Mental Exam #4

Family members of a client ask the nurse to explain the difference between Schizoid and Avoidant personality disorders. Which is the appropriate nursing reply?

"Clients diagnosed with Avoidant personality disorder desire intimacy but fear it, and clients with Schizoid prefer to be alone"

You are the night nurse who has gotten report on the following patient. Prioritize which of the patients you would see first.

70yo male who is post-surgical hip fracture with a history of dementia

A clearly underweight client presents constant descriptions of distorted body images and denies that they never binge eat. You can assume that the client is suffering from?

Anorexia nervosa

Rank the following nursing interventions based on priority of a patient diagnosed with Bulimia

**D, C, A, B, E** A: Draw blood for CBC and CMP B: Assess for depression C: Obtain vitals D: Perform ECG E: Teach and encourage on self-care activities

A nurse is caring for a client who has a new prescription of Risperidone. Which of the following rating scales should the nurse complete prior to administering the 1st dose of Risperidone?

Abnormal Involuntary Movement Scale (AIMS)

A nurse is planing care for a client who has a diagnosed Anxiety disorder. Which of the following intervention should the nurse implement to promote occupational functioning?

Assist the client in identifying triggers

People living with Bulimia nervosa tend to be?

Average weight

A nurse is admitting a 14yo with Conduct disorder. What would the nurse anticipate finding in this assessment?

Bullying of others

A client is experiencing Command hallucinations and appears to be frightened. Which of the following actions are appropriate nursing interventions?

Keep the client physically safe

A nurse in the ED is implementing a plan of care for an older adult client who is experiencing Delirium tremens (severe alcohol withdrawal such as shaking, confusion, and hallucinations). Which of the following actions should the nurse take first?

Lower the bed and rise the side rails

Consider this comment to 3 different nurses by a patient diagnosed with Antisocial personality disorder "Another nurse said you don't do your job right." These interactions can be assessed as?

Manipulative

A nurse is admitting an older adult client who has a suspected Cognitive behavior. Which of the following inventories should be included as part of the admission assessment?

Mental Status Examination (MSE)

The nurse tells the parents of an adolescent diagnosed with Anorexia "The social worker will be contacting you to schedule a family meeting". One of the parents states "Why is that necessary? Our child is the one who needs treatment". Which response by the nurse is best?

"Family intervention and support are important in managing eating disorders"

A nurse is assessing a client who has a history of Alcohol use disorder. Which of the following questions should the nurse include to determine how the use of alcohol affects the client's psychosocial behaviors?

"Has the alcohol use affected your performance at work?"

A home health nurse is speaking to a group of acute care nurses about domestic violence. Which of the following statements by one of the nurses indicates a need for clarification?

"I have heard that abusers think of themselves as very important and have high self-esteem"

A child has been diagnosed with Autism spectrum disorder (ASD). The distraught mother cries out, "I'm such a horrible mother, what did I do to cause this?" Which nursing reply is most appropriate?

"Poor parenting doesn't cause Autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control"

A client is pacing the hall near the nurse's station swearing loudly. An appropriate initial intervention for the nurse would be to address the client by name and say?

"You seem upset. Would you like to tell me about it?"

A nurse is assessing a child and suspects child abuse. Which of the following assessment finding support the nurse's assumption?

A circular burn on the child's arm

The nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first?

A client diagnosed with Conduct Disorder who is verbally abusing a peer in the milieu

The clearest indication of success in behavior modification related to eating disorders would be?

A client showing and demonstrating that they have perceptions of control over their life and treatments

A nurse is reviewing the medical histories of 4 clients, which of the following clients will most likely develop Extrapyramidal symptoms from medication therapy?

A client with schizophrenia taking a 1st-Generation antipychotic

A group of nurses is discussing how food is used in their families and the effects this might have on their ability to work with clients diagnosed with eating disorders. Which nurse is most likely to be most effective with these clients?

A nurse that refused to engage in power struggles over food

A nurse is admitting a client who is in the Manic phase of Bipolar disorder. The nurse should plan to make which of the following room assignments for the client?

A private room in a quiet location that can easily be monitored

A nurse is caring for a client who is Cognitively impaired, which of the following rooms will provide a therapeutic environment for this client?

A room containing personal belongings nearby without contrabands

A nurse is educating staff on personality disorders. Which statement by the staff indicates understanding?

Antisocial personality disorder can start as conduct disorder

Symptoms of Amphetamine withdrawal include:

Anxiety, depressed mood, irritability, and craving for the substance

Which of the following is an FDA approved medication for the pharmacological intervention of Autism spectrum disorder (ASD)?

Aripiprazole

A nurse is caring for a client who has an eating disorder. The nurse is demonstrating which of the following ethical concepts when they allow the client to refuse to drink a meal protein and calorie supplement?

Autonomy

Of the following populations, which would Tourette's be most common in?

Boys, 6-7yo

A patient with Anorexia nervosa. The history shows the patient virtually stopped eating 5mos ago and has lost 25% body weight. The serum potassium is 2.7 mg/dL. The patient is at risk of what complication?

Cardiac arrhythmia

A nurse questions the order to begin nourishing an emaciated client slowly. The prescriber explains the reason behind this choice is?

Clients may die from being nourished too quickly

A nurse is attempting to differentiate between the symptoms of Anorexia nervosa and Bulimia. Which statement delineates the difference between these 2 disorders?

Clients with Anorexia nervosa experience nutritional deficits and Bulimia clients don't

A 28yo client with Body dysmorphic disorder (BDD) tells the nurse that they plan to have a surgical procedure that will affect their appearance. The nurse understands that this plan is an effort to?

Cure the imagined defect

A patient with a substance abuse problem makes statements such as, "I don't have a problem with (substance)" or "I can quit any time I want to." The patient also does not perceive any problems related to use of the substance and is unable to admit the impact of the disease on his or her life patterns and functioning. What nursing diagnosis would you assign to this patient?

Denial

A client is newly diagnosed with OCD and spends 45mins washing their hands and completing ritualistic tasks. Which nursing intervention would best address this client's problem?

Discuss the anxiety-provoking triggers that precipitate the ritualistic behaviors

The nurse is reviewing the plan of care for a 15yo client diagnosed with Anorexia. The treatment plans to implement Cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with Anorexia?

Eliminate emotional components of maladaptive eating patterns

The nurse is reviewing the plan of care for a 15yo diagnosed with Anorexia. The treatment plans to implement Cognitive behavior therapy (CBT). Which is the best rationale for the use of CBT for clients diagnosed with Anorexia?

Eliminate emotional components of maladaptive eating patterns

A nurse is caring for a client with Schizophrenia. The client states "The weather channel lady loves me and she is going to quit her show to be with me!" The nurse should document that the client is experiencing which of the following delusion?

Erotomanic

A nurse is assessing a client with PTSD would expect the client to report which finding?

Fatigue

Possible predisposing factors to Schizoid personality disorder include all the following except?

Having overly protective parents

A client taking Phenelzine has a BP of 210/119, HR of 104 bpm, and diaphoresis. The nurse discovers the client has recently taken OTC for allergies and a cold. The nurse recognizes this client is experiencing?

Hypertensive crisis

A nurse is caring for a newly admitted client who has OCD. Which of the following actions should the nurse take first?

Identifying stressors that precipitate rituals

Which finding is the nurse most likely to assess in a child diagnosed with Separation anxiety disorder?

If the child's mother is diagnosed with an anxiety disorder

A UAP is working with clients that have a diagnosis of Obsessive compulsive disorder (OCD). The UAP understands the reason not to stop the carrying out of compulsions is?

If this is not done therapeutically, the client will have an escalation in anxiety

The nurse knows that Cluster A personality disorders (odd, eccentric) tend to exhibit what behaviors?

Indifference to social situations

The following are characteristics of which Cluster B personality disorder: Arrogance, Grandiosity, Lack of empathy, or Sensitive to criticism?

Narcissistic Personality Disorder

The following are all common Comorbid psychiatric prevalent with ADHD, except?

OCD

What is the difference between Conduct disorder (CD) and Oppositional defiance disorder (ODD)?

ODD doesn't involve physical aggression

A client with Anorexia nervosa is at increased risk for which of the following?

Osteopenia

Personality traits most likely to be documented regarding a patient demonstrating characteristics of an OCD are?

Perfectionist, inflexible

A client is diagnosed with PTSD, which treatment modality expose the client to repeated and prolonged mental recounting of the traumatic event?

Prolonged exposure therapy

Which nursing intervention is the priority when caring for a child diagnosed with Conduct disorder?

Recognize escalating aggressive behaviors and intervene before violence occurs

This is a potentially fatal complication that results in the introduction of fluids and carbohydrates for patients who are malnourished?

Refeeding syndrome

A nurse is assessing a 5yo with Autism spectrum disorder. For which of the following manifestations will the nurse assess?

Repetitive hand gestures

Which of the following defense mechanisms describes the underlying cause of Somatic symptom disorder?

Repression of anxiety

A nurse is planning care for a client who has Antisocial personality disorder. Which of the following actions should the nurse plan to take?

Set limits to prevent exploitation of other clients

A nurse is performing an admission assessment for an adolescent client with a diagnosis of Schizophrenia. Which of the following findings should the nurse identify as a Positive symptom?

Somatic delusions

A client prescribes Sertraline asks about alternative therapies to treat depression that she is experiencing regarding her current family situation. Which statement by the student nurse indicates a need for intervention?

St John's Wort is an excellent treatment for depression

The most important short-term goal of a client with Avoidant personality disorder would be to?

State a positive personality trait

Personality traits most likely to be documented regarding a patient demonstrating characteristics of a Paranoid personality disorder are?

Suspicious, holds grudges

The client states "I just can't fall asleep". The nurse responds "You are having difficulty falling asleep?" Why is the nurse using the restating technique?

The nurse is allowing the client to elaborate or clear up misunderstanding

After an adolescent diagnosed with ADHD begins Methylphenidate therapy, the nurse notes that the adolescent loses 10lbs in a 2mos period. Which is the best explanation for this weight loss?

The pharmacological action of Methylphenidate causes a decrease in appetite

A nurse is teaching a male client who has a Depressive disorder about Escitalopram. Which of the following information should the nurse include in the teaching?

This medication may cause an inability to orgasm

The nurse working with a client diagnosed with Bulimia nervosa asks the client to recall a time in life when food could be consume without purging. Which best explains the purpose of the nurse's question?

To emphasize that the client is capable of consuming food without purging

A patient tells the nurse "I don't like you, you look like my grandmother" This is an example of what concept?

Transference

Jane is a 4yo who wakes up screaming in her room, she is frantic, states she wants her mom who had to leave hours ago to go home. All of the therapeutic techniques may be effective except?

Turning off the lights to calm her down