Ralph is admitted at Nurseslabs Medical Center with the diagnosis of bipolar disorder, single

manic episode. Which of the following behaviors would the nurse expect to assess?

A) Apathy, poor insight, and poverty of ideas.

B) Anxiety, somatic complaints, and insomnia.

C) Elation, hyperactivity, and impaired judgment.

D) Social isolation, delusional thinking, and clang associations.

In a day treatment program, a manic client is creating considerable chaos, behaving in a

dominating and manipulative way. Which nursing intervention is most appropriate?

A) Allow the peer group to intervene.

B) Describe acceptable behavior and set realistic limits with the client.

C) Recommend that the client is hospitalized for treatment.

D) Tell the client that his behavior is inappropriate.

Nurse Nadine is assessing James who is diagnosed with bipolar disorder. The nurse would expect
to find a history of:

A)A depressive episode followed by prolonged sadness.

B) A series of depressive episodes that recur periodically.

C) Symptoms of mania that may or may not be followed by depression.

D) Symptoms of mania that include delusional thoughts.

The nurse is planning activities for a client who has bipolar disorder with aggressive social
behavior. Which of the following activities would be most appropriate for this client?

A) Ping pong.

B) Writing. (minimal stimuli)

C) Chess.

D) Basketball.

The nurse assesses a client with the admitting diagnosis of bipolar affective disorder, mania. The
symptom presented by the client that requires the nurse’s immediate intervention is the client’s:

A) Outlandish behaviors and inappropriate dress.

B) Grandiose delusions of being a royal descendant of King Arthur.

C) Nonstop physical activity and poor nutritional intake.

D) Constant, incessant talking that includes sexual innuendoes and teasing the staff.

Tekla is hospitalized at Nurseslabs Medical Center following a suicide attempt. His history reveals
a previous diagnosis of schizoid personality disorder. Which of the following behaviors would be
atypical of a client with this disorder?

A) Actions designed to please the nurse

B) Limited expressions of feelings and emotions

C) Odd ideas and mannerisms

D) Reluctance to join group activities

An individual with depression has a deficiency in which neurotransmitters, based on the biogenic
amine theory?

A) Dopamine and thyroxin

B) GABA and acetylcholine

C) Cortisone and epinephrine

D) Serotonin and norepinephrine

Nurse Rica is teaching a client and her family about the causes of depression. Which of the
following causative factors should the nurse emphasize as the most significant?

A) Brain structure abnormalities

B) Chemical imbalance

C) Social environment

D) Recessive gene transmission

Clara is under evaluation for imminent suicide risk, which information given by her would be
most significant?

A) At least a 2-year history of feeling depressed more days than not

B) Divorced from spouse 6 months ago

C) Feeling loss of energy and appetite

D) Reference to suicide as best solution to identified problems

Rendell is admitted in an acute psychiatric unit at Nurseslabs Medical Center. He suddenly tells
Nurse Matt about his plans for suicide. The nurse’s priority is to:

A) allow the client time alone for reflection.

B) encourage the client to use problem solving.

C) follow agency protocol for suicide precautions.

D) stimulate the client’s interest in activities.

Which mood disorder is characterized by the client feeling depressed most of the day for a 2-
year period?

A) Cyclothymia

B) Dysthymia

C) Melancholic depressive disorder

D) Seasonal affective disorder

Using cognitive-behavioral therapy, which treatment would be appropriate for a client with
depression?

A) Challenging negative thinking

B) Encouraging analysis of dreams

C) Prescribing antidepressant medications

D) Using ultraviolet light therapy

A client completing requirements for student teaching reports to the nurse an incident in which
a student was rude and disrespectful. The client states, “None of the students respects my
teaching ability.” The nurse identifies this as an example of which common negative cognition?

A) Labeling

B) Fortune telling

C) Overgeneralization

D) “Should” statement

The community nurse is speaking to a group of new mothers as part of a primary prevention
program. Which self-measures would be most helpful as a strategy to decrease the occurrence
of mood disorders?

A) Keeping busy, so as not to confront problem areas

B) Medication with antidepressants

C) Use of crisis intervention services

D) Verbalizing rather than internalizing feelings

Nurse Marge teaches the family of a client with major depression disorder. Which of the
following information should be included in the teaching? Select all that apply.

A) Depression is characterized by sadness, feelings of hopelessness, and decreased self-worth

B) It is common for a pressed individual to have thoughts of suicide.

C) Attempts to cheer up a person with depression are often helpful.

D) Talk therapy, along with antidepressant medications, is usually the treatment.

E) Someone with depression may be preoccupied with spending money and too busy to sleep.

F) Encourage a person with depression to keep a regular routine of activity and rest.

A client is admitted to the hospital with a diagnosis of major depression, severe, single episode.
The nurse assesses the client and identifies a nursing diagnosis of imbalanced nutrition related
to poor nutritional intake. The most appropriate nursing intervention related to this diagnosis is:

A) Explain to the client the importance of a good nutritional intake

B) Weight the client 3 times per week before breakfast

C) Report the nutritional concern to the psychiatrist and obtain a nutritional consultation as soon
as possible.

D) Consult with the nutritionist, offer the client several small meals per day, and schedule brief
nursing interactions with the client during these times.

In planning activities for the depressed client, especially during the early stages of
hospitalization, which of the following plans is best?

A) Provide an activity that is quiet and solitary to avoid increased fatigue, such as working on a
puzzle or reading a book.

B) Plan nothing until the client asks to participate in milieu.

C) Offer the client a menu of daily activities and insist the client participate in all of them
D) Provide a structured daily program of activities and encourage the client to participate.

The depressed client verbalizes feelings of low self-esteem and self-worth typified by statements
such as “I’m such a failure… I can’t do anything right!” The best nursing response would be:

A) To tell the client this is not true; that we all have a purpose in life.

B) To remain with the client and sit in silence; this will encourage the client to verbalize feelings

C) To reassure the client that you know how the client is feeling and that things will get better

D) To identify recent behaviors or accomplishments that demonstrates skill ability.

A client with a diagnosis of major depression, recurrent with psychotic features is admitted to
the mental health unit. To create a safe environment for the client, the nurse most importantly
devises a plan of care that deals specifically with the client’s:

A) Disturbed thought processes

B) Imbalanced nutrition

C) Self-care deficit

D) Deficient knowledge

A depressed client is ready for discharge. The nurse feels comfortable that the client has a good
understanding of the disease process when the client states:

A) “I’ll never let this happen to me again. I won’t let my boss or my job or my family get to me!”

B) “It’s important for me to eat well, exercise, and to take my medication. If I begin to lose my
appetite or not sleep well, I’ve got to get in to see my doctor.”

C) “I’ve learned that I’m a good person and that I am worthy of giving and receiving love. I don’t
need anyone; I have myself to rely on!”

D) “I don’t know what happened to me. I’ve always been able to make decisions for myself and
for my business. I don’t ever want to feel so weak or vulnerable again!”

The nurse reviews the activity schedule for the day and plans which activity for the manic client?

A) Brown-bag luncheon and book review

B) Tetherball (uses muscle energy. other options require concentration)

C) Paint-by-number activity

D) Deep breathing and progressive relaxation group

A hospitalized client is being considered for ECT. The client appears calm, but the family is
anxious. The client’s mother begins to cry and states “My son’s brain will be destroyed. How can
the doctor do this to him?” The nurses best response is:

A) “It sounds as though you need to speak with the psychiatrist”

B) “Your son has decided to have this treatment. You should be supportive to him.”

C) “Perhaps you’d like to see the ECT room and speak to the staff.”

D) “It sounds as though you have some concerns about the ECT procedure. Why don’t we sit
down together and discuss any concerns you may have.”

The manic client announces to everyone in the dayroom that a stripper is coming to perform this
evening. When the nurse firmly states that this will not happen, the manic client becomes
verbally abusive and threatens physical violence to the nurse. Based on the analysis of this
situation, the nurse determines that the most appropriate action would be to:

A) With assistance, escort the manic client to her room and administer Haldol as prescribed if
needed (Antipsychotic medications are useful to manage the manic client. Hyperactive and
agitated behavior usually responds to Haldol)

B) Tell the client that smoking privileges are revoked for 24 hours

C) Orient the client to time, person, and place

D) Tell the client that the behavior is not appropriate.

Select all nursing interventions for a hospitalized client with mania who is exhibiting
manipulative behavior.

A) Communicate expected behaviors to the client

B) Enforce rules and inform the client the he or she will not be allowed to attend group therapy
sessions.

C) Ensure that the client knows that he or she is not in charge of the nursing unit

D) Be clear with the client regarding the consequences of exceeding limits set regarding
behavior.

E) Assist the client in testing out alternative behaviors for obtaining needs

A woman comes into the ER in a severe state of anxiety following a car accident. The most
appropriate nursing intervention is to:

A) Remain with the client

B) Put the client in a quiet room

C) Teach the client deep breathing

D) Encourage the client to talk about their feelings and concern.

Which of the following communication guidelines should the nurse use when talking with a
client experiencing mania?

A) Address the client in a light and joking manner

B) Focus and redirect the conversation as necessary

C) Allow the client to talk about several different topic

D) Ask only open ended questions to facilitate conversations

What information is important to include in the nutritional counseling of a family with a member
who has bipolar disorder?

A) If sufficient roughage isn’t eaten while taking lithium, bowel problems will occur.

B) If the intake of carbohydrates increases, the lithium level increases.

C) If the intake of calories is reduced, the lithium level will increase

D) If the intake of sodium increases, the lithium level will decrease.

In conferring with the treatment team, the nurse should make which of the following
recommendations for a client who tells the nurse that everyday thoughts of suicide are present?

A) A no-suicide contract

B) Weekly outpatient therapy

C) A second psychiatric opinion

D) Intensive inpatient treatment

Which of the following short term goals is most appropriate for a client with bipolar disorder
who is having difficulty sleeping?

A) Obtain medication for sleep

B) Work on solving a problem

C) Exercise before bedtime

D) Develop a sleep ritual

A female client who’s at high risk for suicide needs close supervision. To best ensure the client’s
safety, Nurse Mary should:

A) check the client frequently at irregular intervals throughout the night

B) assure the client that the nurse will hold in confidence anything the client says

C) repeatedly discuss previous suicide attempts with the client

D) disregard decreased communication by the client because this is common in suicidal clients

Nurse Mary is assigned to care for a suicidal client. Initially, which is the nurse’s highest care
priority?

A) Assessing the client’s home environment and relationships outside the hospital

B) Exploring the nurse’s own feelings about suicide

C) Discussing the future with the client

D) Referring the client to a clergyperson to discuss the moral implications of suicide

Nurse Amy is aware that the client is at highest risk for suicide?

A) One who appears depressed, frequently thinks of dying, and gives away all personal
possessions

B) One who plans a violent death and has the means readily available

C) One who tells others that he or she might do something if life doesn’t get better soon

D) One who talks about wanting to die

Which method would a nurse use to determine a client’s potential risk for suicide?

A) Wait for the client to bring up the subject of suicide.

B) Observe the client’s behavior for cues of suicide ideation.

C) Question the client directly about suicidal thoughts.

D) Question the client about future plans.

A client with a bipolar disorder exhibits manic behavior. The nursing diagnosis is Disturbed
thought processes related to difficulty concentrating, secondary to flight of ideas. Which of the
following outcome criteria would indicate improvement in the client?

A) The client verbalizes feelings directly during treatment.

B) The client verbalizes positive “self” statement.

C) The client speaks in coherent sentences.

D) The client reports feelings calmer

A client tells a nurse. “Everyone would be better off if I wasn’t alive.” Which nursing diagnosis
would be made based on this statement?

A) Disturbed thought processes

B) Ineffective coping

C) Risk for self-directed violence

D) Impaired social interaction

A client with bipolar disorder, manic type, exhibits extreme excitement, delusional thinking, and
command hallucinations. Which of the following is the priority nursing diagnosis?

A) Anxiety

B) Impaired social interaction

C) Disturbed sensory-perceptual alteration (auditory)

D) Risk for other-directed violence

The nurse is teaching a group of clients about the mood-stabilizing medications lithium
carbonate. Which medications should she instruct the clients to avoid because of the increased
risk of lithium toxicity?

A) Antacids

B) Antibiotics

C) Diuretics (sodium and water excretion = increase lithium toxicity)

D) Hypoglycemic agents

A client taking the monoamine oxidase inhibitor (MAOI) antidepressant isocarboxazid (Marplan)
is instructed by the nurse to avoid which foods and beverages?

A) Aged cheese and red wine (contain tyramine= precipitate hypertensive crisis)

B) Milk and green, leaf vegetables

C) Carbonated beverages and tomato products

D) Lean red meats and fruit juices

The nurse understands that electroconvulsive therapy is primary used in psychiatric care for the
treatment of:

A) Anxiety disorders.

B) Depression.

C) Mania.

D) Schizophrenia.

A client taking the MAOI phenelzine (Nardil) tells the nurse that he routinely takes all of the
medications listed below. Which medication would cause the nurse to express concern and
therefore initiate further teaching?

A) Acetaminophen (Tylenol)

B) Diphenhydramine (Benadryl) (over the counter used for allergies and cold=increase the
sympathomimetic effects of MAOIs = hypertensive crisis)

C) Furosemide (Lasix)

D) Isosorbide dinitrate (Isordil)

Nurse Monet is caring for a female client who has suicidal tendency. When accompanying the
client to the restroom, Nurse Monet should…

A) Give her privacy

B) Allow her to urinate

C) Open the window and allow her to get some fresh air

D) Observe her

A neuromuscular blocking agent is administered to a client before ECT therapy. The Nurse should
carefully observe the client for…(

A) Respiratory difficulties (Neuromuscular Blocker, such as SUCCINYLCHOLINE (Anectine)

produces respiratory depression because it inhibits contractions of respiratory muscles.)

B) Nausea and vomiting

C) Dizziness

D)Seizures
When teaching parents about childhood depression Nurse Trina should say?

A) It may appear acting out behavior

B) Does not respond to conventional treatment

C) Is short on duration & resolves easily

D) Looks almost identical to adult depression

Nurse Monette is aware that extremely depressed clients seem to do best in settings where they
have:

A) Multiple stimuli

B) Routine Activities

C) Minimal decision making

D) Varied Activities

To further assess a client’s suicidal potential. Nurse Katrina should be especially alert to the
client expression of:

A) Frustration & fear of death

B) Anger & resentment

C) Anxiety & loneliness

D) Helplessness & hopelessness

A nursing care plan for a male client with bipolar I disorder should include:

A) Providing a structured environment

B) Engaging the client in conversing about current affairs

C) Touching the client provide assurance

During electroconvulsive therapy (ECT) the client receives oxygen by mask via positive pressure
ventilation. The nurse assisting with this procedure knows that positive pressure ventilation is
necessary because?

A) Anesthesia is administered during the procedure

B) Decrease oxygen to the brain increases confusion and disorientation

C) Grand mal seizure activity depresses respirations

D) Muscle relaxations given to prevent injury during seizure activity depress respirations.

Nurse Tina is caring for a client with depression who has not responded to antidepressant
medication. The nurse anticipates that what treatment procedure may be prescribed?

A) Neuroleptic medication

B) Short term seclusion

C) Psychosurgery

D) Electroconvulsive therapy

Malou is diagnosed with major depression spends majority of the day lying in bed with the sheet
pulled over his head. Which of the following approaches by the nurse would be the most
therapeutic?

A) Question the client until he responds

B) Initiate contact with the client frequently

C) Sit outside the client’s room

D) Wait for the client to begin the conversation

Joe who is very depressed exhibits psychomotor retardation, a flat affect and apathy. The nurse
in charge observes Joe to be in need of grooming and hygiene. Which of the following nursing
actions would be most appropriate?

A) Waiting until the client’s family can participate in the client’s care

B) Asking the client if he is ready to take shower

C) Explaining the importance of hygiene to the client

D) Stating to the client that it’s time for him to take a shower

When teaching Mario with a typical depression about foods to avoid while taking
phenelzine(Nardil), which of the following would the nurse in charge include?

A) Roasted chicken

B) Fresh fish

C) Salami Foods high in tyramine, those that are fermented, pickled, aged, or smoked must be
avoided because when they are ingested in combination with MAOIs a hypertensive crisis will
occur.

D) Hamburger
When assessing a female client who is receiving tricyclic antidepressant therapy, which of the
following would alert the nurse to the possibility that the client is experiencing anticholinergic
effects?

A) Urine retention and blurred vision (Anticholinergic effects, which result from blockage of the
parasympathetic (craniosacral) nervous system including urine retention, blurred vision, dry
mouth & constipation)

B) Respiratory depression and convulsion

C) Delirium and Sedation

D) Tremors and cardiac arrhythmias

For a male client with dysthymic disorder, which of the following approaches would the nurse
expect to implement?

A) ECT

B) Psychotherapeutic approach

C) Psychoanalysis

D) Antidepressant therapy

Danny who is diagnosed with bipolar disorder and acute mania, states the nurse, “Where is my
daughter? I love Louis. Rain, rain go away. Dogs eat dirt.” The nurse interprets these statements
as indicating which of the following?

A) Echolalia

B) Neologism

C) Clang associations

D) Flight of ideas

Terry with mania is skipping up and down the hallway practically running into other clients.
Which of the following activities would the nurse in charge expect to include in Terry’s plan of
care?

A) Watching TV

B) Cleaning dayroom tables (release the energy)

C) Leading group activity

D) Reading a book
When assessing a male client for suicidal risk, which of the following methods of suicide would
the nurse identify as most lethal?

A) Wrist cutting

B) Headbanging

C) Use of gun

D) Aspirin overdose

Jun has been hospitalized for major depression and suicidal ideation. Which of the following
statements indicates to the nurse that the client is improving?

A) “I’m of no use to anyone anymore.”

B) “I know my kids don’t need me anymore since they’re grown.”

C) “I couldn’t kill myself because I don’t want to go to hell.”

D) “I don’t think about killing myself as much as I used to.”

Which of the following activities would Nurse Trish recommend to the client who becomes very
anxious when thoughts of suicide occur?

A) Using exercise bicycle

B) Meditating

C) Watching TV

D) Reading comics

The primary nursing diagnosis for a female client with a medical diagnosis of major depression
would be:

A) Situational low self-esteem related to altered role

B) Powerlessness related to the loss of idealized self

C) Spiritual distress related to depression

D) Impaired verbal communication related to depression

When developing an initial nursing care plan for a male client with a Bipolar I disorder (manic
episode) nurse Ron should plan to?

A) Isolate his gym time

B) Encourage his active participation in unit programs

C) Provide foods, fluids and rest

D) Encourage his participation in programs

Grace is exhibiting withdrawn patterns of behavior. Nurse Johnny is aware that this type of
behavior eventually produces a feeling of:

A) Repression

B) Loneliness

C) Anger

D) Paranoia

Which of the following groups are considered to be at highest risk for suicide?

A) Adolescents, men over age 45, and persons who have made previous suicide attempts

B) Teachers, divorced persons, and substance abusers

C) Alcohol abusers, widows, and young married men

D) Depressed persons, physicians, and persons living in rural areas

A 48 year old male client is brought to the psychiatric emergency room after attempting to jump
off a bridge. The client’s wife states that he lost his job several months ago and has been unable
to find another job. The primary nursing intervention at this time would be to assess for:

A) past history of depression

B) Current plans to commit suicide

C) The presence of marital difficulties

D) Feelings of excessive failure

Which of the following statements should be included when teaching clients about monoamine
oxidase inhibitor (MAOI) antidepressants?

A) Don’t take aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

B) Have blood levels screened weekly for leucopenia

C) Avoid strenuous activity because of the cardiac effects of the drug

D) Don’t take prescribed or over the counter medications without consulting the physician
Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used
for:

A) General anesthesia

B) Cardiac stress testing

C) Neurologic examination

D) Physical therapy

Jose who is receiving monoamine oxidase inhibitor antidepressant should avoid tyramine, a
compound found in which of the following foods?

A) Figs and cream cheese

B) Fruits and yellow vegetables

C) Aged cheese and Chianti wine

D) Green leafy vegetables

Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT)
treatment. When assessing the client immediately after ECT, the nurse expects to find:

A) Permanent short-term memory loss and hypertension

B) Permanent long-term memory loss and hypomania

C) Transitory short-term memory loss and permanent long-term memory loss

D) Transitory short and long-term memory loss and confusion

Barbara with bipolar disorder is being treated with lithium for the first time. Nurse Clint should
observe the client for which common adverse effect of lithium?

A) Polyuria

B) Seizures

C) Constipation

D) Sexual dysfunction

Discharge instructions for a male client receiving tricyclic antidepressants include which of the
following information?

A) Restrict fluids and sodium intake

B) Don’t consume alcohol

C) Discontinue if dry mouth and blurred vision occur (normal adverse effect)

D) Restrict fluid and sodium intake

Which of the following best explains why tricyclic antidepressants are used with caution in
elderly patients?

A) Central Nervous System effects

B) Cardiovascular system effects

C) Gastrointestinal system effects

D) Serotonin syndrome effects

A client with depressive symptoms is given prescribed medications and talks with his therapist
about his belief that he is worthless and unable to cope with life. Psychiatric care in this
treatment plan is based on which framework?

A) Behavioral framework

B) Cognitive framework

C) Interpersonal framework

D) Psychodynamic framework

A client with depression has been hospitalized for treatment after taking a leave of absence from
work. The client’s employer expects the client to return to work following inpatient treatment.
The client tells the nurse, “I’m no good. I’m a failure”. According to cognitive theory, these
statements reflect:

A) Learned behavior

B) Punitive superego and decreased self-esteem

C) Faulty thought processes that govern behavior

D) Evidence of difficult relationships in the work environment

A client with dysthymic disorder reports to a nurse that his life is hopeless and will never
improve in the future. How can the nurse best respond using a cognitive approach?

A) Agree with the client’s painful feelings

B) Challenge the accuracy of the client’s belief

C) Deny that the situation is hopeless

D) Present a cheerful attitude

A client with major depression has not verbalized problem areas to staff or peers since
admission to a psychiatric unit. Which activity should the nurse recommend to help this client
express himself?

A) Art therapy in a small group

B) Basketball game with peers on the unit

C) Reading a self-help book on depression

D) Watching movie with the peer group

Which activity would be most appropriate for a severely withdrawn client?

A) Art activity with a staff member

B) Board game with a small group of clients

C) Team sport in the gym

D) Watching TV in the dayroom

Tina who is manic, but not yet on medication, comes to the drug treatment center. The nurse
would not let this client join the group session because:

A) The client is disruptive.

B) The client is harmful to self.

C) The client is harmful to others.

D) The client needs to be on medication first.

In preparing a female client for electroconvulsive therapy (ECT), Nurse Michelle knows that
succinylcholine (Anectine) will be administered for which therapeutic effect?

A) Short-acting anesthesia

B) Decreased oral and respiratory secretions.

C) Skeletal muscle paralysis.

D) Analgesia

Nurse Gina is aware that the dietary implications for a client in manic phase of bipolar disorder
is:

A) Serve the client a bowl of soup, buttered French bread, and apple slices.

B) Increase calories, decrease fat, and decrease protein.

C) Give the client pieces of cut-up steak, carrots, and an apple.

D) Increase calories, carbohydrates, and protein.

A client seeks care because she feels depressed and has gained weight. To treat her atypical
depression, the physician prescribes tranylcypromine sulfate (Parnate), 10 mg by mouth twice
per day. When this drug is used to treat atypical depression, what is its onset of action?

A) 1 to 2 days

B) 3 to 5 days

C) 6 to 8 days

D) 10 to 14 days

Nurse Jen is caring for a male client with manic depression. The plan of care for a client in a
manic state would include:

A) Offering a high-calorie meals and strongly encouraging the client to finish all food.

B) Insisting that the client remain active through the day so that he’ll sleep at night.

C) Allowing the client to exhibit hyperactive, demanding, manipulative behavior without setting
limits.

D) Listening attentively with a neutral attitude and avoiding power struggles.

The nurse is aware that the side effect of electroconvulsive therapy that a client may experience:

A) Loss of appetite

B) Postural hypotension

C) Confusion for a time after treatment

D) Complete loss of memory for a time

Nurse Krina recognizes that the suicidal risk for depressed client is greatest:

A) As their depression begins to improve (they have the energy to carry out the act)

B) When their depression is most severe

C) Before nay type of treatment is started

D) As they lose interest in the environment

Josefina is to be discharged on a regimen of lithium carbonate. In the teaching plan for discharge
the nurse should include:

A) Advising the client to watch the diet carefully

B) Suggesting that the client take the pills with milk

C) Reminding the client that a CBC must be done once a month.

D) Encouraging the client to have blood levels checked as ordered.

The psychiatrist orders lithium carbonate 600 mg p.o t.i.d for a female client. Nurse Katrina
would be aware that the teaching about the side effects of this drug were understood when the
client state, “I will call my doctor immediately if I notice any:

A) Sensitivity to bright light or sun

B) Fine hand tremors or slurred speech

C) Sexual dysfunction or breast enlargement

D) Inability to urinate or difficulty when urinating

Tranylcypromine sulfate (Parnate) is prescribed for a depressed client who has not responded to
the tricyclic antidepressants. After teaching the client about the medication, Nurse Marian
evaluates that learning has occurred when the client states, “I will avoid:

A) Citrus fruit, tuna, and yellow vegetables.”

B) Chocolate milk, aged cheese, and yogurt” (high in tyramine)

C) Green leafy vegetables, chicken, and milk.”

D) Whole grains, red meats, and carbonated soda.”

Nurse Judy knows that statistics show that in adolescent suicidal behavior:

A) Females use more dramatic methods than males

B) Males account for more attempts than do females

C) Females talk more about suicide before attempting it

D) Males are more likely to use lethal methods than are females
Mr. Cruz visits the physician’s office to seek treatment for depression, feelings of hopelessness,
poor appetite, insomnia, fatigue, low self-esteem, poor concentration, and difficulty making
decisions. The client states that these symptoms began at least 2 years ago. Based on this report,
the nurse Tiffany suspects:

A) Cyclothymic disorder.

B) Atypical affective disorder.

C) Major depression.

D) Dysthymic disorder

What herbal medication for depression, widely used in Europe, is now being prescribed in the
United States?

A) Ginkgo biloba

B) Echinacea

C) St. John’s wort

D) Ephedra

Cely with manic episodes is taking lithium. Which electrolyte level should the nurse check before
administering this medication?

A) Calcium

B) Sodium

C) Chloride

D) Potassium

Isabel with a diagnosis of depression is started on imipramine (Tofranil), 75 mg by mouth at

bedtime. The nurse should tell the client that:

A) This medication may be habit-forming and will be discontinued as soon as the client feels
better.

B) This medication has no serious adverse effects.

C) The client should avoid eating such foods as aged cheeses, yogurt, and chicken livers while
taking the medication.

D) This medication may initially cause tiredness, which should become less bothersome over
time.
Dennis has a lithium level of 2.4 mEq/L. The nurse immediately would assess the client for which
of the following signs or symptoms?

A) Weakness

B) Diarrhea

C) Blurred vision

Tristan is on Lithium has suffered from diarrhea and vomiting. What should the nurse in-charge
do first:

A) Recognize this as a drug interaction

B) Give the client Cogentin

C) Reassure the client that these are common side effects of lithium therapy

D) Hold the next dose and obtain an order for a stat serum lithium level

Nurse Greta is aware that the following is classified as an Axis I disorder by the Diagnosis and
Statistical Manual of Mental Disorders, Text Revision (DSM-IV-TR) is:

A) Obesity (AXIS III)

B) Borderline personality disorder (AXIS II)

C) Major depression

D) Hypertension (AXIS III)

Ricardo, an outpatient in psychiatric facility is diagnosed with dysthymic disorder. Which of the
following statement about dysthymic disorder is true?

A) It involves a mood range from moderate depression to hypomania

B) It involves a single manic depression

C) It’s a form of depression that occurs in the fall and winter

D) It’s a mood disorder similar to major depression but of mild to moderate severity