NCLEX mental health 2 of 2

Which of the following individuals are communicating a message? (Select all that apply.) A. A mother spanking her son for playing with matches B. A teenage boy isolating himself and playing loud music C. A biker sporting an eagle tattoo on his biceps D. A teenage girl writing, "No one understands me" E. A father checking for new e-mail on a regular basis

A, B, C, D

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 is the most appropriate nursing reply? 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

The nurse should warn a client who is taking a benzodiazepine about using which of the following medications in combination with his current medication? A. Antacids. B. Acetaminophen (Tylenol). C. Vitamins. D. Aspirin.

A

When scheduling electroconvulsive therapy (ECT), which client should the nurse prioritize? A. A client in bed in a fetal position who is experiencing active suicidal ideations B. A client with an irritable mood and exhibiting angry outbursts C. A client experiencing command hallucinations and delusions of reference D. A client experiencing manic episodes of bipolar disorder

A

Which of the following statements by a client who has been taking buspirone (BuSpar) as prescribed for 2 days indicates the need for further teaching? A. "This medication will help my tight, aching muscles." B. "I may not feel better for 7 to 10 days." C. "The drug does not cause physical dependence." D. "I can take the medication with food."

A

A nurse understands that the abnormal secretion of growth hormone may play a role in which illness? A. Acute mania B. Schizophrenia C. Anorexia nervosa D. Alzheimer's disease

C

A hungry, homeless client, diagnosed with schizophrenia, refuses to participate in an admission interview. A nurse streamlines the assessment, verbally assures safety, and provides a warm meal. What is the nurse promoting by these actions? A. Sympathy B. Trust C. Veracity D. Manipulation

B

A man diagnosed with alcohol dependence experiences his first relapse. During his 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? A. Imparting of information B. Instillation of hope C. Catharsis D. Universality

B

Which therapeutic communication technique should the nurse use when communicating with a client who is experiencing auditory hallucinations? A. "My sister has the same diagnosis as you and she also hears voices." B. "I understand that the voices seem real to you, but I do not hear any voices." C. "Why not turn up the radio so that the voices are muted." D. "I wouldn't worry about these voices. The medication will make them disappear."

B

Which of the following are accurate descriptors of a therapeutic community? (Select all that apply.) A. The unit schedule includes unlimited free time for personal reflection. B. Unit responsibilities are assigned according to client capabilities. C. A flexible schedule is determined by client needs. D. The individual is the sole focus of therapy. E. A democratic form of government exists.

B, E

Which of the following is the most appropriate therapy for a client with agoraphobia? a. 10 mg Valium qid. b. Group therapy with other agoraphobics. c. Facing her fear in gradual step progression. d. Hypnosis.

C

The client diagnosed with agoraphobia refuses to walk down the hall to the group room. Which of the following responses by the nurse is appropriate? A. "I know you can do it." B. "Try holding onto the wall as you walk." C. "You can miss group this one time." D. "I'll walk with you."

D

A newly admitted client, diagnosed with OCD, spends 1 hour packing and unpacking, folding and refolding personal belongings. What is the most likely reason for this behavior? a. It relives anxiety b. It fosters organizational skills. c. It delays meeting unfamiliar people in the day room d. It makes the client feel good.

A

A psychiatrist prescribes a monoamine oxidase inhibitor (MAOI) for a client. Which foods should the nurse teach the client to avoid? A. Pepperoni pizza and red wine B. Bagels with cream cheese and tea C. Apple pie and coffee D. Potato chips and diet cola

A

A student nurse is learning about the appropriate use of touch when communicating with clients diagnosed with psychiatric disorders. Which statement by the instructor best provides information about this aspect of therapeutic communication? A. "Touch carries a different meaning for different individuals." B. "Touch is often used when deescalating volatile client situations." C. "Touch is used to convey interest and warmth." D. "Touch is best combined with empathy when dealing with anxious clients."

A

A young child who has been sexually abused has difficulty putting feelings into words. Which of the following should the nurse employ with the child? A. Engaging in play therapy. B. Role-playing. C. Giving the child's drawings to the abuser. D. Reporting the abuse to a prosecutor.

A

According to Peplau, which nursing intervention is most appropriate when the nurse is functioning in the role of a surrogate? A. The nurse functions as a nurturing parent in order to build a trusting relationship. B. The nurse plays cards with a small group of clients. C. The nurse discusses childhood events that may affect personality development. D. The nurse provides a safe social environment.

A

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? A. Democratic B. Autocratic C. Laissez-faire D. Bureaucratic

A

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." A. Restatement B. Offering general leads C. Focusing D. Accepting

A

Which of the following symptoms should a nurse associate with increased levels of thyroid-stimulating hormone (TSH) in a newly admitted client? (Select all that apply.) A. Depression B. Fatigue C. Increased libido D. Mania E. Hyperexcitability

A, B

A nursing instructor is teaching about the prevalence of bipolar disorder. Which student statement indicates that learning has occurred? A. "This disorder is more prevalent in the lower socioeconomic groups." B. "This disorder is more prevalent in the higher socioeconomic groups." C. "This disorder is equally prevalent in all socioeconomic groups." D. "This disorder's prevalence cannot be evaluated based on socioeconomic groups."

B

For the last year, a college student, continually and unrealistically worries about academic performance and love life performance. The student is irritable and suffers from severe insomnia. this behavior is associated with which Axis 1 diagnosis? a. Post-traumatic stress disorder (PTSD) b. Generalized anxiety disorder (GAD) c. Social phobia disorder d. Obsessive-compulsive disorder (OCD)

B

John, a veteran of the war in Iraq, is diagnosed with PTSD. He says to the nurse, "I can't figure out why God took my buddy instead of me." From this statement, the nurse assesses which of the following in John? a. Repressed anger b. Survivor's guilt c. Intrusive thoughts d. Spiritual distress.

B

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

D

Prayer group members at a local Baptist church are meeting with a poor, homeless family they are supporting. Which member statement is an example of Yalom's curative group factor of altruism? A. "I'll give you the name of a friend that rents inexpensive rooms." B. "The last time we helped a family, they got back on their feet and prospered." C. "I can give you all of my baby clothes for your little one." D. "I can appreciate your situation. I had to declare bankruptcy last year."

C

Sandy, a client with OCD, says to the nurse, "I've been here 4 days now, and I'm feeling better. I feel comfortable on this unit, and I'm not ill-at-easse with the staff or other patients anymore." In light of this change, which nursing intervention is most appropriate? a. Give attention to the ritualistic behaviors each time they occur and point out their inappropriateness b. Ignore the ritualistic behaviors, and they will be eliminated for lack of reinforcement. c. Set limits on the amount of time Sandy may engage in the ritualistic behavior. d. Continue to allow Sandy all the time she wants to carry out the ritualistic behavior.

C

The nurse asks a newly admitted client, "What can we do to help you?" What is the purpose of this therapeutic communication technique? A. To reframe the client's thoughts about mental health treatment B. To put the client at ease C. To explore a subject, idea, experience, or relationship D. To communicate that the nurse is listening to the conversation

C

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

C

When interviewing a client, which nonverbal behavior should a nurse employ? A. Maintaining indirect eye contact with the client B. Providing space by leaning back away from the client C. Sitting squarely, facing the client D. Maintaining open posture with arms and legs crossed

C

When planning group therapy, a nurse should identify 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

C

When planning interventions for parents who are abusive, the nurse should incorporate knowledge of which factor as a common parental indicator? A. Lower socioeconomic group. B. Unemployment. C. Low self-esteem. D. Loss of emotional family attachments.

C

Which client diagnosis should a nurse associate with a decrease in gamma-aminobutyric acid (GABA)? A. Alzheimer's disease B. Schizophrenia C. Panic disorder D. Depression

C

Which client statement should a nurse identify as a 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. "I might have a hard time working with you. You remind me of my mother." C. "I really don't want to talk any more about my childhood abuse." D. "I'm not sure that I can count on you to protect my confidentiality."

C

Which of the following observations by the nurse should suggest that a 15-month-old toddler has been abused? A. The child appears happy when personnel work with him. B. The child plays alongside others contentedly. C. The child is underdeveloped for his age. D. The child sucks his thumb.

C

Which of the following points should the nurse include when teaching a client about panic disorder? A. Staying in the house will eliminate panic attacks. B. Medication should be taken when symptoms start. C. Symptoms of a panic attack are time limited and will abate. D. Maintaining self-control will decrease symptoms of panic.

C

Which part of the nervous system should a nurse identify as playing a major role during stressful situations? A. Peripheral nervous system B. Somatic nervous system C. Sympathetic nervous system D. Parasympathetic nervous system

C

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?" A. Reflecting B. Making observations C. Formulating a plan of action D. Giving recognition

C

While a client is taking alprazolam (Xanax), which of the following should the nurse instruct the client to avoid? A. Chocolate. B. Cheese. C. Alcohol. D. Shellfish.

C

While interviewing a 3-year-old girl who has been sexually abused about the event, which approach would be most effective? A. Describe what happened during the abusive act. B. Draw a picture and explain what it means. C. "Play out" the event using anatomically correct dolls. D. Name the perpetrator.

C

A 10-week, prenuptial counseling group composed of five couples is terminating. At the last group meeting, a nurse notices that the two most faithful and participative couples are absent. When considering concepts of group development, what might explain this behavior? A. They are experiencing problems with termination, leading to feelings of abandonment. B. They did not think any new material would be covered at the last session. C. They were angry with the leader for not extending the length of the group. D. They were bored with the material covered in the group.

A

A client diagnosed with bipolar disorder states, "I hate oatmeal. Let's get everybody together to do exercises. I'm thirsty and I'm burning up. Get out of my way; I have to see that guy." What should be the priority nursing action? A. Assess the client's vital signs. B. Offer to have the dietitian discuss food preferences. C. Encourage the client to lead the exercise program in the community meeting. D. Acknowledge the client briefly and then walk away.

A

A client diagnosed with bipolar disorder: depressive phase intentionally overdoses on sertraline (Zoloft). Family reports that the client has experienced anorexia, insomnia, and recent job loss. What 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

A client diagnosed with major depressive disorder was raised in an excessively religiously based household. Which nursing intervention would be most appropriate to address this client's underlying problem? A. Encourage the client to bring into awareness underlying sources of guilt. B. Teach the client that religious beliefs should be put into perspective throughout the life span. C. Confront the client with the irrational nature of the belief system. D. Assist the client to modify his or her belief system in order to improve coping skills.

A

A client diagnosed with obsessive-compulsive disorder arrives late for an appointment with the nurse at the outpatient clinic. During the interview, he fidgets restlessly, has trouble remembering what topic is being discussed, and says he thinks he is going crazy. Which of the following statements by the nurse best deals with the client's feelings of "going crazy?" A. "What do you mean when you say you think you're going crazy?" B. "Most people feel that way occasionally." C. "I don't know you well enough to judge your mental state." D. "You sound perfectly sane to me."

A

A client has been brought to the emergency department for signs and symptoms of Chronic Obstructive Pulmonary Disease (COPD). The client has a history of a suicide attempt 1 year ago. Which nursing intervention would take priority in this situation? A. Assessing the client's pulse oximetry and vital signs B. Developing a plan for safety for the client C. Assessing the client for suicidal ideations D. Establishing a trusting nurse-client relationship

A

A client has made the decision to leave her alcoholic husband. She is feeling very depressed. Which nontherapeutic statement by the nurse conveys sympathy? A. "You are feeling very depressed. I felt the same way when I decided to leave my husband." 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 a prn medication for anxiety?"

A

A client is admitted in the manic phase of bipolar affective disorder. Which nursing intervention should be most therapeutic for this client? A. Using a calm, unemotional approach during client interactions B. Focusing primarily on enforcing limits C. Limiting interactions to decrease external stimuli D. Encouraging the client to establish social relationships with peers

A

A client is admitted to the psychiatric unit with a diagnosis of major depression. 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. A simple, structured daily schedule with limited choices of activities B. A daily schedule filled with activities to promote socialization C. A flexible schedule that allows the client opportunities for decision making D. A schedule that includes mandatory activities to decrease social isolation

A

A client is brought to the emergency department by his brother. The client is perspiring profusely, breathing rapidly, and complaining of dizziness and palpitations. Problems of a cardiovascular nature are ruled out, and the client's diagnosis is tentatively listed as a panic attack. After the symptoms pass, the client states, "I thought I was going to die." Which of the following responses by the nurse is best? A. "It was very frightening for you." B. "We would not have let you die." C. "I would have felt the same way." D. "But you're okay now."

A

A client is diagnosed with bipolar disorder: manic phase. Which nursing intervention would be implemented to achieve the outcome of "Client will gain 2 lbs by the end of the week?" A. Provide client with high-calorie finger foods throughout the day. B. Accompany client to cafeteria to encourage adequate dietary consumption. C. Initiate total parenteral nutrition to meet dietary needs. D. Teach the importance of a varied diet to meet nutritional needs.

A

A client who has been diagnosed with bipolar I disorder states, "God has taught me how to decode the Bible." A nurse should anticipate that which combination of medications would be ordered to address this client's symptoms? A. Lithium carbonate (Lithobid) and risperidone (Risperdal) B. Lithium carbonate (Lithobid) and carbamazepine (Tegretol) C. Valproic acid (Depakote) and sertraline (Zoloft) D. Valproic acid (Depakote) and lamotrigine (Lamictal)

A

A client with OCD spends many hours each day washing her hands. The most likely reason she washers her hands so much is that it: a. Relieves her anxiety b. Reduces the probability of infection c. Gives her a feeling of control over her life d. Increases her self confidence

A

A client with obsessive-compulsive disorder reveals that he was late for his appointment "because of my dumb habit. I have to take off my socks and put them back on 41 times! I can't stop until I do it just right." The nurse interprets the client's behavior as most likely representing an effort to obtain which of the following? A. Relief from anxiety. B. Control of his thoughts. C. Attention from others. D. Safe expression of hostility.

A

A client with panic disorder is taking alprazolam (Xanax) 1 mg P.O. three times daily. The nurse understands that this medication is effective in blocking the symptoms of panic because of its specific action on which of the following neurotransmitters? A. Gamma-aminobutyrate. B. Serotonin. C. Dopamine. D. Norepinephrine.

A

A depressed client states, "I have a chemical imbalance in my brain. I have no control over my behavior. Medications are my only hope to feel normal again." Which nursing response is appropriate? A. "Medications only address biological factors. Environmental and interpersonal factors must also be considered." B. "Because biological factors are the sole cause of depression, medications will improve your mood." C. "Environmental factors have been shown to exert the most influence in the development of depression." D. "Researchers have been unable to demonstrate a link between nature (biology and genetics) and nurture (environment)."

A

A nurse begins the intake assessment of a client diagnosed with bipolar I disorder. The client shouts, "You can't do this to me. Do you know who I am?" Which is the priority nursing action in this situation? A. To provide self and client with a safe environment B. To redirect the client to the needed assessment information C. To provide high-calorie finger foods to meet nutritional needs D. To reorient the client to person, place, time, and situation

A

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? A. "You appear to be talking to someone I do not see." B. "Please describe what you are seeing." C. "Why do you continually look in the corner of this room?" D. "If you hum a tune, the voices may not be so distracting."

A

A nurse observes dental deterioration when assessing a client diagnosed with bulimia nervosa. What explains this assessment finding? A. The emesis produced during purging is acidic and corrodes the tooth enamel. B. Purging causes the depletion of dietary calcium. C. Food is rapidly ingested without proper mastication. D. Poor dental and oral hygiene leads to dental caries.

A

A nurse reviews the laboratory data of a client suspected of having major depressive disorder. Which laboratory value would potentially rule out this diagnosis? A. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL B. Potassium (K+) level of 4.2 mEq/L C. Sodium (Na+) level of 140 mEq/L D. Calcium (Ca2+) level of 9.5 mg/dL

A

A nurse should expect that an increase in dopamine activity might play a significant role in the development of which mental illness? A. Schizophrenia B. Depression C. Body dysmorphic disorder D. Parkinson's disease

A

During a group discussion, members freely interact with each other. Which member statement is an example of Yalom's curative group factor of imparting information? A. "I found a Web site explaining the different types of brain tumors and their treatment." B. "My brother also had a brain tumor and now is completely cured." C. "I understand your fear and will be by your side during this time." D. "My mother was also diagnosed with cancer of the brain."

A

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

A

Immediately after electroconvulsive therapy, in which position should a nurse place the client? A. On his or her side to prevent aspiration B. In semi-Fowler's position to promote oxygenation C. In Trendelenburg's position to promote blood flow to vital organs D. In prone position to prevent airway blockage

A

John, a veteran of the war in Iraq, is diagnosed with PTSD. Which of the followingt therapy regimens would most appropriately be ordered for John? a. Paroxitine and group therapy b. Diazepam and implosion therapy c. Alprazolam and behavior therapy d. Carbamazepine and cognitive therapy

A

The client, a veteran of the Vietnam war who has posttraumatic stress disorder, tells the nurse about the horror and mass destruction of war. He states, "I killed all of those people for nothing." Which of the following responses by the nurse is appropriate? A. "You did what you had to do at that time." B. "Maybe you didn't kill as many people as you think." C. "How many people did you kill?" D. "War is a terrible thing."

A

To promote self-reliance, how should a psychiatric nurse best conduct medication administration? A. Encourage clients to request their medications at the appropriate times. B. Refuse to administer medications unless clients request them at the appropriate times. C. Allow the clients to determine appropriate medication times. D. Take medications to the clients' bedside at the appropriate times.

A

What should the nurse plan to teach a client who is taking alprazolam (Xanax) three times a day? a. That there is a potential for dependence and tolerance. b. The importance of discontinuing Xanax immediately if addiction is suspected. c. That increased caffeine consumption can enhance the effectiveness of Xanax. d. That Xanax is not habit forming.

A

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

A

Which client statement may indicate a transference reaction? A. "I need a real nurse. You are young enough to be my daughter and I don't want to tell you about my personal life." B. "I deserve more that I am getting here. Do you know who I am and what I do? Let me talk to your supervisor." C. "I don't seem to be able to relate to people. I would rather stay in my room and be by myself." D. "My mother is the source of my problems. She has always told me what to do and what to say."

A

Which example of a therapeutic communication technique would be effective in the planning phase of the nursing process? A. "We've discussed past coping skills. Let's see if these coping skills can be effective now." B. "Please tell me in your own words what brought you to the hospital." C. "This new approach worked for you. Keep it up." D. "I notice that you seem to be responding to voices that I do not hear."

A

Which nursing intervention strategy is most appropriate to implement initially with a suicidal client? A. Ask a direct question such as, "Do you ever think about killing yourself?" B. Ask client, "Please rate your mood on a scale from 1 to 10." C. Establish a trusting nurse-client relationship. D. Apply the nursing process to the planning of client care.

A

Which nursing response is an example of the nontherapeutic communication block of requesting an explanation? A. "Can you tell me why you said that?" B. "Keep your chin up. I'll explain the procedure to you." C. "There is always an explanation for both good and bad behaviors." D. "Are you not understanding the explanation I provided?"

A

A nurse should recognize that electroconvulsive therapy (ECT) would potentially improve the symptoms of clients with which of the following Axis I diagnoses? (Select all that apply.) A. Major depressive disorder B. Bipolar disorder: manic phase C. Schizoaffective disorder D. Obsessive-compulsive anxiety disorder E. Body dysmorphic disorder

A, B, C

After a teenager reveals that he is gay, the father responds by beating him. The next morning, the teenager is found hanging in his closet. Which paternal emotions should a nurse anticipate? (Select all that apply.) A. Shock and disbelief B. Guilt and remorse C. Anger and resentment D. Bargaining and depression E. Denial and rationalization

A, B, C

Which of the following instructions regarding lithium therapy should be included in a nurse's discharge teaching? (Select all that apply.) A. Avoid excessive use of beverages containing caffeine. B. Maintain a consistent sodium intake. C. Consume at least 2,500 to 3,000 mL of fluid per day. D. Restrict sodium content. E. Restrict fluids to 1,500 mL per day.

A, B, C

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.) A. "I'll have to let my surgeon know about this medication before I have my cholecystectomy." B. "Guess I will have to give up my glass of red wine with dinner." C. "I'll have to be very careful about reading food and medication labels." D. "I'm going to miss my caffeinated coffee in the morning." E. "I'll be sure not to stop this medication abruptly."

A, B, C, E

Which of the following observed client behaviors would lead a nurse to evaluate a member as assuming a maintenance group role? (Select all that apply.) A. A client decreases conflict within the group by encouraging compromise. B. A client offers recognition and acceptance of others. C. A client outlines the task at hand and proposes solutions. D. A client listens attentively to group interaction. E. A client uses the group to gain sympathy from others.

A, B, D

A client is diagnosed with Generalized Anxiety Disorder (GAD) and given a prescription for venlafaxine (Effexor). Which of the following information should the nurse include in a teaching plan for this client? Select all that apply. A. Various strategies for reducing anxiety. B. The benefits and mechanisms of actions of Effexor in treating GAD. C. How Effexor will eliminate his anxiety at home and work. D. The management of the common side effects of Effexor. E. Substituting adaptive coping strategies for maladaptive ones. F. The positive effects of Effexor being evident in 4 to 5 days.

A, B, D, E

Which assessment test results should a nurse evaluate and report in the process of clearing a client for electroconvulsive therapy (ECT)? (Select all that apply.) A. Electrocardiogram graphic records B. Pulmonary function study results C. Electroencephalogram analysis D. Complete blood count values E. Urinalysis results

A, B, D, E

A client diagnosed with Post Traumatic Stress Disorder is readmitted for suicidal thoughts and continued trouble sleeping. She states that when she closes her eyes, she has vivid memories about being awakened at night. "My dad would be on top of me trying to have sex with me. I couldn't breathe." Which of the following suggestions would be appropriate for the nurse to make for the insomnia? Select all that apply. A. Trying relaxation techniques to help decrease her anxiety before bedtime. B. Taking the quetiapine (Seroquel) 25 mg as needed as ordered by the physician. C. Staying in the dayroom and trying to sleep in the recliner chair near staff. D. Listening to calming music as she tries to fall asleep. E. Processing the content of her flashbacks no less than hour before bedtime. F. Leaving her door slightly open to decrease noise during the nightly checks.

A, B, D, F

Which of the following information should a nurse include when explaining causes of anorexia nervosa to a client? (Select all that apply.) A. There is a possible correlation between abnormal secretion of growth hormone and anorexia nervosa. B. There is a possible correlation between antidiuretic hormone levels and anorexia nervosa. C. There is a possible correlation between low levels of gonadotropin and anorexia nervosa. D. There is a possible correlation between increased levels of prolactin and anorexia nervosa. E. There is a possible correlation between altered levels of oxytocin and anorexia nervosa.

A, C

Which of the following symptoms should a nurse expect to assess in a client experiencing elevated levels of thyroid hormone? (Select all that apply.) A. Emotional lability B. Depression C. Insomnia D. Restlessness E. Apathy

A, C, D

The nurse is developing a long term care plan for an outpatient client diagnosed with Dissociative Identity Disorder. Which of the following should be included in this plan? Select all that apply. A. Learning how to manage feelings, especially anger and rage. B. Joining several outpatient support groups that are process-oriented. C. Identifying resources to call when there is a risk of suicide or self-mutilation. D. Selecting a method for alter personalities to communicate with each other, such as journaling. E. Trying different medicines to find one that eliminates the dissociative process. F. Helping each alter accept the goal of sharing and integrating all their memories.

A, C, D, F

A nursing home resident has a diagnosis of dysthymic disorder. When planning care for this client, which of the following symptoms should a nurse expect the client to exhibit? (Select all that apply.) A. Sad mood on most days B. Mood rating of 2/10 for the past 6 months C. Labile mood D. Sad mood for the past 3 years after spouse's death E. Pressured speech when communicating

A, D

1. A married female client has been referred to the mental health center because she is depressed. The nurse notices bruises on her upper arms and asks about them. After denying any problems, the client starts to cry and says, "He didn't really mean to hurt me, but I hate for the kids to see this. I'm so worried about them." Which of the following is the most crucial information for the nurse to determine? A. The type and extent of abuse occurring in the family. B. The potential of immediate danger to the client and her children. C. The resources available to the client. D. Whether the client wants to be separated from her husband.

B

A client admitted to the psychiatric unit following a suicide attempt is diagnosed with major depressive disorder. Which behavioral symptoms should the nurse expect to assess? A. Anxiety and unconscious anger B. Lack of attention to grooming and hygiene C. Guilt and indecisiveness D. Expressions of poor self-esteem

B

A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate due to excessive weight gain. In order to increase compliance, which medication should a nurse anticipate that a physician would prescribe? A. Sertraline (Zoloft) B. Valproic acid (Depakote) C. Trazodone (Desyrel) D. Paroxetine (Paxil)

B

A client diagnosed with bipolar disorder is distraught over insomnia experienced over the last 3 nights and a 12-pound weight loss over the past 2 weeks. Which should be this client's priority nursing diagnosis? A. Knowledge deficit R/T bipolar disorder 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

B

A client diagnosed with paranoid schizophrenia becomes agitated when asked to play a game. The client responds, "Do you want to be my girlfriend?" Which nursing response is most appropriate? A. "You are upset now. It would be best if you go to your room until you feel better." B. "Remember, we have a professional relationship. Are you feeling uncomfortable?" C. "We have discussed this before. I am not allowed to date clients." D. "I think you should discuss your fantasies with your therapist."

B

A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening? A. "What occurred prior to the rape, 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?"

B

A client diagnosed with schizophrenia functions well and is bright, spontaneous, and interactive during hospitalization but then decompensates after discharge. What does the milieu provide that may be missing in the home environment? A. Peer pressure B. Structured programming C. Visitor restrictions D. Mandated activities

B

A client has been taking lithium for several years with good symptom control. The client presents in the emergency department with blurred vision, tinnitus, and severe diarrhea. The nurse should correlate these symptoms with which lithium level? A. 1.3 mEq/L B. 1.7 mEq/L C. 2.3 mEq/L D. 3.7 mEq/L

B

A client is admitted to a psychiatric unit with the diagnosis of catatonic schizophrenia. Which of the client's neurotransmitters should a nurse expect to be elevated? A. Serotonin B. Dopamine C. Gamma-aminobutyric acid (GABA) D. Histamine

B

A client is admitted with a diagnosis of depression NOS (not otherwise specified). Which client statement would describe a somatic symptom that can occur with this diagnosis? A. "I am extremely sad, but I don't know why." B. "Sometimes I just don't want to eat because I ache all over." C. "I feel like I can't ever make the right decision." D. "I can't seem to leave the house without someone with me."

B

A client is diagnosed with cyclothymic disorder. What client behaviors should the nurse expect to assess? A. The client expresses "feeling blue most of the time." B. The client has endured periods of elation and dysphoria lasting for more than 2 years. C. The client fixates on hopelessness and thoughts of suicide continually. D. The client has labile moods with periods of acute mania.

B

A client slammed a door on the unit several times. The nurse responds, "You seem angry." The client states, "I'm not angry." What therapeutic communication technique has the nurse employed and what defense mechanism is the client unconsciously demonstrating? A. Making observations and the defense mechanism of suppression B. Verbalizing the implied and the defense mechanism of denial C. Reflection and the defense mechanism of projection D. Encouraging descriptions of perceptions and the defense mechanism of displacement

B

A client states, "My doctor has told me I am a candidate for electroconvulsive therapy (ECT). Where will the treatment take place and how much time would this entail?" Which is the most accurate nursing reply? A. "Clients typically receive ECT in their hospital room, daily for 1 month." B. "Clients typically receive 6 to 12 ECT treatments, three times a week in an outpatient setting." C. "Clients typically receive an unlimited number of treatments in the hospital treatment room." D. "Clients typically receive two to three treatments in either an outpatient or inpatient setting."

B

A client tells the nurse that she has been raped but has not reported it to the police. After determining whether the client was injured, whether it is still possible to collect evidence, and whether to file a report, the nurse's next priority is to offer which of the following to the client? A. Legal assistance. B. Crisis intervention. C. A rape support group. D. Medication for disturbed sleep.

B

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical diagnosis of anorexia nervosa. Which nursing diagnosis would take priority at this time? A. Ineffective coping R/T food obsession B. Altered nutrition: less than body requirements R/T inadequate food intake C. Risk for injury R/T suicidal tendencies D. Altered body image R/T perceived obesity

B

A client who is pacing and wringing his hands states, "I just need to walk" when questioned by the nurse about what he is feeling. Which of the following responses by the nurse is most therapeutic? A. "You need to sit down and relax." B. "Are you feeling anxious?" C. "Is something bothering you?" D. "You must be experiencing a problem now."

B

A client with acute stress disorder has avoided feelings of anger toward her rapist and cannot verbally express them. The nurse suggests which of the following activities to assist the client with expressing her feelings? A. Working on a puzzle. B. Writing in a journal. C. Meditating. D. Listening to music.

B

A client with obsessive-compulsive disorder, who was admitted early yesterday morning, must make his bed 22 times before he can have breakfast. Because of his behavior, the client missed having breakfast yesterday with the other clients. Which of the following actions should the nurse institute to help the client be on time for breakfast? A. Tell the client to make his bed one time only. B. Wake the client an hour earlier to perform his ritual. C. Insist that the client stop his activity when it's time for breakfast. D. Advise the client to have breakfast first before making his bed.

B

A client's spouse asks, "What evidence supports the possibility of genetic transmission of bipolar disorder?" Which is the best nursing reply? A. "Clients diagnosed with bipolar disorders have alterations in neurochemicals which affect behaviors." B. "Higher rates of relatives diagnosed with bipolar disorder are found in families of client's diagnosed with this disorder." C. "Higher rates of relatives of clients diagnosed with bipolar disorder respond in an exaggerated way to daily stress." D. "More individuals diagnosed with bipolar disorder come from higher socioeconomic and educational backgrounds."

B

A mother rescues two of her four children from a house fire. In the emergency department, she cries, "I should have gone back in to get them. I should have died, not them." What is the nurse's best response? A. "The smoke was too thick. You couldn't have gone back in." B. "You're feeling guilty because you weren't able to save your children." C. "Focus on the fact that you could have lost all four of your children." D. "It's best if you try not to think about what happened. Try to move on."

B

A newly admitted client diagnosed with major depressive disorder states, "I have never considered suicide." Later the client confides to the nurse about plans to end it all by medication overdose. What is the most helpful nursing reply? A. "I'm glad you shared this. There is nothing to worry about. We will handle it together." B. "Bringing this up is a very positive action on your part." C. "We need to talk about the things you have to live for." D. "I think you should consider all your options prior to taking this action."

B

A newly admitted client is diagnosed with bipolar disorder: manic episode. Which symptom related to altered thought is the nurse most likely to assess? A. Pacing B. Flight of ideas C. Liability of mood D. Irritability

B

A newly admitted client is diagnosed with major depressive disorder with suicidal ideations. Which would be the priority nursing intervention for this client? A. Teach about the effective of suicide on family dynamics. B. Carefully and unobtrusively observe based on assessed data, at varied intervals around the clock. C. Encourage the client to spend a portion of each day interacting within the milieu. D. Set realistic achievable goals to increase self esteem.

B

A nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder. 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 you request to your psychiatrist because it is his decision."

B

A nurse learns at report that a newly admitted client experiencing mania is demonstrating grandiose delusions. The nurse should recognize that which client statement would provide supportive evidence of this symptom? A. "I can't stop my sexual urges. They have led me to numerous affairs." B. "I'm the world's most perceptive attorney." C. "My wife is distraught about my overspending." D. "The FBI has tapped my room and are out to get me."

B

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

B

A nursing instructor is teaching about the monoamine category of neurotransmitters. Which student statement indicates that learning about the function of norepinephrine has occurred? A. Norepinephrine functions to regulate movement, coordination, and emotions. B. Norepinephrine functions to regulate mood, cognition, and perception. C. Norepinephrine functions to regulate arousal, libido, and appetite. D. Norepinephrine functions to regulate pain, inflammatory response, and wakefulness.

B

A preadolescent child is suspected of being sexually abused because he demonstrates the self-destructive behaviors of self-mutilation and attempted suicide. Which common behavior should the nurse also expect to assess? A. Inability to play. B. Truancy and running away. C. Head banging. D. Over-control of anger.

B

A student nurse tells the instructor, "I'm concerned that when a client asks me for advice I won't have a good solution." Which should be the nursing instructor's best response? A. "It's scary to feel put on the spot by a client. Nurses don't always have the answer." B. "Remember, clients, not nurses, are responsible for their own choices and decisions." C. "Just keep the client's best interests in mind and do the best that you can." D. "Set a goal to continue to work on this aspect of your practice."

B

A week ago, a tornado destroyed the client's home and seriously injured her husband. The client has been walking around the hospital in a daze without any outward display of emotions. She tells the nurse that she feels like she's going crazy. Which of the following actions should the nurse use first? A. Explain the effects of stress on the mind and body. B. Reassure the client that her feelings are typical reactions to serious trauma. C. Reassure the client that her symptoms are temporary. D. Acknowledge the unfairness of the client's situation.

B

After fasting from 10 p.m. the previous evening, a client finds out that the blood test has been canceled. The client swears at the nurse and states, "You are incompetent!" Which is the nurse's best response? A. "Do you believe that I was the cause of your blood test being canceled?" B. "I see that you are upset, but I feel uncomfortable when you swear at me." C. "Have you ever thought about ways to express anger appropriately?" D. "I'll give you some space. Let me know if you need anything."

B

After months of counseling, a client abused by her husband tells the nurse that she has decided to stop treatment. There has been no abuse during this time, and she feels better able to cope with the needs of her husband and children. In discussing this decision with the client, the nurse should: A. Tell the client that this is a bad decision that she will regret in the future. B. Find out more about the client's rationale for her decision to stop treatment. C. Warn the client that abuse commonly stops when one partner is in treatment, only to begin again later. D. Remind the client of her duty to protect her children by continuing treatment.

B

After teaching a client about lithium carbonate (Lithane), which client statement would indicate to the nurse that teaching has been successful? A. "I should expect to feel better in a couple of days." B. "I'll call my doctor immediately if I experience any diarrhea or ringing in my ears." C. "If I forget a dose, I can double the dose the next time I take this drug." D. "I need to restrict my intake of any food containing salt."

B

After years of dialysis, an 84-year-old states, "I'm exhausted, depressed, and so over these attempts to keep me alive." Which question should the nurse ask the spouse when preparing a discharge plan of care? A. "Has there been had any appetite or sleep changes?" B. "How often is your spouse left alone?" C. "Has your spouse been following a diet and exercise program consistently?" D. "How would you characterize your relationship with your spouse?"

B

An instructor is teaching nursing students about neurotransmitters. Which term best explains the process of how neurotransmitters released into the synaptic cleft may return to the presynaptic neuron? A. Regeneration B. Reuptake C. Recycling D. Retransmission

B

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

B

During a group session, which client statement demonstrates that the group has progressed to the middle, or working, phase of group development? A. "It's hard for me to tell my story when I'm not sure about the reactions of others." B. "I think Joe's Antabuse suggestion is a good one and might work for me." C. "My situation is very complex, and I need professional, not peer, advice." D. "I am really upset that you expect me to solve my own problems."

B

During a sleep study, a delta rhythm has been recorded for a client experiencing sleep apnea. The nurse recognizes the characteristic that is associated with this rhythm. What stage of sleep activity would be documented? A. Delta rhythm is a period of dozing occurring in stage 1 of sleep activity. B. Delta rhythm is a period of deep and restful sleep occurring in stage 3 of sleep activity. C. Delta rhythm is a period of relaxed waking occurring in stage 0 of sleep activity. D. Delta rhythm is a period of dreaming occurring in stage 2 of sleep activity.

B

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? A. The task role of gatekeeper B. The individual role of recognition seeker C. The maintenance role of dominator D. The task role of elaborator

B

Six months after her husband and children were killed in a car accident, a client is diagnosed with ulcerative colitis. The nurse should recognize that this situation validates which study perspective? A. The study of neuroendocrinology B. The study of psychoimmunology C. The study of diagnostic technology D. The study of neurophysiology

B

The family of a client diagnosed with anorexia nervosa becomes defensive when the treatment team calls for a family meeting. Which is the appropriate nursing reply? A. "Tell me why this family meeting is causing you to be defensive. All clients are required to participate in two family sessions." B. "Eating disorders have been correlated to certain familial patterns; without addressing these, your child's condition will not improve." C. "Family dynamics are not linked to eating disorders. The meeting is to provide your child with family support." D. "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration in family processes needs to be addressed."

B

The initial care plan for a client with OCD who washes her hands obsessively would include which of the following nursing interventions? a. Keep the client's bathroom door locked so she cannot wash her hands all the time. b. Structure the client's schedule so that she has plenty of time for washing her hands. c. Place the client in isolation until she promises to stop washing her hands so much d. Explain the client's behavior to her, since she is probably unaware that it is maladaptive

B

The nurse should utilize which group function to help an extremely withdrawn, paranoid client increase feelings of security? A. Socialization B. Support C. Empowerment D. Governance

B

What is the best rationale for including the client's family in therapy within the inpatient milieu? A. To structure a program of social and work-related activities B. To facilitate discharge from the hospital C. To provide a concrete demonstration of caring D. To encourage the family to model positive behaviors

B

What is the main goal of the working phase of the nurse-client therapeutic relationship? A. Role modeling to improve interaction with others B. Resolution of the client's problems C. Using therapeutic communication to clarify perceptions D. Helping the client access outpatient treatment

B

What tool should a nurse use to differentiate occasional spontaneous behaviors of children from behaviors associated with bipolar disorder? A. "Risky Activity" tool B. "FIND" tool C. "Consensus Committee" tool D. "Monotherapy" tool

B

Which cerebral structure should a nursing instructor describe to students as the "emotional brain"? A. The cerebellum B. The limbic system C. The cortex D. The left temporal lobe

B

Which client statement would the nurse recognize as indicating that the client understands dietary teaching related to lithium carbonate (Lithobid) treatment? A. "I will limit my intake of fluids daily." B. "I will maintain normal salt intake." C. "I will take Lithobid on an empty stomach." D. "I will increase my caloric intake to prevent weight loss."

B

Which mental illness should a nurse identify as being associated with a decrease in prolactin hormone level? A. Major depression B. Schizophrenia C. Anorexia nervosa D. Alzheimer's disease

B

Which nursing action demonstrates the role of the teacher in a therapeutic milieu? A. The nurse implements a self-affirmation exercise during a one-to-one client interaction. B. The nurse holds a group meeting to present common side effects of psychiatric medications. C. The nurse introduces the concept of fair play while playing cards with a group of clients. D. The nurse models adaptive and effective coping mechanisms with clients on the psychiatric unit.

B

Which nursing intervention is appropriate when caring for clients diagnosed with either anorexia nervosa or bulimia nervosa? A. Provide privacy during meals. B. Remain with the client for at least 1 hour after the meal. C. Encourage the client to keep a journal to document types of food consumed. D. Restrict client privileges when provided food is not completely consumed.

B

Which nursing statement is a good example of the therapeutic communication technique of offering self? A. "I think it would be great if you talked about that problem during our next group session." B. "Would you like me to accompany you to your electroconvulsive therapy treatment?" C. "I notice that you are offering help to other peers in the milieu." D. "After discharge, would you like to meet me for lunch to review your outpatient progress?"

B

Which of the following client statements indicates the need for additional teaching about benzodiazepines? A. "I can't drink alcohol while taking diazepam (Valium)." B. "I can stop taking the drug anytime I want." C. "Valium can make me drowsy, so I shouldn't drive for a while." D. "Valium will help my tight muscles feel better."

B

Which phase of the nurse-client relationship begins when the individuals first meet and is characterized by an agreement to continue to meet and work on setting client-centered goals? A. Preinteraction B. Orientation C. Working D. Termination

B

Which situation should a nurse identify as an example of an autocratic leadership style? A. The president of Sigma Theta Tau assigns members to committees to research problems. B. Without faculty input, the dean mandates that all course content be delivered via the Internet. C. During a community meeting, a nurse listens as clients generate solutions. D. The student nurses' association advertises for candidates for president.

B

Which statement indicates that the nurse is acting as an advocate for a client who has recently made a suicide attempt? A. "I must observe you continually for 1 hour in order to keep you safe." B. "Let's confer with the treatment team about the triggers to your attempt that we discussed." C. "You must have been very upset to do what you did today." D. "Are you currently thinking about harming yourself?"

B

An individual experiences sadness and melancholia in September continuing through November. Which of the following factors should a nurse identify as most likely to contribute to the etiology of these symptoms? (Select all that apply.) A. Gender differences in social opportunities that occur with age B. Drastic temperature and barometric pressure changes C. Increased levels of melatonin D. Variations in serotonergic functioning E. Inaccessibility of resources for dealing with life stressors

B, C, D

Which of the following behavioral skills should a nurse implement when leading a group that is functioning in the orientation phase of group development? (Select all that apply.) A. Encouraging members to provide feedback to each other about individual progress B. Ensuring that group rules do not interfere with goal fulfillment C. Working with group members to establish rules that will govern the group D. Emphasizing the need for and importance of confidentiality within the group E. Helping the members to resolve conflicts and foster cohesiveness within the group

B, C, D

A 75-year-old client diagnosed with a long history of depression is currently on doxepin (Sinequan) 100 mg daily. The client takes a daily diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign highest priority? A. Risk for ineffective thermoregulation R/T anhidrosis B. Risk for constipation R/T excessive fluid loss C. Risk for injury R/T orthostatic hypotension D. Risk for infection R/T suppressed white blood cell count

C

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 pounds 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 only occurs during the first month of treatment with this drug."

C

A client diagnosed with bipolar disorder weighs 220 lb. A physician orders lamotrigine (Lamictal) 10 mg/kg/day to a maximum of 400 mg/day for mood stabilization. Which is a true statement about this medication order? A. This calculated dosage is within the recommended dosage range. B. This calculated dosage is lower than the recommended dosage range. C. This calculated dosage is more than twice the recommended dosage range. D. This calculated dosage is four times higher than the recommended dosage range.

C

A client diagnosed with bulimia nervosa is to receive fluoxetine (Prozac) by oral solution. The medication is supplied in a 100 mL bottle. The label reads 20 mg/5 mL. The doctor orders 60 mg q day. Which dose of this medication should the nurse dispense? A. 25 mL B. 20 mL C. 15 mL D. 10 mL

C

A client diagnosed with dependant personality disorder states, "Do you think I should move from my parent's house and get a job?" Which nursing response is most appropriate? A. "It would be best to do that in order to increase independence." B. "Why would you want to leave a secure home?" C. "Let's discuss and explore all of your options." D. "I'm afraid you would feel very guilty leaving your parents."

C

A client has undergone psychological testing. With which member of the interdisciplinary team should a nurse collaborate to review these results? A. The psychiatrist B. The psychiatric social worker C. The clinical psychologist D. The clinical nurse specialist

C

A client is diagnosed with agoraphobia without panic disorder. Which type of therapy is most effective for this illness? A. Insight therapy. B. Group therapy. C. Behavior therapy. D. Psychoanalysis.

C

A client named Jana, with a long history of experiencing Dissociative Identity Disorder, is admitted to the unit after the cuts on her legs were sutured in the Emergency Department. During the admission interview, Jana tearfully states that she does not know what happened to her legs. Then a stronger, alter personality named Jason emerges. Jason states that Jana is useless, weak, and needs to be eliminated completely. The nurse should do which of the following first? A. Explore Jason's attitudes toward Jana more thoroughly. B. Place Jana in restraints when Jason emerges. C. Contract with Jason to tell the nurse when he has the urge to harm Jana and the body they both share. D. Keep Jana in a stress-free environment so that the stronger Jason does not get a chance to emerge.

C

A client on an inpatient psychiatric unit tells the nurse, "I should have died because I am totally worthless." In order to encourage the client to continue talking about feelings, which should be the nurse's initial response? A. "How would your family feel if you died?" B. "You feel worthless now, but that can change with time." C. "You've been feeling sad and alone for some time now?" D. "It is great that you have come in for help."

C

A client on an inpatient unit is diagnosed with bipolar disorder: manic phase. During a discussion in the dayroom about weekend activities, the client raises voice, becomes irritable, and insists that plans change. What should be the nurse's initial intervention? A. Ask the group to take a vote on alternative weekend events. B. Remind the client to quiet down or leave the dayroom. C. Assist the client to move to a calmer location. D. Discuss with the client impulse control problems.

C

A client with suspected abuse describes her husband as a good man who works hard and provides well for his family. She does not work outside the home and states that she is proud to be a wife and mother just like her own mother. The nurse interprets the family pattern described by the client as best illustrating which of the following as characteristic of abusive families? A. Tight, impermeable boundaries. B. Unbalanced power ratio. C. Role stereotyping. 4. Dysfunctional feeling tone.

C

A client's altered body image is evidenced by claims of "feeling fat" even though the client is emaciated. Which is the appropriate outcome criterion for this client's problem? A. The client will consume adequate calories to sustain normal weight. B. The client will cease strenuous exercise programs. C. The client will perceive an ideal body weight and shape as normal. D. The client will not express a preoccupation with food.

C

A client's younger daughter is ignoring curfew. The client states, "I'm afraid she will get pregnant." The nurse responds, "Hang in there. Don't you think she has a lot to learn about life?" This is an example of which communication block? A. Requesting an explanation B. Belittling the client C. Making stereotyped comments D. Probing

C

A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. Which theoretical principle best explains the etiology of this client's depressive symptoms? A. According to psychoanalytic theory, depression is a result of anger turned inward. B. According to object-loss theory, depression is a result of abandonment. C. According to learning theory, depression is a result of repeated failures. D. According to cognitive theory, depression is a result of negative perceptions.

C

A group of nurses are discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders. Which of these nurses will probably be most effective with these clients? A. The nurse who understands the importance of three balanced meals a day B. The nurse who permits children to have dessert only after finishing the food on their plate C. The nurse who refuses to engage in power struggles related to food consumption D. The nurse who grew up poor and frequently did not have enough food to eat

C

A newly admitted client is experiencing the manic phase of bipolar I disorder. The nurse should assign which priority nursing diagnosis to this client? A. Ineffective individual coping R/T hospitalization AEB alcohol abuse B. Altered nutrition: less than body requirements R/T mania AEB 10 lb weight loss C. Risk for violence: directed toward others R/T agitation and hyperactivity D. Sleep pattern disturbance R/T flight of ideas AEB sleeps 1 to 2 hours per night

C

A nurse believes that the members of a parenting group are in the initial, or orientation, phase of group development. Which group behaviors would support this assumption? A. The group members manage conflict within the group. B. The group members use denial as part of the grief response. C. The group members compliment the leader and compete for the role of recorder. D. The group members initially trust one another and the leader.

C

A nurse is caring for four clients diagnosed with major depression. When considering the client's belief system, which client would potentially be at highest risk for suicide? A. Roman Catholic B. Protestant C. Atheist D. Muslim

C

A nurse is planning care for a client diagnosed with bipolar disorder: manic phase. In which order should the nurse prioritize the listed client outcomes? Client Outcomes: 1. Maintains nutritional status. 2. Interacts appropriately with peers. 3. Remains free from injury. 4. Sleeps 6 to 8 hours a night. A. 2, 1, 3, 4 B. 4, 1, 2, 3 C. 3, 1, 4, 2 D. 1, 4, 2, 3

C

A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is the most appropriate, correctly written short-term outcome for this client? A. The client will use stress-reducing techniques to avoid purging. B. The client will discuss chaos in personal life and be able to verbalize a link to purging. C. The client will gain 2 pounds prior to the next weekly appointment. D. The client will remain free of signs and symptoms of malnutrition and dehydration.

C

A nursing instructor is teaching about psychodrama, a specialized type of therapeutic group. Which student statement indicates that further teaching is necessary? A. "Psychodrama provides a safe setting in which to discuss painful issues." B. "In psychodrama, the client is the protagonist." C. "In psychodrama, the client observes actor interactions from the audience." D. "Psychodrama facilitates resolution of interpersonal conflicts."

C

A nursing instructor is teaching about the medications given prior to and during electroconvulsive therapy (ECT) treatments. Which student statement indicates that learning has occurred? A. "Atropine (Atro-Pen) is administered to paralyze skeletal muscles during ECT." B. "Succinylcholine chloride (Anectine) decreases secretions to prevent aspiration." C. "Thiopental sodium (Pentothal) is a short-acting anesthesia to render the client unconscious." D. "Glycopyrrolate (Robinul) is given to prevent severe muscle contractions during seizure."

C

A third-grade child is referred to the mental health clinic by the school nurse because he is fearful, anxious, and socially isolated. After meeting with the client, the nurse talks with his mother, who says, "It's that school nurse again. She's done nothing but try to make trouble for our family since my son started school. And now you're in on it." The nurse should respond by saying: A. "The school nurse is concerned about your son and is only doing her job." B. "We see a number of children who go to your son's school. He isn't the only one." C. "You sound pretty angry with the school nurse. Tell me what has happened." D. "Let me tell you why your son was referred, and then you can tell me about your concerns."

C

A withdrawn client diagnosed with schizophrenia expresses little emotion and refuses to attend group therapy. What altered component of the nervous system should a nurse recognize as being responsible for this behavior? A. Dendrites B. Axons C. Neurotransmitters D. Synapses

C

Adolescents and adults who were sexually abused as children commonly mutilate themselves. The nurse interprets this behavior as: A. The need to make themselves less sexually attractive. B. An alternative to bingeing and purging. C. Use of physical pain to avoid dealing with emotional pain. D. An alternative to getting high on drugs.

C

After being discharged from the hospital with acute stress disorder, a client is referred to the outpatient clinic for follow-up. Which of the following is most important for the client to use for continued alleviation of anxiety? A. Recognizing when she is feeling anxious. B. Understanding reasons for her anxiety. C. Using adaptive and palliative methods to reduce anxiety. D. Describing the situations preceding her feelings of anxiety.

C

After receiving two of nine electroconvulsive therapy (ECT) treatments, a client states, "I can't even remember eating breakfast, so I want to stop the ECT treatments." Which is the most appropriate nursing reply? 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."

C

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? A. Conflict should be avoided at all costs on inpatient psychiatric units. B. Conflict should be resolved by the nursing staff. C. Every interaction is an opportunity for therapeutic intervention. D. Conflict resolution should only be addressed during group therapy.

C

An experienced psychiatric registered nurse has taken a new position leading groups in a day treatment program. Without further education, which group is this nurse most qualified to lead? A. A psychodrama group B. A psychotherapy group C. A parenting group D. A family therapy group

C

An instructor is correcting a nursing student's clinical worksheet. Which instructor statement is the best example of effective feedback? A. "Why did you use the client's name on your clinical worksheet?" B. "You were very careless to refer to your client by name on your clinical worksheet." C. "Surely you didn't do this deliberately, but you breeched confidentiality by using the client's name." D. "It is disappointing that after being told, you're still using client names on your worksheet."

C

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.

C

During the third session with the nurse, a client who is being abused states, "I don't know what to do anymore. He doesn't want me to go anywhere while he's at work, not even to visit my friends." Which nursing diagnosis should the nurse formulate regarding this information? A. Risk for other-directed violence related to an abusive husband, as evidenced by the victim's statement of being battered. B. Situational low self-esteem related to victimization, as evidenced by not being able to leave the house. C. Powerlessness related to control by husband, as evidenced by the inability to make decisions. D. Ineffective coping related to victimization, as evidenced by crying.

C

How does a democratic form of self-government in the milieu contribute to client therapy? A. By setting punishments for clients who violate the community rules B. By dealing with inappropriate behaviors as they occur C. By setting community expectations wherein all clients are treated on an equal basis D. By interacting with professional staff members to learn about therapeutic interventions

C

In working with a rape victim, which of the following is most important? A. Continuing to encourage the client to report the rape to the legal authorities. B. Recommending that the client resume sexual relations with her partner as soon as possible. C. Periodically reminding the client that she did not deserve and did not cause the rape. D. Telling the client that the rapist will eventually be caught, put on trial, and jailed.

C

John, a veteran of the war in Iraq, is diagnosed with PTSD. He experiences a nightmare during his first night in the hospital. He explains to the nurse that he was dreaming about gunfire all around and people being killed. the nurses's most appropriate initial intervention is to: a. Administer alprazolam as ordered prn for anxiety. b. Call the physician and report the incident. c. Stay with John and reassure him of his safety. d. Have John listen to a tape of relaxation exercises

C

One of the myths about sexual abuse of young children is that it usually involves physically violent acts. Which of the following behaviors is more likely to be used by the abusers? A. Tying the child down. B. Bribery with money. C. Coercion as a result of the trusting relationship. D. Asking for the child's consent for sex.

C

Sertraline (Zoloft) has been prescribed for a client complaining of poor appetite, fatigue, and anhedonia. Which consideration should the nurse recognize as influencing this prescriptive choice? A. Zoloft is less expensive for the client. B. Zoloft is extremely sedating and will help with sleep disturbances. C. Zoloft has less adverse side effects than other antidepressants. D. Zoloft begins to improve depressive symptoms quickly.

C

The nurse is providing counseling to clients diagnosed with major depressive disorder. The nurse chooses to assess and attempt to modify the negative thought patterns of these clients. The nurse is functioning under which theoretical framework? A. Psychoanalytic theory B. Interpersonal theory C. Cognitive theory D. Behavioral theory

C

The nurse notices that a client diagnosed with Major Depression and Social Phobia must get up and move to another area when someone sits next to her. Which of the following actions by the nurse is appropriate? A. Ignore the client's behavior. B. Question the client about her avoidance of others. C. Convey awareness of the client's anxiety about being around others. D. Tell the other clients to follow the client when she moves away.

C

What client information does a 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, using 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

C

What should be the nurse's primary goal during the preinteraction phase of the nurse-client relationship? A. To evaluate goal attainment and ensure therapeutic closure B. To establish trust and formulate a contract for intervention C. To explore self-perceptions D. To promote client change

C

When developing the plan of care for a client with acute stress disorder who lost her sister in a boating accident, which of the following should the nurse initiate? A. Helping the client to evaluate her sister's behavior. B. Telling the client to avoid details of the accident. C. Facilitating progressive review of the accident and its consequences. D. Postponing discussion of the accident until the client brings it up.

C

Which client statement reflects an understanding of the effect of circadian rhythms on psychopathology? 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. I get my best work done in the a.m." D. "Every February, I tend to experience periods of sadness."

C

Which nursing statement is a good example of the therapeutic communication technique of giving recognition? A. "You did not attend group today. Can we talk about that?" B. "I'll sit with you until it is time for your family session." C. "I notice you are wearing a new dress and you have washed your hair." D. "I'm happy that you are now taking your medications. They will really help."

C

116.A newly admitted 20-year-old client, diagnosed with Post Traumatic Stress Disorder (PTSD), reluctantly reveals that she escaped from a satanic cult 2 years ago. The mother has been in the cult since the client was 3 years old and refused to leave with the client. The client says, "Nobody will ever believe the horrible things the men did to me and my mother never stopped them." Which of the following responses is appropriate for the nurse to make? A. "I'll believe anything you tell me. You can trust me." B. "I can't understand why your mother didn't protect you. It's not right." C. "Tell me about the cult. I didn't know there were any near here." D. "It must be difficult to talk about what happened. I'm willing to listen."

D

A client is admitted to an emergency department experiencing memory deficits and decreased motor function. What alteration in brain chemistry should a nurse correlate with the presentation of these symptoms? A. Abnormal levels of serotonin B. Decreased levels of dopamine C. Increased levels of norepinephrine D. Decreased levels of acetylcholine

D

A client is diagnosed with dysthymic disorder. Which should a nurse classify as an affective symptom of this disorder? A. Social isolation with a focus on self B. Low energy level C. Difficulty concentrating D. Gloomy and pessimistic outlook on life

D

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 is the appropriate nursing response? A. "I'll talk to Peter and present your concerns." B. "Why are you overreacting to this issue?" C. "You should bring this to the attention of your treatment team." D. "I can see that you are angry. Let's discuss ways to approach Peter with your concerns."

D

A client states, "You won't believe what my husband said to me during visiting hours. He has no right treating me that way." Which nursing response would best assess the situation that occurred? A. "Does your husband treat you like this very often?" B. "What do you think is your role in this relationship?" C. "Why do you think he behaved like that?" D. "Describe what happened during your time with your husband."

D

A client with acute stress disorder states to the nurse, "I keep having horrible nightmares about the car accident that killed my daughter. I shouldn't have taken her with me to the store." Which of the following responses by the nurse is most therapeutic? A. "Don't keep torturing yourself with such horrible thoughts." B. "Stop blaming yourself. It's only hurting you." C. "Let's talk about something that is a bit more pleasant." D. "The accident just happened and could not have been predicted."

D

A client with posttraumatic stress disorder needs to find new housing and wants to wait for a month before setting another appointment to see the nurse. The nurse interprets this action as which of the following? A. A method of avoidance. B. A detriment to progress. C. The end of treatment. D. A necessary break in treatment.

D

A confused client has recently been prescribed sertraline (Zoloft). The client's spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect and what could be its possible cause? A. Neuroleptic malignant syndrome caused by ingestion of two different seratonin reuptake inhibitors (SSRIs) B. Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) C. Serotonin syndrome caused by ingestion of an SSRI and an MAOI D. Serotonin syndrome caused by ingestion of two different SSRIs

D

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? A. "Rates mood 8/10. Exhibiting looseness of association. Euphoric." B. "Mood euthymic. Exhibiting magical thinking. Restless." C. "Mood labile. Exhibiting delusions of reference. Hyperactive." D. "Agitated and pacing. Exhibiting grandiosity. Mood labile."

D

A mother notified 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 husband arrives."

D

A newly admitted client diagnosed with obsessive-compulsive disorder (OCD) washes hands continually. This behavior prevents unit activity attendance. Which nursing statement best addresses this situation? A. "Everyone diagnosed with OCD needs to control their ritualistic behaviors." B. "It is important for you to discontinue these ritualistic behaviors." C. "Why are you asking for help if you won't participate in unit therapy?" D. "Let's figure out a way for you to attend unit activities and still wash your hands."

D

A nurse administers ordered preoperative glycopyrrolate (Robinul) 30 minutes prior to a client's electroconvulsive therapy (ECT) treatment. What is the rationale for administering this medication? A. Robinul decreases anxiety during the ECT procedure. B. Robinul induces an unconscious state to prevent pain during the ECT procedure. C. Robinul prevents severe muscle contractions during the ECT procedure. D. Robinul decreases secretions to prevent aspiration during the ECT procedure.

D

A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis? A. The client is disheveled and malodorous. B. The client refuses to interact with others. C. The client is unable to feel any pleasure. D. The client has maxed-out charge cards and exhibits promiscuous behaviors.

D

A nurse concludes that a restless, agitated client is manifesting a "fight-or-flight" response. The nurse should associate this response with which neurotransmitter? A. Acetylcholine B. Dopamine C. Serotonin D. Norepinephrine

D

A nurse is caring for four clients taking various medications including imipramine (Tofranil), doxepine (Sinequan), ziprasidone (Geodon), and tranylcypromine (Parnate). The nurse orders a special diet for the client receiving which medication? A. Tofranil B. Senequan C. Geodon D. Parnate

D

A nurse should recognize that a decrease in norepinephrine levels would play a significant role in which mental illness? A. Mania B. Schizophrenia C. Anxiety D. Depression

D

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? A. The therapeutic technique of "giving advice" B. The therapeutic technique of "defending" C. The nontherapeutic technique of "presenting reality" D. The nontherapeutic technique of "giving false reassurance"

D

A nurse working on an inpatient psychiatric unit is assigned to conduct a 45-minute education group. What should the nurse identify as an appropriate group topic? A. Dream analysis B. Creative cooking C. Paint by number D. Stress management

D

A nursing instructor is discussing various challenges in the treatment of clients diagnosed with bipolar disorder. Which student statement demonstrates an understanding of the most critical challenge in the care of these clients? A. "Treatment is compromised when clients can't sleep." B. "Treatment is compromised when irritability interferes with social interactions." C. "Treatment is compromised when clients have no insight into their problems." D. "Treatment is compromised when clients choose not to take their medications."

D

A nursing instructor is teaching students about self-help groups like Alcoholics Anonymous (AA). Which student statement indicates that learning has occurred? A. "There is little research to support AA's effectiveness." B. "Self-help groups used to be the treatment of choice, but their popularity is waning." C. "These groups have no external regulation, so clients need to be cautious." D. "Members themselves run the group, with leadership usually rotating among the members."

D

A single, pregnant teenager in a parenting class discloses her ambivalence toward the pregnancy and the subsequent guilt that these thoughts generate. A mother of three admits to having felt that way herself. Which of Yalom's curative group factors does this illustrate? A. Imparting of information B. Instillation of hope C. Altruism D. Universality

D

A student nurse is studying the effect of the drug isocarboxazid (Marplan) on neurobiology. The student should recognize that the neurotransmitter serotonin is catabolized by which enzyme? A. Glycosyltransferase B. Peptidase C. Polymerase D. Monoamine oxidase

D

After a client reveals a history of childhood sexual abuse, the nurse should ask which of the following questions first ? A. "What other forms of abuse did you experience?" B. "How long did the abuse go on?" C. "Was there a time when you did not remember the abuse?" D. "Does your abuser still have contact with young children?"

D

An adult client diagnosed with anxiety disorder becomes anxious when she touches fruits and vegetables. What should the nurse do? A. Instruct the woman to avoid touching these foods. B. Ask the woman why she becomes anxious in these situations. C. Assist the woman to make a plan for her family to do the food shopping and preparation. D. Teach the woman to use cognitive behavioral approaches to manage her anxiety.

D

Ms. T has been diagnosed with agoraphobia. Which behavior would be most characteristic of this disorder? a. Ms. T experiences panic anxiety when she encounters snakes. b. Ms. T refused to fly in an airplane. c. Ms. T. will not eat in a public place. d. Ms. T stays in her home for fear of being in a place from which she cannot escape.

D

The client diagnosed with a fear of eating in public places or in front of other people has finished eating lunch in the dining area in the nurse's presence. Which of the following statements by the nurse should reinforce the client's positive action? A. "It wasn't so hard, now was it?" B. "At supper, I hope to see you eat with a group of people." C. "You must have been hungry today." D. "It is progress for you to eat in the dining room with me."

D

The inpatient psychiatric unit is being redecorated. At a unit meeting, staff discuss bedroom décor for clients experiencing mania. The nurse manager evaluates which suggestion as most appropriate? A. Rooms should contain extra-large windows with views of the street. B. Rooms should contain brightly colored walls with printed drapes. C. Rooms should be painted deep colors and located close to the nurse's station. D. Rooms should be painted with neutral colors and contain pale-colored accessories.

D

The mother of a school-aged child tells the nurse that, "For most of the past year my husband was unemployed and I worked a second job. Twice during the year I spanked my son repeatedly when he refused to obey. It has not happened again. Our family is back to normal." After assessing the family, the nurse decides that the child is still at risk for abuse. Which of the following observations best supports this conclusion? A. The parents say they are taking away privileges when their son refuses to obey. B. The child has talked about family activities with the nurse. C. The parent's are less negative toward the nurse. D. The child wears long sleeve shirts and long pants, even in warm weather.

D

When caring for a client who is experiencing a panic attack, which of the following nursing actions should be implemented? a. Leave the client alone to maintain privacy. b. Instruct the client regarding unit rules and regulations. c. Sit with the client in the day room to provide comfort. d. Communicate with simple words and brief messages.

D

When caring for a client who was a victim of a crime, the nurse is aware that recovery from any crime can be a long and difficult process depending on the meaning it has for the client. Which of the following should the nurse establish as a victim's ultimate goal in reconstructing his or her life? A. Getting through the shock and confusion. B. Carrying out home and work routines. C. Resolving grief over any losses. D. Regaining a sense of security and safety.

D

When obtaining a nursing history from parents who are suspected of abusing their child, which of the following characteristics about the parents should the nurse particularly assess? A. Attentiveness to the child's needs. B. Self-blame for the injury to the child. C. Ability to relate the child's developmental achievements. D. Difficulty with controlling aggression.

D

When planning the care for a client who is being abused, which of the following measures is most important to include? A. Being compassionate and empathetic. B. Teaching the client about abuse and the cycle of violence. C. Explaining to the client her personal and legal rights. D. Helping the client develop a safety plan.

D

Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder? A. "It's just a matter of time and I will be well." B. "If I ignore these feelings, they will go away." C. "I can fight these feelings and overcome this disorder." D. "I deserve to feel this way."

D

Which group leader activity should a nurse identify as being most effective in the final, or termination, phase of group development? A. The group leader establishes the rules that will govern the group after discharge. B. The group leader encourages members to rely on each other for problem solving. C. The group leader presents and discusses the concept of group termination. D. The group leader helps the members to process feelings of loss.

D

Which is the best nursing action when a client demonstrates transference toward a nurse? A. Promoting safety and immediately terminating the relationship with the client B. Encouraging the client to ignore these thoughts and feelings C. Immediately reassigning the client to another staff member D. Helping the client to clarify the meaning of the current nurse-client relationship

D

Which nursing statement is a good example of the therapeutic communication technique of focusing? A. "Describe one of the best things that happened to you this week." B. "I'm having a difficult time understanding what you mean." C. "Your counseling session is in 30 minutes. I'll stay with you until then." D. "You mentioned your relationship with your father. Let's discuss that further."

D

Which of the following may be influential in the predisposition to PTSD? a. Unsatisfactory parent-child relationship. b. Excess of the neurotransmitter serotonin. c. Distorted, negative cognition. d. Severity of the stressor and availability of support systems.

D

Which parental characteristic is least likely to be a risk factor for child abuse? A. Low self-esteem. B. History of substance abuse. C. Inadequate knowledge of normal growth and development patterns. D. Being a member of a large family.

D

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

D

With implosion therapy, a client with phobic anxiety would be: a. Taught relaxation exercises. b. Subjected to graded intensities of the fear. c. Instructed to stop the therapeutic session as soon as anxiety is experienced. d. Presented with massive exposure to a variety of stimuli associated with phobic object/stimulation.

D

Which types of adoption studies should a nurse recognize as providing useful information for the psychiatric community? A. Studies in which children with mentally ill biological parents are raised by adoptive parents who were mentally healthy B. Studies in which children with mentally healthy biological parents are raised by adoptive parents who were mentally ill C. Studies in which monozygotic twins from mentally ill parents were raised separately by different adoptive parents D. Studies in which monozygotic twins were raised together by mentally ill biological parents E. All of the above

E

A 3-year-old child with a history of being abused has blood drawn. The child lies very still and makes no sound during the procedure. Which of the following comments by the nurse would be most appropriate? A. "It's okay to cry when something hurts." B. "That really didn't hurt, did it?" C. "We're mean to hurt you that way, aren't we?" D. "You were very good not to cry with the needle."

A

A chronically depressed and suicidal client is admitted to a psychiatric unit. The client is scheduled for electroconvulsive therapy (ECT). During the course of ECT treatments, a nurse should recognize the continued need for which critical intervention? A. Suicide assessment must continue throughout the ECT course of treatment. B. Antidepressant medications are contraindicated throughout the ECT course of treatment. C. Discourage expressions of hopelessness throughout the ECT course of treatment. D. Encourage high-caloric diet throughout the ECT course of treatment.

A

A client is struggling to explore and solve a problem. Which nursing statement would verbalize the implication of the client's actions? A. "You seem to be motivated to change your behavior." B. "How will these changes affect your family relationships?" C. "Why don't you make a list of the behaviors you need to change." D. "The team recommends that you make only one behavioral change at a time."

A

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? A. The nontherapeutic technique of giving approval B. The nontherapeutic technique of interpreting C. The therapeutic technique of presenting reality D. The therapeutic technique of making observations

A

During a nurse-client interaction, which nursing statement may belittle the client's feelings and concerns? A. "Don't worry. Everything will be alright." B. "You appear uptight." C. "I notice you have bitten your nails to the quick." D. "You are jumping to conclusions."

A

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? A. Autocratic B. Democratic C. Laissez-faire D. Bureaucratic

A

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? A. The group role of aggressor B. The group role of initiator C. The group role of gatekeeper D. The group role of blocker

A

Which of the following explanations should a nurse include when teaching parents why is it difficult to diagnose a child or adolescent exhibiting symptoms of bipolar disorder? (Select all that apply.) A. Bipolar symptoms are similar to attention deficit-hyperactivity disorder symptoms. B. Children are naturally active, energetic, and spontaneous. C. Neurotransmitter levels vary considerably in accordance with age. D. The diagnosis of bipolar disorder cannot be assigned prior to the age of 18. E. Genetic predisposition is not a reliable diagnostic determinant.

A, B

A nursing student is developing a study guide related to historical facts about suicide. Which of the following facts should the student include? (Select all that apply.) A. In the Middle Ages, suicide was viewed as a selfish and criminal act. B. During the Roman Empire, suicide was treated by incineration of the body. C. Suicide was an offense in ancient Greece, and a common site burial was denied. D. During the Renaissance, suicide was discussed and viewed more philosophically. E. Old Norse traditionally set a person who committed suicide adrift in the North Sea.

A, C, D

A client diagnosed with Obsessive-Compulsive Disorder has been taking sertraline (Zoloft) but would like to have more energy every day. At his monthly checkup, he reports that his massage therapist recommended he take St. John's Wort to help his depression. The nurse should tell the client: A. "St. John's Wort is a harmless herb that might be helpful in this instance." B. "Combining St. John's Wort with the Zoloft can cause a serious reaction called Serotonin Syndrome." C. "If you take St. John's, we'll have to decrease the dose of your Zoloft." D. "St. John's Wort isn't very effective for depression, but we can increase your Zoloft dose."

B

A nurse is assessing a client who is being abused. The nurse should assess the client for which characteristic? Select all that apply. A. Assertiveness. B. Self-blame. C. Alcohol abuse. D. Suicidal thoughts. E. Guilt.

B, C, D, E

When working with a group of adult survivors of childhood sexual abuse, dealing with anger and rage is a major focus. Which strategy should the nurse expect to be successful? Select all that apply. A. Directly confronting the abuser. B. Using a foam bat while symbolically confronting the abuser. C. Keeping a journal of memories and feelings. D. Writing letters to the abusers that are not sent. E. Writing letters to the adults who did not protect them that are not sent.

B, C, D, E

A nurse attends an interdisciplinary team meeting on an inpatient unit. Which of the following individuals are typically included as members of the interdisciplinary treatment team in psychiatry? (Select all that apply.) A. Respiratory therapist and psychiatrist B. Occupational therapist and psychologist C. Recreational therapist and art therapist D. Social worker and hospital volunteer E. Mental health technician and chaplain

B, C, E

A client is diagnosed with bipolar disorder and admitted to an inpatient psychiatric unit. Which is the priority outcome for this client? A. The client will accomplish activities of daily living independently by discharge. B. The client will verbalize feelings during group sessions by discharge. C. The client will remain safe throughout hospitalization. D. The client will use problem solving to cope adequately after discharge.

C

A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic? A. "It's quite common for clients to feel that way after a lengthy hospitalization." B. "Why don't you talk to your mother? You may find out she doesn't feel that way." C. "Your mother seems like an understanding person. I'll help you approach her." D. "You feel that your mother does not want you to come back home?"

D

A client who frequently exhibits angry outbursts is diagnosed with antisocial personality disorder. Which appropriate feedback should a nurse provide when this client experiences an angry outburst? A. "Why do you continue to alienate your peers by your angry outbursts?" B. "You accomplish nothing when you lose your temper like that." C. "Showing your anger in that manner is very childish and insensitive." D. "During group, you raised your voice, yelled at a peer, left, and slammed the door."

D

A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total body weight. Which subjective client response would the nurse assess to support this medical diagnosis? A. "I do not use any laxatives or diuretics to lose weight." B. "I am losing lots of hair. It's coming out in handfuls." C. "I know that I am thin, but I refuse to be fat!" D. "I don't know why people are worried. I need to lose this weight."

D

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? A. "Zyprexa in combination with Eskalith cures manic symptoms." B. "Zyprexa prevents extrapyramidal side effects." C. "Zyprexa ensures a good night's sleep." D. "Zyprexa calms hyperactivity until the Eskalith takes effect."

D

A client diagnosed with bipolar disorder, who has taken lithium carbonate (Lithane) for 1 year, presents in an emergency department with severe diarrhea, blurred vision, and tinnitus. How should the nurse interpret these symptoms? A. Symptoms indicate consumption of foods high in tyramine. B. Symptoms indicate lithium carbonate discontinuation syndrome. C. Symptoms indicate the development of lithium carbonate tolerance. D. Symptoms indicate lithium carbonate toxicity.

D

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

D

A client's wife of 34 years dies unexpectedly. The client cries often and becomes socially isolated. The client's therapist encourages open discussion of feelings, proper nutrition, and exercise. What is the best rationale for the therapist's advice? A. The therapist is using an interpersonal approach. B. The client has an alteration in neurotransmitters. C. It is routine practice to remind clients about nutrition, exercise, and rest. D. The client is susceptible to illness due to effects of stress on the immune system.

D

During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, what is the role of the group leader? A. To referee the debate B. To adamantly oppose physical discipline measures C. To redirect the group to a less controversial topic D. To encourage the group to solve the problem collectively

D

In the process of dealing with the intense feelings about being raped, victims commonly verbalize that they were afraid they would be killed during the rape and wish that they had been. The nurse should decide that further counseling is needed if the client voices which of the following? A. "I didn't fight him, but I guess I did the right thing because I'm alive." B. "Suicide would be an easy escape from all this pain, but I couldn't do it to myself." C. "I wish they gave the death penalty to all rapists and other sexual predators." D. "I get so angry at times that I have to have a couple of drinks before I sleep."

D

In the role of milieu manager, which activity should the nurse prioritize? A. Setting the schedule for the daily unit activities B. Evaluating clients for medication effectiveness C. Conducting therapeutic group sessions D. Searching newly admitted clients for hazardous objects

D

On which task should a nurse place priority during the working phase of relationship development? A. Establishing a contract for intervention B. Examining feelings about working with a particular client C. Establishing a plan for continuing aftercare D. Promoting the client's insight and perception of reality

D

What is the purpose of a nurse providing appropriate feedback? A. To give the client good advice B. To advise the client on appropriate behaviors C. To evaluate the client's behavior D. To give the client critical information

D

A client scheduled for electroconvulsive therapy (ECT) at 9:00 a.m. is discovered eating breakfast at 8:00 a.m. Based on this observation, which is the most appropriate nursing action? A. The nurse notifies the client's physician of the situation and cancels the ECT. B. The nurse removes the breakfast tray and assists the client to the ECT treatment room. C. The nurse allows the client to finish breakfast and reschedules ECT for 10:00 a.m. D. The nurse increases the client's fluid intake to facilitate the digestive process.

A

A nurse is caring for a client who has threatened to commit suicide by hanging. The client states, "I'm going to use a knotted shower curtain when no one is around." Which information would determine the nurse's plan of care for this 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

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then purging when alone, is assigned to a client diagnosed with bulimia nervosa. Which is an appropriate outcome related to this nursing diagnosis? A. The client will identify two alternative methods of dealing with isolation by day 3. B. The client will appropriately express angry feelings about lack of control by week 2. C. The client will verbalize two positive self attributes by day 3. D. The client will list five ways that the body reacts to bingeing and purging.

A

A nursing instructor is teaching students about the differences between the symptoms of anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates that learning has occurred? A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas clients diagnosed with bulimia nervosa do not." B. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients diagnosed with anorexia nervosa do not." C. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo, whereas clients diagnosed with anorexia nervosa do not." D. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients diagnosed with bulimia nervosa do not."

A

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client? A. To clarify personal attitudes, values, and beliefs B. To obtain thorough assessment data C. To determine the client's length of stay D. To establish personal goals for the interaction

A

A nurse should identify topiramate (Topamax) as the drug of choice for which of the following conditions? (Select all that apply.) A. Binge eating with obesity B. Bingeing and purging with a diagnosis of bulimia nervosa C. Weight loss with a diagnosis of anorexia nervosa D. Amenorrhea with a diagnosis of anorexia nervosa E. Emaciation with a diagnosis of bulimia nervosa

A, B

During a course of 12 electroconvulsive therapy (ECT) treatments, an anxious client diagnosed with major depression refuses to bathe or attend group therapy. At this time, which of the following nursing diagnoses should be assigned to this client? (Select all that apply.) A. Anxiety R/T post-ECT confusion and memory loss B. Risk for injury R/T post-ECT confusion and memory loss C. Disturbed thought processes R/T post-ECT confusion and memory loss D. Altered sensory perception R/T post-ECT confusion and memory loss E. Social isolation R/T post-ECT confusion and memory loss

A, B, C, E

Which of the following conditions would place a client at risk for injury during electroconvulsive therapy (ECT) treatments? (Select all that apply.) A. Severe osteoporosis B. Acute and chronic pulmonary disorders C. Hypothyroidism D. Recent cardiovascular accident E. Prostatic hypertrophy

A, B, D

A client is diagnosed with major depressive disorder. Which nursing diagnosis should a nurse assign to this client to address a behavioral symptom of this disorder? A. Altered communication R/T feelings of worthlessness 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

B

A client is scheduled for an initial treatment of electroconvulsive therapy (ECT). Which information should a nurse include when teaching about the potential side effects of this procedure? A. "You may experience transient tangential thinking." B. "You may experience some memory deficit surrounding the ECT." C. "You may experience avolution for the remainder of the day." D. "You may experience a higher risk for subsequent seizures."

B

A client who has been taking buspirone (BuSpar) as prescribed for 2 days is close to discharge. Which statement indicates to the nurse that the client has an understanding of important discharge teaching? A. "I cannot drink any alcohol with this medication." B. "It is going to take 2 to 3 weeks in order for me to begin to feel better." C. "This drug causes physical dependence and I need to strictly follow doctor's orders." D. "I can't take this medication with food. It needs to be taken on an empty stomach."

B

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

B

A nurse working with a client diagnosed with bulimia nervosa asks the client to recall a time in life when food could be consumed without purging. Which is the purpose of this nursing intervention? A. To gain additional information about the progression of the disease process B. To emphasize that the client is capable of consuming food without purging C. To incorporate specific foods into the meal plan to reflect pleasant memories D. To assist the client to become more compliant with the treatment plan

B

A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred? A. "During ECT a state of euphoria is induced." B. "ECT induces a grand mal seizure." C. "During ECT a state of catatonia is induced." D. "ECT induces a petit mal seizure."

B

A nursing instructor is teaching about suicide in the elderly population. Which information should the instructor include? A. Elderly people use less lethal means to commit suicide. B. While the elderly make up less than 13% of the population, they account for 16% of all suicides. C. Suicide is the second leading cause of death in the elderly. D. It is normal for elderly individuals to express a desire to die because they have come to terms with their mortality.

B

A nursing student is observing an electroconvulsive therapy (ECT) treatment. The student notices a blood pressure cuff on the client's lower leg. The student questions the instructor about the cuff placement. Which is the most accurate instructor reply? A. "The cuff has to be placed on the leg because both arms are used for intravenous fluids." B. "The cuff functions to prevent succinylcholine from reaching the foot." C. "The cuff position gives a more accurate blood pressure reading during the treatment." D. "The cuff is placed on the leg so that arms can easily be restrained during seizure."

B

A stockbroker commits suicide after being convicted of insider trading. Which information should a nurse share with the grieving family? A. "Keep in mind that your grieving will only last for 1 year." B. "To deal with your grief, try using coping strategies that have worked for you in the past." C. "You need to write a letter to the brokerage firm to express your anger with them." D. "It would be best if you avoid discussing the suicide."

B

If an individual is "two-faced," which characteristic essential to the development of a therapeutic relationship should a nurse identify as missing? A. Respect B. Genuineness C. Sympathy D. Rapport

B

What 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 treatment goals C. Attempt to find alternative placement D. Explore how thoughts and feelings about this client may adversely impact care

B

What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder? A. The attention during the assessment is beneficial in decreasing social isolation. B. Depression can generate somatic symptoms that can mask actual physical disorders. C. Physical health complications are likely to arise from antidepressant therapy. D. Depressed clients avoid addressing physical health and ignore medical problems.

B

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? A. The client will not physically harm self. B. The client will express three positive self-attributes by day 4. C. The client will reveal a suicide plan. D. The client will establish a trusting relationship with the nurse by day 1.

B

The nurse-client therapeutic relationship includes which of the following characteristics? (Select all that apply.) A. Meeting the psychological needs of the nurse and the client B. Ensuring therapeutic termination C. Promoting client insight into problematic behavior D. Collaborating to set appropriate goals E. Meeting both the physical and psychological needs of the client

B, C, D, E

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several months. Which factor should a nurse identify as an appropriate indicator of a positive client behavioral change? A. The client gains 2 pounds in 1 week. B. The client focuses conversations on nutritious food. C. The client demonstrates healthy coping mechanisms that decrease anxiety. D. The client verbalizes an understanding of the etiology of the disorder.

C

A client experienced bradycardia during electroconvulsive therapy (ECT) treatment. A nurse assigns a nursing diagnosis of decreased cardiac output R/T vagal stimulation occurring during ECT. Which outcome would the nurse expect the client to achieve? A. The client will verbalize an understanding of the need for moving slowly after treatment. B. The client will maintain an oxygen saturation level of 88% 1 hour after treatment. C. The client will continue adequate tissue perfusion 1 hour after treatment. D. The client will verbalize an understanding of common side effects of ECT.

C

A client is newly admitted to an inpatient psychiatric unit. Which assessment data are critical in determining an increased risk for suicide? A. Monitoring the client continually for 1 hour after admission B. Encouraging the client to discuss feelings C. Asking the client about any history of suicide attempts D. Removing hazardous materials from the environment

C

A client is newly committed to an inpatient psychiatric unit. Which nursing intervention best lowers this client's risk for suicide? A. Encouraging participation in the milieu to promote hope B. Developing a strong personal relationship with the client C. Observing the client at intervals determined by assessed data D. Encouraging and redirecting the client to concentrate on happier times

C

A client who is learning about electroconvulsive therapy (ECT) treatment asks a nurse "Isn't this treatment dangerous?" Which is the most appropriate nursing reply? A. "No, this treatment is side-effect free." B. "There can be temporary paralysis but full functioning returns within 3 hours of treatment." C. "There are some risks, but a thorough examination will determine your candidacy for ECT." D. "Transient ischemic attacks (TIA) can occur but are rare."

C

A client with cognitive deficits is extremely suicidal. The client has not responded to antidepressants and the treatment team is considering electroconvulsive therapy (ECT). What client information would determine the feasibility of this treatment option? A. Because the client is extremely suicidal, ECT is an appropriate option. B. Because antidepressant medications have been ineffective, ECT is a good alternative. C. Because informed consent is required for ECT, cognitive deficits preclude this option. D. Because of the client's cognitive deficits, a signed consent is waived.

C

A morbidly obese client is prescribed an anorexiant medication. The nurse should prepare to teach the client about which medication? A. Diazepam (Valium) B. Dexfenfluramine (Redux) C. Sibutramine (Meridia) D. Pemoline (Cylert)

C

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

C

A nurse administers pure oxygen to a client during and after electroconvulsive therapy treatment. What is the nurse's 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

C

A 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 exam? A. To rule out bipolar disorder B. To rule out schizophrenia C. To rule out senile dementia D. To rule out a personality disorder

C

A nurse moving out of state speaks to a client about the need to work with a new nurse. The client states, "You're the only one who can make me well." What does this client response indicate to the nurse? A. The client is using manipulation to receive secondary gain. B. The client is using the defense mechanism of denial. C. The client is having trouble terminating the relationship. D. The client is using "splitting" as a way to remain dependent on the nurse.

C

A nurse responsible for conducting group therapy on an eating disorder unit schedules the sessions immediately after meals. Which is the rationale for scheduling group therapy at this time? A. To shift the clients' focus from food to psychotherapy B. To prevent the use of maladaptive defense mechanisms C. To promote the processing of anxiety associated with eating D. To focus on weight control mechanisms and food preparation

C

As the client and nurse move from the orientation stage to the working stage of the therapeutic relationship, which is the nurse's most therapeutic statement? A. "I want to assure you that I will maintain your confidentiality." B. "A long-term goal for someone your age would be to develop better job skills." C. "Which identified problems would you like for us to initially address?" D. "I think first we need to focus on your relationship issues."

C

Family dynamics are thought to be a major influence in the development of anorexia nervosa. Which information related to a client's home environment should a nurse associate with the development of this disorder? A. The home environment maintains loose personal boundaries. B. The home environment places an overemphasis on food. C. The home environment is overprotective and demands perfection. D. The home environment condones corporal punishment.

C

When a community health nurse arrives at the home of a client diagnosed with bulimia nervosa, the nurse finds the client on the floor unconscious. The client has a history of using laxatives for purging. To what would the nurse attribute this client's symptoms? A. Increased creatinine and blood urea nitrogen (BUN) levels B. Abnormal electroencephalogram (EEG) C. Metabolic acidosis D. Metabolic alkalosis

C

Which client data indicate that a suicidal client is participating in a plan for safety? A. Compliance with antidepressant therapy B. A mood rating of 9/10 C. Disclosing a plan for suicide to staff D. Expressing feelings of hopelessness to nurse

C

Which client statement indicates that termination of the therapeutic nurse-client relationship has been handled successfully? A. "I know I can count on you for continued support." B. "I am looking forward to discharge, but I am surprised that we will no longer work together." C. "Reviewing the changes that have happened during our time together has helped me put things in perspective." D. "I don't know how comfortable I will feel when talking to someone else."

C

A client diagnosed with seasonal affective disorder (SAD) states, "I've been feeling 'down' for 3 months. Will I ever feel like myself again?" Which reply by the nurse will best assess this client's symptoms. A. "Have you been diagnosed with any physical disorder within the last 3 months?" B. "Have you experienced any traumatic events that triggered this mood change?" C. "People who have seasonal mood changes often feel better when spring comes." D. "Help me understand what you mean when you say, 'feeling down'?"

D

A 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? A. Paroxetine (Paxil) B. Sertraline (Zoloft) C. Citalopram (Celexa) D. Fluoxetine (Prozac)

D

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. "50% to 80% of all people who kill themselves have a history of a previous attempt."

D

A potential Olympic figure skater collapses during practice and is hospitalized for severe malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects the underlying etiology of this disorder? A. "Skaters need to be thin to improve their daily performance." B. "All the skaters on the team are following an approved 1,200-calorie diet." C. "When I lose skating competitions, I also lose my appetite." D. "I am angry at my mother. I can only get her approval when I win competitions."

D

A suicidal client says to a nurse, "There's nothing to live for anymore." Which is the most appropriate nursing reply? A. "Why don't you consider doing volunteer work in a homeless shelter." B. "Let's discuss the negative aspects of your life." C. "Things will look better in the morning." D. "It sounds like you are feeling pretty hopeless."

D

According to Peplau, which nursing action demonstrates the nurse's role as a resource person? A. The nurse balances a safe therapeutic environment to increase the client's sense of belonging. B. The nurse holds a group meeting with the clients on the unit to discuss common feelings about mental illness. C. The nurse monitors the administration of medications and watches for signs of "cheeking." D. The nurse explains, in language the client can understand, information related to the client's health care.

D

The family of a suicidal client is very supportive and requests more facts related to caring for their family member after discharge. Which information should the nurse provide? A. Address only serious suicide threats to avoid the possibility of secondary gain. B. Promote trust by verbalizing a promise to keep suicide attempt information within the family. C. Offer a private environment to provide needed time alone at least once a day. D. Be available to actively listen, support, and accept feelings.

D

When is self-disclosure by the nurse appropriate in a therapeutic nurse-client relationship? A. When it is judged that the information may benefit the nurse and client B. When the nurse has a duty to warn C. When the nurse feels emotionally indebted toward the client D. When it is judged that the information may benefit the client

D

Why are behavior modification programs the treatment of choice for clients diagnosed with eating disorders? A. These programs help clients correct distorted body image. B. These programs address underlying client anger. C. These programs help clients manage uncontrollable behaviors. D. These programs allow clients to maintain control.

D