibit?
A baseline nursing assessment of a pt recieving Pancrease is to see if ?
pt is experienceing pain with food
A patient experiencing symptoms of hepatic encephelopathy is given lactulose to reduce which component?
What causes pruritis in patients with cirrhosis of the liver?
retention of bile salts
Which vital sign is monitored closely in a patient recieving epotein alfa (Epogen) for the treatment of anemia associated with CRF?
B/P; Epogen may cause hypertension early in treatment
What laboratory findings support the nursing diagnosis of fluid volume deficit in a pt with diabetes insipidus?
increase serum sodium- due to it not being excreted in urine, DI patients excrete high volumes of uring with little mineral content
Gigantism is ?
over-secreation of a growth hormone during childhood
Whty is it important to gradually introduce thyroid supplements to an older adult patinet who has hypothyroidism?
this is necessary to avoid caridiac and neurogenic problems
A masklike face is a charachteristic of?
Sever hypothyroidism-
The most serious is called Hashimoto's
What nursing intervention is priority with patient with pheochromocytoma?
HA, Daiphoresis and palpitations are common with this DZ, so Vitals signs monitoring should be Priority
Prepare a room for partial thyroidectomy, supplies should include?
Tracheostomy tray, Suction, IV calcium gluconate
What statment by the pt describes clinical manifestations of Addison?
lightheadedness-due to hypotension
What manifestations of Cushings?
severe fatigue
weak muscles
high blood pressure
high blood glucose
increased thirst and urination
irritability, anxiety, or depression
a fatty hump between the shoulders
facial hair
A patient with Graves Dz, may need what kind of diet?
High Protien, High Calorie-due to increase metabolic rate and increase peristalisis
mental status of a patient suffering from Cushings?
emotional lability-a condition of excessive emotional reactions and frequent mood changes(also found in
A patient recieveing hemodialysis in an outpt clinic, what problem must the nurse identify related to this procedure?
Leg Cramps-due to rapid fluid and electrolyte loss from extracellular space
A pt with renal failure is given aluminum hydroxide gel (Amphojel) after meals and at HS, the nurse would expect which effect from this therapy. Management of?
Polycystic Kindey Dz?
-chronic condition with no specific tx.
-common inherited disorder
-worsens with age
-heating pad to abd or flank is appropriate
what factor contributes to DM in pts with Cushings?
Excessive cortisol causes increase glucogenesis
decrease eryhtropoietin production in End Stage Renal Disease (ESRD, what is priority nursing dx?
activity intolerance r/t fatigue-

*decrease eryhtropoietin production in ESRD causes waste products to accumulate in the blood causing fatigue
An evaluation of a patient’s life stresses might include which of the following tools? (
Social Readjustment Rating Scale
Which of the following is a true statement?

Antisocial behaviors are more common in women than in men
Men are more prone to gallbladder disease than are women.
Women are more prone to thyroid disease than are men.
Type I diabetes only occurs prior to age thirty.
Women are more prone to thyroid disease than are men
Which of the following patients might benefit the most from a highly structured environment with familiar objects
An older adult with dementia of the Alzheimer’s type
All of the following are characteristic of Alzheimer’s dementia except?

catastrophic reactions.
periods of plateaus.
periods of plateaus.
Teaching for a patient who is taking tricyclic antidepressants might include
information about alcohol-antidepressant interactions.
In the morning, a patient who is taking zolpidem tartrate (Ambien) tells the nurse that he is more tired than ever. What might be the rationale for his statement?
Deprivation of rapid eye movement (REM) sleep results in abnormal sleep patterns
Which of the following vitamins might be given to a patient with Alzheimer’s dementia
Vitamin E
The endocrine gland primarily involved in calcium regulation is the
A patient is admitted to the hospital with a diagnosis of pheochromocytoma. This is related to hypersecretion of which of the following hormones
Epinephrine and norepinephrine
Which of the following should a patient avoid prior to diagnostic testing for catecholamines?
Aspirin, cough medicine, and coffee
Which of the following sets of symptoms is indicative of thyrotoxicosis?
Twitching and tingling of the extremities following thyroidectomy is indicative of which of the following?
If a patient who is on dialysis suddenly experiences chest pain and a drop in blood pressure, what should the nurse do?
Turn the patient to his or her left side and lower the head of the bed
If a patient who is on dialysis suddenly experiences chest pain and a drop in blood pressure, what should the nurse do?
Turn the patient to his or her left side and lower the head of the bed
Which of the following is a gastrointestinal symptom associated with cirrhosis?

Clay-colored stools
Weight gain
A nurse might observe which of the following symptoms in a patient with advanced portal-systemic encephalopathy?
asterixis-flapping tremor
All of the following are diagnostic symptoms of diabetes mellitus except?

increased urinary output
increased thirst.
weight loss.
A patient is taking Ultralente insulin. When would the nurse want to be especially careful to observe the patient?
In the middle of the night
What percent is considered normal carbohydrate intake for an adult diabetic diet?
60 percent
If a patient is passing uric acid stones, what type of diet is recommended?
Alkaline-ash diet
The sequential acquisition of physical, mental, and social skills is called:
the developmental process
A nurse who is interested in applying Caplan’s theory to behavior management would focus on:
preventative strategies to help patients cope with anxiety
A nurse who is caring for a patient with a cyclothymic affective disorder knows that cyclothymia differs from true bipolar disorder in which of the following ways?
Hypomania is a primary characteristic of cyclothymia.
What type of reassurance might patients who are experiencing a severe panic attack most need from the nurse?
Reassurance that they are not having a heart attack
A person who has developed alters may have done so for which of the following reasons?
As a means of dealing with anxiety
The symptoms of which of the following types of dementia can be treated with medication that may prevent additional pathological changes in the brain?
Multi-infarct dementia
Which of the following nursing diagnoses would be most appropriate for a patient with Huntington’s chorea?
Body image disturbance
A patient who is exhibiting negative symptoms of psychosis might benefit most from which of the following medications?
A patient is taking cyproheptadine hydrochloride (Periactin) to treat depression. The nurse knows that the patient’s depression is probably related to
A patient who is about to be discharged is given a prescription for phenelzine sulfate (Nardil). Patient teaching should include information about avoiding which of the following foods and/or beverages?
Aged cheese, chocolate, bananas, and soy sauce
A nurse who is assisting a physician with electroconvulsive therapy (ECT) knows that succinylcholine (Anectine) may be ordered. The purpose of this medication is to:
relax the muscles
Which of the following symptoms are associated with pheochromocytoma?
Hypertension and headache
A patient with malignant hypertension might initially be treated with:
sodium nitroprusside (Nipride)
Which of the following might be a nursing diagnosis appropriate to a patient with Cushing’s syndrome?
Disturbance in body image
The nurse is assigning a room to a nursing home resident with Addison’s disease. Who would be the best roommate for this resident?
A bed-bound resident with a fractured hip
Which of the following symptoms of chronic renal failure is related to a buildup of urate crystals in the joints?
A patient with oxalate stones should avoid which of the following foods?
Tea, chocolate, spinach, strawberries, and nuts
Metabolism of what substance produces ketones?
A patient is suspected of having cholecystitis. What actions might be most helpful for confirming the diagnosis?
Questioning the patient about his recent dietary intake
Which of the following would the nurse expect to see in a patient with chronic cirrhosis?
Elevated AST and ALT
For what purpose would the nurse give a patient lactulose or sorbitol?
To reduce bacteria in the bowel
Blood analysis of the newborn of a mother with uncontrolled gestational diabetes might reveal:
After a patient recovers from a hypoglycemic attack and her blood glucose stabilizes, what should she do next?
Eat a cheese sandwich
All of the following would be included in teaching a diabetic patient about how to prevent renal complications except:
a diet high in protein