PSYCH hesi FINAL.doc

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CUNY Lehman College *

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377

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Medicine

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Jan 9, 2024

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additions 1. CAGE- alcoholism 2. Haldol & then in seclusion, what to look for- Extrapyramidal side effects 3. Pt who takes off clothes during admission assessment- set limit 4. Pt. taking benzo long term therapy- Don’t come off med abruptly/ 5. Pt. complaining of antidepressant Amytrytaline- dry mouth, constipation 6. Atypical side effect of Atypical Antipsychtic- weight gain of 75 lbs. 7. Assessment for admission for not telling family- confidentiality From my memory the answer was worded differently but not sure (confidentiality until pt self harms or others.. something like that) 8. What to do when pt. is about to throw chair- de-escalate w/ other staff 9. person in corner & guarded- attempt to talk in simple questions 10. Person with alcohol percentage 0.22, what med to give?- thiamine/ Folic Acid/ Benzo/ Glucose??? Answer is Thiamine B1 11. manic patient 12. pt. over dosed, and ask family- why? 13. Pt. comes in saying he wants to kills his co worker with a gun- do you have a gun it was worded something like, check if they have a gun on them available for use
14. pt says he’s son of god- 15. pt. was brushing ants off, alcohol dependency - pretty sure this was the “give Librium” answer 16. pt. says he wants to kill himself with knife he wanted to go to the kitchen and get a knife - 1:1 with the UAP 17. postpartum depression pt, what to observe- poor concentration, poor eating habits, sadness 18. Female high school student goes in collapses ( 5’3 & 105 lbs)- 24 hrs diary/ when did you vomit 19. kid with dad that takes 1 beer and then 6 beers- increase tolerance 20. heroine withdrawal- weazing and apnea/ I&O/ send to support group 21. pt is in major depression and whenever answering takes her time- sit w/ p.t quietly 22. Pt. with PTSD, what is best intervention- away from recreation/ put w/ t. with similar stories quiet bedroom 23. Pt. with schizophrenia, what to put in plan of care- bring back to reality 24. pt. is upset because he didn’t get a day pass & begins to yell- lower the tv sound REALLY ? LOL I soooo didn’t put that lmao 25. Borderline depression – borderline personality pt informs staff that he feels unsafe and has thoughts of self harm
26. Pt. with agoraphobia & nurse desensitizing- progressively bring into crowds 27. conversion disorder- pt. becomes blind w/o organic problem 28. Pt. diagnosed w/ breast cancer, & makes family do stuff- Acceptance & part of grief/ Unacceptable 29. Anorexia of young person, what requires immediate intervention- Tachy/ Hypotension/ hypothermia/ someone told me the answer is glucose of 50 30. Pt. with moderate anxiety - SOB & dizziness & lightheadedness- that’s the answer moderate anxiety 31. Pt interviewing w/ nurse and ask for husband to stay- ask husband 32. Pt. in long term care and hiding in closet, what to do when they agitated- remove from 33. Substance Abuse/ Schizo/Depression 34. Pt smears feces on wall what do you do – answer is escort them out of the room 35. Tangential disorder – answer tell patient to repeat what they said (or repeat what you said) 36. Woman getting stalked. What do you tell her – ? 37. Teenage pt OD. What is the most important question you would ask – ? one answer was “what drug” and the other was “how long ago did you consume” (not sure which one is correct but I put what drug. 38. Man who got fired from his job, his girlfriend broke up with him and something else.. what is he experiencing – answer is has sense of loss
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39. Woman with domestic violence.. what would you ask her – I put if she has a plan to leave if her life is in danger ? not sure 40. Woman comes out to the dayroom dressed in short skirt not panties, dressed inappropriately, what do you do? – bring to room and help them change 41. Woman states “I cant take it anymore” what would you say - ? I put are you thinking about committing suicide but not sure. 42. Pt OD on vicodin and you give narcan. In 15 minutes they get better.. what do you observe for - ?? narcotic OD/give fluids 43. Pt secluding themselves in room and opening door frequently: delusion of persecution 44. Pt doing pushups, running through the halls, tosses a chair- priority diagnosis : delusion of grandeur 45. Pt sleeping all weekend and nurse comes back to find them still sleeping, what is the nurses priority: get pt out of bed and into activities 46. Elderly pt is suspected of being abused what is nursing priority: document photographs 47. Bipolar pt comes to nurses’ station and beings to yell at the nurse, what should the nurse do: ignore the patient 48. Changing the dressing on self-inflicted wounds a pt with borderline personality: change dressing in nonjudgmental manner (I’m pretty sure this was it) 49. Nurse goes to clinic see’s bathroom covered with poop, sputum, urine: risk for infection 50. Homeless man comes to the clinic not sleeping for 3-4 days what should you do: allow time for rest
51. Homeless man comes in disorganized and confused: acute confusion 52. Female pt has fear of open spaces: fear of perceived threat to physical integrity in the environment 53. Pt who is convinced his brother is sleeping with his wife: something about not being able to cope in the environment 54. Pt is no longer receiving antipsychotic med what other med should be discontinued: benztropine (anticholinergic) 55. Before giving a female pt screening for abuse how do you tell her that your screening her for abuse: abuse screening will be done because abuse is common 56. High school guy (6’1 weighing 130lbs) with normal vitals what do you check: body mass index 57. When would giving clonidine be contraindicated: pts blood pressure is 90 systolic to 92 systolic (don’t remember diastolic but this is a bp med; these bps are too low) 58. Female pt with mental and physical delay is pregnant and says how sad she is her child will never be fully developed: question if she has intentions of hurting herself or the baby (I think that’s the answer) 59. Pt taking phenelzine what cant they eat: pepperoni pizza 60. Pt complains of diarrhea, muscle ache, malaise; her vitals are normal she mentions her sister thinks she a hypochondriac: what beside your sisters comment is bothering you 61. Woman comes to ED saying she’s been raped: instruct her to remove her clothing carefully
62. Pt who is schizophrenic has developed echolalia and its annoying other pts, what should nurse do: move to a quiet room 63. 3 year old child signs that need to be further assessed: child does repetitive movements 64. How do you prepare a pt for ECT: NPO at midnight before procedure 65. Pt withdrawing from alcohol: give Ativan (worded different but give benzo to pt withdrawing from alcohol) 66. Pt taking Disulfiram what should you teach them: do not drink alcohol 12 hrs prior to first dose 67. Pt taking Disulfiram what should you teach them: check drugs consumed for alcohol content 68. Pt addict gets a MI what could they be addicted to: alcohol (not sure between that or amphetamine) 69. Pt is bulimic what is priority intervention: check electrolytes and report to physician 70. Pt is questioned why he behaved inappropriate – he blames the police officer: projection (not exactly worded but same concept)
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