CLO3 Final Unit Examination (Nursing Psych)

Rosana is in the second stage of Alzheimer's disease who appears to be in pain. Which question by Nurse Jenny would best elicit information about the pain? "Where is your pain located?" "Do you hurt? (pause) "Do you hurt?" "Can you describe your pain?" "Where do you hurt?"

"Do you hurt? (pause) "Do you hurt?"

Which of the following situations constitutes an act of negligence on the part of the nurse who is administering Cloazapine (Clozaril) to a schizophrenic client? A. Administering the drug after learning that the client's WBC count is 2500/mm B. Administering an anti-parkinsonian medication P.R.N. despite the presence of muscle rigidity C. Administering the drug after meals D. Instructing the client to visit the clinic weekly for a drug test

A. Administering the drug after learning that the client's WBC count is 2500/mm

A client with a diagnosis of paranoid schizophrenia comments tothe nurse, "How do I know what is really in those pills?" Which of the following is the best response? A. Allow him to open the individual wrappers of the medication. B. Say, "You know it's your medicine." C. Say, "Don't worry about what is in the pills. It's what is ordered." D. Ignore the comment because it's probably a joke.

A. Allow him to open the individual wrappers of the medication.

Which of the following statements about elderly client is not true? A. Continuous stimulation of the elderly through frequent re-arrangement of room furniture promotes orientation B. Elderly clients have difficulty distinguishing blue and green colors C. Yellow or red bulbs are best suited for the room of elderly client D. Elderly clients seem to have decrease frequency of sexual intercourse

A. Continuous stimulation of the elderly through frequent re-arrangement of room furniture promotes orientation

In preparing a female client for electroconvulsive therapy (ECT), nurse Ana knows that succinylcholine (Anectine) will be administer for which therapeutic effects? A. Skeletal muscle paralysis B. Decrease oral and respiratory secretions C. Analgesia D. Short acting anesthesia

A. Skeletal muscle paralysis

The nurse is caring for a client with schizophrenia. Which of the following outcomes is the least desirable? A. The client spends more time by himself. B. The client demonstrates the ability to meet his own self-care needs. C. The client doesn't harm himself or others. D. The client doesn't engage in delusional thinking.

A. The client spends more time by himself.

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. Transitory short and long term memory loss and confusion B. Transitory short-term memory loss and permanent long-term memory loss C. Permanent long-term memory loss and hypomania D. Permanent short-term memory loss and hypertension

A. Transitory short and long term memory loss and confusion

A client is admitted to the psychiatric unit with a tentative diagnosis of psychosis. Her physician prescribes the phenothiazine thioridazine (Mellaril) 50 mg by mouth three times per day. Phenothiazines differ from central nervous system (CNS) depressants in their sedative effects by producing: A. a calming effect from which the client is easily aroused. B. greater sedation than CNS depressants. C. deeper sleep than CNS depressants. D. more prolonged sedative effects, making the client more difficult to arouse.

A. a calming effect from which the client is easily aroused.

The etiology of schizophrenia is best described by: A. combination of biological, psychological, and environmental factors. B. genetics due to a faulty dopamine receptor. C. structural and neurobiological factors. D. environmental factors and poor parenting.

A. combination of biological, psychological, and environmental factors.

A client is brought to the emergency department after being beaten by her husband, a prominent attorney. The nurse caring for this client understands that: A. domestic violence and abuse span all socioeconomic classes. B. violent behavior is a genetic trait passed from one generation to the next. C. open boundaries are common in violent families. D. violence usually results from a power struggle.

A. domestic violence and abuse span all socioeconomic classes.

A psychotic client reports to the evening nurse that the day nurse put something suspicious in his water with his medication. The nurse replies, "You're worried about your medication?" The nurse's communication is: A. focusing on emotional content. B. an example of presenting reality. C. reinforcing the client's delusions. D. a nontherapeutic technique called mind reading.

A. focusing on emotional content.

When taking a health history from a female client who has a moderate level of cognitive impairment due to dementia, the nurse would expect the nurse to note the presence of: Hyper vigilance Accentuated premorbid traits Increase inhibitions Enhance intelligence

Accentuated premorbid traits

Which of the following interventions is not appropriate for a child who is taking methylphenidate (Ritalin) Avoid intake of tea, cola or chocolates Administer the drug before meals Administer the drug in the morning Monitor the growth rate every three months

Administer the drug before meals

When asking the parents about the onset of the problems in young client with the diagnosis of schizophrenia, nurse Linda would that they would relate the client's difficulties began in: Late childhood Early childhood Puberty Adolescence

Adolescence

After 3 days of taking haloperidol, the client shows an inability to sit still, is restless and fidgety, and paces around the unit. Of the following extrapyramidal adverse reactions, the client is showing signs of: Parkinsonism Dystonia Tardive dyskinesia Akathisia

Akathisia

Which of the following physiologic alteration does not seem to occur in a client with Alzheimer's disease? Neuro fibrillary tangles Altered GABA levels Brain atrophy Deficiency in acetylcholine

Altered GABA levels

which of the following characteristic of client with dementia may possibly result in under medication of pain? Apraxia Agnosia Anomia Aphasia

Aphasia Aphasia is a language disorder caused by damage in a specific area of the brain that controls language expression and comprehension.

The client is taking risperidone (Risperdal) to treat the positive and negative symptoms of schizophrenia. Which of the following negative symptoms will improve? Abnormal thought form. Hallucinations and delusions. Bizarre behaviour. Asocial behaviour and anergia.

Asocial behaviour and anergia.

Joel, aged 2 years old is brought to the pediatric clinic by his parents who reports that he does not want to let go of his pillow; frequently screams and throw himself into a tantrum that involves head banging. Based on his clinical observation, joel is more likely suffering from: Autism Attention deficit hyperactive disorder Down's syndrome Mental retardation

Autism

While pacing in the hall, a client with paranoid schizophrenia runs to the nurse and says, "Why are you poisoning me? I know you work for central thought control! You can keep my thoughts. Give me back my soul!" How should the nurse respond during the early stage of the therapeutic process? A. "I'm not poisoning you. And how could I possibly steal your soul?" B. "I'm a nurse, and you're a client in the hospital. I'm not going to harm you." C. "I'm a nurse. I'm not poisoning you. It's against the nursing code of ethics." D. "I sense anger. Are you feeling angry today?"

B. "I'm a nurse, and you're a client in the hospital. I'm not going to harm you."

The nurse is providing care for a female client with a history of schizophrenia who's experiencing hallucinations. The physician orders 20mg of haloperidol (Haldol) orally or I.M. every 4 hours as needed. What is the nurse's best action? A. Administer the haloperidol orally if the client agrees to take it. B. Call the physician to clarify the order because the dosage is too high. C. Withhold haloperidol because it may worsen hallucinations. D. Call the physician to clarify whether the haloperidol should be given orally or I.M.

B. Call the physician to clarify the order because the dosage is too high.

In an elderly client who is being treated with narcotics which of the following intervention should be given highest priority? A. monitoring the client's serum creatinine level B. Checking the client's liver function test result C. Assessing the clients ability to swallow D. assessing the client's range of motion

B. Checking the client's liver function test result

Situation: communication is product of culture. When the psychiatric nurse communicates with the client, she utilizes the principles designed to make the interaction a part of the total therapeutic process Which of the following statements communication is NOT true? A. Attitudes, values, beliefs and self-concept, influence communication B. Communication refers to an intended message C. The message that was received by the receiver best represent communication D. Communication goals depends on the gender of the message sender

B. Communication refers to an intended message

Which of these approaches would most likely lead to the development of trust? A. Offer prayers frequently B. Ensure that the appointment with the client proceeds as scheduled C. Encourage the client to participate in group activities D. Always call the client by name

B. Ensure that the appointment with the client proceeds as scheduled

Situation: The utilization of psycho therapeutic interaction is based on the identified problem of the client. The goals of care provide direction for utilization of such interventions. Which of the following descriptions best reflects the main goal of family therapy? A. Family therapy enhances group decision making of the family B. Family therapy facilitates effective communication and interaction of the family members C. Family therapy focuses on the relationship of the parents more than the children D. Family therapy focuses on the client as the symptom bearer of a sick family

B. Family therapy facilitates effective communication and interaction of the family members

Neuroleptic Malignant Syndrome is characterized by : A. Hypotension, hypothermia, flushed and dry skin. B. Hypertension, hyperthermia, diaphoresis C. Hypertension, hypothermia, diaphoresis D. hypertension, hyperthermia, flushed and dry skin.

B. Hypertension, hyperthermia, diaphoresis

A client diagnosed with schizophrenia states, "cant you hear him? It's the devil. He is telling me that I am going to hell" which is the most appropriate nursing reply? A. The devil only talks to people who are receptive to his influence B. I know the voices sound scary. The devil is not talking to you. This is a part of your illness C. Did you take you medicine this morning? D. You are not going to hell, you're a good person

B. I know the voices sound scary. The devil is not talking to you. This is a part of your illness

A husband and wife seek emergency crisis intervention because he slapped her repeatedly the night before. The husband indicates that his childhood was marred by an abusive relationship with his father. When intervening with this couple, the nurse knows they are at risk for repeated violence because the husband: A. has only moderate impulse control. B. has learned violence as an acceptable behavior. C. denies feelings of jealousy or possessiveness. D. feels secure in his relationship with his wife.

B. has learned violence as an acceptable behavior.

An autistic child is least likely to be attracted to which objects for play? Blanket Ball Pillow Blocks

Ball

A woman is admitted to the psychiatric emergency department. Her significant other reports that she has difficulty sleeping, has poor judgment, and is incoherent at times. The client's speech is rapid and loose. She reports being a special messenger from the Messiah. She has a history of depressed mood for which she has been taking an antidepressant. The nurse suspects which diagnosis? Paranoid personality Bipolar illness Obsessive-compulsive disorder (OCD) Schizophrenia

Bipolar illness

A client with paranoid personality disorder is admitted to a psychiatric facility. Which remark by the nurse would best establish rapport and encourage the client to confide in the nurse? A. "At times, it's normal not to trust anyone." B. "I know just how you feel. I'd feel the same way in your situation." C. "I get upset once in a while, too." D. "I worry, too, when I think people are talking about me."

C. "I get upset once in a while, too."

Which of the following etiologic factors predispose a client to Tourette syndrome? A. Environmental factors and birth-related trauma B. Abnormalities in the structure and function of the ventricles C. Abnormalities in brain neurotransmitters, structural changes in basal ganglia and genetics D. No known etiology

C. Abnormalities in brain neurotransmitters, structural changes in basal ganglia and genetics

A client with a diagnosis of paranoid schizophrenia comments tothe nurse, "How do I know what is really in those pills?" Which of the following is the best response? A. Say, "Don't worry about what is in the pills. It's what is ordered." B. Ignore the comment because it's probably a joke. C. Allow him to open the individual wrappers of the medication. D. Say, "You know it's your medicine."

C. Allow him to open the individual wrappers of the medication.

The nurse formulates a nursing diagnosis of Impaired verbal communication for a client with schizotypal personality disorder. Based on this nursing diagnosis, which nursing intervention is most appropriate? A. Establishing alternative forms of communication B. Allowing the client to decide when he wants to participate in verbal communication with the nurse C. Establishing a one-on-one relationship with the client D. Helping the client to participate in social interactions

C. Establishing a one-on-one relationship with the client

A paranoid client presents bizarre behaviors, neologism and thought insertion. Which nursing action should be prioritized to maintain the client's safety? A. Assess triggers for bizarre, inappropriate behavior B. Assess for medication non-compliance C. Note escalating behavior and intervene immediately D. Interprets attempts at communication

C. Note escalating behavior and intervene immediately

In a toddler, which of the following injuries is most likely the result of child abuse? A. A 1-inch forehead laceration B. A small isolated bruise on the right lower extremity C. Several small, dime-sized circular burns on the child's back D. A hematoma on the occipital region of the head

C. Several small, dime-sized circular burns on the child's back

which of the following approaches is the best way to communicate with a mute, immobile catatonic schizophrenic client? A. Tell her to say what she wants and needs within a given period of time. B. Use open ended questions C. Talk to her in ways that she does need to response D. Continue to rephrase the question until she makes an effort to response

C. Talk to her in ways that she does need to response

Which of the following approaches is appropriate to initiate interaction with the client? A. Tell the client "You are my client, I was your nurse. Can we begin talking?" B. Address the client by her family name and say " I am Liza your nurse you can talk to me anytime you want" C. Tell the client "hello Mrs. Jane Cruz I am Liza your nurse. I need to learn more about you and the reason you are here. Then we will talk about how can I help you D. Address the client by her first name and say " I am a nurse assigned to talked to you. How are you?

C. Tell the client "hello Mrs. Jane Cruz I am Liza your nurse. I need to learn more about you and the reason you are here. Then we will talk about how can I help you

When interviewing the parents of an injured child, which of the following is the strongest indicator that child abuse may be a problem? A. The family is in low economic income group B. The parents are argumentative and demanding with emergency department personnel. C. The injury isn't consistent with the history or the child's age. D. The mother and father tell different stories regarding what happened.

C. The injury isn't consistent with the history or the child's age.

A 16 year old client diagnosed with paranoid schizophrenia experiences command hallucinations to harm others. The client's parents ask the nurse "where do the voices come from?" which is the appropriate nursing reply? A. Your child has too little serotonin in the brain causing hallucination and delusion B. Your child's abnormal hormonal changes have precipitated auditory hallucinations C. Your child has a chemical imbalance of the brain which leads to altered thoughts D. Your child hallucination are caused by medication interaction

C. Your child has a chemical imbalance of the brain which leads to altered thoughts

A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to: A. tell him his fear is unrealistic. B. engage the client in reality-oriented activities. C. explore the content of the hallucinations. D. take the client's vital signs.

C. explore the content of the hallucinations.

A thorough assessment of a cognitively impaired client reveals: loss of memory, poor judgment, wandering and violent, agitated or anxious behavior. Which nursing diagnosis is a priority? Confusion Chronic confusion Acute confusion Altered thought process

Chronic confusion

Every day for the past 2 weeks, a client with schizophrenia stands up during group therapy and screams, "Get out of here right now! The elevator bombs are going to explode in 3 minutes!" The next time this happens, how should the nurse respond? A. "If you have something to say, you must do it according to our group rules." B. "That is the same thing you said in yesterday's session." C. "Why do you think there is a bomb in the elevator?" D. "I know you think there are bombs in the elevator, but there aren't."

D. "I know you think there are bombs in the elevator, but there aren't."

Which of the following statement is the most appropriate way to address hallucinations in a client? A. "are the voices bothering you again?" B. "don't be afraid, I am here to stay with you" C. "do you hear the voices?" D. "it seems that you are hearing something, what do you hear?"

D. "it seems that you are hearing something, what do you hear?"

Which of the following is one of the advantages of the newer antipsychotic medication risperidone (Risperdal)? A. The absence of anticholinergic effects B. No incidence of neuroleptic malignant syndrome C. Photosensitivity and sedation D. A lower incidence of extrapyramidal effects

D. A lower incidence of extrapyramidal effects

Crisis intervention carried out to the client has this primary goal A. Assist the client to express her feelings B. Support her adaptive coping skills C. Help her identify her resources D. Help her return to her pre-crisis level of function

D. Help her return to her pre-crisis level of function

In therapeutic communication, the nurse relies on the client's disclosure of information. As client advocate, the nurse should: A. Keep the information from the client as a personal secret B. Consider confidentiality of all information when dealing with the members of the health team C. Acts as a friend of the client at all times D. Maintain objectivity by sharing pertinent information with the members of the health team

D. Maintain objectivity by sharing pertinent information with the members of the health team

The nurse is assigned to a client with catatonic schizophrenia. Which intervention should the nurse include in the client's plan of care? A. Giving the client an opportunity to express concerns B. Providing a quiet environment where the client can be alone C. Administering lithium carbonate (Lithonate) as prescribed D. Meeting all of the client's physical needs

D. Meeting all of the client's physical needs

Which of the following is the highest priority the nurse when providing care for a dying client? A. Facilitating the clients expression of feelings and ensuring safety B. Listening to the client and her family's concern C. Involving client's family and friends in her care D. Providing comfort and managing client's physical symptoms

D. Providing comfort and managing client's physical symptoms

Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while the other clients are watching television and he begins to throwing furniture. As a nurse your first reaction is? A. Report to the attending physician the behavior B. Check the clients medical record for an order of p.r.n. IM dose of medication for agitation C. Place the client in full leather restraint D. Remove all the other clients in the day room

D. Remove all the other clients in the day room

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: A. have a good time while he's in the hospital B. accept responsibility for his situation C. internalize his feelings about death and dying. D. express feelings that he can't articulate.

D. express feelings that he can't articulate.

During an admission assessment a nurse ask the client diagnosed with schizophrenia " have you ever felt that certain objects or persons have control over your behavior?" the nurse is assessing for which type of thought disruption? Delusion of influence Delusion of persecution Delusion of grandeur Delusion of reference

Delusion of influence

A nurse assessing a client diagnosed with paranoid schizophrenia. The nurse ask the client, " do you receive special messages from certain sources such as the television or radio? Which potential symptoms of this disorder is the nurse assessing? persecutory delusion Thought insertion Paranoid delusion Delusion of reference

Delusion of reference

Joy who has just experienced her second spontaneous abortion expresses anger towards her physician, the hospital and the "rotten nursing care". When assessing the situation, the nurse recognizes that the client may be using the coping mechanism of: Projection Reaction formation Denial Displacement

Displacement

Which one of the following is essential component of the therapeutic communication? Rapport Sympathy Consistency Empathy

Empathy

A client with disorganized type schizophrenia has been hospitalized for the past 2 years on a unit for chronic mentally ill clients. The client's behavior is labile and fluctuates from childishness and incoherence to loud yelling to slow but appropriate interaction. The client needs assistance with all activities of daily living. Which behavior is a characteristic of disorganized type schizophrenia? Elevated affect Waxy flexibility Extreme social impairment Suspicious delusions

Extreme social impairment

Which of the following is not an example an example of alteration of perception? Illusion Flight of ideas Ideas of reference Hallucination

Flight of ideas

Mr. Marquez reports of losing his job, not being able to sleep at night and feeling upset with his wife. F Nurse Jane responds to the client, " you may want to talk about your current situation in the group today". The nurse is using which therapeutic technique? Exploring Observation Focusing Restating

Focusing

Nursing preparation for a client undergoing electroconvulsive therapy (ECT) resemble those used for: Cardiac stress testing General anesthesia Neurologic examination Physical therapy

General anesthesia

A client begins clozapine (Clozaril) therapy after several other antipsychotic agents fail to relieve her psychotic symptoms. The nurse instructs her to return for weekly white blood cell (WBC) counts to assess for which adverse reaction? Granulocytopenia Systemic dermatitis Infection Hepatitis

Granulocytopenia

Which of the following emotional responses is most likely to observed in a rape victim? Hostility Guilt Fear Anxiety

Guilt

Which of the following statement methods is appropriate to screen a client for dementia? I.Q test Sentence completion test Mental status examination Personality test

Mental status examination

A client diagnosed with schizoaffective disorder is suffering from schizophrenia with elements of which of the following disorders? Amnestic disorder Personality disorder Thought disorder Mood disorder

Mood disorder

In the elderly client which of the following symptoms is the most important? Pain Decreasing eyesight Poor balance Constipation

Pain

The client on Haldol has pill rolling tremors and muscle rigidity he is likely manifesting: Pseudoparkinsonism Tardive dyskinesia Akathisia Dystonia

Pseudoparkinsonism

Which of the following needs of a client with alzheimer's disease should be the highest priority of the nurse? Bowel and bladder elimination Independence Reorientation Safety

Reorientation

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: An attachment to odd objects Responsiveness to the parents Ritualistic behavior An interest in music

Responsiveness to the parents

How soon after chlorpromazine (Thorazine) administration should the nurse expect to see a client's delusional thoughts and hallucinations eliminated? Several hours Several days Several minutes Several weeks

Several weeks

A victim of domestic violence repetitively verbalizes self negating statement and a sense of guilt. Which nursing diagnosis applies to this client? Self mutilation Situational low self esteem Risk for self abuse Disturbed self concept

Situational low self esteem

Marian with schizophrenia tells Nurse Melinda, "My intestines are rotted from worms chewing on them." This statement indicates: Delusion of grandeur Somatic delusion Delusion of persecution Jealous delusion

Somatic delusion

A client with persistent, severe schizophrenia has been treated with phenothiazines for the past 17 years. Now the client's speech is garbled as a result of drug-induced rhythmic tongue protrusion. What is another name for this extrapyramidal symptom? Dystonia Pseudoparkinsonism Tardive dyskinesia Akathisia

Tardive dyskinesia

A client, age 36, with paranoid schizophrenia believes the room is bugged by the Central Intelligence Agency and that his roommate is a foreign spy. The client has never had a romantic relationship, has no contact with family members, and hasn't been employed in the last 14 years. Based on Erikson's theories, the nurse should recognize that this client is in which stage of psychosocial development? Integrity versus despair Autonomy versus shame and doubt Trust versus mistrust Generativity versus stagnation

Trust versus mistrust

A client diagnosed with Pick's disease paces repetitively is disoriented and ambulates endlessly. The appropriate nursing diagnosis is: Wandering Confusion Anxiety Risk for injury

Wandering

A client with schizophrenia who receives fluphenazine (Prolixin) develops pseudoparkinsonism and akinesia. What drug would the nurse administer to minimize extrapyramidal symptoms? diazepam (Valium) dantrolene (Dantrium) benztropine (Cogentin) clonazepam (Klonopin)

benztropine (Cogentin)

A client with a history of medication noncompliance is receiving outpatient treatment for chronic undifferentiated schizophrenia. The physician is most likely to prescribe which medication for this client? chlorpromazine (Thorazine) lithium carbonate (Lithane) imipramine (Tofranil) fluphenazine decanoate (Prolixin Decanoate)

fluphenazine decanoate (Prolixin Decanoate)

A dystonic reaction can be caused by which of the following medications? clonazepam (Klonopin) diazepam (Valium) haloperidol (Haldol) amitriptyline (Elavil)

haloperidol (Haldol)

A client is admitted with a diagnosis of delusions of grandeur. This diagnosis reflects a belief that one is: being persecuted. responsible for the evil in the world. connected to events unrelated to oneself. highly important or famous.

highly important or famous.

A nurse is caring for a client with Parkinson's disease who has been taking carbidopa/levodopa (Sinemet) for a year. Which of the following adverse reactions will the nurse monitor the client for? hypotension glaucoma dykinesia respiratory depression

hypotension

Tourette syndrome is characterized by the presence of multiple motor and vocal tics. A vocal tic that involves repeating one's own sounds or words is known as: palilalia aphonia apraxia. Echolalia

palilalia

A client is admitted to the psychiatric hospital with a diagnosis of catatonic schizophrenia. During the physical examination, the client's arm remains outstretched after the nurse obtains the pulse and blood pressure, and the nurse must reposition the arm. This client is exhibiting: retardation. waxy flexibility. negativity. suggestibility.

waxy flexibility.