NUR123 Exam 3

Parents of a teenager recently diagnosed with serious mental illness express dismay. One parent says, "Our hopes for our child's future are ruined. We probably won't ever have grandchildren." The nurse will use interventions to assist with what? a. denial b. acceptance c. manipulation d. acting out

b. acceptance

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. add extra calories to the diet as between-meal snack b. eat a diet high in fiber c. check temperatures daily d. take medication first thing in the morning before eating

b. eat a diet high in fiber

The nurse is working with a client experiencing depression stemming from low self-esteem. The client is distrustful of unit staff and "just wants to go home." Initially what is the nurse's priority? a. Making the client feel physically and emotionally safe b. Teaching the client effective coping skills c. Identifying the client's positive traits d. Focusing on preparing the client for a speedy discharge

a. Making the client feel physically and emotionally safe

Which suicide prevention intervention that has the greatest impact on a client's safety? a. One-on-one observation by the staff. b. Restricting the client from potentially dangerous areas of the unit. c. Removal of personal items that might prove harmful. d. Educating visitors about potentially dangerous gifts.

a. One-on-one observation by the staff.

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. Remove the patch each day after 9 hours b. Apply the transdermal patch to the anterior waist area c. Apply the patch once daily at bedtime d. Place the patch carefully in a trash can after removal

a. Remove the patch each day after 9 hours

The nurse is conducting a family therapy session. The adolescent son tells the nurse that he plans to make his sister look bad so his parents will think he's the better sibling, which he believes will give him more privileges. The nurse should identify this dysfunctional behavior as which of the following? a. manipulation b. placation c. blaming d. distraction

a. manipulation

A 15-year-old is hospitalized after a suicide attempt. This adolescent lives with the mother, stepfather, and several siblings. When performing a family assessment, what must the nurse first determine? a. the meaning that the patient's suicide attempt has for family members b. names and relationships of the family's members c. the communication patterns between the patient and parents d. how the family expresses and manages emotion

b. names and relationships of the family's members

What is the major reason for the hospitalization of a depressed client? a. Inability to go to work b. Suicidal ideation c. Psychomotor agitation d. Loss of appetite

b. Suicidal ideation

Which side effects of lithium can be expected at therapeutic levels? a. Coarse hand tremor and gastrointestinal upset b. Nausea and thirst c. Ataxia and hypotension d. Fine hand tremor and polyuria

d. Fine hand tremor and polyuria

A client diagnosed with bipolar disorder has a nursing care plan that includes several nursing diagnoses listed. Match the nursing diagnosis to the level of priority (1 to 4). a. Nonadherence b. Risk for injury c. Knowledge, deficient d. Self-care deficit, bathing, and hygiene

First priority----b. Risk for injury Second priority----d. Self-care deficit, bathing, and hygiene Third priority----c. Knowledge, deficient Fourth priority----a. Nonadherence

What is the focus of the SAFE-T assessment tool? (Select all that apply.) a. Identify level of suicidal risk. b. Introduce antidepressant medication therapy c. Stress collaboration with the client d. Facilitate hospitalization. e. Development of client focused treatment.

a, c, e a. Identify level of suicidal risk. c. Stress collaboration with the client e. Development of client focused treatment.

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 the 3 that apply: a. yellowing skin b. increased appetite c. malaise d. somnolence e. fever

a, c, e yellowing skin, malaise, fever

Which of the following describe the symptoms of the manic phase of bipolar disorder? (Select all that apply.) a. Distractibility b. Low self-esteem c. Excessive energy d. Withdrawal from environment e. Racing thoughts f. Purposeless movement g. Pressured speech h. Fatigue and increased sleep

a, c, e, f, g a. Distractibility c. Excessive energy e. Racing thoughts f. Purposeless movement g. Pressured speech

A depressed client is noted to pace most of the time, pull at her clothes, and wring her hands. These behaviors are consistent with which term? a. Psychomotor agitation b. Senile dementia c. Central serotonin syndrome d. Hypertensive crisis

a. Psychomotor agitation

What are the most important characteristics for staff members who work with suicidal clients? a. Problem-solving skills b. Warm, consistent interaction c. Effective interview and counseling skills d. Organization

b. Warm, consistent interaction

A new psychiatric technician mentions to the nurse, "Depression seems to be a disease of old people. All the depressed clients on the unit are older than 60 years." How should the nurse respond to this statement? a. "Depression is seen in people of all ages, from childhood to old age." b. "Depression is most often seen among the middle adult age group." c. "The age of onset for most depressive episodes is given as 18 years." d. "That is a good observation. Depression does mostly strike people older than 50 years."

a. "Depression is seen in people of all ages, from childhood to old age."

An adolescent acts out in disruptive ways. When this adolescent threatens to throw a heavy pool ball at another adolescent, which comment by the nurse would set appropriate limits? a. "Do not throw the ball. Put it back on the pool table" b. "Please do not lose control of your emotions" c. "You will be taken to seclusion if you throw that ball" d. "Attention everyone: we are all going to the craft room"

a. "Do not throw the ball. Put it back on the pool table"

Which statement, made by a patient admitted with a diagnosis of depression, indicates the need for further assessment? a. "I think things will be better soon." b. "I don't have a good support system, but I am planning on joining a recovery group." c. "I know a lot of people care about me and want me to get better." d. "I have suicidal thoughts at times, but I don't have any plan and don't think I would ever actually hurt myself."

a. "I think things will be better soon."

Consider both Sullivan's term security operations and Freud's term defense mechanisms. Which statement suggests that the client's specialized treatment goal has been successfully met? a. "I'm experiencing much less anxiety about school now." b. "I know that I'm not the only person who has a difficult time in school." c. "Going back to school is hard and I'll need support." d. "I really think I can succeed in school now."

a. "I'm experiencing much less anxiety about school now."

An adolescent was recently was recently diagnosed with ODD (oppositional defiant disorder). The parents say to the nurse, "Isn't there some medication that will help with this problem?" Select the nurse's best response. a. "Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use" b. "There are many medications that will help your child manage aggression and destructiveness. The health care provider will discuss them with you" c. "There are no medications to treat this problem. This diagnosis is behavioral in nature" d. "It's a common misconception that there is a medication available to treat every health problem"

a. "Medication is usually not prescribed for this problem. Let's discuss some behavioral strategies you can use"

What is a desired outcome for the maintenance phase of treatment for a manic client? a. Adhere to follow-up medical appointments. b. Take medication more than 50% of the time. c. Use alcohol to moderate occasional mood "highs." d. Exhibit optimistic, energetic, playful behavior.

a. Adhere to follow-up medical appointments.

Using Maslow's model of needs, the nurse providing care for an anxious client identifies which intervention as being a priority? a. Assessing the client for strengths upon which a nurse-client relationship can be based b. Assessing the client's ability to fulfill appropriate developmental level tasks c. Planning one-on-one time to assist in identifying the fears trigger the client's anxiety d. Evaluating the client's ability to learn and retain essential information regarding their current condition

a. Assessing the client for strengths upon which a nurse-client relationship can be based

What term is used to identify the condition demonstrated by a person who has numerous hypomanic and dysthymic episodes over a two-year period? a. Cyclothymia. b. Bipolar II disorder. c. Bipolar I disorder. d. Seasonal affective disorder.

a. Cyclothymia.

A client prescribed a selective serotonin reuptake inhibitor mentions taking the medication along with the St. John's wort daily. What information should the nurse provide the client regarding this practice? a. Explain the high possibility of an adverse reaction. b. Agreeing that this will help the client to remember the medications. c. Caution the client to drink several glasses of water daily. d. Suggest that the client also use a sun lamp daily.

a. Explain the high possibility of an adverse reaction.

Which behavior would be characteristic of a client during a manic episode? a. Going rapidly from one activity to another b. Being unwilling to leave home to see other people c. Taking frequent rest periods and naps during the day d. Watching others intently and talking little

a. Going rapidly from one activity to another

A client tells the nurse that he believes his situation is intolerable and is observed isolating socially. Which nursing diagnosis should be considered? a. Hopelessness b. Compromised family coping c. Deficient knowledge d. Chronic low self-esteem

a. Hopelessness

While intoxicated a client unsuccessfully attempted suicide by using a gun. This method of using a gun to attempt suicide should be described in what terms? a. It is high risk, or a hard method. b. Considering the results, it is a nonlethal means. c. It was not an actual suicide attempt because the client was intoxicated. d. It is low risk, or a soft method.

a. It is high risk, or a hard method.

When educating a client diagnosed with bulimia nervosa about the medication fluoxetine, the nurse should include what information about this medication? a. It will be prescribed at a higher than typical dose. b. Long-term management of symptoms is best achieved with tricyclic antidepressants. c. There are a variety of medications to prescribe if fluoxetine proves to be ineffective. d. It will reduce the need for cognitive therapy.

a. It will be prescribed at a higher than typical dose.

Nurses should assess the lethality of the client's plan for suicide. What factor would be irrelevant to that assessment? (Select all that apply.) a. How long the client has been suicidal b. Whether the plan has specific details c. Has the client been suicidal in the past d. Whether the method is one that could cause death e. Whether the client has the means to implement the plan

b, d, e b. Whether the plan has specific details d. Whether the method is one that could cause death e. Whether the client has the means to implement the plan

A nurse is teaching a client who has intermittent explosive disorder about a new prescription for fluoxetine. Which of the following information should the nurse provide> Select the 3 that apply: a. an adverse effect of this medication is CNS depression b. take the medication in the morning c. this medication blocks the synaptic reuptake of serotonin in the brain d. monitor for weight loss while taking this medication e. therapeutic effects of this medication will take 1-3 weeks to fully develop

b, c, d b. take the medication in the morning c. this medication blocks the synaptic reuptake of serotonin in the brain d. monitor for weight loss while taking this medication

The nurse providing anticipatory operant conditioning guidance to the mother of a toddler should advise that childhood temper tantrums are best handled by which intervention? a. Scolding the child when he/she displays tantrum behaviors b. Ignoring the tantrum and giving attention when the child acts appropriately c. Giving the child what he/she is asking for d. Spanking the child at the onset of the tantrum behaviors

b. Ignoring the tantrum and giving attention when the child acts appropriately

Biological theorists suggest that the cause of eating disorders may be related to which factor? a. Body image disturbance b. Serotonin imbalance c. Dopamine excess d. Normal weight phobia

b. Serotonin imbalance

A client prescribed fluoxetine demonstrates an understanding of the medication teaching when making which statement? a. "I will not take any over-the-counter medication while on the fluoxetine." b. "I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away." c. "I will report increased thirst and urination to my provider." d. "I will make sure to get plenty of sunshine and not use sunscreen to avoid a skin reaction."

b. "I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider right away."

Which statement would best show acceptance of a depressed, mute client? a. "It is important for you to share your thoughts with someone who can help you evaluate your thinking." b. "I would like to sit with you for 15 minutes now and again this afternoon." c. "Each day we will spend time together to talk about things that are bothering you." d. "I will be spending time with you each day to try to improve your mood."

b. "I would like to sit with you for 15 minutes now and again this afternoon."

A depressed, socially withdrawn client tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse can best address this cognitive distortion with which response? a. "Is this part of the reason you think no one likes you?" b. "Let's look at what you just said that you can 'never do anything right.'" c. "Tell me what things you think you are not able to do correctly." d. "That is the most unrealistic thing I have ever heard."

b. "Let's look at what you just said that you can 'never do anything right.'"

Which statement factually describes the act of suicide? a. Suicide is the leading cause of death in the United States. b. A client with schizophrenia is at great risk for attempting suicide. c. More women than men commit suicide. d. Religious Jews have the lowest suicide rate.

b. A client with schizophrenia is at great risk for attempting suicide.

Which room placement would be best for a client experiencing a manic episode? a. A shared room with a client with dementia b. A single room near the nurses' station c. A shared room away from the unit entrance d. A single room near the unit activities area

b. A single room near the nurses' station

According to Freud, a client experiencing dysfunction of the conscious as part of the mind will have problems with which aspect of memory? a. Recent memory b. All memories c. Painful memories d. Long-term memory

b. All memories

A 16-year-old patient being treated for anorexia, has been prescribed medication to reduce compulsive behaviors regarding food now that ideal weight has been reached. Which class of medication is prescribed for this specific issue associated with eating disorders? a. Mood stabilizers b. Antidepressants c. Atypical antipsychotics d. Anxiolytics

b. Antidepressants

Which client problem would be most suited to the use of interpersonal therapy? a. Disturbed sensory perception b. Dysfunctional grieving c. Impaired sensory perception d. Medication noncompliance

b. Dysfunctional grieving

According to current theory, which statement regarding eating disorders is accurate? a. Eating disorders are rarely comorbid with other mental health disorders. b. Eating disorders are possibly influenced by sociocultural factors. c. Eating disorders are frequently misdiagnosed. d. Eating disorders are psychotic disorders in which patients experience body dysmorphic disorder.

b. Eating disorders are possibly influenced by sociocultural factors.

A 31-year-old client admitted with acute mania tells the staff and the other clients that he is on a secret mission for the President of the United States. He states, "I am the only one he trusts, because I am the best!" What term will the nurse use when documenting this behavior? a. Flight of ideas b. Grandiosity c. Rapid cycling d. Unpredictability

b. Grandiosity

Unit practice requires inspection of all items being brought onto the unit by visitors. How can this be most effectively done? a. Asking all visitors to report to the nurse's station before visiting a client. b. Having a staff member sit at the door and check packages as visitors enter. c. Asking clients to give staff any unsafe item that might have been left by a visitor. d. Having a staff member make frequent rounds during visiting hours to inspect gifts.

b. Having a staff member sit at the door and check packages as visitors enter.

A nurse expresses an exclusive belief in the biological model for mental illness when stating "it's the only one I really believe." What conclusion should be drawn from this statement? a. The biological model has been proven to be successful in finding the cause of most symptoms of mental illness. b. In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account. c. The biological model is the most popular theory among leading psychiatrists and therefore the one that should be fully embraced. d. The biological model is the oldest and most reliable model for explaining mental illness

b. In believing only in the biological model, other influences on mental health including cultural, environmental, social, and spiritual influences are not taken into account.

Which nursing intervention demonstrates the theory behind operant conditioning? a. Showing the client how to be assertive without being aggressive b. Rewarding the client with a token for avoiding an argument with another client c. Explaining to the client the consequences of not following unit rules d. Demonstrating deep breathing techniques to a group of clients

b. Rewarding the client with a token for avoiding an argument with another client

What is the priority nursing diagnosis for a hyperactive manic client during the acute phase of treatment? a. Impaired verbal communication b. Risk for injury/suicide c. Ineffective role performance d. Risk for other-directed violence

b. Risk for injury/suicide

A client prescribed a monoamine oxidase inhibitor (MOA) has a pass to go out to lunch. Given a choice of the following entrees, what can the client safely eat? a. kielbasa and sauerkraut. b. avocado salad plate. c. fruit and cottage cheese plate. d. liver and onion sandwich.

c. fruit and cottage cheese plate.

Which is the greatest protective factor against the risk of suicide? a. One or more previous suicide attempts b. A cultural belief that suicide is a shameful resolution for a dilemma c. A sense of responsibility to family d. Fear of dying

c. A sense of responsibility to family

When the clinician mentions that a client has anhedonia, the nurse can expect that the client will demonstrate what behavior? a. Difficulty with tasks requiring fine motor skills b. A weight loss from anorexia c. No pleasure from previously enjoyed activities d. Poor retention of recent events

c. No pleasure from previously enjoyed activities

Question 6 of 7 Dysthymia cannot be diagnosed unless it has existed for what period of time? a. At least 6 months b. At least 1 year c. At least 3 months d. At least 2 years

d. At least 2 years

Assessment of the thought processes of a client diagnosed with depression is most likely to reveal what characteristic? a. Sexual preoccupation b. Good memory and concentration c. Delusions of persecution d. Self-deprecating ideation

d. Self-deprecating ideation

A student nurse on the psychiatric unit expresses being uncomfortable discussing possible suicidal ideations with clients because "It might put ideas in their head about suicide." What is the nurse's best response to this student's concern? a. "If I were you, I'd ask the health provider to talk to the patient about that subject." b. "I'm glad you are thinking that way. They may not have thought of suicide before, and we don't want to introduce that." c. "Actually, it's a myth that asking about suicide puts ideas into someone's head." d. "You are right; however, because of professional liability, we have to ask that question."

c. "Actually, it's a myth that asking about suicide puts ideas into someone's head."

A client on one-to-one supervision at arm's length indicates a need to go to the bathroom but reports, "I cannot 'go' with you standing there." How should the nurse respond to the client's concern? a. "I understand" and allow the client to close the door. b. Keep the door open, but step to the side out of the client's view. c. "For your safety I can be no more than an arm's length away." d. Leave the client's room and wait outside in the hall.

c. "For your safety I can be no more than an arm's length away."

A 38-year-old client is admitted with major depression. Which statement made by the client alerts the nurse to a common accompaniment to depression? a. "I still pray and read my Bible every day." b. "I've heard others say that depression is a sign of weakness." c. "I still feel bad about my sister dying of cancer. I should have done more for her!" d. "My mother wants to move in with me, but I want to independent."

c. "I still feel bad about my sister dying of cancer. I should have done more for her!"

A cognitive therapist would help a client restructure the thought "I am stupid!" to which statement? a. "I am not as smart as others." b. "Things like this should not happen to anyone." c. "What I did was stupid." d. "Things usually go wrong for me."

c. "What I did was stupid."

A client admitted with major depression and suicidal ideation with a plan to overdose is preparing for discharge and asks you, "Why did I get a prescription for only 7 days of amitriptyline?" The nurse's response is based on what fact? a. Amitriptyline is very expensive, so the client may have to buy fewer at a time. b. The health care provider wants to see whether any side effects occur within the first week of administration. c. Amitriptyline is lethal in overdose. d. The goal is to see how the client responds to the first week of medication to evaluate its effectiveness.

c. Amitriptyline is lethal in overdose.

The nurse can expect a client demonstrating typical manic behavior to be attired in clothing that includes with characteristics? a. Ill-fitted and ragged b. Dark colored and modest c. Colorful and inappropriate d. Compulsively neat and clean

c. Colorful and inappropriate

Freud believed that individuals cope with anxiety by implementing which mechanism? a. The superego b. Security operations c. Defense mechanisms d. Cognitive distortions

c. Defense mechanisms

What statement about the comorbidity of depression is accurate? a. Substance abuse and depression are seldom seen as comorbid disorders. b. Depression most often exists in an individual as a single entity. c. Depression is commonly seen in individuals with medical disorders. d. Depression may coexist with other disorders but is rarely seen with schizophrenia.

c. Depression is commonly seen in individuals with medical disorders.

The nurse is planning care for a 14-year-old. The nurse demonstrates an understanding of the developmental task appropriate for this client by providing which experience? a. Spending one-on-one time with staff to establish trust b. Assign them to help clean up the dayroom to develop a sense of industry c. Encouraging them to talk about their school plans to help achieve identity d. Providing them with the opportunity to select which unit activities they will participate in to gain autonomy

c. Encouraging them to talk about their school plans to help achieve identity

A bipolar client tells the nurse, "I have the finest tenor voice in the world. The three tenors who do all those TV concerts are going to retire because they can't compete with me." What term should the nurse use to identify this behavior? a. Limit testing b. Flight of ideas c. Grandiosity d. Distractibility

c. Grandiosity

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? a. Deficient fluid volume related to abnormal eating habits b. Chronic loss self-esteem related to excessive negative feedback c. Impaired social interaction related to difficulty maintaining relationships d. Anxiety related to nightmares and repetitive activities

c. Impaired social interaction related to difficulty maintaining relationships

A nurse is providing care to a 28-year-old client diagnosed with bipolar disorder who was admitted in a manic state. According to Maslow's Hierarchy of Needs theory, the nurse should identify which client symptom as having priority? a. Rapid, pressured speech b. Grandiose thoughts c. Lack of sleep d. Hyperactive behavior

c. Lack of sleep

A depressed client tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse should identify this cognitive distortion as what response? a. Discounting positive attributes b. Catatonia c. Learned helplessness d. Self-blame

c. Learned helplessness

What is the first-line drug used to treat mania? a. Carbamazepine b. Clonazepam c. Lithium carbonate d. Lamotrigine

c. Lithium carbonate

Beck's cognitive theory suggests that the etiology of depression is related to what factor? a. Serotonin circuit dysfunction b. Sleep abnormalities c. Negative processing of information d. S belief that one has no control over outcomes

c. Negative processing of information

Which statement is true regarding culture and protective factors against suicide? a. Asian Americans have the highest rates of suicide. b. American Indians and Pacific Islanders have the lowest rates of suicide. c. Religion and the importance of family are protective factors for Hispanic Americans. d. Older women have the highest risk for suicide among African Americans.

c. Religion and the importance of family are protective factors for Hispanic Americans.

A client states, "I will always be alone because nobody could ever love me." The nurse recognizes that the client is expressing what cognitive-behavioral concept? a. Actualization b. Aversion c. Schema d. Emotional consequence

c. Schema

The nursing diagnosis Risk for self-directed violence has been added to the care plan of a suicidal client. Which is the most appropriate short-term goal for this diagnosis? a. Be able to name three personal strengths. b. Will reclaim any prized possessions that were given away. c. Seek help when feeling self-destructive. d. Consistently participate in a self-help group.

c. Seek help when feeling self-destructive.

Which neurotransmitter has been implicated as playing a part in the decision to commit suicide? a. Acetylcholine b. Dopamine c. Serotonin d. γ-Amino-butyric acid

c. Serotonin

Which theorist is associated with behavioral therapy? a. Sullivan b. Peplau c. Skinner d. Freud

c. Skinner

Which of the following is true of the relationship between bipolar disorder and suicide? a. Clients need to be monitored only in the depressed phase because this is when suicides occur. b. As long as clients with bipolar disorder adhere to their medication regimen, there is little risk for suicide. c. Suicide is a serious risk those diagnosed with bipolar disorder commit suicide. d. Clients with bipolar disorder are not considered high risk for suicide.

c. Suicide is a serious risk those diagnosed with bipolar disorder commit suicide.

An acute phase nursing intervention aimed at reducing hyperactivity is demonstrated by which intervention? a. Directing unit activities b. Orienting a new client to the unit c. Writing in a diary d. Exercising in the gym

c. Writing in a diary

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. somatic problems c. repetitive counting d. destructiveness

c. repetitive counting

A manic client tells a nurse "Bud. Crud. Dud. I'm a real stud! You'd like what I have to offer. Let's go to my room." What is the best initial approach to managing this behavior? a. Enforcing consequences by responding, "Let's walk down to the seclusion room." b. Reprimand the client by stating, "What an offensive thing to suggest!" c. Clarifying the nurse-client relationship by stating, "I don't have sex with clients." d. Distracting the client by suggesting, "It's time to work on your art project."

d. Distracting the client by suggesting, "It's time to work on your art project."

Which subjective symptom should the nurse expect to note during assessment of a client diagnosed with anorexia nervosa? a. Hypotension b. Lanugo c. 25-lb weight loss d. Fear of gaining weight

d. Fear of gaining weight

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

d. "Because of this disorder, your child is at an increased riks for injury"

The parent of an adolescent diagnosed with mental illness asks the nurse, "Why do you want to do a family assessment? My teenager is the patient, not the rest of us." Select the nurse's best response. a. "Family dysfunction might have caused the mental illness" b. "Family assessment is part of the protocol for care of all patients with mental illness" c. "Family members provide more accurate information than the patient" d. "Every family member's perception of events is different and adds to the total picture

d. "Every family member's perception of events is different and adds to the total picture

Ali is a 17-year-old patient diagnosed with bulimia coming to the outpatient mental health clinic for counseling. Which of the following statements by Ali indicates that an appropriate outcome for treatment has been met? a. "I feel a lot calmer lately, just like when I used to eat four or five cheeseburgers." b. "I always purge when I'm alone so that I'm not a bad role model for my younger sister." c. "I purge only once a day now instead of twice." d. "I am a hard worker and I am very compassionate toward others."

d. "I am a hard worker and I am very compassionate toward others."

How does Harry Stack Sullivan's Interpersonal Theory view anxiety? a. A sign of guilt in adults. b. The result of trying to go beyond experiences of guilt and pain. c. An emotional experience felt after the age of 5 years. d. A painful emotion arising from social insecurity.

d. A painful emotion arising from social insecurity.

When working with a client who may have made a covert reference to suicide, the nurse should base the response on what statement? a. Being careful not to mention the idea of suicide. b. Listening carefully to see whether the client mentions suicide more overtly. c. Asking about the possibility of suicidal thoughts in a covert way. d. Asking the client directly if they are thinking of attempting suicide.

d. Asking the client directly if they are thinking of attempting suicide.

What is the premise underlying behavioral therapy? a. Motives must change before behavior changes. b. Behavior is determined by cognitions; change in cognitions produces new behavior. c. Behavior is a product of unconscious drives. d. Behavior is learned and can be modified.

d. Behavior is learned and can be modified.

A client with a history of repeated suicidal attempts refuses to participate in a no-suicide contract. What intensity of nursing observation should be instituted? a. Every 15-minute observation around the clock b. Seclusion with 15-minute observation c. One-to-one observation while client is awake d. Constant 24-hour, one-to-one observation at arm's length

d. Constant 24-hour, one-to-one observation at arm's length

A client hospitalized for a psychotic relapse is being discharged home to family. Which topic is important to address when teaching both the client and the family to recognize possible signs of impending mania? a. Decreased social interaction b. Increased appetite c. Increased attention to bodily functions d. Decreased sleep

d. Decreased sleep

When a colleague committed suicide, the nurse stated, "I do not understand why she would take her own life." This is an expression of which feeling? a. Confusion b. Sympathy c. Anger d. Disbelief

d. Disbelief

The nurse is caring for an adult client who experienced severe physical abuse from the age of 2 through 12. What information should the nurse provide the client concerning the function of the "id" and the ability to function as an adult? a. It provides an individual with the ability to differentiate believed and real experiences. b. It has control over the emotional frustration felt as an adult. c. It is severely damaged by abuse experienced before the age of 5 years. d. It is the source of one's survival instincts.

d. It is the source of one's survival instincts.

The nurse observes the meal tray about to serve a suicidal client. Which item should be removed from the tray? a. Plastic plate b. Cloth napkin c. Styrofoam cup d. Metal utensils

d. Metal utensils

Role-playing is associated with which type of psychotherapy? a. Systematic desensitization b. Operant conditioning c. Psychoanalysis d. Modeling

d. Modeling

Which statement about antidepressant medications, in general, can serve as a basis for client and family teaching? a. They tend to be more effective for men. b. They often cause the client to have diurnal variation. c. Recent memory impairment is commonly observed. d. Onset of action is from 1 to 3 weeks or longer.

d. Onset of action is from 1 to 3 weeks or longer.

Which statement is true of the eating disorder referred to as bulimia? a. Patients with bulimia severely restrict their food intake. b. One sign of bulimia is lanugo. c. Patients with bulimia binge eat but do not engage in compensatory measures. d. Patients with bulimia often appear at a normal weight.

d. Patients with bulimia often appear at a normal weight.

When a client experiences four or more mood episodes in a 12-month period, which term is used to describe this behavior? a. Incongruent b. Cyclothymic c. Dyssynchronous d. Rapid cycling

d. Rapid cycling

What assessment tool is useful to nurses in rating suicide risk? a. AIMS scale. b. Mini-Mental Status Examination. c. CAGE questionnaire. d. SAFE-T.

d. SAFE-T.

When the nurse asks whether a client is having any thoughts of suicide, the client becomes angry and defensive, shouting, "I'm sick of you people! All you ever do is ask me the same question over and over. Get out of here!" What fact concerning hostility should the nurse's response be based upon? a. The client is probably experiencing transference. b. The client may be angry at someone else and projecting that anger to staff. c. The client is getting better and is able to be assertive. d. The client may be at high risk for self-harm.

d. The client may be at high risk for self-harm.

When the partner of a manic client asks about genetic transmission of bipolar disorder, the nurse's answer should be predicated on which information? a. Much depends on the socioeconomic class of the individuals. b. Highly creative people tend toward development of the disorder. c. No research exists to suggest genetic transmission. d. The rate of bipolar disorder is higher in relatives of people with bipolar disorder.

d. The rate of bipolar disorder is higher in relatives of people with bipolar disorder.

When the nurse remarks to a depressed client, "I see you are trying not to cry. Tell me what is happening." The nurse should be prepared to implement which intervention? a. Prompting the client if the reply is slow b. Reviewing the client's medical record to support the client's response c. Repeating the question if the client does not answer promptly d. Waiting quietly for the client to reply

d. Waiting quietly for the client to reply

When a client reports that lithium causes an upset stomach, the nurse should make which suggestion associated with taking the medication? a. 2 hours after meals b. With an antacid c. 30 minutes before meals d. With meals

d. With meals

What action should the nurse take on learning that a manic client's serum lithium level is 1.8 mEq/L? a. Advise the client to curtail salt intake for 24 hours. b. Continue to administer medication as ordered. c. Advise the client to limit fluids for 12 hours. d. Withhold medication and notify the physician.

d. Withhold medication and notify the physician.

Assessment data for a 7-year-old reveals an inability to take turns, blurting our answers to questions before a question is complete, and frequently interrupting others' conversations. How should the nurse document these behaviors? a. disobedience b. hyperactivity c. anxiety d. impulsivity

d. impulsivity

Parents of a mentally ill teenager say, "We have never known anyone with was mentally ill. We have no one to talk to because none of our friends understand the problems we are facing." Select the nurse's most helpful intervention. a. facilitate achievement of normal developmental tasks of the family b. build the parents' self-concept as coping parents c. teach the parents techniques of therapeutic communication d. refer the parents to a support group

d. refer the parents to a support group

When a hyperactive manic client expresses the intent to strike another client, what is the initial nursing intervention? a. question the client's motive. b. initiate physical confrontation. c. prepare the client for seclusion. d. set verbal limits.

d. set verbal limits.