Comprehensive Final Exam

When assessing a client diagnosed with paranoid personality disorder, the nurse might identify which of the following characteristic behaviors? Select all that apply. a. A lack of empathy b. Shyness and emotional coldness c. Suspiciousness without justification d. A lack of remorse for hurting others e. Preoccupation with unjustifiable doubts

ANS: C, E

A client is diagnosed with somatic symptom disorder. When planning care, which nursing intervention should be included? a. Avoid discussing symptoms experienced b. Encourage exploration of the source of anxiety c. Remind the client about previous negative test results d. Redirect the client to the physician when somatic complaints are expressed.

b. Encourage exploration of the source of anxiety

Which drug is commonly prescribed for clients diagnosed with narcolepsy? a. Barbiturates b. Analgesics c. Amphetamines d. Benzodiazepines

c. Amphetamines

The nurse would include which of the following biological interventions when caring for a client experiencing a panic attack? Select all that apply. a. Monitor blood pressure and pulse b. Discuss situations surrounding past panic attacks. c. Stay with the client when signs and symptoms of a panic attack are present. d. Notify the client of the availability of alprazolam prn. e. Educate the client regarding how temperament affects anxiety disorders.

ANS: A, D

While the nurse is completing an initial interview with a client in the emergency department, the client admits tor recent drug use. Which area of assessment should take priority? a. The client's chief complaint b. A complete history and physical examination c. Type of drugs used d. Family history

c. Type of drugs used

Of women who give birth _____% to _____% experience "the blues."

50% to 80%

A 60-year-old woman has been experiencing delusions of persecution, a depressed mood, and flat affect for 6 months. Which of the following factors would rule out a diagnosis of schizophrenia at this time? Select all that apply. a. A medical condition has not been assessed and ruled out b. The client complains of depressed mood c. The client's age is not typical d. The client is experiencing the negative symptoms of a flat affect e. The client is a woman

ANS: A, B, C

Which of the following can be categorized as a benefit of alcohol use? Select all that apply. a. When alcohol enhances the flavor of food. b. When alcohol promotes celebration at special occasions. c. When alcohol is used in religious ceremonies. d. When alcohol helps mask stressful situations. e. When alcohol is used to cope with unacceptable feelings.

ANS: A, B, C

A nurse, administering a medication for ADHD, believes the client is "cheeking" the medication. Which of the following medications would limit "cheeking"? Select all that apply. a. Dyanavel XR (d- & l-amphetamine) b. Quillivant XR (methylphenidate) c. Contempla XR-ODT (methylphenidate extended base) d. Aszenys XR-ODT (d- & l-amphetamine) e. Kapvay (clonidine extended release)

ANS: A, B, C, D

In which of the following situations would the nurse expect a client to exhibit symptoms of increased anxiety? Select all that apply. a. A client has a thyroid-stimulating hormone level of 0.03 mIU/L b. A client has a fasting glucose levels of 60 mg/dL c. A client is experiencing caffeine intoxication d. A client has a diagnosis of gastroesophageal reflux disease. e. A client is experiencing alcohol-induced withdrawal

ANS: A, B, C, E

When a client experiences a manic episode, the nurse would expect to assess which of the following? Select all that apply. a. Grandiosity b. Flight of ideas c. Pressured speech d. Frequent short naps for rest e. Psychomotor agitation

ANS: A, B, C, E

Which of the following factors places a client at high risk for a suicide attempt? Select all that apply. a. A previous suicide attempt b. Access to lethal methods c. Isolation d. Lack of a physical illness e. Impulsive or aggressive tendencies

ANS: A, B, C, E

Which of the following are tasks of the orientation phase of the nurse-client relationship? Select all that apply. a. Establish a contract for intervention b. Identify client's strengths and limitations c. Problem-solve situational crises d. Promote client's insight and perception of reality e. Formulate nursing diagnostic statements

ANS: A, B, E

A hypomanic client diagnosed with bipolar II disorder chatters constantly and becomes disruptive in group. The client is forcibly placed in four-point restraints. Which of the following principles were violated in this scenario? Select all that apply. a. The principle of nonmaleficence b. The principle of veracity c. The principle of least restrictive treatment d. The principle of beneficence e. The principle of negligence

ANS: A, C, D, E

Which of the following rights are afforded to a client who is admitted to an inpatient psychiatric unit as a danger to self? Select all that apply. a. The right to refuse medications b. The right to leave the locked facility at any time c. The right to expect treatment that does no harm d. The right to know the truth about his or her illness e. The right to be treated equally

ANS: A, C, D, E

Which of the following situations would place a client at high risk for a life-threatening hypertensive crisis? Select all that apply. a. A client is prescribed phenelzine and fluoxetine b. A client is prescribed phenelzine and warfarin sodium c. A client is prescribed phenelzine and docusate sodium d. A client is prescribed phenelzine and metformin e. A client is prescribed phenelzine and diet pills

ANS: A, E Phenelzine is an MAOI and cannot be taken with other antidepressants such as fluoxetine and phenelzine cannot be taken with diet pills.

Which of the following situations would place a client at high risk for life-threatening hypertensive crisis? Select all that apply. a. A client is prescribed isocarboxazid and drinks orange juice. b. A client is prescribed tranlycypromine and takes a diet pill. c. A client is prescribed isocarboxazid and has Cheerios for breakfast. d. A client is prescribed tranlycypromine and has a bowl of oatmeal. e. A client is prescribed tranlycypromine and eats miso soup.

ANS: B, E

A nurse is completing a risk assessment on a newly admitted client with increased levels of anxiety. The nurse would document which of the following cognitive symptoms expressed by the client? Select all that apply. a. "Gritting of the teeth." b. "Changes in tone of voice." c. "Increased energy." d. "Misperceptions of stimuli." e. "Difficulty concentrating."

ANS: D, E

Using Kubler-Ross's model of the normal grief response, order the following stages of grief: 1. ______Depression 2. ______ Bargaining 3. ______ Acceptance 4._______ Denial 5. ______ Anger

Order: 4, 3, 5, 1, 2 stages are - denial (1), anger (2), bargaining (3), depression (4), and acceptance (5).

A client diagnosed with posttraumatic stress disorder after a rape states, "Even though I know it is important, I just can't go to my gynecologist." Which nursing diagnosis reflects this client's problem? a. Post trauma syndrome R/T previous rape AEB unrealistic fear b. Nonadherence R/T trauma AEB avoiding yearly examination c. Knowledge deficit R/T importance of follow-up care AEB refusal to adhere to scheduled yearly appointment d. Altered health maintenance R/T no yearly gynecological examination AEB canceled appointment

a. Post trauma syndrome R/T previous rape AEB unrealistic fear

A client diagnosed with somatic symptom disorder who is experiencing pain is admitted to an inpatient psychiatric unit. Which client statement would the nurse assess as evidence of primary gain? a. "Experiencing severe back pain has taken my mind off my pending divorce." b. "My mom only listens to me when I am complaining about the pain." c. "Because of my pain disorder, I had to apply for disability." d. "When I tell people about my pain, they are very sympathetic to my situation."

a. "Experiencing severe back pain has taken my mind off my pending divorce."

A client diagnosed with bipolar disorder states, "My mom has a history of depression." When the nurse uses a biological theory to teach about predisposing factors, which client statement indicates that teaching has been successful? a. "I am going to weigh the pros and cons before having children." b. "My negative thoughts about myself are making me worse." c. "It is entirely my mother's fault that I have this disorder." d. "I learned how to cope by watching my family interactions."

a. "I am going to weigh the pros and cons before having children."

The nurse is teaching a 16-year-old girl, diagnosed with anorexia nervosa, about the potential risk for osteoporosis. Which statement by the client may indicate that further teaching about osteoporosis is necessary? a. "I have high estrogen levels, and that is why I am not having periods." b. "I have a high level of stress hormone, and this can affect my bones." c. "I am not taking in enough calcium, and my bones can be brittle." d. "I'm young, so my bone mass hasn't reached its peak. That puts me at risk."

a. "I have high estrogen levels, and that is why I am not having periods."

A client becomes agitated in group therapy and yells, "You are all making me worse!" Which would be an appropriate response from the group leader? a. "You sound angry and frustrated. Can you tell us more about it?" b. "Maybe you would like to go to another group from now on." c. "We will talk more about this during our individual session." d. " What do the other group members think?"

a. "You sound angry and frustrated. Can you tell us more about it?"

A client diagnosed with bipolar disorder has been taking lithium carbonate for 3 months. Which assessment data would make the nurse request a lithium carbonate level? a. Blurred vision and vomiting b. Increased thirst and urination c. Drowsiness and dizziness d. Headache and anorexia

a. Blurred vision and vomiting

A client diagnosed with panic disorder has a nursing diagnosis of social isolation R/T fear. Using a cognitive approach, which nursing intervention is appropriate? a. During a panic attack, remind the client to say, "I know this attack will last only a few minutes." b. Discuss what occurred prior to the panic attack in order to note cause and effect. c. Encourage the client to acknowledge two trusted individuals who assist the client during a panic attack. d. Remind the client to use a journal to express feelings surrounding the panic attack.

a. During a panic attack, remind the client to say, "I know this attack will last only a few minutes."

Which etiological implication reflects social learning theory? a. Modeling and identification can be observed from early childhood in individuals exhibiting substance abuse behaviors. b. An individual is encouraged to continue using substances because of the pleasure experienced during intoxication. c. A son of a father diagnosed with alcohol use disorder has a four times greater incidence of developing this disorder. d. Identical twins have twice the rate for concordance of alcohol use disorder compared with fraternal twins.

a. Modeling and identification can be observed from early childhood in individuals exhibiting substance abuse behaviors.

A client diagnosed with antisocial personality disorder is facing a 20-year prison term. The client has been prescribed sertraline for depressed mood. Which intervention would take priority? a. Monitor the client for suicidal ideations related to depressed mood. b. Discuss the need to take medications, even when symptoms improve. c. Instruct the client about the risks of stopping medication abruptly. d. Remind the client that it takes 6 to 8 weeks for the medcation's full effect to occur.

a. Monitor the client for suicidal ideations related to depressed mood.

Thiamine deficiency is a major problem for clients diagnosed with alcohol use disorder. Of the presenting signs and symptoms caused by this deficiency, which is most life threatening? a. Paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor b. Impaired mental functioning, apathy, euphoria or depression, sleep disturbance, and increasing confusion leading to coma c. Nausea and vomiting, anorexia, weight loss, abdominal pain, jaundice, edema, anemia, and blood coagulation abnormalities d. Impaired platelet production and risk for hemorrhage

a. Paralysis of ocular muscles, diplopia, ataxia, somnolence, and stupor

A client monitored in an outpatient psychiatric clinic is taking clozapine 200 mg bid. The absolute neutrophil count (ANC) is 600 cells per microliter. Based on the these values, which nursing intervention is appropriate? a. Stop the medication and call the physician because of the low ANC. b. Stop the medication and call the physician because of the high ANC. c. Give the medication because the ANC is within normal range. d. Give the medication but notify the physician about the abnormal ANC.

a. Stop the medication and call the physician because of the low ANC.

A nurse is assessing a client being treated for a fractured leg. History reveals that the client's father and grandfather died of complications of alcohol use disorder. The client admits using alcohol to reduce stress. Which statement is most likely true? a. The client is in the pre-alcoholic phase of drinking patterns and has a genetic predisposition to alcoholism. b. The client is in the early alcoholic phase of drinking patterns and has a biological tendency to drink. c. The client is in the crucial phase of drinking patterns and has learned from his family to reduce stress by drinking. d. The client is in the chronic phase of drinking patterns and needs medication to detox safely from alcohol.

a. The client is in the pre-alcoholic phase of drinking patterns and has a genetic predisposition to alcoholism.

A 16-year-old client has a 6-month history of binge eating, abuse of laxatives, and feeling "down." Which statement accurately described this client's problem? a. The client meets the criteria for bulimia nervosa. b. The client meets the criteria for anorexia nervosa. c. The client meets the criteria for binge-eating disorder. d. The client is exhibiting normal developmental tasks according to Erikson.

a. The client meets the criteria for bulimia nervosa.

A client diagnosed with major depression has a nursing diagnosis of low self-esteem. Which is an appropriate, correctly written short-term outcome related to this diagnosis? a. The client will verbalize tow positive things about self by day two. b. The client will exhibit increased feelings of self-worth by day three. c. The client will set realistic outcomes and try to reach them. d. The client will demonstrate a decrease in fear of failure.

a. The client will verbalize two positive things about self by day two.

The nurse is assessing a client diagnosed with an autism spectrum disorder. According to Mahler's theory of object relations, which describes the clients unmet developmental need? a. The need for survival and comfort b. The need for awareness of an external source of fulfillment c. The need for awareness of separateness of self d. The need for internalization of a sustained image of a love object/person

a. The need for survival and comfort

Which is the purpose of providing psychiatric/mental health nursing care? a. To recognize and address the client's patterns of response to actual or potential problems. b. To gather client data related to psychiatric illness, mental health problems, and potential comorbid physical illnesses. c. To focus nursing interventions on the diagnoses described in (DSM-5). d. To assist the physician in delivering comprehensive holistic client care.

a. To recognize and address the client's patterns of response to actual or potential problems.

In which situation is a client at risk for delayed or inhibited grief? a. When a client's family expects the client to maintain normalcy. b. When a client experiences denial during the first week after the loss. c. When a client experiences anger toward the deceased within 1 month after the loss. d. When a client experiences preoccupation with the decreased for 1 year after the loss.

a. When a client's family expects the client to maintain normalcy.

Which client statement would best support the nursing diagnosis of ineffective coping R/T recent loss of spouse? a. "I use the gym to take my mind off of my loss." b. "A glass or two of wine before bedtime helps me sleep." c. "My doctor prescribed Ambien for 1 week to help me sleep at night." d. "I know I need help, and therapy can help me get through this rough time."

b. "A glass or two of wine before bedtime helps me sleep."

The nurse is interacting with a client on the inpatient unit. The client states, "Most forward actions grows life double plays circle uniform." Which charting entry should the nurse record about this client's statement? a. "Client is experiencing circumstantiality." b. "Client is communicating by the use of word salad." c. "Client is communicating tangentially." d. "Client is perservating."

b. "Client is communicating by the use of word salad."

The nurse focuses on exploration of alternatives rather than providing answers or advice. This is one of the many strategies of nonthreatening feedback. Which nursing statement is an example of this strategy? a. "You should sign up for the Alcoholics Anonymous (AA) meetings to help in your recovery." b. "Let's discuss past successful coping mechanisms that you can try after discharge." c. "I have found that others with problems like yours need an AA sponsor." d. "You need a hobby to get your mind off of alcohol."

b. "Let's discuss past successful coping mechanisms that you can try after discharge."

The student nurse is learning about dissociative identity disorder (DID). Which student statement indicates that learning has occurred? a. "Individuals with DID are unable to function in social or occupational situations." b. "The transition from one personality to another is usually sudden, often dramatic, and usually precipitated by stress." c. "DID is a personality disorder, commonly called multiple personality disorder." d. "All personalities are aware of one another, and events that take place are known by all the different personalities."

b. "The transition from one personality to another is usually sudden, often dramatic, and usually precipitated by stress."

Believing in the dignity and worth of a client is to "respect" as acceptance and a nonjudgemental attitude is to: a. "trust" b. "rapport" c. "genuineness" d. "empathy"

b. "rapport"

A client admitted to an inpatient psychiatric unit following a manic episode is prescribed lithium carbonate 300 mg bid. Which serum lithium carbonate level would the nurse expect on discharge? a. 0.9 mEq/L b. 1.4 mEq/L c. 1.9 mEq/L d. 2.4 mEq/L

b. 1.4 mEq/L

A nurse is discharging a client diagnosed with obsessive-compulsive personality disorder (OCD). Which employment opportunity is most likely to be recommended by the treatment team? a. Home construction b. Air traffic controller c. Night watchman at the zoo d. Prison warden

b. Air traffic controller

A client diagnosed with neurocognitive disorder is becoming increasingly agitated and confused. Which intervention should the nurse implement first? a. Request a physician's order for laboratory tests to rule out infection. b. Assess the client's vital signs and any obvious physiological changes. c. Call the pharmacy to determine possible medication incompatibilities d. Document the findings and notify the oncoming shift of the situation

b. Assess the client's vital signs and any obvious physiological changes.

A client is diagnosed with alcohol-induced neurocognitive disorder. Which intervention is appropriate for this client's nursing diagnosis of altered sensory perception? a. Assess vital signs b. Decrease environmental stimuli c. Maintain a nonjudgemental approach d. Empathetically confront denial

b. Decrease environmental stimuli

A client states, "I know that the night nurse has cast a spell on me." Which nursing diagnosis reflects this client's problem? a. Disturbed sensory perception b. Disturbed thought process c. Impaired verbal communication d. Social isolation

b. Disturbed thought process

A client diagnosed with anorexia nervosa is forced into the emergency department (ED) by a family member. During the intake assessment, this family member answers all questions posed to the client. Which nursing intervention is appropriate at this time? a. Allow the family member to continue directing the conversation to gather critically needed information. b. Emphasize with the family member and communicate the need to gain information directly from the client. c. Request that the physician ask the family member to wait outside during the assessment. d. Request an evaluation by a social worker to assist the client with interpersonal conflicts.

b. Emphasize with the family member and communicate the need to gain information directly from the client.

A client has been admitted to an inpatient psychiatric unit expressing suicidal ideations and complains of insomnia and feelings of hopelessness. During an admission assessment, which nursing intervention takes priority? a. Using humor in the interview to uplift the client's mood b. Evaluating blood work, including thyroid panel and electrolytes c. Teaching the client relaxation techniques d. Evaluating any family history of mental illness

b. Evaluating blood work, including thyroid panel and electrolytes

Which factor is associated with the etiology of ADHD from a genetic perspective? a. Inborn error of metabolism b. Having a sibling diagnosed with ADHD c. A possible dopamine neurotransmitter deficit d. Retarded id development

b. Having a sibling diagnosed with ADHD

A client states, "After retirement, my husband divorced me, and my children left for college." The nurse responds, "It sounds to me like you are feeling pretty lonely." Which is a description of the therapeutic technique used by the nurse? a. Giving the client an opportunity to collect and organize thoughts b. Helping the client to verbalize feelings that are being indirectly expressed. c. Striving to explain that which is vague or incomprehensible d. Repeating the main idea of what the client has said

b. Helping the client to verbalize feelings that are being indirectly expressed.

A client with anorexia who was recently deserted by a spouse is admitted to an inpatient psychiatric unit with a diagnosis of major depressive disorder. Which nursing diagnosis takes priority at this time? a. Social isolation R/T fear of failure b. Imbalanced nutrition, less than body requirements R/T depressed mood c. Powerlessness R/T a lifestyle of helplessness d. Low self-esteem R/T fear of abandonment

b. Imbalanced nutrition, less than body requirements R/T depressed mood

A client is experiencing hyperventilation, depersonalization, and palpitations. Which nursing diagnosis takes priority? a. Social isolation b. Ineffective breathing pattern c. Risk for suicide d. Fatigue

b. Ineffective breathing pattern

Which disorder includes the diagnostic criteria of patterns of negativity, disobedience, and hostile behavior toward authority figures? a. Separation anxiety disorder b. Oppositional defiant disorder (ODD) c. Narcissistic personality disorder d. Autism spectrum disorder

b. Oppositional defiant disorder (ODD)

A client diagnosed with chronic alcohol use disorder has been recently diagnosed with peripheral neuropathy. Which nursing diagnosis addresses this client's problem? a. Altered coping R/T substance abuse AEB a long history of alcoholism. b. Pain R/T effects of alcohol AEB complaints of 6/10 pain. c. Powerlessness R/T substance abuse AEB no control over drinking. d. Altered sensory perception R/T effects of alcohol AEB visual hallucinations.

b. Pain R/T effects of alcohol AEB complaints of 6/10 pain

Three weeks ago, a client suddenly developed a blunt affect and began exhibiting both eccentric behavior and impaired role functioning. These symptoms are reflective of which phase in the development of schizophrenia? a. Phase I - schizoid personality b. Phase II - prodromal phase c. Phase III - schizophrenia d. Phase IV - residual phase

b. Phase II - prodromal phase

A client is newly admitted to an inpatient psychiatric unit. The following nursing diagnoses are formulated for this client. Which of these would the nurse prioritize? a. Defensive coping R/T dysfunctional family process b. Risk for self-directed violence R/T depressed mood c. Impaired social interactions R/T lack of social skills d. Anxiety R/T fear of hospitalization

b. Risk for self-directed violence R/T depressed mood

A client admitted to an inpatient psychiatric unit has given written informed consent to participate in a medication research study. The client states, "I have changed my mind and don't want that medication." Which is the priority nursing intervention? a. Tell the client that once the forms are signed, the client must continue with the research. b. Tell the client that withdrawal from the research can be done at any time. c. Tell the client that he or she should have not been allowed to participate because of a thought d. Tell the client that he or she can withdraw only if the physician gives permission.

b. Tell the client that withdrawal from the research can be done at any time.

The nurse is planning care for a recently admitted client with a long history of crack cocaine use. The nurse intentionally keeps the treatment plan simple. Which is the underlying rationale for this decision? a. The client would be unable to focus because of the use of denial b. The client is at high risk for mild to moderate cognitive problems c. Physical complications would impede learning d. The client has arrested in developmental progression

b. The client is at high risk for mild to moderate cognitive problems

Which assessment data support the diagnosis of (OCD)? a. The client's thoughts, impulses, and/or images are expressed as worried concerning real-life problems and stressors. b. The client is aware at some point during the course of the disorder that the obsessions or compulsions are excessive, unreasonable, or both. c. The obsessions or compulsions experienced significantly interfere with only one area of functioning. d. The client represses thoughts, impulses, or images and then substitutes other thoughts or behaviors.

b. The client is aware at some point during the course of the disorder that the obsessions or compulsions are excessive, unreasonable, or both.

A client diagnosed with body dysmorphic disorder has a nursing diagnosis of self-esteem disturbance. Which short-term outcome is appropriate for this nursing diagnosis? a. The client will participate in self-care by day five. b. The client will express two positive attributes about self by day three. c. The client will demonstrate one coping skill to decrease anxiety by day four. d. The client will interact with peers in school during this fall semester.

b. The client will express two positive attributes about self by day three.

A client diagnosed with an antisocial personality disorder has a nursing diagnosis of ineffective coping R/T parental neglect AEB "I broke the jerk's arm, but he deserved it." Which short-term correctly written outcome is appropriate for this client's problem? a. The client will be able to delay immediate gratification after discharge from the hospital. b. The client will verbalize understanding of unit rules and consequences for infarctions by end of shift. c. The client will eventually have insight into negative behaviors and establish meaningful relationships d. The client will verbalize personal responsibility for difficulties experienced in interpersonal relationships within the year

b. The client will verbalize understanding of unit rules and consequences for infarctions by end of shift.

A client diagnosed with schizophrenia is experiencing emotional ambivalence. When the nurse educates the client's family, which would best describe this symptom? a. An inward focus on a fantasy world. b. The simultaneous need for and fear of intimacy. c. Impairment in social functioning, including social isolation. d. The lack of emotional expression.

b. The simultaneous need for and fear of intimacy.

A client is exhibiting sedation, auditory hallucinations, akathisia, and anhedonia. The client is prescribed haloperidol 5 mg tid and trihexyphenidyl 4 mg bid. Which statement about these medications is accurate? a. The trihexyphenidyl would address the client's auditory hallucinations b. The trihexyphenidyl would counteract the akathisia c. The haloperidol would address the anhedonia d. The haloperidol would decrease the amount of sedation exhibited.

b. The trihexyphenidyl would counteract the akathisia

An adolescent diagnosed with major depression has a nursing diagnosis of social isolation. This client is currently attending groups and communicating with staff. Which statement evaluates this client's behavior accurately? a. The nurse is unable to evaluate this adolescent's ability to socialize, based on the observed behaviors. b. This client is experiencing a positive outcome exhibited by group attendance and communication with staff. c. The nurse is unable to evaluate this adolescent's ability to socialize because the client has not experienced these behaviors for an extended period. d. Attending group and communicating with staff are indications of improved self-esteem, not improved social isolation.

b. This client is experiencing a positive outcome exhibited by group attendance and communication with staff.

Which is an example of the therapeutic technique of "exploring"? a. "Was this before or after...?" b. "And after that you...?" c. "Give me an example of..." d. "How does that compare with...?"

c. "Give me an example of..."

The nurse is evaluating a client diagnosed with an antisocial personality disorder. Which client statement is reflective of this diagnosis? a. "I feel so guilty about hurting her, but I just lost control." b. "I'm very afraid when the voices tell me to kill myself." c. "I don't have a problem. It's your problem for misunderstanding." d. "I find it easier to be alone than with my family."

c. "I don't have a problem. It's your problem for misunderstanding."

Which client suicide plan would be considered most lethal? a. "While my husband is sleeping, I will swallow 30 Zoloft pills." b. "Although I don't own a gun, I am going to shoot myself." c. "I plan to jump from a scheduled bridge after midnight." d. "I will take 10 Tylenol with codeine right before my husband comes home."

c. "I plan to jump from a scheduled bridge after midnight."

A client diagnosed with a schizophrenia spectrum disorder is having trouble expressing fears about impending discharge to the treatment team. Functioning in the role of an advocate, which is an appropriate nursing response? a. "Would you like me to explain how to increase your assertiveness skills?" b. "Let's see how you have effectively communicated to the team in the past." c. "I'll be with you when you talk to the team. I'll remind you of your concerns." d. "I can appreciate how stressful it is to talk to the team. Let's discuss it."

c. "I'll be with you when you talk to the team. I'll remind you of your concerns."

A client, diagnosed with an antisocial personality disorder, is given a nursing diagnosis of defensive coping R/T a dysfunctional family system AEB denial of obvious problems and belligerence. Which client statement would confirm this nursing diagnosis? a. "I know what I did was wrong, and I understand the consequences." b. "I don't see how I can afford follow-up therapy." c. "I'm an angel compared with the rest of my family." d. "I go to church but only when it suits me."

c. "I'm an angel compared with the rest of my family."

The nurse focuses on feedback that serves the needs of the client and not the needs of the nurse. This is one of the many strategies of nonthreatening feedback. Which nursing statement is an example of this strategy? a. "I had an eating disorder when I was 16. Let me tell you how I felt." b. "It upsets me to see your mother so worried about you." c. "Tell me about how you feel when you purge." d. "My friends teased me in high school, and I ignored them. Why not try that?"

c. "Tell me about how you feel when you purge."

A client has an intelligence quotient (IQ) level of 30. Which client cognitive/educational capability would the nurse expect to observe? a. The client is capable of academic skills to a second-grade level b. The client, with supervision, may respond to minimal training in self-help c. The client would profit only from systemic habit training d. The client is capable of academic skills to a sixth-grade level

c. The client would profit only from systemic habit training

A client diagnosed with generalized anxiety disorder is getting ready for discharge. Which statement evaluates the client's cognitive response to nursing interventions? a. "The client appears calm; vital signs within normal limits; diaphoresis noted." b. "The client states that the breathing techniques used helped to decrease anxiety." c. "The client is able to recognize negative self-talk as a sign of increased anxiety." d. "The client uses journaling to express frustrations."

c. "The client is able to recognize negative self-talk as a sign of increased anxiety."

A client diagnosed with major depressive disorder is prescribed bupropion and sertraline. The client states, "Why am I on two antidepressants?" Which is the best nursing response? a. "The bupropion assists with smoking cessation while the sertraline treats depressive symptoms." b. "Sertraline assists with the negative side effects of bupropion." c. "The medications treat the symptoms of depression through different mechanisms of action." d. "Both medications help with the symptoms of anxiety along with depression."

c. "The medications treat the symptoms of depression through different mechanisms of action."

The nurse is interviewing a client who is experiencing a nihilistic delusion. Which client statement confirms the presence of this symptom? a. "The doctor says I'm not pregnant, but I know that I am." b. "Someone is trying to get a message to me through the articles in this magazine." c. "The world no longer exists." d. "The FBI has 'bugged' my room, and they intend to kill me."

c. "The world no longer exists."

What specific information is important to teach a client who has recently been prescribed ziprasidone? a. "It may take 6 to 8 weeks to see the full effect on bothersome symptoms." b. "Blood work needs to be drawn every 2 weeks to monitor for low neutrophil count." c. "To ensure absorption, take this medication on a full stomach." d. "Use diet and regular exercise to reduce the potential weight gain."

c. "To ensure absorption, take this medication on a full stomach."

Difficulty initiating or maintaining sleep is to "insomnia" as parasomnia is to: a. "Sleep disorders that are misaligned between sleep and waking behaviors." b. "Excessive sleepiness or seeking excessive amounts of sleep." c. "Unusual and undesirable behaviors that occur during sleep." d. Temporary cessation of breathing while sleeping."

c. "Unusual and undesirable behaviors that occur during sleep."

An extremely suicidal client needs to be admitted to the locked psychiatric unit. There are no beds available. Which client would the nurse anticipate that the treatment team would discharge? a. A client involuntarily committed 2 days ago with situational depression. b. A client voluntarily committed 2 days ago for alcohol detoxification. c. A client voluntarily committed 4 days ago with alterations in cognition related to a urinary tract infection. d. A client involuntarily committed 5 days ago due to experiencing command hallucinations.

c. A client voluntarily committed 4 days ago with alterations in cognition related to a urinary tract infection.

Which situation reflects the defense mechanism of displacement? a. A disgruntled employee confronts and shouts at his boss. b. A disgruntled employee takes his boss and his wife out to dinner. c. A disgruntled employee inappropriately punished his son. d. A disgruntled employee tells his son how much he likes his job and boss.

c. A disgruntled employee inappropriately punished his son.

A confused, tremulous, diaphoretic client with a short history of heavy drinking has a pulse rate of 120 beats/min, respirations of 24/min, and blood pressure of 180/90 mm Hg. Which would be the suspected cause of these symptoms? a. Wernicke-Korsakoff syndrome b. Alcohol-induced neurocognitive disorder c. Alcohol-induced withdrawal d. Acute alcoholic myopathy

c. Alcohol-induced withdrawal

A client is diagnosed with obsessive-compulsive personality disorder. In which cluster would the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) categorize this personality? a. Cluster A b. Cluster B c. Cluster C d. Cluster D

c. Cluster C

A client states, "I don't know why I'm depressed; my husband takes care of all my needs. I don't even have to write a check or get a driver's license." Based on this statement, this client is mostly likely to be diagnosed with which personality disorder? a. Schizoid personality disorder b. Histrionic personality disorder c. Dependent personality disorder d. Passive-agressive personality disorder

c. Dependent personality disorder

Structure is a component of milieu therapy. Which description is reflective of this component? a. Affirmations of a client's individual self-worth promote self-esteem b. Flexible patterns and varied schedules provide opportunities for growth c. Level systems can provide clients with opportunities to earn privileges d. Decreased demands on clients reduce stress

c. Level systems can provide clients with opportunities to earn privileges

During a nursing interaction, a client, although interacting appropriately, does not make eye contact. Which is a true statement about this nonverbal communication? a. Nonverbal communication is controlled by the conscious mind. b. Nonverbal communication carries less wright than what the client says. c. Nonverbal communication does not have the same meaning for everyone. d. Nonverbal communication generally is a poor reflection of what the client is feeling.

c. Nonverbal communication does not have the same meaning for everyone.

A client consistently chooses solitary activities, seems indifferent to praise and criticism, and has deficits in the ability to form meaningful personal relationships. Which diagnosis would the nurse expect to be documented? a. Schizotypal personality disorder b. Paranoid personality disorder c. Schizoid personality disorder d. Histrionic personality disorder

c. Schizoid personality disorder

Which tool is used to assess for tardive dyskinesia? a. The CAGE assessment tool b. Mini-Mental State Examination (MMSE) c. The Abnormal Involuntary Movement Scale (AIMS) d. Clock face assessment

c. The Abnormal Involuntary Movement Scale (AIMS)

In which situation is a client at highest risk for lorazepam overdose? a. The client exhibits increased tolerance b. The client experiences depression and anxiety c. The client combines the drug with alcohol d. The client takes the drug with antacids

c. The client combines the drug with alcohol

A nursing instructor is teaching the neurochemical effects of escitalopram. Which student statement indicates an understanding of the content presented? a. "Escitalopram increased the amount of norepinephrine available in the synapse." b. "Escitalopram encourages the reuptake of norepinephrine at the postsynaptic site." c. "Escitalopram encourages the reuptake of serotonin at the postsynaptic site." d. "Escitalopram increases the amount of serotonin available in the synapse."

d. "Escitalopram increases the amount of serotonin available in the synapse."

A client on a psychiatric unit has continually told the treatment team, "I am not responsible for the breakup of my marriage." Which client statement would indicate that the client is ready to collaborate with the team? a. "Okay, I'll agree to talk about her, but you have to know that this is her fault." b. "My mother supports me, and in my heart, I know you'll support me too." c. "You make me feel special. You kind of look like my wife." d. "Okay, let's sit down and talk to my wife and work out a counseling plan."

d. "Okay, let's sit down and talk to my wife and work out a counseling plan."

Which statement about attention deficit-hyperactivity disorder (ADHD) is true? a. ADHD is characterized by a persistent pattern of withdrawal into self. b. ADHD is frequently diagnosed before age 2. c. ADHD occurs equally among girls and boys. d. ADHD is characterized by a persistent pattern of inattention.

d. ADHD is characterized by a persistent pattern of inattention.

which describes the therapeutic communication technique of "focusing"? a. Being fully present for a client as information is gathered b. Verification of assumed meaning c. Repetition of the main meaning d. Concentration on one particular theme

d. Concentration on one particular theme

A child diagnosed with Tourette's disorder has a nursing diagnosis of impaired social interaction R/T aggressive behaviors. The child is currently threatening peers and manipulating staff. Which statement accurately evaluates this child's behavior? a. The nurse is unable to evaluate this child's ability to interact socially, based on the observed behaviors. b. The child is being assertive with peers and staff, which indicates improvement in social interaction. c. The nurse is unable to evaluate this child's ability to interact socially because the child has not experienced these behaviors for an extended period. d. Interacting with staff and peers by using threats and manipulation can be evaluated as an indication of continued social interaction impairment.

d. Interacting with staff and peers by using threats and manipulation can be evaluated as an indication of continued social interaction impairment.

Which intervention is a nurse's priority when working with a client suspected of having a conversion disorder? a. Avoid situations in which secondary gains may occur. b. Confront the client with the fact that anxiety is the cause of physical symptoms. c. Teach the client alternative coping skills to use during times of stress. d. Monitor assessments, laboratory reports, and vital signs to rule out organic pathology.

d. Monitor assessments, laboratory reports, and vital signs to rule out organic pathology.

A client on an inpatient psychiatric unit is overheard stating, "I visited Miss Emma yesterday while I was out on a pass with my family." Which would the nurse expect to assess as a positive finding in this client's urine drug screening? a. Heroin b. Oxycodone c. Phencylidine d. Morphine

d. Morphine

A client diagnosed with AIDS becomes confused and has a fluctuating memory loss, difficulty concentrating, and diminished motor speed. Which would be the probable cause of this client's symptoms? a. Impaired immune response b. Persistent generalized lymphadenopathy c. Kaposi's sarcoma (KS) d. Neurocognitive disorder due to HIV.

d. Neurocognitive disorder due to HIV

A client is discussing plans to have a serum lithium carbonate level taken on discharge. To obtain an accurate serum level, which discharge teaching information should be included? a. Remind the client to take lithium as prescribed just prior to having the serum level drawn. b. Remind the client to have the lithium carbonate serum level drawn after fasting at least 12 hours. c. Remind the client to notify the physician if he or she is exhibiting any signs and symptoms of toxicity. d. Remind the client to have serum level drawn 12 hours after taking a dose of lithium carbonate.

d. Remind the client to have serum level drawn 12 hours after taking a dose of lithium carbonate.

A physically abused child diagnosed with conduct disorder bullies and threatens peers on a psychiatric unit. Which nursing diagnosis would take priority? a. Risk for self-mutilation R/T low self-esteem b. Ineffective individual coping R/T physical abuse c. Impaired social interaction R/T neurological alterations d. Risk for violence: directed at others R/T displaced anger

d. Risk for violence: directed at others R/T displaced anger

Which is a behavioral influence on a client's sleep patterns? a. Sleep requirements increase during mental stress b. During periods of intense learning, more sleep is required c. Adolescents tend to sleep late, and older adults awaken early d. Sleep can be used to avoid stressful situations

d. Sleep can be used to avoid stressful situations

Within the community, which nursing intervention is aimed at reducing the prevalence of psychiatric illness by shortening the duration of the illness? a. Teaching techniques of stress management. b. Providing classes on parenting skills. c. Providing education and support to the homeless. d. Staffing suicide hotlines.

d. Staffing suicide hotlines

Which statement is correct regarding clients with a dual diagnosis? a. The substance abuse issue must be addressed first. b. The mental health issue must be addressed first. c. Dual diagnosis is not possible. Only one diagnosis can be assigned. d. The primary focus must be on a holistic view of the client's problems.

d. The primary focus must be on a holistic view of the client's problems.

A client diagnosed with aquaphobia begins a therapeutic process in which he or she must stand in a pool for 1 hour. This is called ________ therapy.

implosion