3554 exam #5

The nurse would expect a client with early Alzheimer's disease to have problems with: 1.Self-care measures. 2.Balancing a checkbook. 3.Relating to family members. 4.Remembering his own name

2 (B)

The nurse enters the room of a client with a cognitive impairment disorder and asks what day of the week it is: what the date, month, and year are; and where the client is. The nurse is attempting to assess: 1.Confabulation 2.Delirium 3.Orientation 4.Perseveration

C

Which nursing intervention is most appropriate for a client with Alzheimer's disease who has frequent episodes emotional lability? 1.Attempt humor to alter the client mood. 2.Explore reasons for the client's altered mood. 3.Reduce environmental stimuli to redirect the client's attention. 4.Use logic to point out reality aspects.

C

A 75-year-old client has dementia of the Alzheimer's type and confabulates. The nurse understands that this client: 1.Denies confusion by being jovial. 2.Pretends to be someone else. 3.Rationalizes various behaviors. 4.Fills in memory gaps with fantasy

D

Which neurotransmitter has been implicated in the development of Alzheimer's disease? 1.Dopamine 2.Epinephrine 3.Serotonin 4.Acetylcholine

D

The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with: a. attention deficit hyperactivity disorder. b. posttraumatic stress disorder. c. communication disorder. d. an anxiety disorder.

a

1. Which statement demonstrates a well-structured attempt at limit setting? a. "Hitting me when you are angry is unacceptable." b. "I expect you to behave yourself during dinner." c. "Come here, right now!" d. "Good boys don't bite."

a

A child diagnosed with attention deficit hyperactivity disorder will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications? a. CNS stimulants b. tricyclic antidepressants c. antipsychotics d. anxiolytics

a

A client is a Vietnam War veteran with a diagnosis of posttraumatic stress disorder. He has a history of nightmares, depression, hopelessness, and alcohol abuse. Which option offers the client the most lasting relief of his symptoms? 1.The opportunity to verbalize memories of trauma to a sympathetic listener 2.Family support 3.Prescribed medications taken as ordered 4.Alcoholics Anonymous (AA) meetings

a

A nurse is counseling the parents of a child with oppositional defiant disorder (ODD). What does the nurse advise the parents for dealing with the maladaptive behavior of their child if there is no evidence of harm to self or others? A. The parents should ignore the child's behavior. B. The parents should take the child to a psychotherapist. C. The parents should scold their child. D. The parents should explain to the child the inappropriateness of the behavior.

a

A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child: a. displays resiliency. b. has a passive temperament. c. is at risk for posttraumatic stress disorder. d. uses intellectualization to deal with problems.

a

A pregnant woman is in a relationship with a male who routinely abuses her. Her unborn child may engage in high-risk behavior as a teen as a result of: a. Maternal stress b. Parental nurturing c. Appropriate stress responses in the brain d. Memories of the abuse

a

A young child is found wandering alone at a mall. A male store employee approaches and asks where her parents are. She responds, "I don't know. Maybe you will take me home with you?" This sort of response in children may be due to: a. A lack of bonding as an infant b. A healthy confidence in the child c. Adequate parental bonding d. Normal parenting

a

Childhood-onset conduct disorder is thought to be a precursor to which of the following psychiatric conditions? a. Antisocial personality disorder b. Bipolar disorder c. Schizophrenia d. Dissociative identity disorder

a

Nick, a construction worker, is on duty when a nearly completed wall suddenly falls, crushing a number of his co-workers. Although badly shaken initially, he seemed to be coping well. About 2 weeks after the tragedy, he begins to experience tremors, nightmares, and periods during which he feels numb or detached from his environment. He finds himself frequently thinking about the tragedy and feeling guilty that he was spared while many others died. Which statement about this situation is most accurate? a. Nick has acute stress disorder and will benefit from antianxiety medications. b. Nick is experiencing posttraumatic stress disorder (PTSD) and should be referred for outpatient treatment. c. Nick is experiencing anxiety and grief and should be monitored for PTSD symptoms. d. Nick is experiencing mild anxiety and a normal grief reaction; no intervention is needed.

a

Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, If my parents loved me, they would work out their problems. Which nursing diagnosis has the highest priority? a. social isolation b. decisions conflict c. chronic low self-esteem d. disturbed personal identity

a

The impulse control spectrum can begin in childhood and continue on into adulthood, often morphing into criminal behaviors. Working with patients diagnosed with these disorders, the best examples of expressed emotion by the nursing staff are a. Low to prevent emotional reactions b. Matched to the patient's level of emotion c. Flat without evidence of any emotional output d. High in expression to improve therapeutic patient emotions

a

Tommy, a 12-year-old boy admitted to the pediatric psychiatric unit, has recently been diagnosed with conduct disorder. In the activity room, the games he wanted to play were already in use. He responded by threatening to throw furniture and to hurt those who had the game he wanted. Nancy, a registered nurse, recognizes that Tommy's therapy must include which of the following? a. Consistency in implementing the consequences of breaking rules b. Empathetic reasoning when Tommy acts out in the activity room c. Teaching Tommy the benefits of socializing d. Solitary time so that Tommy can think about his actions

a

What is the rationale for providing a patient diagnosed with dementia easily accessible finger foods thorough the day? a. It increases input throughout the day b. The person may be anorexic c. It helps with the monitoring of food intake d. It helps to prevent constipation

a

When developing a plan of care for a female client with acute stress disorder who lost her sister in a car accident. Which of the following would the nurse expect to initiate? A. Facilitating progressive review of the accident and its consequences B. Postponing discussion of the accident until the client brings it up C. Telling the client to avoid details of the accident D. Helping the client to evaluate her sister's behavior

a

When taking a health history from a client who has a moderate level of cognitive impairment due to dementia, the nurse would expect to note the presence of: A. Accentuated premorbid traits B. Enhance intelligence C. Increased inhibitions D. Hypervigilance

a

Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness? a. The child has been raised by a parent with chronic major depression. b. The childs best friend was absent from the childs birthday party. c. The child was not promoted to the next grade one year. d. The child moved to three new homes over a 2-year period.

a

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? a. Impaired social interaction related to difficulty relating to others b. Chronic low self-esteem related to excessive negative feedback c. Deficient fluid volume related to abnormal eating habits d. Anxiety related to nightmares and repetitive activities

a

Which statement made by a family member tends to support a diagnosis of delirium rather than dementia? a. "She was fine last night but this morning she was confused." b. "Dad doesn't seem to recognize us anymore." c. "She's convinced that snakes come into her room at night." d. "He can't remember when to take his pills or whether he's bathed."

a

What assessment data would support a diagnosis of conduct disorder? Select all that apply. a. Evidence of social isolation b. Arrested twice for disorderly conduct c. Expresses difficulty in keeping employment d. Demonstrates objective signs of phobia e. Exhibits signs of chronic self-mutilation

a, b, c

Which factors tend to increase the difficulty of diagnosing young children who demonstrate behaviors associated with mental illness? Select all that apply. a. Limited language skills b. Level of cognitive development c. Level of emotional development d. Parental denial that a problem exists e. Severity of the typical mental illnesses observed in young children

a, b, c

When the nurse is discussing oppositional defiant disorder with a group of parents, what information about the disorder should be included? Select all that apply a. Classic symptoms, including anger, irritation, and defiant behavior. b. The fact that children generally outgrow the behaviors without formal treatment. c. That severity is considered mild when symptoms are present in only one setting. d. That the disorder is diagnosed equally in both males and females. e. That the terms argumentative and defiant are often used to describe the patient.

a, b, c, e

. In pediatric mental health, there is a lack of sufficient numbers of community-based resources and providers, and there are long waiting lists for services. This has resulted in: Select all that apply. a. Children of color and poor economic conditions being underserved b. Increased stress in the family unit c. Markedly increased funding d. Premature termination of services

a, b, d

4. What assessment question should the nurse ask when attempting to determine a teenager's mental health resilience? Select all that apply. a. "How did you cope when your father deployed with the Army for a year in Iraq?" b. "Who did you go to for advice while your father was away for a year in Iraq?" c. "How do you feel about talking to a mental health counselor?" d. "Where do you see yourself in 10 years?" e. "Do you like the school you go to?"

a, b, d

What is a common behavior observed in a patient diagnosed with intermittent explosive disorder? Select all that apply. a. Short attention span. b. Threatens suicide. c. Often purges after eating. d. Uses alcohol to excess. e. States, "Everyone is out to get me."

a, b, d

Nurses caring for patients who have neurocognitive disorders are exposed to stress on many levels. Specialized skills training and continuing education are helpful to diffuse stress, as well as which of the following? Select all that apply. a. Expressing emotions by journaling b. Describing stressful events on Facebook c. Engaging in exercise and relaxation activities d. Having realistic patient expectations e. Participating in a happy hour after work to blow off steam

a, c, d

What side effects should the nurse monitor for while caring for a patient taking donepezil (Aricept)? Select all that apply. a. Insomnia b. Constipation c. Bradycardia d. Signs of dizziness e. Reports of headache

a, c, d, e

6. Pam, the nurse educator, is teaching a new nurse about seclusion and restraint. Order the following interventions from least (1) to most (5) restrictive: a. With the patient, identify the behaviors that are unacceptable and consequences associated with harmful behaviors b. Placing the patient in physical restraints c. Allowing the patient to take a time-out and sit in his or her room d. Offering a PRN medication by mouth e. Placing the patient in a locked seclusion room

a-1, b-5, c-3, d-2, e-4

A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will the information focus on? a. Paroxetine (Paxil) b. Imipramine (Tofranil) c. Methylpenidate (Ritalin) d. Carbamazepine (Tegretol)

c

3. Cognitive-behavioral therapy is going well when a 12-year-old patient in therapy reports to the nurse practitioner: a. "I was so mad I wanted to hit my mother." b. "I thought that everyone at school hated me. That's not true. Most people like me and I have a friend named Todd." c. "I forgot that you told me to breathe when I become angry." d. "I scream as loud as I can when the train goes by the house."

b

A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurses best first action? a. Give notice to the chief administrator at the school regarding the events. b. Encourage the victimized child to share feelings about the experience. c. Encourage the victimized child to ignore the bullying behavior. d. Discuss the events with the aggressive classmate.

b

Adolescents often display fluctuations in mood along with undeveloped emotional regulation and poor tolerance for frustration. Emotional and behavioral control usually increases over the course of adolescence due to: a. Limited executive function b. Cerebellum maturation c. Cerebral stasis and hormonal changes d. A slight reduction in brain volume

b

April, a 10-year-old admitted to inpatient pediatric care, has been getting more and more wound up and is losing self-control in the day room. Time-out does not appear to be an effective tool for April to engage in self-reflection. April's mother admits to putting her in time-out up to 20 times a day. The nurse recognizes that: a. Time-out is an important part of April's baseline discipline. b. Time-out is no longer an effective therapeutic measure. c. April enjoys time-out and acts out to get some alone time. d. Time-out will need to be replaced with seclusion and restraint.

b

In clients with a cognitive impairment disorder, the phenomenon of increased confusion in the early evening hours is called: 1.Aphasia 2.Sundowning 3.Agnosia 4.Confabulation

b

In terms of the pathophysiology responsible for both delirium and dementia, which intervention would be appropriate for delirium specifically? a. Assisting with needs related to nutrition, elimination, hydration, and personal hygiene b. Monitoring neurological status on an ongoing basis c. Placing an identification bracelet on patient d. Giving one simple direction at a time in a respectful tone of voice

b

The symptom the nurse can expect a client with depersonalization disorder to manifest is A. aimless wandering with confusion and disorientation. B. a feeling of detachment from one's body or mental processes. C. existence of two or more personalities that take control of behavior. D. worry about having a serious disease based on symptom misinterpretation.

b

Which event experienced in the patient's childhood increases the risk of the development of behaviors associated with intermittent explosive disorder? a. Orphaned at age 4 b. Physically abused from ages 3 to 10 c. Born with a chronic congenital disorder d. Has one parent who has been diagnosed with obsessive-compulsive disorder

b

Which nursing intervention is appropriate for the management of intermittent explosive disorder? A. Providing intensive family therapy B. Establishing a trusting relationship with the patient C. Setting up loose boundaries so the patient will feel relaxed D. Limiting decision-making opportunities to avoid frustration

b

Which statement made by a 9-year-old child after hitting a classmate is a typical comment associated with childhood conduct disorder? a. "I'm sorry, I won't hit him again." b. "He deserved it for being a sissy." c. "I didn't think I hit him very hard." d. "He hit me first. You just didn't see it."

b

Which statement, made by the parent of a teen diagnosed with conduct disorder, demonstrates effective parenting? A. "Do you understand that you hurt your sister's feelings when you call her names?" B. "You will lose your driving privileges for a week if you don't clean your room today." C. "When are you going to learn that bullying is not acceptable behavior?" D. "A person your age knows better than to skip school."

b

You are caring for Susannah, a 29-year-old who has been diagnosed with dissociative identity disorder. She was recently hospitalized after coming to the emergency department with deep cuts on her arms with no memory of how this occurred. The priority nursing intervention for Susannah is: a. Assist in recovering memories of abuse. b. Maintain 1:1 observation. c. Teach coping skills and stress-management strategies. d. Refer for integrative therapy.

b

A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply. A. Barbiturates B. Antipsychotic drugs C. Antidepressant drugs D. Mood-stabilizing drugs E. Stimulant drugs

b&c

At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate? Select all that apply. a. Report the finding to the official child protection social services agency. b. Educate all members of the family about risks associated with cyberbullying. c. Talk with the parents about parental controls on the childrens communication devices. d. Encourage the family to schedule daily time together without communication devices. e. Obtain the familys network password and examine online sites family members have visited.

b, c, d

A nurse prepares to lead a discussion at a community health center regarding childrens health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use? Select all that apply. a. Autism b. Bullying c. Mental retardation d. Autism spectrum disorder e. Intellectual development disorder

b, d, e

1. Which statement made by the primary caregiver of a person with dementia demonstrates an accurate understanding of providing the person with a safe environment? a. "The local police know that he has wandered off before." b. "I keep the noise level low in the house." c. "We've installed locks on all the outside doors." d. "Our telephone number is always attached to the inside of his shirt pocket."

c

A child diagnosed with attention deficit hyperactivity disorder (ADHD) shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts (Adderall). The nurse should monitor for which desired behavior? a. Increased expressiveness in communication with others b. Abilities to identify anxiety and implement self-control strategies c. Improved abilities to participate in cooperative play with other children d. Tolerates social interactions for short periods without disruption or frustration

c

A desired outcome for a 12-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. reality therapyb. simple restitution c. social skills group d. insight-oriented group therapy

c

A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to: a. promote integration of self-concept. b. provide inpatient treatment for the child. c. reduce loneliness and increase self-esteem. d. improve language and communication skills.

c

A nurse works with a child who is sad and irritable because the child's parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? a. Therapeutic relationships provide an outlet for tension. b. Focusing on the strengths increases a persons self-esteem. c. Acceptance and trust convey feelings of security to the child. d. The child should express feelings rather than internalize them.

c

After talking with her 85-year-old mother, Nancy became concerned enough to drive to her home and check on her. Her mother's appearance was disheveled, her words were nonsensical, she smelled strongly of urine, and there was a stain on her dressing gown. Because she is a nurse, Nancy recognizes that her mother's condition is likely due to a. Early-onset dementia b. A mild cognitive disorder c. A urinary tract infection d. Having skipped breakfast

c

An elderly client with Alzheimer's disease becomes agitated and combative when a nurse approaches to help with morning care. The most appropriate nursing intervention in this situation would be to: 1.Tell the client family that it is time to get dressed. 2.Obtain assistance to restrain the client for safety. 3.Remain calm and talk quietly to the client. 4.Call the doctor and request an order for sedation.

c

Ashley is a 21-year-old college student who was sexually assaulted at a party. She was seen in the local emergency department and referred for counseling after being diagnosed by the provider on call as having acute stress disorder. Which of the following treatment modalities would you expect to see used in therapy with Ashley? a. Aversion therapy b. Stress-reduction therapy c. Cognitive behavioral therapy d. Short-term classical analysis therapy

c

Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others conversations. How should the nurse document these behaviors? a. disobedience b. hyperactivity c. impulsive d. anxiety

c

Child protective services have removed 10-year-old Christopher from his parents' home due to neglect. Christopher reveals to the nurse that he considers the woman next door his "nice" mom, that he loves school, and gets above average grades. The strongest explanation of this response is: a. Temperament b. Genetic factors c. Resilience d. Paradoxical effects of neglect

c

Claude is a new nurse on the psychiatric unit. He asks a senior nurse on staff for advice in working with patients with oppositional defiant disorder. Which statement reflects advice on solid therapeutic communication? a. "When you are correcting behavior, use a loud firm tone." b. "Use language beyond the patient's education level." c. "When you are setting limits, be specific and outline the consequences." d. "Aggressive body language will make the patients respect your position."

c

Dissociative identity disorder is characterized by A. the inability to recall important information. B. sudden unexpected travel away from home and inability to remember the past. C. the existence of two or more subpersonalities, each with its own patterns of thinking. D. recurring feelings of detachment from one's body or mental processes.

c

During a routine health screening, a grieving widow whose husband died 15 months ago reports emptiness, a loss of self, difficulty thinking of the future, and anger at her dead husband. The nurse suggests bereavement counseling. The widow is most likely suffering from: a. Major depression b. Normal grieving c. Adjustment disorder d. Posttraumatic stress disorder

c

Lucia, 70 years old, recently underwent a major orthopedic surgical procedure. On postoperative day 3, she responds to the nurse who has been caring for her with affection. At other times, however, she tells the nurse to leave because she does not recognize her and asks to have another nurse care for her, specifically naming the nurse as the "nice one." The most likely reason for Lucia's behavior is that she is a. Attention-seeking and manipulative b. Showing signs of early dementia c. Experiencing an acute delirium d. Playing one staff member off against another

c

Maggie, a child in protective custody, is found to have an imaginary friend, Holly. The foster family shares this information with the nurse. The nurse teaches the family members about children who have suffered trauma and knows her teaching was effective when the foster mother states: a. "I understand that imaginary friends are abnormal." b. "I understand that imaginary friends are a maladaptive behavior." c. "I understand that imaginary friends are a coping mechanism." d. "I understand that we should tell the child that imaginary friends are unacceptable."

c

The nurse is using drawing, puppetry, and other forms of play therapy while treating a terminally ill, school-age child. The purpose of these techniques is to help the child: 1.internalize his feelings about death and dying. 2.accept responsibility for his situation. 3.express feelings that he can't articulate. 4.have a good time while he's in the hospital.

c

The nurse would expect a child with a diagnosis of reactive attachment disorder to: 1.Have more positive relation with the father than the mother 2.Cling to mother & cry on separation 3.Be unable to develop a positive relation with the others 4.Have been physically abuse

c

The parent of a child diagnosed with Tourettes disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate? a. Perhaps your child was misdiagnosed. b. Your observation indicates the medication is effective. c. Tics often change frequency or severity. That doesnt mean they arent real. d. This finding is unexpected. How have you been administering your childs medication?

c

The school guidance counselor refers a family with an 8-year-old child to the mental health clinic because of the child's frequent fighting in school and truancy. Which of the following data would be a priority to the nurse doing the initial family assessment? 1.The child's performance in school 2.Family education and work history 3.The family's perception of the current problem 4.The teacher's attempts to solve the problem

c

What is the nurses priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD)? a. Dystonia, akinesia, and extrapyramidal symptoms b. Bradycardia and hypotensive episodes c. Sleep disturbances and weight lossd. d.Neuroleptic malignant syndrome

c

2. Which activity is most appropriate for a child with ADHD? a. Reading an adventure novel b. Monopoly c. Checkers d. Tennis

d

When a 5-year-old is disruptive, the nurse says, You must take a time-out. The expectation is that the child will: a. go to a quiet room until called for the next activity. b. slowly count to 20 before returning to the group activity. c. sit on the edge of the activity until able to regain self-control. d. sit quietly on the lap of a staff member until able to apologize for the behavior.

c

When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses: a. guided imagery. b. talk focused on a specific issue. c. play and talk about a play activity. d. group discussion about selected topics.

c

Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child: a. plays with one toy for 30 minutes. b. repeats words spoken by a parent. c. holds the parents hand while walking. d. spins around and claps hands while walking.

c

Which childhood disorder is characterized by serious violations of social norms, such as destruction of property? A. Attention deficit hyperactivity disorder (ADHD) B. Obsessive-compulsive disorder (OCD) C. Conduct disorder D. Oppositional defiant disorder (ODD)

c

Which factor presents the highest risk for a child to develop a psychiatric disorder? a. having uncle with schizophrenia b. being oldest in family c. living with alcoholic parent d. being only child

c

Which would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors? A. Social skills training B Self-esteem enhancement C. Limit setting D. Time out

c

A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will: (select all that apply) a. graduate from high school. b. live independently in an apartment. c. independently perform own personal hygiene. d. obtain employment in a local sheltered workshop. e. correctly use public buses to travel in the community.

c, d, e

A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, What should we do? Select the nurses best response. a. Ask the teacher to let the child call you at play time. b. Withdraw the child from preschool until maturity increases. c. Remain with your child for the first hour of preschool time. d. Give your child a kiss before you leave the preschool program.

d

A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child: a. has an improved ability to identify anxiety and use self-control strategies. b. has increased expressiveness in communication with others. c. shows increased responsiveness to authority figures. d. engages in cooperative play with other children.

d

A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder? The child: a. has occasional toileting accidents. b. is unable to read childrens books. c. cries when separated from a parent. d. continuously rocks in place for 30 minutes.

d

In the diagnosis of a possible pervasive developmental autistic disorder. The nurse would find it most unusual for a 3 year old child to demonstrate: 1.An interest in music 2.An attachment to odd objects 3.Ritualistic behavior 4.Responsiveness to the parents

d

Jamie, age 24, has been diagnosed with a dissociative disorder following a traumatic event. Jamie's mother asks you, "Does this mean my daughter is now crazy?" Your best response would be: a. "People with dissociative disorders are out of touch with reality, so in that way, your daughter is now mentally ill. Don't worry. Treatment is available." b. "Jamie will most likely need long-term intensive inpatient treatment to deal with her traumatic memories as well as to work through her delusions." c. "Most mental health providers are skeptical about dissociative disorders and aren't sure they truly exist. Jamie may be making up her symptoms as a cry for help." d. "Jamie is dealing with the anxiety associated with the trauma by separating herself from it. With treatment, she can get back to her previous level of functioning."

d

Ophelia, a 69-year-old retired nurse, attends a reunion of her former coworkers. Ophelia is concerned because she usually knows everyone, and she cannot recognize faces today. A registered nurse colleague recognizes Ophelia's distress and "introduces" Ophelia to those attending. The nurse practitioner understands that Ophelia seems to have a deficit in her a. Lower-level cognitive domain b. Delirium threshold c. Executive function d. Social cognition ability

d

Santiago, an adolescent in a treatment facility, is loudly displaying anger with a visiting family member in the day room. It is obvious to the nurse that this pattern has played out before. Violence is often escalated when family members or authority figures a. Use a soft tone of voice to gain control of the situation b. Move away from the agitated person in fear c. Use simple words to communicate d. Engage in a power struggle

d

Since his wife's death 2 months earlier, Aaron, 90 years of age and in good health, has begun to pay less attention to his hygiene and seems less alert to his surroundings. He complains of difficulty concentrating, disrupted sleep, and lacks energy. His family has to remind and encourage him to shower, take his medications, and eat, all of which he then does. Which of the following responses would be most appropriate? a. Reorient Mr. Smith by pointing out the day and date each time you have occasion to interact with him. b. Meet with the family and support them to accept, anticipate, and prepare for the progression of his stage 2 dementia. c. Avoid touch and proximity. These are likely to be uncomfortable for Mr. Smith and may provoke aggression when he is disoriented. d. Arrange for an appointment with a mental health professional for the evaluation and treatment of suspected major depressive disorder.

d

The nurse is aware that language development in autistic child resembles: 1.Scanning speech 2.Speech lag 3.Shuttering 4.Echolalia

d

The nurse is aware that the symptoms that distinguish post traumatic stress disorder from other anxiety disorder would be: 1.Avoidance of situation & certain activities that resemble the stress 2.Depression and a blunted affect when discussing the traumatic situation 3.Lack of interest in family & others 4.Re-experiencing the trauma in dreams or flashback

d

The nurse is caring for a client with delirium and states that "look at the spiders on the wall". What should the nurse respond to the client? 1."You're having hallucination, there are no spiders in this room at all" 2."I can see the spiders on the wall, but they are not going to hurt you" 3."Would you like me to kill the spiders" 4."I know you are frightened, but I do not see spiders on the wall

d

The parent of a 6-year-old says, My child is in constant motion and talks all the time. My child isnt interested in toys but is out of bed every morning before me. The childs behavior is most consistent with diagnostic criteria for: a. communication disorder b. stereotypic movement disorder b. intellectual development disorder d. attention deficit hyperactivity disorder

d

The school nurse has been alerted to the fact that an 8-year-old boy routinely play acts as a police officer, "locking up" other children on the playground to the point where the children get scared. The nurse recognizes that this behavior is most likely an indication of: a. The need to dominate others b. Inventing traumatic events c. A need to develop close relationships d. A potential symptom of traumatization

d

When a 5-year-old diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair and runs over and slaps another child, what is the nurses best action? a. Instruct the parents to take the aggressive child home. b. Direct the aggressive child to stop immediately. c. Call for emergency assistance from other staff. d. Take the aggressive child to another room.

d

Which child demonstrates behaviors indicative of a neurodevelopmental disorder? a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling b. A 9-month-old who does not eat vegetables and likes to be rocked c. A 3-month-old who cries after feeding until burped and sucks a thumb d. A 3-year-old who is mute, passive toward adults, and twirls while walking

d

Which of the following outcome criteria is appropriate for the client with dementia? 1.The client will return to an adequate level of selffunctioning. 2.The client will learn new coping mechanisms to handle anxiety. 3.The client will seek out resources in the community for support. 4.The client will follow an establishing schedule for activities of daily living.

d

You are caring for Connor, an 8-year-old boy who has been diagnosed with reactive attachment disorder. Which of the following nursing outcomes would be the most appropriate to achieve? a. Increases ability to self-control and decreases impulsive behaviors. b. Avoids situations that trigger conflicts. c. Expresses complex thoughts. d. Writes or draws feelings in a journal.

d