Extra question

The treatment team is recommending disulfiram (Antabuse) for a client who has had multiple admissions for alcohol detoxification. Which nursing question directed to the treatment team would protect this client's right to informed consent? 1. "Does this client have the cognitive ability to be prescribed this medication?" 2. "Will this client be adherent with this medication?" 3. "Will the team be liable if this client is harmed by this medication?" 4. "Is this the least restrictive means of meeting this client's needs?"

1. "Does this client have the cognitive ability to be prescribed this medication?

In a psychiatric in-patient setting, the nurse observes an adolescent client's peers calling the client names. In this context, which statement by the nurse exemplifies the concept of empathy? 1. "I can see that you are upset. Tell me how you feel." 2. "Your peers are being insensitive. I would be upset also." 3. "I used to be called names as a child. I know it can hurt feelings." 4. "I get angry when people are treated cruelly."

1. "I can see that you are upset. Tell me how you feel."

The staff observes a new nurse expressing anger and distrust while treating a client with a long history of alcohol use disorder. The staff suspects that the nurse is experiencing countertransference. Which statement by the new nurse validates the staff's suspicions? 1. "My mother misused alcohol and neglected her family." 2. "The client said I had the same disposition as his cranky wife." 3. "Maybe the client and I can sit down and work out a plan." 4. "The client refuses to accept responsibility for his alcohol misuse."

1. "My mother misused alcohol and neglected her family."

A student nurse asks the instructor about the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Which of the following instructor statements are correct? Select all that apply. 1. "The DSM-5 lists all psychiatric and general medical diagnoses." 2. "The DSM-5 allows clinicians to rate disorders along a continuum of severity." 3. "Conditions that do not meet DSM-5 criteria are termed 'not elsewhere defined' (NED)." 4. "Dimensional assessment tools are included in the DSM-5." 5. "Global Assessment of Functioning (GAF) is included in the DSM-5."

1. "The DSM-5 lists all psychiatric and general medical diagnoses." 2. "The DSM-5 allows clinicians to rate disorders along a continuum of severity." 3. "Conditions that do not meet DSM-5 criteria are termed 'not elsewhere defined' (NED)." 4. "Dimensional assessment tools are included in the DSM-5."

Which nursing intervention takes priority when working with a newly admitted client experiencing suicidal ideations? 1. Monitor the client at close, but irregular, intervals. 2. Encourage the client to participate in group therapy. 3. Enlist friends and family to assist the client in remaining safe after discharge. 4. Remind the client that it takes 6 to 8 weeks for antidepressants to be fully effective.

1. Monitor the client at close, but irregular, intervals.

A nursing student states to the instructor, "I'm afraid of mentally ill clients. They are all violent." Which of the following statements would the instructor use to clarify this perception for the student? Select all that apply. 1. "Even though most mentally ill clients are often violent, there are ways to de-escalate these behaviors." 2. "A very few clients with mental illness exhibit violent behaviors." 3. "There are medications that can be given to clients to prevent violent behaviors." 4. "Only paranoid clients exhibit violent behaviors." 5. "There is little difference in violence statistics between clients diagnosed with mental illness and the general population."

2. "A very few clients with mental illness exhibit violent behaviors." 5. "There is little difference in violence statistics between clients diagnosed with mental illness and the general population."

client in an out-patient clinic states, "I am so tired of these medications." Which nursing response would encourage the client to elaborate further? 1. "I see you have been taking your medications." 2. "Tired of taking your medications?" 3. "Let's discuss different ways to deal with your problems." 4. "How would your family feel about your stopping your medications?

2. "Tired of taking your medications?"

During a recent counseling session with a depressed client, the psychiatric nurse observes signs of transference. Which statement by the client would indicate that the nurse is correct? 1. "Thanks for taking my side against the staff." 2. "You sure do remind me of my mom." 3. "Working on problem-solving together makes sense." 4. "I won't stop drinking just to please my whole family."

2. "You sure do remind me of my mom."

According to Maslow's hierarchy of needs, which situation on an in-patient psychiatric unit would require priority intervention? 1. A client is disturbed that family can be seen only during visiting hours. 2. A client exhibits hostile and angry behaviors toward another client. 3. A client states, "I have no one who cares about me." 4. A client states, "I have never met my career goals."

2. A client exhibits hostile and angry behaviors toward another client.

A client admitted with major depressive disorder has a nursing diagnosis of ineffective sleep pattern R/T aches and pains. Which is an appropriate correctly written short-term outcome for this client? 1. The client will express feeling rested upon awakening. 2. The client will rate pain level at or below a 4/10. 3. The client will sleep 6 to 8 hours at night by day 5. 4. The client will maintain a steady sleep pattern while hospitalized.

3. The client will sleep 6 to 8 hours at night by day 5.

On an in-patient psychiatric unit, which of the following actions exemplify the nurse's role of teacher? Select all that apply. 1. The nurse assesses potentially stressful characteristics of the environment and develops strategies to eliminate or decrease stressors. 2. The nurse orients new clients to the unit and helps them to fit comfortably into the environment. 3. The nurse presents information to help the client and family members to understand the effects of mental illness. 4. The nurse is the guardian of the therapeutic environment. 5. The nurse holds a group to discuss medication side effects

3. The nurse presents information to help the client and family members tounderstand the effects of mental illness. 5. The nurse holds a group to discuss medication side effects.

A nurse is planning care for a hospitalized client who is immobile and in a continuous mitten restraint. Which of the following interventions should be included in the client's care plan? (Select all that apply.) a) Document restraint checks and client status every 2 hr. b) Educate the client's family about restraint use. c) Obtain the provider's prescription renewal every 72 hr. d) Implement passive range-of-motion exercises. e) Release the restraint and reposition the client every 4 hr.

A,B,D

Which of the following situations constitutes an act of negligence on the part of the nurse who is administering Cloazapine (Clozaril) to a schizophrenic client? A. Administering the drug after learning that the client's WBC count is 2500/mm B. Administering an anti-parkinsonian medication P.R.N. despite the presence of muscle rigidity C. Administering the drug after meals D. Instructing the client to visit the clinic weekly for a drug test

A. Administering the drug after learning that the client's WBC count is 2500/mm

The nurse is caring for a client with schizophrenia. Which of the following outcomes is the least desirable? A. The client spends more time by himself. B. The client demonstrates the ability to meet his own self-care needs. C. The client doesn't harm himself or others. D. The client doesn't engage in delusional thinking

A. The client spends more time by himself.

When interviewing the parents of an injured child, which of the following is the strongest indicator that child abuse may be a problem? A. The injury isn't consistent with the history or the child's age B. The mother and father tell different stories regarding what happened C. The family is poor D. The parents are argumentative and demanding with emergency department personnel

A. The injury isn't consistent with the history or the child's age

Erlinda, age 85, with major depression undergoes a sixth electroconvulsive therapy (ECT) treatment. When assessing the client immediately after ECT, the nurse expects to find: A. Transitory short and long term memory loss and confusion B. Transitory short-term memory loss and permanent long-term memory loss C. Permanent long-term memory loss and hypomania D. Permanent short-term memory loss and hypertension

A. Transitory short and long term memory loss and confusion

A 16-year-old client diagnosed with schizophrenia experiences command hallucinations to harm others. The clients parents ask a nurse, Where do the voices come from? Which is the appropriate nursing reply? A. Your child has a chemical imbalance of the brain, which leads to altered thoughts. B. Your childs hallucinations are caused by medication interactions. C. Your child has too little serotonin in the brain, causing delusions and hallucinations. D. Your childs abnormal hormonal changes have precipitated auditory hallucinations.

A. Your child has a chemical imbalance of the brain, which leads to altered thoughts.

Common adverse reactions to ECT select all that apply A. memory loss B. Nausea C. Abd pain D. personality changes E. chest pain F. muscle pain

A. memory loss B. Nausea F. muscle pain

While pacing in the hall, a client with paranoid schizophrenia runs to the nurse and says, "Why are you poisoning me? I know you work for central thought control! You can keep my thoughts. Give me back my soul!" How should the nurse respond during the early stage of the therapeutic process? A. "I'm not poisoning you. And how could I possibly steal your soul?" B. "I'm a nurse, and you're a client in the hospital. I'm not going to harm you." C. "I'm a nurse. I'm not poisoning you. It's against the nursing code of ethics." D. "I sense anger. Are you feeling angry today?"

B. "I'm a nurse, and you're a client in the hospital. I'm not going to harm you."

During an admission assessment, a nurse asks a client diagnosed with schizophrenia, Have you ever felt that certain objects or persons have control over your behavior? The nurse is assessing for which type of thought disruption? A. Delusions of persecution B. Delusions of influence C. Delusions of reference D. Delusions of grandeur

B. Delusions of influence

What is the priority reason for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder? A. The attention during the assessment is beneficial in decreasing social isolation. B. Depression is a symptom of several medical conditions. C. Physical health complications are likely to arise from antidepressant therapy. D. Depressed clients avoid addressing physical health and ignore medical problems.

B. Depression is a symptom of several medical conditions.

A nurse uses CBT techniques when working with a client who experiences panic attacks. Which of the following techniques are appropriate for this therapy model? A. Administering anti-anxiety meds as prescribed B. Encouraging the client to restructure thoughts C. Helping the client to used controlled relaxation breathing D. Helping the client examine evidence of stressors E. Teaching the client about anxiety and panic F. Question the client about early childhood relationships

B. Encouraging the client to restructure thoughts C. Helping the client to used controlled relaxation breathing D. Helping the client examine evidence of stressors E. Teaching the client about anxiety and panic

The utilization of psycho therapeutic interaction is based on the identified problem of the client. The goals of care provide direction for utilization of such interventions. Which of the following descriptions best reflects the main goal of family therapy? A. Family therapy enhances group decision making of the family B. Family therapy facilitates effective communication and interaction of the family members C. Family therapy focuses on the relationship of the parents more than the children D. Family therapy focuses on the client as the symptom bearer of a sick family

B. Family therapy facilitates effective communication and interaction of the family members

Neuroleptic Malignant Syndrome is characterized by : A. Hypotension, hypothermia, flushed and dry skin. B. Hypertension, hyperthermia, diaphoresis C. Hypertension, hypothermia, diaphoresis D. hypertension, hyperthermia, flushed and dry skin.

B. Hypertension, hyperthermia, diaphoresis

A client is diagnosed with major depressive disorder. Which nursing diagnosis should a nurse assign to this client to address a behavioral symptom of this disorder? A. Altered communication R/T feelings of worthlessness AEB anhedonia B. Social isolation R/T poor self-esteem AEB secluding self in room C. Altered thought processes R/T hopelessness AEB persecutory delusions D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

B. Social isolation R/T poor self-esteem AEB secluding self in room

client diagnosed with schizophrenia tells a nurse, The Shopatouliens took my shoes out of my room last night. Which is an appropriate charting entry to describe this clients statement? A. The client is experiencing command hallucinations. B. The client is expressing a neologism. C. The client is experiencing a paranoia. D. The client is verbalizing a word salad.

B. The client is expressing a neologism.

A nurse is caring for a client who has a history of being a perpetrator of abuse and violence. Which of following characteristics should the nurse expect the client to have? select all that apply A.Communicates in short sentences B.Intimidates others C.Shows bravery D.Is demanding E.Has low self-esteem F.Has a low tolerance for frustration

B.Intimidates others C.Shows bravery D.Is demanding E.Has low self-esteem F.Has a low tolerance for frustration

A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. According to learning theory, what is the cause of this clients symptoms? A. Depression is a result of anger turned inward. B. Depression is a result of abandonment. C. Depression is a result of repeated failures. D. Depression is a result of negative thinking

C. Depression is a result of repeated failures.

nurse is planning care for a client newly admitted with MDD. Which actions should the nurse take? A. Ask the client to create her own schedule of daily activities B. Teach the client to use positive communication when interacting with others C. Determine the client's needs for assistance with grooming D. Limit the client's involvement in unit activities

C. Determine the client's needs for assistance with grooming

Parents ask a nurse how they should reply when their child, diagnosed with schizophrenia, tells them that voices command him to harm others. Which is the appropriate nursing reply? A. Tell him to stop discussing the voices. B. Ignore what he is saying, while attempting to discover the underlying cause. C. Focus on the feelings generated by the hallucinations and present reality. D. Present objective evidence that the voices are not real.

C. Focus on the feelings generated by the hallucinations and present reality.

A client diagnosed with schizophrenia states, Cant you hear him? Its the devil. Hes telling me Im going to hell. Which is the most appropriate nursing reply? A. Did you take your medicine this morning? B. You are not going to hell. You are a good person. C. Im sure the voices sound scary. I dont hear any voices speaking. D. The devil only talks to people who are receptive to his influence.

C. Im sure the voices sound scary. I dont hear any voices speaking.

A client diagnosed with brief psychotic disorder tells a nurse about voices telling him to kill the president. Which nursing diagnosis should the nurse prioritize for this client? A. Disturbed sensory perception B. Altered thought processes C. Risk for violence: directed toward others D. Risk for injury

C. Risk for violence: directed toward others

n a toddler, which of the following injuries is most likely the result of child abuse? A. A 1-inch forehead laceration B. A small isolated bruise on the right lower extremity C. Several small, dime-sized circular burns on the child's back D. A hematoma on the occipital region of the head

C. Several small, dime-sized circular burns on the child's back

Which of the following approaches is appropriate to initiate interaction with the client? A. Tell the client "You are my client, I was your nurse. Can we begin talking?" B. Address the client by her family name and say " I am Liza your nurse you can talk to me anytime you want" C. Tell the client "hello Mrs. Jane Cruz I am Liza your nurse. I need to learn more about you and the reason you are here. Then we will talk about how can I help you D. Address the client by her first name and say " I am a nurse assigned to talked to you. How are you?

C. Tell the client "hello Mrs. Jane Cruz I am Liza your nurse. I need to learn more about you and the reason you are here. Then we will talk about how can I help you

A 24-year-old client is experiencing an acute schizophrenic episode. He has vivid hallucinations that are making him agitated. The nurse's best response at this time would be to: A. tell him his fear is unrealistic. B. engage the client in reality-oriented activities. C. explore the content of the hallucinations. D. take the client's vital signs.

C. explore the content of the hallucinations.

Which of the following statement is the most appropriate way to address hallucinations in a client? A. "are the voices bothering you again?" B. "don't be afraid, I am here to stay with you" C. "do you hear the voices?" D. "it seems that you are hearing something, what do you hear?"

D. "it seems that you are hearing something, what do you hear?"

Which of the following is one of the advantages of the newer antipsychotic medication risperidone (Risperdal)? A. The absence of anticholinergic effects B. No incidence of neuroleptic malignant syndrome C. Photosensitivity and sedation D. A lower incidence of extrapyramidal effects

D. A lower incidence of extrapyramidal effects

Which nursing intervention would be most appropriate when caring for an acutely agitated client with paranoia? A. Provide neon lights and soft music. B. Maintain continual eye contact throughout the interview. C. Use therapeutic touch to increase trust and rapport. D. Provide personal space to respect the clients boundaries.

D. Provide personal space to respect the clients boundaries.

Tony refuses his evening dose of Haloperidol (Haldol), then becomes extremely agitated in the dayroom while the other clients are watching television and he begins to throwing furniture. As a nurse your first reaction is? A. Report to the attending physician the behavior B. Check the clients medical record for an order of p.r.n. IM dose of medication for agitation C. Place the client in full leather restraint D. Remove all the other clients in the day room

D. Remove all the other clients in the day room

A confused client has recently been prescribed sertraline (Zoloft). The clients spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect, and what could be its possible cause? A. Neuroleptic malignant syndrome caused by ingestion of two different serotonin reuptake inhibitors (SSRIs) B. Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) C. Serotonin syndrome caused by ingestion of an SSRI and an MAOI D. Serotonin syndrome caused by ingestion of two different SSRIs

D. Serotonin syndrome caused by ingestion of two different SSRIs

A nurse is caring for a client who is hospitalized for the treatment of severe depression. Which approaches is therapeutic to include in the pts plan of care. A. Encourage decision making B. Restricting client choices of activities C. Playing a game of chess with the client D. Spending time sitting with the client

D. Spending time sitting with the client

A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis? A. The client is disheveled and malodorous. B. The client refuses to interact with others. C. The client is unable to feel any pleasure. D. The client has maxed-out charge cards and exhibits promiscuous behaviors

D. The client has maxed-out charge cards and exhibits promiscuous behaviors

A nurse in an emergency department is performing an assessment on a client who reports being sexually assaulted. Which of the following actions should the nurse take first? A.Ask the client for permission to take photographs B.Document the client's verbatim statements C.Provide community sexual assault support contacts D.Determine any signs of physical signs of injury

D.Determine any signs of physical signs of injury

Mr. Marquez reports of losing his job, not being able to sleep at night and feeling upset with his wife. F Nurse Jane responds to the client, " you may want to talk about your current situation in the group today". The nurse is using which therapeutic technique? Exploring Observation Focusing Restating

Focusing

A victim of domestic violence repetitively verbalizes self negating statement and a sense of guilt. Which nursing diagnosis applies to this client? Self mutilation Situational low self esteem Risk for self abuse Disturbed self concept

Situational low self esteem

A client diagnosed with schizoaffective disorder is suffering from schizophrenia with elements of which of the following disorders? Amnestic disorder Personality disorder Thought disorder Mood disorder

Mood disorder

The client on Haldol has pill rolling tremors and muscle rigidity he is likely manifesting: Pseudoparkinsonism Tardive dyskinesia Akathisia Dystonia

Pseudoparkinsonism

Which of the following needs of a client with alzheimer's disease should be the highest priority of the nurse? Bowel and bladder elimination Independence Reorientation Safety

Reorientation

A client with persistent, severe schizophrenia has been treated with phenothiazines for the past 17 years. Now the client's speech is garbled as a result of drug-induced rhythmic tongue protrusion. What is another name for this extrapyramidal symptom? Dystonia Pseudoparkinsonism Tardive dyskinesia Akathisia

Tardive dyskinesia

The nurse is having a therapeutic conversation with a client in a locked in-patient psychiatric unit. The client states, "Please don't tell anyone about my sexual abuse." Which is the appropriate nursing response? 1. "Yes, I will keep this information confidential." 2. "All of the health-care team is focused on helping you. I will bring information to the team that can assist them in planning your treatment." 3. "Why don't you want the team to know about your sexual abuse? It is significant information." 4. "Let's talk about your feelings about your history of sexual abuse."

`2. "All of the health-care team is focused on helping you. I will bring information to the team that can assist them in planning your treatment."

A client diagnosed with MMD is prescribed Zoloft, an SSRI. Which of the following teaching points would the nurse review with the client? a) Discuss the need to take medications even when symptoms improve. b) Remind the client that the medication's full effect may not occur for 6 to 8 weeks c) Instruct the client about the risks of abruptly stopping the medication d) Inform the client to discuss suicidal ideations related to depressed mood with their provider e) Alert the client to the risks of dry mouth, sedation, nausea, and sexual side effects.

all

A nurse observes that a client who has depression is sitting alone in the room crying. As the nurse approaches, the client states, "I'm feeling really down and don't want to talk to anyone right now." Which of the following responses should the nurse make? a) "It might help you feel better if you talk about it." b) "I'll just sit here with you for a few minutes then." c) "I understand. I know exactly how you feel" d) "Why are you feeling so down?"

b) "I'll just sit here with you for a few minutes then."

A nurse is discussing the use of mechanical restraints with a newly licensed nurse. Which of the following situations should the nurse include as an indication for placing a client in mechanical restraints? a) Self-destructive behavior despite alternative interventions b) Coercion to take prescribed medications c) Discipline for throwing objects at staff d)Punishment for verbally abusing other clients

c) Discipline for throwing objects at staff

A nurse is caring for a client following a suicide attempt. The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions is the nurse's priority? a) Reviewing the client's toxicology laboratory report b) Making a contract with the client for eating behavior c) Initiating suicide precautions d) Administering the Hamilton Depression Scale

c) Initiating suicide precautions

A client has been placed in seclusion because the client has been deemed a danger to others. Which is the priority nursing intervention for this client? a) Have little contact with the client to decrease stimulation b) Provide the client with privacy to maintain confidentiality c) Maintain contact and assure the client that seclusion will maintain the client's safety d) Teach the client relaxation techniques and effective coping strategies to deal with anger

c) Maintain contact and assure the client that seclusion will maintain the client's safety

In which situation wold the nurse suspect a diagnosis of social anxiety disorder? a) A client abuses marijuana daily and avoids social situations because of fear of humiliation b) An 8-year-old child isolates from adults because of fear and embarrassment but has good peer relationships in school c) A client diagnosed with Parkinson's disease avoids social situations because of embarrassment regarding tremors and drooling d) A college student avoids taking classes that include an oral presentation because of fear of being scrutinized by others

d

The right to determine one's own destiny is to 'autonomy' as the duty to benefit or promote the good of other is to: a) Nonmaleficence b) Justice c) Veracity d) Beneficence

d

A client diagnosed with Generalized Anxiety Disorder is placed on Buspirone (Buspar). Which client statement indicates teaching has been effective? a) The client verbalizes that the medication should be taken as needed for anxiety b) The client states that the medication should be taken in the morning to improve energy c) The client verbalizes that the medication is for short term use d) The client verbalizes that there is a decreased risk of dependency with this medication

d) The client verbalizes that there is a decreased risk of dependency with this medication

Tourette syndrome is characterized by the presence of multiple motor and vocal tics. A vocal tic that involves repeating one's own sounds or words is known as: palilalia aphonia apraxia. Echolalia

palilalia

Which one of the following is essential component of the therapeutic communication? Rapport Sympathy Consistency Empathy

xEmpathy

When the nurse creates an environment to facilitate healing, the nurse's actions are based on which of the following assumptions? Select all that apply. 1. A therapeutic relationship can be a healing experience. 2. A healthy relationship cannot be transferred to other relationships. 3. Group settings can support ego strengths. 4. Treatment plans can be formulated by observing social behaviors. 5. Countertransference eases the establishment of the nurse-client relationship.

1. A therapeutic relationship can be a healing experience. 3. Group settings can support ego strengths. 4. Treatment plans can be formulated by observing social behaviors.

A nursing student is experiencing fears related to the first clinical experience in a psychiatric setting. This is most likely to occur in which phase of the nurse-client relationship? 1. In the pre-interaction phase, because the student is likely to be suspicious of psychiatric clients. 2. In the orientation phase, because the psychiatric client may threaten the student's role identity. 3. In the working phase, because the student may feel emotionally vulnerable to past experiences. 4. In the termination phase, because the student may be uncertain about his or her ability to make a difference.

1. In the pre-interaction phase, because the student is likely to be suspicious of psychiatric clients.

Which of the following clients retain the right to give informed consent? Select all that apply. 1. A 21 year-old client who is hearing and seeing things that others do not. 2. A 32 year-old client who is diagnosed with severe intellectual development disorder. 3. A 65 year-old client declared legally incompetent. 4. A 14 year-old client with attention-deficit/hyperactivity disorder (ADHD). 5. An 80 year-old client who wants to participate in a medical research study.

1. A 21 year-old client who is hearing and seeing things that others do not. 5. An 80 year-old client who wants to participate in a medical research study.

On which client would a nurse on an in-patient psychiatric unit appropriately use fourpoint restraints? 1. A client who is hostile and threatening the staff and other clients. 2. A client who is intrusive and demanding and requires added attention. 3. A client who is noncompliant with medications and treatments. 4. A client who splits staff and manipulates other clients.

1. A client who is hostile and threatening the staff and other clients.

Which of the following are reasons for the utilization of the DSM-5 in the mental health-care system? Select all that apply. 1. It is a convenient format for organizing and communicating clinical data. 2. It is a means for considering the complexity of clinical situations. 3. It is a means for describing the unique symptoms of psychiatric clients. 4. It is a format for evaluating clients based on a regulated approach. 5. It is a means to better understand the etiology of many psychiatric disorders.

1. It is a convenient format for organizing and communicating clinical data. 2. It is a means for considering the complexity of clinical situations.

Which of the following are true statements about neurotransmitters? Select all that apply. 1. Neurotransmitters are responsible for essential functions in human emotions and behaviors. 2. Neurotransmitters are targets for the mechanism of action of many psychotropic medications. 3. Neurotransmitters are only studied for their effect related to psychiatric disease processes. 4. Neurotransmitters are nerve cells that generate and transmit the body's electrochemical impulses. 5. Neurotransmitters are cholinergics, such as serotonin, norepinephrine, dopamine, and histamine.

1. Neurotransmitters are responsible for essential functions in human emotions and behaviors. 2. Neurotransmitters are targets for the mechanism of action of many psychotropic medications. Neurotransmitters are chemical messengers released by nerve cells (neurons) to communicate with other neurons, muscles, or glands. Acetylcholine is the primary cholinergic neurotransmitter. Serotonin, norepinephrine, and dopamine fall into other categories (monoamines). Histamine is also a monoamine but serves multiple roles in the body. Neurotransmitters are chemical messengers released by nerve cells (neurons) to communicate with other neurons, muscles, or glands.

On an in-patient psychiatric unit, the nurse explores feelings about potentially working with a woman who has allowed her husband to abuse her and her children physically and verbally. This interaction would occur in which phase of the nurse-client relationship? 1. Pre-interaction phase. 2. Orientation (introductory) phase. 3. Working phase. 4. Termination phase.

1. Pre-interaction phase.

Which nursing diagnosis takes priority for a client immediately after electroconvulsive therapy (ECT)? 1. Risk for injury R/T altered mental status. 2. Impaired social interaction R/T confusion. 3. Activity intolerance R/T weakness. 4. Chronic confusion R/T side effect of ECT.

1. Risk for injury R/T altered mental status.

How is the DSM-5 helpful to mental health providers? Select all that apply. 1. The DSM-5 provides a common language related to the diagnoses of mental illness. 2. The DSM-5 lists medications that are appropriate for the treatment of mental disorders. 3. The DSM-5 presents standard criteria for the classification of mental disorders. 4. The DSM-5 provides an axis system to evaluate clients holistically. 5. The DSM-5 presents a comprehensive list of community resources.

1. The DSM-5 provides a common language related to the diagnoses of mental illness. 3. The DSM-5 presents standard criteria for the classification of mental disorders.

Which of the following behaviors exemplifies the concept of countertransference? Select all that apply. 1. The nurse defends the client's inappropriate behavior to the psychiatrist. 2. The nurse empathizes with the client's loss. 3. The nurse subjectively appreciates the client's feelings. 4. The nurse is uneasy when interacting with the client. 5. The nurse recognizes that the client is emotionally attached to the social worker.

1. The nurse defends the client's inappropriate behavior to the psychiatrist. 3. The nurse subjectively appreciates the client's feelings. 5. The nurse recognizes that the client is emotionally attached to the social worker.

Which of the following actions reflect the nurse's role of advocate in an in-patient psychiatric setting? Select all that apply. 1. The nurse speaks on behalf of a mentally ill client to ensure adequate access to needed mental health services. 2. The nurse focuses on improving the mentally ill client's and family members' self-care knowledge and skills. 3. The nurse explains unit rules and ensures that new clients fit comfortably into the therapeutic environment. 4. The nurse continually monitors the client in the milieu for side effects of a new psychotropic medication. 5. The nurse talks with the treatment team to support a shy client's request for less-sedating medications.

1. The nurse speaks on behalf of a mentally ill client to ensure adequate access to needed mental health services. 5. The nurse talks with the treatment team to support a shy client's request for less-sedating medications.

The nursing student is experiencing a severe family crisis. In what way might this situation affect the student's performance in a psychiatric rotation? 1. The student might overidentify with clients and meet his or her own needs. 2. The student might fear clients and avoid them. 3. The student might feel inadequate and fear emotionally harming clients. 4. The student might doubt his or her value in assisting clients due to lack of knowledge.

1. The student might overidentify with clients and meet his or her own needs.

According to Maslow's hierarchy of needs, which situation demonstrates the lowest level of attainment? 1. An individual demonstrates an ability to discuss objectively all points of view and possesses a strong sense of ethics. 2. An individual avoids harm while maintaining comfort, order, and physical safety. 3. An individual establishes meaningful interpersonal relationships and can identify himself or herself within a group. 4. An individual desires prestige from personal accomplishments.

2. An individual avoids harm while maintaining comfort, order, and physical safety.

On an in-patient locked psychiatric unit, a newly admitted client requests to leave against medical advice (AMA). What should be the initial nursing action for this client? 1. Tell the client that, because he or she is on a locked unit, he or she cannot leave AMA. 2. Check the client's admission status and discuss the client's reasons for wanting to leave. 3. In a matter-of-fact way, initiate room restrictions. 4. Place the client on one-on-one observation.

2. Check the client's admission status and discuss the client's reasons for wanting to leave.

Which elements are included in the nurse-client contract? 1. During the pre-interaction phase, the roles are established. 2. During the orientation phase, the purpose of the interaction is established. 3. During the working phase, the conditions for termination are established. 4. During the termination phase, the criteria for discharge are established.

2. During the orientation phase, the purpose of the interaction is established.

Which is the goal for the orientation phase of the nurse-client relationship? 1. Explore self-perceptions. 2. Establish trust. 3. Promote change. 4. Evaluate goal attainment.

2. Establish trust.

The nurse explores any personal misconceptions or prejudices before caring for a client. This action is one of the tasks that occur in a phase of the nurse-client relationship. What is the nurse's major task in this phase? 1. Determining why the client sought help. 2. Exploring self. 3. Assisting the patient in behavioral change. 4. Establishing and preparing the client for the reality of separation

2. Exploring self.

A nursing student observes an incorrect dosage of medication being given to a client receiving electroconvulsive therapy. To implement the ethical principle of veracity, which action would the nursing student take? 1. Keep the information confidential to avoid harm to others. 2. Inform the student's instructor and the client's primary nurse and document the situation. 3. Tell only the client about the incident because the decision about actions would be determined only by the client. 4. Because the client was not harmed, the incident would not need to be reported.

2. Inform the student's instructor and the client's primary nurse and document the situation.

On an in-patient psychiatric unit, a client states, "I want to learn better ways to handle my anger." This interaction is most likely to occur in which phase of the nurse-client relationship? 1. Pre-interaction phase. 2. Orientation (introductory) phase. 3. Working phase. 4. Termination phase.

2. Orientation (introductory) phase.

A client on a psychiatric unit is telling the nurse about anger toward the airline after losing an only child in a plane crash. In which situation is the nurse demonstrating active listening? 1. Agreeing with the client. 2. Repeating everything that the client says to clarify. 3. Assuming a relaxed posture and leaning toward the client. 4. Expressing sorrow and sadness regarding the client's loss.

2. Repeating everything that the client says to clarify.

Which of the following are examples of primary prevention in a community mental health setting? Select all that apply. 1. Ongoing assessment of individuals at high risk for illness exacerbation. 2. Teaching physical and psychosocial effects of stress to elementary school students. 3. Referral for treatment of individuals in whom illness symptoms have been assessed. 4. Monitoring effectiveness of aftercare services. 5. Teaching a class on child-rearing skills for a group of new parents.

2. Teaching physical and psychosocial effects of stress to elementary school students. 5. Teaching a class on child-rearing skills for a group of new parents.

While talking about an abusive childhood, a client addicted to heroin suddenly blurts out, "I hate my doctor." Which client statement would indicate that transference is taking place? 1. "The doctor has told me that his son recovered, and I will also." 2. "I don't care what anyone says, I don't have a problem I can't handle." 3. "I'd bet my doctor beat and locked his son in a closet when he was a boy." 4. "I'm going to stop fighting and start working together with my doctor."

3. "I'd bet my doctor beat and locked his son in a closet when he was a boy."

According to Maslow's hierarchy of needs, which client action would be an example of a highly evolved, mature client? 1. A client discusses the need for avoiding harm and maintaining comfort. 2. A client states the need for giving and receiving support from others. 3. A client begins to discuss feelings of self-fulfillment. 4. A client discusses the need to achieve success and recognition in work.

3. A client begins to discuss feelings of self-fulfillment.

Which of the following clients does not have the ability to refuse medications or treatments? Select all that apply. 1. An involuntarily committed client. 2. A voluntarily committed client. 3. A client who has been deemed incompetent by the court. 4. A client who has a diagnosis of antisocial personality disorder. 5. A client who is an imminent danger to him- or herself.

3. A client who has been deemed incompetent by the court. 5. A client who is an imminent danger to him- or herself.

A client diagnosed with major depressive disorder is being considered for ECT. Which client teaching should the nurse prioritize? 1. Empathize with the client about fears regarding ECT. 2. Monitor for any cardiac alterations to prevent possible negative outcomes. 3. Discuss with the client and family expected short-term memory loss. 4. Inform the client that injury related to induced seizure commonly occurs.

3. Discuss with the client and family expected short-term memory loss.

A client has been placed in seclusion because the client has been deemed a danger to others. Which is the priority nursing intervention for this client? 1. Have little contact with the client to decrease stimulation. 2. Provide the client with privacy to maintain confidentiality. 3. Maintain contact and assure the client that seclusion will maintain the client's safety. 4. Teach the client relaxation techniques and effective coping strategies to deal with anger.

3. Maintain contact and assure the client that seclusion will maintain the client's safety.

A client on an in-patient psychiatric unit has a nursing diagnosis of nonadherence R/T antipsychotic medications. In which role is the nurse functioning when checking for "cheeking"? 1. Advocate. 2. Educator. 3. Medication manager. 4. Counselor.

3. Medication manager.

Which nursing intervention would assist the client who is experiencing bothersome hallucinations in adhering to prescribed medications? 1. Using liquid or IM injection to avoid cheeking of medications. 2. Teaching the client about potential side effects from prescribed medications. 3. Reminding the client that the medication decreases the bothersome hallucinations. 4. Notifying the client of the action, peak, and duration of the medication.

3. Reminding the client that the medication decreases the bothersome hallucinations.

A newly admitted client diagnosed with major depressive disorder has a history of two suicide attempts by hanging. Which nursing diagnosis takes priority? 1. Risk for violence directed at others R/T anger turned outward. 2. Social isolation R/T depressed mood. 3. Risk for suicide R/T history of attempts. 4. Hopelessness R/T multiple suicide attempts.

3. Risk for suicide R/T history of attempts.

The nurse is attempting to establish a therapeutic relationship with an angry, depressed client on a psychiatric unit. Which is the most appropriate nursing intervention? 1. Work on establishing a friendship with the client. 2. Use humor to defuse emotionally charged topics of discussion. 3. Show respect that is not based on the client's behavior. 4. Sympathize with the client when the client shares sad feelings.

3. Show respect that is not based on the client's behavior.

Which is the overall, priority goal of in-patient psychiatric treatment? 1. Maintenance of stability in the community. 2. Medication adherence. 3. Stabilization and return to the community. 4. Better communication skills.

3. Stabilization and return to the community.

A client states, "I don't know what the pills are for or why I am taking them, so I don't want them." Which is an example of the therapeutic communication technique of "giving information"? 1. "You must take your medication to get better." 2. "The doctor wouldn't prescribe these pills if they were harmful." 3. "Do you feel this way about all your medications?" 4. "This medication will help to improve your mood."

4. "This medication will help to improve your mood."

On an in-patient psychiatric unit, a client who is anxious and distressed states, "God has abandoned me." Which nursing action would initiate collaboration with the member of the mental health-care team who can assist this client with this assessed problem? 1. Notify the psychiatrist to get an order for an antianxiety medication prn. 2. Consult the social worker to provide community resources. 3. Notify the psychologist that testing is necessary. 4. Consult with the chaplain and describe the client's concerns.

4. Consult with the chaplain and describe the client's concerns.

An unconscious client with a self-inflicted gunshot wound to the head is admitted. Family members allude to the existence of a living will in which the client mandates no implementation of life support. What is the legal obligation of the health-care team? 1. Follow the family's wishes because of the family's knowledge of the living will. 2. Follow the directions given in the living will because of mandates by state law. 3. Follow the ethical concept of nonmaleficence and place the client on life support. 4. Follow the ethical concept of beneficence, implementing lifesaving measures.

4. Follow the ethical concept of beneficence, implementing lifesaving measures.

A client states, "They're putting rat poison in my food." Which intervention would assist this client to be medication adherent while on the in-patient psychiatric unit? 1. Remind the client that the psychiatrist ordered the medication for him or her. 2. Maintain the same routine for medication administration. 3. Use liquid medication to avoid cheeking. 4. Keep medications in sealed packages and open them in front of the client.

4. Keep medications in sealed packages and open them in front of the client.

A newly admitted client has been diagnosed with major depressive disorder. Which nursing diagnosis takes priority? 1. Social isolation R/T poor mood AEB refusing visits from family. 2. Self-care deficit R/T hopelessness AEB not taking a bath for 2 weeks. 3. Anxiety R/T hospitalization AEB anxiety rating of 8/10. 4. Risk for self-directed violence R/T depressed mood.

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

The nurse helps a client practice various techniques of assertive communication and gives positive feedback for improvement of passive-aggressive interactions. This intervention would occur in which phase of the nurse-client relationship? 1. Pre-interaction phase. 2. Orientation (introductory) phase. 3. Working phase. 4. Termination phase.

4. Termination phase.

The nurse reviews a client's record in preparation for client care. This action is one of the tasks that occur in a phase of the nurse-client relationship. What is the purpose of this phase? 1. Getting to know each other and establishing trust. 2. Implementing nursing interventions to achieve outcomes. 3. Achievement of independence and maintenance of health without nursing care. 4. Understanding the client's diagnosis and evaluating the nurse's attitudes.

4. Understanding the client's diagnosis and evaluating the nurse's attitudes.

In which situation does a health-care worker have a duty to warn a potential victim? 1. When clients manipulate and split the staff and are a danger to self. 2. When clients curse at family members during visiting hours. 3. When clients exhibit paranoid delusions and auditory or visual hallucinations. 4. When clients make specific threats toward someone who is identifiable.

4. When clients make specific threats toward someone who is identifiable.

Crisis intervention carried out to the client has this primary goal A. Assist the client to express her feelings B. Support her adaptive coping skills C. Help her identify her resources D. Help her return to her pre-crisis level of function

D. Help her return to her pre-crisis level of function