Psychiatric and Mental Health Nursing Flashcards

The nurse is planning care for a patient with an eating disorder who is medically cleared. Which therapy is the primary evidence-based treatment for bulimia nervosa?

Answer: Cognitive Behavioral Therapy (CBT)

CBT is the gold-standard treatment for bulimia nervosa, targeting the distorted thoughts about body image and food, as well as breaking the binge-purge cycle. SSRIs (especially fluoxetine at higher doses) are the adjunctive pharmacological treatment.

A nurse is assessing a patient with suspected ADHD in a school-age child. Which finding is most consistent with inattentive-type ADHD?

Answer: Frequently loses items, forgetful, easily distracted, fails to finish tasks

Inattentive-type ADHD presents with poor attention to detail, losing items, forgetfulness, distractibility, and failure to complete tasks — without hyperactivity/impulsivity. Hyperactive-impulsive type presents with the motor and impulse control symptoms.

A nurse is caring for a patient in the ICU who develops ICU psychosis. Which intervention is most effective?

Answer: Reorient the patient frequently, maintain day-night cycles, and reduce sleep disruptions

ICU psychosis (delirium) is best managed non-pharmacologically: frequent reorientation, maintaining circadian rhythms (lights on during day, dim at night), minimizing sleep disruption, early mobility, removing unnecessary catheters/lines, and involving family. This is evidence-based through ABCDEF bundle.

The nurse is reviewing the chart of a patient prescribed tranylcypromine (an MAOI). Which dietary restriction is critical?

Answer: Avoid tyramine-rich foods (aged cheese, cured meats, red wine)

MAOIs inhibit monoamine oxidase, which normally breaks down tyramine in the gut. Consuming tyramine-rich foods (aged cheese, cured meats, fermented foods, red wine) while on MAOIs causes tyramine accumulation, leading to potentially fatal hypertensive crisis.

A patient with depression is started on an SSRI and also takes St. John's Wort. The nurse identifies risk for:

Answer: Serotonin syndrome — agitation, hyperthermia, muscle twitching, and diarrhea

St. John's Wort has serotonergic activity and, combined with SSRIs, significantly increases the risk of serotonin syndrome — an excess of serotonin causing agitation, hyperthermia, muscle hyperreflexia/clonus, diarrhea, and diaphoresis.

The nurse is assessing a patient with borderline personality disorder. Which defense mechanism is most characteristic?

Answer: Splitting — viewing people as entirely good or entirely bad

Splitting is the hallmark defense mechanism in borderline personality disorder, where individuals see people (and themselves) as either all-good or all-bad, with no integration of both qualities. This leads to idealization followed by sudden devaluation of others.