Psychosocial nursing exam 2

a nurse is planning care for a client who has body dysmorphic disorder. Which of the following actions should the nurse plan to take first? a. assessing the clients risk for self harm b. instilling hope for positive outcomes c. encouraging the client to participate in group therapy sessions d. encouraging the client to participate in treatment decisions

A. assessing the clients risk for self harm

a nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following actions is the nurses priority? a. placing the client on one to one observation b. assisting the client to perform ADLs c. encouraging the client to participate in counseling d. teaching the client about medication adverse effects

A. placing the client on one to one observation

A patient is diagnosed with an abscess in the cerebellum. Which nursing diagnosis has priority for the plan of care? a. risk for falls related to loss of balance and equilibrium b. unilateral neglect related to impairments to perception c. impaired physical mobility related to spasticity and changes in muscle tone d. risk for impaired cerebral tissue perfusion related to obstruction secondary to infection

A. risk for falls related to loss of balance and equilibrium

a nurse is caring for a client who has acute stress disorder and is experiencing severe anxiety. Which of the following statements actions should the nurse make? a. tell me about how you are feeling right now b. you should focus on the positive things in your life to decrease your anxiety c. why do you believe you are experiencing this anxiety d. lets discuss the medications your provider is prescribing to decrease your anxiety

A. tell me about how you are feeling right now

Systemic measurement of body weight, body mass index, waist circumference, and glucose levels would be most important for a patient beginning a new prescription for which medication? a. Aripiprazole (Abilify) b. Olanzapine (Zyprexa) c. Ziprasidone (Geodon) d. Quetiapine (Seroquel)

B. Olanzapine (Zyprexa)

Friends invite an adult diagnosed with type 2 diabetes to go on a mountain hike next week. The adult replies, "I cant go because I don't have any hiking shoes". In actuality, this adult fears difficulty with blood glucose management during strenuous activity. Which defense mechanisms evident? a. displacement b. rationalization c. passive aggression d. reaction formation

B. rationalization

a nurse is caring for a client who states "i plan to commit suicide" which of the following assessments should the nurse identify as the priority? a. clients educational and economic background b. lethality of the method and availability of means c. quality of the clients social support d. clients insight into the reasons for the decision

B.lethality of the method and availability of means

A 28 year old second grade teacher is diagnosed with major depressive disorder. She grew up in texas but moved to Alaska 10 years ago to separate from an abusive mother. Her father died by suicide when she was 12 years old. Which combination of factors in this scenario best demonstrates the stress diathesis model? a. cold climate coupled with history of abuse b. current age of 28 coupled with family history of depression c. family history of mental illness coupled with history of abuse d. female gender coupled with the stressful profession of teaching

C. Family history of mental illness coupled with history of abuse

a nurse working in an outpatient clinic is providing teaching to a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? a. i can expect my problems with PMDD to be worst when i am menstruating b. i will use light therapy 30 minutes a day to prevent further recurrences of PMDD c. i am aware that my PMDD causes me to have rapid mood swings d. i should increase my caloric intake with nutritional supplement when my PMDD is active

C. I am aware that my PMDD causes me to have rapid mood swings

A nurse analyzes reports from four adult patients of frightening events they encountered. which patients report most clearly indicates that the resulting fear was mentally healthy? a. i saw a large spider crawling along my kitchen wall b.i was at the mall when a gunman began firing an assault weapon c. i was at home when a storm with heavy thunder and lightening lasted over and hour d. i was trapped on an elevator that stopped between floors when the power went out

C. I was at home when a storm with heavy thunder and lightening lasted over an hour

A patient begins a new prescription for risperidone (Risperdal). Which intervention should the nurse include in the plan of care? a. monitor intake and output daily b. educate the patient about foods that contain tyramines c. assess sitting, standing, and lying blood pressure daily d. administer with food to reduce gastrointestinal irritation

C. assess sitting, standing, and lying blood pressure daily

A nurse observes a client who has OCD repeatedly applying, removing, and then reapplying makeup. The nurse the identifies that repetitive behavior in a client who has OCD is due to which of the following underlying reasons? a. narcissistic behavior b. fear of rejection from staff c. attempt to reduce anxiety d. adverse effect of antidepressant medication

C. attempt to reduce anxiety

A patient tells the community mental health nurse, "I told me health care provider I was having trouble sleeping and he prescribed trazodone 50 mg every night. I read on the internet that drug is an antidepressant, but I'm not depressed. What should i do?" Which response by the nurse is correct? a. I will help you contact your health care provider for clarification regarding this new prescription b. insomnia and depression usually go hand in hand. If your depression is relieved, your sleep will improve c. in low doses, trazodone helps relieve insomnia. Higher doses are needed for antidepressant effects to occur d. information on the internet is often misleading and incorrect it is more important to trust the judgment of your health care provider

C. in low doses, trazadone helps relieve insomnia. Higher doses are needed for antidepressant effects to occur

a patient experiencing depression says to the nurse, "my health care provider said i need talk therapy but i think i need a prescription for an antidepressant medication. What should i do?" Select the nurses best response a. which antidepressant medication do you think would be helpful b. there are different types of talk therapy. Most patients find it beneficial c. lets consider some ways to address your concerns with your health care provider d. are you willing to give talk therapy a try before starting an antidepressant medication

C. lets consider some ways to address your concerns with your health care provider

the nurse cares for a hospitalized adolescent diagnosed with major depressive disorder. The health care provider prescribes a low does antidepressant. In consideration of published warnings about use of antidepressant medications in younger patients, which action should the nurse employ? a. notify the facility's patient advocate about the new prescription b. teach the adolescent about black box warnings associated with antidepressant medications c. monitor the adolescent closely for evidence of adverse effects; particularly suicidal thinking or behavior d. remind the health care provider about warnings associated with the use of antidepressants in children and adolescents

C. monitor the adolescent closely for evidence of adverse effects, particularly suicidal thinking or behavior

a charge nurse is discussing the care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicated an understanding of the teaching? a. care during the continuation phase focuses on treating continued manifestations of MDD b. the treatment of MDD during the maintenance phase lasts for 6 to 12 weeks c. the client is at greatest risk for suicide during the first weeks of an MDD episode d. medication and psychotherapy are most effective during the acute phase of MDD

C. the client is at greatest risk for suicide during the first weeks of an MDD episode

over the past 2 months a patient made eight suicide attempts with increasing lethality. The health care provider informs the patient and family the ECT is needed. The family whispers to the nurse, "isn't this a dangerous treatment?" How should the nurse reply? a. our facility has an excellent record of safety associated with use of ECT b. your family member will eventually be successful with suicide if aggressive measures are not promptly taken c. yes, there are hazards with ECT. You should discuss these concerns with the health care provider d. ECT is very effective when urgent help is needed. Your family member was carefully evaluated for possible risks

D. ECT is very effective when urgent help is needed. Your family member was carefully evaluated for possible risks

Which patient would the nurse expect to have the most difficulty with problem solving and decision making? a. an 18 year old diagnosed with bulimia nervosa at age 14; has taken oral dose of Prozac daily for years b. a 46 year old diagnosed with schizophrenia at age 24; has taken oral doses of clozapine (Clozaril) daily for years c. a 62 year old diagnosed with bipolar disorder at age 28; has taken oral divalproex sodium (Depakote) daily for 16 years d. a 52 year old diagnosed with schizophrenia at age 21; has taken monthly injections of haloperidol (Haldol decanoate) for 12 years

D. a 52 year old diagnosed with schizophrenia at age 21; has ten monthly injections of haloperidol (Haldol decanoate) for 12 years

a nurse is conduction a class for a group of newly licensed nurses on caring for clients who are al risk for suicide. Which of the following information should the nurse include in the teaching? a. a clients verbal threat of suicide is attention seeking behavior b. interventtions are ineffective for clietns who really want to commit suicide c. using the term suicide increases the clients risk for a suicide attempt d. a no suicide contract decreases the clients risk for suicide

D. a no suicide contract decreases the clients risk for suicide

Select the best example of altruism a. after recovering from a gunshot wound, a police officer attends a local support group b. after recovering from open heart surgery, an individual plays tennis three times a week c. an individual who received a liver transplant volunteers a local organ procurement agency d. an individual with a long standing fear of animals volunteers at a community animal shelter

D. an individual with a long standing fear of animals volunteers at a community animal shelter

a nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? a. assign the client to a private room b. document the clients behavior every hour c. allow the client to keep perfume in her room d. ensure that the client swallows medication

D. ensure that the client swallows medicatiton

A patient tells the nurse, "no matter what i do i feel like there is always a dark cloud following me". Select the nurses initial action a. assess the patients current sleep and eating patterns b. explain to the patient :everyone feels down from time to time" c. suggest alternative activities for times when the patient feels depressed d. say to the patient "tell me more about what you mean by a dark cloud"

D. say to the patient "tell me more about what you mean by a dark cloud"

An outpatient psychiatric nurse assesses a patient diagnosed with hoarding disorder. The patient has lost 12 pounds in the past two months, appears disheveled, and is wearing dirty clothing with poor hygiene. What is the nurses priority action? a. review the patients medication regimen b. ask the patient what types of foods have you been eating c. refer the patient to a psychologist for cognitive behavioral therapy d. schedule a home visit to assess the safety of the patients living conditions

D. schedule a home visit to assess the safety of the patients living conditions

A nurse is caring for a client who is experiencing a panic attack. Which of the following actions should the nurse take? a. discuss new relaxation techniques b. show the client how to change his behavior c. distract the client with a TV show d. stay with the client and remain quiet

D. stay with the client and remain quiet

A nursing student arrives late for a clinical experience and is not wearing the correct attire. When the instructor privately criticizes the behavior, the student responds, "I am always the one who gets caught. Youre going to cause me to fail." Select the instructors best response. a. other students get caught as well b. i am not trying to cause you to fail. i am here to help you c. i am sorry you feel that way. I try to treat all my students equally d. the requirements for this experience were discussed during our orientation

D. the requirements for this experience were discussed during our orientation

a nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. Which of the following interventions should the nurse include as a primary intervention? (select all that apply) a. conduction a suicide risk screening on all new clients b. creating a support group for family members of clients who completed suicide c. educating high school teens about suicide prevention d. initiating one on one observation for a client who has current suicidal ideation e. teaching middle school educators about warning indicators of suicide

a, conducting a suicide risk screening on all new clients b. creating a support group for family members of clients who completed suicide c. educating high school teens about suicide prevention d. initiating one on one observation for a client who has current suicidal ideation e. teaching middle school educators about warning indicators of suicide

a nurse working in an acute mental health facility is caring for a 35 year old female client who has manifestations of depression. The client lives at home with her partner and two young children. She currently smokes and has a history of chronic asthma. Which of the following factors put the client at risk for depression? (select all that apply) a. age b, gender c. history of chronic asthma d. smoking e. being married

a. age b. gender c. history of chronic asthma d. smoking

A nurse is assessing a client who has generalized anxiety disorder. Which of the following findings should the nurse expect? (select all that apply) a. excessive worry for 6 months b. impulsive decision making c. delayed reflexes d. restlessness e. need for reassurance

a. excessive worry for 6 months d. restlessness e. need for reassurance

a nurse is assessing a client who has major depressive disorder. The nurse should identify which of the following statements as an overt comment about suicide? (select all that apply) a. my family will be better off if I'm dead b. the stress in my life is too much to handle c. i wish my life was over d. i don't feel like i can ever be happy again e. if i kill myself then my problems will go away

a. my family will be better off if I'm dead c. i wish my life was over e. if i kill myself then my problems will go away

a nurse is interviewing a 25 year old client who has a new diagnosis of dysthymic disorder. Which of the following findings should the nurse expect? a. wide fluctuations in mood b. report of a minimum of five clinical findings c. presence of manifestations for at least 2 years d. inflated sense of self esteem

c. presence of manifestations for atleast 2 years