Psych Modules 1a-5a

A nurse is discussing ageism with a newly licensed nurse. Which of the following statements, by the newly license nurse, indicates understanding?

"Ageism refers to the stereotype that older adults are less intelligent than other age groups."

A nurse is leading a family therapy session. Which of the following statements should the nurse recognize as an example of effective communication among family members?

"Can you tell me the reason you get upset each time I go to the mall?"

A nurse is caring for a client who has schizophrenia. Which of the following client statements indicates concrete thinking?

"I am aware that each problem has only one solution."

A nurse is caring for a client who has a history of alcohol abuse and has been hospitalized following a drinking binge. The nurse enters the room and finds the client shouting in a terrified voice, "Get these bugs off of me!" Which of the following responses by the nurse is appropriate?

"I don't see any bugs, but you seem very frightened."

A nurse is counseling a group of clients at an outpatient mental health clinic. Which of the following client statements indicates a problem with role transition?

"I just can't seem to find any energy to take care of my children since my husband divorced me."

A nurse attending a group therapy session is listening to clients discuss coping strategies. Which of the following statements by clients indicate adaptive coping? (select all that apply):

"I see the glass as half-full when it starts looking empty." "I think about being on my favorite beach vacation." "I call a friend who makes me smile and laugh." "I tense and release my muscles, starting with my feet."

A nurse is teaching a client who has depression about a new prescription for fluoxetine (Prozac). Which of the following statements by the clients indicates understanding of the teaching?

"I should watch my diet to prevent unexpected weight gain."

A nurse is discussing stress management techniques with a group of clients. Which of the following techniques mentioned by a client should the nurse recognize as the least effective?

"I watch TV when I get anxious."

A nurse is caring for a client who is depressed and refuses to participate in group therapy, or perform ADLs. Which of the following nursing statements by the nurse is appropriate?

"I will assist you in getting out of bed and getting dressed."

A client calls the crisis hotline and tells the nurse who answers the phone, "I just took an entire bottle of amitriptyline (Elavil)." Which of the following statements by the nurse is appropriate?

"I'm glad you called, and I want to send an ambulance to help you."

The nurse is caring for a client who was involved in heavy combat and observed war casualties. The nurse suspects that the client is suffering from PTSD when the client states:

"In my dreams, all I can see are the wounded reaching out and trying to grab me."

A nurse is caring for a young adult client who says he is experiencing increasing anxiety and the inability to concentrate. Which of the following is an appropriate response by the nurse?

"It sounds like you're having a difficult time."

A client who is having burn debridement states, "You are the worst nurse I have ever seen. All you do is hurt me." Which of the following responses by the nurse is appropriate?

"Tell me more about that."

A provider diagnoses a client with cancer and advises immediate chemotherapy. The client tells the nurse that she wants to try nontraditional treatments first. Which of the following is an appropriate nursing response?

"Tell me more about your concerns about taking chemotherapy."

A nurse is discussing confidentiality with a newly license nurse. Which of the following statements by the newly licensed nurse indicates an understanding?

"The courts may require me to discuss confidential information."

A nurse is caring for a client who has been diagnosed with end-stage liver cancer. Which of the following client responses is an indication the client is in the denial phase of the grief process?

"The doctor says I only have a few months to live, but I know he is exaggerating to to get me to take my medication"

A nurse is caring for a client who is diagnosed with depression. The client's spouse asks the nurse about possible side effects of electroconvulsive therapy (ECT). After explaining that ECT will not cause brain damage, what additional information should the nurse offer?

"The main side effects are temporary, and may include mild confusion, a slight headache, and short-term memory problems."

A nurse is teaching the family of a client who has a diagnosis of dementia. Which of the following statements is appropriate to include in the teaching?

"The signs of dementia are progressive and irreversible."

A nurse is providing teaching for a client who has a new prescription for clozapine (Clozaril). Which of the following client statements indicates a need for further teaching?

"This medication will help prevent seizures."

A nurse is caring for a client who is receiving chlorpromazine (Thorazine) and is give na pass to attend a family outing on a sunny day. Which of the following is the most important for the nurse to include in the client's teaching about the side effects of Thorazine?

"Wear a hat and a long-sleeved shirt."

A nurse is caring for a client who just learned that she has invasive breast cancer and must start chemotherapy. She tells the nurse she is worried about the side effects of the treatment. Which of the following is an appropriate nursing response?

"What is it about the side effects that worry you?"

A nurse is talking with a client who is discussing important feelings when the time of the session is complete. The next day, when the nurse meets with the client, which of the following statements is appropriate to initiate the interview?

"What would you like to talk about today?"

A male nurse is assigned to care for a female client who was admitted to the hospital following a domestic abuse incident. The client does not want a male nurse as her caregiver. Which of the following responses is appropriate?

"Would you like me to review the assignment and assign a female nurse to care for you?"

A nurse is caring for a client who was admitted to the hospital in critical condition following a cerebrovascular accident. The client's daughter says to the nurse, "I wish I could stay, but I need to go home to see how my children are doing. I really hate to leave." Which of the following responses is the most appropriate for the nurse to give the daughter?

"You are feeling drawn in two separate directions."

A hospitalized client says to the nurse, "My spouse called and told me my boss hired someone to take my place." Which of the following therapeutic responses by the nurse is appropriate?

"You must feel very concerned and disappointed by that information."

A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following statements by the nurse is appropriate?

"You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way."

A nurse is providing medication teaching for a client who has a new prescription for phenelzine (Nardil) a monoamine oxidase inhibitor (MAOI). Which of the following should the nurse include in the teaching?

"You should change positions slowly while taking this medication."

A nurse is caring for a depressed client who attempted suicide. The client tells the nurse, "I should have died because I am totally worthless." The appropriate nursing response is:

"You've been feeling that your life has no meaning." (restating and evaluating the pts feelings)

A nurse is caring for several clients who have mental health disorders at an assisted-living facility. Which of the following clients should the nurse determine needs to be seen by a provider immediately?

A client who is taking clozapine (Clozaril) and has flu like symptoms, fever, and aching joints.

A nurse is performing a mental status exam (MSE) on a client who has a new diagnoses of dementia. Which of the following should the nurse include? (select all that apply)

Affect Grooming Long-term memory

A nurse is performing an admission assessment on a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptoms?

Affective flattening

A nurse is caring for a client who receives a prescription for a benzodiazepine. Which of the following is a contraindication to this medication?

Alcohol abuse (due to the risk for CNS depression)

A nurse is caring for a group of clients in an acute mental health facility. Which of the following clients has the legal right to refuse treatment?

An older adult who was voluntarily admitted.

A nurse is caring for a client who is a resident in a facility designed for the care of clients with Alzheimers disease. The client has been oriented to name and place and is usually cooperative and able to perform ADLs with minimal supervision. When the client refuses to take medications, the nurse should:

Ask the client to express the reasons for refusing the morning medications and document the event.

A nurse is planning care for a client who is being treated for acute PCP intoxication. Which of the following should the nurse include in the plan of care?

Assess for elevation of vital signs

A nurse is conducting a staff education session regarding the manifestations of schizophrenia. Which of the following should the nurse identify as negative symptoms? (select all that apply)

Blunt affect Anhedonia (inability to feel pleasure)

A nurse is caring for a client who receives a new prescription for clozapine (Clozaril). Which of the following is a contraindication to this medication?

Bone marrow depression

A nurse is caring for a client who has schizophrenia. The client states that he hears voices telling him to do "bad things." The nurse correctly identifies this finding as which of the following?

Command hallucination

A nurse in the ED is preparing to care for a client who has signs of alcohol intoxication. Which if the following should the nurse plan to include in the client's care? (Select all that apply)

Contact the laboratory to obtain a blood sample prepare the client for a CT scan Obtain a urine specimen check the client's pupil reactivity

A nurse is caring for a group of clients on a mental health unit. Which of the following actions should the nurse implement?

Demonstrate honesty when communicating.

A nurse is caring for a client in an urgenct care center who has traumatic injuries following an assault. She sits quietly and calmly in the examination room. The nurse should recognize this behavior as which of the following reactions?

Denial

A nurse is performing an admission assessment for a client who is receiving treatment following a situational crisis. Which of the following assessments is the highest priority?

Determining if the client has suicidal thoughts

A nurse is planning discharge teaching for a client who has borderline personality disorder. Which of the following is appropriate for the nurse to include in the teaching?

Dialectical behavior therapy

A nurse in an ED is assessing a client for suspected cocaine intoxication. The nurse should know that which of the following manifestations is consistent with cocaine intoxication?

Dilated pupils

A nurse is assessing a client who has been receiving treatment for schizophrenia with the typical antipsychotic fluphenazine (Prolixin) for 12 months. The nurse observes that the client has fine, fasciculating tongue movements. The nurse correctly associates this finding with which of the following?

Early symptoms of tardive dyskinesia (TD)

A nurse is interviewing a client who has a personality disorder. The client resists discussion of feelings until 5 mins prior to the end of the session. Which of the following is an appropriate intervention?

End just as agreed, but tell the client he can continue at the end of the next scheduled session.

A nurse is caring for a client who is experiencing a crisis related to anxiety. Which of the following interventions are appropriate? (select all that apply.)

Establish rapport with the client Identify the cause of the anxiety Validate the client's feelings

A nurse is caring for a client who has bipolar disorder and is hospitalized for a severe depressive episode. The client has been taking citalopram (Celexa) for 2 weeks and reports sleeping better and having an improved appetite, but the client still feels hopeless. Which of the following is an appropriate action?

Explain that antidepressants often take several weeks to be fully effective.

A nurse is caring for a client who has been hospitalized for treatment of bipolar disorder and will be discharged with a prescription for lithium. The nurse's discharge teaching should include information cautioning against which of the following behaviors that may cause lithium toxicity?

Fasting

A nurse on the psychiatric unit is caring fora client who has moderate anxiety disorder. Which of the following measures should the nurse include in the immediate plan of care?

Foresee anxiety-provoking circumstances

A nurse is collecting a health history on a client who has a diagnosis of Korsakoff's syndrome. Which of the following is an expected finding?

History of chronic alcohol abuse (Korsakoff's is a type of secondary dementia as a result of thiamine deficiency that is commonly associated with chronic alcohol abuse)

A nurse is assessing for the presence of extrapyramidal side effects (EPS) in a client who is taking chlorpromazine (Thorazine). Which of the following findings should the nurse recognize as EPS? (select all that apply)

Impaired gait Muscle contractions of the neck fidgeting behavior

A client who is newly diagnosed with Alzheimer's disease asks how the symptoms will progress. How should the nurse respond? (Put in order of progression)

Inability to find commonly used items Inability to perform common tasks Difficulty with talking or reading Inability to remember family members Difficulty remembering how to swallow

A nurse is planning care for a client following a suicide attempt. Which of the following interventions is appropriate when implementing suicide precautions?

Inspect the client's personal belongings.

A nurse is planning care for a client who has a personality disorder and demonstrates manipulative behavior. Which of the following interventions is appropriate to include in the plan of care?

Institute consequences for manipulative behavior.

A nurse is caring for a client who has bipolar disorder. Which of the following should be recognized as manic behavior? (Select all that apply.)

Interacting with others in a flirtatious way Talking in rapid, continuous speech Spending large sums of money

A nurse is assessing a client who has a diagnosis of conversion disorder. Which of the following is an expected finding?

Involuntary loss of a sensory function

A nurse is caring for a client who has delusional behavior and states, "I can't go to group today. I am expecting a high level official to visit today!" The nurse responds, "I understand, but it is time for group and we expect everyone to attend. Let's walk over together." Why is this nurse's response considered therapeutic?

It clearly articulates what is expected of the client.

A nurse enters the room of a client who becomes verbally abusive. Which of the following actions is appropriate for the nurse to take?

Leave the client's room.

A nurse is planning care for a client who has dementia. Which of the following interventions is appropriate to include in the plan of care?

Limit the client's choices for daily activities.

A nurse is admitting a client with a suspected cognitive disorder. Which of the following inventories should be included as part of the admission assessment?

Mental Status Questionnaire

A nurse is caring for a client who is withdrawing from opioid addiction. Which of the following medications should be included in client care?

Methadone (Dolophine)

A nurse on an acute mental health unit is caring for a client who has depression. Which of the following is the highest priority nursing intervention?

Monitor for risk of self-harm.

A nurse is assessing a client who is receiving treatment with multiple antipsychotic medications. Findings include muscle rigidity, hyperpyrexia, and diaphoresis. The nurse should recognize that which of the following adverse effects may be occurring?

Neuroleptic malignant syndrome (NMS)

A nurse is caring for a client who has a serum lithium level of 2.0 mEq/L. Which of the following is the priority action for the nurse to take?

Notify the primary provider of this toxic blood level.

A nurse is caring for a client who has obsessive-compulsive behavior (OCD). Which of the following actions should the nurse use to handle the client's ritualistic behaviors?

Plan the client's schedule to allow time for rituals.

A nurse is admitting a client to a substance-abuse program. The client states, "This is all my wife and boss' fault." The client's behavior is an example of which of the following defense mechanisms?

Projection

A nurse at a college campus mental health counseling center is caring for a student who just failed an exam. The student spends the session berating the teacher and the course. The nurse should recognize this behavior as an example of the defense mechanism of:

Projection (pt refuses to acknowledge unacceptable personal characteristics and transfers feelings, thoughts, or traits onto another person)

A nurse in an acute mental health facility is creating a plan of care for a new client who has histrionic personality disorder. Which of the following is the priority intervention?

Promote appropriate behavior during group therapy sessions

A nurse is planning care for a group of clients on a mental health unit. Which of the following indicates understanding of a therapeutic environment?

Provide continuity of care by assigning the same staff.

A nurse is discussing legal exceptions to client confidentiality with nursing staff. Which of the following statements indicates an understanding?

Providers are required to warn individuals if the client threatens harm.

A nurse in a drug and alcohol detoxification center is caring for a client who has a long history of alcohol abuse. Which of the following should be the nurse's primary focus of care during the early phase of alcohol withdrawal?

Providing adequate hydration and rest.

A nurse in the ED is implementing a plan of care for a client who has delirium tremens. Which of the following actions should the nurse perform first?

Raise the bed side rails.

A nurse on a mental health unit is caring for clients who have the following depressive disorders. The nurse should identify which of the following diagnoses as presenting the greatest risk for suicide?

Recurrent brief depression

A nurse is counseling a client for the management of anxiety. The client is consistently late for appointments and ignores household chores. The client states, "I'm just too stressed. I need to be taken care of." The nurse identifies this behavior as an example of which of the following defense mechanisms?

Regression (reverting to childlike or immature behaviors)

A nurse on an inpatient mental health unit is admitting a client who has panic-level anxiety. After showing the client to his room, which of the following nursing actions is most therapeutic at this time?

Remain with the client in his room.

A nurse is caring for a client who was admitted with acute psychosis and is being treated with haloperidol (Haldol). The nurse should suspect the client may be experiencing tardive dyskinesia as an adverse reaction when the client exhibits which of the following? (Select all that apply)

Repetitive involuntary movements Facial grimacing and eye blinking tongue thrusting and lip smacking

A nurse on an inpatient mental health unit is caring for a client who has major depressive disorder and malnutrition. Which of the following is an appropriate nursing intervention for helping this client at this time?

Sit with the client during meals and snacks.

A nurse is caring for a young adult client following the death of his wife due to a sudden aneurysm. The client feels paralyzed in his ability to cope with work and family responsibilities. The type of crisis the student is experiencing is:

Situational

A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which of the following nursing approaches is therapeutic to include in the client's plan of care?

Spending time with the client

A nurse is providing a community health education class about suicide prevention. Which of the following should the nurse identify as risk factors? (Select all that apply)

Substance Abuse Age greater than 45 years old Schizophrenia

A nurse on an inpatient mental health unit is admitting a client who reports feeling depressed, sad, moody, and overly anxious. Which of the following is the nurse's assessment priority?

Suicide risk

A physical indicator of possible abuse in a battered woman would be a fracture of the distal bones, such as the skull, face, or extremities. A nurse is discussing factors to include in an abuse assessment with nursing staff. Which of the following should be included in the assessment? (select all that apply)

Suicide risk Coping patterns support systems alcohol use

A nurse is providing teaching for a client who has a new prescription for clozapine (Clozaril). When discussing adverse effects, which of the following should the nurse state is the most common?

Tachycardia

A client is admitted with PTSD following a fire. Which of the following should the nurse recognize as an adaptive defense mechanism?

The client begins reading a book when he experiences hand tremors in response to loud noise. (temporarily blocking memories and perceptions from conscious thought)

A nurse in an addiction rehabilitation center is planning care for a new client with a long-standing history of alcohol abuse. Which of the following goals is of the highest priority?

The client's withdrawal from alcohol will be managed without complications

A nurse is caring for a client who has generalized anxiety disorder on the mental health unit. The client received a telephone call that was upsetting and now the client is pacing up and down the corridors of the unit. Which of the following interventions is appropriate for the nurse to take?

Walk with the client at a gradually slower pace.

A nurse is caring for a client who has bipolar disorder and is in the manic phase. The client says he is bored. Which of the following activities is appropriate for the nurse to suggest to this client?

Walking with the nurse in the courtyard.

A nurse is caring for a client who has been prescribed lithium carbonate (Eskalith) for the treatment of bipolar disorder. Which of the following should the nurse include in her teaching with the client and family regarding this medication?

You will need to stop this medication if you experience diarrhea, vomiting, and/or excessive sweating

A nurse in a hospital is caring for a client who has agoraphobia. The nurse should evaluate that the client is making progress when the client is able to attend:

a picnic in a local park.

A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following signs and symptoms should the nurse expect to find during the assessment?

anxiety and diaphoresis

A nurse in the ED is caring for a rape survivor. Which of the following people will provide the most effective support if the client confides in the individual immediately following the incident?

close friend

A nurse is teaching a community education course about the physical complications related to substance abuse. Which of the following should the nurse include in the discussion about heroin?

dental caries

A nurse is caring for a client who was admitted with delirium tremens five days ago. The client seeks permission from the nurse before performing activities of daily living. This action indicates that the client

is exhibiting dependency

A nurse is assessing a parent who lost a 12-year old child in a traffic accident 2 years prior to the visit. The nurse evaluates that the client is is showing manifestations of dysfunctional grieving if the parent:

leaves the child's room exactly as it was before the loss.

A nurse is caring for an older adult client who has dementia and handles anxiety by confabulating. The nurse should recognize this when the client:

makes up stories when unable to remember actual events.

A nurse in an ED is caring for a client who has been taking haloperidol (Haldol) for the past 3 months. The client has a temp of 38.9 (102), a blood pressure of 150/110, and is tachycardic. The nurse should know that these manifestations indicate a diagnosis of

neuroleptic malignant syndrome (NMS)

A nurse is assessing a client who is experiencing alcohol withdrawal delirium. Which of the following is an expected finding? (select all that apply)

paranoid delusions tremors visual hallucinations

A nurse is providing a staff education session about how to decrease the risk for injury when working with clients who have a history of anger and aggression. Which of the following should the nurse include in the teaching? (select all that apply)

provide immediate and verbal feedback for escalating behavior avoid wearing necklaces during client care know the layout of the facility

A nurse is caring for a client who reports acute anxiety. Which of the following is the priority nursing action?

remain with the client.