Psych Final Exam
Which statement shows a nurse has empathy for a patient who made a suicide attempt? a. "You must have been very upset when you tried to hurt yourself" b. "It makes me sad to see you going through such a difficult experience" c. " If you tell me what is troubling you, I can help you solve your problems." d. "Suicide is a drastic solution to a problem that may not be such a serious matter."
a
A women just received notification that her husband died. She approaches the nurse who cared for him during his last hours and says angrily, "If you had given him your undivided attention, he would still be alive." Which analysis applies? a. The comment warns of a malpractice suit b. Anger is a phenomenon experienced during grief c. The wife had conflicted feelings about her husband d. In some cultures, grief is expressed solely through anger
b
An adult diagnosed with schizophrenia lives with elderly parents. The client was recently hospitalized with acute psychosis. One parent is very anxious , and the other is ill because of the stress. Which nursing diagnosis is most applicable to this scenario? a. Ineffective family coping related to parental role conflict b. Caregiver role strain related to the stress of chronic illness c. Impaired parenting related to client's repeated hospitalization d. Interrupted family processes related to relapse of acute psychosis
b
An adult with a history of mental illness is hospitalized with pneumonia. The client and family are very anxious. What is the best outcome to add to the plan of care for this family? a. Describe the stages of anticipatory grieving process b. Identify and describe effective methods for coping with anxiety c. Recognize ways dysfunctional communication is expressed in the family d. Examine previously unexpressed feelings related to the client's sexuality
b
An advanced practice nurse observes a novice nurse expressing irritability regarding a patient with a long history of alcoholism and suspects the new nurse is experiencing countertransference. Which comment by the new nurse confirms this suspicion? a. "This patient continues to deny problems resulting from drinking." b. "My parents were alcoholics and often neglected our family." c. "The patient cannot identify any goals for improvement." d. "The patient said I have many traits like her mother."
b
An older male client has been treated for episodic pruritus and skin eruptions for over 2 years. This client tells the nurse, "When my skin gets better for a few days, I start worrying that it's going to start itching again soon. I think my worry may actually trigger the problems to start all over again." Which self-help technique should the nurse consider suggesting for this client? a. Melatonin b. Meditation c. Purification d. Acupuncture
b
Chapter 14: What is the focus of priority nursing intervention for the period immediately after electroconvulsive therapy (ECT) treatment? a. Nutrition and hydration b. Supporting physiological stability c. Reducing disorientation and confusion d. Assisting the client to identify and test negative thoughts
b
Chapter 15: A women is 5'7, 160 lbs, and wears a size 8 shoe. She says, "My feet are huge, I've asked three orthopedists to surgically reduce my feet." This person tries to buy shoes to make her feet look smaller and , in social settings, conceals both feet under a table or chair. Which health problem is likely? a. Social anxiety disorder b. Body dysmorphic disorder c. Separation anxiety disorder d. Obsessive-compulsive disorder due to a medical condition
b
Chapter 29: A nurse interviews a patient abducted and raped at gunpoint by an unknown assailant. The patient says, "I shouldn't have been there alone. I knew it was a dangerous area." What is the patient's present coping strategy? a. Projection b. Self-blame c. Suppression d. Rationalization
b
Chapter 31: A student nurse visiting a senior center says, "It's depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion." The student is expressing what bias? a. Reality b. Ageism c. Empathy d. Vulnerability
b
Chapter 36: A client tells the nurse, "I've been having problems getting a good night's sleep, I read some information on the Internet and started taking kava." What is the nurse's priority response? a. "The internet does not have reliable health information for consumers" b. "The food and drug administration warned against using it due to the link to severe liver damage" c. "Melatonin has been shown to have better effects for treating sleep disturbances" d. "Your sleep disturbances are related to your problems with anxiety. Herbs will not help"
b
Chapter 6: A nurse finds a psychiatric advanced directive in the medical record of a client currently experiencing psychosis. The directive was executed during a period when the client was stable and competent. What is the appropriate nursing action? a. Review the directive with the client to ensure it is current b. Ensure that the directive is respected in the treatment plan c. Consider the directive only if there is a cardiac or respiratory arrest d. Encourage the client to revise the directive in light of the current health problem
b
Chapter 7: A new staff nurse completes an orientation to the psychiatric unit. This nurse will expect to ask an advanced practice nurse to perform which action for clients? a. Perform mental health assessment interviews b. Prescribe psychotropic medication c. Establish therapeutic relationships d. Individualize nursing care plans
b
Chapter 8: A nurse assesses a confused older adult. The nurse experiences and reflects, "This patient is like one of my grandparents.... so helpless." Which response is the nurse demonstrating? a. Transference b. Countertransference c. Catastrophic reaction d. Defensive coping reaction
b
For clients diagnosed with serious mental illness (SMI), what is the major advantage of case management? a. The case manager can modify traditional psychotherapy b. With one coordinator of services, resources can be more efficiently used c. The case manager can focus on social skills, training and esteem building d. Case managers bring groups of clients together to discuss common problems
b
Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says "Our hopes for our child's future are ruined. We probably won't ever have grandchildren." The nurse will use interventions to assist with which likely reaction? a. denial b. Acceptance c. Acting out d. Manipulation
b
What feelings are most commonly experienced by nurses working with abusive families? a. Outrage toward the victim and discouragement regarding the abuser b. Helplessness regarding the victim and anger toward the abuser c. Unconcern for the victim and dislike or the abuser d. Vulnerability for self and empathy with the abuser
b
When a nurse assesses a family, which family task has the highest priority for healthy family functioning? a. Allocation of family resources b. Physical maintenance and safety c. Maintenance of order and authority d. Reproduction of new family members
b
Which statement about aging provides the best rationale for focused assessment of elderly clients? a. The elderly are usually socially isolated and lonely b. Vision, hearing, touch, taste, and smell decline with age c. The majority of elderly clients have some form of early dementia d. As people age, thinking becomes more rigid and learning is impaired
b
a 15-year-old is hospitalized after a suicide attempt. This adolescent lives with the mother, stepfather, and several siblings. When performing a family assessment, the nurse must first determine information? a. How the family expresses and manages emotion b. Names and relationships of the family's members c. The communication patterns between the client and parents d. The meaning that the client's suicide attempt has for the family members
b
a 75-year-old client comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important? a. Complete a neurological assessment b. Determine whether the client can hear as the nurse speaks c. Suggest that the client lie down in a darkened room for a few minutes d. Administer medication to relieve the client's pain before continuing the assessment
b
Chapter 2: A nurse wants to find information on current evidence-based research, programs, and practices regarding mental illness and addictions. Which resource should the nurse consult? a. American Psychiatric Association b. American Psychological Association c. Clinician's quick guide to interpersonal psychotherapy d. Substance Abuse and Mental Health Services Administration
d
Chapter 30: An adult says to the nurse, "The cancer in my neck spread in only 2 months. I've been cursed my whole life. Maybe if I had been more generous with others..." Considering the stages of grief described by Kubler-Ross, which stage is evident? a. Anger b. Denial c. Depression d. Bargaining
d
Chapter 3: A client asks, "What are neurotransmitters? My doctor said mine are imbalanced." What is the nurse's best response? a. "How do you feel about having imbalanced neurotransmitters?" b. "Neurotransmitters protect us from harmful effects of free radicals." c. " Neurotransmitters are substances we consume that influence memory and mood." d. Neurotransmitters are natural chemicals that pass messages between brain cells."
d
Chapter 5: Which western cultural feature may result in establishing unrealistic outcomes for clients of other cultural groups? a. Interdependence b. Present orientation c. Flexible perception of time d. Direct confrontation to solve problems
d
Four teenagers died in an automobile accident. Six months later, which behavior by the parents best demonstrates acceptance of the tragedy? a. Isolating themselves at home b. Returning immediately to employment c. Forbidding other teens in the household to drive a car d. Creating a scholarship fund at their child's high school
d
Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, "Our child acts so strangely that we don't invite friends to our home. We quit taking vacations. Sometimes we don't get any sleep." Which nursing diagnosis best applies? a. Impaired parenting b. Dysfunctional grieving c. Impaired social interaction d. Interrupted family processes
d
For which client would it be most important for the nurse to urge immediate discontinuation of kava? a. A client with a comorbid diagnosis of cirrhosis b. A client with a comorbid diagnosis of osteoarthritis c. A client with a comorbid diagnosis of multiple sclerosis d. A client with a comorbid diagnosis of back pain
a
The parents of a 15-year-old seek to have this teen declared a delinquent because of excessive drinking, habitually running away, and prostitution. The nurse interviewing the patient should recognize these behaviors often occur in adolescents who a. have been abused. b. are attention seeking. c. have eating disorders. d. are developmentally delayed.
a
What information is most appropriate to obtain during assessment of an older adult diagnosed with health problems? a. Functional ability and emotional status b. Chronological age and sexual function c. Economic status and sources of income d. Developmental history, interests, and activities
a
What is the priority nursing diagnosis for a client diagnosed with antisocial personality disorder who has made threats against staff, ripped art off the walls, and thrown objects? a.. Risk for other-directed violence b. Risk for self-directed violence c. Impaired social interaction d. Ineffective denial
a
When assessing an elderly client, the nurse should complete the Geriatric Depression Scale if the client answers which question affirmatively? a. "Would you say your mood is often sad?" b. "Are you having any trouble with your memory?" c. "Have you noticed an increase in your alcohol use?" d. "Do you often experience moderate to severe pain?"
a
Which documentation of family assessment indicates a healthy and functional family? a. Members provide mutual support b. Power is distributed equally among all members c. Members believe there are specific causes for events d. Under stress, members turn inward and become enmeshed
a
Chapter 24: Which intervention is appropriate for an individual diagnosed with an antisocial personality disorder who frequently manipulates others? a. Refer requests and questions related to care to the case manager b. Encourage the client to discuss feelings of fear and inferiority c. Provide negative reinforcement for acting-out behavior d. Ignore,, rather than confront, inappropriate behavior
a
Chapter 26: While conducting the initial interview with a client in crisis, the nurse should implement what intervention? a. Speak in short, concise sentences b. Convey a sense of urgency to the client c. Be forthright about time limits of the interview d. Let the client know the nurse controls the interview
a
Chapter 4: In-client hospitalization for persons with mental illness is generally reserved for clients who demonstrate which characteristic? a. Present a clear danger to self or others b. Are noncompliant with medication at home c. Have limited support systems in the community d. Develop new symptoms during the course of an illness
a
A client asks, "What is the major difference between conventional health care and complementary and alternative medicine (CAM)?" The nurse's best reply is that conventional health care a. focuses on what is done to the client, whereas CAM focuses on body-mind interaction with an actively involved client b. Has been tested by research so less regulation is needed, but CAM is religiously based and highly regulated c. Is controlled by the health care industry, but CAM is the people's medicine and not motivated by profit d. Is holistic and focused on health promotion, whereas CAM treats illness and is symptom specific
a
A client asks, "What is the purpose of having advanced directives?" What is the nurse's best response? a. It give you control gives your treatment decisions during any illness if you are incapacitated" b. "It can be given only to a relative, usually the next of kin, who has your best interests at heart" c. "It can be used only if you have a terminal illness" d. " The instructions take effect immediately"
a
A client diagnosed with major depressive disorder tells the nurse, "I want to try supplementing my selective serotonin reuptake inhibitor (SSRI) with St. John's wort." Which action should the nurse take first? a. Advise the client of the danger of serotonin syndrome b. Suggest the aromatherapy may produce better results c. Assess the client for depression and risk for suicide d. Suggest the client decreases the antidepressant dose
a
A client reports good results from taking an herb to manage migraine headache pain. The nurse confirms there are no hazardous interactions between the herb and the client's current prescription drugs. What is the nurse's best comment to the client? a. "Thanks for telling me. I'll make a note in your medical record that you take it" b. "You are experiencing a placebo effect. When we believe something will help, it usually does c. "Self-management of health problems can be dangerous. You should have notified me sooner" d. "Research studies show that herbals actually increase migraine pain by inflaming nerve cells in the brain"
a
A client who was responding to auditory hallucinations earlier in the morning now approaches the nurse shaking a fist and shouts, "Back off!" and then goes to the dayroom. While following the client into the dayroom, the nurse should take what precaution? a. make sure there is adequate physical space between the nurse and client b. move into a position that places the client close the door c. maintain one arm's length distance from the client d. begin talking to the client about appropriate behavior
a
A newly admitted client diagnosed with major depressive disorder has gained 20 pounds in one month, has chronic low self-esteem, and a plan for suicide. The client has taken antidepressant medication for 1 week. Which nursing intervention has the highest priority? a. Implement suicide precautions b. Offer high-calorie snacks and fluids frequently c. Assist the client to identify three personal strengths d. Observe client for therapeutic effects of antidepressant medication
a
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include? a. Pain assessment techniques for older adults b. Psychosocial stimulation for those who live alone c. Preparation of psychiatric advance directives in the elderly d. Ways to manage disinhibition in elderly persons with dementia
a
A nurse uses Maslow's hierarchy of needs to plan care for a client diagnosed with mental illness. Which problem will receive priority? a. Refusal to eat or bathe b. Reporting feelings of alienation from family c. Reluctance to participate in unit social activities d. Being unaware of medication action and side effects
a
A physically frail elderly client with mild cognitive impairments needs services of a facility that can provide supervision and safety as well as recreation and social interaction. The family cares for this client during the evening and night. Which type of facility should the nurse suggest to meet the client's needs? a. Adult day care program b. Skilled nursing facility c. Partial hospitalization d. Group home
a
A psychiatric nurse leads a medication education group for Hispanic clients. This nurse holds a Western worldview and uses pamphlets as teaching tools. Groups are short and concise. After the group, the clients are most likely to believe? a. The nurse was uncaring b. The session was effective c. The teaching was efficient d. They were treated respectfully
a
A rape victim says to the nurse, "I always try to be so careful, I know I should have not walked to my car alone. Was this attack my fault?" Which communication by the nurse is most therapeutic? a. Support the victim to separate issues of vulnerability from blame b. Emphasize the importance of using a buddy system in public places c. Reassure the victim that the outcome of the situation will be positive d. Pose questions about the rape and help the patient explore why it happened
a
An elderly client must be physically restrained. Who is responsible for the client's safety? a. The nurse assigned to care for the client b. Unlicensed assistive personnel who apply the restraint c. Family member who agrees to application of the restraint d. Health care provider who prescribed application of restraint
a
A client comes to the crisis center saying, "I'm in a terrible situation. I don't know what to do." The triage nurse can initially assume that the client is experiencing what response? a. Suicidal ideations b. Anxiety and fear c. Misperceived reality d. Potential homicidal thoughts
b
A client had a venous thrombosis 3 weeks ago and is now taking warfarin. When visiting the laboratory to have a prothrombin time drawn, the client reports drinking ginseng tea to stimulate the immune system. Which nursing diagnosis applies? a. Impaired memory related to neurological changes b. Deficient knowledge related to potentially harmful drug interactions c. Ineffective denial related to consequences of mismanagement of therapeutic regime d. Effective management of the therapeutic regime related to augmentation of anticoagulant therapy
b
A client has tried a variety of complementary and alternative medicine (CAM) approaches to manage health concerns. The nurse asks, "How is going to CAM practitioners different from seeing your medical doctors?" What is the client most likely response? a. "The CAM practitioners usually prescribe a course of invasive and sometimes painful treatments" b. The CAM practitioners spend more time talking with me and not just about my symptoms" c. "The CAM practitioners say I need to become much more spiritual to be well" d. "The CAM practitioners order many tests to determine my diagnoses"
b
A client says, "I have taken mega doses of vitamins for 3 months to improve my circulation, but I think I feel worse." Which action should the nurse take first? a. Explain to the client that vitamin mega doses may be harmful and advise caution b. Assess the client for symptoms and signs of toxicity from excess vitamin exposure c. Assess for signs of circulatory integrity to determine whether improvement has occurred d. Educate the client that research has not shown that megavitamin therapy produces benefits
b
A client tells the nurse, "I get sick so much, so I started taking ginseng to boost my immune system." The client's only other medication is warfarin daily. Which potential complication should be included in the nursing assessment? a. Gastrointestinal distress b. Spontaneous bleeding c. Thromboembolism d. Drowsiness
b
A nurse interviews a homeless parent with two teenage children. To best assess the family's use of resources, the nurse should ask which question? a. "Can you describe a problem your family has successfully resolved?" b "What community agencies have you found helpful in the past?" c. "What aspect of being homeless is most frightening for you?" d. "Do you feel you have adequate resources to survive?"
b
A nurse interviews a homeless parent with two teenage children. To best assess the family's use of resources, the nurse should ask which question? a. "Can you describe a problem your family has successfully resolved?" b. "What community agencies have you found helpful in the past?" c. "What aspect of being homeless is most frightening for you?" d. "Do you feel you have adequate resources to survive?"
b
A nurse prepares to administer a scheduled intramuscular (IM) injection of an antipsychotic medication to an out-patient diagnosed with schizophrenia. As the nurse swabs the site, the client shouts, "Stop! I don't want to take that medication anymore. I hate the side effects." What is the nurse's best action? a. Assemble other staff for a show of force and proceed with the injection, using restraint if necessary b. Stop the medication administration procedure and say to the client, "tell me more about the side effects you have been having" c. Proceed with the injection but explain to the client that there are medications that will help reduce the unpleasant side effects d. Say to the client, "since I have already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about delaying the next months dose."
b
A nurse receives these three phone calls regarding a newly admitted client. The psychiatrist wants to complete an initial assessment, an internist wants to perform a physical examination, and the clients attorney wants an appointment with the client. The nurse schedules the activities for the client. Which role has the nurse fulfilled? a. Advocate b. Case manager c. Milieu manager d. Provider of care
b
A parent is admitted to a unit for treatment of addictions. The client's spouse and adolescent children attend a family session. Which initial assessment question should the nurse ask of family members? a. "What changes are most important to you?" b. "How are feelings expressed in your family?" c. "What types of family education would benefit your family?" d. "Can you identify a long-term goal for improved functioning?"
b
A parent is admitted to a unit for treatment of addictions. The patient's spouse and adolescent children participate in a family session. What is the most important aspect of this family's assessment? a. Spouse's codependent behaviors b. Interactions among family members c. Patient's reaction to the family's anger d. Children's responses to the family sessions
b
A primary health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2g sodium diet, restraint as needed, limit fluids to 180 mL daily, continue antihypertensive medication, milk of magnesia in 30mL PO once if no bowel movement for 3 days. The nurse should implement what action regarding these prescriptions? a. Implement the fluid restriction b. Question the order for restraint c. Transcribe the prescriptions as written d. Assess the resident's bowel elimination
b
A client diagnosed with depression confidently tells the nurse, "I've been supplementing my prescribed antidepressants with St. John's wort. It has helped a great deal." What is the nurse's priority action? a. Assess changes in the client's level of depression b. Remind the client to use a secondary form of birth control c. Educate the client about the risks of selective serotonin syndrome d. Suggest adding valerian to the treatment regimen to further improve results
c
A client is pacing the hall near the nurses' station, swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and to make what statement? a. " What is going on?" b. "Please be quiet and sit down in this chair immediately?" c. "I'd like to talk with you about how you're feeling right now?" d. "You must go to your room and try to get control of yourself."
c
A client shows a nurse to respond to this advertisement: "Our product is a scientific breakthrough helpful for depression, anxiety, and sleeplessness. Made from an ancient formula, it stimulates circulation and excretes toxins. Satisfaction guaranteed or your money back." What is the nurse's best response? a. "Over-the-counter products for sleep problems are ineffective" b. "Do not take anything unless it's prescribed by your doctor" c. "Let's do some additional investigation on that product" d. "It sounds like you are trying to self-medicate"
c
A client tells the nurse, "I prefer to treat my physical problems with herbs and vitamins. They are natural substances, and natural products are safe." Which response by the nurse would be most appropriate? a. "Natural substances tend to be safer than conventional medical remedies." b. "Natural remedies give you the idea that you are controlling your treatment." c. "The word natural can be a marketing term used imply a product is healthy, but that's not always true." d. "You should not treat your own physical problems. You should see your health care provider for these problems."
c
A client was hospitalized for 24 hours after a reaction to a psychotropic medication. While planning discharge, the case manager learned that the client received a notice of eviction immediately prior to admission. What is the case manager's most appropriate action? a. Postpone the client's discharge from the hospital b. Contact the landlord who evicted the client to further discuss the situation c. Arrange a temporary place for the client to stay until new housing can be arranged d. Determine whether the adverse medication reaction was genuine because the client had nowhere to live
c
A married couple has two children living in the home. Recently, the wife's mother moved in. This family should be identified using what term? a. Nuclear b. Blended c. Extended d. Alternative
c
A new nurse asks the nurse manager, "My elderly client's CT scan of the head shows many Lewy bodies are present. What should I do about assessing for pain?" What is the best response from the nurse manager? a. "Ask the client's family if they think the client is experiencing pain" b. "Use a visual analog scale to help the client determine the presence and severity of pain" c. "There are special scales for assessing clients with dementia. Let's review how to use them" d. " The perception of pain is diminished by this type of dementia. Focus your assessment on the client's mental status"
c
A newly admitted client diagnosed with major depressive disorder has gained 20 pounds over a few months and has suicidal ideations. The client has taken antidepressant medication for 1 week without remission of symptoms. What is the priority nursing diagnosis? a. Imbalanced nutrition: more than body requirements b. Chronic low self-esteem c. Risk for suicide d. Hopelessness
c
Acupuncture is a traditional Chinese medical treatment based on what belief? a. Insertion of needles in key locations will drain toxic energies b. Pressure on meridian points will correct problems in energy flow c. Insertion of needles modulates the flow of energy along body meridians d. Taking small doses of noxious substances will alleviate specific symptoms
c
After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference? a. The patient's reactions toward the nurse seem realistic and appropriate. b. The patient states, "Talking to you feels like talking to my parents." c. The nurse feels unusually happy when the patient's mood begins to lift. d. The nurse develops a trusting relationship with the patient.
c
An advance directive gives legally binding direction for health care interventions when a client presents with what scenario? a. has a new diagnosis of cancer b. is diagnosed with Parkinson's disease c. is unable to make decisions for self because of illness d. diagnosed with amyotrophic lateral sclerosis is unable to speak
c
Chapter 28: An 11-year-old reluctantly tells the nurse - my parents don't like me. They said they wish I was never born-. Which type of abuse is likely? a. Sexual b. Physical c Emotional d. Economic
c
Chapter 32: Which service would be expected to provide resources 24 hours a day, 7 days a week if needed for persons with serious mental illness (SMI)? a. Clubhouse model b. Cognitive-behavioral therapy (CBT) c. Assertive community treatment (ACT) d. Cognitive enhancement treatment (CET)
c
Chapter 35: A married couple has two biological children who live with them as well as a child from the wife's first marriage. What type of family is evident? a. Homogenous b. Extended c. Blended d. Nuclear
c
Consider this comment to three different nurses by a client with an antisocial personality disorder, "Another nurse said you don't do your job right." Collectively, these interactions can be documented using which term? a. Seductive b. Detached c. Manipulative d. Guilt-producing
c
Operant conditioning is part of the treatment plan to encourage speech in a child who is nearly mute. Which technique applies? a. Encourage the child to observe others talking b. Include the child in small group activities c. Give the child a small treat for speaking d. Teach the child relaxation techniques
c
The unit secretary receives a phone call from the health insurer for a hospitalized client. The caller seeks information about the client's projected length of stay. How should the nurse instruct the unit secretary to handle the request? a. Obtain the information from the client's medical record and relay it to the caller b. Inform the caller that all information about clients is confidential c. Refer the request for information to the client's case manager d. Refer the request to the health care provider
c
What is an appropriate initial outcome for a client diagnosed with a personality disorder who frequently manipulates others? a. The client will identify when feeling angry b. The client will use manipulation only to get legitimate needs met c. The client will acknowledge manipulative behavior when it is called to his or her attention d. The client will accept fulfillment of his or her requests within an hour rather than immediately
c
When a client diagnosed with a personality disorder uses manipulation to get needs met, the staff applies limit-setting interventions. What is the correct rationale for this action? a. It provides an outlet for feelings of anger and frustration b. It respects the client's wishes, so assertiveness will develop c. External controls are necessary due to failure of internal control d. Anxiety is reduced when staff assumes responsibility for the client's behavior
c
Which behavior demonstrated by that a client diagnosed with an antisocial personality disorder most clearly warrants limit settings? a. Flattering the nurse b. Lying to other clients c. Verbal abuse of another client d. Detached superficiality during counseling
c
Which client would most likely benefit from taking St. John's wort? a. A client with mood swings b. A client with hypomanic symptoms c. A client with mild depressive symptoms d. A client with panic disorder with agoraphobia
c
Which comment best indicates that a patient perceived the nurse was caring? "My nurse: a. always asks me which type of juice I want to help me swallow my medication." b. explained my treatment plan to me and asked for my ideas about how to make it better." c. spends time listening to me talk about my problems. That helps me feel like I am not alone." d. told me that if I take all the medicines the doctor prescribes, then I will get discharged sooner."
c
Which complementary and alternative therapy may be safely combined with traditional Western Medicine in the treatment of anxiety disorder? a. Electroconvulsive therapy b. Mega doses of vitamins c. Meditative practices d. Herbal therapy
c
Which individual diagnosed with mental illness may need involuntary hospitalization? An individual a. The individual who has panic attack after her child gets lost in a shopping mall b. The individual with visions of demons emerging from cemetery pots throughout the community c. The individual who takes 38 acetaminophen tablets after the person's stock portfolio becomes worthless d. The individual diagnosed with major depression who stops taking prescribed antidepressant medication
c
A client wants to learn more about integrative therapies. Which response should the nurse suggest for the most reliable information? a. Internet b. American Nurses Association c. Food and Drug Administration d. National Center for Complementary and Integrative Health
d
A client with a history of asthma says, "I've been very nervous lately. I think aromatherapy will help. I am ordering $250 worth of oils from an Internet site that promised swift results." What is the nurse's best action? a. Support the client's efforts to become informed and to find health solutions b. Suggest the client check with friends who have tried aromatherapy for treatment of anxiety c. Remind the client, "If you spend that much on oils, you may not be able to buy your prescribed medication" d. Tell the client, "Aromatherapy can complicate respiratory problems such as asthma. Let's consider some other options"
d
A client's spouse filed charges after repeatedly being battered. Which statement by this person supports an antisocial personality disorder? a. "I have a quick temper, but I can usually keep it under control." b. "I've done some stupid things in my life, but I've learned a lesson." c. "I'm feeling terrible about the way my behavior has hurt my family." d. "I hit because I am tired of being nagged. My spouse deserves the beating."
d
A rape victim tells the nurse, "I should not have been out on the street alone." Select the nurse's most therapeutic response. a. "Rape can happen anywhere" b. "Blaming yourself increases your anxiety and discomfort c. "You are right. You should not have been aloe on the street at night" d. "You feel as though this would have not happened if you had not been alone"
d
A widower tells friends, "I am taking my neighbor out for dinner. It's time for me to be more sociable again." Considering the stages of grief described by Kubler-Ross, which stage is evident? a. Anger b. Denial c. Depression d. Acceptance
d
After a spouse's death, an adult repeatedly says, "I should have recognized what was happening and been more helpful." This adult is experiencing a. depression. b. bargaining. c. anger. d. guilt.
d
Chapter 11: The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for which disorder? a. Communication disorder b. Stereotypic movement disorder c. Intellectual developmental disorder d. Attention deficit hyperactivity disorder
d
Chapter 1: A nurse is part of a multidisciplinary team working with groups of depressed clients. One group of clients receives supportive interventions and antidepressant medication. The other group receives only medication. The team measures outcomes for each group. Which type of study is evident? a. Incidence b. Prevalence c. Comorbidity d. Clinical epidemiology
d
Chapter 25: Which individual in the emergency department should be considered at highest risk for completing suicide? a. An adolescent Asian American girl with superior athletic and academic skills who has asthma b. A 38-year-old single, African American female church member with fibrocystic breast disease c. A 60-year-old married Hispanic man with 12 grandchildren who has type 2 diabetes d. A 79-year old single, white male diagnosed recently with terminal cancer of the prostate
d
Chapter 27: A confused older adult client in a skilled nursing facility was asleep when unlicensed assistive personnel (UAP) entered the room quietly and touched the bed to see if it was wet. The client awakened and hit the UAP in the face. Which statement best explains the client's action? a. Older adult clients often demonstrate exaggerations of behaviors used earlier in life b. Crowding in skilled nursing facilities increases an individual's tendency toward violence c. The client learned violent behavior by watching other clients act out d. The client interpreted the UAP's behavior as potentially harmful
d
The parent of an adolescent diagnosed with mental illness asks the nurse, "Why do you want to do a family assessment? My teenager is the client, not the rest of us." What is the nurse's best response? a. "Family dysfunction might have caused the mental illness" b. Family members provide more accurate information than the client" c. "Family assessment is part of the protocol for care of all clients with mental illness" d. "Every family member's perception of events is different and adds to the total picture"
d
What is the best comment for a nurse to begin an interview with an elderly client? a. "I am a nurse. Are you familiar with what nurses do?" b. "Hello I am going to ask you some questions to get to know you better" c. "You look comfortable and ready to participate in an admission interview. Shall we get started?" d. "Hello my name is _______ and I am a nurse. How you would like to be addressed by staff?"
d
What is the best response for the nurse to provide to a question from another health professional regarding the difference between a diagnosis in DSM-V and a nursing diagnosis. a. "There is no functional difference between the two. Both identify human disorders b. "The DSM-V diagnosis disregards culture, whereas the nursing diagnosis takes culture into account c. "The DSM-V diagnosis describes cause of disorders whereas a nursing diagnosis does not explore etiology" d. "The DSM-V diagnosis guides medical treatment, whereas the nursing diagnosis offers a framework for identifying interventions for issues a client is experiencing."
d
Which behavior demonstrated by an individual diagnosed with mental illness may require emergency or involuntary commitment? a. Resuming the use of heroin while still taking naltrexone b. Reports hearing angels playing harps during thunderstorms c. Not keeping an outpatient appointment with the mental health nurse d. Throwing a heavy plate at a waiter at the direction of command hallucinations
d
Which client meets criteria for involuntary hospitalization for psychiatric treatment? a. The client who is noncompliant with the treatment regimen b. The client who fraudulently files for bankruptcy c. The client who sold and distributed illegal drugs d. The client who threatens to harm self and others
d
Which information is the nurse most likely to find when assessing the family of a client with a serious mental illness? a. The family exhibits many characteristics of dysfunctional families b. Several family members have serious problems with their physical health c. Power in the family is maintained in the parental dyad and rarely delegated d. Stress from living with a mentally ill member has challenged the family's function
d
