Exam 3 Behavioral Questions
A 37-year-old patient, referred to the mental health clinic with a suspected personality disorder, is withdrawn and suspicious and states, "I've always preferred to be alone" and then adds, "I can read your thoughts whenever I want to." This presentation supports which psychiatric diagnosis? A. Obsessive-compulsive personality disorder B. Narcissistic personality disorder C. Avoidant personality disorder D. Schizotypal personality disorder (STPD)
D
A client with a history of social drinking presents to the ED. He has the following vitals: TPR: 101.4, 126, 24; BP 140/96. The nurse notes the client has gross hand tremors and is screaming for someone to kill the bugs in his bed. The nurse should suspect which of the following: A. Infection B. Acute sepsis C. Pneumonia D. Alcohol withdrawal
D
A syndrome that occurs after stopping the long-term use of a drug is called A.amnesia. B.tolerance. C.enabling. D.withdrawal.
D
Benzodiazepines are useful for treating alcohol withdrawal because they are associated with which action? A.Blocking cortisol secretion B. Increasing dopamine release C. Decreasing serotonin availability D Exerting a calming effect
D
The etiology of schizophrenia is best described by: a. Genetics due to a faulty dopamine receptor b. Environmental factors and poor parenting c. Structural and neurobiological factors d. A combination of biological, psychological, and environmental factors
D
The term tolerance, as it relates to substance abuse, refers to which situation? A. The use of a substance beyond acceptable societal norms B. The additive effects achieved by taking two drugs with similar actions C. The signs and symptoms that occur when an addictive substance is withheld D. The need to take larger amounts of a substance to achieve the same effects
D
When a client diagnosed with paranoid schizophrenia tells the nurse, "I have to get away. The volmers are coming to execute me," an appropriate response for the nurse would be: A. "You are safe here. This is a locked unit, and no one can get in." B. "I do not believe I understand the word volmers. Tell me more about them." C. "Why do you think someone or something is going to harm you?" D. "It must be frightening to think something is going to harm you."
D
Which characteristic presents the greatest risk for injury to others by the patient diagnosed with schizophrenia? a. Depersonalization b. Pressured speech c. Negative symptoms d. Paranoia
D
You are evaluating a patient's progress. Which treatment outcome would indicate a poor general prognosis for long-term recovery from substance abuse? A. Patient demonstrates improved self-esteem B. Patient demonstrates enhanced coping abilities C. Patient demonstrates relationships with others D. Patient demonstrates positive expectations for ongoing drug use
D
Antipsychotics administered PO, SubQ, or IM?
PO, IM
_____________________________ prevents or reverses Wernicke-Korsakoff's syndrome that is associated with heavy, long term alcohol abuse
Thiamine (VB1)
A client is admitted to the psychiatric unit with a diagnosis of delusions of grandeur. This diagnosis is the belief that one is: A. Highly important or famous B. Being persecuted C. Connected to events unrelated to oneself D. Responsible for the evil in the world
a
Akathisia can sometimes be misdiagnosed as agitation in schizophrenic patients. A. TRUE B. FALSE
a
Mr. Allen has psychosis and has been treated with Haloperidol (Haldol). You need to assess him for movement disorders as a side effect of Haldol. What is another name for movement disorders associated with use of antipsychotics? A. Extrapyramidal symptoms B. Autonomic dysreflexia C. Biologic rigidity reactions D. Delusional etiologies
a
Peter is diagnosed with schizophrenia paranoid type and is admitted to the psychiatric unit. Which of the following nursing interventions would be most appropriate? A. Establishing a non-demanding relationship B. Encouraging involvement in-group activities C. Spending more time with Peter D. Waiting until Peter initiates interaction
a
What information should be included by the nurse when teaching the family of a client with schizophrenia? A. Relapse can be prevented if the client takes the prescribed medication(s) B. Support is available to help family members meet their own needs C. Improvement should occur if the client has a stimulating environment D. Stressful family situations can precipitate a relapse in the client
a
Which of the following behavioral characteristics are indicative of Paranoid Personality Disorder? A.Guarded, suspicious, distrustful B.Lack of confidence, indecisive, reliant on others C.Intense anger, unstable mood, relationship difficulties D.Aggressive, guiltless, irresponsible E.Overly sensitive to criticism, expects preferential treatment, self-absorbed
a
Which statement is correct about a 25-year-old client with newly diagnosed schizophrenia? A. Age of onset is typical for schizophrenia. B. Age of onset is later than usual for schizophrenia. C. Age of onset is earlier than usual for schizophrenia. D. Age of onset follows no predictable pattern in schizophrenia
a
With addictive disorders, there are cycles of relapse and remission. A. True B. False
a
A 20-year old college student has been brought to the psychiatric hospital by her parents. Her admitting diagnosis is borderline personality disorder. When talking with her parents, what symptoms should the nurse expect to be included in the client's history? Select all that apply. A. Impulsiveness B. Lability of mood C. Ritualistic behavior D. Psychomotor retardation E. Self-destructive behavior
a,b,e
Clozaril (Clozapine) is prescribed when?
after 3 failed antipsychotics - sides effect of agranulocytosis
A client diagnosed with schizoaffective disorder is suffering from schizophrenia with elements of which of the following disorders? A. Personality Disorder B. Mood disorder C. Thought disorder D. Amnestic disorder
b
A client with schizophrenia tells the nurse he hears the voices of his dead parents. To help the client ignore the voices, the nurse should recommend that he: a. Sit in a quiet, dark room and concentrate on the voices. b. Listen to a personal stereo through headphones and sing along with the music. c. Call a friend and discuss the voices and his feelings about them. d. Engage in strenuous exercise.
b
A nurse is teaching a psychiatric client about newly prescribed drugs, Chlorpromazine (Thorazine) and Benztropine (Cogentin). Why is Benztropine (Cogentin) administered? a. To reduce psychotic symptoms b. To reduce extrapyramidal symptoms c. To control nausea and vomiting d. To relieve anxiety
b
An example of a potentially nonreversible drug side effect is: A. Hallucinations B. Tardive dyskinesia C. Hyperprolactinemia D. Agranulocytosis
b
David told his nurse that the FBI is monitoring and recording his every movement and that microphones have been plated in the unit walls. Which action would be the most therapeutic response? A. Confront the delusional material directly by telling David that this simply is not true. B. Inform David that this must seem frightening to him but that you believe he is safe here. C. Tell David to wait and talk about these beliefs in his one-on-one counseling sessions. D. Isolate David when he begins to talk about these beliefs.
b
The client with antisocial personality disorder: A. Suffers from a great deal of anxiety B. Is generally unable to postpone gratification C. Rapidly learns by experience and punishment D. Has a great sense of responsibility toward others
b
The nurse is caring for a client experiencing false sensory perceptions with no basis in reality. These perceptions are known as: A. Delusions B. Hallucinations C. Loose associations D. Neologisms
b
Which of the following behavioral characteristics are indicative of Dependent Personality Disorder? A.Guarded, suspicious, distrustful B.Lack of confidence, indecisive, reliant on others C.Intense anger, unstable mood, relationship difficulties D.Aggressive, guiltless, irresponsible E.Overly sensitive to criticism, expects preferential treatment, self-absorbed
b
Which of the following client behaviors documented in David's chart would validate the nursing diagnosis of Risk for Other-Directed Violence? A. David's description of being endowed with superpowers B. Frequent angry outburst noted toward peers and staff C. Refusal to eat cafeteria food D. Refusal to join in-group activities
b
Nurse Jane assesses for evidence of positive symptoms of schizophrenia in a newly admitted client. Which of the following symptoms are considered positive? Select all that apply. A. Anhedonia B. Delusions C. Flat affect D. Hallucinations E. Loose associations F. Social withdrawal
b,d,e
Anosognosia occurs in 60% of individuals with schizophrenia. Another term for this this type of deviation in neurocognition is: A. Delusional thinking B. Negativism C. Poor insight D. Catatonia
c
Bob, a 45 year old patient with schizophrenia, sometimes moves his lips silently or murmurs to himself when he does not realize others are watching. Sometimes when talking to others, he suddenly stops, appears distracted for a moment and then resumes. Based on these observations, Bob is most likely experiencing: a.Illusions b.Delusional thinking c.Auditory hallucinations d.Impaired reality testing
c
Mr. B. barely communicates with staff and does not spontaneously initiate conversation. This is an example of: A. Anergia B. Avolition C. Alogia D. Anhedonia
c
Which non-antipsychotic medication is used to treat clients with schizoaffective disorder? A.Phenelzine (Nardil) B. Chlordiazepoxide (Librium) C. Valproate (Depakote) D. Imipramine (Tofranil)
c
Which of the following are symptoms of schizophrenia, paranoid type A. Delusions of being malevolently treated B. Avolition and eccentric beliefs C. Delusions of persecution by aliens and auditory hallucinations D. Catalepsy and stupor E. Bizarre delusions and depression
c
Which of the following behavioral characteristics are indicative of Borderline Personality Disorder? A.Guarded, suspicious, distrustful B.Lack of confidence, indecisive, reliant on others C.Intense anger, unstable mood, relationship difficulties D.Aggressive, guiltless, irresponsible E.Overly sensitive to criticism, expects preferential treatment, self-absorbed
c
Which therapeutic communication statement might a psychiatric-mental health registered nurse use when a patient's nursing diagnosis is altered thought processes? a. "I know you say you hear voices, but I cannot hear them." b. "Stop listening to the voices, they are NOT real." c. "You say you hear voices, what are they telling you?" d. "Please tell the voices to leave you alone for now."
c
Antabuse (Disulfiram) is used long-term for alcohol abuse. What effect does Antabuse have if the client drinks alcohol while taking this medication? Select all that apply A. The client will have illusions B. The client will be hypertensive C. The client will have severe nausea and vomiting D. The client will have tachycardia
c,d
A female patient diagnosed with schizophrenia has been prescribed a first-generation antipsychotic medication. What information should the nurse provide to the patient regarding her signs and symptoms? a. Her memory problems will likely decrease. b. Depressive episodes should be less severe. c. She will probably enjoy social interactions more. d. She should experience a reduction in hallucinations.
d
Eric has experienced auditory hallucinations for many years and tells Nurse Carol that the voices prevent his participation in a social skills training program at the community health center. Which intervention is most appropriate? A. Let Eric analyze the content of the voices. B. Advise Eric to participate in the program when the voices cease. C. Advise Eric to take his medications as prescribed. D. Teach Eric to use thought stopping techniques.
d
Taylor has a diagnosis of schizophrenia with negative symptoms. In planning care for the client, Nurse Diane would anticipate a problem with: A. Auditory hallucinations. B. Bizarre behaviors. C. Ideas of reference. D. Motivation for activities
d
When patients diagnosed with schizophrenia suffer from anosognosia, they often refuse medication, believing that: a. Medications provided are ineffective. b. Nurses are trying to control their minds. c. The medications will make them sick. d. They are not actually ill.
d
Which of the following are symptoms of schizophrenia, catatonic type A. Delusions of being malevolently treated B. Avolition and eccentric beliefs C. Delusions of persecution by aliens and auditory hallucinations D. Catalepsy and stupor E. Bizarre delusions and depression
d
Which of the following behavioral characteristics are indicative of Antisocial Personality Disorder? A.Guarded, suspicious, distrustful B.Lack of confidence, indecisive, reliant on others C.Intense anger, unstable mood, relationship difficulties D.Aggressive, guiltless, irresponsible E.Overly sensitive to criticism, expects preferential treatment, self-absorbed
d
Drugs of abuse (i.e., psychoactive drugs) stimulate the release of what neurotransmitter in the brain?
dopamine
Neurotransmitter insufficient in schizophrenia?
dopamine
Which of the following are symptoms of schizoaffective disorder A. Delusions of being malevolently treated B. Avolition and eccentric beliefs C. Delusions of persecution by aliens and auditory hallucinations D. Catalepsy and stupor E. Bizarre delusions and depression
e
Which of the following behavioral characteristics are indicative of Narcissistic Personality Disorder? A.Guarded, suspicious, distrustful B.Lack of confidence, indecisive, reliant on others C.Intense anger, unstable mood, relationship difficulties D.Aggressive, guiltless, irresponsible E.Overly sensitive to criticism, expects preferential treatment, self-absorbed
e
John is brought to the ED by the police. He has a 5-year history of multiple psychiatric admissions. He was found wandering the streets disheveled, shoeless, and confused. Based on his previous medical records and current behavior, he is diagnosed with chronic schizophrenia. Which nursing diagnosis is highest priority? The second? A. Anxiety B. Impaired verbal communication C. Disturbed thought processes D. Self-care deficit: Dressing/grooming
first: C second: D
_______________________________________use of a substance of abuse to excess.
intoxication
Second generation antipsychotic are at high risk for?
metabolic syndrome
Tardive Dyskinesia is?
movement disoder - involuntary, uncontrollable
A 20-year-old Amish patient was diagnosed with paranoid schizophrenia 1 year ago who lives with his parents. When the nurse attempts to educate him about his diagnosis and the need for medication, the client persistently mumbles, "I don't have mental illness. No, I am not sick." What term is used to describe this response? A. Anosognosia B. Resistance C. Apathy D. Religiosity
A
A client arrested for an assault in which he savagely beat a classmate states, "The guy deserved everything he got." The behaviors described are most consistent with the clinical picture of which disorder? A. Antisocial personality disorder B. Borderline personality disorder C. Schizotypal personality disorder D. Narcissistic personality disorder
A
A client diagnosed with obsessive-compulsive personality disorder takes the nurse aside and mentions, "I've observed you interacting with that new patient. You are not approaching him properly. You should be more forceful with him." What response should the nurse provide to address the client's comment? A. "I will be continuing to follow the care plan for the patient." B. "I see you are trying to control that patient's therapy as well as your own." C. "Your eye for perfection extends even to my nursing interventions." D. "That patient's care is really of no concern to you or to other clients."
A
A client tells the nurse that Martian invaders are coming to take over the earth. Which response by the nurse would be most therapeutic? a. "That must be frightening to you. Can you tell me how you feel about it?" b. "There are no people living on Mars." c. "What do you mean when you say they're going to invade the earth?" d. "I know you believe the earth is going to be invaded, but I don't believe that."
A
A client with paranoid schizophrenia is admitted to the psychiatric unit of a hospital. Nursing assessment should include careful observation of the client's: a. Thinking, perceiving, and decision-making skills b. Verbal and nonverbal communication processes c. Affect and behavior d. Psychomotor activity
A
For the client experiencing NEGATIVE symptoms, the nurse should expect: A. Bizarre behavior B. Ideas of reference C. Auditory hallucinations D. Avolition
A
Patients diagnosed with BPD exhibit negative effect, which includes rapidly moving from one emotional extreme to another. What term is used to describe this characteristic? A. Lability B. Impulsivity C. Splitting D. Denial
A
Positive symptoms of schizophrenia include which of the following? A. Hallucinations, delusions, and disorganized thinking B. Somatic delusions, echolalia, and a flat affect C. Waxy flexibility, alogia, and apathy D. Flat affect, avolition, and anhedonia
A
Schizophrenia spectrum disorders are biological disorders of the brain, with psychosis being the most pronounced symptom. A.True B. False
A
When providing care for a client diagnosed with borderline personality disorder, the nurse will need to consider strategies for dealing with which of the client's classic characteristics? A. Mood shifts, impulsivity, and splitting B. Grief, anger, and social isolation C. Altered sensory perceptions and suspicion D. Perfectionism and preoccupation with detail
A
Which characteristics will the nurse assess in the client diagnosed with antisocial personality? A. Deceitfulness, impulsiveness, and lack of empathy B. Perfectionism, preoccupation with detail, and verbosity C. Avoidance of interpersonal contact and preoccupation with being criticized D. A need for others to assume responsibility for decision making and seeking nurture
A
Which signs and symptoms are associated with opioid withdrawal? A. Lacrimation, rhinorrhea, dilated pupils, and muscle aches. B. Illusions, disorientation, tachycardia, and tremors. C. Fatigue, lethargy, sleepiness, and convulsions. D. Synesthesia, depersonalization, and hallucinations.
A
Which statement is descriptive of clients with a personality disorder? A. They are resistant to behavioral change. B. They have an ability to tolerate frustration and pain. C. They usually seek help to change maladaptive behaviors. D. They have little difficulty with cognitive functioning.
A
Which statement is true of pharmacological therapies associated with the treatment of personality disorders? A. Although there are no FDA-approved drugs specific to the treatment of personality disorders, patients benefit from specific off-label uses of antipsychotics, mood stabilizers, and antidepressants, depending on which personality disorder is evident. B. Research has shown that currently available psychotropic drugs have not been shown to be effective in treating personality disorders. C. Patients with narcissistic personality disorder and obsessive-compulsive personality disorder have shown the most benefit from the use of antianxiety medications along with use of selective serotonin reuptake inhibitors. D. Patients with personality disorders have been shown to be resistant to accepting medication, and as a result most providers do not prescribe psychotropic drugs to these patients.
A
Kyle, a patient with schizophrenia, began to take the first-generation antipsychotic haloperidol (Haldol) last week. One day you find him sitting very stiffly and not moving. He is diaphoretic, and when you ask if he is okay he seems unable to respond verbally. His vital signs are: BP 170/100, P 110, T 104.2°F. What is the priority nursing intervention? Select all that apply. a. Hold his medication and contact his prescriber. b. Wipe him with a washcloth wet with cold water or alcohol. c. Administer a medication such as benztropine IM to correct this dystonic reaction. d. Reassure him that although there is no treatment for his tardive dyskinesia, it will pass. e. Hold his medication for now and consult his prescriber when he comes to the unit later today.
A,B
What would be a POSITIVE symptom of schizophrenia? Select all that apply A. Bizarre behavior B. Ideas of reference C. Auditory hallucinations D. Avolition
A,B,C
Select the appropriate interventions when caring for a client in alcohol withdrawal (select all that apply): a. Monitor vital signs b. Provide stimulation in the environment c. Maintain NPO status d. Provide reality orientation as appropriate e. Address hallucinations therapeutically
A,D,E
A newly admitted client has a diagnosis of schizoid personality disorder. The nursing intervention of highest priority will be directed toward which classic client need? A. Set firm limits on behavior. B. Respect need for social isolation. C. Encourage expression of feelings. D. Involve in milieu and group activities.
B
Research has indicated that the antisocial personality may be characterized by what behavior? A. Social isolation B. Lack of remorse C. Learning difficulties D. Difficulty with reality testing
B
The drug most often prescribed for alcohol withdrawal during hospitalization: A. Barbituates B. Benzodiazepines C. Disulfiram (Antabuse) D. Acamprosate (Campral
B
A client, who has been prescribed clozapine 6 weeks ago, reports flulike symptoms including a fever and a very sore throat, the nurse should initiate which nursing intervention? A. Suggest that the client take something for the fever and get extra rest. B. Advise the physician that the client should be admitted to the hospital. C. Arrange for the client to have blood drawn for a white blood cell count. D. Consider recommending a change of antipsychotic medication
C
A nurse caring for a client who has been diagnosed with a personality disorder should expect that the client will exhibit which behaviors? A. Frequent episodes of psychosis B. Constant involvement with the needs of significant others C.Inflexible and maladaptive responses to stress D. Abnormal ego functioning
C
An agitated and incoherent client, age 29, is brought into the ED by police who reports the client is experiencing visual and auditory hallucinations. Client history reveals that he was hospitalized for paranoid schizophrenia at 20 and 22 years of age. The physician prescribes Haloperidol (Haldol), 5mg I.M. The nurse understands that this drug is used to treat: A. Dyskinesia B. Dementia C. Psychosis D. Tardive dyskinesia
C
Requiring increasing amounts of a substance of abuse to get the desired effect is: A. Addiction B. Withdrawal C. Tolerance D. Intoxication
C
Serious mental illness (SMI) affects how many adults in the United States? A. 11 million B. 8 million C. 4 million D. 1 million
C
Splitting is a process in which the client demonstrates what behavior? A. Unconsciously represses undesirable aspects of self B. Places responsibility for his or her behavior outside the self C. Sees things as divided into "all good" or "all bad" D. Evidences lack of personal boundaries
C
The client, diagnosed with which personality disorder, will most likely require admission to a psychiatric unit? A. Paranoid personality disorder B. Narcissistic personality disorder C. Borderline personality disorder D. Dependent personality disorder
C
What characteristic behaviors will the nurse assess in the narcissistic client? A. Dramatic expression of emotion, being easily led B. Perfectionism and preoccupation with detail C. Grandiose, exploitive, and rage-filled behavior D. Angry, highly suspicious, aloof, withdrawn behavior
C
When working with a patient who is intoxicated from alcohol, it is useful to first: A. Let the patient sober up B. Decide immediately on care goals C. Ask what drugs other than alcohol the patient has recently used D. Gain adherence by sharing your personal drinking habits with the patient
C
