Mental Health Exam III RN3

Borderline Personality Disorder (BPD)

"splitting" where things are seen as all good or all bad

Lithium:

-For bipolar disorder (manic depression) it decreases mania. -Salt competes for salt and calcium, potassium, magnesium ions and glucose. -Levels drawn 12 hours after last dose.

The nurse is teaching a client with bulimia to use self-monitoring techniques. Which client statement would let the nurse know that this has been effective? A) "I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging." B) "I am beginning to understand how my lack of self-control is hurting me." C) "I am keeping a record of everything I eat and how I am feeling every day." D) "I am getting more comfortable confronting people when I have conflict with them."

A) "I am learning to recognize events and emotions that trigger my binges and am working on responses other than binging and purging." Binge eating- consuming large amounts of food in 2 hours or less

Which individual is at highest risk for committing suicide? A) A 71-year-old male, alcohol user, independent minded B) A 16-year-old female, diabetic, two best friends C) A 47-year-old male, schizophrenic, unemployed D) A 57-year-old female, depression, active in church

A) A 71-year-old male, alcohol user, independent minded Review SAD PERSONAS Suicide Risk Assessment

Which of the following are critical components in assessment of a person's grief? Select all that apply. A) Adequate perception regarding the loss B) Adequate time to experience the loss C) Adequate support while grieving for the loss D) Adequate opportunities to say goodbye to the person E) Adequate coping behaviors during the process

A) Adequate perception regarding the loss C) Adequate support while grieving for the loss E) Adequate coping behaviors during the process

A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms? A) Alcohol withdrawal syndrome B) Continuing intoxication C) Delirium tremens D) WernickeñKorsakoff syndrome

A) Alcohol withdrawal syndrome

A client is admitted for major depression. What should the nurse expect to find during assessment? A) Anhedonia, feelings of worthlessness, and difficulty focusing B) Depressed mood, guilt, and pressured speech C) Changes in sleep pattern, tired, and grandiose mood D) Difficulty focusing, feelings of helplessness, and flight of ideas

A) Anhedonia, feelings of worthlessness, and difficulty focusing

A 15-year-old female is admitted for treatment of anorexia nervosa. Which is characteristic of anorexia nervosa? A) Body weight less than normal for age, height, and overall physical health B) Amenorrhea for at least two cycles C) Absence of hunger feelings D) Erosion of dental enamel

A) Body weight less than normal for age, height, and overall physical health

Chapter 22 Reflection:

ADHD- limit setting, echolalia

A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse? A) "I am going to take up a new hobby. It's time to start something new." B) "I can still hang out with my old friends. I am just not going to use." C) "I'm not very comfortable with being alone yet." D) "Shooting baskets helps me not think about getting high."

B) "I can still hang out with my old friends. I am just not going to use."

The nurse has been teaching a client about bulimia. Which statement by the client indicates that the teaching has been effective? A) "I know if I eat pasta, I'll binge." B) "I'll eat small meals and snacks regularly." C) "I'll take my medication when I feel the urge to binge." D) "I'll limit my intake of carbohydrates and fats."

B) "I'll eat small meals and snacks regularly."

Which is the primary objective of nursing interventions in the care of a client with anorexia nervosa? A) Changing her irrational thinking about her body B) Establishing a target weight to be achieved by discharge C) Restoring nutritional status to normal D) Gaining insight into the effects of anorexia on her physical health

C) Restoring nutritional status to normal

Cultural perspective on alcohol:

Muslims do not drink alcohol or use alcohol containing substances.

CNS stimulants (Amphetamines, Cocaine, Bath Salts)

NO pharmacological tx for withdrawal

Chapter 19 Reflection:

Prevention programs like D.A.R.E

Prevention tiers:

Primary- education, management (prevention of illness) Secondary- early identification (illness has occurred) Tertiary- monitoring, rehabilitation (restoring health)

SUBLOCADE (buprenorphorine ER)

SQ injection for withdrawal Must include counseling Monthly with 26 days between doses

Screening for Alcohol and other drugs:

SSI-AOD

Bi-polar Treatment

-Antimanic: Lithium Anticonvulsant for mood stabilization: -Klonopin/clonazepam -Third-gen antipsychotic- Abilify/aripiprazole for reduction of manic behavior

Opioid/Alcohol Dependent tx:

-Vivitrol/naltrexone: Depot injection Q 28 days -Must undergo 2 week trial of Revia/naltrexone P.O. first -Must be Opioid/suboxone-free 7-10 days -4.0 mL suspension as ONE inj. w/1.5-2" needle

Chapter 17 Reflection:

Acknowledge feelings and validate. Limit setting on aggressive/intimidating behaviors. Redirect "Let's go to conference room to talk." Set boundaries and rules. Provide structure and establish expectations.

Major Depressive Disorder (MDD) is unipolar: Decreases w/age in women; increases in age w/men and highest in single/divorced.

Bipolar Disorder (previously manic-depressive)

A client with conduct disorder starts yelling at another client and calling the client insulting names. Which is the most appropriate response by the nurse? A) "How would you feel if someone yelled at you like that?" B) "What's the matter with you? Don't you know any better?" C) "Yelling at others is unacceptable. You need to let staff know you're upset." D) "You're still having problems controlling your anger."

C) "Yelling at others is unacceptable. You need to let staff know you're upset."

Which of the following interventions would be appropriate for a client with anorexia nervosa? A) Allowing the client to eat whenever she feels hungry B) Insisting that the client sit in the dining room until all food is eaten C) Having the client in view of staff for 90 minutes after each meal D) Permitting the client to eat any food she chooses, as long as she is eating

C) Having the client in view of staff for 90 minutes after each meal

Several medications are prescribed for a client who has anorexia. Which medication may be prescribed to help treat the client's distorted body image? A) Amitriptyline (Elavil) B) Cyproheptadine (Periactin) C) Olanzapine (Zyprexa) D) Fluoxetine (Prozac)

C) Olanzapine (Zyprexa) *distorted body image Other meds are: amitriptyline (Elavil) cyproheptadine (Periactin) fluoxetine (Prozac) > weight gain

A nurse asks an assigned client, "How are you doing today?" The client responds with "doing today, doing today, doing today." Which speech pattern disturbance is this an example of? A) Reactive attachment disorder B) Stereotypic movement disorder C) Selective mutism D) Echolalia

D) Echolalia

Which disorder is exemplified by vandalism, conning others, running away from home, verbal bullying and intimidation, drinking alcohol, and sexual promiscuity? A) Intermittent explosive disorder B) Mild conduct disorder C) Oppositional defiance Disorder D) Moderate conduct disorder

D) Moderate conduct disorder

Primary Gain- relief of anxiety by self

Secondary Gain- relief of anxiety through others

Stages of alcohol withdrawal

Stage 1 (6-24 hours) mild sx of agitation, N/V Stage 2 (24-72 hours) ^BP/temp, tachycardia Stage 3 (after 72 hours) hallucinations, fever, seizures

Ensuring safety in children with ADHD: *she said to review this on page 429/430 in book

"It is unsafe to jump down stairs. From now on, you are to walk down the stairs, one at a time." "It is not OK to cut ahead of others. Take your place at the end of the line." "It is not OK to grab other people. When you are playing with others, you must ask for the toy." "You walked down the stairs safely" or "You did a good job of asking to play with the guitar and waited until it was your turn."

Chapter 23 Reflection:

-Limit setting -Enforce consequences -Time outs to regain control Conduct Disorder- emotional/behavioral problems younger population. Oppositional Defiant Disorder [ODD]- behavior disorder in children characterized by disobedience. Intellectual disability- IQ <70 Autism- boys more than girls

Symptoms of alcohol withdrawal occur:

4-12 hours after cessation or decrease of intake. Withdrawal usually peaks 2nd day Complete by day 5

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child? A) Break tasks into small steps. B) Let the child complete tasks at his own pace. C) Offer rewards when all tasks are completed. D) Set a time limit to complete all tasks.

A) Break tasks into small steps.

Which are most likely included in the history of a child with conduct disorder? Select all that apply. A) Disturbed relationships with peers B) Major antisocial violations C) Aggression toward people or animals D) Destruction of property E) Serious violation of rules

A) Disturbed relationships with peers C) Aggression toward people or animals D) Destruction of property E) Serious violation of rules

The nurse understands that which biologic factors may influence the development of an eating disorder? Select all that apply. A) Family history of eating disorders B) Dysfunction of the hypothalamus C) Norepinephrine imbalances D) First-degree relatives with psychotic disorder E) Decreased serotonin levels

A) Family history of eating disorders B) Dysfunction of the hypothalamus C) Norepinephrine imbalances E) Decreased serotonin levels

A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 AM, which behavior might the school nurse expect to see at noon? A) Increased impulsivity or hyperactive behavior B) Lack of appetite for lunch C) Sleepiness or drowsiness D) Social isolation from peers

A) Increased impulsivity or hyperactive behavior [short half-life]

The nurse is co-leading a family therapy group for clients and families of drug-addicted individuals. The family of a cocaine addict is angry and cannot understand why the client cannot just stop using. The nurse guides the group to discuss their understanding of the nature of addiction. Which statements would the nurse identify as an accurate understanding of the nature of addiction? Select all that apply. A) It is a medical illness that is progressive. B) The client will eventually be cured. C) Relapses and remissions are part of the illness. D) Clients can learn to get control over the substance

A) It is a medical illness that is progressive. C) Relapses and remissions are part of the illness.

For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders? A) It is much more difficult to diagnose psychiatric disorders in children and adolescents. B) It is not necessary because psychiatric disorders do not occur in children and adolescents. C) Children and adolescents experience some of the same mental health problems as adults. D) Psychiatric disorders in children manifest themselves very quickly.

A) It is much more difficult to diagnose psychiatric disorders in children and adolescents. Lack of abstract/cognitive abilities.

Which factors may contribute to the frequency of eating disorders in adolescents? Select all that apply. A) Media portrayal of slimness as an ideal B) Body dissatisfaction in adolescent females C) Stress-free existence of adolescents D) Body image disturbance E) Seeking autonomy F) Seeking to develop a unique identity

A) Media portrayal of slimness as an ideal B) Body dissatisfaction in adolescent females D) Body image disturbance E) Seeking autonomy F) Seeking to develop a unique identity

The nurse is assessing a client's risk factors for developing a substance abuse disorder. Which family characteristics would the nurse identify as a significant risk factor? A) One parent who is an alcoholic B) Parents who practiced strict discipline C) Overprotective parents D) Being raised in an urban area

A) One parent who is an alcoholic

The nurse is planning the type of approach that will be most effective in developing a therapeutic relationship with the client. The nurse should use a matter-of-fact approach with clients with which types of personality disorders? Select all that apply. A) Paranoid B) Antisocial C) Schizotypal D) Narcissistic E) Avoidant

A) Paranoid B) Antisocial D) Narcissistic

A child has been displaying behaviors associated with conduct disorder. The nurse should further assess for which common risk factors seen in children with conduct disorder. Select all that apply. A) Poor family functioning B) Strict disciplinary practices C) Family history of substance abuse D) Possible child abuse E) Poverty conditions

A) Poor family functioning C) Family history of substance abuse D) Possible child abuse E) Poverty conditions

Of the following personality disorders, which are most likely related to lack of caring about others? Select all that apply. A) Schizotypal personality disorder B) Borderline personality disorder C) Antisocial personality disorder D) Narcissistic personality disorder E) Obsessiveñcompulsive personality disorder

A) Schizotypal personality disorder C) Antisocial personality disorder D) Narcissistic personality disorder Cluster B

Which steps are involved in limit setting? Select all that apply. A) State expected behavior. B) Inform clients or the rule or limit. C) Threaten incarceration. D) Explain the consequences if clients exceed the limit. E) Occasionally limit enforcement.

A) State expected behavior. B) Inform clients or the rule or limit. D) Explain the consequences if clients exceed the limit.

Which are important in the limit-setting technique to deal with manipulative behavior? Select all that apply. A) Stating the behavioral limit B) Identifying the consequences if the limit is exceeded C) Identifying the expected or desired behavior D) Providing choices E) Allowing flexibility

A) Stating the behavioral limit B) Identifying the consequences if the limit is exceeded C) Identifying the expected or desired behavior

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply. A) The child displays little eye contact with others. B) The child thrives on changes in routine. C) The child makes few facial expressions toward others. D) The child does not like repetition. E) The child answers questions verbally.

A) The child displays little eye contact with others. C) The child makes few facial expressions toward others. D) The child does not like repetition.

Which are characteristics of intermittent explosive disorder (IED)? Select all that apply. A) The episode may occur with seemingly no warning. B) They usually last less than 30 minutes. C) Afterward, the person with IED will not have any remorse. D) It involves repeated episodes of impulsive, aggressive, violent behavior, and angry verbal outbursts. E) The intensity of the emotional outburst is usually within proportion to the stressor or situation.

A) The episode may occur with seemingly no warning. B) They usually last less than 30 minutes. D) It involves repeated episodes of impulsive, aggressive, violent behavior, and angry verbal outbursts.

A client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, "Not again! Why should we keep trying to help this guy? He obviously doesn't want it." What does this statement reflect? A) The nurse lacks the self-awareness to work effectively with this addicted client. B) The nurse understands the cycle of remission and relapse characteristic of addiction. C) The nurse has repressed negative emotions from past experiences with addiction. D) The nurse is trying to conceal his or her own addictions.

A) The nurse lacks the self-awareness to work effectively with this addicted client.

Which is a possible explanation for the increased risk of suicide in persons who have had a relative who committed suicide? A) The relative's suicide offers a sense of 'permission' or acceptance of suicide as a method of escaping a difficult situation. B) Many people with depression who have suicidal ideation lack the energy to implement suicide plans, but antidepressant treatment can actually give clients with depression the energy to act on suicidal ideation. C) Suicide is more likely to occur in April when natural energy from increased sunlight may give the client the energy to act on suicidal ideation. D) The relative's suicide caused the family members to realize that suicide is emotionally harmful to the ones left behind and vow not to consider suicide.

A) The relative's suicide offers a sense of 'permission' or acceptance of suicide as a method of escaping a difficult situation.

A client with borderline personality disorder says to the nurse, "I feel so comfortable talking with you. You seem to have a special way about you that really helps me." Which would be the most appropriate response by the nurse? A) "I'm glad you feel comfortable with me." B) "I'm here to help you just as all the staffs are." C) "You feel others don't understand you?" D) "I cannot be your friend. We need to be clear on that."

B) "I'm here to help you just as all the staffs are."

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step? A) "I need to talk to you." B) "Stop that right now." C) "You are going to hurt yourself." D) "Why are you jumping off the bed?"

B) "Stop that right now." *safety*

Which of the following losses are likely to result in disenfranchised grief? Select all that apply. A) A young adult whose spouse has just died suddenly B) A family whose long-time pet snake has just died C) A nurse who has just witnessed the death of a patient D) A couple who has just experienced pregnancy loss E) The gay lover of a man who just died from AIDS F) The mother and sister of a soldier who was killed in war

B) A family whose long-time pet snake has just died C) A nurse who has just witnessed the death of a patient D) A couple who has just experienced pregnancy loss E) The gay lover of a man who just died from AIDS These are losses that society or others may not consider valid to mourning.

Which eating disorder is characterized by consuming an amount of food much larger than a person would normally eat and of near-normal weight? Afterward, the client may purge the food or exercise excessively, and between binges, the client may eat low-calorie foods or fast. A) Anorexia nervosa B) Bulimia nervosa C) Pica D) Rumination

B) Bulimia nervosa

What is the primary difference between anorexia nervosa and bulimia nervosa? A) Anorexia has a psychological basis, whereas the cause of bulimia is biologic. B) Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior. C) Bulimia can be life threatening, whereas anorexia is seldom so. D) There is no real difference between these two types of disorders.

B) Clients who are anorexic are proud of their control over eating, and clients with bulimia are ashamed of their behavior.

When working with the family of a client with anorexia nervosa, which of the following issues must be addressed? A) Codependence B) Control issues C) Self-discipline D) Sexual identity

B) Control issues

A client is being discharged on lithium. The nurse encourages the client to follow which health maintenance recommendations? Select all that apply. A) Weigh self weekly at the same time of day. B) Drink a 2-L bottle of decaffeinated fluid daily. C) Do not alter dietary salt intake. D) See the doctor if you get the flu. E) Restrict involvement in intense exercise

B) Drink a 2-L bottle of decaffeinated fluid daily. C) Do not alter dietary salt intake. D) See the doctor if you get the flu.

A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice? A) Give the child his medicine at night. B) Have the child eat a good breakfast and snacks late in the day and at bedtime. C) Limit the number of calories the child eats each day. D) Let the child take daytime naps.

B) Have the child eat a good breakfast and snacks late in the day and at bedtime.

Which of the following symptoms are characteristic of ADHD? Select all that apply. A) Enuresis B) Inattentiveness C) Encopresis D) Overactivity E) Impulsiveness

B) Inattentiveness D) Overactivity E) Impulsiveness

The nurse is conducting a history and physical exam on a client who is grieving the unwanted loss of a marriage by divorce. Which of the following physical symptoms of grief would the nurse most likely expect to detect in the history? A) Headaches B) Insomnia C) Weight loss D) GI upset

B) Insomnia

Which variables represent the highest risk for developing major depressive disorder? Select all that apply. A) Male gender B) Mood disorder in first-degree relatives C) Substance abuse D) Divorced E) Older adult

B) Mood disorder in first-degree relatives D) Divorced

The nurse observes a client sitting alone at a table, looking sad and preoccupied. The nurse sits down and says, "I saw you sitting alone and thought I might keep you company." The client turns away from the nurse. Which would be the most therapeutic nursing intervention? A) Move to another chair closer to the client and say, "the staff is here to help you." B) Move to a chair a little further away and say, "We can just sit together quietly." C) Remain in place and say, "How are you feeling today?" D) Say, "I'll visit with you a little later" and leave the client alone for a while.

B) Move to a chair a little further away and say, "We can just sit together quietly." Respect personal space while showing interest.

The nurse is assessing a client with bulimia nervosa. Which of the following symptoms would the nurse expect to find? Select all that apply. A) Cold intolerance B) Normal weight for height C) Dental erosion D) Hypotension E) Metabolic alkalosis

B) Normal weight for height C) Dental erosion E) Metabolic alkalosis

Which is the most commonly used treatment for oppositional defiant disorder? A) Pharmacologic treatment B) Parent training models of behavioral interventions C) Individual therapy D) 'Boot camp'

B) Parent training models of behavioral interventions

Which of the following are critical components to assess in a grieving person? Select all that apply. A) Genetic risk B) Perception of the loss C) Support system D) Coping behaviors E) Religion

B) Perception of the loss C) Support system D) Coping behaviors

Which are important points for the nurse to consider when working with clients with disruptive behavior disorders and their families? Select all that apply. A) Most behavior disorders are caused by being raised by parents who had behavior disorders in their own childhoods. B) Remember to focus on the client's strengths and assets, as well as their problems. C) Transient conduct disorders are common in all children. D) Avoid a 'blaming' attitude toward clients and/or families. E) Focus on positive actions to improve situations and/or behaviors.

B) Remember to focus on the client's strengths and assets, as well as their problems. D) Avoid a 'blaming' attitude toward clients and/or families. E) Focus on positive actions to improve situations and/or behaviors.

The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that his relationship with the client was codependent and enabling. Which is an example of codependent behavior? A) The friend called Alcoholics Anonymous when the client expressed a need to stop drinking. B) The friend called the client every night to make sure he got home safely and went looking for him if he was not at home. C) The friend confronted the client on the effect of his drinking on their relationship. D) The friend refused to go out drinking with the client to celebrate the client's birthday.

B) The friend called the client every night to make sure he got home safely and went looking for him if he was not at home.

A client with antisocial personality disorder is begging to use the phone to call his wife, even though it is against the unit rules. The client begs, ìIt is just this once, and she will be so hurt if I don't call her.î Which would be the most appropriate response by the nurse? A) "Only to help your wife, you can call this time." B) "I will get in trouble with my supervisor if I let you call." C) "You may not use the phone to call your wife." D) "You cannot call because you need to focus on your recovery while you are here, not your wife."

C) "You may not use the phone to call your wife."

The most effective way for the nurse to provide culturally competent care to individuals who are grieving is which of the following? A) Understand the practices associated with a client's culture. B) Suggest developing a new ritual to make mourning meaningful. C) Ask the client what rituals are personally meaningful. D) Contact a spiritual leader from the client's culture to become involved.

C) Ask the client what rituals are personally meaningful.

The nurse understands that before a client with an eating disorder can accept their body image, he or she must first learn effective coping skills. Which statement best describes the relationship between body image and coping skills? A) Coping skills are dependent on a supportive upbringing. B) When body image is positive, the client will develop better coping skills. C) Being able to cope in healthy ways improves the ability to accept a realistic body image. D) Neurotransmitters that are deficient in clients with eating disorders prohibit the development of effective coping skills.

C) Being able to cope in healthy ways improves the ability to accept a realistic body image.

Which of the following terms is used to describe the process by which a person experiences the grief? A) Anticipatory grieving B) Disenfranchised grief C) Bereavement D) Mourning

C) Bereavement Bereavement is the 'experience' of grief. Mourning is the outward expression- think of watching someone Mourn and Bereavement leave through work.

Which best explains the neurochemical processes responsible for depression? A) Increased activity of dopamine B) Decreased glucocorticoid activity C) Decreased serotonin and norepinephrine activity D) Potentiating of the kindling process

C) Decreased serotonin and norepinephrine activity

Which meal would the nurse provide to best meet the nutritional needs of a client who is manic? A) Peanut butter sandwich, chips, cola B) Fried chicken, mashed potatoes, milk C) Ham sandwich, cheese slices, milk D) Spaghetti, garlic bread, salad, tea

C) Ham sandwich, cheese slices, milk

Which would most likely be a type of behavior that would be manifested by a client who has histrionic personality disorder? A) Insisting that others follow the rules of the unit B) Wondering why others are being friendly to her C) Having a tantrum if not getting enough attention D) Getting others to make decisions for her

C) Having a tantrum if not getting enough attention

A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive? A) Take disulfiram with food to avoid stomach upset. B) Skip the daily dose of disulfiram on days when consumption of alcoholic beverages is likely. C) Read products labels carefully to avoid all products containing alcohol. D) Disulfiram will prevent the desire to drink alcoholic beverages.

C) Read products labels carefully to avoid all products containing alcohol.

A nurse is teaching a client with borderline personality disorder to reshape thinking patterns. Which is an example of a cognitive restructuring technique that would be helpful for this client? A) When negative thoughts begin, tell yourself "stop." B) Learn to look at situations realistically rather than assuming the worst. C) Recognize negative thoughts and replace them with positive ones. D) Express needs using "I" statements.

C) Recognize negative thoughts and replace them with positive ones Cognitive Restructuring involves reshaping how one thinks.

The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time? A) Review effective disciplinary practices with the parents again. B) Refer the parents to a family therapist. C) Try to remember that the parents are trying to the best of their ability to carry out the suggestions. D) Explore alternative living arrangements for the child

C) Try to remember that the parents are trying to the best of their ability to carry out the suggestions.

The client asks the nurse, ìWhat will happen if I drink while taking Antabuse?î What should be the nurse's reply? A) "You will not want to drink while taking Antabuse. It reduces the cravings." B) "You will not get any effect from the alcohol you drink." C) "Antabuse will reverse the effects of alcohol." D) "You will experience a severe reaction, including a throbbing headache and vomiting."

D) "You will experience a severe reaction, including a throbbing headache and vomiting."

A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm? A) Immediately after a family visit B) On the anniversary of significant life events in the client's life C) During the first few days after admission D) Approximately 2 weeks after starting antidepressant medication

D) Approximately 2 weeks after starting antidepressant medication

A child is expelled from school for repeated fighting and vandalizing school property. The school nurse and counselor meet with the parents to explain that the child may benefit from counseling as the child is experiencing signs of which disorder? A) Oppositional defiant disorder B) Asperger's syndrome C) Attention deficit hyperactivity disorder D) Conduct disorder

D) Conduct disorder

A woman has just had a therapeutic abortion to end an unintended pregnancy. Afterward, the woman cries because although she wanted to have children in future years, this pregnancy was not well-timed. Which type of grief is this woman most likely to experience? A) Anticipatory grief B) Absence of grief C) Complicated grief D) Disenfranchised grief

D) Disenfranchised grief

The nurse is assessing a client with an eating disorder. Which personality characteristic would the nurse expect to detect when interacting with the client? A) Careless B) Outspoken C) Defiance D) Eager to please

D) Eager to please

Which is likely to be most effective for adolescents with conduct disorder? A) Involvement with the legal system B) Focusing on the parenting education C) Incarceration D) Early intervention

D) Early intervention

The nurse teaches an antisocial client to take a time-out in his room when challenged by another person instigating an argument. What is the main reason for the time-out? A) It allows time for the instigator to leave the area. B) It allows adequate space between the client and the instigating individual. C) It prevents the client from experiencing negative consequences of behavior. D) It allows an opportunity for the client to regain control of emotions.

D) It allows an opportunity for the client to regain control of emotions.

A nurse has been caring for a gunshot victim who has just died. Various family and friends are present. One of the visitors privately discloses to the nurse that she and the client were having an illicit affair. Which of the following is the best action by the nurse after learning of this relationship? A) Give the name of a clergy to the visitor and suggest she contact him for support B) Encourage the visitor to ask for support from the friends who are present C) Ignore the information about the affair and tend to the family D) Privately offer support to the visitor who was having the affair with the client

D) Privately offer support to the visitor who was having the affair with the client

Which thought process would cause a client with antisocial personality disorder to want to do everything for himself? A) Belief in his own self-worth B) Inability to delay gratification C) Rewards for competitive behavior D) Sense of mistrust of others

D) Sense of mistrust of others

Which is true of the time-out strategy that may be used for persons with conduct disorder? A) It is a punishment. B) It should only be used as a last resort. C) Eventually, the goal is for the client to avoid time-out. D) Time-out is retreat to a neutral place, so clients can regain self-control.

D) Time-out is retreat to a neutral place, so clients can regain self-control.

Chapter 20 Reflection:

Imbalanced Nutrition: Less than body requirements Anorexia- control Bulimia- shame Involve family with tx- love, support and attention Address physical aspects first (nutrition), then psyche CBT (cognitive behavioral therapy) Avoid sounding parental

Chapter 18 Reflection:

Paranoid- suspicious of others, deviation from reality Schizoid- avoid relationships/attachment, "loners" Personality- behaviors/psychological Anti-social- manipulation Borderline Personality- Boundaries, risks Histrionic- attention seeking/center of attention Narcissist- need attention/admiration but don't want to be the center of attention, grandiose and entitled. 1. Set limits 2. Identify consequences 3. Identify expected/desired behavior

Chapter 10 Reflection:

What does loss mean to/for the person? How is the loss impacting them/the family? Offer understanding and empathy Cultural awareness