Mental Health Final

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The nurse should recognize which acronym as representing problem-oriented recording? SOAPIE SOLER DAR PQRST

A client is diagnosed with major depressive disorder (MDD). Which nursing diagnosis should the nurse assign to the client to address a behavioral symptom of this disorder? A. Altered communication related to (R/T) feelings of worthlessness as evidenced by (AEB) anhedonia B. Social isolation R/T poor self-esteem AEB secluding self in room C. Altered thought processes R/T hopelessness AEB persecutory delusions D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

A client shows a nurse a piece of artwork that took 3 days to create. How will this achievement improve the client's self-esteem? A. By providing a framework for assertive behavior B. By providing an expression of feelings and a sense of competence and pride C. By providing a positive perception of body image D. By providing appropriate boundaries for relationship establishment

A client states, "I have come to the conclusion that this disease has not paralyzed me." The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andresen and associates? Moratorium Awareness Preparation Rebuilding

A client whose child is diagnosed with terminal breast cancer is constantly crying and depressed. Which type of grieving is she experiencing? Delayed grieving Anticipatory grieving Prolonged grieving Distorted grief

A nursing instructor is teaching students about clients diagnosed with HPD and the quality of their relationships. Which student statement indicates that learning has occurred? A. "Their dramatic style tends to make their interpersonal relationships quite interesting and fulfilling." B. "Their interpersonal relationships tend to be shallow and fleeting, serving their dependency needs." C. "They tend to develop few relationships because they are strongly independent but generally maintain deep affection." D. "They pay particular attention to details, which can frustrate the development of relationships."

Six months after a client's spouse and children were killed in a car accident, the client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective? Neuroendocrinology Psychoneuroimmunology Diagnostic technology Neurophysiology

Teaching is effective if the students identify which cerebral structure as the "emotional brain?" Cerebellum Limbic system Cerebral cortex Left temporal lobe

The adult client is diagnosed with a trauma disorder and is being treated at an inpatient psychiatric unit. Which nursing short-term goal is most appropriate for this client? The client resolves all feelings of survivor's guilt within 1 week. The client demonstrates three relaxation techniques upon discharge. The client moves through all stages of grief within 1 month. The client agrees to seek community resources upon admission.

The nurse expects a client experiencing prodromal symptoms of schizophrenia to demonstrate which of the following? Significant deterioration in functioning Poor relationships with peers Disturbances in thought processing Disorganized motor behavior

The nurse is administering medications to a client experiencing acute psychosis. The client's medication orders include haloperidol 50 mg PO bid; benztropine 1 mg PO daily, and zolpidem 10 mg PO at bedtime daily. The nurse administers benztropine to address which of the following? Tactile hallucinations Involuntary facial movements Psychomotor retardation Pacing back and forth

The nurse tells the parents of an adolescent diagnosed with anorexia nervosa, "The social worker will be contacting you to schedule a family meeting." One of the client's parents states, "Why is that necessary? Our child is the one who needs treatment." Which response by the nurse is best? "We expect every client and their family to attend two family sessions." "Family intervention and support are important in managing eating disorders." "The sessions are used to educate all family members about eating disorders. "During the meeting you will be able to resolve conflicts with your child."

The school nurse is assessing a high school student who is distraught because her parents cannot afford horseback-riding lessons. The nurse recognizes the student's perception is that the problem is: A. Endangering her well-being B. Personally relevant C. Based on immaturity D. Exceeding her capacity to cope

Which nursing diagnosis is correctly formulated? A. Schizophrenia related to (R/T) biochemical alterations as evidenced by (AEB) altered thought B. Self-care deficit: hygiene R/T altered thought AEB disheveled appearance C. Depressed mood R/T multiple life stressors D. Developmental disability R/T early-onset schizophrenia AEB hallucinations

Which situation contradicts the ethical principle of veracity? A. A nurse provides a client with outpatient resources to benefit recovery. B. A nurse refuses to give information to a physician who is not responsible for a client's care. C. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room. D. A nurse treats all clients equally, regardless of the acuity of their illness.

Which tool would be appropriate for a nurse to use when assessing mental acuity prior to and immediately following electroconvulsive therapy (ECT)? CIWA scale GGT MMSE CAPS scale

A client diagnosed with OCD spends hours bathing and grooming. During a one-on-one interaction, the client discusses the rituals in detail, but avoids any feelings that the rituals generate. Which defense mechanism should the nurse identify? Sublimation Dissociation Rationalization Intellectualization

The nurse is providing care to a client who has become emotionally labile with paranoia after losing their career and home due to a motor vehicle accident. The nurse recognizes that the client is at what phase of crisis development? Phase 1 Phase 2 Phase 3 Phase 4

Which best describes the impact that the National Mental Health Act of 1946 had on care for the mentally ill in the United States? A. People were no longer perceived as demonized when displaying mental illness. B. Mental health professionals were provided funding to increase their education. C. A system of hospitals for the mentally ill was developed in communities. D. The first hospital for just the mentally ill was opened and staffed by professionals.

A 16-year-old client diagnosed with schizophrenia is experiencing auditory command hallucinations. The client reports the voices are telling him to harm others. The client's parents ask the nurse, "Where do the voices come from?" Which is the nurse's most appropriate reply? A. "Auditory hallucinations are caused by increased dopamine levels in the brain." B. "Hallucinations can be caused by medication interactions." C. "Hallucinations occur when there is not enough serotonin in the brain." D. "Auditory hallucinations are mainly due to abnormal hormonal changes."

A child who recently brought his extremely confused parent to a nursing home for admission reports feelings of guilt. Which is the appropriate nursing reply? A. "Support groups are held here on Mondays for children of residents." B. "You did what you had to do. I wouldn't feel guilty if I were you." C. "Support groups are available to low-income families." D. "Your parent is doing just fine. We'll take very good care of him."

A client diagnosed with NCD has progressive memory loss, diminished cognitive functioning, verbal aggression, and is experiencing frustration. Which nursing intervention is most appropriate? Schedule structured daily routines. Minimize environmental lighting. Organize a group activity to present reality. Explain the consequences for aggressive behaviors.

A client diagnosed with bipolar disorder: depressive episode intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent job loss. Which should be the priority nursing diagnosis for this client? A. Risk for suicide R/T hopelessness B. Anxiety: severe R/T hyperactivity C. Imbalanced nutrition: less than body requirements R/T refusal to eat D. Dysfunctional grieving R/T loss of employment

A client diagnosed with chronic alcohol use disorder is being discharged from an inpatient treatment facility after detoxification. Which client outcome related to AA is most appropriate for the nurse to discuss with the client during discharge teaching? A. After discharge, the client will attend 90 AA meetings in 90 days. B. After discharge, the client will rely on an AA sponsor to control alcohol cravings. C. After discharge, the client will incorporate family members in AA attendance. D. After discharge, the client will seek appropriate deterrent medications through AA.

A client diagnosed with obsessive-compulsive disorder (OCD) reports to the nurse that he can't stop thinking about all the potentially life-threatening germs in the environment. Which is the most accurate way for the nurse to document this symptom? Client is expressing an obsession with germs. Client is manifesting compulsive thinking. Client is expressing delusional thinking about germs. Client is manifesting arachnophobia of germs.

A client diagnosed with obsessive-compulsive disorder states, "I really think my future will improve because of my successful treatment choices. I'm going to make my life better." Which guiding principle of recovery has assisted this client? Recovery emerges from hope. Recovery is person-driven. Recovery occurs via many pathways. Recovery is holistic.

A client diagnosed with panic disorder states, "When an attack happens, I feel like I am going to die." Which is the nurse's most appropriate reply? A. "I know it's frightening, but try to remind yourself that it will only last a short time." B. "Death from a panic attack happens so infrequently that there is no need to worry." C. "Most people who experience panic attacks have feelings of impending doom." D. "Tell me why you think you are going to die every time you have a panic attack."

A client has a history of excessive fear of water. Which term should the nurse use to describe this specific phobia, and under what subtype is this phobia identified? Aquaphobia; a natural environment type of phobia Aquaphobia; a situational type of phobia Acrophobia; a natural environment type of phobia Acrophobia; a situational type of phobia

A client has made the decision to leave her alcoholic spouse and reports feeling very depressed. Which of the following statements by the nurse represents sympathy? A. "You are feeling very depressed. I felt the same way when I decided to leave my spouse." B. "I can understand you are feeling depressed. It was a difficult decision. I'll sit with you." C. "You seem depressed. It was a difficult decision to make. Would you like to talk about it?" D. "I know this is a difficult time for you. Would you like medication for anxiety?"

A client is admitted to the psychiatric unit with a diagnosis of MDD. The client is unable to concentrate, has no appetite, and is experiencing insomnia. Which should be included in this client's plan of care? A simple, structured daily schedule with limited choices of activities A daily schedule filled with activities to promote socialization A flexible schedule that allows the client opportunities for decision-making A schedule that includes mandatory activities to decrease social isolation

A client states, "My illness is so devastating; I feel like my life is on hold." The nurse recognizes that this client is in which stage of the Psychological Recovery Model as described by Andresen and associates? Moratorium Awareness Preparation Rebuilding

A lonely, depressed, divorced person has been self-medicating with cocaine for the past year. Which term should the nurse use to best describe the client's situation? Psychological addiction Physical addiction Substance addiction Social addiction

A mental health nurse is speaking with parents who are concerned about their teenage children's responses to stress. One child becomes anxious and irritable and the other withdraws and cries. Which is the nurse's best response? A. "Individual responses to stress are affected by many factors and can vary." B. "Children from the same family should not react so differently to stress." C. "Children should have similar dispositions and responses to stress." D. "Environmental factors influence stress responses more than genetic factors."

A military veteran who recently returned from active duty in a Middle Eastern country and suffers from PTSD states that he will not allow the laboratory technician, who is Iranian, to draw his blood. The client states, "He'll probably use a contaminated needle on me." Which of these is the most appropriate nursing response by the nurse? A. "Let me see if I can arrange for a different technician to draw your blood." B. "Let me help you overcome your cultural bias by letting him draw your blood." C. "There is no other technician, so you're just going to have to let him draw your blood." D. "I don't think the technician is really Middle Eastern."

A new psychiatric-mental health nurse states, "This client's use of defense mechanisms should be eliminated." Which is the correct evaluation of the nurse's statement? A. Defense mechanisms are self-protective responses to stress and do not need to be eliminated. B. Defense mechanisms are maladaptive attempts of the ego to manage anxiety and should be eliminated. C. Defense mechanisms are used by individuals with weak ego integrity and should not be eliminated. D. Defense mechanisms cause disintegration of the ego and should be fostered and encouraged.

A newly admitted client asks, "Why do we need a unit schedule? I'm not going to these groups. I'm here to get some rest." Which reply by the nurse is appropriate? A. "Group therapy provides the opportunity to learn and practice new coping skills." B. "Group therapy is mandatory. All clients must attend." C. "Group therapy is optional. You can go if you find the topic helpful and interesting." D. "Group therapy is an economical way of providing therapy to many clients concurrently."

A nurse is assessing a client diagnosed with schizophrenia for the presence of hallucinations. Which therapeutic communication technique used by the nurse is an example of making observations? "You appear to be talking to someone I do not see." "Please describe what you are seeing." "Why do you continually look in the corner of this room?" "If you hum a tune, the voices may not be so distracting."

A nurse is caring for a client threatening to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which factor will guide the nurse's plan of care for the client? A. The more specific the plan is, the more likely the client will attempt suicide B. Clients who talk about suicide never actually commit it. C. Clients who threaten suicide should be observed every 15 minutes. D. After a brief assessment, the nurse should avoid the topic of suicide.

A nurse is running a group on self-esteem. A client asks, "Where does self-esteem come from?" Which is the most appropriate nursing reply? A. "Factors over the life span influence the development and maintenance of self-esteem." B. "Self-esteem is determined by factors outside of an individual's control." C. "Self-esteem is established in childhood and remains relatively fixed throughout life." D. "Genetics are the single largest contributor to an individual's self-esteem."

A nursing instructor is teaching about donepezil. A student asks, "How does this work? Will this cure Alzheimer's disease?" Which reply by the instructor is appropriate? A. "Donepezil delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the disease." B. "Donepezil encourages production of acetylcholine, a chemical in the brain necessary for memory processes. It delays the progression of the disease." C. "Donepezil delays the destruction of dopamine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the disease." D. "Donepezil encourages production of dopamine, a chemical in the brain necessary for memory processes. It delays the progression of the disease."

A nursing instructor is teaching about the medications used to treat panic disorder. Which student statement indicates that learning has occurred? A. "Clonazepam (Klonopin) is particularly effective in the treatment of panic disorder." B. "Clozapine (Clozaril) is used off-label for the long-term treatment of panic disorder." C. "Doxepin (Sinequan) can be used in low doses to relieve symptoms of panic attacks." D. "Buspirone (BuSpar) is used for its immediate effect to lower anxiety during panic attacks."

A nursing instructor is teaching students about eating disorders. Which statement indicates that a student understands the differences between anorexia nervosa and bulimia nervosa? A. "Clients diagnosed with anorexia nervosa exhibit malnutrition and dehydration." B. "Hyperkalemia and hyponatremia are associated with anorexia nervosa." C. "Signs of bulimia nervosa include hypotension, edema, and erosion of tooth enamel." D. "Amenorrhea and parotid gland enlargement are symptoms of bulimia nervosa."

A patient with depression and substance abuse has an interrupted sleep pattern. The patient demands a sedative. Which teaching should the nurse provide about the rationale for the use of nonpharmacological interventions instead? A. "Sedative-hypnotics are potentially addictive and gradually lose their effectiveness as one builds up tolerance to them." B. "Sedative-hypnotics work best in combination with other techniques, such as guided imagery." C. "Sedative-hypnotics are not permitted for use in patients with substance abuse disorders." D. "Sedative-hypnotics are not as effective as the antidepressant medications for treating sleep disturbances."

A psychiatrist prescribes an MAOI for a client. Which foods should the nurse teach the client to avoid? Pepperoni pizza and red wine Bagels with cream cheese and tea Apple pie and coffee Potato chips and diet cola

A successful business executive continually thinks her job accomplishments are not adequate. The nurse recognizes the client's thinking reflects which cognitive error? Minimization Dichotomous thinking Arbitrary inference Personalization

A third-grader feigns illness to avoid doing homework. The teacher recommends an educational program that uses token economy. Which of the following statements by the school nurse best explains token economy? A. "Your child will receive green tokens for completing homework that can be cashed in for desired rewards." B. "Your child will receive red tokens when homework is incomplete, and this will result in school suspension." C. "Without any tokens, your child will receive a time-out for each homework assignment not completed. D. "You will use tokens or stars to help your child envision receiving rewards when homework is completed."

A woman returns home after delivering a stillborn infant to find that neighbors have dismantled the nursery that she and her spouse planned. According to Worden, which indicates the effect the neighbors' action may have on the woman's grieving task completion? It may hamper the woman from accepting the reality of the loss. It would help the woman forget the sorrow and move on with life. It communicates full support from her neighbors. It would motivate the woman to look to the future and not the past.

After assertiveness training, a formerly passive client appropriately confronts a peer in group therapy. The group leader states, "I'm so proud of you for being assertive. You are so good!" Which communication technique has the leader employed? Giving approval Interpreting Presenting reality Making observations

An adolescent client who was diagnosed with conduct disorder at the age of 8 years is sentenced to juvenile detention after bringing a gun to school. Which statement indicates the nurse's understanding of conduct disorder related to this client's situation? A. Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood. B. Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood. C. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5 years; therefore, improvement is likely. D. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive ODD.

An advanced practice nurse is counseling a client diagnosed with generalized anxiety disorder. The nurse plans to use activity scheduling to address this client's concerns. What is the purpose of this nursing intervention? To identify important areas needing concentration during therapy To increase self-esteem and decrease feelings of helplessness To modify maladaptive behaviors using role-play To divert away from intrusive thoughts and depressive ruminations

During a community meeting, a nurse encourages clients to present unit problems and discuss possible solutions. Which type of leadership style is the nurse demonstrating? Democratic Autocratic Laissez-faire Energized

During a therapeutic group, two clients engage in an angry verbal exchange. The nurse leader interrupts the exchange and excuses both of the clients from the group. The nurse has demonstrated which leadership style? Autocratic Democratic Laissez-faire Bureaucratic

During an inpatient educational group, a client shouts out, "This information is worthless. Nothing you have said can help me." These statements indicate to the nurse leader that the client is assuming which group role? Aggressor Initiator Gatekeeper Blocker

Family members of a client ask the nurse to explain the difference between schizoid and avoidant personality disorders. Which is the appropriate nursing reply? A. "Clients diagnosed with avoidant personality disorder desire intimacy but fear it, and clients diagnosed with schizoid personality disorder prefer to be alone." B. "Clients diagnosed with schizoid personality disorder exhibit odd, bizarre, and eccentric behavior, whereas clients diagnosed with avoidant personality disorder do not." C. "Clients diagnosed with avoidant personality disorder are eccentric, and clients diagnosed with schizoid personality disorder are dull and vacant." D. "Clients diagnosed with schizoid personality disorder have a history of psychotic thought processes, whereas clients diagnosed with avoidant personality disorder remain based in reality."

For which client would the nurse question the use of electroconvulsive therapy (ECT)? A client with schizophrenia and hypertension A client with mania and seasonal allergies A client with obsessive-compulsive disorder (OCD) and a history of cancer A client with major depressive disorder (MDD) who feels sad

Immediately after an initial electroconvulsive (ECT) procedure, a client states, "I'm not hungry and just want to stay in bed and sleep." Based on this information, which nursing intervention is appropriate? Allow the client to remain in bed. Encourage the client to join the milieu to promote socialization. Obtain a physician's order for parenteral nutrition. Obtain a physician's order for parenteral nutrition.

In defiance of parental wishes, a teenager succumbs to peer pressure and gets a tattoo. According to Bowen's family systems theory, how should the community health nurse interpret the teenager's action? The teenager is attempting to differentiate self. The teenager is triangulating self. The teenager is cutting self off emotionally. The teenager is exhibiting antisocial traits.

In the treatment of anxiety disorders, benzodiazepines (e.g., Ativan, Xanax) are indicated for ____ use and have ____ abuse potential. A. Short-term; high B. Long-term; high C. Short-term; low D. Long-term; low

In which position would the nurse place the client immediately after electroconvulsive therapy (ECT)? On his or her side to prevent aspiration In semi-Fowler's position to promote oxygenation In Trendelenburg's position to promote blood flow to vital organs In Trendelenburg's position to promote blood flow to vital organs

Meditation has been shown to be an effective stress management technique. Which finding indicates meditation has been effective? A. Achieving a state of relaxation B. Attaining insight into one's feelings C. Demonstrating appropriate role behaviors D. Enhanced problem-solving skills

The client arrives to the ED complaining of severe abdominal pains. The attending health-care provider determines that the client is in labor. Upon further investigation, the nurse discovers that the client uses illegal substances and did not seek prenatal care. Which of the following would best explain this lack of prenatal care? A. Many states consider substance use during pregnancy as child abuse. B. The client was never educated about the need for prenatal care. C. The client had children at home and considered prenatal care unnecessary. D. The client did not have the financial resources to obtain prenatal care.

The client with a myocardial infarction tells the intensive care nurse, "You won't have to care for me pretty soon. I will not be a burden to you or others." Which initial action should the nurse take? Screen the client for suicide. Transfer the client to the medical unit. Allow the client some private, quiet time. Reinforce independence with self-care.

The family practice clinic nurse is triaging clients. The nurse should require which client with nonsuicidal self-injuring behavior to be seen immediately? The patient who is self-cutting in response to command hallucinations The patient who has a history of borderline personality disorder The patient who has recently retired from the military The patient who has thoughts of being detached from the body

The nurse discovers that the client who has been admitted to the facility with depression has been a victim of childhood trauma. The nurse reports this discovery to the health-care provider and the staff. What is the rationale for the nurse to inform the staff of the trauma? A. Interventions that may mimic the childhood trauma may retraumatize the adult client. B. The client may start to act out during group sessions. C. The client may have other underlying health concerns. D. This should be a part of the family therapy session.

The nurse is administering clozapine to a client diagnosed with schizophrenia. Which symptoms require the nurse to intervene immediately? Sore throat, fever, and malaise Akathisia and hypersalivation Akinesia and insomnia Dry mouth and urinary retention

The nurse is assessing a new client diagnosed with schizophrenia. The client states "Those people behind the desk won't stop laughing at me." The nurse determines the client is experiencing which symptom? Ideas of reference Loose associations Delusion of influence Tangentiality

The nurse is preparing an education program regarding early identification of students at risk for developing anorexia nervosa. Which client does the nurse recognize as having the highest risk of developing an eating disorder? Female ballet dancer Female cheerleader Male wrestler Male swimmer

The nurse is providing discharge teaching to a client taking a benzodiazepine. Which client statement indicates a need for further instructions? A. "I will need scheduled bloodwork to monitor for toxic levels of this drug." B. "I won't stop taking this medication abruptly, because there could be serious complications." C. "I will not drink alcohol while taking this medication." D. "I won't take extra doses of this drug because I can become addicted."

The nurse is working with a client diagnosed with somatic symptom disorder. Which predominant symptoms would the nurse expect to assess? A. Disproportionate and persistent thoughts about the seriousness of one's symptoms B. Amnestic episodes in which the client is pain free C. Excessive time spent discussing psychosocial stressors D. Lack of physical symptoms

The nurse manager has set a new policy on the unit to facilitate effective collaboration and locate referrals for clients who require mental health services. Which of the following is an appropriate resource to locate resources? A. Online treatment map provided by the Substance Abuse and Mental Health Services Administration B. Nonsuicidal self-injuring behavioral screening tool C. Screen for adverse childhood events D. SBIRT

The nurse suspects the client of having MDD due to the client having psychomotor retardation. Which of the following would be an example of psychomotor retardation? A. The client is disheveled and malodorous. B. The client exhibits promiscuous behaviors. C. The client ambulates independently. D. The client has maxed-out charge cards.

Two clients are roommates on an inpatient psychiatric unit. At breakfast, client A, who had been missing her gold locket, notices client B wearing it. Which does the nurse recognize as a nonassertive or passive behavioral response from client A? A. Client A ignores the situation and decides to buy another necklace. B. Client A discusses the situation with her nurse and develops a plan of action. C. Client A immediately approaches client B and pulls the necklace off her neck. D. Client A offers to wash client B's clothes and "accidentally" spills bleach in the water.

What is the most essential task for a nurse prior to forming a therapeutic relationship with a client? A. Clarify personal attitudes, values, and beliefs. B. Obtain thorough assessment data. C. Determine the client's length of stay. D. Establish personal goals for the interaction.

When an individual's stress response is sustained over a long period, the nurse anticipates which physiological effect? A. Decreased resistance to disease B. Increased libido C. Decreased blood pressure D. Increased feelings of well-being

Which client statement alerts the nurse that the client may be maladaptively responding to stress? A. "Avoiding contact with others helps me cope." B. "I really enjoy journaling; it's my private time." C. "I signed up for a yoga class this week." D. "I made an appointment to meet with a therapist."

Which client statement demonstrates improvement in anger and aggression management? A. "I realize I have a problem expressing my anger appropriately." B. "I know I can't use physical force anymore, but I can verbally intimidate others." C. "It's bad to feel as angry as I feel. I'm working on eliminating this poisonous emotion entirely." D. "Because my wife seems to be the one to set me off, I've decided to remain separated from her."

Which is an appropriate initial nursing intervention for a client with chronic low self-esteem? Assessing the content of negative self-talk Administering anxiolytic medications Using reassurance and physical touch Using distraction techniques

Which is the priority nursing diagnosis for a client experiencing alcohol withdrawal? A. Risk for injury related to (R/T) central nervous system (CNS) stimulation B. Disturbed thought processes R/T tactile hallucinations C. Ineffective coping R/T powerlessness over alcohol use D. Ineffective denial R/T continued alcohol use despite negative consequences

Which nursing approach should be used to maintain a therapeutic relationship with a client diagnosed with BPD? A. Being firm, consistent, and empathetic while addressing specific client behaviors B. Promoting client self-expression by implementing laissez-faire leadership C. Using authoritative leadership to help clients learn to conform to societal norms D. Overlooking inappropriate behaviors to avoid promoting secondary gains

Which nursing diagnosis is appropriate for a client who is unable to identify objects, confabulating, screaming, and demanding verbalizations? Impaired verbal communication Disturbed sensory perception Situational low self-esteem; grieving Disturbed thought processes; impaired memory

Which of the following best defines secondary depression? A. Depressive symptoms that occur as a consequence of an adverse side effect of certain medications. B. Depressive symptoms as a result of MDD exacerbation and elevated serotonin levels. C. Depressive symptoms that occur as a result of psychomotor retardation. D. Depressive symptoms that occur with abrupt discontinuation of antidepressants.

Which of the following best defines the basis of cognitive behavior therapy? A. Cognitive behavior therapy is based on the concept that distorted thoughts are the foundation of many emotional, mental, and behavioral disorders. B. Cognitive behavior therapy is based on the concept that higher education can prevent emotional, mental, and behavioral disorders. C. Cognitive behavior therapy is based on the concept that a contingency contract can help a client develop adaptive behaviors. D. Cognitive behavior therapy is based on a reward system of positive reinforcement of positive self-statements.

Which outcome does the nurse expect during the working phase of the nurse-client relationship? The client gains insight and incorporates alternative behaviors. The client and nurse establish rapport and mutually develop treatment goals. The client explores feelings related to reentering the community. The client explores personal strengths and weaknesses that impact behaviors.

Which situation will most likely lead to maladaptive grief in the survivor? A. A woman loses her spouse, who was the primary breadwinner of the family. B. A man loses a sibling 15 years after losing his other sibling. C. A man loses his spouse and has been attending a support group for 3 months. D. A woman loses her colleague to a heroin overdose.

Which statement best describes how the perspective on psychopharmacological use of phenothiazines has historically changed? A. Phenothiazines were originally used as a preoperative medication and found to improve the client's anxiety. B. Phenothiazines were originally used for infection control and found to improve a client's treatment compliance. C. Phenothiazines were originally used for postoperative care and found to improve the client's ability to recover from anesthesia. D. Phenothiazines were originally used for diabetics to control their appetite and blood sugars.

Which statement indicates to the nurse that a client is experiencing a delusion? "Spies are watching everything I do." "There is a worm on the back of the television." "Bugs are crawling all over me." "I really don't feel like going to group today."

Which student statement about clients diagnosed with this disorder indicates that learning has occurred regarding the etiology of dissociative disorders from a psychoanalytical perspective? A. "Dissociative behaviors occur when individuals repress distressing mental information from their conscious awareness." B. "When their physical symptoms relieve them from stressful situations, their amnesia is reinforced. C. "People with dissociative disorders typically have strong egos." D. "There is clear and convincing evidence of a familial predisposition to this disorder."

Which student statement indicates that learning has occurred regarding risk factors for the development of delirium in older adults? "Taking multiple medications may lead to adverse interactions or toxicity." "Age-related cognitive changes may lead to alterations in mental status." "Lack of rigorous exercise may lead to decreased cerebral blood flow." "Decreased social interaction may lead to profound isolation and psychosis."

Which therapeutic communication technique is being used in this nurse-client interaction?Client: "My father spanked me often."Nurse: "Your father was a harsh disciplinarian." Restating Offering general leads Focusing Accepting

Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurse's coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworker's lack of involvement? A. Taking no action is still considered an action by the coworker. B. Taking no action is releasing the coworker from ethical responsibility. C. Taking no action is advised when potential adverse consequences are foreseen. D. Taking no action is acceptable, because the coworker is a bystander.

The nurse is teaching parents of a 14-year-old client diagnosed with anorexia nervosa about prescribed medications. Which carries a black-box warning? Fluoxetine Phenelzine Topiramate Amitriptyline

A SSRI - black box for suicide

A 20-year-old client tells the nurse in the outpatient clinic, "I am so disgusted with myself. For the past month, there are times when I eat everything I can find. I want to vomit it all back up, but I have never been able to." Which is the nurse's best reply? "It's normal to feel depressed after eating so much." "Tell me about relationships with the people in your life." "I am not surprised to hear you feel so disgusted with yourself." "Have you ever been diagnosed with clinical depression?"

A child has been diagnosed with autism spectrum disorder (ASD). The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing reply is most appropriate? A. "Researchers really don't know what causes autistic disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored." B. "Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control." C. "Research has shown that the mother appears to play a greater role in the development of this disorder than does the father." D. "Lack of early infant bonding with the mother has shown to be a cause of autistic disorder. Did you breastfeed or bottle feed?"

A child has been recently diagnosed with mild ID. Which information about this diagnosis would the nurse include when teaching the child's mother? A. Children with mild ID need constant supervision. B. Children with mild ID develop academic skills up to a sixth-grade level. C. Children with mild ID appear different from their peers. D. Children with mild ID have significant sensory-motor impairment.

A client continually waits more than an hour before being seen at the mental health clinic. The client approaches the nurse and states, "When I have to wait for more than an hour to be seen, I feel like my time is not important." The nurse recognizes this as what type of behavior? Aggressive behavior Assertive behavior Passive-aggressive behavior Passive behavior

A client diagnosed with OCD is admitted to a psychiatric unit. The client has an elaborate routine for toileting activities. Which should be the initial client outcome during the first week of hospitalization? The client will refrain from ritualistic behaviors during daylight hours. The client will wake early enough to complete rituals prior to breakfast. The client will participate in three unit activities by day 3. The client will substitute a productive activity for rituals by day 1.

A client diagnosed with alcohol abuse disorder is referred to a residential care facility after discharge. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), which dimension of recovery is supporting this client? Health Home Purpose Community

A client diagnosed with bipolar I disorder is distraught over insomnia experienced over the past 3 nights and a 12-lb weight loss over the past 2 weeks. Which should be this client's priority nursing diagnosis? A. Knowledge deficit related to (R/T) bipolar disorder as evidenced by (AEB) concern about symptoms B. Altered nutrition: less than body requirements R/T hyperactivity AEB weight loss C. Risk for suicide R/T powerlessness AEB insomnia and anorexia D. Altered sleep patterns R/T mania AEB insomnia for the past 3 nights

A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because he complains that it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders? Sertraline (Zoloft) Valproic acid (Depakote) Trazodone (Desyrel) Paroxetine (Paxil)

A client diagnosed with borderline personality disorder (BPD) brings up a conflict with the staff in a community meeting and develops a following of clients who unreasonably demand modification of unit rules. Which approach is best for the nursing staff to implement? A. Allow the clients to apply the democratic process when developing unit rules. B. Maintain consistency of care by open communication to avoid staff manipulation. C. Allow the client spokesperson to verbalize concerns during a unit staff meeting. D. Maintain unit order by the application of autocratic leadership.

A client diagnosed with posttraumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which utterance made by the nurse is an example of a broad opening? A. "What occurred prior to the traumatic event, and when did you go to the emergency department?" B. "What would you like to talk about?" C. "I notice you seem uncomfortable discussing this." D. "How can we help you feel safe during your stay here?"

A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. Which statement is true regarding what the milieu provides that may be missing in the home environment? Peer pressure Structured programming Visitor restrictions Mandated activities

A client diagnosed with schizophrenia tells the nurse, "The 'Shopatouliens' took my shoes out of my room last night." Which is the correct charting entry to describe this client's statement? "The client is speaking with clang associations." "The client is expressing feelings with a neologism." "The client demonstrates paranoid thinking." "The client is communicating with a word salad."

A client exhibits paranoia, bizarre behaviors, neologisms, and delusions of persecution. While eating breakfast in the dayroom, the client starts yelling at others. Which is the nurse's first action? Ensure client is swallowing each dose of medication. Ask other clients to step out of the dayroom. Call the provider for an order to place the client in restraints. Escort the client to a less-stimulating environment.

A client is diagnosed with an anxiety disorder. The nurse counselor recommends the behavioral technique of reciprocal inhibition. The client asks, "What's that?" Which is the best nursing reply? A. "At the beginning of this intervention, a contract will be drawn up explicitly stating the behavior change agreed upon." B. "By introducing an adaptive behavior that is mutually exclusive to your maladaptive behavior, we will expect subsequent behavior to improve." C. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." D. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."

A client is diagnosed with terminal cancer. Which situation would the nurse assess as reflecting Kübler-Ross's grief stage of anger? A. The client registers for an iron-man marathon to be held in 9 months. B. The client is a devoted Catholic but refuses to attend church and states that his faith has failed him. C. The client promises God to give up smoking if allowed to live long enough to witness a grandchild's birth. D. The client gathers family to plan a funeral and make their last wishes known.

A client is served divorce papers while on the inpatient psychiatric unit. When the nurse tells the client that the unit telephone cannot be used after-hours, the client raises his fists, swears, and spits at the nurse. What would be the priority nursing diagnosis at this time? A. Ineffective coping related to dysfunctional family system as evidenced by (AEB) aggressive behavior B. Risk for violence related to dysfunctional family system AEB aggressive behavior C. Risk for anger related to dysfunctional family system AEB aggressive behavior D. Ineffective grieving related to dysfunctional family system AEB pending divorce

A client presents in the emergency department with a friend who reports that the client has been sitting in her apartment "staring off into space" and doesn't seem interested in doing anything. During the assessment, the client reveals, with little emotion, that she was raped 4 months ago. Which of these is the most appropriate interpretation of the client's lack of emotion? A. The client is probably hearing voices telling her to be emotionless. B. The client is experiencing a common symptom of numbing of emotional response. C.The client is attempting to be secretive and lying, which are common symptoms in post-traumatic stress disorder (PTSD). D. The client is having a dissociative episode and revisiting the traumatic event.

A client refuses to go on a cruise to the Bahamas with his spouse because of fearing that the cruise ship will sink and all aboard will drown. Using a cognitive theory perspective, the nurse should use which of these statements to explain the etiology of this fear to his spouse? A. "Your spouse may be unable to resolve internal conflicts, which result in projected anxiety." B. "Your spouse may be experiencing a distorted and unrealistic appraisal of the situation." C. "Your spouse may have a genetic predisposition to overreacting to potential danger." D. "Your spouse may have high levels of brain chemicals that may distort thinking."

A client treated for symptoms of PTSD following a shooting incident at a local elementary school reports, "I feel like there's no reason to go on living when so many others are dead." Which is the most appropriate response by the nurse now? "You have lots of reasons to go on living." "Are you having thoughts of hurting or killing yourself?" "You're just experiencing survivor guilt." "There must be something that gives you hope."

A client was admitted to the hospital after being treated in the emergency department for seizures following a head trauma. Within a few minutes of arriving on the floor, the admitting nurse noticed that the client had a difficult time sustaining attention and did not know where she was. Which statement describes the rationale for the abnormal behavior? The client likely has a systemic illness. The client is experiencing delirium. The client is experiencing a metabolic imbalance from dehydration. The client likely has a major NCD.

A client who has been taking fluvoxamine (Luvox) without significant improvement asks the nurse, "I heard about something called monoamine oxidase inhibitors (MAOIs). Can't my doctor add that to my medications?" Which is the most appropriate nursing reply? "This combination of drugs can lead to delirium tremens." "A combination of an MAOI and fluvoxamine can lead to a life-threatening hypertensive crisis." "That's a good idea. There have been good results with the combination of these two drugs." "The only disadvantage would be the exorbitant cost of the MAOI."

A client who is diagnosed with MDD asks the nurse what causes depression. Which is the nurse's most accurate response? A. "Depression is caused by a deficiency in neurotransmitters, including serotonin and norepinephrine." B. "The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role." C. "Depression is a learned state of helplessness caused by ineffective parenting." D. "Depression is caused by intrapersonal conflict between the id and the ego."

A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, which diagnosis would the nurse expect the physician to assign? A. Medication-induced delirium B. VNCD C. Altered thought processes D. Alzheimer's disease

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the past 24 hours. Which client symptom should the nurse immediately report to the ED physician? Antecubital bruising Blood pressure of 180/100 mm Hg Mood rating of 2/10 Dehydration

A family asks why their father is attending activity groups at the long-term care facility. The son states, "My father worked hard all of his life. He just needs some rest at this point." Which is the appropriate nursing reply? A. "I'm glad we discussed this. We'll excuse him from the activity groups." B. "The groups benefit your father by providing sensory stimulation and reality orientation." C. "The groups are optional. Only clients at high-functioning levels would benefit." D. "If your father doesn't go to these activity groups, he will develop dementia."

A family member is seeking advice about an elderly parent who seems to worry unnecessarily about everything. The family member asks, "Should I seek psychiatric help for my mother?" Which is the nurse's most appropriate reply? A. "My mother also worries unnecessarily. I think it is part of the aging process." B. "Anxiety is considered abnormal when it is out of proportion to the stimulus causing it and when it impairs functioning." C. "From what you have told me, you should get her to a psychiatrist as soon as possible." D. "Anxiety is a complex phenomenon and is effectively treated only with psychotropic medications."

A high school student is attracted to a female teacher. The student is uncomfortable with his feelings and says to his friend, "I know she wants me." Which defense mechanism is the student demonstrating? A. Displacement B. Projection C. Rationalization D. Sublimation

A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. The nurse postpones the admission interview, verbally assures safety, and provides the client with a warm meal. Which of the following does the nurse's action demonstrate? A. Sympathy B. Trust C. Veracity D. Manipulation

A man diagnosed with alcohol dependence experiences his first relapse. During his Alcoholics Anonymous (AA) meeting, another group member states, "I relapsed three times but now have been sober for 15 years." Which of Yalom's curative group factors does this illustrate? Imparting of information Instillation of hope Catharsis Universality

A nurse maintains a client's confidentiality, addresses the client appropriately, and does not discriminate based on sex, age, race, or religion. Which guiding principle of recovery has this nurse employed? Recovery is culturally based and influenced. Recovery is based on respect. Recovery involves individual, family, and community strengths and responsibility. Recovery is person-driven.

A nurse maintains an uncrossed arm and leg posture. This nonverbal behavior is reflective of which letter of the SOLER acronym for active listening? S O L E

A nurse recently admitted a client to an inpatient unit after a suicide attempt. The health-care provider orders amitriptyline (Elavil) for the client. Which intervention related to this medication should be initiated to maintain this client's safety upon discharge? A. Provide a 6-month supply of Elavil to ensure long-term compliance. B. Provide a 3-day supply of Elavil with refills given at follow-up appointments. C. Provide a pill dispenser and a smart-phone application as a reminder system. D. Provide education regarding the avoidance of foods containing tyramine.

A nursing instructor is teaching about reminiscence therapy. What student statement indicates that learning has occurred? A. "Reminiscence therapy is a group in which participants create collages representing significant aspects of their lives." B. "Reminiscence therapy encourages members to share significant life memories to promote resolution." C. "Reminiscence therapy is a social group where members chat about past events and future plans." D. "Reminiscence therapy encourages members to share positive memories of significant life transitions."

A nursing instructor is teaching about specific phobias. Which student statement indicates that learning has occurred? A. "These clients do not recognize that their fear is excessive, and they rarely seek treatment." B. "These clients have overwhelming symptoms of panic when exposed to the phobic stimulus." C. "These clients experience symptoms that mirror a cerebrovascular accident (CVA)." D. "These clients experience the symptoms of tachycardia, dysphagia, and diaphoresis."

A nursing instructor is teaching about suicide in the elderly population. Which information is appropriate to include? A. Elderly men use less-lethal means to commit suicide. B. The second-highest rates of suicide are among those 85 years or older. C. Suicide is the second-leading cause of death among the elderly. D. The elderly who are single are less likely to attempt and succeed at suicide.

A patient was recently admitted to the inpatient unit after a suicide attempt. During the hospitalization, the patient was placed on a tricyclic antidepressant. Which action should the nurse implement to maintain the patient's safety when the patient is discharged? A. Provide the patient with a 6-month supply of medication. B. Provide a 1-week supply of medication to be refilled after visiting the provider. C. Instruct increased fluid intake to counteract the medication's side effects. D. Provide education on fluid restrictions to prevent side effects.

A pessimistic client expresses low self-worth, has much difficulty making decisions, avoids positions of responsibility, and has a behavioral pattern of "suffering" in silence. Which underlying cause of this client's personality disorder should the nurse recognize? A. Nurturance was provided from many sources, and independent behaviors were encouraged. B. Nurturance was provided exclusively from one source, and independent behaviors were discouraged. C. Nurturance was provided exclusively from one source, and independent behaviors were encouraged. D. Nurturance was provided from many sources, and independent behaviors were discouraged.

A stockbroker commits suicide after being convicted of insider trading. While speaking with the family, which statement by the nurse demonstrates accurate and appropriate sharing of information? A. "Your grieving will subside within 1 year; until then, I recommend antidepressants." B. "Support groups are available specifically for survivors of suicide, and I would be glad to help you locate one in this area." C."The only way to deal effectively with this kind of grief is to write a letter to the brokerage firm to express your anger with them." D. "Since stigmatization often occurs in these situations, it would be best if you avoid discussing the suicide with anyone."

A student confides in the school nurse that he is feeling stress about deciding whether to go to college or work to provide needed income for his family. Which is the best approach by the nurse to assist the student? A. Teach the student meditation techniques. B. Assist the student with problem-solving strategies. C. Suggest relaxation methods for the student. D. Recommend getting a pet for the student.

A student nurse has just entered a psychiatric rotation. The student asks a nursing instructor, "How will we know if someone may get violent?" Which is the most appropriate reply by the nursing instructor? A. "You can't really say for sure. There are limited indicators of potential violence." B. "Certain behaviors indicate a potential for violence, such as rigid posture, clenched fists, and raised voice." C. "Any client can become violent, so be aware of your surroundings at all times." D. "When a client suddenly becomes quiet, is withdrawn, and maintains a flat affect, this is an indicator of potential violence."

A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, "I can't function any longer under all this stress." Which type of crisis is the client experiencing? Maturational/developmental crisis Psychiatric emergency crisis Anticipated life-transition crisis Traumatic stress crisis

After years of dialysis, an 84-year-old states, "I'm exhausted, depressed, and done with these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care? "Have there been any changes in your spouse's appetite or sleep?" "How often is your spouse left alone?" "Has your spouse been following a diet and exercise program consistently?" "How does your spouse cope with illness?"

An adolescent comes from a family where physical and verbal abuse prevails. The adolescent bullies and fights with classmates at school. Which of the following is the probable source of this behavior? Shaping Modeling Premack principle Reciprocal inhibition

An adult client assaults another client and is placed in restraints. Which client statement alerts the nurse that further assessment is necessary? "I hate all of you!" "My fingers are tingly." "You wait until I tell my lawyer." "I have a sinus headache."

An elderly, emaciated client is brought to an emergency department by the client's caregiver. The client has bruises and abrasions on the shoulders and back in multiple stages of healing. When directly asked about these symptoms, which type of client response should a nurse anticipate? The client will honestly reveal the nature of the injuries. The client may deny or minimize the injuries. The client may have forgotten what caused the injuries. The client will ask to be placed in a nursing home.

An isolative client was admitted 4 days ago with a diagnosis of MDD. Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu? "We'll go to the dayroom when you are ready for group." "I'll walk with you to the dayroom. Group is about to start." "It must be difficult for you to attend group when you feel so bad." "Let me tell you about the benefits of attending this group."

During a psychoeducational group on assertiveness training, a client asks, "Why do we need to learn about this stuff?" Which is the most appropriate nursing reply? A. "Because your doctor requires you to attend this group to learn how to cooperate." B. "Being assertive is the ability to stand up for yourself while respecting the rights of others." C. "Assertiveness training teaches you how to ask for what you want, when you want it." D. "Assertive people are more vocal and place the needs and rights of others before their own."

During a therapeutic group, a client talks about personal accomplishments in an effort to gain attention. Which group role, assumed by this client, should the nurse identify? Task role of gatekeeper Individual role of recognition seeker Maintenance role of dominator Task role of elaborator

During an assessment interview, a client diagnosed with antisocial personality disorder spits, curses, and refuses to answer questions. Which is the most appropriate nursing statement to address this behavior? A. "You are very disrespectful. You need to learn to control yourself." B. "I understand that you are angry, but this behavior will not be tolerated." C. What behaviors could you modify to improve this situation?" D. "What antisocial personality disorder medications have helped you in the past?"

On the basis of Erikson's theory, how should a nurse encourage a 40-year-old client to improve self-esteem? A. Encourage the client to review life goals and accomplishments. B. Encourage the client to volunteer at a school, reading to underprivileged children. C. Encourage the client to form lasting intimate relationships. D. Encourage the client to seek recognition for task achievement.

Teaching regarding the concepts of mental health and mental illness is effective when the student nurse states which of the following? "The concepts are rigid and based on religious beliefs." "The concepts are multidimensional and culturally defined." "The concepts are universal and unchanging." "The concepts are fixed and unidimensional."

The client's 8-year-old child went missing 1 year ago. The police have few leads and have lost interest in the case. The client visits an outpatient mental health clinic to determine the treatment options available to help cope with the grief. The client begins to sob uncontrollably when attempting to speak to the nurse. Which statement made by the nurse demonstrates support of the client? "Please don't cry. It will make me cry to see you so upset." "I'll be right back with some tissues and a glass of water." "Kidnapping is a terrible thing, but maybe your child will be returned home." "I think you need a long vacation to help you forget all about this situation."

The nurse assesses a client who exhibits a flat affect, paranoia, anhedonia, anergia, neologisms, and echolalia. Which statement indicates the nurse understands the characteristics of positive and negative symptoms of schizophrenia? Paranoia, anhedonia, and anergia are positive symptoms. Paranoia, neologisms, and echolalia are positive symptoms. Paranoia, anergia, and echolalia are negative symptoms. Paranoia, flat affect, and anhedonia are negative symptoms.

The nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance use disorder? A. Narcotic pain medication is contraindicated for all clients with active substance use problems. B. Clients who are regularly using alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control. C. There is no need to assess the client for substance use disorder. There is an obvious PCA malfunction. D. The client is experiencing symptoms of withdrawal and needs to be accurately assessed for lorazepam (Ativan) dosage.

The nurse is caring for an Irish client who has recently lost a spouse. The client states to the nurse, "I'm planning an elaborate wake and funeral." According to George Engel, which purpose do these rituals serve? A. To delay the recovery process initiated by the loss of the client's spouse B. To facilitate the acceptance of the loss of the client's spouse C. To avoid dealing with grief associated with the loss of the client's spouse D. To eliminate emotional pain related to the loss of the client's spouse

The nurse is developing a care plan for a client diagnosed with anorexia nervosa and determines "disturbed body image" is the priority nursing diagnosis. Which is the most appropriate outcome criterion? Achieve and maintain expected body mass index (BMI). Verbalize understanding of maladaptive eating behaviors. Exhibit decreased preoccupation with own appearance. Discuss feelings and emotions associated with eating.

The nurse is developing nursing diagnoses for a newly admitted client diagnosed with anorexia nervosa. The client has a BMI of 15.8 kg/m2. Which is the priority nursing diagnosis? Ineffective coping Imbalanced nutrition Obesity Disturbed body image

The nurse is discussing the concept of anger versus aggression with clients during a counseling session. Which of the following statements best differentiates between anger and aggression? A. "Aggression is a physiological arousal state due to a painful experience, where anger is a learned behavior." B. "Anger is a normal, healthy emotional response to a negative stimulus, where aggression is an expression of anger." C. "Aggression is a normal emotional response to a negative stimulus, where anger is an emotional expression of aggression." D. "There is no difference between anger and aggression; they are essentially the same phenomenon."

The nurse is educating the parents of a child diagnosed with schizophrenia on how to reply when their child experiences auditory hallucinations. Which is the nurse's best reply? "Tell him to stop talking about the voices." "Ask him what the voices are saying to him." "Tell him you know the voices are real to him." "Encourage him not to worry about the voices."

The nurse is implementing a one-on-one suicide observation level with a client diagnosed with MDD. The client states, "I'm feeling a lot better, so you can stop watching me. I have taken up too much of your time already." Which is the best nursing reply? A. "I really appreciate your concern, but I have been ordered to continue to watch you." B. "Because we are concerned about your safety, we will continue to observe you." C. "I am glad you are feeling better. The treatment team will consider your request." D. "I will forward your request to your psychiatrist because it is his decision."

The nurse is interviewing a client with a history of excessive drinking and multiple arrests for impaired driving. The client states, "I work hard to provide for my family. I don't see why I can't drink to relax." Which defense mechanism is the client demonstrating? Projection Rationalization Regression Sublimation

The nurse recognizes that a client is mildly anxious when beginning a session that incudes client teaching. Which is the most appropriate interpretation of the situation? A. The nurse should wait until the client is more anxious to enhance learning. B. The mild anxiety the client displays will likely enhance learning for the client. C. The nurse should wait until there is no anxiety to achieve the best learning. D. The mild anxiety will have no impact on learning and does not need consideration.

What is the priority reason for the nurse to perform a full physical health assessment on a client admitted with a diagnosis of MDD? A. The attention during the assessment is beneficial in decreasing social isolation. B. Depression is a symptom of several medical conditions. C. Physical health complications are likely to arise from antidepressant therapy. D. Depressed clients avoid addressing physical health and ignore medical problems.

When used in combination with anxiolytic medication, alcohol leads to ____ effects and caffeine leads to ____ effects. A. Increased; increased B. Increased; decreased C. Decreased; decreased D. Decreased; increased

Which finding is the nurse most likely to assess in a child diagnosed with separation anxiety disorder? The child has a history of antisocial behaviors. The child's mother is diagnosed with an anxiety disorder. The child previously had an extroverted temperament. The child's parents have inconsistent parenting styles.

Which function is exclusive to the advanced practice psychiatric-mental health nurse's scope of practice? Teaching about the side effects of neuroleptic medications Using psychotherapy to improve mental health status Using milieu therapy to structure a therapeutic environment Providing case management to coordinate continuity of health services

Which indicates a client is likely demonstrating a mental disorder? A. The client expresses mild anxiety and is eating more than usual before an examination. B. The client displays an inability to concentrate, including reduced job performance. C. The client describes engaging in fidgeting behavior consistently over a few days. D. The client states an increase in smoking over a few days from 0.5 to 1 pack per day.

Which is a typical part of the fight-or-flight syndrome? Decreased heart rate Decreased peristalsis Increased salivation Pupil constriction

Which is an example of an intentional tort? A. A nurse fails to assess a client with rigid muscles and an elevated temperature. B. A nurse physically places a client in restraints without the client's consent. C. A nurse makes a medication error and does not report the incident. D. A nurse gives confidential client information to an unauthorized person.

Which is used as first-line outpatient psychological treatment for adolescents diagnosed with anorexia nervosa? Cognitive-based therapy Family-based therapy Dialectical behavior therapy Individual psychotherapy

Which mental illness would a nurse identify as being associated with a decrease in prolactin levels? Attention deficit disorder Schizophrenia Anorexia nervosa Alzheimer's disease

Which neurotransmitters would the nurse expect to be elevated in a client with a diagnosis of catatonic schizophrenia? Serotonin Dopamine Norepinephrine Histamine

Which nursing intervention related to self-care is most appropriate for a teenager diagnosed with moderate ID? A. Meet all of the client's self-care needs to avoid injury. B. Provide simple directions and praise client's independent self-care efforts. C. Avoid interference with the client's self-care efforts to promote autonomy. D. Encourage family to meet the client's self-care needs to promote bonding.

Which of the following is the priority nursing action during the orientation (introductory) phase of the nurse-client relationship? A. Acknowledge the client's actions and generate alternative behaviors. B. Establish rapport and develop mutually agreeable treatment goals. C. Attempt to find alternative placement for the client. D. Explore how thoughts and feelings may adversely impact nursing care.

Which outcome is appropriate when planning care for an inpatient client diagnosed with somatic symptom disorder? A. The client will admit to fabricating physical symptoms to gain benefits by day 3. B. The client will list three potential adaptive coping strategies to deal with stress by day 2. C. The client will comply with medical treatments for physical symptoms by day 3. D. The client will openly discuss physical symptoms with staff by day 4.

Which psychiatric disorder would a nurse expect to see diagnosed in a client's later life? Schizophrenia Major depressive disorder Phobic disorder Dependent personality disorder

Which statement about tricyclic antidepressant medications is accurate? A. Strong or aged cheese should not be eaten while taking them. B. Their full therapeutic potential may not be reached until 4 weeks. C. They may cause hypomania or recent-memory impairment. D. They should not be given with antianxiety agents.

Which statement accurately describes dissociative fugue? A. Dissociative fugue is not precipitated by stressful events. B. Dissociative fugue is characterized by sudden, unexpected travel or bewildered wandering with inability to recall some or all of one's past. C. Dissociative amnesia and dissociative fugue are completely different types of disorders. D. Dissociative fugue is characterized by a sense of observing oneself from outside the body.

Which statement is most accurate regarding the assessment of clients diagnosed with psychiatric problems? A. Medical history is of little significance and can be eliminated from the nursing assessment. B. Assessment provides a holistic view of the client, including biopsychosocial aspects. C. Comprehensive assessments can be performed only by advanced practice nurses. D. Psychosocial evaluations are gained by subjective reports rather than objective observations.

Which statement is true regarding the priority focus of recovery models? A. Empowerment of the health-care team to bring its expertise to decision-making B. Empowerment of the client to make decisions related to individual health care C.Empowerment of the family system to provide supportive care D. Empowerment of the physician to provide appropriate treatments

Which student statement indicates that further teaching is needed regarding recovery as it applies to mental illness? "The goal of recovery is improved health and wellness." "The goal of recovery is expedient, comprehensive behavioral change." "The goal of recovery is the ability to live a self-directed life." "The goal of recovery is the ability to reach full potential."

Which student statement indicates that further teaching is needed regarding the recovery process according to Andresen and associates? A. "A client has a better chance of recovery if he or she truly believes that recovery can occur." B. "If a client is willing to give the responsibility of treatment to the health-care team, he or she is likely to recover." C. "A client who has a positive sense of self and a positive identity is likely to recover." D. "A client has a better chance of recovery if he or she has purpose and meaning in life."

Which student statement indicates that learning has occurred regarding electroconvulsive therapy (ECT)? "During ECT, a state of euphoria is induced." "ECT induces a grand mal seizure." "During ECT, a state of catatonia is induced." "ECT induces a petit mal seizure."

While assessing a client diagnosed with bulimia nervosa, the nurse observes multiple cavities, enamel erosion, and tooth sensitivity. Which best explains the nurse's findings? Electrolyte imbalances Self-induced vomiting Nutritional deficits Dehydration

The client is an 18-year-old college student being treated in the community mental health clinic for an adjustment disorder after receiving news of her parents' impending divorce. While talking about her feelings, she becomes angry and starts shouting and crying. She screams, "I wish they would both die!" Which of these is the most appropriate nursing response? A. Contact the parents and the police to report that the client is expressing homicidal ideation. B. Encourage the client to talk more about her anger. C. Instruct the client that it is not acceptable to talk that way about her parents. D. Assess the client for harming herself or others.

B ?

A 2-year-old engages in frequent temper tantrums that usually result in the parents giving in to the child's demands. During family therapy, which is the best nursing statement when counseling the parents? "You are shaping your child's behavior." "Your child has modeled your behavior." "You are positively reinforcing your child's behavior." "You are negatively reinforcing your child's behavior."

A 30-year-old client seeking therapy states, "My parent cries when she is not included in all my social activities and thinks of my friends as her own." Which of the following indicates the nurse's description of this family's boundaries? The boundaries are rigid. The boundaries are restructured. The boundaries are enmeshed. The boundaries are disengaged.

A client began taking lithium for the treatment of bipolar disorder approximately 1 month ago. The client asks if it is normal to have gained 12 lb in this time frame. Which is the appropriate nursing reply? A. "That's strange. Weight loss is the typical pattern." B. "What have you been eating? Weight gain is not usually associated with lithium." C. "Weight gain is a common but troubling side effect." D. "Weight gain occurs only during the first month of treatment with this drug."

A client diagnosed with DID switches personalities when confronted with destructive behavior. The nurse recognizes that this dissociation serves which function? It is a means to attain secondary gain. It is a means to explore feelings of excessive and inappropriate guilt. It serves to isolate painful events so that the primary self is protected. It serves to establish personality boundaries and limit inappropriate impulses.

A client diagnosed with Lewy body dementia has been prescribed an antipsychotic medication to manage a decline in mental capacities. Why would the nurse question this prescription? A. Antipsychotic medications can cause Lewy body dementia to become a permanent condition. B. Lewy body dementia does not affect cognitive functioning. C. Clients with Lewy body dementia are highly sensitive to the extrapyramidal effects of antipsychotic medications. D. Lewy body dementia causes an increase in acetylcholinesterase concentrations, which makes antipsychotic medications contraindicated.

A client diagnosed with an NCD due to Alzheimer's disease is disoriented, ataxic, and wanders. Which nursing diagnosis is the priority? Disturbed thought processes Self-care deficit Risk for injury Altered health-care maintenance

A client diagnosed with an NCD is exhibiting behavioral problems every day. At change of shift, the client's behavior escalates from pacing to screaming and flailing. Which action would the nurse implement first? A. Consult the psychologist regarding behavior-modification techniques. B. Medicate the client with prn antianxiety medications. C. Assess environmental triggers and potential unmet needs. D. Anticipate the behavior, and restrain when pacing begins.

A client diagnosed with antisocial personality disorder comes to the nurses' station at 11:00 p.m., requesting to phone a lawyer to discuss filing for a divorce. The unit rules state that no phone calls are permitted after 10:00 p.m. Which nursing reply is most appropriate? A. "Go ahead and use the phone. I know this pending divorce is stressful." B. "You know better than to break the rules. I'm surprised at you." C. "It is after the 10:00 p.m. phone curfew. You will be able to call tomorrow." D. "The decision to divorce should not be considered until you have had a good night's sleep."

A client diagnosed with brief psychotic disorder states, "The voices keep telling me I must kill the president." Which is the priority nursing diagnosis? Disturbed sensory perception Disturbed thought processes Risk for violence: other directed Impaired verbal communication

A client diagnosed with bulimia nervosa has been receiving CBT at the eating disorders clinics. Which of the following client actions indicates to the nurse that the client is making progress toward using adaptive eating behaviors? Gains 2 lb in 1 week Verbalizes importance of adequate nutrition Identifies feelings associated with desire to binge Takes antidepressant medications as prescribed

A client diagnosed with major depressive disorder with psychotic features hears voices commanding self-harm. The client refuses to commit to developing a plan for safety. Which is the nurse's priority intervention at this time? A. Obtaining an order for locked seclusion until the client is no longer suicidal B. Conducting 15-minute checks to ensure safety C. Placing the client on one-to-one observation while monitoring suicidal ideations D. Encouraging client to express feelings related to suicide

A client diagnosed with neurocognitive disorder due to Alzheimer's disease has difficulty communicating because of cognitive deterioration. Which nursing intervention is appropriate to improve communication? Discourage attempts at verbal communication. Increase the volume of the nurse's communication responses. Verbalize the nurse's perception of the implied communication. Encourage the client to communicate by writing.

A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate? Provide objective evidence that violence is unwarranted. Initially restrain the client to maintain safety. Use clear, calm statements and a confident physical stance. Empathize with the client's paranoid perceptions.

A client diagnosed with schizoaffective disorder is admitted for social skills training. Which information should the nurse teach the client? Side effects of medications Deep breathing techniques Ways to make eye contact when communicating Techniques to improve memory and attention

A client diagnosed with schizophrenia refuses to take medication, citing the right of autonomy. Under which circumstance would a nurse have the right to medicate the client? A. The client makes inappropriate sexual innuendos to a staff member. B. The client repeatedly demands constant attention from the nurse. C. The client physically attacks another client during group therapy. D. The client refuses to bathe or attend to personal hygiene.

A client diagnosed with schizophrenia says, "Can't you hear him? The devil keeps telling me I'm going to hell!" Which is the nurse's most appropriate reply? "Did you take your medication this morning?" "You are a good person, and you are not going to hell." "It must be scary to hear that, but I don't hear a voice." "The devil only talks to people who are receptive to his influence."

A client has been diagnosed with somatic symptom disorder. As the nurse is talking with this client and her family, which statement suggests primary or secondary gains that the physical symptoms are providing for the client? A. The family agrees that the client began having physical symptoms after she lost her job. B. The client states that even though medical tests have not found anything wrong, she is convinced her headaches are indicative of a brain tumor. C. The client's mother reports that someone from the family stays with her each night because the physical symptoms are incapacitating. D. The client states she noticed feeling hotter than usual the last time she had a headache.

A client has experienced the death of a close family member and at the same time becomes unemployed. The client's 6-month score on the Recent Life Changes Questionnaire is 110. The nurse: A. Understands the client is at risk for significant stress-related illness. B. Determines the client is not at risk for significant stress-related illness. C. Needs further assessment of the client's coping skills to determine susceptibility to stress-related illness. D. Recognizes the client may view the losses as challenges and perceive them as opportunities.

A client has recently been placed in a long-term care facility because of marked confusion and inability to perform most activities of daily living. Which nursing intervention is most appropriate to maintain the client's self-esteem? Leave the client alone in the bathroom. Assign a variety of caregivers. Allow the client to choose between two different outfits. Modify the daily schedule often to maintain variety.

A client has undergone psychological testing. With which member of the interdisciplinary team would a nurse collaborate to review these results? Psychiatrist Psychiatric social worker Clinical psychologist Clinical nurse specialist

A client is angry because her spouse has forgotten their anniversary. The following week, the client is still unwilling to discuss this with her spouse because she is afraid she will lose control. How should the nurse interpret this client's means of coping with anger? Coping by attacking Coping by surrendering Coping by avoiding Coping by belittling

A client is experiencing a severe panic attack. Which nursing intervention would meet this client's immediate need? Teach deep-breathing relaxation exercises. Place the client in a Trendelenburg position. Stay with the client and offer reassurance of safety. Administer the ordered PRN buspirone (BuSpar).

A client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. The nurse recognizes these as classic signs of which condition? Mania Delirium NCD Parkinsonism

A client living on the beachfront seeks help with an extreme fear of crossing bridges, which interferes with daily life. A psychiatric-mental health nurse practitioner decides to try systematic desensitization. Which explanation of this therapy should the nurse convey to the client? A. "Using your imagination, we will attempt to achieve a state of relaxation that you can replicate when faced with crossing a bridge." B. "Because anxiety and relaxation are mutually exclusive states, we can attempt to substitute a relaxation response for the anxiety response." C. "Through a series of increasingly anxiety-provoking steps, we will gradually increase your tolerance to anxiety." D. "In one intense session, you will be exposed to a maximum level of anxiety that you will learn to tolerate."

A client reports, "My friend panicked at the sight of spiders. Her therapist used gradual exposure to spiders that initially made her increasingly more anxious." Which technique was the friend's therapist using? Extinction Covert sensitization Systematic desensitization Reciprocal inhibition

A client who is diagnosed with schizophrenia expresses little emotion and refuses to attend group therapy is influenced by which component of the nervous system? Dendrites Axons Neurotransmitters Synapses

A client who will be receiving ECT must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent? A. The client is demonstrating symptoms of paranoia. B. The client is 87 years old. C. The client is not oriented to person, date, or time. D. The client asks the spouse's opinion.

A client with a history of three suicide attempts has been taking fluoxetine (Prozac) for 1 month. The client suddenly presents with a bright affect, is much more communicative, and rates mood at 9/10. Which action should be the nurse's priority at this time? A. Give the client off-unit privileges as positive reinforcement. B. Encourage the client to share mood improvement in group. C. Increase frequency of client observation. D. Request a medication reevaluation.

A college student is unable to take a final examination because of severe test anxiety. Instead of studying, the student relieves stress by attending a movie. Which is the priority nursing diagnosis that the campus nurse should assign for this client? Noncompliance related to (R/T) test taking Ineffective role performance R/T helplessness Altered coping R/T anxiety Powerlessness R/T fear

A depressed client reports to the nurse a history of divorce, job loss, family estrangement, and cocaine abuse. According to learning theory, which is the cause of this client's symptoms? Depression is a result of anger turned inward. Depression is a result of abandonment. Depression is a result of repeated failures. Depression is a result of negative thinking.

A fatherless, 11-year-old African American girl lives with her grandmother after the death of her mother. Her older stepbrother is very involved in her life. How should the community health nurse view this family constellation, and why? A. Abnormal; the grandmother should be concerned with issues other than childrearing. B. Abnormal; a two-parent household is the most advantageous arrangement. C. Normal; this is an example of a cultural variation that exists in the family life cycle. D. Normal; older adults make better parenting figures due to life experiences.

A highly emotional client presents at an outpatient clinic appointment wearing flamboyant attire, spiked heels, and theatrical makeup. Which personality disorder should the nurse associate with these assessment data? Compulsive personality disorder Schizotypal personality disorder Histrionic personality disorder (HPD) Manic personality disorder

A man calls the psychiatric unit to speak to his sister. The nurse connects him to the community phone and the sister is summoned. The nurse later realizes that the brother was not on the client's approved call list. What law has the nurse broken? A. National Alliance for the Mentally Ill (NAMI) B. Tarasoff Ruling C. Health Insurance Portability and Accountability Act (HIPAA) D. Good Samaritan law

A new nursing graduate asks the psychiatric-mental health nurse manager how to best classify suicide. Which is the nurse manager's best reply? "Suicide is a medical diagnosis." "Suicide is a mental disorder." "Suicide is a behavior." "Suicide is an antisocial affliction."

A nurse administers pure oxygen to a client during and after electroconvulsive therapy (ECT). Which statement describes the rationale for this procedure? A. To prevent increased intracranial pressure resulting from anoxia B. To prevent hypotension, bradycardia, and bradypnea due to electrical stimulation C. To prevent anoxia due to medication-induced paralysis of respiratory muscles D. To prevent blocked airway resulting from seizure activity

A nurse discovers a client's suicide note that details the time, place, and means to commit suicide. What is the priority nursing intervention and accompanying rationale for this action? A. Administering lorazepam (Ativan) prn, because the client is angry about the discovery of the note B. Establishing room restrictions, because the client's threat is an attempt to manipulate the staff C. Placing this client on one-to-one suicide precautions, because the more specific the plan, the more likely the client will attempt suicide D.

A nurse is working in a nursing home. How can this nurse best foster self-esteem in the residents of this facility? Allowing them to remain in their rooms as much as they desire Administering anti-anxiety medications as ordered Providing choices when appropriate Teaching assertiveness skills and self-esteem principles

A nurse on an inpatient unit helps a client understand the significance of treatments and provides the client with copies of all documents related to the plan of care. This nurse is employing which commitment in the Tidal Model of Recovery? Know that change is constant. Reveal personal wisdom. Be transparent. Give the gift of time.

A nursing student comes down with a sinus infection toward the end of every semester. Which stage of stress is the student most likely experiencing when this occurs? A. Alarm reaction B. Resistance C. Exhaustion D. Fight or Flight

A nursing student states, "The instructor gave me a failing grade on my research paper. I know it's because the instructor doesn't like me." Which cognitive error does the nurse recognize in this student's statement? Dichotomous thinking Catastrophic thinking Magnification Overgeneralization

A patient began taking lithium for the treatment of bipolar disorder approximately 1 month ago and asks why he has gained 12 pounds since then. Which is the most appropriate nursing response? A. "It is surprising that you have gained; weight loss is the typical pattern when taking lithium." B. "Your weight gain is more likely related to food intake and decreased activity than medication." C. "Weight gain is a common but troubling side effect. Let's talk about some strategies for safely improving your nutrition and exercise habits." D. "There's not much you can do about the weight gain. It's better than being emotionally unstable though."

A patient who is older with chronic schizophrenia takes an antipsychotic and propranolol, a beta-adrenergic blocking agent, for hypertension. Given the combined side effects of these drugs, which patient teaching should the nurse provide? A. "Make sure you concentrate on taking slow, deep, cleansing breaths." B. "Watch your diet and try to engage in some regular physical activity." C. "Rise slowly when you change position from lying to sitting or sitting to standing." D. "Wear sunscreen and try to avoid midday sun exposure."

After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of a major NCD due to Alzheimer's disease. Which statement would cause the nurse to question this diagnosis? A. NCDs do not typically occur in African American clients. B. The symptoms presented are more indicative of parkinsonism. C. NCD does not develop suddenly. D. There has been no triiodothyronine or thyroxine level evaluation ordered.

After undergoing two of nine electroconvulsive (ECT) procedures, a client states, "I can't even remember eating breakfast, so I want to stop the ECT." Which reply by the nurse is appropriate? A. "After you begin the course of treatments, you must complete all of them." B. "You'll need to talk with your doctor about what you're thinking." C. "It is within your right to discontinue the treatments, but let's talk about your concerns." D. "Memory loss is a rare side effect of the treatment. I don't think it should be a concern."

An angry client on an inpatient unit approaches a nurse, stating, "Someone took my lunch! People need to respect others, and you need to do something about this now!" The nurse's response should be guided by which basic assumption of milieu therapy? Conflict should be avoided at all costs on inpatient psychiatric units. Conflict should be resolved by the nursing staff. Every interaction is an opportunity for therapeutic intervention. Conflict resolution should be addressed only during group therapy.

An elderly client who lives with a caregiver is admitted to an emergency department for a fractured arm. The client is soaked in urine and has dried fecal matter on the lower extremities. The client is 6 feet tall and weighs 120 pounds. Which condition should the nurse suspect? Self-care deficits Alzheimer's dementia Abuse or neglect or both Care giver strain

An inpatient client is newly diagnosed with DID stemming from severe childhood sexual abuse. Which nursing intervention is the priority? Encourage exploration of sexual abuse. Encourage guided imagery. Establish trust and rapport. Administer antianxiety medications.

An unemployed college graduate confides in the clinic nurse that she is experiencing severe anxiety over not finding a teaching position and that she is having difficulty with independent problem-solving. Which nursing intervention is best? A. Encourage her to seek counseling from a therapist. B. Instruct her to listen to her favorite music daily. C. Assist her with the problem-solving process. D. Encourage her to keep a daily journal of feelings.

At which time during a 24-hour period should a nurse expect clients with Alzheimer's disease to exhibit more pronounced symptoms? When they first awaken In the middle of the night At twilight After taking medications

During a therapeutic group, which nursing action demonstrates a laissez-faire leadership style? A. The nurse mandates that all group members reveal an embarrassing personal situation. B. The nurse asks for a show of hands to determine group topic preference. C. The nurse sits silently as the group members stray from the assigned topic. D. The nurse shuffles through papers to determine the facility policy on length of group.

During an intake assessment, the nurse asks a client physiological and psychosocial questions. The client angrily responds, "I'm here for my heart problems, not for my head." Which is the nurse's best response? A. "We ask all clients these questions." B. "Why are you concerned about these questions?" C. "Psychological stress can affect medical conditions." D. "We can skip these questions if you prefer."

During family counseling a child states, "I just want to surf like other kids. Mom says it's OK, but Dad says I'm too young." The mother allows surfing when the father is absent. In the structural model of family therapy, what family interactional pattern should the nurse recognize? Multigenerational transmission Disengagement Mother-child subsystem Emotional cutoff

How would the nurse differentiate a client diagnosed with a social phobia from a client diagnosed with a schizoid personality disorder (SPD)? A. Clients diagnosed with social phobia can manage anxiety without medications, whereas clients diagnosed with SPD can manage anxiety only with medications. B. Clients diagnosed with SPD are distressed by the symptoms experienced in social settings, whereas clients diagnosed with social phobia are not. C. Clients diagnosed with social phobia avoid interactions only in social settings, whereas clients diagnosed with SPD avoid interactions in all areas of life. D. Clients diagnosed with SPD avoid interactions only in social settings, whereas clients diagnosed with social phobias tend to avoid interactions in all areas of life.

In a family that is in the life cycle stage "The Family With Adolescents," which changes must occur for the family to proceed developmentally? A. Making adjustments within the marital system to meet the responsibilities of parenthood B. Establishing a new identity as a couple by realigning relationships with extended family C. Redefining the level of dependence so that adolescents are provided with greater autonomy D. Reestablishing the bond of the dyadic marital relationship and eventual death of parents

In planning care for a child diagnosed with ASD, which is a realistic client outcome? The client will communicate all needs verbally by discharge. The client will participate with peers in a team sport by day 4. The client will establish trust with at least one caregiver by day 5. The client will perform most self-care tasks independently.

In which setting should the nurse be aware that the client with a substance use disorder would most likely seek initial treatment? Psychiatric hospital Addiction treatment center Urgent care clinic Inpatient psychiatric unit

On the first day of a client's alcohol detoxification, which nursing intervention is the priority? A. Encourage the client to attend 90 Alcoholics Anonymous (AA) meetings in 90 days. B. Educate the client about the biopsychosocial consequences of alcohol abuse. C. Administer ordered chlordiazepoxide (Librium) in a dosage per protocol. D. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.

Studies have suggested that reexperiencing a traumatic event can become an addiction of sorts. The evidence suggests that the reason for this is which of the following? A. Those with addictive personalities tend to experience PTSD more often. B. Perpetuating the traumatic experience yields secondary gains. C. The reexperiencing of trauma enhances production of endogenous opioid peptides. D. Concurrent substance abuse issues are symptoms of PTSD.

The client is hospitalized with coronary artery disease and demonstrates other conditions often associated with diseases of adaptation, including headaches and depression. Currently, the client is demonstrating anxiety and states he is "really worried" about his spouse. Which is the most appropriate nursing response to the situation? A. Inform the client that he has to learn to cope with stressors. B. Teach the client how to meditate when he is feeling anxious. C. Encourage the client to talk through his concerns about his spouse. D. Ask the client if he has a pet he would like to see while in the hospital.

The client, a rape survivor, is being treated for PTSD. Which of these statements is a good indication that the client is beginning to recover from PTSD? A. "I still have nightmares every night, but I don't always remember them anymore." B. "I'm not drinking as much alcohol as I had been over the past several months." C. "This traumatic event immobilized me for a while, but I have found imagery helpful in reducing my anxiety." D. "Whenever I am reminded of the rape, I have to hide until the memory goes away."

The clinic nurse is reviewing assessment findings of a client diagnosed with anorexia nervosa. Which of the following indicate that the client requires immediate hospitalization? Body temperature of 98.6ºF Potassium level above 3.5 mmol/L BMI less than 75% of expected Weight less than 90% of expected

The nurse admits an older client who is experiencing memory loss, confused thinking, and apathy. A psychiatrist suspects depression. What is the rationale for performing a Mini-Mental Status Examination? To rule out bipolar disorder To rule out schizophrenia To rule out a neurocognitive disorder (NCD) To rule out a personality disorder

The nurse assesses a client as experiencing maladaptive grieving. Which factor confirms the nurse's assessment? The client's spouse died 12 months ago. The client still cries when recalling memories of the deceased. The client reports feelings of worthlessness. The client reports intermittent anxiety.

The nurse assesses a woman whose spouse died 13 months ago. She isolates herself, screams at her deceased spouse, and is increasingly restless and aimless. According to Bowlby, this widow is in which stage of the grieving process? Stage I: numbness or protest Stage II: disequilibrium Stage III: disorganization and despair Stage IV: reorganization

The nurse encounters a client's angry family member in the hallway. The nurse states "You seem very angry right now. I don't want to discuss his matter with you while you are so upset. I will discuss this matter later today." What is the technique that the nurse used to avoid manipulation of the family member? The nurse asks the family member to clarify the problem. The nurse accepted negative aspects about oneself. The nurse is defusing the situation with a cooling-off period. The nurse is persistently repeating in a calm voice what is wanted.

The nurse in the outpatient clinic determines the priority nursing diagnosis for a client diagnosed with anorexia nervosa is "imbalanced nutrition: less than body requirements." Which is the most appropriate short-term goal for the client? Demonstrate adaptive eating behaviors. Discuss fears and anxieties. Gain 2 lb per week. Exhibit no signs of malnutrition and dehydration.

The nurse is assessing a patient who has a diagnosis of schizophrenia and takes an antipsychotic agent daily. Which finding requires further nursing assessment? Respirations of 22 breaths/minute Weight gain of 8 pounds in 2 months Oral temperature of 101°F Complaints of dry mouth

The nurse is caring for a client who blinks when the nurse asks a question and coughs when the nurse looks at him. Which condition does the nurse suspect? Oppositional defiant disorder (ODD) ASD Tourette's disorder Conduct disorder

The nurse is interviewing a newly admitted psychiatric client. Which nursing statement is an example of offering a general lead? "Do you know why you are here?" "Are you feeling depressed or anxious?" "Yes, I see. Go on." "Can you chronologically order the events that led to your admission?"

The nurse is planning care for a client diagnosed with bipolar disorder: manic episode. Which should be the first priority of the listed client outcomes? A. Maintains nutritional status B. Interacts appropriately with peers C. Remains free from injury D. Sleeps 6 to 8 hours per night

The nurse is providing care for clients in a free community clinic. Which technique should the nurse use to conduct a trauma screening? Perform a general environmental survey. Implement a thorough head-to-toe assessment. Interview in a secluded area. Use empathy with the family members.

The nurse is providing care to a depressed, introverted client who is recovering from surgery for a fractured hip. Which action should the nurse take to provide client-centered care? Refer the client for involuntary hospitalization. Allow the client plenty of solitude during the day. Involve the client in choosing a blue or green gown to wear. Develop a partnership with the spouse who is not withdrawn.

The nurse is providing discharge teaching to an elderly client diagnosed with schizophrenia. The client's medications include an antipsychotic (risperidone) and a beta-adrenergic blocking agent (propranolol). Which statement indicates the nurse understands the combined side effects of these medications? A. "Concentrate on taking slow, deep, cleansing breaths." B. "Limit your intake of foods that are high in sugar." C. "Move slowly when you change from a lying down or sitting position." D. "Always wear sunscreen and a hat when you are exposed to the sun."

The nurse is reviewing the plan of care for a 15-year-old client diagnosed with anorexia nervosa. The treatment team plans to implement cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with anorexia nervosa? Recognize maladaptive eating patterns as defense mechanisms. Promote autonomy and control over eating behaviors. Eliminate emotional components of maladaptive eating patterns. Allow client to establish goals of the treatment plan.

The nurse is working in an ED. With which client should the nurse use the screening, brief intervention, and referral to treatment approach (SBIRT)? The patient who has suicidal thoughts The patient who has nonsuicidal self-injuring behavior The patient who has an opioid addiction The patient who has been sexually assaulted

The nurse is working with a 15-year-old client suffering from low self-esteem. According to Erikson's psychosocial developmental theory, which factor has most likely influenced this client's self-esteem? A. Regret over life choices B. Lack of personal concern for others C. Inconsistent, overly harsh, or absent parental discipline D. Parental labeling of the child as "good" regardless of his or her behavior

The nurse notices that Martha, the primary caregiver for her spouse with Alzheimer's disease, seems distracted, and she asks how Martha is doing. "I'm doing OK," said Martha. "I'm just so overwhelmed. I can't seem to get anything done. Just when I think I'm handling everything, something else comes up. Hopefully things will settle down soon, and I can get a break." Which intervention would most help Martha cope with the caregiver strain she's expressing? Teaching about symptoms of Alzheimer's disease Information about the management of Alzheimer's disease Referrals to support services for Alzheimer's disease Recommending an Alzheimer's-friendly residence facility

The nurse observes that a client diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication does the nurse anticipate the provider will prescribe? Benztropine Clonazepam Risperidone Sertraline

The young parents of a child in preschool are attending a parenting group. Many of the participants have older children and are able to influence the young parents about the expected norms for communication and behavior. What has this group provided this young couple? Task completion Governance Normative influence Information sharing

Upon admission for symptoms of alcohol withdrawal, a client states, "I haven't eaten in 3 days." Assessment reveals blood pressure of 170/100 mm Hg, pulse of 110 bpm, respirations of 28 breaths/min, and a temperature of 97°F with dry skin, dry mucous membranes, and poor skin turgor. Which of the following is the priority nursing diagnosis? Knowledge deficit Denial Deficient fluid volume Ineffective individual coping

What is the first step the nurse should take to reduce the stigmatization of mental health clients? Increase social contact with mental health clients. Attend on-the-job training about mental health clients. Have a willingness to interact with mental health clients. Understand the person as a mental health client.

When planning group therapy, the nurse identifies which configuration as most optimal for a therapeutic group? A. Open-ended membership, circle of chairs, group size of 5 to 10 members B. Open-ended membership, chairs around a table, group size of 10 to 15 members C. Closed membership, circle of chairs, group size of 5 to 10 members D. Closed membership, chairs around a table, group size of 10 to 15 members

Which adult client should the nurse recognize as exhibiting the characteristics of a dependent personality disorder? A. A physically healthy client who is dependent on meeting social needs by having contact with 15 cats B. A physically healthy client who has a history of depending on intense relationships to meet basic needs C. A physically healthy client who lives with parents and relies on public transportation D. A physically healthy client who is serious, inflexible, perfectionistic, and depends on rules to provide security

Which client information does the nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)? A. The client's understanding of the need for regular blood work B. The client's mood and affect score, according to the facility's mood scale C. The client's cognitive ability to understand information about the medication D. The client's access to a support network willing to participate in treatment

Which client statement does the nurse recognize as the client's typical response to stress most often experienced in the working phase of the nurse-client relationship? A. "I can't bear the thought of leaving here and failing." B. "You remind me of one of my parents. I might have a hard time working with you." C. "I can't tell my spouse how I feel; he wouldn't listen anyway." D. "I'm not sure that I can count on you to protect my confidentiality."

Which client statement indicates the nurse's teaching about the effect of circadian rhythms is effective? A. "When I dream about my mother's horrible train accident, I become hysterical." B. "I get really irritable during my menstrual cycle." C. "I'm a morning person, so I get my best work done in the a.m." D. "Every February, I tend to experience periods of sadness."

Which nursing intervention would take priority for a client in the late stage of Alzheimer's disease? A. Improve cognitive status by encouraging involvement in social activities. B. Decrease social isolation by providing group therapies. C. Promote dignity by providing comfort, safety, and self-care measures. D. Facilitate communication by providing assistive devices.

Which nursing student statement requires further teaching regarding care for the client with NCD experiencing hallucinations? A. "I will assess for side effects of medications that could cause hallucinations." B. "My client wears a hearing aid. I need to ensure it is working properly." C. "If I am not experiencing the hallucination, then it is likely the client is not either." D. "I took the mirror off the wall because the client was seeing a false image."

Which part of the nervous system would the nurse identify as playing a major role during stressful situations? Peripheral nervous system Somatic nervous system Sympathetic nervous system Parasympathetic nervous system

Which statement regarding nursing interventions is accurate? A. Nursing interventions are independent of the treatment team's goals. B. Nursing interventions are directed solely by written physician orders. C. Nursing interventions occur independently but align with overall treatment team goals. D. Nursing interventions are standardized by policies and procedures with client input.

Which student statement indicates an understanding regarding dissociative identity disorder (DID)? A. "I suspect my client inherited this disease from his parent." B. "It is unlikely my client had a diagnosis of schizophrenia before DID, since the two do not go hand in hand." C. "My client experiences periods of blackouts, or lost time where he doesn't know what happened during that time frame." D. "I assume my client has other personalities because he doesn't want to deal with real life."

Which therapeutic communication technique is being used in this nurse-client interaction?Client: "When I am anxious, the only thing that calms me down is alcohol."Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?" Reflecting Making observations Formulating a plan of action Giving recognition

Which treatment should the nurse identify as most appropriate for clients diagnosed with GAD? Long-term treatment with diazepam (Valium) Acute symptom control with citalopram (Celexa) Long-term treatment with buspirone (BuSpar) Acute symptom control with ziprasidone (Geodon)

Which would the nurse recognize as an example of localized amnesia? A. A client cannot relate any lifetime memories, including personal identity. B. A client can relate family memories but has no recollection of a particular brother. C. A client cannot remember events surrounding a fatal car accident. D. A client whose home was destroyed by a tornado only remembers waking up in the hospital.

While trying to control aggressive behavior, a client asks an assertiveness training nurse to give an example of an "I" statement. Which of the following statements is the best example of this assertive communication technique? A. "I would like to know why you came home late without calling me." B. "I hate it when you think you can just come home late without calling." C. "I feel angry when you come home late without calling." D. "I think you don't care about me, because if you did, you'd call me."

A cab driver stuck in traffic is suddenly lightheaded, tremulous, and diaphoretic and experiences tachycardia and dyspnea. An extensive work-up in an emergency department reveals no pathology. Which medical diagnosis is suspected, and which nursing diagnosis is the priority? A. Generalized anxiety disorder (GAD) and a nursing diagnosis of fear B. Altered sensory perception and a nursing diagnosis of panic disorder C. Pain disorder and a nursing diagnosis of altered role performance D. Panic disorder and a nursing diagnosis of panic anxiety

A client comes to a psychiatric clinic, experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. Which long-term outcome is realistic to address the client's crisis? A. The client will develop adaptive behaviors by week 1. B. The client will list five positive self-attributes by week 2. C. The client will examine how childhood events led to this behavior by week 3. D. The client will return to previous adaptive levels of functioning by week 6.

A client diagnosed with MDD states, "I've been feeling 'down' for 3 months. Will I ever feel like myself again?" Which statement by the nurse best assesses this client's affective symptoms? A. "Have you been diagnosed with any physical disorder within the past 3 months?" B. "Have you ever felt this way before? C. "People who have mood changes often feel better when spring comes." D. "Help me understand what you mean when you say 'feeling down'."

A client diagnosed with a neurocognitive disorder (NCD) due to Alzheimer's disease can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent verbalizations. The nurse recognizes that these symptoms indicate which stage of the illness? Moderate cognitive decline Very mild change Moderately severe cognitive decline Very severe cognitive decline

A client diagnosed with an NCD due to late-stage Alzheimer's disease is incapable of performing ADLs. Which intervention is the nurse's priority? Present evidence of objective reality to improve cognition. Design a bulletin board to represent the current season. Label the client's room with name and number. Assist the client with bathing and toileting.

A client diagnosed with bipolar I disorder is exhibiting severe manic behaviors. A physician prescribes lithium carbonate (Eskalith) and olanzapine (Zyprexa). The client's spouse questions the Zyprexa order. Which is the appropriate nursing reply? "Zyprexa in combination with Eskalith cures manic symptoms." "Zyprexa prevents extrapyramidal side effects." "Zyprexa ensures a good night's sleep." "Zyprexa calms hyperactivity until the Eskalith takes effect."

A client diagnosed with major depressive disorder asks, "Which part of my brain controls my emotions?" Which nursing response is best? "The occipital lobe judges perceptions as positive or negative." "The parietal lobe has been linked to depression." "The medulla regulates key biological and psychological activities." "The limbic system is largely responsible for one's emotional state."

A client diagnosed with vascular dementia is discharged to home under the care of his spouse. Which information causes the nurse to question the client's safety? His spouse works from home in telecommunication. The client has worked the night shift his entire career. His spouse has minimal family support. The client smokes one pack of cigarettes per day.

A client experiences an exacerbation of psychiatric symptoms to the point of threatening self-harm. Which action step of the Wellness Recovery Action Plan (WRAP) Model should be employed, and which action reflects this step? Step 3: Triggers that cause distress or discomfort are listed. Step 4: Signs indicating a relapse are identified and plans for responding are developed. Step 5: A specific plan to help with symptoms is formulated. Step 6: Following a client-designed plan, caregivers now become decision-makers.

A client is diagnosed with DID. Which statement describes the primary goal of therapy for this client? To recover memories and improve thinking patterns To prevent social isolation To decrease anxiety and the need for secondary gain To collaborate among subpersonalities to improve functioning

A client is diagnosed with persistent depressive disorder (PDD) (dysthymia). Which should the nurse classify as an affective symptom of this disorder? Social isolation with a focus on self Low energy level Difficulty concentrating Gloomy and pessimistic outlook on life

A client on an inpatient unit angrily states to a nurse, "Peter is not cleaning up after himself in the community bathroom. You need to address this problem." Which response by the nurse is appropriate? "I'll talk to Peter and present your concerns." "Why are you overreacting to this issue?" "You should bring this to the attention of your treatment team." "I can see that you are angry. Let's discuss ways to approach Peter with your concerns."

A client on an inpatient unit is angry with a peer. During lunch, when the peer is not looking, the client spits into his soup. How would the nurse document this interaction? "Client is displaying assertive behaviors." "Client is displaying aggressive behaviors." "Client is displaying passive behaviors." "Client is displaying passive-aggressive behaviors."

A client's spouse of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist stresses the importance of proper sleep, nutrition, and exercise. Which statement is true regarding the rationale for the therapist's advice? A. An interpersonal approach is indicated for depressed clients. B. Sleep, nutrition, and exercise affect imbalances in neurotransmitters. C. Sleep, nutrition, and exercise will alleviate symptoms of depression. D. The client is susceptible to illness due to effects of stress on the immune system.

A couple has been married for 20 years. They argue constantly, belittle feelings, and continuously contradict each other. During a therapy session, the nurse documents "marital schism." Which of the following is the meaning of the nurse's documentation? The couple has a compatible marriage relationship. The husband has a dominant relationship over the wife. The couple has an enmeshed relationship. The couple has an incompatible marriage relationship.

A couple resides in a long-term care facility. The husband is admitted to the psychiatric unit after physically abusing his wife. He states, "My wife is having an affair with a young man, and I want it investigated." Which is the appropriate nursing reply? "Your wife loves you too much to have an affair." "Why do you think that your wife is having an affair?" "Your wife has told us that these thoughts have no basis in fact." "I understand that you are upset. Let's talk about it."

A depressed 21-year-old client has lived with his mother ever since the death of his father 3 years ago. After the client received a college acceptance, the mother repeatedly stated, "That's wonderful. I'll be fine all alone." How would the nurse interpret the mother's statements? The mother is withholding supportive messages. The mother is expressing denigrating remarks. The mother is communicating indirectly. The mother is using double-bind communication.

A first-time parent is crying and asks the nurse, "How can I go to work if I can't afford child care?" Which is the appropriate initial response by the nurse to assist with problem-solving? A. Determine the risks and benefits for each alternative. B. Formulate goals for resolution of the problem. C. Evaluate the outcome of the implemented alternative. D. Assess the facts of the situation.

A highly agitated client paces the unit and states, "I could buy and sell this place." The client's mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this client's behavior? "Rates mood 8/10. Exhibiting looseness of association. Euphoric." "Mood euthymic. Exhibiting magical thinking. Restless." "Mood labile. Exhibiting delusions of reference. Hyperactive." "Agitated and pacing. Exhibiting grandiosity. Mood labile."

A home care nurse notices the client who startles easily is exhibiting signs of posttraumatic stress disorder. The nurse asks, "Have you ever made a suicide attempt?" to which the client responds, "Yes, I have." Which response should the nurse make next? Immediately notify the primary care provider. Gently touch the client's arm. Ask "Why would you do that?" Ask "Are you having thoughts of suicide now?"

A kindergarten rule states that if unacceptable behavior occurs, a child's personalized fish will be moved to the sea grass. Children who behave keep their fish out of the sea grass. The school nurse identifies this intervention is based on which principle of behavior therapy? Classical conditioning Conditioned response Positive reinforcement Negative reinforcement

A nurse charts, "Verbalizes understanding of the side effects of Prozac." This is an example of which category of focus charting? Data Problem Action Response

A nurse is assessing a client who is experiencing occasional feelings of sadness because of the recent death of a beloved pet. The client's appetite, sleep patterns, and daily routine have not changed. The nurse determines the client's behaviors: Demonstrate typical variations in daily mood, not mental illness Are clinically significant and indicate serious mental illness Are incongruent with cultural norms and indicate mental illness Show common symptoms of grief and do not indicate mental illness

A nurse is caring for four clients. Which client does the nurse identify is least prone to developing problems with anger and aggression? A child raised by a physically abusive parent An adult with a history of epilepsy A young adult living in the ghetto of an inner city An adolescent raised by Scandinavian immigrant parents

A nurse states to a client, "Things will look better tomorrow after a good night's sleep." This is an example of which communication technique? The nontherapeutic technique of "giving advice" The therapeutic technique of "formulating a plan of action" The therapeutic technique of "presenting reality" The nontherapeutic technique of "giving false reassurance"

A nursing instructor is teaching about suicide. Which student statement indicates that learning has occurred? A. "Suicidal threats and gestures should be considered manipulative and/or attention seeking." B. "Suicide is the act of a psychotic person." C. "All suicidal individuals are mentally ill." D. "Fifty to eighty percent of all people who kill themself have a history of a previous attempt."

A nursing student is developing a plan of care for a suicidal client. Which intervention should the student implement first? Communicate therapeutically. Observe the client. Provide a hazard-free environment. Assess suicide risk.

A parent is concerned about her ability to perform in her new role. She is quite anxious and refuses to leave the postpartum unit. To offer effective client care, a nurse should recognize which information about this type of crisis? A. This type of crisis is precipitated by unexpected external stressors. B. This type of crisis is precipitated by preexisting psychopathology. C. This type of crisis is precipitated by an acute response to an external stressor. D. This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.

A parent who has learned that her child was killed in a tragic car accident states, "I can't bear to go on with my life." Which nursing statement conveys empathy? A. "This situation is very sad, but time is a great healer." B. "You are sad, but you must be strong for your other children." C. "Once you cry it all out, things will seem so much better." D. "It must be horrible to lose a child; I'll stay with you until your spouse arrives."

A patient was admitted with a chronic level of major depression. The patient was started on an MAOI orally daily during this hospitalization. The nurse's discharge teaching should include which of the following? A. "Continue taking medication as prescribed. You will continue to see improvement over the next few days." B. "You will not need to follow up with outpatient psychotherapy, as you and the social worker have completed your therapy." C. "You may be able to discontinue the medication within 6 months to 1 year but only under a doctor's supervision. However, there is a chance of recurring episodes." D. "You should avoid foods with tyramine, including beer, beans, processed meats, and red wine."

A physically and emotionally healthy client has just been fired. During a routine office visit, he tells the nurse, "Perhaps this was the best thing to happen. Maybe I'll consider pursuing an art degree." The nurse determines the client perceives the stressor of his job loss as: A. Irrelevant B. Harm or loss C. Threatening D. A challenge

A psychiatric-mental health nurse is counseling a client who has thought patterns consisting of rapid responses to a situation without rational analysis. Which assessment data will the nurse document? A. "Thought patterns are triggered by specific stressful stimuli." B. "Thought patterns contain the client's fundamental beliefs and assumptions." C. "Thought patterns are flexible and based on personal experience." D. "Thought patterns include a predominance of automatic thoughts."

A school nurse is assessing a high school student who is overly concerned about her appearance. The client's parent states, "That's not something to be stressed about!" Which response by the nurse is best? A. "Teenagers don't truly understand stress." B. "Why are you so concerned about your appearance?" C. "You surely know that isn't something to be concerned with." D. "I understand you feel stressed about this; tell me more about your stress."

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the best nursing reply? "Have you considered doing volunteer work?" "Let's discuss the negative aspects of your life." "Things will look better to you in the morning." "It sounds like you are feeling pretty hopeless."

A teenager has recently lost a parent. Which grieving behavior would the school nurse expect when assessing this client? Denial of personal mortality Preoccupation with the loss Clinging behaviors and personal insecurity Aggressive and defiant behaviors

A welder has been selected as employee of the year. The welder wants to ask for a promotion but is hampered by poor self-esteem. Which is the best technique for the employee health nurse to use to help the employee request the promotion? Socratic questioning Activity scheduling Distraction Cognitive rehearsal

After less-restrictive means have been attempted, an order for client restraints has been obtained for a hostile, aggressive 30-year-old client. If client aggression continues, how long will the nurse expect the client to remain in restraints without a physician order renewal? 1 hour 2 hours 3 hours 4 hours

After the client's restraints are removed, the staff discusses the incident and establishes guidelines for the client's return to the therapeutic milieu. Which unit procedure is the staff implementing? Milieu reenactment Treatment planning Crisis intervention Debriefing

An advanced practice nurse recommends that a client participate in cognitive behavior therapy. The client asks, "What's cognitive behavior therapy, and how can it help me?" Which is the nurse's best reply? A. "It is a system of techniques in which you use positive thinking to improve your mood." B. "It is a long-term interpersonal approach that emphasizes the role of early childhood experiences." C. "It is an interpersonal treatment approach that specifically targets magical thinking." D. "It is a focused treatment for the modification of distorted thinking and maladaptive behaviors."

An elderly client recently moved to a nursing home. The client is having trouble concentrating and is isolating from others. A physician believes the client would benefit from medication therapy. Which medication would the nurse expect the physician to prescribe? Haloperidol Donepezil Diazepam Sertraline

An involuntarily committed client is verbally abusive to the staff and repeatedly threatens to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit? A. Verbally redirect the client and limit one-on-one interaction. B. Involve the hospital's security division. C. Inform the client that hospital policy prohibits documenting personal staff information. D. Continue professional attempts to establish a positive working relationship.

An involuntarily committed client, when offered a dinner tray, pushes it off the bedside table onto the floor. Which is the nurse's priority intervention? Initiate forced-medication protocol. Help the client to explore the source of anger. Avoid reinforcement of the behavior. Set firm limits on the behavior.

During a one-to-one session, the client states, "Nothing will ever get better" and "Nobody can help me." Which nursing diagnosis is most appropriate for the nurse to assign at this time? A. Powerlessness related to (R/T) altered mood as evidenced by (AEB) client statements B. Risk for injury R/T altered mood AEB client statements C. Risk for suicide R/T altered mood AEB client statements D. Hopelessness R/T altered mood AEB client statements

During an assertiveness training group, a client admits to aggressive behaviors. The client asks for suggestions for how to become more assertive and less aggressive. Which is the most appropriate nursing reply? A. "Several techniques, including meditation and progressive muscle relaxation, appear helpful." B. "There's not much that can be done about aggressive behavior because of biological responses." C. "Certain types of medications have been proven effective in promoting assertive communication." D. "There are several techniques, including 'I' statements and thought stopping, that promote assertive behaviors and decrease aggressive behaviors."

During an interview, which client statement indicates to the nurse that a potential diagnosis of schizotypal personality disorder should be considered? A. "I really don't have a problem. My family is inflexible, and every relative is out to get me." B. "I am so excited about working with you. Have you noticed my new nail polish, 'Ruby Red Roses?'" C. "I spend all my time tending my bees. I know a whole lot of information about bees." D. "I am getting a message from the beyond that we have been involved with each other in a previous life."

During family counseling a spouse states, "Every time my partner and I discuss child discipline, we get into shouting matches." The nurse instructs the couple to shout at each other for 2 weeks on Tuesdays and Thursdays for 30 minutes. Which intervention is the nurse using? Reframing Restructuring the family Expressive psychotherapy Paradoxical intervention

During the planning of care for a suicidal client, which correctly written outcome should be the nurse's priority? The client will not physically harm self. The client will express hope for the future by day 3. The client will establish a trusting relationship. The client will remain safe during the hospital stay.

How would the nurse differentiate a client diagnosed with panic disorder from a client diagnosed with generalized anxiety disorder (GAD)? A. GAD is acute in nature, and panic disorder is chronic. B. Chest pain is a common GAD symptom, whereas this symptom is absent in panic disorders. C. Hyperventilation is a common symptom in GAD and rare in panic disorder. D. Depersonalization is commonly seen in panic disorder and absent in GAD.

In what way should a nurse expect a school-age child to gain positive self-esteem, according to Erikson's psychosocial developmental stages? A. Through basic need fulfillment and environmental predictability B. Through exploration and experimentation to build self-confidence in ability C. Through positive reinforcement of creativity and recognition of performance D. Through receiving recognition when learning, competing, and performing successfully

The family of a suicidal client is supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? Address only serious suicide threats to avoid the possibility of secondary gain. Promote trust by not sharing suicide attempt information outside the family. Offer a private environment to provide needed time alone at least once a day. Be available to actively listen, support, and accept the client's feelings.

The nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention? To assess for emotional strength and regret To assess for Wernicke-Korsakoff syndrome To assess for tachycardia To assess for fine tremors

The nurse in the emergency department (ED) is assessing a client with a long history of depression. The nurse finds that the client has gained weight, has dry skin, and has cold sensitivity. The nurse determines the client's depression is exacerbating; further examination and testing reveal the client has hypothyroidism. Which phenomenon occurred? Depression screening Social distancing Trauma-informed caring Diagnostic overshadowing

The nurse is assessing a client diagnosed with schizophrenia and asks, "Do you ever get messages through things, like the television or microwave?" Which symptom of schizophrenia is the nurse assessing for? Illusions Circumstantiality Hallucinations Delusions of reference

The nurse is assessing an adolescent who was brought to the emergency department after collapsing during Olympic figure skating training. The adolescent is diagnosed with severe malnutrition due to anorexia nervosa. Which client statement supports the use of a family-based approach? "I just didn't drink enough water during practice." "I eat just as much as everyone else on the team." "I have to practice until my skating routine is perfect." "I'm tired of fighting with my parents about eating."

The nurse is conducting a grief counseling session for those who have survived a national disaster. Which of the following group member statements shows effective resolution of their complicated grief? "Had I not taken that phone call away from them, I could have saved them." "I only wish I did not call in sick so I could have died with them." "I cannot drive past the building without crying." "I have started to jog every day to help get rid of this tense energy."

The nurse notices a client is becoming very agitated. Which nursing intervention is most appropriate? Instruct the client to watch television in the dayroom. Maintain continuous eye contact when talking to the client. Hold the client's hand while walking in the hallway. Provide the client with adequate personal space.

The rape crisis nurse has completed several counseling sessions with a client who was nearly raped while jogging. Which client statement made at the final session most clearly suggests that the goals of crisis intervention have been met? A. "You've really been helpful. Can I count on you for continued support?" B. "I use the indoor track on campus and avoid going outside." C. "I'm really glad I didn't go home. It would have been hard to come back." D. "I carry mace when I jog. It makes me feel safe and secure."

The treatment team is planning to discharge a previously suicidal client from the hospital. Which assessment information should the nurse recognize as contributing to the team's decision to discharge the client safely? A. No previous admissions for major depressive disorder B. Vital signs stable; no psychosis noted and positive mood C. Able to comply with medication regimen; able to problem-solve life issues D. Able to participate in a plan for safety; family agrees to constant observation

When seeking special privileges, a child always chooses to ask the mother rather than the father. The father is more apt to disagree with the child's requests, whereas the mother usually consents. Which component of operant conditioning explains the child's choice? Conditioned stimuli Unconditioned stimuli Aversive stimuli Discriminative stimuli

Which action by the nurse, who is first meeting a client, would likely send a nonverbal message that is inappropriate for the therapeutic relationship? The nurse provides eye contact intermittently during the meeting. The nurse is dressed in business casual attire; a tattoo is visible. The nurse offers a handshake during initial interaction with the client. The nurse gives a client a strong hug at the end of the meeting.

Which action would the nurse take to promote safety in the client with an NCD? Keep the client in the room furthest from the nurse's station. Provide the client with glass items instead of disposable items. Keep the bed in high position. Encourage the client to call for assistance when getting out of bed.

Which client statement demonstrates positive progress toward recovery from a substance use disorder? A. "I have completed detox and therefore am in control of my drug use." B. "I will attend Narcotics Anonymous (NA) meetings when I can't control my cravings." C. "As a church deacon, my focus will now be on spiritual renewal." D. "Taking those pills got out of control. It cost me my job, marriage, and children."

Which client statement indicates a knowledge deficit related to substance use? A. "Although it's legal, alcohol is one of the most widely abused drugs in our society." B. "Tolerance to heroin develops quickly." C. "Flashbacks from lysergic acid diethylamide (LSD) use may reoccur suddenly." D. "Everyone smokes marijuana. It's harmless."

Which developmental characteristic should the nurse identify as typical of a client diagnosed with severe intellectual disability (ID)? The client can perform some self-care activities independently. The client has advanced speech development. Other than possible coordination problems, the client's psychomotor skills are not affected. The client communicates wants and needs by "acting out" behaviors.

Which is a correctly written, appropriate outcome for a client with a history of suicide attempts who is currently exhibiting symptoms of low self-esteem by isolating self? The client will not physically harm self. The client will express three positive self-attributes by day 4. The client will reveal a suicide plan. The client will establish a trusting relationship with the nurse.

Which is the nurse's best action when a client demonstrates transference? A. Promote safety and immediately terminate the relationship with the client. B. Encourage the client to ignore these thoughts and feelings. C. Immediately reassign the client to another staff member. D. Help the client clarify the meaning of the nurse-client relationship.

Which neurotransmitter is associated with the fight-or-flight response of a restless, agitated client? Acetylcholine Dopamine Serotonin Norepinephrine

Which nursing action is most appropriate to establish trust with a suspicious client? Maintain consistent staff assignments. Reinforce and focus on reality. Maintain low environmental stimuli. Use a passive communication approach.

Which of the following is considered a predisposing factor for depression? Decreased serum cortisol levels Decreased thyroid function Decreased sodium levels Genetic factors

Which situation describes an example of the basic concept of a recovery model? A. The client's family is encouraged to make decisions to facilitate discharge. B. A social worker, discovering the client's income, changes the client's discharge placement. C. A psychiatrist prescribes an antipsychotic drug based on observed symptoms. D. A client diagnosed with schizophrenia schedules follow-up appointments and group therapy.

Which statement describes the development of trust between the nurse and client? "You cannot draw a picture until you take your medication." "I am sorry you are angry." "I am going to teach you how to change your dressing." "I will listen if you would like to tell me about your day."

Which statement made by the nursing student indicates an understanding regarding the role of the social worker? A. "The social worker can encourage a client to express their feelings through the use of music." B. "My client has been eating drywall, so I have contacted the social worker to come speak to them." C. "I have asked the social worker to organize a game of volleyball this weekend." D. "My client cannot afford medications when they are discharged, so the social worker is arranging some assistance."

Which student statement indicates further instruction is needed regarding developmental characteristics of clients diagnosed with moderate intellectual developmental disorder? "These clients can work in a sheltered workshop setting." "These clients can perform some personal care activities." "These clients may have difficulty relating to peers." "These clients can successfully complete elementary school."

Which term should the nurse use to describe the administration of a CNS depressant during alcohol withdrawal? Antagonist therapy Deterrent therapy Codependency therapy Substitution therapy

Which therapeutic communication technique is being used in this nurse-client interaction?Client: "When I get angry, I get into a fistfight with my partner or I take it out on the kids."Nurse: "I notice that you are smiling as you talk about this physical violence." Encouraging comparison Exploring Formulating a plan of action Making observations

he nurse is planning care for a child who is experiencing depression. Which medication is approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children and adolescents? Paroxetine (Paxil) Sertraline (Zoloft) Citalopram (Celexa) Fluoxetine (Prozac)

Which dining arrangement would the nurse use to best promote a sense of community? A. Arrange tables for two around the dining room B. Allow clients to take their meals to their rooms C. Set up rectangular tables in the shape of a large square around the room to seat everyone D. Arrange tables seating 5 or 6 clients around the dining room

Mental Health Final

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