Mental Health Exam 3 Questions
When interviewing any client with a personality disorder, the nurse would assess for which of the following? a. ability to charm and manipulate people b. desire for interpersonal relationships c. disruption in some aspects of his or her life d. increased need for approval from others
C
When the client describes fear of leaving his apartment as well as the desire to get out and meet others, it is called A. ambivalence B. Anhedonia C. Alogia D. Avoidance
A
Which of the following would the nurse most likely assess in a child with conduct disorder? a. high self esteem b. aggression toward animals c. disorientation d. lack of rational thinking
B. aggression toward animals - these children have low self esteem; are oriented; and are capable of logical, rational thinking
A nurse is caring for a client who has avoidant personality disorder. Which of the following statements is expected from a client who has this type of personality disorder? A. Im scared that you're going to leave me B. Ill go to group therapy if you'll let me smoke C. I need to feel that everyone admires me D. I sometimes feel better if i cut myself
A ATI
A client with bulimia is leaning to use the technique of self-monitoring. Which of the following interventions by the nurse would be most beneficial for this client? a. Ask the client to write about all feelings and experiences related to food b. assist the client to make out daily meal plans for 1 week c. encourage the client to ignore feelings and impulses related to food d. teach the client about nutrition content and calories of various foods
A
All but which of the following are initial goals for treating the severely malnourished client with anorexia nervosa? a. correction of body image disturbance b. correction of electrolytes imbalances c. nutritional rehabilitation d. weight restoration
A
The most important short-term goral for the client who tries to manipulate others would be to a. acknowledge own behavior b. express feelings verbally c. stop initiating arguments d. sustain lasting relationships
A
The nurse is working with a client with anorexia. Even though the client has been eating all her meals and snacks, her weight has remained unchanged for 1 week. Which of the following interventions is indicated? a. supervise the client closely for 2 hrs after meals and snacks b. increase the dly caloric intake from 1500 to 2000 c. increase clients fluid intake d. request an order from the physician for fluoxetine
A
A nurse is caring for an adolescent client who has anorexia with recent rapid weight loss and a current weight of 90 lbs. which of the following statements indicated the client is experiencing the cognitive distortion of catastrophizing? A. life isn't worth living if I gain weight B. Dont pretend like you odnt know how fat i am C. If i could be skinny i know id be popular D. When I look in the mirror, i see myself as obese
A ATI
Assessment of a patient with anorexia nervosa would reveal which of the following symptoms? Select all that apply A. Cold intolerance B. Hypotension C. Normal weight for height D. Dental erosion E. Metabolic alkalosis
A, B Cold intolerance and hypotension are symptoms associated with emaciation seen in anorexia nervosa. Normal weight for height, dental erosion and metabolic alkalosis are all symptoms associated with bulimia nervosa.
A nurse is obtaining a health history from the parents of a 12 year old client who has conduct disorder. Which of the following findings should the nurse expect (select all) A. Bullying of others B. Threats of suicide C. law breaking activities D. narcissistic Behavior E. Flat affect
A, B, C ATI
A teaching plan for the client taking an antipsychotic medication will include which of the following? A. apply sun block before going outdoors B. Drink sugar free beverages for dry mouth C. Have serum blood levels drawn one a month D. rise slowly from a sitting position E. Skip any dose that is not taken on time F. Take med with food to avoid nausea
A, B, D
A 12 year old child demonstrates signs and symptoms of conduct disorder (CD). The nurse would assess the following in the child: (Select all that apply) A. Hostility B. Frequent lying C. Poor eye contact with others D. Law breaking activities E. Cruelty to neighborhood pets F. Careless mistakes
A, B,D, E Hostility, telling lies, breaking laws and cruetly to animals are all manifestations common in conduct disorder. Breaking objects and making careless mistakes are more likely related to ADHD. Poor eye contact is likely a manifestation of Autism.
A nurse doing an assessment with a client with anorexia would expect to find which of the following? a. belief that dieting behavior is not a problem b. feelings of guilt and shame about eating behavior c. history of dieting at a young age d. performance of rituals or compulsive behavior e. strong desire to get treatment f. view of self as overweight or obese
A, C, D, F
A charge nurse is preparing a staff education session on personality disorders. Which of the following personality characteristics associated with all of the personality disorders should the charge nurse include in the teaching (select all) A. Difficulty in getting along with other members of a group B. Belief in the ability to become invisible during time of stress C. display of defense mechanisms when routines are changed D. claiming to be more important than other persons E. Difficulty understanding why it is inappropriate to have a person relationship with staff
A, C, E ATI
A nurse is preparing to obtain a nursing history from a client who has a new diagnosis of anorexia. Which of the following questions should the nurse include in the assessment (select all) A. what is your relationship like with your family B. why do you want to lose weight C. Would you describe your current eating habits D. at what weight do you believe you will look better E. Can you discuss your feelings about your appearance
A, C, E ATI
A 16 year old female is being treated for anorexia nervosa. Which of the following are characteristics of anorexia nervosa? A. Body weight less than normal for age, height, and overall physical health B. Absence of hunger feelings C. Pain D. Erosion of dental enamel
A- Body weight less than normal for age, height and overall physical health The other distractor answer choices are not characteristic of anorexia. Anorexics do experience hunger, however they ignore it. Dental erosion is characteristic of bulimia nervosa
Which of the following is normal adolescent behavior? A. being critical of self and others B. Defiant, negative, and depressed behavior C. Frequent hypochondriacal complaints D. Unwillingness to assume greater authority
A.
A nurse is assessing a client with IED would expect which of the following? A. blaming others for provoking angry outbursts B. Difficulty coping with ordinary life stressors C. Lack of remorse for aggressive behaviors D. Premeditated aggressive outbursts to get what the client wants
B
An effective nursing intervention for the impulsive and aggressive behaviors that accompany conduct disorder is A. assertiveness training B. consistent limit setting C. negotiation of rules D. open expression of feelings
B
The client who hesitates 30 seconds before responding to any question is described as having A. blunted affect B. Latency of response C. paranoid Delusions D. poverty of speech
B
The nurse has completed teaching sessions for parents about conduct disorder. Which of the following statements indicates a need for further teaching? A. Being consistent with rules at home will probably be a real challenge for me and my child B. It helps to know that these problems will get better as my child gets older C. Real progress for our child is likely to take several weeks or even months D. We need to set up a system forewords and consequences for our child's behaviors
B
The nurse is evaluating the progress of a client with bulimia. Which of the following behaviors would indicate that the client is making positive progress? a. Client can identify calorie content for each meal b. client identifies healthy ways of coping with anxiety c. client spends time resting in her room after meals d. client verbalizes knowledge of former eating patterns as unhealthy
B
The nurse is planning discharge teaching for a client taking clozapine (Clozaril). Which of the following is essential to include? A. Caution the client not to be outdoors in the sunshine without protective clothing B. Remind the client to go to the lab to have blood drawn for a WBC C. Instruct client about dietary restrictions D. Give client a chart to record the daily pulse rate
B
Transiet psychotic symptoms that occur with borderline personality disorder are most likely treated with which of the following? a. anticonvulsant mood stabilizers b. antipsychotics c. benzodiazepines d. lithium
B
Treating clients with anorexia with a SSRI antidepressant such as fluoxetine (Prozac) may present which of the following problems? a. clients object to the side effect of weight gain b. Prozac can cause appetite suppression and weight loss c. can cause clients to become giddy and silly d. clients with anorexia get no benefit from fluoxetine
B
Which of the following statements are true a. anorexia was not recognized as an illness until the 1960s b. cultures where beauty is linked to thinness have an increased risk for eating disorders c. eating disorders are a major health problem only in the US and Europe d. persons with anorexia are popular with their peers as a result of their thinness
B
A nurse is caring for a client who has borderline personality disorder. The client says " the nurse on the evening shift is always nice. You are the meanest nurse ever!" The nurse should recognize the client's statement as an example of which of the following defense mechanism? A. regression B. splitting C. Undoing D. identification
B ATI
There is one bed open on the inpatient eating disorders unit. Assessment findings for four patients are listed as follows. Which patient should receive the bed? A. Weight decreased from 90- 78 lbs in 5 months. Vital signs are: T 97.7F; P 62 BPM, BP 74/52 mmHg. Menstruation irregular for 6 months. B. Weight decreased from 150-102lbs in 4 months. Vital signs are: T 96.9 F; P 40BPM, BP 68/48mmHg. Amenorrhea for 8 months. C. Weight decreased from 120lb to 09 lb in 3 months. Vital signs are: T 98 F; P 50 BPM, BP 70/50mmHg. Menstruation scant for 3 months. D. Weight decreased from 110 to 86 lbs in 4 months. Vital signs are: T 97.5F, P 60 BPM, BP 80/66mm Hg. Amenorrhea for 2 months
B is the correct answer. Physical findings indicative of an acute status include: amenorrhea for 3 consecutive menstrual cycles, weight loss more than 30% of body weight within 6 months, hypothermia, pulse less than 40 bpm and systolic bp less than 70mmhg
The nurse understands that effect limit setting for children includes A. allowing the child to participate in defining limits B. consistent enforcement of limit by entire team C. Explaining the consequences of exceeding limits D. informing the child of the rule or limit E. negotiation of reasonable requests for change in limits F. Providing three or four cues or prompts to follow the established limit
B, C, D
The nurse working with a client with antisocial personality disorder would expect which of the following behaviors (select all that apply) a. compliance with expectations and rules b. Exploitation of other clients c. seeking special privileges d. superficial friendliness toward others e. utilization of rituals to allay anxiety f. withdrawal from social activities
B, C, D
When working with a client with a personality disorder, the nurse would expect to assess which of the following (select all that apply) a. high levels of self-awareness b. impaired interpersonal relationships c. inability to empathize with others d. minimal insight e. motivation to change f. poor reality testing
B, C, D
Which of the following are considered to be positive signs of schizophrenia? A. anhedonia B. delusions C. hallucinations D. disorganized thinking E. illusions F. social withdrawal
B, C, D
A nursing doing an assessment with a client with bulimia would expect to find which of the following? a. compensatory behaviors limited to purging b. dissatisfaction with body shape and size c. feeling of guilt and shame about eating behaviors d. near normal body weight for height and age e. performance of rituals or compulsive behavior f. strong desire to please others
B, C, D, F
A 16 year old with ODD is most likely to have difficulty in relationships with A. family friends B. law enforcement C. Parents - mother, father, or both D. peers of the same age group E. School superintendent F. store manager at work
B, C, E, F
A nurse is performing an admission assessment of a client who has bulimia with purging behavior. Which of the following is an expected finding (select all) A. amenorrhea B. hypokalemia C. mottling of the skin D. slightly elevated body weight E. presence of lanugo on the face
B, D ATI
Which of the following are considered to be positive signs of schizophrenia? (Select all that apply) A. Anhedonia B. Delusions C. Hallucinations D. Disorganized thinking E. Social Withdrawal
B,C,D Anhedonia and social withdrawal are negative symptoms
An effective nursing intervention for the impulsive and aggressive behaviors that accompany conduct disorder is: A. Assertiveness training B. Consistent limit setting C. Negotiation of rules D. Open expression of feelings
B- Consistent limit setting is an appropriate effective intervention for conduct disorder The other interventions are not appropriate.
Which of following statements would indicate that family teaching of schizo has been effective? A. If our son takes his meds properly, he won't have another psychotic episode B. I guess we'll have to face the fact that our daughter will eventually be institutionalized C. It's a relief to find out that we did not cause our son's schizophrenia D. It is a shame our daughter will never be able to have children
C
Which of the following is an example of a Cognitive behavioral technique? a. distraction b. relaxation c. self-monitoring d. verbalization of emotions
C
The nurse is caring for a patient with anorexia nervosa with a nursing diagnosis of imbalanced nutrition, less than body requirements related to inadequate food intake. The long-term goal of the treatment plan is that the patient will: A. Gain 1 to 3lb weekly B. Identify cognitive distortions about weight and shape C. Restore healthy eating patterns and normalize weight. D. Exhibit fewer signs of malnurtition.
C Restore healthy eating patterns and normalize weight. The goal that is directly related to the nursing diagnosis is to restore healthy eating patterns and normalize weight. The distracters are short-term or vague or are not directly related to the nursing diagnosis.
A nurse is caring for a client who has bulimia and has stopped purging behavior. The client tells the nurse that she is afraid she is going to gain wight. Which of the following response should the nurse make? A. Many clients are concerned about their weight. However the dietitian will ensure that you don't get too many calories in your diet B. Instead of worrying about your weight, try to focus on other problems at this time C. I understand you have concerns about your weight but first, let's talk about your recent accomplishments D. You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. We know that is important to you.
C ATI
A nurse manager is discussing the care of a client who has a personality disorder with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching. A. I can promote my client's sense of control by establishing a schedule B. I should encourage clients who have a schizoid personality disorder to increase socialization C. I should practice limit setting to help prevent client manipulation D. I should implement assertiveness trying with clients who have antisocial personality disorder
C ATI
A nurse is assisting the parents of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following is an appropriate strategy for the nurse to recommend (select all) A. Allow child to choose consequences for negative behavior B. Use role-playing to act out unacceptable behavior C. develop a reward system for acceptable behavior D. encourage the child to participate in school sports E. Be consistent when addressing unacceptable behavior
C, D, E ATI
A nurse is assisting with a court-ordered evaluation of a client who has antisocial personality disorder. Which of the following findings should the nurse expect (select) A. Demonstrates extreme anxiety when placed in a social situation B. has difficulty making even simple decisions C. attempts to convince other clients to give him their belongings D. becomes agitated if his personal area is not neat and orderly E. Blames other for his past and current problems
C, E ATI
The patient states "I am the king of the world!" Which of the following is an appropriate response by the nurse? A. "And I am your servant" B. "Where are your kingsman?" C. "You are now at the hospital, and I am your nurse." D. "Would his royal highness be so kind to take his medications for the day?"
C- an appropriate response should focus on reality rather than on the delusion itself
Which of the following is considered a characteristic of IED? a. episodes of anger lasting greater than 30 minutes b. No feeling of guilt or remorse after episode c. Injury to self, others, or property d. Comorbidity of an autistic disorder
C. Injury to self others, or property. - episodes last less than 30 minutes, and typically the person experiences guilt/remorse but is unable to refrain from future outbursts.
Which of the following would a nurse expect to assess in a pt with antisocial personality disorder? A. Overwhelming empathy B. High self esteem C. Manipulative behaviors D. Pervasive suspiciousness
C. Manipulative Behaviors
A teenaged girl is being evaluated for an eating disorder. Which of the following would suggest anorexia? a. guilt and shame about eating patterns b. lack of knowledge about food and nutrition c. refusal to talk about food related topics d. unrealistic perception of body size
D
Cognitive restructuring techniques include all of the following except a. decatastrophizing b. positive self talk c. reframing d. relaxation
D
Parents of a child with ODD are referred to a parent management training program. The parents ask the nurse what to expect from these sessions. The best response by the nurse is A. This is a method of parenting that involves negotiation of responsibilities with your child B. This is a support group for parents to discuss the difficulties they are having with their children C. You will have a chance to learn how to manage all of your child's negative behaviors D. You will learn behavior management techniques to use at home with your child
D
The family of a client with schizo asks the nurse about the difference between conventional and atypical antipsychotic medications. The nurse's answer is based on which of the following? A. atypical antipsychotics are newer meds but act in the same ways as conventional antipsychotics B. Conventional antipsychotics are dopamine antagonists; atypical antipsychotics inhibit the reuptake of serotonin C. Conventional antipsychotics have serious side effects; atypical antipsychotics have virtually no side effects D. Atypical antipsychotics are dopamine and serotonin antagonists; conventional antipsychotics are only dopamine antagonists
D
The nurse is caring for a pt who has been taking fluphenazine (Prolixin) for 2 days. The client suddenly cries out, his neck twists to one side, and his eyes appear to roll back in the sockets. The nurse finds the following PRN med ordered for the client. Which one should the nurse administer? A. Benztropine (Cogentin) 2 mg PO B. Fluphenazine (Prolixin) 2 mg PO C. Haloperidol (Haldol) 5 mg IM D. diphenhydramine (benadryl) 25 mg IM
D
The overall goal of psychiatric rehabilitation is for the client to gain A. Control of symptoms B. freedom from hospitalization C. management of anxiety D. recovery from the illness
D
A patient who is being treated for bulimia has stopped purging. She tells the nurse that she is afraid she is going to gain weight. Which of the following is an appropriate response by the nurse? A. "You don't need to be concerned. The dietitian will ensure that you don't get too many calories in your diet." B. "Don't worry about your weight. We are going to work on other problems while you are in the hospital." C. "You are not overweight, and the staff will ensure that you do not gain weight while you are in the hospital. WE know that is important to you." D. "I understand you have concerns about your weight, but right now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."
D D is the only option that acknowledges the patient's concerns and then focuses on a conversation on the patient's accomplishment. The other options minimize the patient's concerns about being overweight and/or gaining weight.
A nurse on an acute care unit is planning care for a client who has anorexia with binge-eating and purging behavior. Which of the following nursing actions should the nurse include in the client's plan of care? A. Allow the client to select preferred meal times B. Establish consequences for purging behavior C. provide the client with a high fat diet at the start of treatment D. implement one to one observation during meal time
D ATI
Parents of a child with ODD are referred to a parent management training program. The parents ask the nurse what to expect from these sessions. The best response by the nurse is: A. "This is a method of parenting that involves negotiation of responsibilities with your child." B. "This is a support group for parents to discuss the difficulties they are having with their children." C. "You will have a chance to learn how to manage all of your child's negative behaviors." D. "You will learn behavior management techniques to use at home with your child."
D- Behavior management techniques are what is taught to parents in a parent management training program
Which of the following would be considered a neurologic side effect of antipsychotic therapy? A. Blurred vision B. Agranulocytosis C. Sedation D. Tardive dyskinesia
D. Tardive dyskinesia -rest are nonneurologic side effects
The nurse notes that the patient taking Chlorpromazine (Thorazine) is showing off his tongue, constantly imitates a chewing motion, and presents with involuntary body movements. The nurse recognizes the following as an adverse effect of the medication and reports it as which of the following? A. Neuroleptic Malignant Syndrome B. Parkinsonism C. Akathisia D. Tardive Dyskinesia
D. Tardive dyskinesia is an adverse reaction of antipsychotic meds. It is manifested by uncontrollable and involuntary movements of the extremities, the mouth and the tongue.
Anticonvulsant mood-stabilizing medications are frequently used to treat ODD T or F
False - involves behavioral interventions/behavior therapy
Self-monitoring is an effective technique that a pt with anorexia can use T or F
False - technique for bulimia
The nurse should confront a patient's delusions. T or F
False - when a pt is experience delusions, the nurse should focus on the reality and not confront or reinforce the pt's delusions
One current biologic theory about eating disorders is that it involves a disruption in the cerebellum portion of the brain. T or F
False - disruption of the nuclei in the hypothalamus that relate to hunger and satiety
Typical age of onset for anorexia is which of the following? a. 10-14 b. 14-18 c. 18-22 d. 22 and older
b. 14-18
