Psycho-Nursing

Front 1

The nurse is caring for a 40-year-old client. Which behavior by the client indicates adult cognitive development?


1. Has perceptions based on reality


2. Assumes responsibility for actions


3. Generates new levels of awareness


4. Has maximum ability to solve problems and learn new skills

Back 1

Correct Answer: 3
Adults ages 31 to 45 generate new levels of awareness. Having perceptions based on reality and assuming responsibility for actions indicate socialization development — not cognitive development. Demonstrating maximum ability to solve problems and learning new skills occur in young adults ages 20 to 30.

Front 2

The nurse is assessing a newly admitted client. When filling out the family assessment, who should the nurse consider to be a part of the client's family?


1. People related by blood or marriage


2. All the people whom the client views as family


3. People who live in the same house


4. People who the nurse thinks are important to the client


5. People who live in the same house with the same racial background as the client


6. People who provide for the physical and emotional needs of the client

Back 2

Correct Answer: 2,6
When providing care to a client, the nurse should consider family members to be all the people whom the client views as family. Family members may also include those people who provide for the physical and emotional needs of the client. The traditional definition of a family has changed and may include people not related by blood or marriage, those of a different racial background, and those who may not live in the same house as the client. Family members are defined by the client, not by the nurse

Front 3

A client in her first postpartum month has developed mastitis secondary to breast-feeding. Her nurse, a mother who developed and recovered from mastitis after her third child, says, "I remember the discomfort I had and how quickly it resolved when I began getting treatment." The therapeutic communication being used by the nurse is:


1. clarification.


2. reflection.


3. restating.


4. self-disclosure.

Back 3

Correct Answer: 4
Using self-disclosure as a therapeutic communication technique encourages an open and authentic relationship between the nurse and her client. Self-disclosure involves the nurse revealing personal information. Clarification involves the nurse asking the client for more information. Reflection is reviewing the client's ideas. Restating is the nurse's repetition of the client's main message.

Front 4

An obese client is admitted to the facility for abusing amphetamines in an attempt to lose weight. Which nursing intervention isappropriate for this client?


1. Encouraging the client to suppress his feelings regarding obesity


2. Reinforcing the client's concerns over physical appearance


3. Using an abrupt, forceful manner to communicate with the client


4. Teaching the client alternative ways to lose weigh

Back 4

Answer: 4
Teaching the client alternative ways to lose weight is the appropriate intervention. Instead of encouraging the client to suppress his feelings, the nurse should encourage him to express his feelings, especially those related to obesity. Reinforcing the client's concerns about physical appearance may make the client's anxiety worse and lead to more self-destructive behavior. Using an abrupt, forceful manner discourages therapeutic communication with the client.

Front 5

A 26-year-old client with chronic renal failure plans to receive a kidney transplant. Recently, the physician told the client that he is a poor candidate for transplant because of chronic uncontrolled hypertension and diabetes mellitus. Now, the client tells the nurse, "I want to go off dialysis. I'd rather not live than be on this treatment for the rest of my life." Which responses are appropriate?


1. Take a seat next to the client and sit quietly.


2. Say to the client, "We all have days when we don't feel like going on."


3. Leave the room to allow the client to collect his thoughts.


4. Say to the client, "You're feeling upset about the news you got about the transplant."


5. Say to the client, "The treatments are only 3 days a week. You can live with that."

Back 5

Correct Answer: 1,4
Silence is a therapeutic communication technique that allows the nurse and client to reflect on what has taken place or been said. By waiting quietly and attentively, the nurse encourages the client to initiate and maintain conversation. By reflecting the client's implied feelings, the nurse promotes communication. Using such platitudes as "We all have days when we don't feel like going on" fails to address the client's needs. The nurse should not leave the client alone because he may harm himself. Reminding the client of the treatment frequency doesn't address his feelings.

Front 6

A nurse is working with the family of a client who has Alzheimer's disease. The nurse notes that the client's spouse is too exhausted to continue providing care all alone. The adult children live too far away to provide relief on a weekly basis. Which nursing interventions would be most helpful?


1. Calling a family meeting to tell the absent children that they must participate in helping the client


2. Suggesting the spouse seek psychological counseling to help cope with exhaustion


3. Recommending community resources for adult day care and respite care


4. Encouraging the spouse to talk about the difficulties involved in caring for a loved one with Alzheimer's disease


5. Asking whether friends or church members can help with errands or provide short periods of relief


6. Recommending that the client be placed in a long-term care facility

Back 6

Correct Answer: 3,4,5
Many community services exist for Alzheimer's clients and their families. Encouraging use of these resources may make it possible for the client to stay at home and to alleviate the spouse's exhaustion. The nurse can also support the caregiver by urging her to talk about the difficulties she's facing in caring for a spouse. Friends and church members may be able to help provide care to the client, allowing the caregiver time for rest, exercise, or an enjoyable activity. A family meeting to tell the children to participate more would probably be ineffective and may evoke anger or guilt. Counseling may be helpful, but it wouldn't alleviate the caregiver's physical exhaustion and wouldn't address the client's immediate needs. A long-term care facility is not an option until the family is ready to make that decision.

Front 7

While providing care to a 26-year-old married female, the nurse notes multiple ecchymotic areas on her arms and trunk. The color of the ecchymotic areas ranges from blue to purple to yellow. When asked by the nurse how she got these bruises, the client responds, "Oh, I tripped." How should the nurse respond?


1. Document the client's statement and complete a body map indicating the size, color, shape, location, and type of injuries.


2. Report suspicions of abuse to the local authorities.


3. Assist the client in developing a safety plan for times of increased violence.


4. Call the client's husband to discuss the situation.


5. Tell the client that she needs to leave the abusive situation as soon as possible.


6. Provide the client with telephone numbers of local shelters and safe houses.

Back 7

Correct Answer: 1,3,6
The nurse should objectively document her assessment findings. A detailed description of physical findings of abuse in the medical record is essential if legal action is pursued. All women suspected to be victims of abuse should be counseled on a safety plan, which consists of recognizing escalating violence within the family and formulating a plan to exit quickly. The nurse shouldn't report this suspicion of abuse because the client is a competent adult who has the right to self-determination. Nurses do, however, have a duty to report cases of actual or suspected abuse in children or elderly clients. Contacting the client's husband without her consent violates confidentiality. The nurse should respond to the client in a nonthreatening manner that promotes trust, rather than ordering her to break off her relationship.

Front 8

lithium

-- therapeutic level 0.5 --1.5 mEq/L

Back 8

electroconvulsive therapy:

-- aspect that can cause most serious complication: use of succinylcholine chloride (paralyzes the mucles), including those for respiration. Therefore some artificial means of respiration is necessary until the drug is metabolized and excreted.

Front 9

Narcan

-- used for heroin overdose.

-- still need to watch pt. closed because the narcotic effect may cause return of symtoms after Narcon is metabolized.

-- Narcan competes with narcotics for receptors controlling respiration.

Back 9

imipramine (Tofranil)

-- can cause glaucoma

Front 10

Prolixin decanoate

--can be given IM every 2 to 3 weeks for pt. with schizophrenia who can not be relied upon to take oral medications. It allows them to live in the community while keeping the symptoms under control.
(used as outpatient basis.)

Back 10

-Haldol (haloperidol )

-- discharge instruction : photosensitivity , avoid staying in sun

Front 11

Prozac (fluoxetine )

-- used for depression
-- slow effect, take 2 -4 wks for noticeable improvement.

Back 11

Chlorpromazine hydrochloride (Thorazine )

--photosensitive.

Front 12

methylphenidate (Ritalin )

-- used for ADHD
-- should be given after meal ( it can reduce appetite. )

Back 12

personal fable

- adolescent thinking
(they think that they are immune to laws of nature )

Front 13

ADHD

-- treated with Ritalin.

Back 13

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