Mental Health Chapter 21 Practice Questions

Claude is a new nurse to the psychiatric unit. He asks a senior nurse on staff for the best advice when working with oppositional defiant disorder. Which statement reflects advice on solid therapeutic communication? A. "When correcting behavior, use a loud firm tone B. "Use language beyond the patient's education level C. "When setting limits, be specific and outline consequences D. "An aggressive body language will make the patients respect your position

C. "When setting limits, be specific and outline consequences

Assessment for oppositional defiant disorder should include which interventions? A. Assessing the history, frequency, and triggers for violent outbursts B. Assessing moral development, belief system, and spirituality for the ability to understand the impact of hurtful behavior on others, to empathize with others, and to feel remorse C. Assessing issues that result in power struggles and triggers for outbursts D. Assessing sibling birth order to understand the dynamics of family interaction

C. Assessing issues that result in power struggles and triggers for outbursts

When parents share that their 8-year-old child seems to "always try to be annoying and hateful," the nurse suspects the child is demonstrating which characteristic? A. Emotionally immature B. Anxiety C. Vindictiveness D. Depression

C. Vindictiveness

Which behavior consistently demonstrated by a child is a predictor of future antisocial personality disorder in adults? A. Sadness B. Remorse C. Guilt D. Callousness

D. Callousness

Larry, a middle-aged male in treatment is loudly displaying anger in the day room with a visiting family member. It is obvious to the nurse that this pattern has played out before. Violence is often escalated when family members or authority figures: A. Use soft tone of voice to gain control of the situation B. Move away from the agitated person in fear C. Use simple words to communicate D. Engage in a power struggle

D. Engage in a power struggle

A poorly developed sense of empathy is thought to be the result of having what life experience? A. A family history of mental illness B. a low serum testosterone level C. suffered head trauma at an early age D. unmet physical and emotional needs

D. unmet physical and emotional needs

Which statement is true about the characteristics of the oppositional defiant child? A. The defiance is generally directed toward parents and siblings. B. These behaviors are a predictor of future mental health disorders. C. Arguing tends to be more prevalent in boys. D. Girls display more blaming than do boys.

B. These behaviors are a predictor of future mental health disorders

Which child is demonstrating behaviors that support a diagnosis of adolescent onset conduct disorder? A. A 12-year-old male who steals a bicycle as a gang initiation B. A 9-year-old male who smokes half a pack of cigarettes a day C. A 12-year-old female who regularly bullies her younger siblings D. A 9-year-old female who engages in sexually provocative behaviors

A. A 12-year-old male who steals a bicycle as a gang initiation

Which of the following classifications of medication may be prescribed in intermittent explosive disorder? A. Anticonvulsants B. Psychostimulants C. Antianxiety agents such as benzodiazepines D. Monoamine oxidase (MAO) inhibitors

A. Anticonvulsants

As an adult, a client who has been diagnosed with childhood-onset conduct disorder is at high risk for developing which comorbid disorder? A. Antipersonality disorder B. Obsessive-compulsive disorder C. Kleptomania D. Depression

A. Antipersonality disorder

When discussing Oppositional Defiant Disorder with a group of parents, what information should the nurse include about the disorder? Select all that apply A. Classic symptoms include anger, irritation, and defiant behavior B. Children generally outgrow the behaviors without formal treatment C. Severity is considered mild when symptoms are present only in one setting D. Disorder is diagnosed equally in males and females E. Argumentative and defiant are terms often used to describe the patient

A. Classic symptoms include anger, irritation, and defiant behavior B. Children generally outgrow the behaviors without formal treatment C. Severity is considered mild when symptoms are present only in one setting E. Argumentative and defiant are terms often used to describe the patient

The nurse is preparing to set goals for a 10-year-old diagnosed with an impulse control disorder. To best ensure the expected therapeutic outcomes, the nurse includes goals that focus on what client need? A. Client centered and includes the client's input B. Age appropriate and achievable in a short period of time C. Simple and easily defined D. Family centered and long term in nature

A. Client centered and includes the client's input

Tommy, a 12yo boy admitted to the pediatric psychiatric unit, has recently been diagnosed with conduct disorder. In the activity room, the games he wanted to play were already in use. He responded by threatening to throw the furniture and to hurt his peers who had the game he wanted. Nancy, a RN, recognizes that Tommy's therapy must include: A. Consistency in implementing the consequences of breaking the rules B. Empathetic reasoning when Tommy acts out in the activity room C. Teaching Tommy the benefits of socializing D. Solitary time so that Tommy can think about his actions

A. Consistency in implementing the consequences of breaking the rules

hat assessment data would support a diagnosis of conduct disorder? Select all that apply. A. Evidence of social isolation B. Arrested twice for disorderly conduct C. Expresses difficulty in keeping employment D. Demonstrates objective signs of phobia E. Exhibits signs of chronic self-mutilation

A. Evidence of social isolation B. Arrested twice for disorderly conduct C. Expresses difficulty in keeping employment

A client diagnosed with conduct disorder craves what experience? A. Excitement without concern for possible negative outcomes B. Control of situations and constantly strategizes for such power C. Friendship but from those older than themselves D. Material possessions but lacks focus and direction

A. Excitement without concern for possible negative outcomes

Which of the following statements are true regarding childhood-onset conduct disorder? Select all that apply. A. It is more commonly diagnosed in males. B. It is characterized by feelings of remorse and regret. C. It is usually diagnosed in late teen years. D. It is characterized by disregard for the rights of others. E. Those with conduct disorder rationalize their aggressive behaviors. F. It is usually outgrown by early adulthood.

A. It is more commonly diagnosed in males D. It is characterized by disregard for the rights of others. E. Those with conduct disorder rationalize their aggressive behaviors.

The impulse control spectrum can begin in childhood and continue on into adulthood, often morphing into criminal behaviors. Working with patients diagnosed with these disorders, the best examples of expressed emotion by the nursing staff are: A. Low to prevent emotional reactions B. Matched to the patient's level of emotion C. Flat without evidence of any emotional output D. High expression to improve therapeutic patient emotions

A. Low to prevent emotional reactions

When working with a client demonstrating impulse control disorders, which nursing interventions have initial priority?Select all that apply. A. Providing a safe environment B. Establishing a therapeutic nurse-client relationship C. Setting and enforcing limits D. Confronting the client concerning the disruptive behavior E. Presenting appropriate expectations

A. Providing a safe environment B. Establishing a therapeutic nurse-client relationship C. Setting and enforcing limits E. Presenting appropriate expectations

What is a common behavior observed in a patient diagnosed with intermittent explosive behavior? Select all that apply A. Short attention span B. Threatens suicide C. Often purges after eating D. Uses alcohol to excess E. States, "Everyone is out to get me"

A. Short attention span B. Threatens suicide D. Uses alcohol to excess

Pyromania, a behavior associated with impulse control disorders, causes an individual to engage in what behavior? A. Starting fires B. Stealing for thrill C. Self-mutilate D. Directing anger toward others

A. Starting fires

Which statement made by a 9yo child after hitting a classmate is a typical comment associated with childhood conduct disorder? A. "I'm sorry, I won't hit him again B. "He deserved it for being a sissy C. "I didn't think I hit him very hard D. "He hit me first, You just didn't see it

B. "He deserved it for being a sissy

Which comorbid conditions are commonly associated with oppositional defiant disorder? Select all that apply. A. Conversion disorder B. Attention deficit hyperactivity disorder (ADHD) C. Depression D. Anxiety E. Substance abuse

B. Attention deficit hyperactivity disorder (ADHD) C. Depression D. Anxiety

The mother of a 6-year-old child expresses concern over the child's frequent temper outbursts. He deals with any frustration by bullying and hitting and seldom shows any remorse for his actions. The nurse who gathers this data will note that the child's behaviors are most consistent with which diagnosis? A. Social phobia B. Conduct disorder C. Oppositional defiant disorder D. Attention deficit hyperactivity disorder (ADHD)

B. Conduct disorder

Some cultures have lower rates of dx conduct disorders than observed in Western societies. The lower rate of incidence may be contributed to: A. Strict parenting with corporal punishment B. Cultural expression of anger as normal behavior C. Parents' limited tolerance for externalizing behavior D. Widespread acceptance of conduct disorders

B. Cultural expression of anger as normal behavior

Which nursing intervention is appropriate for the management of intermittent explosive disorder? A. Providing intensive family therapy B. Establishing a trusting relationship with the patient C. Setting up loose boundaries so the patient will feel relaxed D, Limiting decision-making opportunities to avoid frustration

B. Establishing a trusting relationship with the patient

A 17-year-old patient is admitted to the psychiatric unit after threatening his mother during an argument and is diagnosed with conduct disorder. Which of the following would be an appropriate short-term outcome for this patient? A. Engages in appropriate coping skills to manage stressors B. Expresses feelings C. Maintains self-control during hospitalization D. Mother will improve communication skills to interact with Eli.

B. Expresses feelings

When treating impulse control disorders, psychodynamic psychotherapy is directed toward which goal? A. Mastering relaxation techniques B. Identifying the triggers of the rage C. Teaching the client self-distracting techniques D. Helping the client replace the rage with acceptable alternative feelings

B. Identifying the triggers of the rage

Which event experienced in the patient's childhood increases the risk of development of behaviors associated with intermittent explosive disorder? A. Orphaned at age 4 B. Physically abused from ages 3-10 C. Born with a chronic congenital disorder D. One parent was diagnosed with OCD E. Physically abused from ages 3-10

B. Physically abused from ages 3-10