MH TEXTBOOK PRACTICE QUESTIONS (3)

An 80-year-old woman says to the nurse, "I'm all alone now. My husband is gone. My best friend is gone. My daughter is busy with her work and family. I might as well just go, too." Which is the best response by the nurse? a. "Are you thinking that you want to die?" b. "You have lots to live for." c. "Cheer up. You have so much to be thankful for." d. "Tell me about your family."

a. "Are you thinking that you want to die?"

Dana's husband, who was deployed to Afghanistan a year ago, is returning home this week. Which of the following postdeployment situations have been identified as likely to occur during the first few months of his return? (Select all that apply.) a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy c. Rejection by the children for perceived abandonment d. A period of adjustment to reconnect emotionally

a. A honeymoon period of physical reconnection b. Resistance from the spouse regarding possible loss of autonomy d. A period of adjustment to reconnect emotionally

Which of the following is least likely to predispose a child to Tourette's disorder? a. Absence of parental bonding b. Family history of the disorder c. Abnormalities of brain neurotransmitters d. Structural abnormalities of the brain

a. Absence of parental bonding

In a group exercise, Mr. B., a 79-year-old man with major depression, becomes tired and short of breath very quickly. This symptom is most likely due to which of the following causes? a. Age-related changes in the cardiovascular system b. Anxiety c. The effects of pathological depression d. Medication the physician has prescribed for depression

a. Age-related changes in the cardiovascular system

Shane, a veteran of the war in Iraq, has been diagnosed with PTSD. He is a client of the VA outpatient clinic. He tells the nurse that he experiences panic attacks. Which of the following medications may be prescribed for Shane to treat his panic attacks? a. Alprazolam b. Lithium c. Carbamazepine d. Haldol

a. Alprazolam

A school nurse notices bruises and scars on a child's body. The nurse suspects that the child is being physically abused. Which action by the nurse is a priority at this point? a. As a health-care worker, report the suspicion to child protective services. b. Check the child again in a week and see if there are any new bruises. c. Meet with the child's parents and ask them how she got the bruises. d. Initiate paperwork to have the child placed in foster care.

a. As a health-care worker, report the suspicion to child protective services.

Mike, a veteran of combat in Afghanistan, has a diagnosis of mild TBI. The psychiatric home health nurse from the VA medical center is assigned to make home visits to Mike and his wife, Marissa, who is his caregiver. Which of the following would be an appropriate nursing intervention by the home health nurse? (Select all that apply.) a. Assess for the use of substances by Mike or Marissa. b. Encourage Marissa to do everything for Mike to prevent further deterioration in his condition. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible. e. Suggest that Marissa ask the physician for a nursing home placement for Mike.

a. Assess for the use of substances by Mike or Marissa. c. Assess Marissa's level of stress and potential for burnout. d. Encourage Marissa to allow Mike to be as independent as possible.

A client, age 79, is admitted to the psychiatric unit for depression. He has lost weight and become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing diagnosis for Mr. B.? a. Complicated grieving b. Imbalanced nutrition: less than body requirements c. Social isolation d. Risk for injury

a. Complicated grieving

What is the ultimate goal of therapy for a client with dissociative identity disorder? a. Integration of the personalities into one b. The ability to switch from one personality to another voluntarily c. The ability to select one personality as the dominant self d. Recognition that the various personalities exist

a. Integration of the personalities into one

A client on the psychiatric unit has a diagnosis of antisocial personality disorder. Which of the following characteristics is consistent with this diagnosis? a. Lack of guilt for wrongdoing b. Insight into his own behavior c. Ability to learn from past experiences d. Compliance with authority

a. Lack of guilt for wrongdoing

Which of the following symptom profiles would you expect when assessing a client with somatic symptom disorder? a. Multiple somatic symptoms in several body systems b. Fear of having a serious disease c. Loss or alteration in sensorimotor functioning d. Belief that his or her body is deformed or defective in some way

a. Multiple somatic symptoms in several body systems

Which of the following behavioral patterns is characteristic of individuals with narcissistic personality disorder? a. Overly self-centered and exploitative of others b. Suspicious and mistrustful of others c. Rule conscious and disapproving of change d. Anxious and socially isolated

a. Overly self-centered and exploitative of others

A client presents in the emergency department with complaints of suicidal ideation. The following information is collected by the nurse. Which of these assessment findings suggests that bulimia nervosa might be a health problem? (Select all that apply.) a. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. d. Client's weight is within the expected range.

a. Parotid glands appear enlarged. b. Teeth have a "moth-eaten" pattern of tooth decay. c. Client reports that she takes laxatives daily. d. Client's weight is within the expected range.

A psychiatric nurse has been asked to lead an educational group on anger management for patients admitted to the psychiatric unit. Which of these actions by the nurse is the most important priority? a. Provide information and handouts on anger management. b. Ask patients how long they would like the group to last. c. Restrict the group to only those who have been complying with unit rules and expectations. d. Ask the patients if they would rather have a group on something else.

a. Provide information and handouts on anger management.

A client diagnosed with borderline personality disorder manipulates the staff in an effort to fulfill her own desires. All of the following may be examples of manipulative behaviors in the borderline patient except: a. Refusal to stay in a room alone, stating, "It's so lonely." b. Asking the nurse for cigarettes after 30 minutes, knowing the assigned nurse has explained she must wait 1 hour. c. Stating to the nurse, "I really like having you for my nurse. You're the best one around here." d. Cutting arms with razor blade after discussing dismissal plans with physician.

a. Refusal to stay in a room alone, stating, "It's so lonely."

Which of the following nursing diagnoses would be considered the priority in planning care for the child with severe autism spectrum disorder? a. Risk for self-mutilation evidenced by banging head against wall b. Impaired social interaction evidenced by unresponsiveness to people c. Impaired verbal communication evidenced by absence of verbal expression d. Disturbed personal identity evidenced by inability to differentiate self from others

a. Risk for self-mutilation evidenced by banging head against wall

A veteran who has returned 6 months ago reports to the mental health clinic, stating, "I'm falling apart. I think I'm losing it." Based on an understanding of common problems among military personnel and veterans, which of the following items should the nurse prioritize in conducting an assessment? (Select all that apply.) a. Screen for alcohol and other drug abuse. b. Assess for suicide risk. c. Evaluate for evidence of TBI. d. Assess for signs and symptoms of PTSD. e. Assess whether the client had evidence of any mental illness symptoms before entry in the military.

a. Screen for alcohol and other drug abuse. b. Assess for suicide risk. c. Evaluate for evidence of TBI. d. Assess for signs and symptoms of PTSD.

A staff nurse on a surgical unit is the leader of a newly established group of staff nurses organized to determine ways to decrease the number of medication errors occurring on the unit. At each meeting, he addresses the group to convince the members to adopt his ideas. Which type of group and style of leadership is described in this situation? a. Task group, autocratic leadership b. Teaching group, autocratic leadership c. Self-help group, democratic leadership d. Supportive-therapeutic group, laissez-faire leadership

a. Task group, autocratic leadership

A battered woman presents to the emergency department with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. What is the priority nursing intervention? a. Tending to the immediate care of her wounds b. Providing her with information about a safe place to stay c. Administering the prn tranquilizer ordered by the physician d. Explaining how she may go about bringing charges against her husband

a. Tending to the immediate care of her wounds

During a family meeting, the parents who are in the process of getting a divorce report to the nurse that their teenage son with his "depression and attention-seeking behavior" is the root of all of their problems. Using concepts from Bowen's theory, which of these is the most accurate interpretation of this parental communication? a. The parents are scapegoating. b. Parental boundaries are diffuse. c. The parents are assuming healthy roles. d. The parents are disengaged.

a. The parents are scapegoating.

The Maudsley approach to treatment of adolescents with anorexia nervosa advances which of the following fundamental concepts? a. The patient's family should be actively involved in each phase of treatment. b. Parents should be prohibited from involvement in helping their child eat since there are often control issues. c. Adolescents need to work on developing healthy self-identities before they can begin to gain weight. d. Individual psychotherapy is the most effective treatment for adolescents with anorexia nervosa.

a. The patient's family should be actively involved in each phase of treatment.

Using the structural approach with a family in therapy, the therapist would: a. Try to change family principles that may be promoting dysfunctional behavior patterns. b. Strive to create change in destructive behavior through improvement in communications and interaction patterns. c. Encourage differentiation of individual family members. d. Promote change in dysfunctional behavior by encouraging the formation of more diffuse boundaries between family members.

a. Try to change family principles that may be promoting dysfunctional behavior patterns.

The nurse is caring for a client who has been hospitalized with anorexia nervosa and is severely malnourished. The client continues to refuse to eat. What is the most appropriate response by the nurse? a. "You know that if you don't eat, you will die." b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube." c. "You might as well leave if you are not going to follow your therapy regimen." d. "You don't have to eat if you don't want to. It is your choice."

b. "If you continue to refuse to take food orally, you will be fed through a nasogastric tube."

A client arrives at the emergency department and tells the nurse her husband inflicted the cuts to her face that required sutures. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is: a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

b. "It is not your fault. You did the right thing by coming here."

A client has sought help for his concern that he is binge eating and feels like it has "gotten out of control." He asks the nurse what can be done to help him. Which of the following is the most accurate response? a. "Nothing can be done." b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors." c. "The primary problem is obesity. I can help you set up a calorie-restricted diet." d. "Medications can help with weight loss, but there are no medications effective for reducing binge eating."

b. "Some medications and psychological treatments have demonstrated effectiveness in reducing binge eating behaviors."

A college-age client is brought to the emergency department by her roommate after she confided that she was raped by her date who invited her to a frat party. The client says to the nurse, "It's all my fault. I shouldn't have gone to a party where I knew there was going to be alcohol." Which of these is the best response by the nurse? a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to get you drunk." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."

Which of the following behavioral patterns is characteristic of individuals with schizotypal personality disorder? a. Belittling themselves and their abilities b. A lifelong pattern of social withdrawal c. Suspicious and mistrustful of others d. Overreacting inappropriately to minor stimuli

b. A lifelong pattern of social withdrawal

A client is hospitalized on the psychiatric unit with a history and current diagnosis of bulimia nervosa. Which of the following symptoms would be congruent with this client's diagnosis? a. Binging, purging, obesity, hyperkalemia b. Binging, purging, normal weight, hypokalemia c. Binging, laxative abuse, amenorrhea, severe weight loss d. Binging, purging, severe weight loss, hyperkalemia

b. Binging, purging, normal weight, hypokalemia

Which of the following is the leading cause of TBI in active-duty military personnel in combat? a. Military vehicle accidents b. Blasts from explosive devices c. Falls d. Blows to the head from falling debris

b. Blasts from explosive devices

Which of the following groups is most commonly used for drug management of the child with attention deficit-hyperactivity disorder? a. CNS depressants (e.g., diazepam [Valium]) b. CNS stimulants (e.g., methylphenidate [Ritalin]) c. Anticonvulsants (e.g., phenytoin [Dilantin]) d. Major tranquilizers (e.g., haloperidol [Haldol])

b. CNS stimulants (e.g., methylphenidate [Ritalin])

A nurse on the psychiatric unit documents that the client was attempting to use "splitting" behaviors with staff. This should be interpreted to mean that the client is: a. Trying to keep staff away from other patients. b. Characterizing staff members as either all good or all bad. c. Having brief psychotic episodes. d. Manifesting two or more distinct subpersonalities when communicating with staff.

b. Characterizing staff members as either all good or all bad.

The nursing supervisor asks one of the staff nurses to initiate a group with other staff nurses to identify new ways to prevent patient falls. Which of these would be the most appropriate style of leadership for the nurse to implement? a. Autocratic b. Democratic c. Laissez-faire d. Militaristic

b. Democratic

Which of the following medications is used to treat Tourette's disorder? a. Methylphenidate (Ritalin) b. Haloperidol (Haldol) c. Imipramine (Tofranil) d. Phenytoin (Dilantin)

b. Haloperidol (Haldol)

A 14-year-old client has just been admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the priority nursing diagnosis for this client? a. Complicated grieving b. Imbalanced nutrition: Less than body requirements. c. Interrupted family processes d. Anxiety (severe)

b. Imbalanced nutrition: Less than body requirements.

A 75-year-old male client, who is taking a selective serotonin reuptake inhibitor (SSRI) for depression, reports to the nurse that he recently began having erectile dysfunction. Which of these is the most appropriate action by the nurse? a. Set clear boundaries that this is not an appropriate topic to discuss with the nurse. b. Instruct the client that this is a potential side effect of his medication and ask if he would prefer to explore other treatment options. c. Educate the client that this is a normal age-related change and cannot be treated. d. Reinforce that this is a common symptom of depression and should subside after 4 to 6 weeks of antidepressant treatment.

b. Instruct the client that this is a potential side effect of his medication and ask if he would prefer to explore other treatment options.

A client diagnosed with somatic symptom disorder states, "My doctor thinks I should see a psychiatrist. I can't imagine why he would make such a suggestion." What is the most common basis for the client's statement? a. Lack of trust in the physician. b. Lack of understanding about the correlation of symptoms and stress. c. Lack of understanding about the role of a psychiatrist. d. Lack of financial resources.

b. Lack of understanding about the correlation of symptoms and stress.

In establishing trust with a client diagnosed with dissociative identity disorder, the nurse should: a. Respond as if the client did not have multiple personalities. b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states. c. Ignore behaviors that the client attributes to other subpersonalities. d. Explain to the client that they must remain in their primary identity state while communicating with the nurse. e. All of the above

b. Listen nonjudgmentally and respond empathically when the client transitions to different personality states.

A child, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that the child has numerous bruises on her arms and torso in various stages of healing. She also notices some small scars, and her abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse should screen further for: a. Physical and sexual abuse. b. Physical abuse and neglect. c. Emotional neglect. d. Sexual and emotional abuse.

b. Physical abuse and neglect.

Which of the following factors are most associated with mental health in older adults? a. Pureed foods and warm beverages b. Physical activity and socialization c. Moderate alcohol and lower calorie intake d. Living alone and adhering to antidepressant medications

b. Physical activity and socialization

A young man who has just undergone a sexual assault is brought into the emergency department by a friend. What is the priority nursing intervention? a. Help him to bathe and clean himself up. b. Provide physical and emotional support during evidence collection. c. Provide him with a written list of community resources for survivors of rape. d. Discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

b. Provide physical and emotional support during evidence collection.

The ultimate goal of therapy for a client with dissociative identity disorder is most likely achieved through: a. Crisis intervention and directed association. b. Psychotherapy and hypnosis. c. Psychoanalysis and free association. d. Insight psychotherapy and dextroamphetamines.

b. Psychotherapy and hypnosis.

A couple reports to the generalist staff nurse at the mental health clinic that they are having trouble in their marriage and want to enter therapy. Which of these is the most appropriate next action by the nurse? a. Offer to begin meeting with them as a couple. b. Recommend referral to a marriage and family therapist. c. Assess how many times each partner has been married before. d. Assess which of the partners is responsible for the marital discord.

b. Recommend referral to a marriage and family therapist.

A male client with antisocial personality disorder was found in a female patient's room on her bed. When instructed to leave the room, the client states, "I'm sick of you telling me what I can or can't do. If I want to carry on a relationship with a female patient, it's my right. I'll do exactly as I please!" Which of these actions by the nurse is a priority at this point? a. Reassure the client that he will have plenty of opportunities with women after he is discharged. b. Reinforce the rules of the treatment program that all clients are expected to follow. c. Escort the client to seclusion. d. Establish a trusting relationship by telling the client that you will make an exception just this once.

b. Reinforce the rules of the treatment program that all clients are expected to follow.

Which of the following ego defense mechanisms describes the underlying psychodynamics of somatic symptom disorder? a. Denial of depression b. Repression of anxiety c. Suppression of grief d. Displacement of anger

b. Repression of anxiety

A veteran of the war in Iraq has been diagnosed with PTSD. He has been hospitalized after swallowing a handful of his antipanic medication. His physical condition was stabilized in the emergency department, and he has been admitted to the psychiatric unit. In developing his initial plan of care, which of the following should the nurse identify as the priority nursing diagnosis? a. Post-trauma syndrome b. Risk for suicide c. Complicated grieving d. Disturbed thought processes

b. Risk for suicide

To help the child with mild to moderate intellectual developmental disorder develop satisfying relationships with others, which of the following nursing interventions is most appropriate? a. Interpret the child's behavior for others. b. Set limits on behavior that is socially inappropriate. c. Allow the child to behave spontaneously because he or she has no concept of right or wrong. d. This child is not capable of forming social relationships.

b. Set limits on behavior that is socially inappropriate.

The child with attention deficit-hyperactivity disorder has a nursing diagnosis of impaired social interaction. Which of the following nursing interventions are appropriate for this child? (Select all that apply.) a. Socially isolate the child when interactions with others are inappropriate. b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.

b. Set limits with consequences on inappropriate behaviors. c. Provide rewards for appropriate behaviors. d. Provide group situations for the child.

A nurse who is leading a childbirth preparation group shows a film each week and sets out reading materials. She expects the participants to utilize their time on a topic of their choice or practice skills they have observed in the films. Which type of group and style of leadership is described in this situation? a. Task group, democratic leadership b. Teaching group, laissez-faire leadership c. Self-help group, democratic leadership d. Supportive-therapeutic group, autocratic leadership

b. Teaching group, laissez-faire leadership

A nurse has been asked to facilitate a group in the outpatient mental health clinic that is focused on helping patients problem-solve issues with adherence to medications. Which of these decisions about group size is most appropriate? a. The group should be open to all patients who express interest. b. The optimal size for this type of group is around 7 to 8 patients. c. Patients should democratically decide on the size of the group. d. The group should be limited to the first 35 patients who sign up.

b. The optimal size for this type of group is around 7 to 8 patients.

The nurse-therapist is counseling the Smith family: Mr. and Mrs. Smith, 10-year-old Rob, and 8-year-old Lisa. When Mr. and Mrs. Smith start to argue, Rob hits Lisa and Lisa starts to cry. The Smiths then turn their attention to comforting Lisa and scolding Rob, complaining that he is "out of control" and "we don't know what to do about his behavior." These dynamics are an example of which of the following? a. Double-bind messages b. Triangulation c. Pseudohostility d. Multigenerational transmission

b. Triangulation

A child with ADHD is admitted to a residential treatment program. Which of the following group activities would be most appropriate for the nurse to recommend? a. Monopoly b. Volleyball c. Pool d. Checkers

b. Volleyball

A hospitalized client with bulimia nervosa has stopped vomiting in the hospital and tells the nurse she is afraid she is going to gain weight. Which is the most appropriate response by the nurse? a. "Don't worry. The dietitian will ensure 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. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment." d. "You are not fat, and the staff will ensure that you do not gain weight while you are in the hospital, because we know that is important to you."

c. "I understand that you are concerned about your weight, and we will talk about the importance of good nutrition, but for now I want you to tell me about your recent invitation to join the National Honor Society. That's quite an accomplishment."

A client diagnosed with somatic symptom disorder tells the nurse about a pain in her side. She says she has not experienced it before. Which is the most appropriate response by the nurse? a. "I don't want to hear about another physical complaint. You know they are all in your head. It's time for group therapy now." b. "Let's sit down here together and you can tell me about this new pain you are experiencing. You'll just have to miss group therapy today." c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes." d. "I will call your physician and see if he will order a new pain medication for your side. The one you have now doesn't seem to provide relief. Why don't you get some rest for now?"

c. "I will report this pain to your physician. In the meantime, group therapy starts in 5 minutes."

The staff nurse on a psychiatric unit is approached by the client's husband, who reports, "I know my wife has bipolar disorder, but I can't tolerate the lying and the infidelity when she has manic episodes. I don't want a divorce, but I don't know what to do next." Which of these would be the most appropriate response by the nurse? a. "I can't discuss this with you, but I can refer you to a family therapist." b. "These are illness symptoms that are permanent. You will have to learn to cope with them." c. "Let's sit down and explore some options for next steps." d. "I'm sure you and your family will get through this. It will just take some time."

c. "Let's sit down and explore some options for next steps."

During the admission assessment for a 72-year-old male client the nurse notices an open sore on Stanley's arm. When she questions him about it, he says, "I scraped it on the fence two weeks ago. It's smaller than it was." Which of the following is the best interpretation of this finding? a. Lower testosterone levels in older adult men results in injury-prone skin. b. Confusion is common in the elderly, so the client probably doesn't remember how long ago he sustained the injury. c. A diminished inflammatory response in the elderly increases healing time. d. The supply of blood vessels to the skin increases with age and delays healing time.

c. A diminished inflammatory response in the elderly increases healing time. d. The supply of blood vessels to the skin increases with age and delays healing time.

A client with BPD reports to the nurse that she is having abdominal pain and is requesting pain medication. Which action by the nurse is a priority? a. Explore alternative pain management strategies. b. Confront the client about her manipulation to try to get drugs. c. Assess her pain in more detail. d. Set limits on her attempts to cling to the nurse.

c. Assess her pain in more detail.

The child with autism spectrum disorder has difficulty with trust. With this in mind, which of the following nursing actions would be most appropriate? a. Encourage all staff to hold the child as often as possible, conveying trust through touch. b. Assign a different staff member each day so the child will learn that everyone can be trusted. c. Assign the same staff person as often as possible to promote feelings of security and trust. d. Avoid eye contact because it is extremely uncomfortable for the child and may even discourage trust.

c. Assign the same staff person as often as possible to promote feelings of security and trust.

Which of the following physical manifestations would you expect to assess in a client suffering from anorexia nervosa? a. Tachycardia, hypertension, hyperthermia b. Bradycardia, hypertension, hyperthermia c. Bradycardia, hypotension, hypothermia d. Tachycardia, hypotension, hypothermia

c. Bradycardia, hypotension, hypothermia

A client who was injured during combat in Afghanistan has a diagnosis of TBI. Which of the following medications might the physician prescribe to improve his memory and thinking capability? a. Carbamazepine b. Duloxetine c. Donepezil d. Bupropion

c. Donepezil

An elderly female client with depression says to the nurse, "I don't want to go to that crafts class. I'm too old to learn anything." Which of these is the most appropriate action by the nurse at this point? a. Tell the client that groups are mandatory and escort her by the hand. b. Pat the client on the shoulder and empathize about how annoying it is to get old. c. Educate the client that people don't typically lose the ability to learn as they age and encourage her to express her thoughts and feelings associated with aging. d. Assess the client for suicide risks and warning signs.

c. Educate the client that people don't typically lose the ability to learn as they age and encourage her to express her thoughts and feelings associated with aging.

A generalist nurse in the outpatient mental health clinic is approached by the medical director who requests that the nurse initiate a cognitive behavior therapy group. Which of these is the most appropriate action by the nurse? a. Establish a self-help group for any patients who are interested. b. Conduct cognitive behavior therapy for a small group of 7 to 10 patients. c. Educate the medical director that according to nursing practice standards, therapy groups should be conducted by nurses who have a minimum of a master's degree in psychiatric nursing. d. Ask the nursing supervisor for approval to initiate the medical director's request.

c. Educate the medical director that according to nursing practice standards, therapy groups should be conducted by nurses who have a minimum of a master's degree in psychiatric nursing.

Using Bowen's systems approach with a family in therapy, the therapist would: a. Try to change family principles that may be promoting dysfunctional behavior patterns. b. Strive to create change in destructive behavior through improvement in communication and interaction patterns. c. Encourage differentiation of individual family members. d. Promote change in dysfunctional behavior by encouraging the formation of more diffuse boundaries between family members.

c. Encourage differentiation of individual family members.

The nursing history and assessment of an adolescent with conduct disorder might reveal all of the following behaviors except: a. Manipulation of others for fulfillment of own desires. b. Chronic violation of rules. c. Feelings of guilt as fociated with the exploitation of others. d. Inability to form close peer relationships.

c. Feelings of guilt as fociated with the exploitation of others.

Which medication has been used with some success in clients with anorexia nervosa? a. Lorcaserin (Belviq) b. Diazepam (Valium) c. Fluoxetine (Prozac) d. Carbamazepine (Tegretol)

c. Fluoxetine (Prozac)

In a bereavement group for widows, one of the new members hears a longer-term member describe that the group support has helped her adjust to the loss of her husband. The new member states, "Well, maybe I can get through this, too." This statement is evidence of which of the following therapeutic factors? a. Universality b. Imitative behavior c. Installation of hope d. Imparting of information

c. Installation of hope

A veteran of the war in Iraq has been diagnosed with PTSD. He has been hospitalized on the psychiatric unit following an attempted suicide. In the middle of the night, he wakes up yelling and tells the nurse he was having a flashback to when his unit transport drove over an improvised explosive device (IED) and most of his fellow soldiers were killed. He is breathing heavily, perspiring, and his heart is pounding. The nurse's most appropriate initial intervention is which of the following? a. Contact the doctor on call to report the incident. b. Administer the prn order for chlorpromazine. c. Stay with the client and reassure him of his safety. d. Instruct him to sit outside the nurses' station until he is calm.

c. Stay with the client and reassure him of his safety.

Some obese individuals take amphetamines to suppress appetite and help them lose weight. Which of the following is an adverse effect associated with the use of amphetamines that makes this practice undesirable? a. Bradycardia b. Amenorrhea c. Tolerance d. Convulsions

c. Tolerance

A nurse leader is explaining about group "therapeutic factors" to members of the group. She tells the group that group situations are beneficial because members can see that they are not alone in their experiences. Which of the following therapeutic factors is the nurse describing? a. Altruism b. Imitative behavior c. Universality d. Imparting of information

c. Universality

A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is: a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

d. "I hope you have made the right decision. Call this number if you need help."

A patient diagnosed with antisocial personality disorder approaches the nurse and says, "You're so cute, are you married?" Which of these is the most appropriate response by the nurse? a. "I'm married, but that's none of your business." b. "Let's talk about your love life instead." c. "Thank you so much for the compliment but I'm married." d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion."

d. "Our relationship is strictly professional. It is not appropriate for us to have that kind of discussion."

Which of the following psychosocial therapies has been shown to be helpful for clients with TBI? a. Eye movement desensitization b. Psychoanalysis c. Reality therapy d. Cognitive behavior therapy

d. Cognitive behavior therapy

According to researchers, which of the following is a common theme in the health history of the client with BPD? a. Autism b. Attention deficit-hyperactivity disorder c. Positive and fulfilling interpersonal relationships d. Early childhood trauma

d. Early childhood trauma

A client, age 79, is admitted to the psychiatric unit for depression. He has lost weight and has become socially isolated. His wife died 5 years ago, and his son tells the nurse, "He did very well when Mom died. He didn't even cry." Which would be the priority nursing intervention? a. Take blood pressure once each shift. b. Ensure that the client attends group activities. c. Encourage the client to eat all of the food on his food tray. d. Encourage the client to talk about his wife's death.

d. Encourage the client to talk about his wife's death.

A nurse is conducting a diabetic medication education group for patients on a medical unit. Which of these actions by the nurse is the most important priority during the first meeting of this group? a. Ask the patients where they would like to begin. b. Try to identify what role each of the members is assuming. c. Conduct fingerstick blood sugars on each attendee. d. Explain how the meetings will be structured.

d. Explain how the meetings will be structured.

Lucille has a diagnosis of illness anxiety disorder. Which of the following symptoms would be consistent with this diagnosis? a. Complains of a multitude of incapacitating physical symptoms b. Manifests with pseudoseizures or pseudocyesis c. Takes substances to induce vomiting to convince the nurse that she needs treatment d. Expresses persistent fears of having life-threatening disease

d. Expresses persistent fears of having life-threatening disease

The developmental task of transcendence suggests that mental health in older adulthood is contingent upon: a. Being able to ignore the stigmas associated with being elderly. b. Developing the ability to be alone. c. Transcending physical limitations imposed by age-related changes in the body. d. Having a sense of meaning in life and a sense of satisfaction.

d. Having a sense of meaning in life and a sense of satisfaction.

Nursing care for a client with somatic symptom disorder should focus on helping the client to: a. Eliminate stressors. b. Discontinue focusing on numerous physical complaints. c. Take medication only as prescribed. d. Learn more adaptive coping strategies.

d. Learn more adaptive coping strategies.

Certain family dynamics often predispose adolescents to the development of conduct disorder. Which of the following patterns is thought to be a contributing factor? a. Parents who are overprotective b. Parents who have high expectations for their children c. Parents who consistently set limits on their children's behavior d. Parents who are alcohol dependent

d. Parents who are alcohol dependent

The nurse is providing education to a support group for survivors of rape. Which of the following items is evidence-based information to include in this teaching? a. Rapists typically drink alcohol and are not in control of their actions. b. Rape is usually an event that occurs between two people who are sexually frustrated. c. Men who are born into poverty are predisposed to becoming rapists after puberty. d. Rape is an expression of power and dominance by means of sexual aggression and violence.

d. Rape is an expression of power and dominance by means of sexual aggression and violence.

A client reports to the nurse that her children are threatening to break up her second marriage because they don't like their stepfather. She admits that he is a disciplinarian and that he broke her son's arm when they got into an argument about her son's report card. Which of these is the most important priority action by the nurse? a. Make a referral to a family therapist. b. Encourage the client to consider divorce as an acceptable option. c. Suggest that her husband consider anger management classes. d. Report suspicions of child abuse to child protective services.

d. Report suspicions of child abuse to child protective services.

A client with a history of childhood physical and sexual abuse was diagnosed with dissociative identity disorder 6 years ago and has been admitted to the psychiatric unit following a suicide attempt. What is the priority nursing diagnosis for this client? a. Disturbed personal identity related to childhood abuse b. Disturbed sensory perception related to repressed anxiety c. Impaired memory related to disturbed thought processes d. Risk for suicide related to unresolved grief

d. Risk for suicide related to unresolved grief

A client with a diagnosis of borderline personality disorder exhibits alternating clinging and distancing behaviors with the nurse who has been assigned to her care. The most appropriate nursing intervention with this type of behavior would be to: a. Encourage the client to establish trust in one staff person, with whom all therapeutic interaction should take place. b. Secure a verbal contract from the client that she will discontinue these behaviors. c. Withdraw attention if these behaviors continue. d. Rotate staff members who work with the client so that she will learn to relate to more than one person.

d. Rotate staff members who work with the client so that she will learn to relate to more than one person.

What is the most appropriate way to communicate with an elderly person who is hard of hearing in his right ear? a. Speak loudly into his left ear. b. Speak to him from a position on his left side. c. Speak face-to-face in a high-pitched voice. d. Speak face-to-face in a low-pitched voice.

d. Speak face-to-face in a low-pitched voice.

A psychiatric nurse is leading a group for women who desire to lose weight. The criterion for membership is that members must be at least 20 pounds overweight. All have tried to lose weight on their own many times in the past without success. At their first meeting, the nurse provides suggestions as the members determine what their goals will be and how they plan to go about achieving those goals. They decide how often they want to meet and what they plan to do at each meeting. Which type of group and style of leadership is described in this situation? a. Task group, autocratic leadership b. Teaching group, democratic leadership c. Self-help group, laissez-faire leadership d. Supportive-therapeutic group, democratic leadership

d. Supportive-therapeutic group, democratic leadership

A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. Which of the following is an evidence-based approach for further assessment by the nurse? a. Have her evaluated by the school psychologist. b. Tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. Explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. Use a "family" of dolls to role-play the child's family with her.

d. Use a "family" of dolls to role-play the child's family with her.