Mental health

A 20-year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he became unconscious. Which medication would the nurse most likely expect to administer? A) Naloxone B) Naltrexone C) Bupropion D) Varenicline

A

A client is admitted to the mental health unit with a diagnosis of factitious disorder. When reviewing the clients history, which of the following would the nurse most likely find? A) Intentional self-injurious behavior B) Pain to achieve a self-serving goal C) Malingering to avoid work D) Parents who were restrictive

A

A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordination B) Stupor C) Emotional lability D) Ataxia

A

A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include? A) Success usually involves more than one type of intervention. B) Relapse is fairly rare within the first year of quitting. C) Ear acupressure is a highly proven method for quitting. D) Education is key for smoking cessation.

A

A client with body dysmorphic disorder is admitted to the inpatient unit. Based on the nurses understanding about this disorder, the nurse would assess this client closely for which of the following? A) Suicidal ideation B) Escalating violence C) Anorexia D) Psychosis

A

A client with bulimia nervosa is scheduled for a visit to the clinic. When assessing this client, which of the following would the nurse expect to find? A) Impulsivity B) Panic C) Hyperactivity D) Delusions

A

A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder. Which nursing diagnosis would the nurse most likely identify as the priority? A) Disturbed Body Image B) Ineffective Coping C) Low Self-Esteem D) Risk for Other-Directed Violence

A

A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies? A) Low self-esteem B) Genetic predisposition C) Dysfunctional family D) Peer influence

A

A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan)

A

A psychiatricmental health nurse working in the community is planning an educational program for fifth and sixth grade teachers. Which of the following would the nurse include? A) Discussion of strategies the teachers can use to counteract the role media plays in encouraging eating disorders B) Emphasis on the need for teachers to focus their prevention efforts on female students C) Stressing of the need to allow students to eat without undue attention or supervision to prevent inadvertently influencing eating patterns D) Clarification that peer pressure is not typically problematic in children who are in the fifth and sixth grades

A

The nurse is caring for a client with complex somatic symptom disorder. When assessing this client, the nurse would be especially alert for symptoms of which of the following? a. Depression b. avoidance personality disorder c. delirium d. bipolar disorder

A

While caring for a client with anorexia nervosa, the nurse anticipates that the client would have difficulty making which of the following comments? A) Im mad at you because you wont let me go on a pass unless I gain weight! B) I need to have everything in its place and perfect. C) If I gain a pound, Ill just keep gaining weight. D) I am very involved in preparing my food and counting calories.

A

A group of nursing students is reviewing the similarities and differences between bulimia nervosa and binge-eating disorder. The students demonstrate understanding when they identify which characteristics as specific to binge-eating disorder? Select all that apply. A) Clients typically are obese. B) Clients refrain from purging behaviors. C) Binge-eating periods are shorter. D) Clients engage in overexercising. E) Feelings of guilt do not occur after binging.

A B

A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis

A B C

The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure

A B C

A nursing instructor is reviewing the various theories related to anorexia nervosa. Which of the following would the instructor include when describing theories related to the biologic domain? Select all that apply. A) Genetic vulnerability B) Separationindividuation C) Role pressures D) Dieting leading to starvation E) Pursuit of thinness F) Decreased serotonin activity

A B F

A nurse is providing care for a client who has complex somatic symptom disorder and is exhibiting anxiety about having a severe illness. Which of the following would be appropriate for the nurse to do? Select all that apply. A) Listening closely to the clients report of symptoms B) Discouraging the client from talking about fears C) Acknowledging that what the client is saying may be real D) Encouraging the client to write down symptoms in a journal E) Reviewing symptom pattern with the client

A C D E

A nurse is preparing a presentation for a local middle school health class about eating disorders as a means for prevention and early detection. Which of the following would the nurse incorporate into the presentation as being common to both anorexia nervosa and bulimia nervosa? Select all that apply. A) Body dissatisfaction B) Feelings of control C) Obsessiveness D) Boundary problems E) Sexuality fears F) Cognitive distortions

A C F

A nursing instructor is preparing a class about functional neurologic symptoms. Which of the following would the instructor most likely include as an assessment finding? Select all that apply. A) Difficulty swallowing B) Spasticity C) Urinary frequency D) Aphonia E) Blindness

A D E

A 52-year-old male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority? A) Disturbed Thought Processes B) Risk for Injury C) Ineffective Coping D) Ineffective Denial

B

A client diagnosed with complex somatic symptom disorder and depression is prescribed medication therapy to treat both the pain and the symptoms of depression. When teaching the client about the medication, which of the following would the nurse emphasize? A) Need for signing a no-suicide contract B) Avoidance of foods that contain aged cheese C) Use of sunscreen when exposed to bright sunlight D) Limiting of the amount of water ingested

B

A client is admitted to the mental health unit because she was found trying to inject diluted feces into her hospitalized childs intravenous line. The client has a history of similar attempts of harming the child. The nurse would most likely suspect which of the following? A) Schizoid personality traits B) Munchausens syndrome by proxy C) Functional neurologic symptoms D) Borderline personality disorder

B

A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, How will this drug help me? Which response by the nurse would be most appropriate? A) It will help to cure your alcoholism. B) It can help to prevent you from drinking. C) It makes the withdrawal symptoms less troublesome. D) It helps to clear the alcohol out of your body.

B

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) I can have a glass of wine with dinner if I choose. B) I should eat small frequent meals if I get nauseated. C) I should take the drug on an empty stomach. D) I might experience diarrhea with this drug.

B

A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following? A) Ive admitted to myself and others the wrongdoings Ive done. B) I realize that there is a higher power that can help me. C) I know now that I am powerless over alcohol. D) I am making amends to all those that Ive harmed.

B

A client with complex somatic symptom disorder also has anxiety. Which of the following would the nurse expect to be prescribed? A) Monoamine oxidase inhibitor (MAOI) B) Selective serotonin reuptake inhibitor (SSRI) C) Tricyclic antidepressant (TCA) D) Atypical antipsychotic

B

A client with complex somatic symptom disorder is complaining of significant pain in the joints. When providing care to this client, which of the following would be most important for the nurse to keep in mind? A) Opioid analgesics are the primary mode of therapy. B) The clients experience of pain is real. C) Complementary therapies are usually of little benefit. D) Outcomes need to reflect the biologic aspects of the pain.

B

A nurse is developing a plan of care for a client newly diagnosed with bulimia nervosa. Which of the following would the nurse expect to implement in conjunction with pharmacologic therapy? A) Behavioral therapy B) Cognitive behavioral therapy C) Interpersonal therapy D) Family therapy

B

A nurse is evaluating the outcomes for a client diagnosed with complex somatic symptom disorder. Which of the following would the nurse most likely identify as interfering with achievement? A) Outcomes were stated in realistic terms B) Outcomes addressed overall issues C) Outcomes indicated small successes D) Outcomes were identified for specific behaviors

B

A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation

B

A nurse is performing an admission assessment for an adolescent girl with an eating disorder who is being admitted to the psychiatric unit. Which statement would the nurse interpret as most likely supporting the clients diagnosis? A) My father was always very thin. B) Ive never really liked myself. C) I have a lot of confidence in myself. D) I feel really close to my parents and my brother.

B

A nursing instructor is describing complex somatic symptom disorder to a group of nursing students. The instructor determines that the teaching was successful when the students state which of the following? A) The disorder typically is diagnosed in men. B) The first symptom usually appears during adolescence. C) The disorder commonly occurs with substance abuse. D) Highly educated individuals often develop this disorder.

B

The nurse is initiating a group for adolescent girls diagnosed with anorexia nervosa. Many of the clients in the group are irritable and resent having to attend. One of them comments, This is a stupid waste of time! Which of the response by the nurse would be most appropriate? A) If you feel that way, then you can just leave. B) You sound irritated; tell me about what is bothering you. C) You were assigned to this group by your therapist, so you must participate. D) Sit down and be quiet; your peers would appreciate some peace and quiet.

B

A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils

B C

A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking

B C D

A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine

B D

A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drugs purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status

C

A client has made multiple visits to the clinic. The nurse suspects that the client may be experiencing complex somatic symptom disorder based on which of the following? A) Expressions of concern about psychological problems B) Indications that parents were always in good health C) Reports of the same symptoms repeatedly D) Evidence of a need for social support from her friends

C

A client is being assessed for complex somatic symptom disorder. Which client statement would the nurse interpret as most likely supporting this diagnosis? A) Its like my foot is asleep all the time; I cant feel anything that touches my foot. B) Im losing weight no matter what or how much I eat. C) I am always in pain; there is nothing I can do to relieve it. D) It seems like I am always having diarrhea at the most inconvenient times.

C

A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria

C

A nurse is reviewing the plan of care for a client with anorexia nervosa and notes a behavioral plan for increasing weight. The nurse correlates this intervention with which nursing diagnosis? A) Disturbed Body Image B) Anxiety C) Imbalanced Nutrition: Less Than Body Requirements D) Ineffective Coping

C

A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so shed remember to get well. The nurse suspects that the client may be experiencing which of the following? A) Wernickes syndrome B) Delirium tremens C) Korsakoffs psychosis D) Malignant hyperthermia

C

A nurse is working with a client diagnosed with complex somatic symptom disorder. Which of the following would the nurse identify as the most difficult aspect of providing care to this client? A) Managing the clients pain. B) Relieving the clients anxiety. C) Developing the therapeutic relationship. D) Monitoring the clients treatment program.

C

The husband of a client diagnosed with complex somatic symptom disorder asks the nurse, What causes this condition? Which response by the nurse would be most accurate? A) There is definitely an underlying genetic link for this disorder. B) Your wife is experiencing chronic stress that causes hypoarousal. C) The symptoms reflect an emotion that your wife cannot verbalize. D) The symptoms reflect an internal preoccupation with events.

C

The nurse is caring for several hospitalized clients with anorexia nervosa. The nurse would be especially alert for which of the following if noted in the clients histories? A) Paranoia B) Primary insomnia C) Depression D) Aggression

C

The nurse is planning to explain the purpose of the behavioral therapy technique of self-monitoring to a client with bulimia nervosa. The nurse would emphasize keeping a diary to record which of the following? A) Feelings of hunger B) Efforts at distraction C) Environmental stimuli D) Rigid rules about eating

C

While assessing a client thought to have a factitious disorder, the nurse asks the client to describe when she felt nurtured as a child. Which response would the nurse interpret as supporting the clients diagnosis? A) I never felt nurtured or loved when I was growing up. B) The only time I felt loved and appreciated was when I made the honor roll at school. C) The only time I ever felt loved was when I was sick enough to miss school. D) I felt loved and accepted when my father apologized for spanking me so hard.

C

An adolescent is brought to the emergency department by her parents because they were concerned about their daughters appearance. The client appears emaciated and pale. The parents tell the nurse that the client has been diagnosed with anorexia nervosa. A history and physical examination and laboratory testing are completed. Which of the following would lead the nurse to suspect that the client will be admitted to the hospital? Select all that apply. A) Blood pressure of 110/60 mm Hg B) Elevated serum potassium level C) Decreased serum magnesium level D) Heart rate of 40 beats/min E) Statements of being hopeless

C D E

A client with bulimia nervosa is being treated at an outpatient clinic and is prescribed a selective serotonin reuptake inhibitor (SSRI). Which of the following would the nurse include when teaching the client about the prescribed medication? A) Closely monitor your fluid intake while taking this medication. B) Stop taking this medication if it causes weight gain. C) Expect menstrual irregularities, particularly if theyve occurred previously. D) Report any weight changes that occur during the first few weeks this medication is taken.

D

A nurse is interviewing a client diagnosed with bulimia nervosa about her family and her relationship with her mother. Which statement by the client would the nurse least likely associate with bulimia nervosa? A) My mother is my confidante for everything. B) My mothers happiness depends on me. C) My family basically has very few rules. D) My mother and I are close but not joined at the hip.

D

A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you cant make me stop drinking. Which response by the nurse would be most appropriate? A) You have to stop drinking and driving; you could kill someone. B) Youre right; youre not an alcoholic. C) You should consider what you are doing to your marital relationship. D) Youre the only one who can make yourself stop drinking.

D

An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities

D

The nurse is assisting in planning a series of group therapy sessions with several female clients diagnosed with complex somatic symptom disorder. The nurse plans to focus the sessions on which of the following as a priority? A) Causes of medical illnesses B) Positive self-talk C) Side effects of medications D) Assertiveness skills

D

The nurse is caring for a client in the neighborhood clinic. The client tells the nurse that ever since he was an adolescent, he has avoided social situations because he has one ear that is obviously bigger than the other ear. The nurse observes that one of the clients ears does not appear to be larger than the other ear. The nurse suspects that the client may be experiencing which of the following? A) Complex somatic symptom disorder B) Functional neurologic symptoms C) Factitious disorder D) Body dysmorphic disorder

D

The nurse is preparing to discharge a client who has been hospitalized with anorexia nervosa. Which of the following would the nurse include in the teaching plan? A) Knowing the calorie content of numerous foods B) Learning strategies to control impulses C) Describing physiologic consequences of anorexia nervosa D) Setting realistic goals

D

The nurse is preparing to interview a client diagnosed with complex somatic symptom disorder. The nurse anticipates that the client will most likely exhibit which of the following? A) No facial expression during the interview B) Intermittent nodding and glancing at the clock on the wall C) Altered mental status D) Rapidly changing moods during the interview

D

While talking with a client with an eating disorder, the client states, Ive gained 2 pounds, so soon Ill be over 100 pounds. The nurse interprets this as which of the following? A) Magnification B) Selective abstraction C) Overgeneralization D) Dichotomous thinking

D