QUIZ 1 - PSY MTL THEORY

A nurse is interviewing a client who has a new diagnosis of major depression. Which of the following questions is the nurse's priority? A. "Have you thought about hurting yourself?" B. "What has been troubling you?" C. "Do you have anyone who can offer you support?" D. "When did you start feeling bad?"

A. "Have you thought about hurting yourself?"

A nurse is caring for a client who has depression and started taking paroxetine 1 week ago. The client states to the nurse, "My family would be better off without me." Which of the following responses should the nurse make? A. "Why do you feel your family would be better off without you?" B. "Many people feel this way when they are depressed." C. "You sound upset. Are you thinking of hurting yourself?" D. "Your medication hasn't started working yet. Soon, you'll be feeling differently."

C. "You sound upset. Are you thinking of hurting yourself?"

A nurse is caring for a client who has schizophrenia. The nurse notices that the client is pacing up and down the hall rapidly and muttering in an angry manner. Which of the following actions should the nurse perform first? A. Apply mechanical restraints to the client B. Administer PRN haloperidol IM to the client C. Approach the client in a non-threatening manner D. Place the client in seclusion

C. Approach the client in a non-threatening manner

What refers to a nurses behavioral and emotional response to a client. These responses may be related to unresolved feelings toward significant others from the nurses past.

Countertransference

A nurse is caring for a client who has schizophrenia. Which of the following client statements indicates clang associations? A. "I am the king, and everyone should bow to me." B. "I'm feeling schmoolizious today." C. "Option, contrary, moose, allergic." D. "Basketball in the hall very tall."

D. "Basketball in the hall very tall." A client who speaks using clang associations is choosing words based on their sound rather than meaning. The words often rhyme

A nurse is collecting data from a client with schizophrenia who was recently admitted to acute care. Which of the following findings should the nurse expect? A. Seductive behaviors B. Obsession with rituals C. Uncontrolled appetite D. Associative looseness

D. Associative looseness

A nurse is caring for a client with schizophrenia who is having command hallucinations. Which of the following actions is the priority for the nurse to take? A. Identify triggers that initiate the client's hallucinations B. Administer an antipsychotic medication C. Focus on reality-based orientation D. Determine what the voices are saying

D. Determine what the voices are saying

A nurse is admitting a client who has schizophrenia. During the initial interview, which of the following behaviors should the nurse identify as a positive manifestation of schizophrenia? A. Anhedonia B. Avolition C. Flat affect D. Hallucinations

D. Hallucinations

A nurse is assessing a client who has schizophrenia. The client states, "I need to get my gummamoshu from by my house." The nurse recognizes this statement as an example of which of the following? A. Flight of ideas B. Echolalia C. Perseveration D. Neologism

D. Neologism

A scientific structuring of the environment in order to effect behavioral changes and to improve the psychological health and functioning of the individual is defined as________________________ therapy.

Milieu Therapy

A nurse is caring for a client who has schizophrenia and is hearing voices. Which of the following actions is the nurse's priority? A. Ask the client what the voices are saying B. Focus the client's attention on reality-based activities C. Make eye contact when speaking with the client D. Encourage the client to listen to music through headphones

A. Ask the client what the voices are saying

A nurse is assessing a client who has schizophrenia. The client suddenly states, "I'm blue, so are you, and I'm leaving on a choo, choo, choo!" The nurse should identify the client's statement as which of the following speech patterns? A. Clang association B. Word salad C. Neologism D. Echolalia

A. Clang association

A nurse is assessing a client who was diagnosed with schizophrenia. Which of the following client findings is considered a positive symptom of schizophrenia? A. Hallucinations B. Social withdrawal C. Anergia D. Flat affect

A. Hallucinations

A nurse is assessing a client who has schizophrenia and takes haloperidol 3 times daily. The client has developed involuntary writhing movements of the tongue and constant lip smacking. The nurse should identify that these manifestations indicate which of the following adverse effects of haloperidol? A. Akathisia B. Acute dystonia C. Tardive dyskinesia D. Pseudoparkinsonism

C. Tardive dyskinesia

A nurse is organizing a therapeutic support group for individuals who have bulimia nervosa. Which of the following tasks should the nurse plan to include during the orientation phase of group development? A. Determine the rules that the group will follow B. Address disagreements among group members C. Help clients work through the grief response D. Transition from the role of leader to facilitator

A. Determine the rules that the group will follow

A nurse is caring for a client who has schizophrenia. The client states, "My internal organs have turned to stone." The nurse should document this finding as which of the following types of delusions? A. Somatic B. Reference C. Persecutory D. Grandiose

A. Somatic

A nurse is speaking with a client whose partner was killed unexpectedly. The client states, "I just don't know what to do now." Which of the following actions should the nurse take? A. Talk to the client about available community resources B. Distract the client by discussing events not related to the crisis C. Reassure the client that he will feel better soon D. Give the client advice about what to do during the next few days

A. Talk to the client about available community resources

A nurse is planning recreational activities for a young adult client who has an acute exacerbation of schizophrenia. Which of the following activities should the nurse plan for this client? A. Walking with a staff member B. Playing ping-pong in the dayroom with another client C. Playing basketball with other clients in the gym D. Riding a stationary bike alone in the fitness room

A. Walking with a staff member

A nurse is teaching a client who has acrophobia about the use of systematic desensitization as a method of behavioral therapy. Which of the following client statements indicates an understanding of the teaching? A. "I will snap a rubber band on my wrist when heights scare me." B. "I will slowly be exposed to places of increasing height." C. "I will need to stand on a very high place until I'm calm." D. "I will be asked to imitate my therapist's actions around heights."

B. "I will slowly be exposed to places of increasing height."

Number the following nursing interventions as they would proceed through the steps of the nursing process. a. ________ Determine if an antianxiety medication is decreasing a clients stress. b. ________ Measure a clients vital signs and review past history. c. ________ Encourage deep breathing and teach relaxation techniques. d. ________ Aim, with client collaboration, for a seven-hour nights sleep. e. ________ Recognize and document the clients problem

1. Measuring a clients vital signs and reviewing past history is a nursing intervention that occurs in the assessment step of the nursing process. 2. Recognizing and documenting the clients problem occurs in the nursing diagnosis step. 3. Setting a goal with client collaboration, for a seven-hour nights sleep occurs in the planning step. 4. Encouraging deep breathing and teaching relaxation techniques occur in the implementation step. 5. Determining if an antianxiety medication is decreasing a clients stress occurs in the evaluation step.

he nurse is talking with a male client who is actively hallucinating. The client is fearful that the voices he hears will direct him to kill himself or will hurt him directly. Which of the following nursing statements would be therapeutic at this time? a. "I don't hear them, but it must be frightening to hear voices that others can't hear." b. "I can hear the voices too, but they are telling you to go to bed now." c. "I know whose voices you are hearing and told them not to hurt you." d. "I know you believe they are going to cause you harm, but it's not true."

a. "I don't hear them, but it must be frightening to hear voices that others can't hear."

The nurse is preparing a client for discharge who was hospitalized following a suicide attempt. The nurse evaluates that the client could benefit from further development of coping strategies if the client was overheard making which of the following statements prior to discharge? a. "I know that I won't become depressed again after the treatment I received here." b. "I know now that I can't be all things to all people all the time." c. "It's been good to learn better ways to deal with the stresses in my life." d. "It is important for me to take my medications just as prescribed."

a. "I know that I won't become depressed again after the treatment I received here."

An acutely depressed client is receiving cognitive-behavioral therapy. The nurse is developing a plan of care for the client and includes interventions that focus on this type of therapy. Which of the following interventions would the nurse include? Select all that apply. a. Assisting the client to rehearse new cognitive and behavioral responses b. Assisting the client with the administration of antidepressant medications c. Assisting the client to develop alternative thinking patterns d. Assisting the client's family to participate in group therapy on a regular basis e. Assisting the client to participate in the treatment process f. Assisting the client to identify and test negative cognition

a. Assisting the client to rehearse new cognitive and behavioral responses c. Assisting the client to develop alternative thinking patterns e. Assisting the client to participate in the treatment process f. Assisting the client to identify and test negative cognition

What is the most essential task for a nurse to accomplish prior to forming a therapeutic relationship with a client? a. Clarify personal attitudes, values, and beliefs. b. Obtain thorough assessment data. c. Determine the clients length of stay. d. Establish personal goals for the interaction.

a. Clarify personal attitudes, values, and beliefs.

Which client action 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 establishes rapport with the nurse and mutually develops treatment goals. c. The client explores feelings related to reentering the community. d. The client explores personal strengths and weaknesses that impact behavioral choic

a. The client gains insight and incorporates alternative behaviors.

What should be the priority nursing action during the orientation (introductory) phase of the nurse-client relationship? a. Acknowledge the clients 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 nursing care

b. Establish rapport and develop treatment goals.

A paranoid client presents with bizarre behaviors, neologisms, and thought insertion. Which nursing action should be prioritized to maintain this clients safety? a. Assess for medication nonadherance. b. Note escalating behaviors and intervene immediately. c. Interpret attempts at communication. d. Assess triggers for bizarre, inappropriate behaviors

b. Note escalating behaviors and intervene immediately.

To evaluate outcomes for a patient with schizophrenia receiving typical antipsychotic drug therapy, the nurse would look for improvement in: a. Affective mobility b. Positive symptoms c. Self-care activities d. Cognitive functioning

b. Positive symptoms

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. Structured programming

What is the best rationale for including family in the clients therapy within the inpatient milieu? a. To structure a program of social and work-related activities b. To facilitate discharge from hospitalization c. To provide a concrete demonstration of caring d. To encourage the family to model positive behaviors

b. To facilitate discharge from hospitalization

The nurse in the pediatric unit is admitting a 2-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development?Select one: a. Trust versus mistrust b. Industry versus inferiority c. Autonomy versus shame and doubt d. Initiative versus guilt

c. Autonomy versus shame and doubt

In preparing for the orientation phase of the therapeutic relationship, the nurse suggests addressing which of the following subjects?Select one: a. Promoting problem solving skills in the client b. Promoting self-esteem in the client c. Establishing the parameters of the relationship d. Facilitating behavioral change

c. Establishing the parameters of the relationship

A client diagnosed with schizophrenia spectrum disorder takes an antipsychotic agent daily. Which assessment finding should a nurse prioritize? a. Respirations of 22 beats/minute b. Weight gain of 8 pounds in 2 months c. Temperature of 104F (40C) d. Excessive salivation

c. Temperature of 104F (40C) *** With Psyc meds, temp is the key!

If a client demonstrates transference toward a nurse, how should the nurse respond? a. Promote safety and immediately terminate the relationship with the client. b. Encourage the client to ignore these thoughts and feelings. c. Immediately reassign the client to another staff member. d. Help the client to clarify the meaning of the relationship, based on the present situation

d. Help the client to clarify the meaning of the relationship, based on the present situation

The nurse is preparing for the arrival of a new client at a drug abusers' residential treatment center and prepares to explain to the client that the emphasis of the center is on group and social interaction, and that rules and expectations are mediated by peer pressure. The most likely focus of therapy of this residential center is:Select one: a. Aversion conditioning b. Systematic desensitization c. Cognitive-behavioral therapy d. Milieu therapy

d. Milieu therapy