N222 QUIZ 5 REVIEW

A nurse is assessing a client who has conduct disorder. Which of the following findings should the nurse expect? A. Fearfulness of authority figures B. Flat affect C. Preoccupation with enforcing rules D. Aggressive behavior toward others

D

A nurse is assessing a 24-month-old toddler who has a new diagnosis of autism spectrum disorder (ASD). Which of the following findings should the nurse expect? A. Wanting to be held frequently B. Ability to build a tower of 10 cubes C. Impaired language skills D. Ability to stand on 1 foot

C

A nurse is assessing a client who has oppositional, defiant disorder. Which of the following findings should the nurse expect? A. Displaying a flat affect B. Unmotivated by rewards C. Ignoring unit rules D. Fearing a loss of privileges

C

A nurse is assessing a client who has illness anxiety disorder. Which of the following are expected for this disorder? (Select all that apply.) A. Obsessive thoughts about disease B. History of childhood abuse C. Avoidance of health care providers D. Depressive disorder E. Narcissistic personality

A,B,C,D

A nurse is caring for a client who takes paroxetine to treat post traumatic stress disorder. The client states, "I grind my teeth during the night, which causes pain in my mouth." The nurse should identify which of the following interventions as possible measures to manage the client's bruxism? (Select all that apply.) A. Concurrent administration of buspirone B. Administration of a different SSRI C. Use of a mouth guard D. Changing to a different class of antianxiety medication E. Increasing the dose of paroxetine

A, C, D

A nurse working on an acute mental health unit is caring for a client who has posttraumatic stress disorder (PTSD). Which of the following findings should the nurse expect? (Select all that apply.) A. Difficulty concentrating on tasks B. Obsessive need to talk about the traumatic event C. Negative self-image D. Recurring nightmares E. Diminished reflexes

A, C, D

A nurse is caring for a client who has post-traumatic stress disorder (PTSD). Which of the following actions by the client indicates the current treatment plan is effective? A. The client reports techniques she uses to promote sleep. B. The client shows limited emotion when witnessing a traumatic event. C. The client asks the nurse's opinion about the clothes she is wearing. D. The client avoids situations that might trigger memories of past trauma.

A

A nurse is teaching a group of guardians about manifestations of conduct disorder. Which of the following findings should the nurse include? (Select all that apply.) A. Bullying of others B. Threats of suicide C. Law-breaking activities D. Narcissistic behavior E. Flat affect

A, B, C

A nurse is teaching the guardians of a child who has autism spectrum disorder about indications of imipramine toxicity. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Seizures B. Agitation C. Photophobia D. Dry mouth E. Irregular pulse

A, B, E

A nurse is discussing the factors for somatic symptom disorder with a newly licensed nurse. Which of the following risk factors should the nurse include? (Select all that apply.) A. Age older than 65 years B. Anxiety disorder C. Childhood trauma D. Coronary artery disease E. Obesity

B, C

A nurse is involved in a serious and prolonged mass casualty incident in the emergency department. Which of the following strategies should the nurse use to help prevent developing a trauma-related disorder? (Select all that apply) A. Avoid thinking about the incident when it is over. B. Take breaks during the incident for food and water. C. Debrief with others following the incident. D. Avoid displays of emotion in the days following the incident. E. Take advantage of offered counseling.

B, C, E

A nurse is teaching a child who has intermittent explosive disorder about a new prescription for fluoxetine. Which of the following information should the nurse provide? (Select all that apply.) A. An adverse effect of this medication is CNS depression. B. Administer the medication in the morning. C. Monitor for weight loss while taking this medication. D. Therapeutic effects of this medication will take 1 to 3 weeks to fully develop. E. This medication blocks the synaptic reuptake of serotonin in the brain.

B, C, E

A nurse is performing an admission assessment on an adolescent client who has depression. Which of the following findings are expected for this disorder? (Select all that apply.) A. Fear of being alone B. Substance use C. Weight gain D. Irritability E. Aggressiveness

B, D, E

A nurse is providing teaching to an adolescent client who is to begin taking atomoxetine for ADHD. The nurse should instruct the client to monitor for which of the following adverse effects? (Select all that apply.) A. Somnolence B. Yellowing skin C. Increased appetite D. Fever E. Malaise

B, D, E

A nurse is caring for a client who has derealization disorder. Which of the following findings should the nurse identify as an indication of derealization? A. The client describes a feeling of floating above the ground. B. The client has suspicions of being targeted in order to be killed and robbed. C. The client states that the furniture in theBroom seems to be small and far away. D. The client cannot recall anything that happened during the past 2 weeks.

C

A nurse is counseling several clients. Which of the following client statements should the nurse identify as expected for factitious disorder imposed on another? A. "I had to pretend I was injured in order to get disability benefits." B. "I know that my abdominal pain is caused by a malignant tumor." C. "I needed to make my child sick so that someone else would take care of them for a while." D. "I became deaf when I heard that my partner was having an affair with my best friend."

C

A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will the information focus on? A. Paroxetine B. Imipramine C. Methyphenidate D. Carbamazepine

C

The diagnosis of impaired intellectual functioning is supported when a child diagnosed with IDD A. can neither brush the teeth nor combing the hair effectively. B. cries uncontrollably when a toy is temporarily missing. C. cannot put together a five-piece jigsaw puzzle. D. has difficulty with the concept of social boundaries.

C

The information that is least relevant when assessing a patient with a suspected somatization disorder is: A. Understanding coping mechanisms B. Results of diagnostic workups C. Potential for Violence D. Limitations in activities of daily living

C

The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate? A. "Perhaps your child was misdiagnosed." B. "Your observation indicates the medication is effective." C. "Tics often change frequency or severity. That doesn't mean they aren't real." D. "This finding is unexpected. How have you been administering your child's medication?"

C

A nurse is providing teaching to the parent of a school-aged child who has ADHD and a new prescription for methylphenidate IR. Which of the following pieces of information should the nurse provide? A. "Have your child take the medication once daily." B. "This medication might make your child gain weight." C. "Your child's growth might slow while using this medication." D. "Avoid giving your child food when taking this medication."

C rationale: The nurse should instruct the parent that an adverse effect of methylphenidate is growth suppression related to the appetite suppression associated with the medication. Administering the medication with or after meals will help protect the child's appetite.

A nurse is assisting the guardians of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following strategies should the nurse recommend? (Select all that apply.) A. Allow the child to choose which behaviors are unacceptable. B. Use role-playing to act out unacceptable behavior. C. Develop a reward system for acceptable behavior. D. Encourage the child to participate in school sports E. Be consistent when addressing unacceptable behavior.

C, D, E

Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child: A. plays with one toy for 30 minutes. B. repeats words spoken by a parent. C. holds the parent's hand while walking. D. spins around and claps hands while walking

C.

A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child: A. has an improved ability to identify anxiety and use self-control strategies. B. has increased expressiveness in communication with others. C. shows increased responsiveness to authority figures. D. engages in cooperative play with other children.

D

A nurse in a pediatric clinic is caring for a preschool-age child who has a new diagnosis of ADHD. When teaching the guardian about this disorder, which of the following statements should the nurse include in the teaching? A. "Behaviors associated with ADHD are present prior to age 3." B. "This disorder is characterized by argumentativeness. C. "Below-average intellectual functioning is associated with ADHD" D. "Because of this disorder, your child is at an increased risk for injury."

D

A nurse in an acute mental health facility is planning care for a client who has dissociative fugue. Which of the following interventions should the nurse add to the plan of care? A. Teach the client to recognize how stress brings on a personality change in the client. B. Repeatedly present the client with information about past events. C. Make decisions for the client regarding routine daily activities. D. Work with the client on grounding techniques.

D

A nurse is caring for a client who has post-traumatic stress disorder (PTSD) and who is undergoing eye movement desensitization and reprocessing (EMDR) therapy. The nurse should identify that EMDR includes which of the following strategies? A. Exposes the client to circumstances that trigger the PTSD B. Assists the client with behavioral modification C. Encourages the client to visualize a relaxing scene when traumatic memories occur D. Uses stimuli to change how the client processes the trauma

D

A nurse is caring for a school age child who has conduct disorder and a new prescription for methylphenidate transdermal patches. Which of the following information should the nurse provide about the medication? A. Apply the patch once daily at bedtime. B. Place the patch carefully in a trash can after removal. C. Apply the transdermal patch to the anterior waist area. D. Remove the patch each day after 9 hr.

D

What is the client experiencing? "The client describes a feeling of floating above the ground."

Depersonalization

A nurse is collecting an admission history for a client who has acute stress disorder (ASD). Which of the following client behaviors should the nurse expect? A. The client remembers many details about the traumatic incident. B. The client expresses heightened elation about what is happening. C. The client remembers first noticing manifestations of the disorder 6 weeks after the traumatic incident occurred. D. The client expresses a sense of unreality about the traumatic incident.

D

A nurse is developing a plan of care for a client who has conversion disorder. Which of the following actions should the nurse include? A. Encourage the client to spend time alone in their room. B. Monitor the client for self-harm once per day. C. Allow the client unlimited time to discuss physical manifestations. D. Discuss alternative coping strategies with the client.

D

A patient with fears of serious heart disease was referred to the mental health center by a cardiologist. Extensive diagnostic evaluation showed no physical illness. The patient says, "My chest is tight, and my heart misses beats. I'm often absent from work. I don't go out much because I need to rest." Which health problem is most likely? A. Conversion disorder B. Somatic symptom disorder C. Antisocial personality disorder D. Illness anxiety disorder

D

A nurse is planning care for a client who has dissociative disorder and is experiencing flashbacks while in public. Which of the following interventions should the nurse include in the plan to help the client recognize and counter the flashbacks? A. Encourage reality testing B. Provide opportunities for socialization c. Consistently remind the client of past traumatic events D. Discourage client expressions of negative feelings

A

A nurse is providing teaching to an adolescent client who has a new prescription for clomipramine for OCD. Which of the following information should the nurse provide? A. Eat a diet high in fiber. B. Check temperature daily. C. Take medication first thing in the morning before eating. D. Add extra calories to the diet as between-meal snacks.

A

A nurse is reviewing the medical record of a client who has conversion disorder. Which of the following findings should the nurse identify as placing the client at risk for conversion disorder? A. Death of a child 2 months ago B. Recent weight loss of 30 Ib C. Retirement 1 year ago D. History of migraine headaches

A

Sam, a 9-year-old patient, has deficits in social functioning, intellectual functioning, and cannot manage practical aspects of daily life and functioning. You suspect: A. intellectual development disorder (IDD). B. specific learning disorder. C. autism spectrum disorder (ASD). D. attention deficit hyperactivity disorder (ADHD).

A

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? A. Impaired social interaction related to difficulty relating to others B. Chronic low self-esteem related to excessive negative feedback C. Deficient fluid volume related to abnormal eating habits D. Anxiety related to nightmares and repetitive activities

A

A nurse is providing teaching to the parents of a school-age child who has attention-deficit/hyperactivity disorder (ADHD). Which of the following instructions should the nurse include in the teaching? A. "Ignore your child's attention-seeking behaviors that are not dangerous." B. "Administer ADHD medications within 30 min of your child's bedtime." C. "Continue with an activity as planned, even if your child becomes frustrated." D. "Expect your child to gain weight after starting ADHD medications."

A Rationale: The nurse should instruct the child's parents about the use of planned ignoring. This technique ignores attention-seeking behaviors that are not dangerous to the child or others. If the child learns that the behavior will not elicit the desired response, then the behavior should decrease.

A nurse is assessing a client who has adjustment disorder. Which of the following statements by the client should the nurse recognize as a manifestation of this disorder? A. "I am unable to remember my address." B. "I feel like l am living in a fog" C. "I sometimes cannot remember large blocks of time." D. "I could have done something to prevent my cousin's death."

D Rationale: manifestations can include guilt, depression, anxiety, and anger. It can also include physical manifestations, social withdrawal, or work or academic changes

A medical-surgical nurse works with a patient diagnosed with a somatic symptom disorder. Care planning is facilitated by understanding that the patient will probably: A. readily seek psychiatric counseling. B. be resistant to accepting psychiatric help. C. attend psychotherapy sessions without encouragement. D. be eager to discover the true reasons for physical symptoms.

B

A nurse is admitting a client who has derealization disorder. Which of the following manifestations should the nurse expect? A. The inability to recall important personal information B. The feeling that the surroundings are unreal C. The inability to recall identity D. The presence of at least 2 distinct personalities

B

A nurse is assessing a 4-year-old child for indications of autism spectrum disorder. For which of the following manifestations should the nurse assess? A. Impulsive behavior B. Repetitive counting C. Destructiveness D. Somatic problems

B

Which assessment data would help the health care team distinguish symptoms of conversion (functional neurological) disorder from symptoms of illness anxiety disorder (hypochondriasis)? A. Voluntary control of symptoms B. Patient's style of presentation C. Results of diagnostic testing D. The role of secondary gains

B

Which prescription medication would the nurse expect to be prescribed for a patient diagnosed with a somatic symptom disorder? A. Narcotic analgesics for use as needed for acute pain B. Antidepressant medications to treat underlying depression C. Long-term use of benzodiazepines to support coping with anxiety D. Conventional antipsychotic medications to correct cognitive distortions

B

A nurse is providing teaching to a client who has ADHD and a new prescription for a transdermal methylphenidate patch. Which of the following statements by the client indicates an understanding of the teaching? A. "I will rotate placing the patch on different parts of my upper body." B. "I can take showers with the patch in place." C. "If the patch bothers my skin, I will switch to the oral form of the medication." D. "I will apply a patch each night at bedtime."

B Rationale: The nurse should instruct the client that transdermal methylphenidate patches can be worn during bathing, showering, and swimming. The nurse should instruct the client that transdermal methylphenidate patches are to be applied to alternating hips daily.

A nurse is providing teaching to the guardian of a school-aged child who has ADHD and a new prescription for clonidine. Which of the following statements by the guardian indicates an understanding of the teaching? A. "I will not allow my child to eat anything within 2 hours of taking the medication." B. "I can expect my child to be drowsy while taking this medication." C."I Will give my child a dose of the medication at noon every day." D. "I will cut the tablet in half before giving it to my child."

B Rationale: cause adverse effects like somnolence, fatigue, and hypotension

To assist patients diagnosed with somatic symptom disorders, nursing interventions of high priority: A. explain the pathophysiology of symptoms. B. help these patients suppress feelings of anger. C. shift focus from somatic symptoms to feelings. D. investigate each physical symptom as it is reported.

C

Which behavior is most indicative of a 4-year-old child diagnosed with Tourette's syndrome? A. Difficulty in social relationships B. Humming only while performing activities that require concentration C. Frequent eye blinking D. Difficulty in completing tasks on time

C

Which treatment modality should a nurse recommend to help a patient diagnosed with a somatic symptom disorder to cope more effectively? A. Flooding B. Response prevention C. Relaxation techniques D. Systematic desensitization

C

A nurse is providing teaching to the partner of a client who has conversion disorder. Which of the following statements by the partner shows an understanding of the teaching? A. "My partner is pretending to be ill to get attention." B. "My partner is purposefully making our child sick." C. "The stress of losing our child caused my partner to go blind." D. "My partner is worried that he has cancer, even though his tests are normal."

C Rationale: conversion disorder manifests as deficits in motor or sensory functions

A nurse is caring for a client with ADHD who has recently started taking lithium. For which of the following findings should the nurse monitor when evaluating the effectiveness of the medication? A. Increased attention span B. Decreased anxiety C. Reduced aggression D. Weight loss

C Rationale: Clients who have ADHD can experience a low tolerance for frustration, which can result in aggressive behaviors. Although psychosocial interventions should include developing coping mechanisms and cognitive behavior therapy, the client might require medication to manage aggressive behaviors. The nurse should monitor for reduced aggression when a client who has ADHD is taking a mood stabilizer such as lithium.