On what is the choice of tricyclic antidepressants based?
a. The need to decrease the action of norepinephrine, dopamine, or serotonin
b. Patient age and gender
c. An absence of adverse effects, such as orthostatic hypotension
d. The need for stimulation and increased mental alertness
ANS: B
The choice of tricyclic antidepressants is based on their individual therapeutic characteristics. Tricyclics prolong the action of norepinephrine, dopamine, and serotonin. All tricyclics produce orthostatic hypotension to some degree. All tricyclics produce sedation, not stimulation.
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A new staff nurse completes orientation to a psychiatric unit. This nurse may expect an advanced practice nurse to perform which additional interventions?
a. Conduct mental health assessments b. Establish therapeutic relationships c. Individualize nursing care plans d. Prescribe psychotropic medication
The community mental health nurse calls on a highly suspicious psychiatric client, saying "I'm a
nurse from the mental health center. I'd like to come in and find out how you're doing.". The client refuses to allow the nurse access to her apartment, saying "My neighbor talks to me every day. I don't know you. You could be from the IRS or the CIA. The less you know about me, the better.". The best initial intervention for the nurse to take to try to gain access would be to a. ask the client's neighbor to go with her. b. have the police accompany her. c. deny a relationship with the IRS or CIA. d. mention the client will have to go to the hospital unless she sees the nurse.
A patient admitted for depression tells a nurse that he feels so hopeless that he doesn't care if he lives or dies. The patient tells the nurse that he no longer attends church with his family. The nurse identifies that possibly the patient
1. Does not value faith the way he previously had. 2. Wishes to be left alone to reflect on his lost faith. 3. Could be experiencing spiritual distress. 4. Wants the nurse to discuss his feelings with his family.
A patient who is experiencing a manic episode approaches the nurse and with pressured speech states, "I hate oatmeal. Let's get everybody together to do exercises
I'm thirsty and I'm burning up. Get out of my way; I have to see that guy." The priority nursing action is to: a. Measure the patient's temperature and pulse. b. Offer to have the dietitian visit to discuss his diet. c. Tell the patient he can lead exercises at the community meeting. d. Show relief when the patient ends the interaction and walks away.