NURS 322 Exam 2

For which patient is the nurse most likely to need to plan interventions to minimize overtly manipulative behaviors? A.Mr A diagnosed with Dependent Personality B.Ms B diagnosed with Borderline PD C.Mr C diagnosed with Paranoid PD D.Ms D diagnoses with Schizoid PD

B.Ms B diagnosed with Borderline PD

Mr. Johnson was recently admitted to a psychiatric unit because of severe obsessive-compulsive behavior. Which initial response by the nurse would be most therapeutic for him? A. Accepting the client's ritualistic behaviors. B. Challenging the client's need for rituals. C. Expressing concern about the harmfulness of the client's rituals. D. Limiting the client's rituals that are excessive.

A. Accepting the client's ritualistic behaviors.

David is preoccupied with numerous bodily complaints even after a careful diagnostic workup reveals no physiologic problems. Which nursing intervention would be therapeutic for him? A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems. B. Challenge the physical complaints by confronting the client with the normal diagnostic findings. C. Ignore the client's complaints, but request that the client keeps a list of all symptoms. D. Listen to the client's complaints carefully, and question him about specific symptoms.

A. Acknowledge that the complaints are real to the client, and refocus the client on other concerns and problems.

Genevieve only attends social events when a family member is also present. She exhibits behavior typical of which anxiety disorder? A. Agoraphobia B. Generalized anxiety disorder C. Obsessive-compulsive disorder D. Post-traumatic stress disorder

A. Agoraphobia

Joey, a client with antisocial personality disorder belches loudly. A staff member asks Joey, "Do you know why people find you repulsive?" This statement most likely would elicit which of the following client reactions? A. Defensiveness B. Embarrassment C. Shame D. Remorsefulness

A. Defensiveness

Which outcome is most appropriate for Francis who has a dissociative disorder? A. Francis will deal with uncomfortable emotions on a conscious level. B. Francis will modify stress with the use of relaxation techniques. C. Francis will identify his anxiety responses. D. Francis will use problem-solving strategies when feeling stressed.

A. Francis will deal with uncomfortable emotions on a conscious level.

The characteristic manifestation that will differentiate bulimia nervosa from anorexia nervosa is that bulimic individuals: A. Have episodic binge eating and purging. B. Have repeated attempts to stabilize their weight. C. Have peculiar food handling patterns. D. Have threatened self-esteem.

A. Have episodic binge eating and purging.

A male client is diagnosed with a schizotypal personality disorder. Which signs would this client exhibit during a social situation? A. Paranoid thoughts B. Emotional affect C. Independence need D. Aggressive behavior

A. Paranoid thoughts

A nursing diagnosis for bulimia nervosa is powerlessness related to feeling not in control of eating habits. The goal for this problem is: A. Patient will learn problem-solving skills. B. Patient will have decreased symptoms of anxiety. C. Patient will perform self-care activities daily. D. Patient will verbalize how to set limits on others.

A. Patient will learn problem-solving skills.

Which of the following is an appropriate expected outcome when working with a patient with DID? The patient will A. verbalize a clear sense of personal identity. B. express feelings verbally rather than through the development of physical symptoms. C. experience no symptoms as a result of psychologic distress. D. understand the distinction between true physical pain and imagined pain.

A. verbalize a clear sense of personal identity.

When a patient is admitted for an acute stress disorder, the nurse is aware that the expectation for resolution of the event should occur within ________ months. A.1 month B.3 months C.6 months D.12 months

A.1 month

A binging episode is though to involve: A.A release of tension, followed by feelings of depression. B.Feelings of fear, followed by feelings of relief. C.Unmet dependency needs and a way to gain attention. D.Feelings of euphoria, excitement, and self-gratification

A.A release of tension, followed by feelings of depression.

A patient states, "I am always late for group because I have to check my personal things. I can't seem to stop my behavior!" What is the most appropriate action for the nurse to implement at this time? A.Allow the patient enough time to carry out his ritual. B.Explore childhood experiences that may be connected to this behavior. C.Stay with the patient while he checks his personal items.

A.Allow the patient enough time to carry out his ritual.

Which of the emotional states listed below is the nurse caring for a patient with PD most likely to experience? A.Anger B.Depression C.Pleasure D.Spiritual distress

A.Anger

A variety of medications are used in the treatment of severe anxiety disorders. Which class of medication used to treat anxiety is potentially addictive? A.Benzodiazepines B.Beta-blockers C.Buspirone D.Selective serotonin reuptake inhibitors (SSRI's)

A.Benzodiazepines

Which of the following would the nurse expect to assess with a patient diagnosed with a conversion (Functional Neurological ) Disorder? Select all that apply. A.Deep tendon reflexes intact. B.Muscle wasting. C.The client is unaware of the link between anxiety and physical symptoms. D.Physical symptoms can be explained by a physiological cause.

A.Deep tendon reflexes intact. C.The client is unaware of the link between anxiety and physical symptoms.

After a routine dental examination on an adolescent patient, the dentist reports to the parents that bulimia nervosa is suspected. Which of the following assessment data would support this determination? Select All That Apply. A.Dental erosion B.Inflammation of the throat C.Russell's sign D.Weight loss

A.Dental erosion B.Inflammation of the throat C.Russell's sign

A newly admitted patient is diagnosed with obsessive compulsive disorder. Which behavioral symptom would the nurse expect to assess? A.The patient uses excessive hand washing to relieve anxiety. B.The patient rates anxiety at 8/10. C.The patient uses breathing techniques to decrease anxiety. D.The patient exhibits diaphoresis and tachycardia.

A.The patient uses excessive hand washing to relieve anxiety.

A patient has just been told by his physician that surgery will be required to treat a health problem. The patient states that he feels lightheaded, and the nurse observes excessive sweating with an increase in respiratory rate. The nurse interprets these findings as the __________ stage of the general adaptation syndrome. A.alarm B.anxiety C.stage of resistance D.state of exhaustion

A.alarm

After a family visit, the patient experiences a panic attack. What actions should the nurse implement. Select all that apply. A.Call 911 B.Remain with the patient C.Ask the patient to take some deep breaths D.Distract the patient by counting together

B.Remain with the patient C.Ask the patient to take some deep breaths D.Distract the patient by counting together

The nurse is planning care for a patient diagnosed as having generalized anxiety disorder. Which goal would be most appropriate for this patient? A.The patient will describe any phobias that may cause a panic attack. B.The patient will identify effective coping mechanisms. C.The patient will verbalize any past traumatic events. D.The patient will demonstrate control over ritualistic behaviors.

B.The patient will identify effective coping mechanisms.

The most common physiological cause of obesity is most related to: A.lack of nutritional education B.more calories consumed than expended C.impaired endocrine functioning D.low basal metabolic rate

B.more calories consumed than expended

A group of community nurses sees and plans care for various clients with different types of problems. Which of the following clients would they consider the most vulnerable to post-traumatic stress disorder? A. An eight (8)-year-old boy with asthma who has recently failed a grade in school. B. A 20-year-old college student with DM who experienced date rape. C. A 40-year-old widower who has recently lost his wife to cancer. D. A wife of an individual with a severe substance abuse problem.

B. A 20-year-old college student with DM who experienced date rape.

During a community visit, volunteer nurses teach stress management to the participants. The nurses will most likely advocate which belief as a method of coping with stressful life events? A. Avoidance of stress is an important goal for living. B. Control over one's response to stress is possible. C. Most people have no control over their level of stress. D. Significant others are important to provide care and concern.

B. Control over one's response to stress is possible.

Conney with borderline personality disorder who is to be discharged soon threatens to "do something" to herself if discharged. Which of the following actions by the nurse would be mostimportant? A. Ask a family member to stay with the client at home temporarily. B. Discuss the meaning of the client's statement with her. C. Request an immediate extension for the client. D. Ignore the client's statement because it's a sign of manipulation.

B. Discuss the meaning of the client's statement with her.

The psychiatric nurse uses cognitive-behavioral techniques when working with a client who experiences panic attacks. Which of the following techniques are common to this theoretical framework? Select all that apply. A. Administering anti-anxiety medication as prescribed. B. Encouraging the client to restructure thoughts. C. Helping the client to use controlled relaxation breathing. D. Helping the client examine evidence of stressors. E. Questioning the client about early childhood relationships. F. Teaching the client about anxiety and panic.

B. Encouraging the client to restructure thoughts. C. Helping the client to use controlled relaxation breathing. D. Helping the client examine evidence of stressors. F. Teaching the client about anxiety and panic.

Which of the following interventions is the most appropriate therapy for a patient with agoraphobia? A. Administer a prn antianxiety medication. B. Group therapy with other patients that have phobias. C. Using a gradual step progression approach to address his/her fears. D. Hypnosis

B. Group therapy with other patients that have phobias.

When planning care for a female client using ritualistic behavior, Nurse Gina must recognize that the ritual: A. Helps the client focus on the inability to deal with reality. B. Helps the client control the anxiety. C. Is under the client's conscious control. D. Is used by the client primarily for secondary gains.

B. Helps the client control the anxiety.

Nurse Claire is caring for a client diagnosed with bulimia. The most appropriate initial goal for a client diagnosed with bulimia is? A. Encourage to avoid food. B. Identify anxiety-causing situations. C. Eat only three meals a day. D. Avoid shopping for plenty of groceries.

B. Identify anxiety-causing situations.

Malingering is different from somatoform disorder because the former: A. Has evidence of an organic basis. B. It is a deliberate effort to handle upsetting events. C. Gratification from the environment is obtained. D. Stress is expressed through physical symptoms.

B. It is a deliberate effort to handle upsetting events.

Jordanne is a client with a fear of air travel. She is being treated in a mental institution for phobic disorder. The treatment method involves systematic desensitization. The nurse would consider the treatment successful if: A. Jordanne plans a trip requiring air travel. B. Jordanne takes a short trip on an airplane. C. Jordanne recognizes the unrealistic nature of the fear of riding on airplanes. D. Jordanne verbalizes a decreased fear of air travel.

B. Jordanne takes a short trip on an airplane.

Nurse Maureen is developing a plan of care for a female client with anorexia nervosa. Which action should the nurse include in the plan? A. Provide privacy during meals. B. Set-up a strict eating plan for the client. C. Encourage the client to exercise to reduce anxiety. D. Restrict visits with the family.

B. Set-up a strict eating plan for the client.

Which of the following approaches would be most appropriate to use with a client suffering from narcissistic personality disorder when discrepancies exist between what the client states and what actually exists? A. Rationalization B. Supportive confrontation C. Limit setting D. Consistency

B. Supportive confrontation

The client with anorexia nervosa is improving if: A. She eats meals in the dining room. B. Weight gain C. She attends ward activities. D. She has a more realistic self-concept.

B. Weight gain

A patient diagnosed with bulimia nervosa tells the nurse that she needs to go to the bathroom as the meal trays are being removed from the unit. Select the most therapeutic nursing response. A."Thank you for checking in." B."I will accompany you to the bathroom." C."Let me know when you get back to the dayroom." D."Is there anything that you would like to talk about?"

B."I will accompany you to the bathroom."

The nurse is caring for a patient who has been hospitalized with anorexia nervosa and is severely malnourished. The patient continues to refuse to eat. What is the most appropriate response by the nurse? A."You should be aware if you don't eat, you will die." B."If you continue to refuse to take food orally, you will be fed through a feeding tube." C."There is no reason for you to stay in the hospital if you are not going to follow the recommended treatment." D "You do not have to eat. It is your choice."

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

A patient with Bulimia Nervosa is admitted to the mental health unit. Which symptoms would be congruent with this diagnosis? A.Binging, purging, obesity, hyperkalemia B.Binging, purging, normal weight, hypokalemia C.Binging, laxative abuse, severe weight loss D.Binging, purging, severe weight loss, hyperkalemia

B.Binging, purging, normal weight, hypokalemia

Which intervention would directly assist a hospitalized patient with a diagnosis of bulimia nervosa avoid purging after meal consumption? A.Locking the door to the patient's bathroom B.Holding a mandatory group to assist in exploration of feelings C.Discussing preplanned meals to decrease anxiety around eating D.Educating the patient to recognize purging side effects

B.Holding a mandatory group to assist in exploration of feelings

A 14-year-patient old patient was admitted to the psychiatric unit for anorexia nervosa. She is emaciated and refuses to eat. What is the most appropriate nursing diagnosis? A.Complicated grieving B.Imbalanced nutrition: less than body requirements C.Interrupted family processes D.Anxiety (severe)

B.Imbalanced nutrition: less than body requirements

Nurse Wayne is planning a psychoeducational discussion for a group of adolescent clients with anorexia nervosa. Which of the following topics would Nurse Wayne select to enhance understanding about central issues in this disorder? A. Anger management B. Parental expectations C. Peer pressure and substance abuse D. Self-control and self-esteem

D. Self-control and self-esteem

What is the best intervention to teach the client when she feels the need to starve? A. Allow her to starve to relieve her anxiety. B. Do a short-term exercise until the urge passes. C. Approach the nurse and talk out her feelings. D. Call her mother on the phone and tell her how she feels.

C. Approach the nurse and talk out her feelings.

A nurse at Nurseslabs Medical Center is developing a care plan for a female client with post-traumatic stress disorder. Which of the following would she do initially? A. Instruct the client to use distraction techniques to cope with flashbacks. B. Encourage the client to put the past in proper perspective. C. Encourage the client to verbalize thoughts and feelings about the trauma. D. Avoid discussing the traumatic event with the client.

C. Encourage the client to verbalize thoughts and feelings about the trauma.

The following statements describe somatoform disorders: A. Physical symptoms are explained by organic causes. B. It is a voluntary expression of psychological conflicts. C. Expression of conflicts through bodily symptoms. D. Management entails a specific medical treatment.

C. Expression of conflicts through bodily symptoms.

A 39-year-old mother with obsessive-compulsive disorder has become immobilized by her elaborate hand washing and walking rituals. Nurse Trish recognizes that the basis of O.C. disorder is often: A. Problems with being too conscientious B. Problems with anger and remorse C. Feelings of guilt and inadequacy D. Feeling of unworthiness and hopelessness

C. Feelings of guilt and inadequacy

Marty is pacing and complains of racing thoughts. Nurse Lally asks the client if something upsetting happened, and Marty's response is vague and not focused on the question. Nurse Lally assess Marty's level of anxiety as: A. Mild B. Moderate C. Severe D. Panic

C. Severe

A client is experiencing an anxiety attack. The most appropriate nursing intervention should include? A. Turning on the television. B. Leaving the client alone. C. Staying with the client and speaking in short sentences. D. Ask the client to play with other clients.

C. Staying with the client and speaking in short sentences.

Mr. Bartowski who is newly diagnosed with rheumatoid arthritis asks the community nurse how stress can affect his disease. The nurse would explain that: A. The psychological experience of stress will not affect symptoms of physical disease. B. Psychological stress can cause painful emotions, which are harmful to a person with an illness. C. Stress can overburden the body's immune system, and therefore one can experience increased symptoms. D. The body's stress response is stimulated when there are major disruptions in one's life.

C. Stress can overburden the body's immune system, and therefore one can experience increased symptoms.

When planning the discharge of a client with chronic anxiety, Nurse Chris evaluates achievement of the discharge maintenance goals. Which goal would be A. The client eliminates all anxiety from daily situations. appropriately having been included in the plan of care requiring evaluation? A. The client eliminates all anxiety from daily situations. B. The client ignores feelings of anxiety. C. The client identifies anxiety-producing situations. D. The client maintains contact with a crisis counselor.

C. The client identifies anxiety-producing situations.

A 20-year-old college student is admitted to the medical ward because of sudden onset of paralysis of both legs. Extensive examination revealed no physical basis for the complaint. The nurse plans intervention based on which correct statement about conversion disorder? A. The symptoms are conscious effort to control anxiety. B. The client will experience a high level of anxiety in response to the paralysis. C. The conversion symptom has symbolic meaning to the client. D. A confrontational approach will be beneficial for the client.

C. The conversion symptom has symbolic meaning to the client.

Marlyn is diagnosed with anorexia nervosa and is admitted to the special eating disorder unit. The initial treatment priority for her is: A. To determine her current body image. B. To identify family interaction patterns. C. To initiate a refeeding program. D. To promote the client's independence.

C. To initiate a refeeding program.

Nurse Kerrick observes Toni who is hospitalized on an eating disorder unit during mealtimes and for 1 hour after eating. An explanation for this intervention is: A. To develop a trusting relationship. B. To maintain focus on the importance of nutrition. C. To prevent purging behaviors. D. To reinforce the behavioral contact.

C. To prevent purging behaviors.

A nurse sitting with a patient diagnosed with anorexia nervosa notices that the patient has eaten 80% of their lunch. The patient asks the nurse, "What do you like better, hamburger or spaghetti?" Select the most therapeutic response by the nurse. A."I'm Italian, so I really enjoy a large plate of spaghetti." B."It is time for me to check your weight." C."Let's focus on your progress as you ate 80% of your lunch today." D."Why do you always talk about food? Let's talk about swimming."

C."Let's focus on your progress as you ate 80% of your lunch today."

Which of the following physical manifestations would the nurse expect to assess in a patient diagnosed with anorexia nervosa? A.Tachycardia, hypertension, hyperthermia B.Bradycardia, hypertension, hyperthermia C.Bradycardia, hypotension, hypothermia D.Tachycardia, hypotension, hypothermia

C.Bradycardia, hypotension, hypothermia

A patient arrives at the clinic for a mental health appointment wearing exaggerated clothing and makeup. She announces loudly and dramatically that she needs to be seen immediately because she is feeling very overwhelmed. The nurse should recognize this personality type as: A.Borderline personality disorder B.Narcissistic personality disorder C.Histrionic personality disorder D.Antisocial personality disorder

C.Histrionic personality disorder

A patient is leaving an in-patient psychiatric facility after one month of treatment for anorexia nervosa. Which outcome is appropriate during discharge planning for the patient? A.Patient will continue their previous work out routine. B.Patient will perform nasogastric tube feeding independently. C.Patient will maintain a positive perception of their body weight. D.Patient will discuss the importance of monitoring their weight on a daily basis.

C.Patient will maintain a positive perception of their body weight.

The nurse caring for a patient diagnosed with anti-social personality disorder would place highest priority on which nursing diagnosis? A.Disturbed Personal Identity B.Fear C.Risk for Violence directed at others D.Social Isolation

C.Risk for Violence directed at others

A patient with generalized anxiety disorder states, "I now know the best thing for me to do is just to try to forget my worries." How should the nurse evaluate this statement? A.The patient is developing insight B.The patient's coping skills are improving. C.The patient needs to be encouraged to verbalize feelings. D.The nurse-patient relationship should be terminated.

C.The patient needs to be encouraged to verbalize feelings.

The nurse observes a client pacing in the hall. Which statement by the nurse may help the client recognize his anxiety? A. "I guess you're worried about something, aren't you? B. "Can I get you some medication to help calm you?" C. "Have you been pacing for a long time?" D. "I notice that you're pacing. How are you feeling?"

D. "I notice that you're pacing. How are you feeling?"

A 24-year-old female has an intense fear of spiders. Initial intervention for the client should be to: A. Encourage to verbalize her fears as much as she wants. B. Assist her to find meaning to her feelings in relation to her past. C. Establish trust through a consistent approach. D. Accept her fears without criticizing.

D. Accept her fears without criticizing.

A 20-year-old client was diagnosed with dependent personality disorder. Which behavior is not mostlikely to be evidence of ineffective individual coping? A. Recurrent self-destructive behavior. B. Avoiding relationships. C. Showing interest in solitary activities. D. Inability to make choices and decisions without advice.

D. Inability to make choices and decisions without advice.

The nurse evaluates the treatment of Mrs. Montez with somatoform disorder as successful if: A. Mrs. Montez practices self-medication rather than changing health care providers. B. Mrs. Montez recognizes that physical symptoms increase anxiety level. C. Mrs. Montez researches treatment protocols for various illnesses. D. Mrs. Montez verbalizes anxiety directly rather than displacing it.

D. Mrs. Montez verbalizes anxiety directly rather than displacing it.

Nurse Penny is aware that the symptoms that distinguish post-traumatic stress disorder from other anxiety disorder would be: A. Avoidance of situation & certain activities that resemble the stress. B. Depression and a blunted affect when discussing the traumatic situation. C. Lack of interest in family & others. D. Re-experiencing the trauma in dreams or flashbacks

D. Re-experiencing the trauma in dreams or flashbacks

To establish an open and trusting relationship with a female client who has been hospitalized with severe anxiety, the nurse in charge should? A. Encourage the staff to have frequent interaction with the client. B. Share an activity with the client. C. Give client feedback on behavior. D. Respect client's need for personal space.

D. Respect client's need for personal space.

The nurse develops a countertransference reaction. This is evidenced by: A. The client feels angry towards the nurse who resembles his mother. B. Focusing on the feelings of the client. C. Confronting the client about discrepancies in verbal or non-verbal behavior. D. Revealing personal information to the client.

D. Revealing personal information to the client.

An appropriate nursing intervention for a client having a panic attack is to A. Teach the client relaxation techniques. B. Show the client how to change his behavior. C. Distract the client with a television show. D. Stay with the client be direct and speak in a calm firm manner.

D. Stay with the client be direct and speak in a calm firm manner.

Which is the desired outcome in conducting desensitization: A. The client verbalizes his fears about the situation. B. The client will voluntarily attend group therapy in the social hall. C. The client will socialize with others willingly. D. The client will be able to overcome his disabling fear.

D. The client will be able to overcome his disabling fear.

During a mother's class, the nurse who is teaching the participants on stress management is questioned about the use of alternative treatments, such as herbal therapy and therapeutic touch. She explains that the advantage of these methods would include all of the following except: A. They are congruent with many cultural belief systems. B. They encourage the consumer to take an active role in health management. C. They promote interrelationships within the mind-body-spirit. D. They usually work better than traditional medical practice.

D. They usually work better than traditional medical practice.

During group therapy, a patient diagnosed with somatoform disorder focuses on discussing back pain. Select the most therapeutic nursing response. A."Let's see if anyone in the group has ideas on how to deal with pain." B."The goal for the group is discuss ways to manage anxiety." C."Let's include the other group members by asking them how they feel." D."Right now we need to focus on the group activity, but we can have a brief discussion after group."

D."Right now we need to focus on the group activity, but we can have a brief discussion after group."

A patient diagnosed with narcissistic personality disorder arrives late to group therapy. Without apologizing, the patient interrupts another patient and says "Well, I'm here. The group can start now." The nurse interprets this behavior as: A.Splitting B.Hypersensitivity C.Suspiciousness D.Entitlement

D.Entitlement

Which of the following best describes a person with a Personality Disorder? A.Readily assume the roles of compromiser and harmonizer B.Often seek help to change maladaptive behaviors C.Have the ability to tolerate high levels of anxiety D.Have difficulty working and loving

D.Have difficulty working and loving

The nurse is responsible for providing care to a group of patients with various personality disorders. The nurse should anticipate that a characteristic common personality disorders includes: A.The ability to charm and manipulate people B.A desire for interpersonal relationships. C.A diminished need for approval. D.Inflexibility and functional impairment.

D.Inflexibility and functional impairment.

A newly admitted patient to the eating disorder unit has a potential diagnosis of anorexia nervosa. Which assessment should the nurse implement first? A. Explore abuse issues. B. Review a family history. C.Obtain an accurate height and weight. D.Perform a complete physical assessment.

D.Perform a complete physical assessment.

A priority nursing intervention undertaken by the nurse dealing with patients with PDs is: A.Offering advice B.Probing for etiological factors C.Encouraging diversional activity D.Setting limits

D.Setting limits

Which statement reflects successful achievement of a therapeutic long-term goal for a client diagnosed with somatic symptom disorder? a. "I haven't missed a day of work in the last 6 months." b. "My symptoms may not be signs of a serious cancer." c. "I may have found a doctor who can really help me." d. "My husband is starting to believe I'm really in pain."

a. "I haven't missed a day of work in the last 6 months." The overall long-term goal in treating individuals with somatic symptom disorders is that people with these disorders will eventually be able to live as normal a life as possible. This includes symptom or pain reduction, improved level of independence, and a better overall quality of life. Not missing work is an indication of desired independence and overall quality of life. The remaining client statements indicate a continued belief that a health problem will be found and that the reports of pain are accepted by family.

A patient at a general medical clinic tells the nurse, "I have so many ailments that I need to see six different doctors. None of them has discovered what is really wrong with me." Which comment should the nurse offer next? a. "Let's review all the medications you currently take." b. "Tell me about allergic reactions you've had to medication." c. "Selecting one primary care provider would be better for you." d. "I'm not sure I understand how you can afford these expenses."

a. "Let's review all the medications you currently take." Safety is the nurse's first concern. One serious risk associated with doctor-shopping is medication interactions and duplicate medications.

A person shoplifts merchandise from a community cancer thrift shop. When confronted, the person replies, "All this stuff was donated, so I can take it." This comment suggests features of which personality disorder? a. Antisocial b. Histrionic c. Borderline d. Schizotypal

a. Antisocial The persons exhibits callousness, entitlement, lack of remorse, and disregard for the rights of others. These characteristics are common in persons diagnosed with antisocial personality disorder.

A veteran of the war in Afghanistan tells the nurse, "Every day, something happens that makes me feel like I'm still there. My family has grown impatient with me. They say it's time for me to move on from that time in my life, but I can't." What is the nurse's first priority? a. Assess the veteran for suicide risk. b. Refer the veteran for specialized mental health services. c. Assess the veteran for evidence of traumatic brain injury. d. Refer the veteran's family to a posttraumatic stress disorder group.

a. Assess the veteran for suicide risk. The veteran has high risk for posttraumatic stress disorder (PTSD). When PTSD is untreated or undertreated, painful repercussions often occur, particularly marital problems, unemployment, heavy substance abuse, and suicide. The highest priority is an assessment of suicide risk.

The nurse is managing a group of clients diagnosed with somatic symptom disorders. Which client behavior best demonstrates the nurse's ability to manage manipulative behaviors therapeutically? a. Clients direct all requests to a designated nurse. b. Clients are involved in their personal discharge planning. c. All clients attend assertiveness training daily. d. Each client is aware of the role stress plays in his or her behaviors.

a. Clients direct all requests to a designated nurse. While all the options demonstrate behaviors that are appropriate, the implementation of the designated nurse reduces manipulation by the clients. The client is unable to make similar requests to multiple staff members thus increasing the chances of confusion and inconsistent care

Your next patient is accompanied by her husband and it takes a good ten minutes to convince her to have the interview alone. During the interview you discover that the patient makes no decisions for herself without consulting with her husband. She frequently calls him to consult about what she can eat, wear and where she should go. She comments that it "drives him crazy, but I just feel like I need the reassurance." Which disorder does the patient likely have? a. Dependent Personality Disorder b. Narcissistic Personality Disorder c. Avoidant Personality Disorder d. Paranoid Personality Disorder

a. Dependent Personality Disorder

A nurse plans care for a patient diagnosed with borderline personality disorder. Which patient problem is most likely to apply to this patient? a. Ineffective relationships related to frequent splitting b. Social isolation related to fear of embarrassment or rejection c. Ineffective impulse control related to violence as evidenced by cruelty to animals d. Disturbed thought processes related to recurrent suspiciousness of people and situations

a. Ineffective relationships related to frequent splitting People diagnosed with borderline personality disorder frequently use the defense of splitting, which strains personal relationships. Splitting is the inability to integrate both the positive and the negative qualities of an individual into one person.

Your next patient comes into your office wearing a very nice shirt. You compliment him on it and he doesn't seem to care. In the interview you discover that he has very few relationships outside of his family. Which disorder is most likely? a. Schizoid Personality Disorder b. Histrionic Personality Disorder c. Paranoid Personality Disorder d. Avoidant Personality Disorder

a. Schizoid Personality Disorder

A college student has been experiencing significant stress associated with academic demands. Last month, the student began attending yoga sessions three times a week. Which outcome indicates this activity has been successful? a. The student reports improved feelings of well-being. b. The student increases the use of caffeine to enhance concentration. c. The student reports, "Now I am sleeping about 10 hours every day." d. The student says, "I withdrew from two courses to reduce my academic load."

a. The student reports improved feelings of well-being. Yoga and other physical activities can be effective ways to manage stress. These activities deepen breathing, relieve muscle tension, and can elevate levels of the body's own endorphins, which induces a sense of well-being.

The school nurse assesses four adolescents who appear to have a healthy weight. Which comment would lead the nurse to explore further for an eating disorder? a. "I usually try to exercise 30 minutes a day." b. "I know everything in my life will be better once I lose 15 more pounds." c. "I forgot my lunch today, so I will only be eating an apple." d. "I know I shouldn't eat potato chips, but I just love them."

b. "I know everything in my life will be better once I lose 15 more pounds." People with eating disorders may perceive themselves as overweight and place unrealistic value on being thin. Losing 15 pounds is not likely to alter all aspects of someone's life.

A patient diagnosed with dissociative identity disorder is hospitalized on an acute care psychiatric unit after a suicide attempt. During a team meeting, which staff nurse's comment should prompt the nursing supervisor to intervene? a. "I have never taken care of a patient diagnosed with this disorder." b. "I think this patient was misdiagnosed and probably has schizophrenia." c. "I find myself more fascinated and engaged with this patient than others." d. "I recently read an autobiographical book about someone with this problem."

b. "I think this patient was misdiagnosed and probably has schizophrenia."

Four adult patients describe frightening events that resulted in panic levels of anxiety/fear. Which patient's report most clearly indicates a reasonable fear response? a. "I saw a large spider crawling along my kitchen wall." b. "I was at the mall when a gunman began firing an assault weapon." c. "I was at home when a storm with heavy thunder and lightning lasted over an hour." d. "I was trapped in an elevator that stopped between floors when the power went out."

b. "I was at the mall when a gunman began firing an assault weapon." Although all of these situations may produce some level of fear or anxiety, the correct response presents a scenario of imminent, specific danger

A nurse in an outpatient medical clinic talks to a patient with a long history of malingering and doctor-shopping. The patient continues to express complaints of multiple problems. Select the nurse's best comment to the patient. a. "The treatment team believes you would benefit more from seeing a mental health professional." b. "The treatment team discussed your case and wants to begin a special case management program for you." c. "Because you take a number of medications, it would be safer to have them all filled at the same pharmacy." d. "Diagnostic testing has shown no medical problems, and you are using more than your fair share of health care services."

b. "The treatment team discussed your case and wants to begin a special case management program for you." It's important for the nurse to convey compassion and support to the patient but without reinforcing the symptoms. Case management can help to limit health care costs. Seeing the patient at regular intervals can instill security and avoid frantic and frequent demands. The patient who establishes a relationship with the case manager often feels less anxiety because he or she has an advocate and feels that someone is managing and aware of his or her care.

Which nursing assessment question is focused on determining the client's motivation for binge eating? a. "Does binging help you get the attention you need?" b. "Would you say that you are less depressed after binging?" c. "Are you less likely to hear voices while you are binging?" d. "Do you sleep better at least temporarily after binging?

b. "Would you say that you are less depressed after binging?" Overeating is frequently noted as a symptom of a depression. Binge eaters report that binge eating is soothing and helps to regulate their moods. The dysfunctional eating pattern is not associated with a need for attention, auditory hallucinations, or a sleep disorder.

A mental health nurse assesses a patient diagnosed with an antisocial personality disorder. Which comorbid problem is most important for the nurse to include in the assessment? a. Generalized anxiety b. Alcohol or substance use disorder c. Compulsions and phobias d. Dysfunctional sleep patterns

b. Alcohol or substance use disorder Alcohol abuse is a commonly occurring problem in persons diagnosed with antisocial personality disorder.

Your next patient is brought into your office in the custody of police officers. It seems he recently burned down a building and is being forced to undergo psychological evaluation. While interviewing the patient you find he has a history of cruelty to animals as well as lying and stealing. Which personality disorder comes to mind? a. Histrionic Personality Disorder b. Antisocial Personality Disorder c. Dependent Personality Disorder d. Schizotypal Personality Disorder

b. Antisocial Personality Disorder

Which nursing intervention will best address the intense need to control demonstrated by a client receiving treatment of bulimia nervosa? a. Monitoring the client for the presence of suicidal thoughts and behaviors b. Clearly stating expectations and admitting that they differ from those of the client c. Helping the client reframe irrational thinking that leads to dysfunctional eating d. Having the client keep a journal that identifies triggers that cause dysfunctional eating

b. Clearly stating expectations and admitting that they differ from those of the client A straightforward statement that the nurse's perceptions are different will help avoid a power struggle. Arguments and power struggles intensify the patient's need to control. Suicide assessment relates to client safety. While reframing and journaling are appropriate, those interventions are not associated with the need for the client to control his or her life

A client recently diagnosed as obese is experiencing stress related to the need to lose weight. How can the nurse best help the client focus on the eustress nature of this stressor? a. Encourage the client to discuss his or her feelings about being obese. b. Discuss weight loss strategies with the client. c. Re-enforce for the client that obesity is a health problem that is manageable. d. Provide the client with a list of realistic, time-focused weight loss goals.

b. Discuss weight loss strategies with the client. Eustress is beneficial stress; it motivates people to develop the skills they need to solve problems and meet personal goals. Providing support with identifying and selecting weight loss strategies will help the client to be motivated and empowered to reach weight loss goals. The remaining options are not inappropriate but they lack the element that best promotes the client's personal motivation

A mature, professional couple plans a large wedding in a city that is 100 miles from their home. Which response is most likely to be associated with this experience? a. Distress b. Eustress c. Acute stress d. Depersonalization

b. Eustress Eustress is beneficial stress that will help the couple to focus, problem solve, and successfully plan their wedding

A patient in the emergency department was seen for the third time in a month with complaints of tremors and paresthesia in the lower extremities. Neurological functional disorder was diagnosed. While preparing for discharge, the patient says, "Now I'm having chest pain, but it's probably nothing." How should the nurse respond? a. Assess the patient's most current laboratory values. b. Interrupt the discharge and arrange additional medical evaluation of the patient. c. Remind the patient, "The diagnostic tests showed you did not have a medical problem." d. Tell the patient, "Being in the emergency department for a long time can be very distressing."

b. Interrupt the discharge and arrange additional medical evaluation of the patient. A paresthesia is a tingling or pricking sensation. Conversion disorder (functional neurobiological symptom disorder) usually involves weakness or paralysis, abnormal movement, swallowing or speech difficulties, seizures or attacks, and sensory problems. Patients may be distressed or show la belle indifference (a lack of emotional concern). Despite the diagnosis, the patient's complaints must be taken seriously. Further evaluation is needed.

Which behavior is most characteristic of a client diagnosed with antisocial personality disorder? a. Insisting that it is necessary to eat only green foods on Thursdays. b. Justifying taking another client's dessert by stating, "I deserve two desserts." c. Repeatedly accusing the staff of favoring another client. d. Throwing a book when asked to turn down the volume on the television.

b. Justifying taking another client's dessert by stating, "I deserve two desserts." Entitlement is a characteristic demonstrated by clients diagnosed with antisocial personality disorder. Poor impulse control is a hallmark of borderline personality disorder. Schizotypal personality disorder is associated with eccentric behavior while intense jealousy is characteristic of paranoid personality disorder.

The nurse is managing care for a client who is reporting increased stress related to a new work-related position. What intervention suggested by the nurse is associated with an increase of energy and fewer muscle aches? a. Adding Vitamin C to the daily diet b. Limiting or eliminating caffeine from diet c. Being screened for depression d. Monitoring heart and respiratory rates daily

b. Limiting or eliminating caffeine from diet

The next patient who enters your office listed her profession as "The manager of finance" at the company she works at. When asked about her job she stated, "I am the most important person at the office. Without me the company I work for would crash and burn." When you interview the patient's husband he tells you that she is actually just one of hundreds of accountants at her company. Which disorder do you suspect? a. Antisocial Personality Disorder b. Narcissistic Personality Disorder c. Obsessive Compulsive Personality Disorder d. Paranoid Personality Disorder

b. Narcissistic Personality Disorder

Friends invite an adult diagnosed with type 2 diabetes to go on a mountain hike. The adult replies, "I can't go because I don't have any hiking shoes." Unconsciously, this person is concerned about difficulty with blood glucose management during strenuous activity. Which defense mechanism is evident? a. Displacement b. Rationalization c. Passive aggression d. Reaction formation

b. Rationalization Rationalization refers to justifying an action to satisfy the listener.

Which intervention will the nurse include in the plan of care to address a common co-morbid condition demonstrated by many clients diagnosed with body dysmorphic disorder (BDD)? a. Set and enforce reasonable limits regarding boundaries b. Frequent re-orientation to time and place c. Suicide precautions d. Anger management group

c. Suicide precautions

A patient has been identified as having a somatoform disorder. Which of the following should the nurse do when interacting with the patient? a. Ignore feelings to avoid promoting progression of symptoms. b. Redirect conversation away from feelings but show interest toward the patient. c. Encourage the use of benzodiazepines on a consistent basis to reduce anxiety. d. Suggest the patient direct all questions to the nurse and not the medical provider.

b. Redirect conversation away from feelings but show interest toward the patient. Nurses should avoid emphasizing feelings but should continue to show interest in the patient. Ignoring feelings or symptoms completely could result in missing a serious medical issue. Frequent use of benzodiazepines is not recommended, but patients may benefit from other anxiolytic medications. When somatic symptom disorders are suspected, a nurse may be assigned as a main contact point, but the patient should still be encouraged to discuss care his or her providers.

Which patient behaviors noted by the nurse supports the diagnosis of severe level panic? a. Pacing nervously. b. Too preoccupied to respond when unit fire alarm is tested. c. Repeatedly demands that the staff, "make the voices stop saying those bad things." d. Reports being, "too nervous to eat."

b. Too preoccupied to respond when unit fire alarm is tested. Severe level anxiety is associated with the inability to attend to events occurring in the environment such as reacting to a fire alarm. Pacing and a disinterest in things like eating are associated with moderate anxiety. Hallucinations are characteristic of the psychotic behavior triggered by panic level anxiety.

When assessing for the subjective symptoms of posttraumatic stress disorder (PTSD), which question will the nurse ask a client hospitalized for severe anxiety related to a sexual assault by a family member as a teenager? a. "On a regular basis, do you get enough restful sleep?" b. "Am I correct to say that you try to avoid certain family members?" c. "Are you experiencing a flashback of the rape right now?" d. "Can we discuss what triggered your angry outburst a few minutes ago?"

c. "Are you experiencing a flashback of the rape right now?" There are considered to be four cardinal symptoms of PTSD. Intrusive re-experiencing of the traumatic event (flashback) is a subjective symptom of this disorder. The other options assess objective or behavioral symptoms of PTSD.

The nurse assesses a new patient suspected of having a schizotypal personality disorder. Which assessment question is this patient most likely to answer affirmatively? a. "Do some types of situations frighten you?" b. "Do you often have episodes of prolonged crying?" c. "Has anyone in your family ever been diagnosed with a mental illness?" d. "Is it ever very important for you to do everything correctly?"

c. "Has anyone in your family ever been diagnosed with a mental illness?" Genetics seems to play a significant role in the development of schizotypal personality disorder, which is more common in families with a history of schizophrenia.

2. A nurse assesses four adolescents diagnosed with various eating disorders. Which comment would the nurse expect from the adolescent diagnosed with anorexia nervosa? a. "I look good because whenever I overeat, I purge myself." b. "I love sweets. I make myself throw up so I can eat more." c. "I've lost 60 pounds, but I'm still a size 2. I want to be a size 0." d. "I've hidden my eating disorder from everyone, even my parents."

c. "I've lost 60 pounds, but I'm still a size 2. I want to be a size 0." Thought processes that accompany anorexia nervosa include a terror of gaining weight, viewing oneself as fat even when emaciated, and judging one's self-worth by one's weight or size.

Shortly after hospitalization, an adolescent diagnosed with anorexia nervosa says to the nurse, "Being fat is the worst thing in the world. I hope it never happens to me." Which response by the nurse is appropriate? a. "You need to gain weight to become healthier." b. "Your world would not change if you gained a few pounds." c. "Tell me how your world would be different if you were fat." d. "Your attractiveness is not defined by a number on the scale."

c. "Tell me how your world would be different if you were fat." Cognitive distortions with underlying emotions of anxiety, dysphoria, low self-esteem, and feelings of lack of control are often present in persons with eating disorders. In this instance, the adolescent is catastrophizing. The nurse should first help the patient to identify the fears. Cognitive distortions are consistently confronted by all members of the interdisciplinary team in preparation for carefully planned challenges to the patient later in treatment.

Which statement demonstrates a defense mechanism often implemented by clients diagnosed with a borderline personality disorder? a. "I'm so ashamed when I lose my temper." b. "I can't go to group unless you go with me." c. "There is nothing good I can say about my mother." d. "I've attempted suicide on three different occasions."

c. "There is nothing good I can say about my mother." Splitting is a primitive defense mechanism used by individuals demonstrating borderline personality characteristics. Shame, clinging, and suicidal attempts are behaviors not associated with defense mechanisms used by these individuals

A nurse has worked on a mental health unit for an extended period of time. Which statement is best associated with behaviors demonstrated as a result of compassion fatique? a. "I'm really looking forward to the day I can retire and travel." b. "The clients often behave in a manner that makes them unlikable." c. "These clients are like living with my mother and aunt." d. "I'm so tired; having a 4-day stretch off will be so wonderful."

c. "These clients are like living with my mother and aunt." Nurses should be alert to secondary traumatic stress/compassion fatigue. The secondary traumatic stress/compassion fatigue symptoms include having difficulty separating work from personal life. The statement about the nurse's family members suggests a problem with countertransference. Recognizing the difficulty of interacting with certain clients is not a concrete indication of being ineffective when working with them. The remaining options are expressions that are typical and not associated with burnout

After a power outage, a facility must serve a dinner of sandwiches and fruit to patients. Which comment is most likely from a patient diagnosed with a narcissistic personality disorder? a. "These sandwiches are probably contaminated with bacteria." b "I suppose it's the best we can hope for under these circumstances." c. "You should have ordered a to-go meal from a local restaurant for me." d. "I would rather wait to eat until the dietary department can prepare a meal."

c. "You should have ordered a to-go meal from a local restaurant for me." People diagnosed with narcissistic personality disorder consider themselves special and expect special treatment. Their demeanor is arrogant and haughty. They have a sense of entitlement.

A nurse managing the care of a client diagnosed with an eating disorder has begun to experience frustration when the client consistently pushes back against the planned interventions. What action on the part of the nurse is indicated to help strengthen the nurse-client relationship? a. Regularly sharing with peers the feelings and asking for their suggestions on minimizing the frustration b. Demonstrating a very matter-of-fact attitude when addressing issues related to interventions c. Acknowledging to the client that working toward these treatment goals must be very frightening d. Asking that a more experienced nurse be allowed to act as monitor in order to identify any existing countertransference

c. Acknowledging to the client that working toward these treatment goals must be very frightening In the effort to motivate the patient and take advantage of the decision to seek help and be healthier, the nurse must take care not to cross the line toward authoritarianism and assumption of a parental role in the relationship. Frequent acknowledgment of the situation for the client and of the constant struggle that so characterizes the treatment will help during times of extreme resistance. Being supervised by a competent, supportive, more experienced clinician and sharing with peers help minimize feelings of frustration and can contribute to therapeutic growth in the nurse.

Select the best example of altruism. a. After recovering from a gunshot wound, a police officer attends a local support group. b. After recovering from open-heart surgery, an individual plays tennis three times a week. c. An individual who received a liver transplant volunteers at a local organ procurement agency. d. An individual with a long-standing fear of animals volunteers at a community animal shelter.

c. An individual who received a liver transplant volunteers at a local organ procurement agency. Altruism is a health defense mechanism in which emotional conflicts and stressors are addressed by meeting the needs of others. With altruism, the person receives gratification either vicariously or from the response of others

When considering comorbid conditions, which nursing intervention is most appropriate for a client diagnosed with a somatic symptom disorder? a. Preparing for diagnostic testing to evaluate client's report that, "my heart skips beats" b. Administering medication to manage constipation as prescribed c. Assessing client for suicidal ideations d. Inspecting skin for signs of damage resulting from repetitive hand washing

c. Assessing client for suicidal ideations A suicide assessment should be performed with any psychiatric patient. Patients with somatic symptom may be especially prone to self-harm behaviors. While clients may experience constipation, cardiac arrhythmia, and compulsive behaviors, these conditions are not typically associated with dissociative disorders

The next patient of the day you have seen many times before. She tends to threaten you with committing suicide whenever she feels slighted and has many cut marks on her arms. Some days she states, "You are the best doctor I have ever had!" while on other days she says, "I hate you! How did you even become a doctor?" Which disorder are you most likely treating her for? a. Paranoid Personality Disorder b. Antisocial Personality Disorder c. Borderline Personality Disorder d. Schizotypal Personality Disorder

c. Borderline Personality Disorder

What is the foundational principle to consider when assessing clients from varying ethnic cultures for behaviors associated with anxiety disorders? a. There are basic anxiety-driven behaviors demonstrated by all cultures. b. Asian Americans are least reluctant to seek psychiatric help. c. Effective diagnosis of anxiety is dependent on an awareness of cultural norms. d. Anxiety triggers somatic symptoms more prevalently than cognitive ones.

c. Effective diagnosis of anxiety is dependent on an awareness of cultural norms.

Which disorder would the nurse suspect when a person takes their child from doctor to doctor and from hospital to hospital with a variety of intentionally induced symptoms? a. Illness anxiety disorder b. Functional neurological disorder c. Factitious disorder imposed by another d. Rumination disorder

c. Factitious disorder imposed by another People with factitious disorder imposed by another may do things to cause symptoms or illness in another person. They will often go from provider to provider or hospital to hospital. The motivation is for the attention, caring, and sympathy they receive as the caregiver of the victim.

Your next patient enters your office with her mother. She is wearing a short skirt and a plunging blouse. As soon as she sees you she smiles and asks, "How do I look?" When you interview her mother, the patient becomes uncomfortable and quickly interrupts and shifts the conversation back towards herself. Throughout the course of the visit she laughed, cried and became excessively angry. Which disorder do you diagnose? a. Avoidant Personality Disorder b. Paranoid Personality Disorder c. Histrionic Personality Disorder d. Dependent Personality Disorder

c. Histrionic Personality Disorder

While weighing patients on an eating disorders unit, the nurse overhears a psychiatric technician say, "I wish I had an eating disorder; maybe I'd lose a little weight." What is the nurse's best action? a. Report the clinical observation to the nursing supervisor. b. Ask the psychiatric technician, "What did you mean by that comment?" c. Privately discuss the importance of sensitivity with the psychiatric technician. d. Immediately interrupt the interaction between the patient and the psychiatric technician.

c. Privately discuss the importance of sensitivity with the psychiatric technician. The comment by the psychiatric technician trivializes the patients' problems. Low self-esteem and self-doubts about personal worth are characteristic features of persons who have eating disorders. The comment contributes to these aspects of self-perception.

The nurse concludes that the treatment plan for a client diagnosed with a somatic disorder best demonstrates success when which observation is made? a. The client agrees to adhere to interventions identified in the treatment plan. b. Client engages in productive discussions related to managing aggression. c. Reports of physical pain have lessened substantially. d. Client regularly attends aversion training group.

c. Reports of physical pain have lessened substantially. Treatment is considered successful when outcomes are met. When somatization is present, the patient's ability to perform self-care activities may be impaired. In general, nursing interventions involve the use of a straightforward approach to support the highest level of functioning. While agreement to adhere to the treatment plan is a positive indicator, it doesn't necessarily demonstrate achievement of a foundational goal. Neither of the remaining options are associated with a diagnosis of somatic disorder; but rather anger management disorder or phobias

Which nursing assessment question is focused on evaluating for the most prevalent comorbid mental ill issue among the clients diagnosed with anxiety disorder?" a. "Do you ever engage in binge eating?" b. "Are you hearing voices that no one else can hear?" c. "Can you tell me the names and ages of your grandchildren?" d. "Are you currently experiencing any suicidal ideations?"

d. "Are you currently experiencing any suicidal ideations?"

Which response is characteristic of the implementation of an immature defense mechanism? a. Giving an expense gift to someone who you took advantage of. b. Drinking alcohol to get the courage to ask for a salary increase. c. "I'm not a bully; it's just that people are envious of how rich I am." d. "I only steal from stores that overcharge for the products in the first place."

d. "I only steal from stores that overcharge for the products in the first place." Projection, example of an immature defense mechanism, is characterized by attributing the blame for unacceptable behavior someone or something else. Such behavior generally abandoned by adulthood is maladaptive when demonstrated by adults. The remaining options are examples of intermediate defenses that include rationalization, undoing, and compensation

Recognizing that somatic symptom disorders focus on physical symptoms, which client statement best demonstrates the unique characteristic of this type of disorder? a. "I wonder if my fear of cancer is real or imagined." b. "For a while medication helped but now my stomach problems are back again." c. "The pain I feel is nearly constant and very specific." d. "I've been to so many doctors but none can find out what's wrong with me."

d. "I've been to so many doctors but none can find out what's wrong with me." The emphasis in the DSM-5 is not only on the presence of physical symptoms but also on the way an individual presents and interprets the symptoms in a persistent and excessive manner. Often, people with somatic symptom disorders are associated with increased health care use, and dissatisfaction with and changing providers. The client never considers that the physical issues could be imagined. The symptoms tend to be vague and constant rather than specific and intermittent.

A nursing student arrives late for a clinical experience and is not wearing the correct attire. When the instructor privately criticizes the behavior, the student responds, "I'm always the one who gets caught. You're going to cause me to fail." Select the instructor's best response. a. "Other students get caught as well." b. "I am not trying to cause you to fail. I am here to help you." c. "I am sorry you feel that way. I try to treat all my students equally." d. "The requirements for this experience were discussed during our orientation."

d. "The requirements for this experience were discussed during our orientation." The student is demonstrating projection, as evidenced by not taking responsibility for his or her own behavior and blaming the instructor for a perception of failing. In the correct answer, the instructor avoids a defensive response and reinforces that the responsibility belongs to the student.

Your busy day gets busier as your next patient, a 30 year old male, comes into your office and offers you "magic crystals" that will heal any ailment. During your interview he interrupts you and says, "Wait, do you feel that? An invisible force just came into the room." He has never had any hallucinations and gives a clear history. Which personality disorder is most likely? a. Narcissistic Personality Disorder b. Borderline Personality Disorder c. Histrionic Personality Disorder d. Schizotypal Personality Disorder

d. Schizotypal Personality Disorder

Your first patient of the day comes into your office with his wife and she recounts that he is constantly video taping the garbage collector because he suspects he is an undercover CIA agent. He also has been cold and hostile with many of his relationships, often commenting on how he "can't trust anyone anymore." After further history taking you diagnose the patient with paranoid personality disorder. What would be the best way to respond to the patient's suspicions? a. Tell the patient his suspicions are completely ridiculous b. Immediately prescribe electroconvulsive therapy c. "Play along" with the patients suspicions d. Acknowledge the patient's concerns but neither reinforce nor dispute them

d. Acknowledge the patient's concerns but neither reinforce nor dispute them

Your next patient is a middle age man who confesses to you that he has never married or even dated because of an intense fear of rejection. He works as a mail sorter in the basement of a large law firm where he feels he can do his job without fear of being criticized or disapproved of. He states that his thoughts are usually preoccupied with fears of someone rejecting him. Which disorder is this man suffering from? a. Schizotypal Personality Disorder b. Paranoid Personality Disorder c. Schizoid Personality Disorder d. Avoidant Personality Disorder

d. Avoidant Personality Disorder

Which assessment data confirms that the client diagnosed with anorexia nervosa has achieved a fundamental treatment outcome? a. Acknowledges that symptoms of depression exist. b. Client has eaten 60% of three meals per day for 3 consecutive weeks. c. Demonstrates an understanding of what constitutes healthy eating habits. d. Client has maintained weight at 87% of ideal body weight for 2 months.

d. Client has maintained weight at 87% of ideal body weight for 2 months. Some common outcome criteria for patients with anorexia nervosa include normalize eating patterns, as evidenced by eating 75% of three meals per day plus two snacks and achieving 85% to 90% of ideal body weight; demonstrating two new, healthy eating habits and improved self-acceptance; and participating in treatment of associated psychiatric symptoms (defects in mood, self-esteem), not just acknowledging the presence of symptoms

How can the nurse manager on a mental health unit devoted to the care of clients diagnosed with personality disorders address the needs of the nursing staff? a. Design schedules to provide staff with 3 consecutive days off each period. b. Schedule monthly in-services on the management of this client population. c. Require that nursing staff rotate to another nursing unit for 6 months every 24 months. d. Hold a daily meeting to focus on communication between nursing and supervisory staff.

d. Hold a daily meeting to focus on communication between nursing and supervisory staff. Frequent communication among staff and continuous availability of supervision and support are vital in times when the behaviors of these patients start to affect the confidence, feelings, behaviors, and effectiveness of staff members. The remaining options fail to provide the opportunity for communication and support.

Which stress management behavior is most reflective of those associated with personality disorders? a. Demonstrating ritualistic behaviors b. Binge drinking every weekend c. Having difficulty making a decision concerning which movie to view d. Holding spouse responsible for the client's poor work performance

d. Holding spouse responsible for the client's poor work performance In people with personality disorders (PDs), personality traits tend to be inflexible and unpredictable, and coping strategies tend to be more primitive and immature. They often blame others for their difficulties or even deny having a problem. None of the other options are specifically associated with characteristics/behaviors associated with personality disorders

After a long day your final patient walks into your office. While talking with him you find that he is an extremely productive individual and takes pride in being orderly and in control. He finds it difficult to yield control over to you and your team but has improved since you saw him last. He is obsessed with perfection and has little empathy for those who can't "shape up." Which personality disorder have you been treating him for? a. Borderline Personality Disorder b. Dependent Personality Disorder c. Histrionic Personality Disorder d. Obsessive-Compulsive Personality Disorder

d. Obsessive-Compulsive Personality Disorder

A disaster relief nurse has just arrived to help efforts after a tornado that destroys a town. Which approach would be most appropriate when talking with survivors? a. Provide active listening. b. Help the survivors generate possible solutions. c. Help the survivors develop self-awareness to understand their stress response. d. Offer firm, short, simple statements and instructions.

d. Offer firm, short, simple statements and instructions. People who have just experienced a disaster such as a tornado will most likely be experiencing severe or panic levels of anxiety. People at this level would benefit most from short, clear instructions. The other options are more appropriate for someone with mild to moderate anxiety.

What classic characteristic is noted in clients diagnosed with bulimia nervosa? a. Involved in sports b. Obesity c. Male d. Onset in late adolescence

d. Onset in late adolescence The most common age of onset for eating disorders is during adolescence, although eating disorders can occur in patients of any age, gender, race, or ethnicity. The risk is highest for young men and women between 13 and 17 years of age. The onset of binge-eating disorders is most common in the mid-20s. The DSM-5 states that approximately one-third of binge eaters are obese. Being athletic is not considered a characteristic. Eating disorders of all kinds are more prevalent in females than males.

An adult required a heart transplant 5 years ago. Multiple medical complications followed, resulting in persistent irritability, depression, and insomnia. The adult's spouse says, "I've walked on eggshells for 5 years, never knowing when something else will go wrong." What is the nurse's priority intervention regarding the spouse? a. Explore the spouse's feelings, showing care and compassion. b. Encourage the spouse to attend a community support group. c. Teach stress reduction and relaxation techniques to the spouse. d. Refer the spouse to the primary care provider for health assessment.

d. Refer the spouse to the primary care provider for health assessment. The scenario suggests that the spouse has experienced the effects of long-term stress. When stress is prolonged, the body stays alert. Chemicals produced by the stress response can have damaging effects on the body, causing physical diseases. Although all of the actions may be indicated, obtaining a health assessment from the primary care provider has the first priority

A nurse is planning interventions for a veteran who has recently been discharged from the military and is reporting difficulty sleeping. When considering the client's past medical history, which data is most relevant to the development of posttraumatic stress disorder (PTSD)? a. Family history of depression b. Regularly smoked marijuana as a teenager c. Quit smoking tobacco 2 months ago d. Sustained a concussion a month before discharge

d. Sustained a concussion a month before discharge A concussion can result in traumatic brain injury (TBI). Recent TBI is the strongest predictor of PTSD. A family history of depression is a risk factor for possible depression that can be diagnosed in some cases of PTSD, but it is not a strong predictor of the disorder. The remaining options are not relevant to the diagnosis of PTSD.