PRACTICE EXAM QUESTIONS AND ANSWERS FOR
NCLEX RN: 6 NEW UPDATE QUESTIONS
A night shift psychiatric RN on the unit is going out of a pt's room & notices a pt w/ bipolar experiencing an episode of mania @ RN's station. Which intervention would promote therapeutic interaction w/ the pt?
1.) Approaching pt & assertively ask him to abide by acceptable behavior 2.) Redirect the pt to room & minimize triggers of behavior 3.) Reminding pt of limits & isolating pt to his room 4.) Going over unit rules & pt's rights, then encourage pt to go to room & sleep b/c its late - CORRECT ANSWER 2 => Effective strategies include redirecting pt & reducing environmental triggers -redirect pt to room
Explanations:
- = pt does NOT have active listening
- = does NOT work; should NOT isolate pt if not harming self or others
- = trigger in environment; won't listen
If a pt has the following what psychiatric disorder are they experiencing?
1.) Poor concentration 2.) Hyperactivity 3.) Impulsivity 4.) Distractability - CORRECT ANSWER Mania => apart of bipolar disorder -manic-depressive illness
This is manifested by mood swings involving euphoria (intense excitement & happiness), grandiosity, & an inflated sense of self-worth
=> May or may not include sudden swings to depression - CORRECT ANSWER Bipolar Disorder (Mania-Depressive disorder)
(Bipolar Disorder) Name the 11 Depressive symptoms - CORRECT ANSWER 1.) Feelings of hopelessness, worthlessness, guilt, shame
2.) Despair => lack of hope
3.) Flat affect
4.) Indecisiveness
5.) Lack of motivation & DECREASED concentration
6.) Changes in physical appearance => slumped postures, unkempt => sit unkempt. shoulders unkept
7.) Suicidal thoughts
8.) Possible delusions of hallucinations
9.) Sleep & appetite disturbances
10.) Loss of interest in sexual activities
11.) Constipation
(Bipolar Disorder) Nursing plan for Depressive phase (8 things) - CORRECT ANSWER 1.) Directly ask the pt about feelings & plan to harm self
2.) Monitor sleep, nutrition, & elimination patterns
3.) Initiate interaction w/pt, but sit in silence of pt is non-talkative
4.) Insist for participation in activities => do NOT give options; say time to go somewhere -tell pt's what to do when they are in depressive phase
5.) Observe for sudden elevation in mood => indicates INCREASED risk for suicide
6.) Encourage discussion of feelings => ask open-ended questions
7.) Admin anti-depressants
8.) Spend time w/ pt & return to room when promised => if NOT, pt will feel unwanted & will go down deeper in their depression
*"are you having suicidal thought?" "Do you plan to harm yourself?"
What type of drugs are Amitriptyline, Desopramine, Imipramine, Nortiptyline, Protriptyline, & Maprotiline? - CORRECT ANSWER Antidepressant drugs => Tricyclics
The following side effects of these antidepressant drugs are apart of what drug class & the drugs included?
1.) Anticholinergic effects
=> dry mouth, burred vision, constipation, & urinary retention
2.) Poor concentration 3.) Cardiovascular effects
4.) N/V - CORRECT ANSWER Tricyclics:
=> Amitriptyline, => Desopramine, => Imipramine, => Nortiptyline, => Protriptyline, & => Maprotiline
(Antidepressant drugs: Tricyclics: Amitriptyline, Desopramine, Imipramine, Nortiptyline, Protriptyline, & Maprotiline) What is the pt. teaching for these drugs? (5 things) - CORRECT ANSWER 1.) Give @ hs to minimize sedation effect 2.) Take 2-6 wks for therapeutic effects 3.) AVOID alcohol 4.) Evaluate suicide risk 5.) Lethal in overdose
(Antidepressant drugs) What type of meds & drug class have the following side effects?
1.) Tachycardia, constipation, impotence 2.) Dizziness, insomnia, muscle twitching 3.) Drowsiness, dry mouth, fluid retention 4.) HTN crisis => Severe HTN, severe HA, chest pain, fever, sweating, N/V, confusion - CORRECT ANSWER MAO-inhibitors => Isocarboxazid => Phenelzine => Tranylopromine sulfate &