Questions 42

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LPN Custom Mental Health Questions

Extract:

Diagnostic Results: Sodium: 135 mEq/L (expected reference range 136 to 145 mEq/L), Potassium 2.9 mEq/L (expected reference range 3.5 to 5 mEq/L), Chloride: 94 mEq/L (expected reference range 98 to 106 mEq/L), Phosphate: 3.1 mg/dL (expected reference range 3 to 4.5 mg/dL), Magnesium: 2 mg/dL (expected reference range 1.3 to 2.1 mg/dL), Glucose 74 mg/dL (expected reference range 74 to 106 mg/dL).


Question 1 of 5

A nurse working in a mental health facility is admitting a client. Exhibits: A nurse is assisting with initiating the client's plan of care. Complete the following sentence by using the list of options (Separate using a comma). The nurse should first address the client's ___ followed by the client's ___

Correct Answer: A,B

Rationale: The nurse should first address the client's cardiac status followed by the client's nutritional status. Cardiac status: Potassium levels are critically low, which can significantly impact cardiac function. Nutritional status: The client has multiple electrolyte imbalances, which could be related to nutrition or absorption issues.

Extract:


Question 2 of 5

A nurse is caring for a client who was recently diagnosed with an opioid use disorder. They were a student in a local community college but were recently dismissed for failing their classes. Their previous diagnoses include anxiety, Crohn's disease, and chronic back pain due to a gymnastics injury in high school. Which of the following should the nurse identify as potential underlying reasons why the client might have started using opioids?

Correct Answer: D

Rationale: Using opioids to treat hallucinations is not a common reason, as opioids are not typically prescribed for this purpose. Hallucinations might be indicative of another underlying mental health condition that needs assessment and appropriate treatment. Witnessing parents using drugs or alcohol to cope is a risk factor for substance use disorders, but it does not directly explain the client's initiation of opioid use. There may be other contributing factors, such as pain or anxiety. Using opioids to promote sleep and rest is a possibility, especially if the client has chronic pain or anxiety affecting their sleep. Opioids can have sedative effects, which might be appealing to individuals experiencing sleep difficulties. However, treating pain and anxiety is often a primary reason for opioid use in such cases.
To treat pain and ease anxiety. Chronic back pain due to a gymnastics injury and anxiety are identified as pre-existing conditions. The client may have started using opioids to manage chronic pain and potentially as a way to cope with anxiety. Opioids are often prescribed for pain relief, and individuals may misuse them to self-medicate emotional distress.

Question 3 of 5

A nurse is collecting data from a client who has major depressive disorder (MDD). Which of the following findings should the nurse expect?

Correct Answer: B

Rationale: Hyperexcitability is not typically associated with major depressive disorder. In fact, individuals with depression often experience a decrease in energy, motivation, and overall activity levels. Significant change in weight. Major depressive disorder (MD
D) is often associated with changes in appetite and weight. Clients with MDD may experience either weight loss or weight gain. This can result from changes in eating habits related to the individual's emotional state. Exaggerated response of pleasure to stimuli is not a characteristic finding in major depressive disorder. In contrast, individuals with depression may experience anhedonia, which is a reduced ability to experience pleasure from previously enjoyable activities. Attention-seeking behavior is not a specific characteristic of major depressive disorder. Individuals with depression may withdraw socially and experience difficulties in concentration and attention.

Question 4 of 5

As part of the plan of care for a client with borderline personality disorder, the nurse reviews the day's schedule with him each morning. While doing so, the client states. 'Why don't you shut up already! I can read it myself, you know!' Which of the following is an appropriate nursing response?

Correct Answer: C

Rationale: I know you can read it yourself, but will you?' This response may escalate the situation and may not effectively address the inappropriate tone. It also has the potential to be perceived as confrontational. 'We do this every day. Why are you so angry with me this morning?' This response is somewhat confrontational and may not be as effective in setting clear boundaries. It also focuses on the client's emotion without directly addressing the inappropriate tone. 'I expect you to speak to me in a civil tone of voice.' Option C sets clear boundaries and communicates the expectation of respectful communication. Addressing the inappropriate tone of voice is important in working with individuals with borderline personality disorder. It reinforces the importance of maintaining a therapeutic and respectful interaction. 'Fine. Here is the schedule. I expect you to be on time for your therapy sessions.' While this response provides the information, it doesn't address the issue of the client's disrespectful tone. It's important to address the inappropriate behavior while still providing necessary information.

Extract:

Graphic Record 0800: Blood pressure 118/76 mm Hg, Temperature 36.9°C (98.4°F), Heart rate 88/min, Respiratory rate 18/min. 1300: Blood pressure 116/74 mm Hg, Temperature 37.7°C (99.9°F), Heart rate 96/min, Respiratory rate 16/min


Question 5 of 5

. A nurse is assisting with the care for a newly admitted client who has major depressive disorder. Select 1 condition and 1 client finding to fill in the following sentence (Separate using a comma). The client is at risk for developing ___ due to the Client's intake of ___

Correct Answer: C,B

Rationale: The client is at risk for developing Serotonin syndrome due to the Client's intake of St. John's wort. St. John's wort is an herbal supplement that can interact with certain medications, including selective serotonin reuptake inhibitors (SSRIs) and other medications that increase serotonin levels. Serotonin syndrome is a potentially life-threatening condition characterized by an excess of serotonin in the body. In the given scenario, the nurse should identify: Condition: The client's intake of St. John's wort; Client Finding: At risk for developing serotonin syndrome. This is because the use of St. John's wort, combined with medications that affect serotonin levels, increases the risk of serotonin syndrome. The nurse should monitor for symptoms of serotonin syndrome, such as changes in vital signs, hyperthermia, altered mental status, and neuromuscular abnormalities. If serotonin syndrome is suspected, medical attention should be sought promptly.

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