MH Practice Questions
A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? Select all that apply. A.) "Methadone is a replacement for a physical dependence to opioids." B.) "Methadone reduces the unpleasant effects associated with abstinence syndrome." C.) "Methadone can be used during opioid withdrawal and to maintain abstinence." D.) "Methadone increases the risk for acetaldehyde syndrome." E.) "Methadone must be prescribed and dispensed by an approved treatment center."
A.) "Methadone is a replacement for a physical dependence to opioids." B.) "Methadone reduces the unpleasant effects associated with abstinence syndrome." C.) "Methadone can be used during opioid withdrawal and to maintain abstinence." E.) "Methadone must be prescribed and dispensed by an approved treatment center."
A nurse is assessing a client who has major depressive disorder. The nurse should identify which of the following client statements as an overt comment about suicide? Select all that apply. A.) "My family will be better off if I'm dead." B.) "The stress in my life is too much to handle." C.) "I wish my life was over." D.) "I don't feel like I can ever be happy again." E.) "If I kill myself then my problems will go away."
A.) "My family will be better off if I'm dead." C.) "I wish my life was over." E.) "If I kill myself then my problems will go away."
Dan begins attendance at AA meetings. Which of the following statements by Dan reflects the purpose of this organization? A.) "They claim they will help me stay sober." B.) "I'll dry out in AA, then I can have a social drink now and then." C.) "AA is only for people who have reached the bottom." D.) "If I lose my job, AA will help me find another."
A.) "They claim they will help me stay sober."
A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? A.) "This medication will help prevent seizures during alcohol withdrawal." B.) "Taking this medication will decrease your cravings for alcohol." C.) "This medication maintains your blood pressure at a normal level during alcohol withdrawal." D.) "Taking this medication will improve your ability to maintain abstinence from alcohol."
A.) "This medication will help prevent seizures during alcohol withdrawal."
A nurse is caring for a client who has substance-induced psychotic disorder and is experiencing auditory hallucinations. The client states, "The voices won't leave me alone!" Which of the following statements should the nurse make? Select all that apply. A.) "When did you start hearing these things?" B.) "The voices are not real, or else we would both hear them." C.) "It must be scary to hear voices." D.) "Are the voices you hear telling you to hurt yourself?" E.) "Why are the voices talking to only you?"
A.) "When did you start hearing these things?" C.) "It must be scary to hear voices." D.) "Are the voices you hear telling you to hurt yourself?"
A nurse is completing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse document as positive symptoms? Select all that apply. A.) Auditory hallucination B.) Lack of motivation C.) Use of clang associations D.) Delusion of persecution E.) Constantly waving arms F.) Flat affect
A.) Auditory hallucination C.) Use of clang associations D.) Delusion of persecution E.) Constantly waving arms
A charge nurse is discussing manifestations of schizophrenia with a newly licensed nurse. Which of the following manifestations should the charge nurse identify as being effectively treated by first-generation antipsychotics? Select all that apply. A.) Auditory hallucinations B.) Withdrawal from social situations C.) Delusions of grandeur D.) Severe agitation E.) Anhedonia
A.) Auditory hallucinations C.) Delusions of grandeur D.) Severe agitation
A client with depression has just been prescribed the antidepressant phenelzine (Nardil). She says to the nurse, "The doctor says I will need to watch my diet while I'm on this medication. What foods should I avoid?" Which of the following is the correct response by the nurse? A.) Blue cheese, red wine, raisins B.) Black beans, garlic, pears C.) Pork, shellfish, egg yolks D.) Milk, peanuts, tomatoes
A.) Blue cheese, red wine, raisins
A nurse is assisting with the development of protocols to address the increasing number of suicide attempts in the community. Which of the following interventions should the nurse include as a primary intervention? Select all that apply. A.) Conducting a suicide risk screening on all new clients B.) Creating a support group for family members of clients who completed suicide C.) Educating high school teens about suicide prevention D.) Initiating one-on-one observation for a client who has current suicidal ideation E.) Teaching middle-school educators about warning indicators of suicide
A.) Conducting a suicide risk screening on all new clients C.) Educating high school teens about suicide prevention E.) Teaching middle-school educators about warning indicators of suicide
Clint, a client on the psychiatric unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Clint's belief is an example of which of the following? A.) Delusion of persecution B.) Delusion of reference C.) Delusion of control or influence D.) Delusion of grandeur
A.) Delusion of persecution
Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The defense mechanism that Dan is using is: A.) Denial B.) Projection C.) Displacement D.) Rationalization
A.) Denial
Recent research on the RAISE approach to treat schizophrenia incorporates which of the following elements as important to improving outcomes? Select all that apply. A.) Early intervention of the first episode of psychosis B.) Support for employment and/or educational pursuits C.) Rapid, high-dose loading with antipsychotic medications D.) Court-ordered sanctions for treatment E.) Recovery-focused psychotherapy
A.) Early intervention of the first episode of psychosis B.) Support for employment and/or educational pursuits E.) Recovery-focused psychotherapy
Some biological factors may be associated with the predisposition to suicide. Which of the following biological factors have been implicated? A.) Genetics and decreased levels of serotonin B.) Heredity and increased levels of norepinephrine C.) Temporal lobe atrophy and decreased levels of acetylcholine D.) Structural alterations of the brain and increased levels of dopamine
A.) Genetics and decreased levels of serotonin
Which of the following has been implicated in the predisposition to substance abuse? A.) Hereditary factor B.) Fixation in the adolescent stage of psychosexual development C.) Punitive ego D.) Narcissistic and dependent personality traits
A.) Hereditary factor
What is the goal of cognitive therapy with depressed clients? A.) Identify and change dysfunction patterns of thinking B.) Resolve the symptoms and initiate or restore adaptive family functioning C.) Alter the neurotransmitters that are creating the depressed mood D.) Provide feedback from peers who are having similar experiences
A.) Identify and change dysfunction patterns of thinking
A home health nurse is making a visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following suggestions should the nurse make to decrease the client's risk for injuries? A.) Install extra locks at the top of exit doors B.) Place rugs over electrical cords C.) Put cleaning supplies on the top of a shelf D.) Place the client's mattress on the floor E.) Install light fixtures above stairs
A.) Install extra locks at the top of exit doors D.) Place the client's mattress on the floor E.) Install light fixtures above stairs
A client says to the nurse, "I read an article about Alzheimer's and it said the disease is hereditary. My mother has Alzheimer's disease. Does that mean I'll get it when I'm old?" The nurse bases her response on the knowledge that which of the following factors is *not* associated with increased incidence of NCD due to Alzheimer's disease? A.) Multiple small strokes B.) Family history of Alzheimer's C.) Head trauma D.) Advanced age
A.) Multiple small strokes
A nurse is caring for a client who takes ziprasidone. The client reports difficulty swallowing the oral medication and becomes extremely agitated with injectable administration. The nurse should contact the provider to discuss a change to which of the following medications? (Select all that apply) A.) Olanzapine B.) Quetiapine C.) Aripiprazole D.) Clozapine E.) Asenapine
A.) Olanzapine C.) Aripiprazole D.) Clozapine E.) Asenapine
In addition to disturbances in cognition and orientation, individuals with Alzheimer's disease may also show changes in which of the following? Select all that apply. A.) Personality B.) Vision C.) Speech D.) Hearing E.) Mobility
A.) Personality C.) Speech E.) Mobility
A nurse working on an acute mental health unit is admitting a client who has major depressive disorder and comorbid anxiety disorder. Which of the following actions is the nurse's priority? A.) Placing the client on one-to-one observation B.) Assisting the client to perform ADLs C.) Encouraging the client to participate in counseling D.) Teaching the client about medication adverse effects
A.) Placing the client on one-to-one observation
Which of the following interventions are appropriate for a client on suicide precautions? Select all that apply. A.) Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. B.) Accompany the client to off-unit activities. C.) Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours. D.) Put all of the client's possessions in storage and explain to her that she may have them back when she is off suicide precautions.
A.) Remove all sharp objects, belts, and other potentially dangerous articles from the client's environment. B.) Accompany the client to off-unit activities. C.) Obtain a promise from the client that she will not do anything to harm herself for the next 12 hours.
A client has just been admitted to the psychiatric unit with a diagnosis of Major Depressive Disorder. Which of the following behavioral manifestations might the nurse expect to assess? Select all that apply. A.) Slumped posture B.) Delusional thinking C.) Feelings of despair D.) Feels best early in the morning and worse as the day progresses E.) Anorexia
A.) Slumped posture B.) Delusional thinking C.) Feelings of despair E.) Anorexia
Sally is admitted to the hospital with Major Depressive Disorder and repeatedly makes negative statements about herself. Which of the following interventions is identified as an approach that promotes positive self-esteem in the patient? Select all that apply. A.) Teach assertive communication skills. B.) Make observations to Sally when she completes a goal or task. C.) Instruct Sally that you will not talk with her unless she stops talking negatively about herself. D.) Offer to spend time with Sally using a nonjudgmental, accepting approach.
A.) Teach assertive communication skills. B.) Make observations to Sally when she completes a goal or task. D.) Offer to spend time with Sally using a nonjudgmental, accepting approach.
A polysubstance abuser makes the statement, "The green and whites do me good after speed." How might the nurse interpret the statement? A.) The client abuses amphetamines and anxiolytics. B.) The client abuses alcohol and cocaine. C.) The client is psychotic. D.) The client abuses narcotics and marijuana.
A.) The client abuses amphetamines and anxiolytics.
The nurse identifies the primary nursing diagnosis for Theresa as Risk for Suicide related to feelings of hopelessness from loss of relationship. Which is the outcome criterion that would most accurately measure achievement of this diagnosis? A.) The client has experienced no physical harm to herself. B.) The client sets realistic goals for herself. C.) The client expresses some optimism and hope for the future. D.) The client has reached a stage of acceptance in the loss of the relationship with her boyfriend.
A.) The client has experienced no physical harm to herself.
A client admitted to the emergency department smells strongly of alcohol, and his wife reports he has been a heavy drinker for the last 25 years. Which of the following assessment findings are consistent with long-term chronic alcohol abuse? Select all that apply. A.) The client reports weak leg muscles, and his gait is unsteady. B.) The client's abdomen is distended. C.) The client reports he was coughing up some blood. D.) The client reports he has double vision. E.) Blood tests reveal a low white blood cell count.
A.) The client reports weak leg muscles, and his gait is unsteady. B.) The client's abdomen is distended. C.) The client reports he was coughing up some blood. D.) The client reports he has double vision. E.) Blood tests reveal a low white blood cell count.
Which of the following medications have been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease? Select all that apply. A.) donepezil (Aricept) B.) rivastigmine (Exelon) C.) risperidone (Risperdal) D.) sertraline (Zoloft) E.) galantamine (Razadyne)
A.) donepezil (Aricept) B.) rivastigmine (Exelon) E.) galantamine (Razadyne)
Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for a number of years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical dependency unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur? A.) several hours after the last drink B.) 2 to 3 days after the last drink C.) 4 to 5 days after the last drink D.) 6 to 7 days after the last drink
A.) several hours after the last drink
A nurse who is helping a client in the preparation stage of the Psychological Recovery Model might include which of the following interventions? A.) teach about effects of the illness and how to recognize, monitor, and manage symptoms B.) help the client identify "triggers" that cause distress or discomfort C.) help the client establish a daily maintenance list D.) listen actively while the client composes his or her personal story
A.) teach about effects of the illness and how to recognize, monitor, and manage symptoms
An acutely depressed client isolates herself in her room and just sits and stares into space. Which of these is the best example of an active communication approach with this client? A.) "Do you like exercise?" B.) "Come with me. I will go with you to group therapy." C.) "Would you like to go to group therapy, stay in bed, or come out to the day lounge for some activities?" D.) "Why do you stay in your room all the time?"
B.) "Come with me. I will go with you to group therapy."
A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates an understanding of the teaching? Select all that apply. A.) "We need to understand that our sibling is responsible for their disorder." B.) "Eliminating codependent behavior will promote recovery." C.) "Our sibling should participate in an Al-Anon group to assist with recovery." D.) "The primary goal of treatment is abstinence from substance use." E.) "Our sibling needs to discuss personal feelings about substance use to help with recovery."
B.) "Eliminating codependent behavior will promote recovery." D.) "The primary goal of treatment is abstinence from substance use." E.) "Our sibling needs to discuss personal feelings about substance use to help with recovery."
A nurse is caring for a client who has schizoaffective disorder. Which of the following statements indicates the client is experiencing depersonalization? A.) "I am a superhero and am immortal." B.) "I am no one, and everyone is me." C.) "I feel monsters pinching me all over." D.) "I know that you are stealing my thoughts."
B.) "I am no one, and everyone is me."
The physician orders sertraline (Zoloft) 50 mg PO bid for Margaret, a 68 year old woman with Major Depressive Disorder. After 3 days of taking the medication, Margaret says to the nurse: "I don't think this medicine is doing any good. I don't feel better." What is the most appropriate response by the nurse? A.) "Cheer up, Margaret. You have so much to be happy about." B.) "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." C.) " I'll report that to the physician, Margaret. Maybe he will order you something different." D.) "Try not to dwell on your symptoms, Margaret. Why don't you join the others in the dayroom?"
B.) "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms."
Mrs. G, who has NCD due to Alzheimer's Disease, says to the nurse, "I have a date tonight. I always have a date on Christmas." Which of the following is the most appropriate response? A.) "Don't be silly. It's not Christmas Mrs. G." B.) "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon and then your daughter will come to visit." C.) "Who is your date, Mrs. G?" D.) "I think you need some more medication, Mr.s G. I'll bring it to you now."
B.) "Today is Tuesday, Oct. 21, Mrs. G. We will have supper soon and then your daughter will come to visit."
Mr. Stone is a client in the hospital with a diagnosis of Vascular NCD. In explaining this disorder to Mr. Stone's family, which of the following by the nurse is correct? A.) "He will probably live longer than if his disorder was of the Alzheimer's type." B.) "Vascular NCD shows step-wise progression. This is why he sometimes seems okay." C.) Vascular NCD is caused by plaques and tangles that form in the brain." D.) "The cause of vascular NCD is unknown."
B.) "Vascular NCD shows step-wise progression. This is why he sometimes seems okay."
A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which if the following statements by the client indicates an understanding of the teaching? A.) "Taking this medication will help reduce my craving for heroin." B.) "While taking this medication, I should keep a pack of sugarless gum." C.) "I can expect some diarrheas from taking this medication" D.) "Rach dose of this medication should be placed under my tongue to dissolve"
B.) "While taking this medication, I should keep a pack of sugarless gum."
Dan, who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job, states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know. My boss is a jerk! I haven't missed any more days than my coworkers." The nurse's best response is: A.) "Maybe your boss is mistaken, Dan." B.) "You are here because your drinking was interfering with your work, Dan." C.) "Get real, Dan! You're a boozer and you know it!" D.) "Why do you think your boss sent you here, Dan?"
B.) "You are here because your drinking was interfering with your work, Dan."
A nurse is caring for a client who has early stage Alzheimer's disease and a new prescription for donepezil. The nurse should include which of the following statements when teaching the client about the medication? A.) "You should avoid taking OTC acetaminophen while on donepezil." B.) "You should take this medication before going to bed at the end of the day." C.) "You will be screened for underlying kidney disease prior to starting donepezil." D.) "You should stop taking donepezil if you experience nausea or diarrhea."
B.) "You should take this medication before going to bed at the end of the day."
The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking mid-sentence, and listens intently. The nurse recognizes these behaviors as a symptom of the client's illness. What is the most appropriate nursing intervention for this symptom? A.) Ask the client to describe his physical symptoms B.) Ask the client to describe what he is hearing C.) Administer a dose of benztropine D.) Call the physician for additional orders
B.) Ask the client to describe what he is hearing
A nurse is speaking with a client who has schizophrenia when the client suddenly seems to stop focusing on the nurse's questions and begins looking at the ceiling and talking to themselves. Which of the following actions should the nurse take? A.) Stop the interview at this point, and resume later when the client is better able to concentrate. B.) Ask the client, "Are you seeing something on the ceiling?" C.) Tell the client, "You seem to be looking at something on the ceiling. I see something there, too." D.) Continue the interview without comment on the client's behavior.
B.) Ask the client, "Are you seeing something on the ceiling?"
Theresa, who has been hospitalized following a suicide attempt, is placed on suicide precautions on the psychiatric unit. She admits that she is still feeling suicidal. Which of the following interventions is most appropriate in this instance? A.) Obtain an order from the physician to place Theresa in restraints to prevent any attempts to harm herself. B.) Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis. C.) Obtain an order from the physician to give Theresa a sedative to calm her and reduce suicide ideas. D.) Do not allow Theresa to participate in any unit activities while she is on suicide precautions.
B.) Check on Theresa every 15 minutes or assign a staff person to stay with her on a one-to-one basis.
Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? A.) Haloperidol (Haldol) B.) Chlordiazepoxide (Librium) C.) Methadone (Dolophine) D.) Phenytoin (Dilantin)
B.) Chlordiazepoxide (Librium)
Which of the following is the primary goal in working with an actively psychotic, suspicious client? A.) Promote interaction with others B.) Decrease his anxiety and increase trust C.) Improve his relationship with his parents D.) Encourage participation in therapy activities
B.) Decrease his anxiety and increase trust
A nurse is assessing a client who is currently taking perphenazine. Which of the following findings should the nurse identify as an extrapyramidal symptom (EPS)? Select all that apply. A.) Decreased level of consciousness B.) Drooling C.) Involuntary arm movements D.) Urinary retention E.) Continual pacing
B.) Drooling C.) Involuntary arm movements E.) Continual pacing
Tony, age 21, has been diagnosed with Schizophrenia. He has been socially isolated and hearing voices telling him to kill his parents. He has been admitted to the psychiatric unit from the emergency department. What is the initial nursing intervention for Tony? A.) Give him an injection of Thorazine B.) Ensure a safe environment for him and others C.) Place him in restraints D.) Order him a nutritious diet
B.) Ensure a safe environment for him and others
Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The primary nursing intervention in working with Mrs. G is which of the following? A.) Ensuring that she receives food she likes, to prevent hunger B.) Ensuring that the environment is safe, to prevent injury C.) Ensuring that she meets the other patients, to prevent social isolation D.) Ensuring that she takes care of her own ADLs, to prevent dependence
B.) Ensuring that the environment is safe, to prevent injury
A nurse is performing an admission assessment for a client who has delirium related to an acute urinary tract infection. Which of the following findings should the nurse expect? Select all that apply. A.) History of gradual memory loss B.) Family report of personality changes C.) Hallucinations D.) Unaltered level of consciousness E.) Restlessness
B.) Family report of personality changes C.) Hallucinations E.) Restlessness
A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? Select all that apply. A.) Bradycardia B.) Fine tremors of both hands C.) Hypotension D.) Vomiting E.) Restlessness
B.) Fine tremors of both hands D.) Vomiting E.) Restlessness
A nurse is caring for a client who has major depressive disorder. Which of the following should the nurse identify as a risk factor for depression? Select all that apply. A.) Male sex B.) History of chronic bronchitis C.) Recent death in client's family D.) Family history of depression E.) Personal history of panic disorder
B.) History of chronic bronchitis C.) Recent death in client's family D.) Family history of depression E.) Personal history of panic disorder
A nurse is caring for a client on an acute mental health unit. The client reports hearing voices that are stating, "kill your doctor." Which of the following actions should the nurse take first? A.) Encourage the client to participate in group therapy on the unit. B.) Initiate one-to-one observation of the client. C.) Focus the client on reality. D.) Notify the provider of the client's statement.
B.) Initiate one-to-one observation of the client.
Which of the following individuals is at highest risk for suicide? A.) Nancy, age 33, Asian American, Catholic, middle socioeconomic group, alcoholic B.) John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas. C.) Carol, age 15, African American, Buddhist, high socioeconomic group, no physical or mental health problems D.) Mike, age 55, Jewish, middle socioeconomic group, suffered MI a year ago
B.) John, age 72, white, Methodist, low socioeconomic group, diagnosis of metastatic cancer of the pancreas.
In teaching a client about this antidepressant medication, fluoxetine, which of the following would the nurse include? Select all that apply. A.) Don't eat chocolate while taking this medication B.) Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect. C.) Don't take this medication with the migraine drugs "triptans" D.) Go to the lab each week to have your blood drawn for the therapeutic level of this drug E.) This drug causes a high degree of sedation, so take it just before bedtime
B.) Keep taking this medication, even if you don't feel it is helping. It sometimes takes a while to take effect. C.) Don't take this medication with the migraine drugs "triptans"
A nurse is caring for a client who states, "I plan to commit suicide." Which of the following assessments should the nurse identify as the priority? A.) Client's educational and economic background B.) Lethality of the method and availability of means C.) Quality of the client's social support D.) Client's insight into the reasons for the decision
B.) Lethality of the method and availability of means
Which of the following is a true statement about mental health recovery? Select all that apply. A.) Mental health recovery applies only to severe and persistent mental illnesses B.) Mental health recovery serves to provide empowerment to the consumer C.) Mental health recovery is based on the medical model D.) Mental health recovery is a collaborative process
B.) Mental health recovery serves to provide empowerment to the consumer D.) Mental health recovery is a collaborative process
From which of the following symptoms might the nurse identify a chronic cocaine user? A.) Clear, constricted pupils B.) Red, irritated nostrils C.) Muscle aches D.) Conjunctival redness
B.) Red, irritated nostrils
Success of long-term psychotherapy with Theresa (who attempted suicide following a breakup with her boyfriend) could be measured by which of the following behaviors? A.) Theresa has a new boyfriend. B.) Theresa has an increased sense of self-worth. C.) Theresa does not take antidepressants anymore. D.) Theresa told her old boyfriend how angry she was with him for breaking up with her.
B.) Theresa has an increased sense of self-worth.
A nurse is teaching a client who has a new diagnosis of premenstrual dysphoric disorder (PMDD). Which of the following statements by the client indicates understanding of the teaching? A.) "I can expect my problems with PMDD to be worse when I'm menstruating." B.) "I should avoid exercising when I am feeling depressed." C.) "I am aware that my PMDD causes me to have rapid mood swings." D.) "I should increase my caloric intake with a nutritional supplement when my PMDD is active."
C.) "I am aware that my PMDD causes me to have rapid mood swings."
A nurse is providing discharge teaching for a client who has schizophrenia and a new prescription for iloperidone. Which of the following client statements indicates understanding of the teaching? A.) "I will be able to stop taking this medication as soon as I feel better." B.) "If I feel drowsy during the day, I will stop taking this medication and call my provider." C.) "I will be careful not to gain too much weight while taking this medication." D.) "This medication is highly addictive and must be withdrawn slowly."
C.) "I will be careful not to gain too much weight while taking this medication."
A charge nurse is discussing care of a client who has major depressive disorder (MDD) with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? A.) "Care during the continuation phase focuses on treating continued manifestations of MDD." B.) "The treatment of MDD during the maintenance phase lasts for 6 to 12 weeks." C.) "The client is at greatest risk for suicide during the first weeks of an MDD episode." D.) "Medication and psychotherapy are most effective during the acute phase of MDD."
C.) "The client is at greatest risk for suicide during the first weeks of an MDD episode."
The night nurse finds Mrs. G, a client with Alzheimer's, wandering the hallway at 4 am and trying to open the door to the side yard. Which statement by the nurse probably reflects the most accurate assessment of the situation? A.) "That door leads out to the patio, Mrs. G. It's nighttime. You don't want to go outside now." B.) "You look confused, Mrs. G. What is bothering you?" C.) "This is the patio door, Mrs. G. Are you looking for the bathroom?" D.) "Are you lonely? Perhaps you'd like to go back to your room and talk for a while"
C.) "This is the patio door, Mrs. G. Are you looking for the bathroom?"
A client whose husband died 6 months ago is diagnosed with Major Depressive Disorder. She says to the nurse, "I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? A.) "Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer." B.) "I can understand how you must feel." C.) "Those feelings are a normal part of the grief response." D.) "Just think about the good times that you had while he was alive."
C.) "Those feelings are a normal part of the grief response."
Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll choose a no-fail method." Which is the best response by the nurse? A.) "You are safe here. We will make sure nothing happens to you." B.) "You're just lucky your roommate came home when she did." C.) "What exactly do you plan to do?" D.) "I don't understand. You have so much to live for."
C.) "What exactly do you plan to do?"
Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, "My boyfriend broke up with me. We had been together for 6 years. I love him so much. I know I'll never get over him." Which is the best response by the nurse? A.) "You'll get over him in time, Theresa." B.) "Forget him. There are other fish in the sea." C.) "You must be feeling very sad about your loss." D.) "Why do you think he broke up with you, Theresa?"
C.) "You must be feeling very sad about your loss."
A client recently admitted to the hospital reports to the nurse, "I don't understand why I was brought here. I was simply hanging out in my apartment, and the police said I had to come with them." This is an example of what symptom of schizophrenia? A.) Delusions of reference B.) Loose association C.) Anosognosia D.) Auditory hallucinations
C.) Anosognosia Lack of insight (impairs a person's ability to understand their illness)
Which of the following interventions is most appropriate in helping a client with Alzheimer's Disease with her ADLs? Select all that apply. A.) Perform ADLs for her while she is in the hospital B.) Provide her with a written list of activities she is expected to perform C.) Assist her with step by step instructions D.) Tell her that if her morning care is not completed by 9 AM, it will be performed for her by the nurse's aide so that she can attend group therapy E.) Encourage her and give her plenty of time to perform as many of her ADLs as possible independently
C.) Assist her with step by step instructions E.) Encourage her and give her plenty of time to perform as many of her ADLs as possible independently
The nurse is interviewing a client on the psychiatric unit. The client tilts his head to the side, stops talking in mid-sentence, and listens intently. The nurse recognizes from these signs that the client is likely experiencing which of the following? A.) Somatic delusions B.) Catatonic stupor C.) Auditory hallucinations D.) Pseudoparkinsonism
C.) Auditory hallucinations
A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? A.) Chew the gum for no more than 10 min B.) Rinse out the mouth immediately before chewing the gum C.) Avoid eating 15 min prior to chewing the gum D.) Use of gum is limited to 90 days
C.) Avoid eating 15 min prior to chewing the gum
When a client suddenly becomes aggressive and violent on the unit, which of the following approaches would be best for the nurse to use *first*? A.) Provide large motor activities to relieve the client's pent-up tension. B.) Administer a dose of prn chlorpromazine to keep the client calm C.) Call for sufficient help to control the situation safely D.) Convey to the client that his behavior is unacceptable and will not be permitted
C.) Call for sufficient help to control the situation safely
A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? A.) Chlordiazepoxide B.) Bupropion C.) Disulfiram D.) Carbamazepine
C.) Disulfiram
A nurse is assisting in the discharge planning for a client following alcohol detoxification. The nurse should expect prescriptions for which of the following medications to promote long-term abstinence from alcohol? Select all that apply. A.) Lorazepam B.) Diazepam C.) Disulfiram D.) Naltrexone E.) Acamprosate
C.) Disulfiram D.) Naltrexone E.) Acamprosate
A client diagnosed with chronic alcoholism says to the nurse, "I'm tired of using and I want to stop. Is there a medication that can help me maintain sobriety?" About which medication would the nurse provide information? A.) Carbamazepine (Tegretol) B.) Clonidine (Catapres) C.) Disulfiram (Antabuse) D.) Folic acid (Folvite)
C.) Disulfiram (Antabuse)
An example of a treatable (reversible) form of NCD is one that is caused by which of the following? Select all that apply. A.) Multiple sclerosis B.) Multiple small brain infarcts C.) Electrolyte imbalances D.) HIV disease E.) Folate deficiency
C.) Electrolyte imbalances E.) Folate deficiency
In determining degree of suicidal risk with a suicidal client, the nurse assesses the following behavioral manifestations: severely depressed, withdrawn, statements of worthlessness, difficulty accomplishing activities of daily living, no close support systems. The nurse identifies the client's risk for suicide as: A.) Low B.) Moderate C.) High D.) Unable to determine
C.) High
A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following interventions should the nurse identify as a priority? A.) Orient the client frequently to time, place, and person B.) Offer fluids and nourishing diet as tolerated C.) Implement seizure precautions D.) Encourage participation in group therapy sessions
C.) Implement seizure precautions
A nurse is planning a staff education program on substance use in older adults. Which of the following information should the nurse to include in the presentation? A.) Older adults require higher doses of a substance to achieve a desired effect. B.) Older adults commonly use rationalization to cope with a substance use disorder. C.) Older adults are at an increased risk for substance use following retirement. D.) Older adults develop substance use to mask manifestations of dementia.
C.) Older adults are at an increased risk for substance use following retirement.
A nurse is interviewing a client who has a new diagnosis of persistent depressive disorder. Which of the following findings should the nurse expect? A.) Wide fluctuations in mood B.) Report of a minimum of five clinical findings of depression C.) Presence of manifestations for at least 2 years D.) Inflated sense of self-esteem
C.) Presence of manifestations for at least 2 years
The nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's partner, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following actions should the nurse take? A.) Verify that a current power of attorney document is on file B.) Instruct the client's partner to offer finger foods to increase oral intake C.) Provide information on resources for respite care D.) Schedule the client for placement of an enteral feeding tube
C.) Provide information on resources for respite care
Margaret, age 68, is a widow of 6 months. Since her husband died, her sister reports that Margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. She told her sister today that she "didn't have anything more to live for." She has been hospitalized for Major Depressive Disorder. Which of the following is the priority nursing diagnosis for Margaret? A.) Imbalance nutrition: less than body requirements B.) Complicated grieving C.) Risk for suicide D.) Social isolation
C.) Risk for suicide
A nurse is caring for a client who has schizophrenia and exhibits a lack of grooming and a flat affect. The nurse should expect a prescription for which of the following medications? A.) Chlorpromazine B.) Thiothixene C.) Risperidone D.) Haloperidol
C.) Risperidone
Dan has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job. Dan's drinking buddies come for a visit, and when they leave, the nurse smells alcohol on Dan's breath. Which of the following would be the best intervention with Dan at this time? A.) Search his room for evidence B.) Ask, "Have you been drinking alcohol, Dan?" C.) Send a urine specimen from Dan to the lab for drug screening. D.) Tell Dan, "These guys cannot come to the unit to visit you again."
C.) Send a urine specimen from Dan to the lab for drug screening.
A nurse is assisting an individual with mental illness recovery using the Tidal Model. Which of the following is a component of this model? A.) The wellness toolbox B.) The daily maintenance list C.) The individual's personal story D.) Triggers
C.) The individual's personal story
A nurse who is helping a client with mental illness recovery using the WRAP Model. The nurse says to the client, "First you must create a wellness toolbox." She explains to the client that a wellness toolbox is which of the following: A.) a list of words that describe how the individual feels when he or she is feeling well B.) a list of things the client needs to do every day to maintain wellness C.) a list of strategies the client has used in the past that help relieve disturbing symptoms D.) a list of the client's favorite health care providers and phone numbers
C.) a list of strategies the client has used in the past that help relieve disturbing symptoms
Symptoms of alcohol withdrawal include: A.) euphoria, hyperactivity, and insomnia B.) depression, suicidal ideation, and hypersomnia C.) diaphoresis, nausea and vomiting, and tremors D.) unsteady gait, nystagmus, and profound disorientation
C.) diaphoresis, nausea and vomiting, and tremors
The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Why is chlorpromazine ordered? A.) To reduce extrapyramidal symptoms B.) To prevent neuroleptic malignant syndrome C.) To decrease psychotic symptoms D.) To induce sleep
C.) to decrease psychotic symptoms
A nurse in a long-term care facility is caring for a client who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following statements should the nurse make? A.) "You have forgotten that this is your home." B.) "You cannot go outside without a staff member." C.) "Why would you want to leave? Aren't you happy with your care?" D.) "I am your nurse. Let's walk together to your room."
D.) "I am your nurse. Let's walk together to your room."
Clint, a client on the psychiatric unit, has been diagnosed with Schizophrenia. He begins to tell the nurse about how the CIA is looking for him and will kill him if they find him. Which of the following is the most appropriate response by the nurse? A.) "That's ridiculous, Clint. No one is going to hurt you." B.) "The CIA isn't interested in people like you, Clint." C.) "Why do you think the CIA wants to kill you?" D.) "I know you believe that, Clint, but it's really hard for me to believe."
D.) "I know you believe that, Clint, but it's really hard for me to believe."
A nurse is conducting a class for a group of newly licensed nurses on caring for clients who are at risk for suicide. Which of the following information should the nurse include in the teaching? A.) A client's verbal threat of suicide is attention-seeking behavior B.) Interventions are ineffective for clients who really want to commit suicide C.) Using the term suicide increases the client's risk for a suicide attempt D.) A no-suicide contract decreases the client's risk for suicide
D.) A no-suicide contract decreases the client's risk for suicide
Mrs. G, who has NCD due to Alzheimer's disease, has trouble sleeping and wanders around at night. Which of the following nursing actions would be best to promote sleep in Mrs. G? A.) Ask the doctor to prescribe flurazepam (Dalmane) B.) Ensure that Mrs. G gets an afternoon nap so she will not be overtired at bedtime C.) Make Mrs. G a cup of tea with honey before bedtime D.) Ensure that Mrs. G gets regular physical exercise during the day
D.) Ensure that Mrs. G gets regular physical exercise during the day
A nurse is caring for a client who is on suicide precautions. Which of the following interventions should the nurse include in the plan of care? A.) Assign the client to a private room B.) Document the client's behavior every hour C.) Allow the client to keep perfume in her room D.) Ensure that the client swallows medication
D.) Ensure that the client swallows medication
The nurse is assisting a client with mental illness recovery using the WRAP model. Which of the following interventions would be included? A.) Assisting the individual to tell his personal story B.) Helping the client examine his philosophy of life in search of meaning and purpose C.) Taking control of the recovery process for the client D.) Helping the client craft a psychiatric advance directive for when he can no longer care for himself
D.) Helping the client craft a psychiatric advance directive for when he can no longer care for himself
An individual who is addicted to heroin is likely to experience which of the following symptoms of withdrawal? A.) Increased heart rate and blood pressure B.) Tremors, insomnia, and seizures C.) In-coordination and unsteady gate D.) Nausea and vomiting, diarrhea and diaphoresis
D.) Nausea and vomiting, diarrhea and diaphoresis
Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Freudian psychoanalytic theory would explain Theresa's suicide attempt in which of the following ways? A.) She feels hopeless about her future without her boyfriend. B.) Without her boyfriend, she feels like an outsider with her peers. C.) She is feeling intense guilt because her boyfriend broke up with her. D.) She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.
D.) She is angry at her boyfriend for breaking up with her and has turned the anger inward on herself.
The nurse is caring for a client with schizophrenia. Orders from the physician include 100 mg chlorpromazine IM STAT and then 50 mg PO bid; 2 mg benztropine PO bid prn. Because benztropine was ordered on a PRN basis, which of the following assessments by the nurse would convey a need for this medication? A.) The client's level of agitation increases B.) The client complains of a sore throat C.) The clients skin has a yellowish cast D.) The client develops tremors and a shuffling gait
D.) The client develops tremors and a shuffling gait
Which of the following is the primary focus of family therapy for clients with schizophrenia and their families? A.) To discuss concrete problem solving and adaptive behaviors for coping with stress B.) To introduce the family to others with the same problem C.) To keep the client and family in touch with the health care system D.) To promote family interaction and increase understanding of the illness
D.) To promote family interaction and increase understanding of the illness
Education for the client who is taking monoamine oxidase inhibitors (MAOIs) should include which of the following? A.) Fluid and sodium replacement when appropriate, frequent blood drug levels, signs and symptoms of toxicity B.) Lifetime of continuous use, possible tardive dyskinesia, advantages of an injection every 2 to 4 weeks C.) Short term use, possible tolerance to beneficial effects, careful tapering of the drug at the end of treatment D.) Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification
D.) Tyramine-restricted diet, prohibitive concurrent use of over the counter medications without physician notification
Mrs. G has been diagnosed with NCD due to Alzheimer's disease. The cause of this disorder is which of the following? A.) Multiple small brain infarcts B.) Chronic alcohol abuse C.) Cerebral abscess D.) Unknown
D.) Unknown
A nurse is assisting an individual with mental illness recovery using the Psychological Recovery Model. The client says to the nurse, "I have schizophrenia. Nothing can be done. I might as well die." In which stage of the Psychological Recovery model would the nurse assess the individual to be? A.) the awareness stage B.) the preparation stage C.) the rebuilding stage D.) the moratorium stage
D.) the moratorium stage
A client is brought to the emergency department. The client is aggressive, has slurred speech, and impaired motor coordination. Blood alcohol level is 347 mg/dL. Among the physician's orders is thiamine. Which is the rationale for this intervention? A.) to prevent nutritional deficits B.) to prevent pancreatitis C.) to prevent alcoholic hepatitis D.) to prevent Wernick's encephalopathy
D.) to prevent Wernick's encephalopathy
