Chapter 31 Mental Health Disorders and Substance Abuse

Chapter 31  Mental Health Disorders and Substance Abuse

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A client with a history of bipolar disorder is called by the postpartum support nurse for follow-up. Which symptoms would reassure the nurse that the client is not experiencing a manic episode?
a.
Psychomotor agitation and lack of sleep
b.
Increased appetite and lack of interest in activities
c.
Hyperactivity and distractibility
d.
Pressured speech and grandiosity

ANS: B
An increased appetite and a lack of interest would reassure the nurse that the client is not experiencing an episode of mania. Clinical manifestations of a manic episode include at least three of the following: grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, psychomotor agitation, and excessive involvement in pleasurable activities. The pregnant woman exhibiting symptoms of a manic episode will likely have a decreased interest in eating and an increased level of interest in pleasurable activities without regard for negative consequences. Psychomotor agitation and a lack of sleep, hyperactivity and distractibility, and pressured speech and grandiosity are all clinical manifestations of a manic episode.

DIF: Cognitive Level: Apply REF: p. 746
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity

2. When a woman is diagnosed with postpartum depression (PPD) with psychotic features, what is the nurse’s primary concern in planning the client’s care?
a.
Displaying outbursts of anger
b.
Neglecting her hygiene
c.
Harming her infant
d.
Losing interest in her husband

ANS: C
Thoughts of harm to herself or to the infant are among the most serious symptoms of PPD and require immediate assessment and intervention. Although outbursts of anger and neglecting personal hygiene are symptoms attributable to PPD, the major concern remains the potential of harm to herself or her infant. Although this client is likely to lose interest in her spouse, it is not the nurse’s primary concern.

DIF: Cognitive Level: Understand REF: p. 748 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity

3. During an inpatient psychiatric hospitalization, what is the most important nursing intervention?
a.
Contacting the client’s significant other
b.
Supervising and guiding visits with her infant
c.
Allowing no contact with anyone who annoys her
d.
Having the infant with the mother at all times

ANS: B
In the hospital setting, the reintroduction of the infant to the mother can and should occur at the mother’s own pace. A schedule is set that increases the number of hours the mother cares for her infant over several days, culminating in the infant staying overnight in the mother’s room. These supervised and guided visits allow the mother to experience meeting the infant’s needs and giving up sleep for the infant. Reintroducing the mother to her infant while in a supervised setting is essential. Another important task for a mother under psychiatric care is to reestablish positive interactions with others.

DIF: Cognitive Level: Understand REF: pp. 749-750 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity

4. Despite warnings, prenatal exposure to alcohol continues to far exceed exposure to illicit drugs. Which condition is rarely associated with fetal alcohol syndrome (FAS)?
a.
Respiratory conditions
b.
Intellectual impairment
c.
Neural development disorder
d.
Alcohol-related birth defects (ARBDs)

ANS: A
Respiratory difficulties are not attributed to exposure to alcohol in utero. Other abnormalities related to FAS include mental retardation, neurodevelopment disorders, and ARBDs.

DIF: Cognitive Level: Understand REF: p. 752
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity

5. As a powerful central nervous system (CNS) stimulant, which of these substances can lead to miscarriage, preterm labor, placental separation (abruption), and stillbirth?
a.
Heroin
b.
Alcohol
c.
Phencyclidine (1-phenylcyclohexylpiperidine; PCP)
d.
Cocaine

ANS: D
Cocaine is a powerful CNS stimulant. Effects on pregnancy associated with cocaine use include abruptio placentae, preterm labor, precipitous birth, and stillbirth. Heroin is an opiate; its use in pregnancy is associated with preeclampsia, intrauterine growth restriction, miscarriage, premature rupture of membranes, infections, breech presentation, and preterm labor. The most serious effect of alcohol use in pregnancy is FAS. The major concern regarding PCP use in pregnant women is its association with polydrug abuse and its neurobehavioral effects on the neonate.

DIF: Cognitive Level: Understand REF: pp. 752-753
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity